Empyema necessitatis is an empyema that spreads outside of the pleural space involving the chest wall. Tuberculosis is the most common cause. It occurs in both immunocompetent and immunocompromised patients. Due to the long latency period and the paucity of symptoms, diagnosis can be challenging. Clinicians must have a high awareness of this disease, especially in patients from endemic regions. The disease is treatable with surgical and medical interventions. Failure to diagnose can lead to grave consequences for both the individual patient and public health. This is particularly true in endemic regions where controlling the spread of TB is challenging. We report a rare presentation of pulmonary tuberculosis in an otherwise healthy 72-year-old USA immigrant from Thailand. He presented with a painless, chronic chest wall swelling with minimal systemic symptoms. Imaging revealed empyema necessitatis. Histopathology could not give a definitive diagnosis because the tissue was too necrotic. Despite negative acid-fast staining, sputum cultures were positive for tuberculosis. The case presentation is followed by a brief review of the current relevant literature. This case highlights the importance of clinical suspicion and increased awareness for this silent but serious infection.

Purpose: To determine the test-retest reliability and variance of metrics obtained from pancreatic diffusion-weighted magnetic resonance imaging (DW-MRI) and T2-MRI (i.e., apparent diffusion coefficients (ADC) and T2relaxation times). Methods: A two scanning session, two observer test-retest study in healthy volunteers (N=10) at 1.5T was performed with DW-MRI and T2-mapping scans acquired. In addition to region-specific (head, neck, body and tail) ADC and T2-relaxation values, coefficients of variation (CVs) and Bland-Altman plots were calculated. Results: We observed mean ADC values (x 10-3 mm 2 /sec) of head: 1.50

Expression of the PMLRARα fusion dominant-negative oncogene in the epidermis of transgenic mice resulted in spontaneous skin tumors attributed to changes in both the PML and RAR pathways [1]. To determine the contribution of PML to skin tumor susceptibility, transgenic mice were generated on an FVB/N background, that overexpressed the human PML protein in epidermis and hair follicles under the control of the bovine keratin 5 promoter. PML was highly expressed in the epidermis and hair follicles of these mice and was also increased in cultured keratinocytes where it was confined to nuclear bodies. While an overt skin phenotype was not detected in young transgenic mice, expression of keratin 10 (K10) was increased in epidermis and hair follicles and cultured keratinocytes. As mice aged, they exhibited extensive alopecia that was accentuated on the C57BL/6J background. Following skin tumor induction with 7, 12-dimethylbenz[a]anthracene (DMBA) as initiator and 12-O-tetradecanoylphorbol-13-acetate (TPA) as promoter, papilloma multiplicity and size were decreased in the transgenic mice by 35%, and the conversion of papillomas to carcinomas was delayed. Cultured transgenic keratinocytes underwent premature senescence and upregulated transcripts for p16 and Rb but not p19 and p53. Together, these changes suggest that PML participates in regulating the growth and differentiation of keratinocytes that likely influence its activity as a suppressor for tumor development.

conditions are associated with mild increase of general inflammatory markers and a further investigation into their relationship shall be investigated.Objective: The aim of this study is to describe the prevalence and incidence of arterial hypertension (AH) recorded in a computerized outpatient information system implemented in almost all primary health centres of Comunidad Valenciana (Spain).Design and Methods: From the information recorded by the primary care (diagnosis of hypertension -ICD 401 to 405 -) and the population assigned to each center is estimated prevalence (total cases diagnosed) and the annual incidence (new cases diagnosed during the year) for the years 2007, 2008 and 2009.We have taken into account for analysis three age groups (under 15 years, between 15 and 64 and over 64) also have analyzed the data by sex.We calculated the confidence interval (95%) to assess whether the differences were statistically significant.