Private clouds and public clouds are turning mutually into the open integrated cloud computing environment,which can aggregate and utilize WAN and LAN networks computing,storage,information and other hardware and soft...Private clouds and public clouds are turning mutually into the open integrated cloud computing environment,which can aggregate and utilize WAN and LAN networks computing,storage,information and other hardware and software resources sufficiently,but also bring a series of security,reliability and credibility problems.To solve these problems,a novel secure-agent-based trustworthy virtual private cloud model named SATVPC was proposed for the integrated and open cloud computing environment.Through the introduction of secure-agent technology,SATVPC provides an independent,safe and trustworthy computing virtual private platform for multi-tenant systems.In order to meet the needs of the credibility of SATVPC and mandate the trust relationship between each task execution agent and task executor node suitable for their security policies,a new dynamic composite credibility evaluation mechanism was presented,including the credit index computing algorithm and the credibility differentiation strategy.The experimental system shows that SATVPC and the credibility evaluation mechanism can ensure the security of open computing environments with feasibility.Experimental results and performance analysis also show that the credit indexes computing algorithm can evaluate the credibilities of task execution agents and task executor nodes quantitatively,correctly and operationally.展开更多
In order to fully utilize all potential available network resources and make the interoperability of systems possible, we propose to integrate cloud computing and peer-to-peer （P2P） computing environments together. ...In order to fully utilize all potential available network resources and make the interoperability of systems possible, we propose to integrate cloud computing and peer-to-peer （P2P） computing environments together. We utilize the mobile multi-agent technology to construct an effective hierarchical integration model named Cloud-P2P. As the original management mechanisms for traditional cloud computing and P2P computing systems are no longer applicable to Cloud-P2P, we propose a novel hybrid collaborative management ring based on mobile multi-agent in order to ensure the efficiency and success rate of task implementation in the Cloud- P2P environment. This mechanism needs to divide the system into core ring, cloud inner rings and several peer rings. In each ring, every node is in collaboration with its neighbor nodes with multi-agent, or uses mobile agent moving from node to node with string or parallel methods to monitor the statuses and performances of all nodes, in order to avoid problems of performance bottleneck and single point failure. This paper analyses the node conditions of cloud computing and P2P computing environments in-depth, then elaborates on Cloud-P2P and the hybrid collaborative management ring based on mobile multi-agent （HCMRMMA）. After that, the construction method of the network ring topology for Cloud-P2P is introduced. Finally, experimental results and performance analysis of HCMRMMA are presented.展开更多
Background: T-lymphocyte dysfunction has been seldom investigated in collagen vascular disorders. The search for dominant T-cell clones has been scarcely reported, although the presence of such clones might be expecte...Background: T-lymphocyte dysfunction has been seldom investigated in collagen vascular disorders. The search for dominant T-cell clones has been scarcely reported, although the presence of such clones might be expected in disorders showing immune responses directed against a variety of autoantigens. Objectives: We conducted a systematic search for dominant T-cell clones in peripheral blood in patients with collagen vascular disorders. Patients and methods: Ninety-seven patients with collagen vascular disorders were studied (7 cutaneous and 38 systemic lupus erythematosus; 8 multiple morphea; 12 regional scleroderma; 32 systemic sclerosis of the CREST type). A dominant T-cell clone was searched for in peripheral blood by polymerase chain reaction targeting the T-cell receptor γchain followed by a size analysis of amplified fragments. Peripheral blood from patients with nonlymphocyte-dependent disorders and matched by age and sex was assessed in the same conditions. Results in both groups were compared using nonparametric statistical tests. Results: Overall, a circulating dominant T-cell clone was found in 52%of patients compared with 16.9%in controls. More precisely, such a dominant clone was present in 43%and 37%of cutaneous and systemic lupus erythematosus, respectively, in 75%of multiple morphea, 75%of regional scleroderma and 60%of CREST syndrome patients. The percentages in all subsets of patients were significantly higher than in the control group. Conclusions: The presence of a dominant T-cell clone in peripheral blood is significantly more frequent in collagen vascular disorders than in controls, especially in patients with scleroderma, whatever the clinical subset, which suggests T-cell involvement in the immune response dysfunction in these diseases classically characterized by disturbances of B lymphocytes. The relevance of such a dominant clone regarding diagnosis, pathomechanisms, longterm outcome and visceral prognosis of these diseases as well as therapeutic decisions remains to be evaluated.展开更多
We present a numerical study of the resolution power of Padé Approximations to the Z-transform, compared to the Fourier transform. As signals are represented as isolated poles of the Padé Approximant to the ...We present a numerical study of the resolution power of Padé Approximations to the Z-transform, compared to the Fourier transform. As signals are represented as isolated poles of the Padé Approximant to the Z-transform, resolution depends on the relative position of signal poles in the complex plane i.e. not only the difference in frequency (separation in angular position) but also the difference in the decay constant (separation in radial position) contributes to the resolution. The frequency resolution increase reported by other authors is therefore an upper limit: in the case of signals with different decay rates frequency resolution can be further increased.展开更多
Background: Psoriasis is a common inflammatory skin disease characterized by uncontrolled proliferation of keratinocytes and recruitment of T lymphocytes int o the skin. The possible role of human endogenous retroviru...Background: Psoriasis is a common inflammatory skin disease characterized by uncontrolled proliferation of keratinocytes and recruitment of T lymphocytes int o the skin. The possible role of human endogenous retroviruses (HERVs) in the in duction of psoriasis has been suggested, based upon the previous observations of retrovirus-like particles in psoriasis from skin lesional plaques, urine and stimulated lymphocytes. Objectives: To investigate the expression of HERV-E tr ansmembrane envelope glycoprotein (HERV-E env) in normal, psoriatic and atopic human skin, and to examine the influence of ultraviolet (UV) B irradiation onHE RV-E env expression in normal human epidermal keratinocytes. Methods: The anal ysis was performed on both skin biopsies and organotypic skin cultures using imm unofluorescence andWestern immunoblotting. UVB irradiation (312 nm) of cultured normal human keratinocytes was performed using a dose of 30 mJ cm- 2. Results: Positive staining was observed in most of the psoriatic and atopic skin samples, whereas only 15% of the normal skin samples were faintly positive. In additio n, the pattern of expression of HERV- E env differed markedly in psoriasis vs. atopy. By Western blotting analysis, two main proteins of 54 and 57 kDa were det ected in extracts of normal skin, normal keratinocyte cultures and reconstructed epidermis from psoriatic and normal punch biopsies. An increased level of expre ssion of these proteins was noted in extracts from psoriatic vs. normal reconstr ucted epidermis. The overexpression of the 57- kDa protein in normal human cult ured keratinocytes was dramatically reduced by UVB irradiation. Conclusions: The se data suggest for the first time that HERV-E env is expressed in normal and pathological human skin. Further studies are now required to elucidate the role of such viral proteins in the pathogenesis of psoriasis.展开更多
Attacks by swarm of bees realize arrays of mass poisoning. We report the case of a 9 years old boy whoes severity was related to the large number of bees which was about 400 and their locations spread throughout the s...Attacks by swarm of bees realize arrays of mass poisoning. We report the case of a 9 years old boy whoes severity was related to the large number of bees which was about 400 and their locations spread throughout the skin surface with a preponderance to the cephalic end. Complications were hemolytic anemia, kidney failure and convulsions. The outcome was favorable with symptomatic care and hemodialysis.展开更多
The integration of distributed renewable energy sources into the conventional power grid has become a hot research topic, all part of attempts to reduce greenhouse gas emission. There are many distributed renewable en...The integration of distributed renewable energy sources into the conventional power grid has become a hot research topic, all part of attempts to reduce greenhouse gas emission. There are many distributed renewable energy sources available and the network participants in energy delivery have also increased. This makes the management of the new power grid with integrated distributed renewable energy sources extremely complex. Applying the technical advantages of blockchain technology to this complex system to manage peer-to-peer energy sharing, transmission, data storage and build smart contracts between network participants can develop an optimal consensus mechanism within the new power grid. This paper proposes a new framework for the application of blockchain in a decentralised energy network. The microgrid is assumed to be private and managed by local prosumers. An overview description of the proposed model and a case study are presented in the paper.展开更多
Using an unmanned aerial vehicle (UAV) paired with image semantic segmentation to classify land cover within natural vegetation can promote the development of forest and grassland field. Semantic segmentation normally...Using an unmanned aerial vehicle (UAV) paired with image semantic segmentation to classify land cover within natural vegetation can promote the development of forest and grassland field. Semantic segmentation normally excels in medical and building classification, but its usefulness in mixed forest-grassland ecosystems in semi-arid to semi-humid climates is unknown. This study proposes a new semantic segmentation network of LResU-net in which residual convolution unit (RCU) and loop convolution unit (LCU) are added to the U-net framework to classify images of different land covers generated by UAV high resolution. The selected model enhanced classification accuracy by increasing gradient mapping via RCU and modifying the size of convolution layers via LCU as well as reducing convolution kernels. To achieve this objective, a group of orthophotos were taken at an altitude of 260 m for testing in a natural forest-grassland ecosystem of Keyouqianqi, Inner Mongolia, China, and compared the results with those of three other network models (U-net, ResU-net and LU-net). The results show that both the highest kappa coefficient (0.86) and the highest overall accuracy (93.7%) resulted from LResU-net, and the value of most land covers provided by the producer’s and user’s accuracy generated in LResU-net exceeded 0.85. The pixel-area ratio approach was used to calculate the real areas of 10 different land covers where grasslands were 67.3%. The analysis of the effect of RCU and LCU on the model training performance indicates that the time of each epoch was shortened from U-net (358 s) to LResU-net (282 s). In addition, in order to classify areas that are not distinguishable, unclassified areas were defined and their impact on classification. LResU-net generated significantly more accurate results than the other three models and was regarded as the most appropriate approach to classify land cover in mixed forest-grassland ecosystems.展开更多
BACKGROUND Data regarding the most suitable diagnostic method for the diagnosis of glucose impairment in asymptomatic children and adolescents are inconclusive.Furthermore,limited data are available on the reproducibi...BACKGROUND Data regarding the most suitable diagnostic method for the diagnosis of glucose impairment in asymptomatic children and adolescents are inconclusive.Furthermore,limited data are available on the reproducibility of the oral glucose tolerance test(OGTT)in children and adolescents who are obese(OB).AIM To investigate the usefulness of the OGTT as a screening method for glucose dysregulation in children and adolescents.METHODS Eighty-one children and adolescents,41 females,either overweight(OW),OB or normal weight(NW)but with a strong positive family history of type 2 diabetes mellitus(T2DM),were enrolled in the present observational study from the Outpatient Clinic of Paediatric Endocrinology of the University Hospital of Patras in Greece.One or two 3-h OGTTs were performed and glucose,insulin and Cpeptide concentrations were measured at several time points(t=0 min,t=15 min,t=30 min,t=60 min,t=90 min,t=120 min,t=180 min).RESULTS Good repetitiveness was observed in the OGTT response with regard to T2DM,while low repetitiveness was noted in the OGTT response with regard to impaired glucose tolerance(IGT)and no repetitiveness with regard to impaired fasting glucose(IFG).In addition,no concordance was observed between IFG and IGT.During the 1st and 2nd OGTTs,no significant difference was found in the glucose concentrations between NW,OW and OB patients,whereas insulin and C-peptide concentrations were higher in OW and OB compared to NW patients at several time points during the OGTTs.Also,OW and OB patients showed a worsening insulin and C-peptide response during the 2nd OGTT as compared to the 1st OGTT.CONCLUSION In mild or moderate disorders of glucose metabolism,such as IFG and IGT,a diagnosis may not be reached using only one OGTT,and a second test or additional investigations may be needed.When glucose metabolism is profoundly impaired,as in T2DM,one OGTT is probably more reliable and adequate for establishing the diagnosis.Excessive weight and/or a positive family history of T2DM possibly affect the ins展开更多
Introduction. Familial dyskeratotic comedones is a rare affection of autosomal transmission and characterized by pseudo-comedone papules predominantly on the limbs. We report a new familial case characterized by its c...Introduction. Familial dyskeratotic comedones is a rare affection of autosomal transmission and characterized by pseudo-comedone papules predominantly on the limbs. We report a new familial case characterized by its clinical and histolog ical profile. Case report. A 6 year-old boy presented with a papular, pseudo-c omedone eruption that had appeared shortly afterbirthandhadprogressivelyextended symmetricallytoboth legs. The child’s father complained of a similar eruption s ince childhood. Histological examination of the papules revealed a pseudo-folli cular invagination, obstructed by keratin and associated with areas of focal dys keratosis. Treatment with local retinoids was ineffective. Discussion. Since it is often asymptomatic, the prevalence of dyskeratosis comedones is probably unde restimated. A review of the literature on the preceding observations is presente d. The dermatites that would represent differential diagnoses because of the pre sence of comedone-like lesions and/or histological dyskeratosis are discussed.展开更多
Introduction. Capillary malformations such as benign hereditary telangiectasia are a familial affection, of dominant autosomal transmission, characterized by the progressive development of cutaneous telangiectasia dur...Introduction. Capillary malformations such as benign hereditary telangiectasia are a familial affection, of dominant autosomal transmission, characterized by the progressive development of cutaneous telangiectasia during childhood. The association with cutaneous vascular, arteriovenous or lymphatic malformations is exceptional and has only recently been described Case report. A 5 year-old girl presented with widespread erythematous, predominantly telangiectasic, congenital and acquired macules when she was one year-old. Her history was marked by right temporal cerebral hemorrhage at the age of 4, revealing a right temporal cavernoma-like vascular malformation. The familial history of telangiectasic macules and clinical and histological examination led to the diagnosis of benign hereditary telangiectasia. Discussion. This case report raises doubt on the exclusively cutaneous nature of benign hereditary telangiectasic-type capillary malformations. Moreover, it illustrates the possibility of a particular clinical form of this affection, associating classical telangiectasia and post-wine stain-type macules. The recent localization of the locus implied in this affection in 5q14 in the same chromosomic space as the CMCi locus incriminated in familial capillary malformations, suggests that these two affections are in fact phenotype variations of a single and same clinical entity.展开更多
Gemcitabine is a nucleosid analog approved for use in the treatment of metastatic urothelial carcinoma of the bladder. We describe an unusual case of scleroderma-like changes of the lower extremities after treatment b...Gemcitabine is a nucleosid analog approved for use in the treatment of metastatic urothelial carcinoma of the bladder. We describe an unusual case of scleroderma-like changes of the lower extremities after treatment by gemcitabine for metastatic carcinoma of the bladder. The patient developed initial inflammatory edema (3 kg) restricted to the lower extremities and subsequent scleroderma-like changes after 2 cycles of gemcitabine. Cutaneous biopsy specimen revealed diffuse sclerosis without involvment of the fascia or muscle. Discontinuation of gemcitabine resulted in dramatic removal of the edema, softening of the skin, and partial reversibility of the fibrotic process. This is the first case report of a scleroderma-like reaction associated with gemcitabine. This antineoplastic agent must be added to the very limited number of cytostatic agents capable of giving rise to scleroderma-like features.展开更多
基金Projects(61202004,61272084)supported by the National Natural Science Foundation of ChinaProjects(2011M500095,2012T50514)supported by the China Postdoctoral Science Foundation+2 种基金Projects(BK2011754,BK2009426)supported by the Natural Science Foundation of Jiangsu Province,ChinaProject(12KJB520007)supported by the Natural Science Fund of Higher Education of Jiangsu Province,ChinaProject(yx002001)supported by the Priority Academic Program Development of Jiangsu Higher Education Institutions,China
文摘Private clouds and public clouds are turning mutually into the open integrated cloud computing environment,which can aggregate and utilize WAN and LAN networks computing,storage,information and other hardware and software resources sufficiently,but also bring a series of security,reliability and credibility problems.To solve these problems,a novel secure-agent-based trustworthy virtual private cloud model named SATVPC was proposed for the integrated and open cloud computing environment.Through the introduction of secure-agent technology,SATVPC provides an independent,safe and trustworthy computing virtual private platform for multi-tenant systems.In order to meet the needs of the credibility of SATVPC and mandate the trust relationship between each task execution agent and task executor node suitable for their security policies,a new dynamic composite credibility evaluation mechanism was presented,including the credit index computing algorithm and the credibility differentiation strategy.The experimental system shows that SATVPC and the credibility evaluation mechanism can ensure the security of open computing environments with feasibility.Experimental results and performance analysis also show that the credit indexes computing algorithm can evaluate the credibilities of task execution agents and task executor nodes quantitatively,correctly and operationally.
基金supported by National Natural Science Foundation of China(Nos.61472192 and 61202004)Special Fund for Fast Sharing of Science Paper in Net Era by CSTD(No.2013116)Natural Science Fund of Higher Education of Jiangsu Province(No.14KJB520014)
文摘In order to fully utilize all potential available network resources and make the interoperability of systems possible, we propose to integrate cloud computing and peer-to-peer （P2P） computing environments together. We utilize the mobile multi-agent technology to construct an effective hierarchical integration model named Cloud-P2P. As the original management mechanisms for traditional cloud computing and P2P computing systems are no longer applicable to Cloud-P2P, we propose a novel hybrid collaborative management ring based on mobile multi-agent in order to ensure the efficiency and success rate of task implementation in the Cloud- P2P environment. This mechanism needs to divide the system into core ring, cloud inner rings and several peer rings. In each ring, every node is in collaboration with its neighbor nodes with multi-agent, or uses mobile agent moving from node to node with string or parallel methods to monitor the statuses and performances of all nodes, in order to avoid problems of performance bottleneck and single point failure. This paper analyses the node conditions of cloud computing and P2P computing environments in-depth, then elaborates on Cloud-P2P and the hybrid collaborative management ring based on mobile multi-agent （HCMRMMA）. After that, the construction method of the network ring topology for Cloud-P2P is introduced. Finally, experimental results and performance analysis of HCMRMMA are presented.
文摘Background: T-lymphocyte dysfunction has been seldom investigated in collagen vascular disorders. The search for dominant T-cell clones has been scarcely reported, although the presence of such clones might be expected in disorders showing immune responses directed against a variety of autoantigens. Objectives: We conducted a systematic search for dominant T-cell clones in peripheral blood in patients with collagen vascular disorders. Patients and methods: Ninety-seven patients with collagen vascular disorders were studied (7 cutaneous and 38 systemic lupus erythematosus; 8 multiple morphea; 12 regional scleroderma; 32 systemic sclerosis of the CREST type). A dominant T-cell clone was searched for in peripheral blood by polymerase chain reaction targeting the T-cell receptor γchain followed by a size analysis of amplified fragments. Peripheral blood from patients with nonlymphocyte-dependent disorders and matched by age and sex was assessed in the same conditions. Results in both groups were compared using nonparametric statistical tests. Results: Overall, a circulating dominant T-cell clone was found in 52%of patients compared with 16.9%in controls. More precisely, such a dominant clone was present in 43%and 37%of cutaneous and systemic lupus erythematosus, respectively, in 75%of multiple morphea, 75%of regional scleroderma and 60%of CREST syndrome patients. The percentages in all subsets of patients were significantly higher than in the control group. Conclusions: The presence of a dominant T-cell clone in peripheral blood is significantly more frequent in collagen vascular disorders than in controls, especially in patients with scleroderma, whatever the clinical subset, which suggests T-cell involvement in the immune response dysfunction in these diseases classically characterized by disturbances of B lymphocytes. The relevance of such a dominant clone regarding diagnosis, pathomechanisms, longterm outcome and visceral prognosis of these diseases as well as therapeutic decisions remains to be evaluated.
文摘We present a numerical study of the resolution power of Padé Approximations to the Z-transform, compared to the Fourier transform. As signals are represented as isolated poles of the Padé Approximant to the Z-transform, resolution depends on the relative position of signal poles in the complex plane i.e. not only the difference in frequency (separation in angular position) but also the difference in the decay constant (separation in radial position) contributes to the resolution. The frequency resolution increase reported by other authors is therefore an upper limit: in the case of signals with different decay rates frequency resolution can be further increased.
文摘Background: Psoriasis is a common inflammatory skin disease characterized by uncontrolled proliferation of keratinocytes and recruitment of T lymphocytes int o the skin. The possible role of human endogenous retroviruses (HERVs) in the in duction of psoriasis has been suggested, based upon the previous observations of retrovirus-like particles in psoriasis from skin lesional plaques, urine and stimulated lymphocytes. Objectives: To investigate the expression of HERV-E tr ansmembrane envelope glycoprotein (HERV-E env) in normal, psoriatic and atopic human skin, and to examine the influence of ultraviolet (UV) B irradiation onHE RV-E env expression in normal human epidermal keratinocytes. Methods: The anal ysis was performed on both skin biopsies and organotypic skin cultures using imm unofluorescence andWestern immunoblotting. UVB irradiation (312 nm) of cultured normal human keratinocytes was performed using a dose of 30 mJ cm- 2. Results: Positive staining was observed in most of the psoriatic and atopic skin samples, whereas only 15% of the normal skin samples were faintly positive. In additio n, the pattern of expression of HERV- E env differed markedly in psoriasis vs. atopy. By Western blotting analysis, two main proteins of 54 and 57 kDa were det ected in extracts of normal skin, normal keratinocyte cultures and reconstructed epidermis from psoriatic and normal punch biopsies. An increased level of expre ssion of these proteins was noted in extracts from psoriatic vs. normal reconstr ucted epidermis. The overexpression of the 57- kDa protein in normal human cult ured keratinocytes was dramatically reduced by UVB irradiation. Conclusions: The se data suggest for the first time that HERV-E env is expressed in normal and pathological human skin. Further studies are now required to elucidate the role of such viral proteins in the pathogenesis of psoriasis.
文摘Attacks by swarm of bees realize arrays of mass poisoning. We report the case of a 9 years old boy whoes severity was related to the large number of bees which was about 400 and their locations spread throughout the skin surface with a preponderance to the cephalic end. Complications were hemolytic anemia, kidney failure and convulsions. The outcome was favorable with symptomatic care and hemodialysis.
基金National Reserach Fund of South Africa(NRF),Grant No.:CSRP190311422854/120397.
文摘The integration of distributed renewable energy sources into the conventional power grid has become a hot research topic, all part of attempts to reduce greenhouse gas emission. There are many distributed renewable energy sources available and the network participants in energy delivery have also increased. This makes the management of the new power grid with integrated distributed renewable energy sources extremely complex. Applying the technical advantages of blockchain technology to this complex system to manage peer-to-peer energy sharing, transmission, data storage and build smart contracts between network participants can develop an optimal consensus mechanism within the new power grid. This paper proposes a new framework for the application of blockchain in a decentralised energy network. The microgrid is assumed to be private and managed by local prosumers. An overview description of the proposed model and a case study are presented in the paper.
基金The work was supported by the Fundamental Research Funds for the Central Universities(NO.2021ZY92)major program of State Administration of Forestry and Grassland“Study on the assessment technologies for ecologically restoring the degraded grasslands”(20,200,507).
文摘Using an unmanned aerial vehicle (UAV) paired with image semantic segmentation to classify land cover within natural vegetation can promote the development of forest and grassland field. Semantic segmentation normally excels in medical and building classification, but its usefulness in mixed forest-grassland ecosystems in semi-arid to semi-humid climates is unknown. This study proposes a new semantic segmentation network of LResU-net in which residual convolution unit (RCU) and loop convolution unit (LCU) are added to the U-net framework to classify images of different land covers generated by UAV high resolution. The selected model enhanced classification accuracy by increasing gradient mapping via RCU and modifying the size of convolution layers via LCU as well as reducing convolution kernels. To achieve this objective, a group of orthophotos were taken at an altitude of 260 m for testing in a natural forest-grassland ecosystem of Keyouqianqi, Inner Mongolia, China, and compared the results with those of three other network models (U-net, ResU-net and LU-net). The results show that both the highest kappa coefficient (0.86) and the highest overall accuracy (93.7%) resulted from LResU-net, and the value of most land covers provided by the producer’s and user’s accuracy generated in LResU-net exceeded 0.85. The pixel-area ratio approach was used to calculate the real areas of 10 different land covers where grasslands were 67.3%. The analysis of the effect of RCU and LCU on the model training performance indicates that the time of each epoch was shortened from U-net (358 s) to LResU-net (282 s). In addition, in order to classify areas that are not distinguishable, unclassified areas were defined and their impact on classification. LResU-net generated significantly more accurate results than the other three models and was regarded as the most appropriate approach to classify land cover in mixed forest-grassland ecosystems.
文摘BACKGROUND Data regarding the most suitable diagnostic method for the diagnosis of glucose impairment in asymptomatic children and adolescents are inconclusive.Furthermore,limited data are available on the reproducibility of the oral glucose tolerance test(OGTT)in children and adolescents who are obese(OB).AIM To investigate the usefulness of the OGTT as a screening method for glucose dysregulation in children and adolescents.METHODS Eighty-one children and adolescents,41 females,either overweight(OW),OB or normal weight(NW)but with a strong positive family history of type 2 diabetes mellitus(T2DM),were enrolled in the present observational study from the Outpatient Clinic of Paediatric Endocrinology of the University Hospital of Patras in Greece.One or two 3-h OGTTs were performed and glucose,insulin and Cpeptide concentrations were measured at several time points(t=0 min,t=15 min,t=30 min,t=60 min,t=90 min,t=120 min,t=180 min).RESULTS Good repetitiveness was observed in the OGTT response with regard to T2DM,while low repetitiveness was noted in the OGTT response with regard to impaired glucose tolerance(IGT)and no repetitiveness with regard to impaired fasting glucose(IFG).In addition,no concordance was observed between IFG and IGT.During the 1st and 2nd OGTTs,no significant difference was found in the glucose concentrations between NW,OW and OB patients,whereas insulin and C-peptide concentrations were higher in OW and OB compared to NW patients at several time points during the OGTTs.Also,OW and OB patients showed a worsening insulin and C-peptide response during the 2nd OGTT as compared to the 1st OGTT.CONCLUSION In mild or moderate disorders of glucose metabolism,such as IFG and IGT,a diagnosis may not be reached using only one OGTT,and a second test or additional investigations may be needed.When glucose metabolism is profoundly impaired,as in T2DM,one OGTT is probably more reliable and adequate for establishing the diagnosis.Excessive weight and/or a positive family history of T2DM possibly affect the ins
文摘Introduction. Familial dyskeratotic comedones is a rare affection of autosomal transmission and characterized by pseudo-comedone papules predominantly on the limbs. We report a new familial case characterized by its clinical and histolog ical profile. Case report. A 6 year-old boy presented with a papular, pseudo-c omedone eruption that had appeared shortly afterbirthandhadprogressivelyextended symmetricallytoboth legs. The child’s father complained of a similar eruption s ince childhood. Histological examination of the papules revealed a pseudo-folli cular invagination, obstructed by keratin and associated with areas of focal dys keratosis. Treatment with local retinoids was ineffective. Discussion. Since it is often asymptomatic, the prevalence of dyskeratosis comedones is probably unde restimated. A review of the literature on the preceding observations is presente d. The dermatites that would represent differential diagnoses because of the pre sence of comedone-like lesions and/or histological dyskeratosis are discussed.
文摘Introduction. Capillary malformations such as benign hereditary telangiectasia are a familial affection, of dominant autosomal transmission, characterized by the progressive development of cutaneous telangiectasia during childhood. The association with cutaneous vascular, arteriovenous or lymphatic malformations is exceptional and has only recently been described Case report. A 5 year-old girl presented with widespread erythematous, predominantly telangiectasic, congenital and acquired macules when she was one year-old. Her history was marked by right temporal cerebral hemorrhage at the age of 4, revealing a right temporal cavernoma-like vascular malformation. The familial history of telangiectasic macules and clinical and histological examination led to the diagnosis of benign hereditary telangiectasia. Discussion. This case report raises doubt on the exclusively cutaneous nature of benign hereditary telangiectasic-type capillary malformations. Moreover, it illustrates the possibility of a particular clinical form of this affection, associating classical telangiectasia and post-wine stain-type macules. The recent localization of the locus implied in this affection in 5q14 in the same chromosomic space as the CMCi locus incriminated in familial capillary malformations, suggests that these two affections are in fact phenotype variations of a single and same clinical entity.
文摘Gemcitabine is a nucleosid analog approved for use in the treatment of metastatic urothelial carcinoma of the bladder. We describe an unusual case of scleroderma-like changes of the lower extremities after treatment by gemcitabine for metastatic carcinoma of the bladder. The patient developed initial inflammatory edema (3 kg) restricted to the lower extremities and subsequent scleroderma-like changes after 2 cycles of gemcitabine. Cutaneous biopsy specimen revealed diffuse sclerosis without involvment of the fascia or muscle. Discontinuation of gemcitabine resulted in dramatic removal of the edema, softening of the skin, and partial reversibility of the fibrotic process. This is the first case report of a scleroderma-like reaction associated with gemcitabine. This antineoplastic agent must be added to the very limited number of cytostatic agents capable of giving rise to scleroderma-like features.
