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Rare Instances (rare + instance)
Selected AbstractsInfantile Crohn Disease Presenting with Diarrhea and Pyoderma GangrenosumPEDIATRIC DERMATOLOGY, Issue 1 2006James G. H. Dinulos M.D. We describe an infant with chronic diarrhea and failure to thrive who developed extensive ulcerations in the inguinal folds and perineum that were initially thought to be exclusively caused by local irritation. A cutaneous examination found signs consistent with those of pyoderma gangrenosum, leading to a diagnosis of infantile Crohn disease. Cutaneous signs can lead to the diagnosis of an underlying systemic disease in infants with chronic diarrhea and rash. Prompt diagnosis is especially important in infantile Crohn disease, since many infants require surgical resection of affected bowel, and 60% die from disease complications. This article reports a rare instance of an infant who developed pyoderma gangrenosum due to Crohn disease and reviews cutaneous signs of systemic disease in infants presenting with chronic diarrhea and rash. [source] On the bootstrap in cube root asymptoticsTHE CANADIAN JOURNAL OF STATISTICS, Issue 1 2006Christian Léger Abstract The authors study the application of the bootstrap to a class of estimators which converge at a nonstandard rate to a nonstandard distribution. They provide a theoretical framework to study its asymptotic behaviour. A simulation study shows that in the case of an estimator such as Chernoff's estimator of the mode, usually the basic bootstrap confidence intervals drastically undercover while the percentile bootstrap intervals overcover. This is a rare instance where basic and percentile confidence intervals, which have exactly the same length, behave in a very different way. In the case of Chernoff's estimator, if the distribution is symmetric, it is possible to bootstrap from a smooth symmetric estimator of the distribution for which the basic bootstrap confidence intervals will have the claimed coverage probability while the percentile bootstrap interval will have an asymptotic coverage of 1! A propos du bootstrap pour des estimateurs convergeant a la vitesse racine cubique Les auteurs étudient l'application du bootstrap à une classe d'estimateurs qui convergent à une vitesse et vers une loi non standard. Ils présentent un cadre théorique pour l'étude de son comportement asymptotique. Une simulation démontre que dans le cas d'un estimateur du mode de Chernoff, la probabilité de couverture de l'intervalle de confiance bootstrap de base est grandement inférieure au niveau prescrit, alors que celle des intervalles de type percentile dépasse le niveau prescrit. C'est un rare cas où les intervalles de confiance de base et percentile ont un comportement si différent malgré des longueurs identiques. Dans le cas de l'estimateur de Chernoff, si la distribution est symétrique, il est possible d'appliquer le bootstrap à partir d'un estimateur lisse et symétrique de la distribution qui mènera à des intervalles bootstrap de base dont la probabilité de couverture asymptotique sera la bonne, alors que celle de l'intervalle percentile convergera vers 1! [source] Horizontal ridge augmentation using autogenous block grafts and the guided bone regeneration technique with collagen membranes: a clinical study with 42 patientsCLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2006Thomas Von Arx Abstract Objective: To analyze the clinical outcome of horizontal ridge augmentation using autogenous block grafts covered with anorganic bovine bone mineral (ABBM) and a bioabsorbable collagen membrane. Material and methods: In 42 patients with severe horizontal bone atrophy, a staged approach was chosen for implant placement following horizontal ridge augmentation. A block graft was harvested from the symphysis or retromolar area, and secured to the recipient site with fixation screws. The width of the ridge was measured before and after horizontal ridge augmentation. The block graft was subsequently covered with ABBM and a collagen membrane. Following a tension-free primary wound closure and a mean healing period of 5.8 months, the sites were re-entered, and the crest width was re-assessed prior to implant placement. Results: Fifty-eight sites were augmented, including 41 sites located in the anterior maxilla. The mean initial crest width measured 3.06 mm. At re-entry, the mean width of the ridge was 7.66 mm, with a calculated mean gain of horizontal bone thickness of 4.6 mm (range 2,7 mm). Only minor surface resorption of 0.36 mm was observed from augmentation to re-entry. Conclusions: The presented technique of ridge augmentation using autogenous block grafts with ABBM filler and collagen membrane coverage demonstrated successful horizontal ridge augmentation with high predictability. The surgical method has been further simplified by using a resorbable membrane. The hydrophilic membrane was easy to apply, and did not cause wound infection in the rare instance of membrane exposure. [source] Women and Classical Translation in the Eighteenth CenturyGERMAN LIFE AND LETTERS, Issue 3 2006Hilary Brown Women in Germany first began to take up their pens in substantial numbers during the eighteenth century. One area where they apparently did not leave their mark was in the translation of classical literature, despite a wave of interest in the classics in the literary world at large. However, this article sheds new light on women's involvement in this field. It focuses on a handful of women who translated from Greek or Latin, namely Luise Gottsched (1713,62), Fräulein von Erath (?,1776) and Ernestine Christine Reiske (1735,98). It looks at the conditions in which they did so, at their presentation of the texts, and at contemporary reactions to their work. It shows that women could only make their way in this area in exceptional cases, and that they usually exercised a considerable degree of caution. Yet, in some rare instances, translation gave women a new freedom. A translator could put her name to works of a surprising nature, such as philosophy and erotica. Adopting the detached stance of translator meant she could publish texts which women at the time would probably never have dared to write themselves. Thus, the act of translation could open up new spheres of literary activity for women. [source] DPT vaccine-induced lipoatrophy: an observational studyINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 10 2007Kabir Sardana MD, MNAMS Introduction Diphtheria Pertussis Tetanus (DPT) vaccine is universally used in infants and children. It is generally safe and well tolerated. Local reactions such as erythema, induration, palpable nodules, and injection site abscess are well known. Injection site lipoatrophy has not been reported earlier. Patients and Methods Retrospective review of all cases presenting with lipoatrophy developing at injection site following DPT administration between 2000,2005 in 3 hospitals in New Delhi, India was performed. In each case, the patients were extensively evaluated for other possible causes of lipoatrophy. Results 8 infants (2 boys & 6 girls), age range 4,12 months, had presented with injection site lipoatrophy following DPT vaccination. The duration between the last injection and lipoatrophy ranged from 4 to 8 weeks. All had been administered the vaccine in the buttock instead of the thigh, as generally recommended in infants. Majority (6/8) developed lipoatrophy after the second dose. No systemic causes were found. Conclusion DPT vaccine may, in rare instances, lead to injection site lipoatrophy. Inadvertent administration into the subcutaneous fat of the buttock may have been causative. Other possible mechanisms are discussed. Paramedics and general practitioners need to be educated to administer intramuscular vaccines in the thigh in infants and young children. [source] Long-term asymptomatic biochemical cholestasis after fulminant or subfulminant liver failure is associated with extensive postnecrotic collapse with regeneration of the liverLIVER INTERNATIONAL, Issue 1 2002Michèle Ngassa Abstract: Fulminant or subfulminant liver failure usually leads to liver failure or to recovery. In rare instances, patients who recover exhibit prolonged asymptomatic biochemical cholestasis which coincides with the development into the parenchyma of large postnecrotic collapse with regeneration. This hitherto poorly recognized form of recovery may now be assessed by noninvasive techniques such as magnetic resonance imaging. We report the case of three patients who recovered from fulminant or subfulminant liver failure and in whom investigation of long-term biochemical cholestasis led to that unusual diagnosis. [source] Pulmonary aspergilloma with renal oxalosis: fatal effect at a distanceMYCOSES, Issue 3 2009Pradeep Vaideeswar Summary Some species of the fungus Aspergillus, especially Aspergillus niger, produce oxalic acid as a fermentation byproduct. The acid combines with calcium ions at physiological pH to form insoluble calcium oxalate crystals that are mainly deposited at local sites. This is often seen in the lungs, where the crystals tend to potentiate the destructive capacity of the fungus. In rare instances, there is hyperoxaluria and deposition of the crystals in the renal tubules. We report this rare occurrence in a 59-year-old man with pulmonary aspergilloma and acute renal failure. To the best of our knowledge, this is the fifth case to be reported. [source] Monochorionic-diamniotic twins discordant in gender from a naturally conceived pregnancy through postzygotic sex chromosome loss in a 47,XXY zygotePRENATAL DIAGNOSIS, Issue 8 2008Nicolas H. Zech Abstract Objective It is generally believed that monochorionic-diamniotic twin pregnancies result from one fertilized oocyte with both siblings having the same genotype and phenotype. In rare instances, due to somatic mutations or chromosome aberrations, the karyotypes and phenotypes of the two twins can differ. Method We report cytogenetic, molecular genetic and clinical examinations in monochorionic-diamniotic twins discordant in gender. Results The monochorionic-diamniotic status of the twins was diagnosed by ultrasound and histologic examination of the placenta. Prenatal chromosome examination performed on amniocytes revealed a normal female karyotype in one and a 46,XX(26)/46,XY(3) karyotype in the other twin. Molecular examinations confirmed monozygosity despite discordant sex. Based on the cytogenetic and molecular results of lymphocytes and placental cells, the only explanation for gender discordance was that the conceptus originally had a 47,XXY chromosome complement. Conclusion A 47,XXY zygote appears to have undergone a twinning process. A postzygotic loss of the X chromosome in some cells and the Y chromosome in other cells, either before or after twinning, resulted in 46,XX/46,XY mosaicism in both monozygotic (MZ) twins. The sex discordance of the MZ twins can be explained by different proportions of the 46,XX and 46,XY cell lines in the gonads and other tissues. Copyright © 2008 John Wiley & Sons, Ltd. [source] | ||||||||||