ABSTRACT
BACKGROUND: Melanoma is a malignant skin disease. The tumor development is caused by an uncontrollable proliferation of melanocytes. The most common occurrence is on the skin, but melanoma may also develop on the mucous membrane, meninges, and eyes. Some melanomas develop from melanocytic nevus. Acral lentiginous melanoma occurs on palms, feet, fingers and under nails, and is the most common type of melanoma for phototype VI. The most important factor for successful treatment of malignant melanoma is an early detection, excision of the primary tumor and histological staging. Surgical treatment of an early-stage melanoma is a key to successful therapy; however, many patients (mostly men) do not seek medical attention before it istoo late. CASE REPORT: This case study presents a 59-year-old patient, who suffers from white coat syndrome and whose finger was amputated for alleged gangrene. Subsequently, brownish black nodules appeared across his arm. Histological examination proved metastases of malignant melanoma. It was only at this phase, when the patient admitted a nevus at the tip of his amputated finger, from which ulceration and gangrene gradually emerged. CONCLUSION: This case demonstrates a combination of multiple unfavorable factors, which led to delayed diagnosis and therapy.
Subject(s)
Delayed Diagnosis/adverse effects , Diagnostic Errors , Gangrene/etiology , Hutchinson's Melanotic Freckle/diagnosis , Skin Neoplasms/diagnosis , Humans , Male , Middle AgedSubject(s)
Glucosyltransferases/isolation & purification , Adsorption , Bacillus/enzymology , Photometry , Starch , TemperatureABSTRACT
The formation of cellulases by Trichoderma viride in a medium containing cellulose as a sole source of carbon depends on the oxygen transfer rate (OSR); the OSR, on the other hand, depends on the concentration of cellulose in the medium because the concentration of cellulose strongly affects the viscosity of the medium. In the work presented here, the dependence has been determined for the oxygen transfer rate on geometric relations and viscosity in cellulose-containing media during cultivation in shaken flasks, and the oxygen transfer rate on N(Re') N(G') and N(a) during cultivation in a laboratory fermentor of 3000-mL volume. Two cellulosic materials have been compared with a different effect on viscosity: Microcrystalline beach cellulose and fibrous cellulose. It has been found that, in an applicable range of concentration, microcrystalline cellulose does not affect the oxygen transfer rate (at concentrations up to 3%). Fibrous cellulose increases the OSR during cultivation in shake flasks but decreases it during civilization in fermentors. On the basis of these results, the optimization has been carried out on the cultivation conditions in fermentors.