SESSION TYPE: Cancer Student/Resident Case Report PostersPRESENTED ON: Tuesday, October 23, 2012 at 01:30 PM - 02:30 PM

INTRODUCTION:

While fludeoxyglucose-avid lung nodules often represent cancer, a broader differential diagnosis must be considered.

CASE PRESENTATION:

A 74 year old woman presented with multiple, progressive symptoms of lower motor neuron leg weakness, left ptosis, papular rash on the extremities, weight loss and a fludeoxyglucose-avid lung nodule. Past medical history was significant for malignant melanoma 11 years prior, colon cancer 8 years prior, and hypertension. She was a lifetime non-smoker. Her only medication was metoprolol. On physical examination, vital signs, cardiac and pulmonary systems were unremarkable. There was no lymphadenopathy or hepatosplenomegaly. Neurologic examination revealed a left ptosis and 4+/5 weakness and decreased sensation to light touch in the bilateral lower extremities with a distal, symmetric distribution. Multiple non-tender erythematous papules over the arms and legs were noted. Complete blood count, serum creatinine and urinalysis were unremarkable. Carcinoembryonic antigen level, anti-nuclear antibody, anti-neutrophil cytoplasmic antibodies (ANCA), erythrocyte sedimentation rate and C-reactive protein were normal. Computed tomography of the chest showed a spiculated 1.6 cm right lower lobe pulmonary nodule, and innumerable diffuse bilateral pulmonary nodules measuring up to 6 mm. Only the dominant nodule was found to be hypermetabolic on a subsequent positron emission tomography scan (standardized uptake value 8.6). A transthoracic needle aspiration of the lung nodule demonstrated a lymphohistiocytic infiltrate with poorly formed granulomas and necrosis. Grocott's methenamine silver and acid-fast bacillus stains were negative. No malignant cells were seen. Flow cytometry demonstrated no clonal proliferation, and Epstein-Barr virus (EBV) stains were negative. Multiple skin biopsies demonstrated an atypical lymphohistiocytic infiltrate with granulomatous features. A repeat biopsy of the same lung nodule revealed identical pathology. A diagnosis of probable ANCA-negative systemic vasculitis was made, with pulmonary, neurologic and cutaneous manifestations. The patient was initiated on corticosteroid therapy with significant improvement in her symptoms.

DISCUSSION:

Lymphoma and related lymphoid granulomatosis are less likely given normal flow cytometry and the lack of EBV, respectively. Conversely, the lack of positive serum markers does not rule out vasculitis. Routine immunsuppression by corticosteroids may be inadequate in the treatment of lymphohistiocytic lung tumor. Aggressive efforts may be required to break the cycle of lymphocyte-histiocyte activation, potentially by cell-specific monoclonal antibodies.

CONCLUSIONS:

Inflammatory lung tumors, although rare, may mimic malignant tumors both clinically and radiologically. Clinical suspicion and tissue biopsies are required for the diagnosis.1) Brown KK. Pulmonary Vasculitis. Proc Am Thoracic Soc. 3(1): 48-57. 2006DISCLOSURE: The following authors have nothing to disclose: Ryan Van Wert, Daya UpadhyayNo Product/Research Disclosure InformationStanford University, Stanford, CA.

We report a series of dermatitis cases caused by the staphilinid beetles, Paederusfuscipes Curtis, among university students staying in the residential college in Puncak Alam, Selangor, Malaysia from 1 January to 31 December 2010. A total of 360 cases (6.0%) were recorded in the Student Health Center throughout the year; the majority of patients stayed at a hostel near an oil palm plantation. Skin symptoms included erythema, edema, vesicular papules, painful blisters, burning sensation, pruritus, hyper pigmentation and peeling of skin. The commonly involved sites were the face, neck, shoulders and arms. Most students noticed the symptoms upon awakening in the morning. The patients were treated with fusidic acid cream and the symptoms resolved within 5 days. These beetles are nocturnally active and enter the room whenever a light source is available. The unintentional crushing of these beetles during sleep causes the release of its hemolymph (paederin) which is the cause of the dermatitis.

Near-infrared (NIR) light constitutes an integrated part of solar radiation. The principal ability to sense NIR under laboratory conditions has previously been demonstrated in fish. The availability of NIR in aquatic habitats, and thus its potential use as a cue for distinct behaviors such as orientation and detection of prey, however, depends on physical and environmental parameters. In clear water, blue and green light represents the dominating part of the illumination. In turbid waters, in contrast, the relative content of red and NIR radiation is enhanced, due to increased scattering and absorption of short and middle range wavelengths by suspended particles and dissolved colored materials. We have studied NIR detection thresholds using a phototactic swimming assay in five fish species, which are exposed to different NIR conditions in their natural habitats. Nile and Mozambique tilapia, which inhabit waters with increased turbidity, displayed the highest spectral sensitivity, with thresholds at wavelengths above 930 nm. Zebrafish, guppy and green swordtail, which prefer clearer waters, revealed significantly lower thresholds of spectral sensitivity with 825-845 nm for green swordtail and 845-910 nm for zebrafish and guppy. The present study revealed a clear correlation between NIR sensation thresholds and availability of NIR in the natural habitats, suggesting that NIR vision, as an integral part of the whole spectrum of visual abilities, can serve as an evolutionarily adaptable trait in fish.

Regulation of an intracellular acidic environment plays a pivotal role in biological processes and functions. However, spatiotemporal analysis of the acidification in complex tissues of living subjects persists as an important challenge. We developed a photo-inactivatable bioluminescent indicator, based on a combination of luciferase-fragment complementation and a photoreaction of a light, oxygen, and voltage domain from Avena sativa Phototropin1 (LOV2), to visualize temporally dynamic acidification in living tissue samples. Bioluminescence of the indicator diminished upon light irradiation and it recovered gradually in the dark state thereafter. The recovery rate was remarkably sensitive to pH changes but unsusceptible to fluctuation of luciferin or ATP concentrations. Bioluminescence imaging, taken as an index of the recovery rates, enabled long-time recording of acidification in apoptotic and autophagous processes in a cell population and an ischemic condition in living mice. This technology using the indicator is widely applicable to sense organelle-specific acidic changes in target biological tissues.

Point-light animations of biological motion are perceived quickly and spontaneously, giving rise to an irresistible sensation of animacy. However, the mechanisms that support judgments of animacy based on biological motion remain unclear. The current study demonstrates that animacy ratings increase when a spatially scrambled animation of human walking maintains consistency with two fundamental constraints: the direction of gravity and congruency between the directions of intrinsic and extrinsic motion. Furthermore, using a reverse-correlation method, we show that observers employ structural templates, or form-based "priors," reflecting the prototypical mammalian body plan when attributing animacy to scrambled human forms. These findings reveal that perception of animacy in scrambled biological motion involves not only analysis of local intrinsic motion, but also its congruency with global extrinsic motion and global spatial structure. Thus, they suggest a strong influence of prior knowledge about characteristic features of creatures in the natural environment.

Near death experiences (NDE) are receiving increasing attention by the scientific community because not only do they provide a glimpse of the complexity of the mind-brain interactions in 'near-death' circumstances but also because they have significant and long lasting effects on various psychological aspects of the survivors. The over-all incidence-reports of NDEs in literature have varied widely from a modest Figure of 10% to around 35%, even up to an incredible Figure of 72% in persons who have faced close brush with death. Somewhat similar to this range of difference in incidences are the differences prevalent in the opinions that theorists and researchers harbor around the world for explaining this phenomena. None the less, objective evidences have supported physiological theories the most. A wide range of physiological processes have been targeted for explaining NDEs. These include cerebral anoxia, chemical alterations like hypercapnia, presence of endorphins, ketamine, and serotonin, or abnormal activity of the temporal lobe or the limbic system. In spite of the fact that the physiological theories of NDEs have revolved around the derangements in brain, no study till date has taken up the task of evaluating the experiences of near-death in patients where specific injury has been to brain. Most of them have evaluated NDEs in cardiac-arrest patients. Post-traumatic coma is one such state regarding which the literature seriously lacks any information related to NDEs. Patients recollecting any memory of their post-traumatic coma are valuable assets for NDE researchers and needs special attention.Our present study was aimed at collecting this valuable information from survivors of severe head injury after a prolonged coma. The study was conducted in the head injury department of Guangdong 999 Brain hospital, Guangzhou, China. Patients included in the study were the ones Recovered from the posttraumatic coma following a severe head injury. A total of 86 patients were chosen. Near death experience scale (NDES) score of 7 or more was used as the criteria of screening NDE experiences. After identifying such individuals, the Prakash-modification of the Interpretative Phenomenological Analysis (IPA) was used to interview and record the data for qualitative analysis.We found that contrary to earlier incidence reports, NDEs in post head injury patients were markedly low. Only 3 out of 86 of the patients recruited had a clear and confident experience of NDE. We conducted a qualitative study to explore further into these experiences. IPA of these 3 patients revealed four master themes: 1. Unique light visions 2. Intense feelings of astonishment, pleasure, and fear 3. The sense of helplessness 4. Supernatural but rationality of experience.NDE is uncommon in head-injury cases as compared to other near-death conditions. But the persons experiencing it have immense impacts on their belief systems and emotions. This experience should be further explored by studies of larger samples.

There is size information in speech sounds because the vocal tract and the vocal cords both grow as a child develops into an adult. Specifically, average pitch and mean formant frequency decrease as speaker size increases. Nevertheless, human speech recognition is effectively size invariant across the full range of sizes in the normal population of speakers and well beyond. It is also the case that listeners can discriminate speaker size with great accuracy; indeed, with greater accurately than they can discriminate the loudness of sound or the brightness of light. The first part of this talk describes how the peripheral auditory system normalizes speech sounds automatically to produce a size invariant representation for speech recognition. The second part presents a model of how the central auditory system transforms information in the cochlea into our perception of who is speaking and what they are saying. The model suggests that the system combines information about vocal resonator size with a small amount of contextual information to determine what the person is saying (at the phonological level), and then it adds voice pitch information to determine who is speaking (in the sense of the sex and size of the speaker).

"Death and its approach represent a field of study for nurses": thus ended his article Montserrat Salvador Borrell in Revista ROL de Enfermería in November 2010. Address it also from the point of view of the soul brings perspective and gives horizon in the sense of one greater understanding. Death, contemplated and lived exclusively from the material side, flees from as a not only traumatic event for which the experience but also unsurpassed for loved ones. Paradoxically, it's a more natural and frequent phenomenon. Why humans so hard that naturalness? Because we have not cultivated, sometimes not even recognized, other spiritual nature which forms us and who has the key to give sense to the decisive events. For many spiritual traditions, death is birth to another world that, from here, we call beyond. In accompaniment of soul seminars, based on the teachings transmitted by Elisabeth Kübler Ros and Marie Lise Labonte, patterns are learned to accompany the personality and soul--which does not always go according to the time of split--and to help the soul to rediscover his way toward the light, toward the origin. The soul knows it well, but the emotional ties forged during his earthly journey can retain it and hinder the process, which becomes slow and painful. The accompaniment of the soul is a "service" human, social and spiritual. Guides in a forgotten and often feared territory is a relief. You have guides to prepare the great journey allows, especially, make peace with himself with others I with the world. The Egyptians used the symbol of the solar boat, which waits for the deceased to cross the great waters. Nurses are, unknowingly, barqueras of small and large transits of existence.

The molecular function of mTERFs (mitochondrial transcription termination factors) has so far only been described for metazoan members of the protein family and in animals they control mitochondrial replication, transcription and translation. Cells of photosynthetic eukaryotes harbour chloroplasts and mitochondria, which are in an intense cross-talk that is vital for photosynthesis. Chlamydomonas reinhardtii is a unicellular green alga widely used as a model organism for photosynthesis research and green biotechnology. Among the six nuclear C. reinhardtii mTERF genes is mTERF-like gene of Chlamydomonas (MOC1), whose inactivation alters mitorespiration and interestingly also light-acclimation processes in the chloroplast that favour the enhanced production of biohydrogen. We show here from in vitro studies that MOC1 binds specifically to a sequence within the mitochondrial rRNA-coding module S3, and that a knockout of MOC1 in the mutant stm6 increases read-through transcription at this site, indicating that MOC1 acts as a transcription terminator in vivo. Whereas the level of certain antisense RNA species is higher in stm6, the amount of unprocessed mitochondrial sense transcripts is strongly reduced, demonstrating that a loss of MOC1 causes perturbed mitochondrial DNA (mtDNA) expression. Overall, we provide evidence for the existence of mitochondrial antisense RNAs in C. reinhardtii and show that mTERF-mediated transcription termination is an evolutionary-conserved mechanism occurring in phototrophic protists and metazoans.

Both competitive and facilitative interactions between species play a fundamental role in shaping natural communities. A recent study showed that competitive interactions between plants can be mediated by some alternative signalling channel, extending beyond those channels studied so far (i.e. chemicals, contact and light). Here, we tested whether such alternative pathway also enables facilitative interactions between neighbouring plant species. Specifically, we examined whether the presence of a 'good' neighbouring plant like basil positively influenced the germination of chilli seeds when all known signals were blocked. For this purpose, we used a custom-designed experimental set-up that prevented above- and below-ground contact and blocked chemical and light-mediated signals normally exchange by plants.We found that seed germination was positively enhanced by the presence of a 'good' neighbour, even when the known signalling modalities were blocked, indicating that light, touch or chemical signals may not be indispensible for different plant species to sense each other's presence.We propose that this alternative signalling modality operates as a general indicator of the presence of heterospecifics, enabling seeds to detect and identify a neighbour prior to engaging in a more finely-tuned, but potentially more costly, response.