ABSTRACT
Vasculitis refers to inflammation of the systemic vessels. Eosinophilic granulomatosis with polyangiitis (EGPA) is a medium and small vessel vasculitis characterized by hypereosinophilia, pulmonary infiltrates, difficult to treat asthma and polyneuropathies. Diagnosis can often be challenging. In this article, we present a case of a young lady who was diagnosed ANCA negative EGPA.
ABSTRACT
We generate coherent ultraviolet radiation at 313 nm as the third harmonic of an external-cavity diode laser. We use this radiation for laser cooling of trapped beryllium atomic ions and sympathetic cooling of co-trapped beryllium-hydride molecular ions. An LBO crystal in an enhancement cavity generates the second harmonic, and a BBO crystal in a doubly resonant enhancement cavity mixes this second harmonic with the fundamental to produce the third harmonic. Each enhancement cavity is preceded by a tapered amplifier to increase the fundamental light. The 36-mW output power of this all-semiconductor-gain system will enable quantum control of the beryllium ions' motion.
ABSTRACT
A 62-year-old woman presented with ischemic pain of her lower limb on 2 occasions, without upper limb or cranial vessel involvement. She was treated with open bypass of her left lower limb when she presented with critical limb ischemia during her second admission. Although bilateral temporal artery biopsies were negative, superficial femoral artery biopsy at the time of surgery confirmed the diagnosis of giant cell arteritis. Corticosteroid therapy was promptly commenced.
Subject(s)
Femoral Artery , Giant Cell Arteritis/complications , Ischemia/etiology , Lower Extremity/blood supply , Adrenal Cortex Hormones/therapeutic use , Angiography, Digital Subtraction , Biopsy , Constriction, Pathologic , Critical Illness , Female , Femoral Artery/diagnostic imaging , Femoral Artery/drug effects , Giant Cell Arteritis/diagnosis , Giant Cell Arteritis/drug therapy , Humans , Ischemia/diagnosis , Ischemia/surgery , Middle Aged , Treatment Outcome , Vascular GraftingABSTRACT
OBJECTIVES: Previous studies looking at the influence of positive circumferential margin (CRM) on survival after oesophagectomy are conflicting. This may be due to the fact that older versions of the TNM classification were used, which do not predict survival as accurately as the new 7th edition. We examine whether CRM involvement has an impact on survival when the 7th TNM classification is used. METHODS: Over a 10-year period, 199 patients who had undergone potentially curative resection for oesophageal cancer with postoperative histopathological T3 were identified. A total of 151 (75.9%) were found to have CRM involvement (<1 mm), and these were compared with patients in whom the CRM was free of tumour. Cancers were staged according to the International Union against Cancer TNM 7th edition. First, univariate and then multivariate Cox regression analysis were performed to assess the factors influencing survival. Potentially significant predictors (P < 0.1) from the univariate analysis were inserted in the forward-stepwise Cox regression model and was allowed to remain in the final model if a P-value of <0.05 was achieved. A sub-group analysis was also performed for different N-stages (N0-N3). RESULTS: After all analyses were performed, CRM involvement was found to have no effect on survival following oesophagectomy [hazard ratio 1.28 (95% CI: 0.82-2.01) (P = 0.28)]. This was seen for all N-stages. Stage of disease, age at operation, % predicted forced expiratory volume in 1 second and shortness of breath [(according to New York Heart Association classification)] were all significant predictors of survival. CONCLUSIONS: With this study, it became clear that CRM involvement does not affect long-term survival of patients after oesophagectomy. Patients with CRM involvement should not necessarily be considered to have had an incomplete resection.
