Xeroderma pigmentosum is a rare genodermatosis inherited as an autosomal recessive trait and caused by one of several defects in the excision repair mechanism of DNA. As a result numerous cutaneous malignancies develop at a very early age 1000 to 2000 times more than which is expected for normal individuals. It starts with markedly increased tendency to skin burns in first few years of life. Skin changes such as atrophy, depigmentation soon follows. Since repair mechanism is impaired in DNA, UV rays from sunlight causes damage and makes them prone to get actinic keratosis which progresses into a carcinoma. This presentation is about a girl of very young age suffering from xeroderma pigmentosa with squamous cell carcinoma of lower lip.
Rare inherited skin disorder due to defective repair of DNA
characterized by; photosensitivity, pigmentary changes, premature skin aging, early malignant tumor development
Rare genetic disorder that occurs worldwide in all races and ethnic groups.
First described by Hebra and Kaposi in 1874.
Photosensitivity and premature onset of all major types of skin cancer .
Inability of a cell to repair damage caused by UV leading to genetic instability and skin cancer.
Responsible for removing the damaged segments of DNA and restoring the original sequence of DNA.
The NER mechanism is composed of two types:
Transcription coupled(TCR): Which rapidly repairs areas of DNA that are "active" and being transcribed into RNA
Global genome(GGR): Which repairs damage in the rest of the genome more slowly
Seven XP genes are central to NER which includes many other accessory proteins
The term “complementation group” is based on cell fusion experiments.
Cells from different XP patients are fused to investigate if the DNA repair defect in the fused cells is corrected.
If DNA repair in the fused cell is increased, each cell provides proteins that the other is lacking and the cells “complement” each other and are in different complementation groups.
If DNA repair in the fused cells is not normalized, the cells do not “complement” each other, meaning that both cells harbor mutations in the same DNA repair gene.
Seven such complementation groups have been identified (XP-A to XP-G), which correspond with mutations in seven distinct genes that can cause XP.
Severity changes is dependent on the amount of sun exposure and the degree of UVR protection
Acute and severe sunburn on minimal sun exposure takes weeks to resolve.
50% of XP patients suffer from severe and prolonged sunburn reactions.
Rest 50% have sunburn reactions that are normal and present with lentigines as well as hypopigmented macules.
Development of many freckles at an early age.
• Rough-surfaced growths (solar keratoses), and skin cancers
• Blistering or freckling on minimum sun exposure
• Telangiectasia (spider veins)
• Limited growth of hair on chest and legs
•
Rare inherited skin disorder due to defective repair of DNA
characterized by; photosensitivity, pigmentary changes, premature skin aging, early malignant tumor development
Rare genetic disorder that occurs worldwide in all races and ethnic groups.
First described by Hebra and Kaposi in 1874.
Photosensitivity and premature onset of all major types of skin cancer .
Inability of a cell to repair damage caused by UV leading to genetic instability and skin cancer.
Responsible for removing the damaged segments of DNA and restoring the original sequence of DNA.
The NER mechanism is composed of two types:
Transcription coupled(TCR): Which rapidly repairs areas of DNA that are "active" and being transcribed into RNA
Global genome(GGR): Which repairs damage in the rest of the genome more slowly
Seven XP genes are central to NER which includes many other accessory proteins
The term “complementation group” is based on cell fusion experiments.
Cells from different XP patients are fused to investigate if the DNA repair defect in the fused cells is corrected.
If DNA repair in the fused cell is increased, each cell provides proteins that the other is lacking and the cells “complement” each other and are in different complementation groups.
If DNA repair in the fused cells is not normalized, the cells do not “complement” each other, meaning that both cells harbor mutations in the same DNA repair gene.
Seven such complementation groups have been identified (XP-A to XP-G), which correspond with mutations in seven distinct genes that can cause XP.
Severity changes is dependent on the amount of sun exposure and the degree of UVR protection
Acute and severe sunburn on minimal sun exposure takes weeks to resolve.
50% of XP patients suffer from severe and prolonged sunburn reactions.
Rest 50% have sunburn reactions that are normal and present with lentigines as well as hypopigmented macules.
Development of many freckles at an early age.
• Rough-surfaced growths (solar keratoses), and skin cancers
• Blistering or freckling on minimum sun exposure
• Telangiectasia (spider veins)
• Limited growth of hair on chest and legs
•
A mitochondrion (singular of mitochondria) is part of every cell in the body that contains genetic material.
Mitochondria are responsible for processing oxygen and converting substances from the foods we eat into energy for essential cell functions.
The mitochondria of the zygote come from the oocyte, that is, from the mother and almost never from the sperm, form of transmission is called maternal inheritance
Which mitochondrial gene is mutated.
The extent of replicative segregation of the mutant mitochondrial genome during the early stages of embryonic development.
The abundance of the mutant mitochondrial gene in a particular tissue.
The threshold level of mutant mitochondrial DNA required in a tissue before an abnormality is evident clinically
Mitochondrial disease affects tissues most highly dependent on ATP production
*Nerves
*Muscles
Endocrine
Kidney
Low energy-requiring tissues are rarely directly affected, but may be secondarily
Lung
Connective tissue
Symptoms can be intermittent
Increased energy demand (illness, exercise)
Decreased energy supply (fasting)
Common feature
myoclonus epilepsy, deafness, blindness, anemia, diabetes, seizures and loss of cerebral blood supply (stroke).
Myoclonic epilepsy and ragged-red fiber disease (MERRF)
MERRF is a member of a group of disorders called mitochondrial encephalomyopathies that feature mitochondrial defects with altered brain and muscle functions.
The term “ragged red fibers” refers to large clumps of abnormal mitochondria that accumulate mostly in muscle cells and are stained red by a dye that is specific for complex II of the electron transport chain.
rare, maternally inherited, heteroplasmic, (point mutation in tRNA lysine gene)
Mutation is MTTK*MERRF8344G.
MT means mitochondrial gene is mutated
T means transfer RNA gene
K means the single-letter amino acid designation for lysine
MERRF means the clinical features
8344G means the mutant nucleotide is guanine (G) at nucleotide position 8344
If 90% of the mitochondria in nerve and muscle cells carry the MTTK*MERRF8344G mutation, then the defining symptoms of MERRF are present.
Maternally inherited mitochondrial disease
The MTTL1*MELAS3243G mutation accounts for more than 80% of the cases of MELAS.
This base substitution is in one of the two mitochondrial transfer RNALeu genes.
the A3243G mutation occurs in thetRNALeu(UUR) gene
When this mutation is present in ≥90% of the mitochondrial DNA of muscle tissue, there is an increased likelihood of recurrent strokes, dementia, epilepsy, and ataxia.
When heteroplasmy for the A3243G mutation
is ~40% to 50%, chronic progressive external ophthalmoplegia (CPEO), myopathy, and deafness are likely to occur.
Other MELAS mutations occur at sites 3252, 3271, and 3291 within the tRNALeu(UUR) gene and in the mitochondrial tRNAVal (MTTV) and COX III (MTCO3) genes.
Reduced activities in Complexes I and IV are established
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Abstract:
Xeroderma pigmentosum with squamous cell carcinoma of skin has been
infreqently reported .Is a rare autosomal recessive disease characterized by defective
DNA repair. . A seven year old boy having xeroderma pigmentosa presented with
extensive ulceration of the face . On investigation, the ulceration was found to be
squamous cell carcinoma. The details of the case are presented and its pathological
findings are discussed
A mitochondrion (singular of mitochondria) is part of every cell in the body that contains genetic material.
Mitochondria are responsible for processing oxygen and converting substances from the foods we eat into energy for essential cell functions.
The mitochondria of the zygote come from the oocyte, that is, from the mother and almost never from the sperm, form of transmission is called maternal inheritance
Which mitochondrial gene is mutated.
The extent of replicative segregation of the mutant mitochondrial genome during the early stages of embryonic development.
The abundance of the mutant mitochondrial gene in a particular tissue.
The threshold level of mutant mitochondrial DNA required in a tissue before an abnormality is evident clinically
Mitochondrial disease affects tissues most highly dependent on ATP production
*Nerves
*Muscles
Endocrine
Kidney
Low energy-requiring tissues are rarely directly affected, but may be secondarily
Lung
Connective tissue
Symptoms can be intermittent
Increased energy demand (illness, exercise)
Decreased energy supply (fasting)
Common feature
myoclonus epilepsy, deafness, blindness, anemia, diabetes, seizures and loss of cerebral blood supply (stroke).
Myoclonic epilepsy and ragged-red fiber disease (MERRF)
MERRF is a member of a group of disorders called mitochondrial encephalomyopathies that feature mitochondrial defects with altered brain and muscle functions.
The term “ragged red fibers” refers to large clumps of abnormal mitochondria that accumulate mostly in muscle cells and are stained red by a dye that is specific for complex II of the electron transport chain.
rare, maternally inherited, heteroplasmic, (point mutation in tRNA lysine gene)
Mutation is MTTK*MERRF8344G.
MT means mitochondrial gene is mutated
T means transfer RNA gene
K means the single-letter amino acid designation for lysine
MERRF means the clinical features
8344G means the mutant nucleotide is guanine (G) at nucleotide position 8344
If 90% of the mitochondria in nerve and muscle cells carry the MTTK*MERRF8344G mutation, then the defining symptoms of MERRF are present.
Maternally inherited mitochondrial disease
The MTTL1*MELAS3243G mutation accounts for more than 80% of the cases of MELAS.
This base substitution is in one of the two mitochondrial transfer RNALeu genes.
the A3243G mutation occurs in thetRNALeu(UUR) gene
When this mutation is present in ≥90% of the mitochondrial DNA of muscle tissue, there is an increased likelihood of recurrent strokes, dementia, epilepsy, and ataxia.
When heteroplasmy for the A3243G mutation
is ~40% to 50%, chronic progressive external ophthalmoplegia (CPEO), myopathy, and deafness are likely to occur.
Other MELAS mutations occur at sites 3252, 3271, and 3291 within the tRNALeu(UUR) gene and in the mitochondrial tRNAVal (MTTV) and COX III (MTCO3) genes.
Reduced activities in Complexes I and IV are established
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Abstract:
Xeroderma pigmentosum with squamous cell carcinoma of skin has been
infreqently reported .Is a rare autosomal recessive disease characterized by defective
DNA repair. . A seven year old boy having xeroderma pigmentosa presented with
extensive ulceration of the face . On investigation, the ulceration was found to be
squamous cell carcinoma. The details of the case are presented and its pathological
findings are discussed
Skin cancer exposed - Background informationXplore Health
This guide provides background information on melanoma, the most serious type of skin cancer. Explore all aspects of melanoma from the causes to treatment. Investigate the latest research, and uncover the ethical, legal and social issues surrounding this disease.
Right Sided Optic Meningioma in a Young Girl _Crimson PublishersCrimsonpublishersMSOR
ONSMs are rare tumors of anterior visual pathway [1]. ONSMs arise from meningoepithelial cap cells of the arachnoids villi and can develop at any location along the entire course of the optic nerve sheath [2,3]. We received a case of right sided optic tumor completely involving the eyeball requiring exentration surgery and were sent to our department for analysis. On cut opening a firm whicte tumor surface was seen and on microscopy a diagnosis og meningothelial meningioma was made. The diagnosis was confirmed by EMA positivity.
Presentation by Scott Oliver, MD. Presented at the 2018 Eyes on a Cure: Patient & Caregiver Symposium, hosted by the Melanoma Research Foundation's CURE OM initiative.
Merkel Cell Carcinoma: From Diagnosis to Treatment (webinar)Natalie Richardson
Merkel Cell Carcinoma: From Diagnosis to Treatment ~ view the webinar recording on our youTube channel: https://youtu.be/vIcrzSTabKw
Hear Dr. Marco Iafolla, Medical Oncologist at William Osler Health System, review the latest news, clinical data and other updates as they relate to the treatment of merkel cell carcinoma (MCC). Dr. Iafolla provides an update on the science behind primary and metastatic MCC diagnosis, an overview of the disease features, staging and prognostication, surgery and treatment options including immuno-oncology for MCC, and the impact of all of this to patients. (Rec. Nov. 27, 2019)
Early Detection of Melanoma and Other Skin CancersSummit Health
This lecture provides an overview of skin cancer including risks, early detection, and treatment. Learn to identify the early signs of skin cancer. Melanoma and non-melanoma skin tumors will be discussed and prevention of skin cancer will be emphasized.
Similar to Children of the dark- XERODERMA PIGMENTOSUM (20)
Oral diseases, especially periodontitis has been proposed as having an etiological role in cardiovascular and cerebrovascular disease, diabetes, respiratory disease and adverse pregnancy outcome.
Oral lesions are indicators of disease progression and oral cavity can be a window to systemic disease. Hence good oral health is important to your overall well-being.
Oral lesions are indicators of disease progression and oral cavity can be a window to systemic disease. Hence good oral health is important to your overall well-being.
Maxillofacial trauma is a major cause of mortality and morbidity worldwide. It is a frequent occurrence in Pakistan and is associated with high incidence of facial fractures in different combinations. Mandibular fractures are one of the most common facial fractures.1-6 Some of the most severe injuries are caused by automobile accidents but many others result from interpersonal violence, industrial accidents, sports, home accidents and missiles or gun shots.7 Road traffic accidents (RTA) have been reported as a leading cause of mandible fractures in many third world countries while interpersonal altercations are mainly responsible in the developed countries.8-10 The differences reflect a lack of traffic regulations including seat belt and helmet enforcements, absence of air bags in the vehicles and poor road infrastructure in the underdeveloped and alcohol abuse in the developed countries.11-13 Countries where the use of seat belt and safety helmet regulations have been made compulsory showed a decrease trend of mandibular fractures associated with RTA as compared to the past.14,15 Mandible fractures overwhelmingly occur in young males.3,16-18
Although there is a universal agreement as to the treatment goals and basic therapeutic principles of reduction and stabilization, a variety of currently accepted treatment modalities indicate a lack of consensus.
Awareness regarding the systemic effects- PERIO SYSTEMIC RELATIONSHIPNagarajan Srini
For decades, physicians and dentists have paid close attention to their own respective fields, specializing in medicine pertaining to the body and the oral cavity, respectively. However, recent findings have strongly suggested that oral health may be indicative of systemic health. Currently, this gap between allopathic medicine and dental medicine is quickly closing, due to significant findings supporting the association between periodontal disease and systemic conditions such as cardiovascular disease, type 2 diabetes mellitus, adverse pregnancy outcomes, and osteoporosis. Significant effort has brought numerous advances in revealing the etiological and pathological links between this chronic inflammatory dental disease and these other conditions. Therefore, there is reason to hope that the strong evidence from these studies may guide researchers towards greatly improved treatment of periodontal infection that would also ameliorate these systemic illnesses. Hence, researchers must continue not only to uncover more information about the correlations between periodontal and systemic diseases but also to focus on positive associations that may result from treating periodontal disease as a means of ameliorating systemic diseases.
Oral cancer is one of the deadliest diseases affecting the human population, being one among the top ten causes of death occurring worldwide. Its high morbidity and mortality rate has not changed for the past 30 years, even after revolutions that are happening in its diagnosis and management. This alarming stage is a sequelae of its late diagnosis, with 80% of cases being diagnosed at late stages. A good number of screening techniques have been time tested for the predictive value in diagnosing oral cancer in an early premalignant stage. Although surgical biopsy is a gold standard for diagnosing, it needs professional services. Hence screening methods which are noninvasive and highly sensitive are accepted as an alternative of histopathology. Vital staining and vizilite are widely accepted methods among all the screening techniques and are widely used in a clinical setup.
Transoral robotic surgery(TORS)has emerged as a technique thatallows head and neck surgeons to safely resect large and complex oropharyngeal tumors without dividing the mandible or performing a lip-split incision. These resections provide a reconstructive challenge because the cylinder of the oropharynx remains closed and both physical access and visualization of oropharyngeal anatomy is severely restricted. Transoral robotic reconstruction (TORRS) of such defects allows the reconstructive surgeon to inset freeflaps or perform adjacent tissue transfer while seeing what the resecting surgeon sees. Early experience with this technique has proved feasible and effective. Robotic reconstruction has many distinct advantages over conventional surgery,and offers patients a less morbid surgical course. Robotic-assisted head and neck cancer surgery is an alternative approach for the management of oropharyngeal tumors, but necessitates the development of appropriate reconstructive methods. TORR represents a bourgeoning robotic transoral reconstructive technique and may eventually be a critical part of any robust TORS program rational approach to the use of the robot in transoral reconstruction will help guide the development of this field.
As the emphasis shifts from damage mitigation to reversal of early disease in the oral cavity, the need for sensitive detection and diagnostic tools become more important. Optical diagnostics have higher value of sensitivity proving its promising role as a screening aid. Newer techniques are being introduced to improve the specificity of optical diagnosis. Light-based imaging of the tissues detects minimal changes such as (i) cell microanatomy, e.g. nuclear/cytoplasmic ratio, (ii) expression of specific biomarkers. These properties are ideal for the detection of early changes, for assessing the margins of lesions and, for repeated non-invasive monitoring of existing lesions. In the presentation, the principles behind optical diagnostic approaches, and their potential usefulness as a tool in the diagnosis of oral lesions, and other pathologies will be reviewed.
Nitric oxide was known as a toxic gas, as an air pollutant, as an agent causing ozone holes and acid rain till 1987 but this Nitric oxide (NO), a free radical, possesses various modulatory effects on biological systems. NO is synthesized from arginine by the action of nitric oxide synthase (NOS) enzymes.
ROLE IN CARDIOVASCULAR SYSTEM
ROLE IN IMMUNE SYSTEM
ROLE IN NERVOUS SYSTEM
ROLE IN REPRODUCTIVE SYSTEM
ROLE IN RESPIRATORY SYSTEM
ROLE IN RENAL SYSTEM
ROLE IN ENDOCRINE SYSTEM
ROLE IN WOUND HEALING
ROLE IN HAIR GROWTH
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
10. Type A, I, XPA Type E, V, XPE
Type F, VI, XPFType B, II, XPB
Type G, VII, XPGType C, III, XPC
Dominant Type,
XPV
Type D, IV, XPD
TYPES OF XP & MUTATED GENE
11.
12. CLINICAL FEATURES
Scaly skin
Blood shotsFreckles
SKIN
Sunburn when exposed to
sunlight
Freckles on face and
extremities
Scaly skin
Blisters
EYES
Blood shots
Corneal keratitis
Blepharitis
Lid tumors
CNS
Neurological
deficit
15. Un married female
Aged 40
Chief complaint: growth on lower
lip for the past 8 months
HOPI:
The growth was smaller in size
initially and gradually increased to
the current size.
The patient gave a history of pain in
that ulcer for the past 2 week
PAST MEDICAL HISTORY:
Patient had multiple pigmented
lesions which was noticed right
from her birth
The patient did not suffer from any
neurodegenerative conditions
FAMILY HISTORY:
She was born with three siblings
who were all girls and were
apparently healthy.
16. EXTRA ORAL EXAMINATION
Palpable right and left submandibular
lymph nodes which were firm in consistency
and non tender.
Face and extremities showed freckling.
Right eye revealed corneal clouding.
17. EXAMINATION OF ULCER:
Inspection
Located at left side of lower lip
Dimension 3×2 cm
Was 1 cm away from midline
Palpation
Swelling was tender
Firm in consistency
And base was indurated
18. FINAL DIAGNOSIS:
Xeroderma pigmentosum
Squamous cell carcinoma of
lower lip.
INVESTIGATION
Edge wedge biopsy was taken
and presence of cancerous
epithelial cells were noticed in
microscope.
20. DIAGNOSIS
NONSPECIFIC Usually detected in early infancy
Clue to diagnosis-severe sunburn after first
exposure to sunlight
Based on clinical features
SPECIFIC
Measuring DNA repair factor from skin and blood
samples
21. DIAGNOSIS BEFORE CHILD BIRTH
AMNIOCENTESIS
CHORIONIC VILLOUS SAMPLING
CULTURE OF AMNIOTIC CELLS
24. PROGNOSIS
Many die at an early age (within 20 yrs.) due to cancer
Some with less severe cases survive up to their 40s
If diagnosed early
Protective measures
followed
Less severe neurological
symptoms
Can survive beyond middle age
25. CONCLUSION
Psychological support from family and protection against
disease progression is the only way to make them live longer.
They are meant to face the unavoidable struggles in life.
26. REFERENCES
1. Biology of xeroderma- JAMES E. CLEAVER
2. Xeroderma a multidisciplinary approach- MIERAN
SETHI, ALAN R. LEHMAN, HIVA FASSIHI
3. Cancer in xeroderma pigmentosum and related
disorders of DNA repair- JAMES E. CLEAVER
4. Patient information publication - NATIONAL
INSTITUITE OF HEALTH
5. Xeroderma pigmentosum pathophysiology- DR. IRIS
ARONSON
6. Xeroderma pigmentosum- MIRIA STEFFANINI,
DAVID MCGIBBON
7. Xeroderma pigmentosum- WIKIPEDIA
