A middle aged, non-addict male presented with right upper abdominal pain and swelling with respiratory distress. Examination revealed central cyanosis, bipedal pitting edema with prominent epigastric and back veins. L...A middle aged, non-addict male presented with right upper abdominal pain and swelling with respiratory distress. Examination revealed central cyanosis, bipedal pitting edema with prominent epigastric and back veins. Liver was enlarged, tender, spanned 20 cm without any splenomegaly or ascites. Other systems were clinically normal. Laboratory investigations showed polymorphonuclear leucocytosis with slightly deranged liver function. Abdominal ultrasonography showed an abscess in the right lobe of the liver with compressed inferior vena cava （IVC）, middle and left hepatic veins. Arterial blood gas （ABG） documented hypoxia with orthodeoxia and air-contrast echocardiography was suggestive of an intrapulmonary shunt. A diagnosis of hepato-pulmonary syndrome （HPS） was made with near normal liver function secondary to amebic liver abscess. It reversed completely following successful treatment of the liver abscess.展开更多
Authors describe a 53-year-old woman who presentedto their diabetes clinic with a three week history of multiple painful and swollen joints. She had been diagnosed with type 2 diabetes 5 years back. On examination, bo...Authors describe a 53-year-old woman who presentedto their diabetes clinic with a three week history of multiple painful and swollen joints. She had been diagnosed with type 2 diabetes 5 years back. On examination, both knee joints and left ankle were swollen. A soft tissue swelling appeared over the medial end of the left clavicle few days later. Rheumatoid arthritis, collagen vascular diseases and other common causes of polyarthritis were ruled out by appropriate investigations. Non steroidal anti-inflammatory drugs failed to give satisfactory pain relief and the arthritis persisted. Conventional cultures of synovial fluid samples including cultures for tuberculosis were negative. Computed tomography showed a space occupying lesion involving the left sternoclavicular joint. Fine needle aspiration from the lesion was performed and acidfast bacilli were demonstrated in the smear using ZiehlNeelsen stain. The explanation of her arthritis was therefore tuberculous arthritis in left sternoclavicular joint and reactive arthritis in the rest of the joints. A diagnosis of Poncet's disease was considered in her case. We treated her with standard anti-tuberculosis drugs and the arthritis resolved within a few days. She remained symptom-free at her 2 years' follow-up.展开更多
Despite scarce studies have analyzed the relative growth inhibition of As (III) and As (V) to diatom, clear pattern of interspecies difference have been shown, identifying cell size as a key property determining the s...Despite scarce studies have analyzed the relative growth inhibition of As (III) and As (V) to diatom, clear pattern of interspecies difference have been shown, identifying cell size as a key property determining the sensitivity of diatom to As. Evidence from cultures suggests that cell size is a key factor in determining the extent of arsenic (III) & (V) stress of diatom, with relatively lesser effects of As (V) than As (III) on small cells. Cent percent growth inhibition was observed for large size group (Coscinodiscus radiatus, Surirella, Amphipleura, Thalassiothrix, Cyclotella and Thalassiosira decipiens) relative to smaller size group (Skeletonema cf. costatum, Navicula rhombica, Amphora hyaline, Nitzschia longissima except Thalassisira. Interspecies differences in As tolerance by diatom in the mangrove ecosystem indicates cell size could be only one factor contributing to these differences. The results show that 81.7% of total arsenic was uptaken from culture media originally amended with arsenic. Looking to the extreme tolerance and arsenic removal efficiency, application of the species with smaller cell size relative to the other tested diatom for bioremediation purpose can be envisaged.展开更多
文摘A middle aged, non-addict male presented with right upper abdominal pain and swelling with respiratory distress. Examination revealed central cyanosis, bipedal pitting edema with prominent epigastric and back veins. Liver was enlarged, tender, spanned 20 cm without any splenomegaly or ascites. Other systems were clinically normal. Laboratory investigations showed polymorphonuclear leucocytosis with slightly deranged liver function. Abdominal ultrasonography showed an abscess in the right lobe of the liver with compressed inferior vena cava （IVC）, middle and left hepatic veins. Arterial blood gas （ABG） documented hypoxia with orthodeoxia and air-contrast echocardiography was suggestive of an intrapulmonary shunt. A diagnosis of hepato-pulmonary syndrome （HPS） was made with near normal liver function secondary to amebic liver abscess. It reversed completely following successful treatment of the liver abscess.
文摘Authors describe a 53-year-old woman who presentedto their diabetes clinic with a three week history of multiple painful and swollen joints. She had been diagnosed with type 2 diabetes 5 years back. On examination, both knee joints and left ankle were swollen. A soft tissue swelling appeared over the medial end of the left clavicle few days later. Rheumatoid arthritis, collagen vascular diseases and other common causes of polyarthritis were ruled out by appropriate investigations. Non steroidal anti-inflammatory drugs failed to give satisfactory pain relief and the arthritis persisted. Conventional cultures of synovial fluid samples including cultures for tuberculosis were negative. Computed tomography showed a space occupying lesion involving the left sternoclavicular joint. Fine needle aspiration from the lesion was performed and acidfast bacilli were demonstrated in the smear using ZiehlNeelsen stain. The explanation of her arthritis was therefore tuberculous arthritis in left sternoclavicular joint and reactive arthritis in the rest of the joints. A diagnosis of Poncet's disease was considered in her case. We treated her with standard anti-tuberculosis drugs and the arthritis resolved within a few days. She remained symptom-free at her 2 years' follow-up.
文摘Despite scarce studies have analyzed the relative growth inhibition of As (III) and As (V) to diatom, clear pattern of interspecies difference have been shown, identifying cell size as a key property determining the sensitivity of diatom to As. Evidence from cultures suggests that cell size is a key factor in determining the extent of arsenic (III) & (V) stress of diatom, with relatively lesser effects of As (V) than As (III) on small cells. Cent percent growth inhibition was observed for large size group (Coscinodiscus radiatus, Surirella, Amphipleura, Thalassiothrix, Cyclotella and Thalassiosira decipiens) relative to smaller size group (Skeletonema cf. costatum, Navicula rhombica, Amphora hyaline, Nitzschia longissima except Thalassisira. Interspecies differences in As tolerance by diatom in the mangrove ecosystem indicates cell size could be only one factor contributing to these differences. The results show that 81.7% of total arsenic was uptaken from culture media originally amended with arsenic. Looking to the extreme tolerance and arsenic removal efficiency, application of the species with smaller cell size relative to the other tested diatom for bioremediation purpose can be envisaged.
