scholarly journals Gemcitabine-Induced Extensive Skin Necrosis

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Sara D'epiro ◽  
Monica Salvi ◽  
Carlo Mattozzi ◽  
Simona Giancristoforo ◽  
Marco Campoli ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Skin Necrosis ◽  
Lower Limbs ◽  
Back Side ◽  
Careful Attention ◽  
Vascular Toxicity ◽  
Convincing Argument ◽  
Chemotherapy Administration ◽  
Ulcerative Lesions ◽  
Arterial Vascular Disease

An 82-year-old woman presented with oedema and extensive necrotic ulcerative lesions on the back side of her lower limbs, emerging after the second cycle of chemotherapy consisting of Gemcitabine for metastatic pancreatic cancer. The absence of any convincing argument in favor of cardiovascular or autoimmune disease led us to attribute the onset of skin necrosis to chemotherapy administration. Although skin ischemia has also been described as a paraneoplastic syndrome, in this case we could observe a temporal and causal relationship to Gemcitabine infusion. Recently, this drug has been associated with important vascular side effects; its vascular toxicity is in fact higher than previously estimated. To our knowledge, careful attention should be reserved to neoplastic patients candidated to Gemcitabine administration, especially if previously affected by arterial vascular disease, venous thromboembolism, or collagenoses.

scholarly journals Henoch-Schonlein purpura masquerading as vesiculobullous lesions in a child

2020 ◽  
Vol 8 (1) ◽  
pp. 170
Author(s):  
Rajeshwari N. ◽  
Prahada J. ◽  
Kala K.
Keyword(s):  
Leukocytoclastic Vasculitis ◽  
Lower Limbs ◽  
Small Vessel Vasculitis ◽  
Direct Immunofluorescence ◽  
Henoch Schonlein Purpura ◽  
Diagnostic Challenge ◽  
Serum Iga ◽  
Ulcerative Lesions ◽  
Schonlein Purpura ◽  
Henoch Schönlein Purpura

Henoch-Schönlein purpura (HSP) is a systemic small vessel vasculitis occurring commonly in children presenting with palpable non-thrombocytopenic purpura, arthralgia and abdominal pain. Haemorrhagic bullous and ulcerative lesions are rare in HSP in children and can be a diagnostic challenge. We present a case of 6-year-old boy child who presented with bullous purpuric lesions in lower limbs, arthralgia and increased serum IgA. Histopathology of skin lesion revealed leukocytoclastic vasculitis. However, the direct immunofluorescence was negative for IgA deposits. 

scholarly journals Bilateral extensive skin necrosis of the lower limbs following prolonged epidural blockade

1988 ◽  
Vol 35 (6) ◽  
pp. 628-630 ◽  
Author(s):  
Vito A. Peduto ◽  
Giancarlo Boero ◽  
Antonio Marchi ◽  
Riccardo Tani
Keyword(s):  
Skin Necrosis ◽  
Lower Limbs ◽  
Epidural Blockade

scholarly journals Oxaliplatin Induced Digital Ischemia and Necrosis

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Kubilay Karabacak ◽  
Murat Kadan ◽  
Erkan Kaya ◽  
Baris Durgun ◽  
Gokhan Arslan ◽  
...  
Keyword(s):  
Rare Complication ◽  
Symptomatic Relief ◽  
Endothelial Damage ◽  
Vascular Toxicity ◽  
Right Hand ◽  
Digital Ischemia ◽  
Immunologic Effect ◽  
Chemotherapy Protocol ◽  
Ulcerative Lesions ◽  
New Generation

Introduction. Digital ischemia is a rare complication of several chemotherapeutic medications. We aimed to present a patient with digital ischemia, secondary to a new generation chemotherapeutic drug, oxaliplatin.Case Report. 62-year-old woman presented to our department with severe pain, paresthesia, and distal acrocyanosis on her right hand fingertips. Her complaints started five days after the third cycle of a chemotherapy protocol consisting of 5-fluorourasil (5-FU), folinic acid, and oxaliplatin due to advanced colon carcinoma. On physical examination, hemorrhagic and partly ulcerative lesions were detected at her right hand fingertips. Radial and ulnar pulses were absent at affected side. Digital subtraction angiography revealed severe vascular resistance in the affected extremity. Iloprost trometamol treatment was started with the dosage of 1 ng/kg/min. In addition, low-molecule-weight heparin was used for preventing possible microemboli. Symptomatic relief was provided after five days, and patient was discharged on 7th day of treatment.Discussion. The pathogenesis of oxaliplatin induced vascular toxicity remains unclear. Endothelial damage, increased adherence of platelets, deposition of immune complexes as an immunologic effect of oxaliplatin, and hypercoagulable state may be the reason for arterial thrombosis, digital microemboli, possible digital ischemia, and their several consequences.

scholarly journals A 29-Year-Old Male with Borderline Lepromatous Leprosy

2013 ◽  
Vol 3 (2) ◽  
pp. 109-112
Author(s):  
Lubna Khondker ◽  
Md. Shirajul Islam Khan ◽  
Md. Anwar Husain
Keyword(s):  
Peripheral Nerves ◽  
Histopathological Examination ◽  
Dorsal Surface ◽  
Lepromatous Leprosy ◽  
The Body ◽  
Lower Limbs ◽  
Upper Respiratory Tract ◽  
Medical College ◽  
Great Auricular Nerve ◽  
Ulcerative Lesions

Leprosy (Hansen’s disease) is a chronic granulomatous infectious disease that primarily affects the peripheral nerves, skin, upper respiratory tract mucosa, eyes and certain other tissues. It is diagnosable and curable if recognized early and treated adequately. A twenty nine-year-old male from Jessore, Bangladesh reported in Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh with the complaints of multiple erythematous, large, raised and circumscribed lesions with loss of sensations on different parts of the body, especially distal portions of all four limbs for last eight months. Subsequently he developed ulcers on the anesthetic fingers due to smoking and few ulcerative lesions on both feet. Skin examination revealed multiple erythematous, large nodular lesions on both sides of the cheek and forehead, multiple erythematous, indurated, large plaques with raised margin and central clearing on the trunk, waist and all four limbs, few satellite lesions around the large plaques on the trunk, few hypopigmented patches and plaques on buttock and lower limbs, multiple painless ulcers on dorsal surface of fingers of both hands, both lateral malleoluses and right sole. On examination of peripheral nerves, left great auricular nerve, both ulnar nerves and both common peroneal nerves were moderately enlarged and tender. Slit skin smear for AFB (modified Z-N stain) was done and revealed that there were large number of acid and alcohol-fast bacilli arranged in straight and curved parallel bundles with globular masses (cigar-bundle appearance), morphologically resembling Mycobacterium leprae. Skin biopsy for histopathological examination revealed extensive infiltration of macrophages in the dermis, separated from epidermis by narrow grenz zone, with destruction of skin adnexa. Few foci of poorly defined granuloma in dermis were also noted. The patient was managed with rifampicin, clofazimine, dapsone, prednisolone and omeprazole. Journal of Enam Medical College; Vol 3 No 2 July 2013; Page 109-112 DOI: http://dx.doi.org/10.3329/jemc.v3i2.16134

scholarly journals Autoimmune Hepatitis and Systemic Sclerosis: a Rare Association

2019 ◽  
Author(s):  
Elisabete Pereira Coelho ◽  
Ana Rita Matos ◽  
Sofia Caridade
Keyword(s):  
Alcoholic Hepatitis ◽  
Alcohol Intake ◽  
Lower Limbs ◽  
Histologic Examination ◽  
Rare Association ◽  
History Of ◽  
Excessive Alcohol ◽  
Laboratory Investigations ◽  
Ulcerative Lesions ◽  
Smooth Muscle Antibodies

A woman in her early 40s, with a history of excessive alcohol intake, presented with purpuric, ulcerative lesions on the lower limbs. On examination, hirsutism and generalized stiffening and thickening of the skin were noted. Laboratory investigations revealed hyperbilirubinemia, hypergammaglobulinemia and positive anti-smooth muscle antibodies. Histologic examination of the skin was compatible with scleroderma. Histologic examination of the liver was suggestive of autoimmune and alcoholic hepatitis.

scholarly journals The symptoms of depression and anxiety in patients with diabetic foot treated with hyperbaric oxygen - preliminary results

2016 ◽  
Vol 54 (1) ◽  
pp. 23-30
Author(s):  
Agnieszka Koźmin-Burzyńska ◽  
Agnieszka Bratek ◽  
Grzegorz Knefel ◽  
Krzysztof Krysta ◽  
Marek Kawecki ◽  
...  
Keyword(s):  
Hyperbaric Oxygen ◽  
Diabetic Foot ◽  
Objective Evaluation ◽  
Lower Limbs ◽  
Self Report ◽  
Diabetic Foot Syndrome ◽  
Depression And Anxiety ◽  
Symptoms Of Depression ◽  
Ulcerative Lesions

Abstract The aim of the study was to assess the level of anxiety and depressiveness in patients who had qualified for hyperbaric oxygen therapy (HBOT) for the treatment of ulcerative lesions in the lower limbs, occurring as a result of diabetic foot syndrome (DFS),. A total of 50 patients with type 2 diabetes and diabetic foot syndrome were enrolled to the study. All patients have received 30 sessions of HBOT. During the therapy blood glucose was measured and photographic documentation was carried out. All patients underwent the following procedures: medical history and socioeconomic interview, psychiatric examination, self-report and objective psychometric tests to measure anxiety and depressiveness. Based on the obtained results, we reported that patients with a greater degree of tissue damage had higher levels of depressive symptoms in the self-report tests as well as in the objective evaluation of the investigator. In terms of location of ulcerative lesions - the level of depressiveness was greater when the affected area included toes, and the level of anxiety was increased when it concerned the heel. Regarding other parameters, statistically significant correlations were not observed.

Plasticity of the neural coding metaphor: An unnoticed rhetoric in scientific discourse

2019 ◽  
Vol 42 ◽  
Author(s):  
Giulia Frezza ◽  
Pierluigi Zoccolotti
Keyword(s):  
Discourse Analysis ◽  
Neural Coding ◽  
Scientific Discourse ◽  
Convincing Argument ◽  
Unified View ◽  
Brain Behavior

Abstract The convincing argument that Brette makes for the neural coding metaphor as imposing one view of brain behavior can be further explained through discourse analysis. Instead of a unified view, we argue, the coding metaphor's plasticity, versatility, and robustness throughout time explain its success and conventionalization to the point that its rhetoric became overlooked.

HREM observation of dislocations near room temperature fractures in silicon

1988 ◽  
Vol 46 ◽  
pp. 892-893
Author(s):  
M. H. Rhee ◽  
W. A. Coghlan
Keyword(s):  
Cross Section ◽  
Room Temperature ◽  
Single Crystal Silicon ◽  
Dislocation Nucleation ◽  
Back Side ◽  
Ion Milling ◽  
Crystal Silicon ◽  
Flat Surfaces ◽  
Induced Fractures ◽  
Vicker’S Microhardness

Silicon is believed to be an almost perfectly brittle material with cleavage occurring on {111} planes. In such a material at room temperature cleavage is expected to occur prior to any dislocation nucleation. This behavior suggests that cleavage fracture may be used to produce usable flat surfaces. Attempts to show this have failed. Such fractures produced in semiconductor silicon tend to occur on planes of variable orientation resulting in surfaces with a poor surface finish. In order to learn more about the mechanisms involved in fracture of silicon we began a HREM study of hardness indent induced fractures in thin samples of oxidized silicon.Samples of single crystal silicon were oxidized in air for 100 hours at 1000°C. Two pieces of this material were glued together and 500 μm thick cross-section samples were cut from the combined piece. The cross-section samples were indented using a Vicker's microhardness tester to produce cracks. The cracks in the samples were preserved by thinning from the back side using a combination of mechanical grinding and ion milling.

Practical High Resolution Microscopy

1968 ◽  
Vol 26 ◽  
pp. 302-303
Author(s):  
P. A. Marsh ◽  
T. Mullens ◽  
D. Price
Keyword(s):  
High Resolution ◽  
Magnetic Fields ◽  
Low Frequency ◽  
Resolving Power ◽  
Careful Attention ◽  
Electron Microscopes ◽  
The Relationship ◽  
High Resolution Microscopy ◽  
New Facilities

It is possible to exceed the guaranteed resolution on most electron microscopes by careful attention to microscope parameters essential for high resolution work. While our experience is related to a Philips EM-200, we hope that some of these comments will apply to all electron microscopes.The first considerations are vibration and magnetic fields. These are usually measured at the pre-installation survey and must be within specifications. It has been our experience, however, that these factors can be greatly influenced by the new facilities and therefore must be rechecked after the installation is completed. The relationship between the resolving power of an EM-200 and the maximum tolerable low frequency interference fields in milli-Oerstedt is 10 Å - 1.9, 8 Å - 1.4, 6 Å - 0.8.

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