How old is luigi yotoko

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Recent Searches. Chronic granulomatous disease mimicking early-onset Crohn's disease with cutaneous manifestations. Chronic granulomatous disease is a rare inherited disorder of the innate immune system. In patients with a clinical history of recurrent or persistent infections, especially infections caused by uncommon species, chronic granulomatous disease should be considered. We report the case of a 5-year-old boy with a presumptive diagnosis of Crohn's disease with extraintestinal manifestations.

Chronic granulomatous disease was suspected in this case after Serratia marcescens was isolated from a skin ulcer culture. Granulomas were confirmed on histology and chronic granulomatous disease was diagnosed. This case emphasizes the importance of high clinical suspicion of an alternative diagnosis of immune deficiency in patients with presumed inflammatory bowel disease and opportunistic infections, especially when disease occurs in early life.

Tinnitus in children: an uncommon symptom? Tinnitus in children is regarded as an uncommon problem rarely noted by general paediatricians.

Some children do not spontaneously complain of it, but may demonstrate behavioural problems at school and home. A careful history, in conjunction with clinical findings, should guide the appropriate management approach.

Even very young children are able to provide insights into what troubles them allowing children's thoughts and fears regarding this symptom to be addressed. We review the available literature on the nature and impact of tinnitus and as guidelines for this do not exist, suggest a pragmatic approach to the management of tinnitus in children. Children with troublesome tinnitus, however, should be referred on to a paediatric audiology department for further investigation and management.

Intracranial fibrous histiocytomas are rare; Benign Fibrous Histiocytoma BFH being uncommon than its malignant counterpart. BFH comprises fibroblasts and histiocytes without any nuclear pleomorphism or atypia. We present a case of a year-old male who had swelling over the occipital region for the past five years, which progressively increased in size.

He developed headache, dizziness, and gait disturbance over the last six months. Computed tomographic scan revealed a posterior fossa space-occupying lesion. Fine-needle aspiration cytology from the swelling revealed spindled fibroblasts along with histiocytes and multinucleated giant cells. Later, histopathology showed presence of spindle-shaped cells in storiform pattern admixed with histiocytes and giant cells.

The giant cells and histiocytes were immunopositive for CD68 and spindled cells were positive for vimentin, but immunonegative for CD34, epithelial membrane antigen, CD1a and S The final diagnosis was intracranial BFH. We present this case because of its extreme rarity and unusual location.

Melanized Fungi in Human Disease. Summary: Melanized or dematiaceous fungi are associated with a wide variety of infectious syndromes. Many are soil organisms and are generally distributed worldwide, though certain species appear to have restricted geographic ranges. Though they are uncommon causes of disease , melanized fungi have been increasingly recognized as important pathogens, with most reports occurring in the past 20 years.

The spectrum of diseases with which they are associated has also broadened and includes allergic disease , superficial and deep local infections, pneumonia, brain abscess, and disseminated infection. For some infections in immunocompetent individuals, such as allergic fungal sinusitis and brain abscess, they are among the most common etiologic fungi. Melanin is a likely virulence factor for these fungi.

Diagnosis relies on careful microscopic and pathological examination, as well as clinical assessment of the patient, as these fungi are often considered contaminants.

Therapy varies depending upon the clinical syndrome. Local infection may be cured with excision alone, while systemic disease is often refractory to therapy. Triazoles such as voriconazole, posaconazole, and itraconazole have the most consistent in vitro activity. Further studies are needed to better understand the pathogenesis and optimal treatment of these uncommon infections. Cutaneous horn has been a matter of discussion to mankind since time immemorial and a subject of fascination for the layman.

There have been instances where certain groups saw it with angst and disgust, with a person having a large cutaneous horn on an exposed area getting a dismal look.

We present a case of a year-old man with a giant cutaneous horn over his left gluteal region. Cutaneous horns more commonly present in the sun-exposed areas. In our case it has presented in an uncommon site. The patient had delayed and denied medical treatment due to his superstitious beliefs, after having sought advice from faith healers leading to progression of the disease. This case has been presented for its giant size rare variety , its location being over the gluteal region photo-protected site and its benign histopathology suggestive of wart in spite of the giant size.

Uncommon EGFR mutations in cytological specimens of 1, newly diagnosed Indonesian lung cancer patients. Purpose We aimed to evaluate the distribution of individual epidermal growth factor receptor EGFR mutation subtypes found in routine cytological specimens. Testing was performed by ISO accredited central laboratory. Results Overall test failure rate was 5. EGFR mutation frequency was Approximately Women had higher EGFR mutation rate We aimed to evaluate the distribution of individual epidermal growth factor receptor EGFR mutation subtypes found in routine cytological specimens.

Overall test failure rate was 5. A patient with congenital hyperlactataemia and Leigh syndrome: an uncommon mitochondrial variant. We report an uncommon mitochondrial variant in a baby girl with congenital hyperlactataemia and Leigh syndrome. The patient presented with a single episode of generalised clonic convulsion at day 19, and was found to have isolated and persistent hyperlactataemia ranging from 3.

She had elevated serum lactate-to-pyruvate ratios of up to 35 and high plasma alanine concentration, indicative of a respiratory chain defect. At the age of 8 months, she developed evolving neurological and imaging features compatible with Leigh syndrome.

Genetic testing for common mitochondrial DNA mutations, large mitochondrial DNA deletions, and selected nuclear genes was negative. ValAla , which was previously shown to reduce complex I activity. In patients in whom there was a high suspicion of mitochondrial disorder, entire mitochondrial DNA analysis may be warranted if initial screening of common mitochondrial DNA mutations is negative.

A year-old woman presented with weight loss and tiredness. Investigations revealed hyperthyroidism. She was commenced on treatment and later became pregnant.

Her thyroid levels remained raised, and she later underwent an elective cesarean delivery and ovarian cystectomy. Only a partial cystectomy was achieved, and histopathology examination revealed struma ovarii.

An isotope uptake scan I including her pelvis revealed low uptake in the thyroid gland and an area of high uptake in her pelvis. The cyst was subsequently removed, and within days, her thyroid hormone levels dropped.

This case illustrates the importance of considering uncommon causes of hyperthyroidism. Cavernous hemangioma-- uncommon presentation in zygomatic bone. Hemangiomas are benign vascular neoplasms characterized by an abnormal proliferation of blood vessels. They may occur in any vascularized tissue including skin, subcutaneous tissue, muscle, and bone.

The most frequent sites are the calvaria and the vertebral column. Involvement of the facial bones is rare and occurs most commonly in the maxilla, mandible, and nasal bones.

In literature, only 20 cases of zygomatic involvement have been reported. We report a case of an intraosseous hemangioma of the zygoma with the history and physical findings of slowly growing, bony, hard tumor causing facial and ocular deformity. The typical clinicopathologic and radiologic findings helped to set up the correct diagnosis. Early recognition and excision are recommended to preserve facial contour.

Operative blood loss is minimal, and there is no need for preoperative angiography. Grave's disease can cause asymptomatic elevation of liver enzymes, jaundice and rarely acute liver failure.

It is associated with other autoimmune diseases like autoimmune hepatitis, or primary biliary cirrhosis. The cause of jaundice in Grave's disease is multifactorial. Bordetella pertussis is an uncommon pathogen in children hospitalized with bronchiolitis during the winter season. In the United States U. Cough and apnea are common findings in pertussis and also in bronchiolitis, the most common cause of hospitalization in U.

The objective was to determine the prevalence of B. Children hospitalized with bronchiolitis and age Disease Control and Prevention pertussis classification questions.

Nasopharyngeal aspirates were obtained and tested by real-time polymerase chain reaction for 16 viruses, Mycoplasma pneumoniae and B. All 4 were younger than 4 months; 2 met the Centers for Disease Control and Prevention definition of probable pertussis; and 3 had received at least 1 dose of an acellular pertussis vaccine. During the hospitalization, 2 had paroxysmal cough, 1 required intensive care unit care and the median length of stay was 13 days. Our data support that B.

Making a diagnosis of pertussis can be challenging because the disease can be atypical and may not meet the Centers for Disease Control and Prevention definition of probable infection. Nonrheumatic myopericarditis post acute streptococcal pharyngitis: An uncommon cause of sore throat with ST segment elevation.

Nonrheumatic myopericarditis is an uncommon complication of acute pharyngitis caused by Group A Streptococcal infection GAS. While the natural history of carditis complicating acute rheumatic fever is well established, the incidence, pathophysiology and clinical course of nonrheumatic myopericarditis are ill defined.

Advances in rapid bedside testing for both myocardial injury and GAS pharyngitis have allowed for increasing recognition of this uncommon complication in patients presenting with a sore throat with associated chest discomfort. We describe a case of a 34years old man with GAS pharyngitis complicated by acute myopericarditis who presented with chest pain, ST segment elevation on electrocardiogram, and elevated cardiac biomarkers.

Objective To test the extent to which participants exposed to an uncommon versus common exercise stimulus would result in more favourable affect at post task. Design Experimental design. Main Outcome Measures Self-reported affect and intentions for future exercise were measured before and after the minute exercise bout. At post-task, participants assigned to HOOP reported more positively valenced affect, higher ratings of positive activated affect, lower ratings of negative deactivated affect, and stronger intentions for future aerobic exercise compared to participants assigned to WALK.

Conclusions Participants who completed an uncommon bout of aerobic exercise HOOP reported more favourable affect post-exercise, as well as stronger intentions for future exercise, compared to participants who completed a common bout of aerobic exercise WALK. Future work using a longitudinal design is needed to understand the relationships between familiarity with an exercise stimulus, affective responses to exercise, motivation for future exercise behaviour, and exercise maintenance over time.

Acute strychnine poisoning is an uncommon form of intoxication, characterized by severe tonic clonic seizures and tetanus-like contractions while the patient is fully conscious. It can result in respiratory failure, leading to death. A year-old man was admitted to the casualty department 2 hours after self-poisoning with strychnine. The clinical picture consisted of persistent seizures, which were treated with midazolam and propofol.

The patient went into respiratory failure and asystole, so intubation and cardiac massage were initiated. Other complications were severe metabolic acidosis, hyperthermia and rhabdomyolysis with renal failure.

The treatment consisted of cooling, hyperhydration and intravenous administration of sodium bicarbonate. He was discharged to a mental care institution with no persistent symptoms 11 days later.

Early aggressive treatment of a strychnine intoxication can be life-saving. Knowledge of the clinical picture and the right treatment is important. Treatment is primarily focussed on stopping the convulsions and securing the airway.

An uncommon presentation of Kikuchi Fujimoto disease : a case report with literature review. Kikuchi-Fujimoto disease is so named because Kikuchi and Fujimoto were the first scientists to describe it in Japan in Although the disease has been reported from all over the world and more so from Asia, it is rare.

To date only eight cases have been reported from Nepal. Cervical lymphadenopathy, fever and raised Erythrocyte Sedimentation Rate are usual presenting features of this disease.

We describe a case which presented with thrombocytopenia and axillary lymphadenopathy in addition to the usual features. Out of the total eight cases that have been reported from Nepal so far, no patients had thrombocytopenia and only one patient had axillary lymphadenopathy. A year-old Nepali female presented with a 3-week history of low-grade fever, headache, and painful, discrete, unilateral left-sided cervical and axillary lymphadenopathy.

Among the multitude of tests that were carried out, Erythrocyte Sedimentation Rate was raised and there was thrombocytopenia while other tests were normal. Painful lymphadenopathy pointed to bacterial lymphadenitis while chronic low-grade fever suggested tuberculosis. A cervical lymph node was excised for histopathological examination to reach an accurate diagnosis.

On the basis of pathognomonic features viz. On follow-up evaluation after 6 weeks, the patient had no systemic symptoms, enlarged lymph nodes had regressed in size significantly, and Erythrocyte Sedimentation Rate and platelet count had become normal.

Kikuchi-Fujimoto disease should be kept in the differential diagnosis of lymphadenopathy in young patients, female or male even in tuberculosis-endemic countries and even in patients who have unusual features; for example thrombocytopenia and involvement of axillary lymph nodes in addition to cervical lymph nodes as in this.

Extraordinary electronic properties in uncommon structure types. In this thesis I present the results of explorations into several uncommon structure types. In Chapter 1 I go through the underlying idea of how we search for new compounds with exotic properties in solid state chemistry. The ideas of exploring uncommon structure types, building up from the simple to the complex, using chemical intuition and thinking by analogy are discussed.

Also, the history and basic concepts of superconductivity, Dirac semimetals, and magnetoresistance are briefly reviewed. In chapter 2, the 1s-InTaS2 structural family is introduced along with the discovery of a new member of the family, AgVS2; the synthesis, structure, and physical properties of two different polymorphs of the material are detailed. Also in this chapter, we report the observation of superconductivity in another 1s structure, PbTaSe2.

This material is especially interesting due to it being very heavy resulting in very strong spin orbit coulping SOC , layered, and noncentrosymmetric. Electronic structure calculations reveal the presence of a bulk 3D Dirac cone very similar to graphene that is gapped by SOC originating from the hexagonal Pb layer.

In Chapter 3 we show the re-investigation of the crystal structure of the 3D Dirac semimetal, Cd3As2. It is found to be centrosymmetric, rather than noncentrosymmetric, and as such all bands are spin degenerate and there is a 4-fold degenerate bulk Dirac point at the Fermi level, making Cd3As2 a 3D electronic analog to graphene. Also, for the first time, scanning tunneling microscopy experiments identify a 2x2 surface reconstruction in what we identify as the cleavage plane of single crystals; needle crystals grow with a [] long axis direction.

Silicone in HIVinfected patients: a cause of misdiagnosed granulomatous disease. Granulomatous diseases are common in HIV-infected patients and are usually related to opportunistic infectious or tumoral conditions. We report three cases of uncommon granulomatous disease in HIV-infected patients who had previously received silicone and for which diagnostic investigations remained negative.

Published by Elsevier Ltd. Undulating tongue in Wilson's disease. We report an unusual occurrence of involuntary movement involving the tongue in a patient with confirmed Wilson's disease WD. She manifested with slow, hypophonic speech and dysphagia of 4 months duration, associated with pseudobulbar affect, apathy, drooling and dystonia of upper extremities of 1 month duration.

Our patient had an uncommon tongue movement which was arrhythmic. There was no feature to suggest tremor, chorea or dystonia. It might be described as athetoid as there was a writhing quality, but of lesser amplitude. Isolated lingual dyskinesias are rare in WD. It is important to evaluate them for WD, a potentially treatable disorder.

Rectal ulcer with an elusive diagnosis: all that ulcers is not Crohn disease. A single rectal ulcer is an uncommon finding in children with gastrointestinal disease. Although inflammatory bowel disease IBD is foremost among the differential diagnoses, a primary immunological defect should not be forgotten.

Because of the paucity of literature on the association of rectal ul TKIs were globally well tolerated. Exon 19 EGFRm achieved the best TKIs treatment outcome, while the optimal treatment of exon 18 and 20 mutations should be further clarified. Most people believe that science arose as a natural end-product of our innate intelligence and curiosity, as an inevitable stage in human intellectual development.

But physicist and educator Alan Cromer disputes this belief. Cromer argues that science is not the natural unfolding of human potential, but the invention of a particular culture, Greece, in a particular historical period. Indeed, far from being natural, scientific thinking goes so far against the grain of conventional human thought that if it hadn't been discovered in Greece, it might not have been discovered at all. In Uncommon Sense , Alan Cromer develops the argument that science represents a radically new and different way of thinking.

Using Piaget's stages of intellectual development, he shows that conventional thinking remains mired in subjective, "egocentric" ways of looking at the world--most people even today still believe in astrology, ESP, UFOs, ghosts and other paranormal phenomena--a mode of thought that science has outgrown.

He provides a fascinating explanation of why science began in Greece, contrasting the Greek practice of debate to the Judaic reliance on prophets for acquiring knowledge. Other factors, such as a maritime economy and wandering scholars both of which prevented parochialism and an essentially literary religion not dominated by priests, also promoted in Greece an objective, analytical way of thinking not found elsewhere in the ancient world.

He examines India and China and explains why science could not develop in either country. In China, for instance, astronomy served only the state, and the private study of astronomy was forbidden. Cromer also provides a perceptive account of science in Renaissance Europe and of figures such as Copernicus, Galileo, and Newton.

Along the way, Cromer touches on many intriguing topics, arguing, for instance, that much of science is essential complete; there are no new elements yet to be discovered. The "other primary headaches" encompasses a group of uncommon but distinct headache disorders.

The coexistence of their subforms such as primary sexual and exercise headache is not a new phenomenon, but in association with cough headache is rather uncommon. Report of cases: We report three cases with a rare coexistence of primary cough, exercise and associated with sexual activity headache.

Indomethacin was effective in all patients. The leading pathophysiological explanation involves a rapid rise in intra-abdominal pressure exertional factors or an inappropriate reaction in the cerebral vasculature.

Further studies are needed to confirm a common pathogenic mechanism in these patients. Hippokratia ; 19 4 : Geode of the femur: an uncommon manifestation potentially reflecting the pathogenesis of rheumatoid arthritis.

Geodes are noted frequently in rheumatoid arthritis RA , but large geodes of the femur are uncommon. We describe a patient with RA and a large geode in his femur; histological findings were consistent with a rheumatoid nodule and chronically inflamed synovium.

We review the literature of large femoral geodes and what this particular manifestation may reflect about the pathogenesis of RA. Dermatomyositis and myastenia gravis: An uncommon association with therapeutic implications. The association of dermatomyositis with myasthenia gravis MG is uncommon , having been reported so far in only 26 cases. We report the case of a 69 year-old man diagnosed with MG two years ago and currently treated with piridostigmyne.

The patient developed acute proximal weakness, shoulder pain and elevated creatine-kinase CK. He also developed generalized facial erythema and Gottron's papules.

Laboratory tests showed positive antinuclear and anti-Mi2 antibodies. The clinical management of the patient and the therapeutic implications derived from the coexistence of both entities are discusssed. Atopic dermatitis AD is a chronic inflammatory skin disease that manifests as dry skin with a relentless itch and eczema.

AD is considered an allergic disease in which the skin inflammation manifests in response to chronic exposure to contact allergens. However, identification of a responsible allergen is uncommon. Meanwhile, analyses have demonstrated that the surface of.

Mammary and extramammary Paget's disease. Mammary and extramammary Paget's disease are uncommon intraepithelial adenocarcinomas. Both conditions have similar clinical features, which mimic inflammatory and infective diseases. Histological diagnostic confusion can arise between Paget's disease and other neoplastic conditions affecting the skin, with the most common differential diagnoses being malignant melanoma and atypical squamous disease.

The glandular differentiation of both mammary Paget's disease and extramammary Paget's disease is indicated by morphological appearances, the presence of intracellular mucin in many cases, and positive immunohistochemical staining for glandular cytokeratins, epithelial membrane antigen, and carcinoembryonic antigen.

This article provides an overview of mammary and extramammary Paget's disease and discusses recent evidence regarding the cell of origin. The concepts of primary and secondary Paget's disease are presented and the differential diagnosis is discussed with reference to immunohistochemical markers that might be of diagnostic value.

The Cyborg Astrobiologist: scouting red beds for uncommon features with geological significance. The site at Riba de Santiuste is dominated by layered deposits of red sandstones. The Cyborg Astrobiologist is a wearable computer and video camera system that has demonstrated a capability to find uncommon interest points in geological imagery in real time in the field. In this second field trial, the computer vision system of the Cyborg Astrobiologist was tested at seven different tripod positions, on three different geological structures.

Summary: As the sun rises, birds, horses, rabbits, flowers, bugs, and finally children get. Summary: Describes how Chipmunk gathers and stores food to prepare for winter. Summary: The story of the gifts that children brought for a church at christmastime retells. Summary: A class learns about butterflies on a field trip to the Hallberg Butterfly Gardens.

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In this. Summary: Provides instructions for propagating and caring for plants, with more than. Summary: Cookie Monster and a clever, selfish witch are for ced into a seemingly. Summary: Simple text introduces corn, its cultivation, history, uses, and instructions for. Summary: An illustrated introduction to trees and woodlands with in for mation on how to. Includes a recipe for cucumber soup and.

Includes in for mation about the flower, a recipe, and science activities. Summary: A poetic depiction of the desert as the provider of com for t, food, spirit, and.

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Summary: Discusses the beauty and harmony of gardens and gives simple in for mation. Summary: Simple rhyming text and pictures take children through four seasons in the. Summary: When the dog he is caring for runs away from Alan into the for bidden garden. Summary: Stories and poems about children 's gardens and the world of nature. US Vice President Kamala Harris laid a wreath of white flowers in front of a Paris cafe on Saturday as France marked six years since deadly terror attacks that left people dead.

Two of the containers were confiscated on board a mainland-bound cargo. The Taliban has been waging a counter-insurgency campaign against Isis in recent months. Riot police faced protesters in The Hague as the Dutch premier announced a fresh partial lockdown. India's pollution control body warned of a looming health emergency in New Delhi as deteriorating air quality in the capital turned the sky a murky grey. Rising prices taking a bite out of American wallets caused consumer sentiment to drop to a year low in November, a sign inflation is increasingly a political liability for President Joe Biden.

A new draft text urged nations to accelerate efforts to phase-out of unfiltered coal and "inefficient" fossil fuel subsidies.