Synchronous lesion

All CIS ultimately progress to micro-invasive ESSCC [79]. Unforeseen occult synchronous lesions in the central airways have been found in 10% of individuals [80]. 

Signs and Symptoms Clinical manifestations begin acutely with malaise, fever, rigors, vomiting, headache, and backache. Two to three days later lesions appear which quickly progress from macules (a small, discolored patch or spot on the skin, neither elevated above nor depressed below the skin s surface) to papules (a small, circumscribed, solid elevation on the skin), and eventually to pustular vesicles. They are more abundant on the extremities and face, and develop synchronously. 

Within the first 2 to 3 days of exposure a person will experience symptoms such as malaise, fever, headache, chills, and backache. The fever can last 1 to 5 days. Usually after the fever is gone, a skin eruption or rash appears. It begins as a pimple lesion for 1 to 4 days, becomes blister-like for 1 to 4 days, and then fills with pus for 2 to 6 days. It then forms a crust that falls off 2 to 4 weeks after the first skin lesion appears, leaving pink scars. An important characteristic is that all smallpox lesions in any affected area are generally found in the same state. In contrast, chickenpox lesions are not synchronous they form in crops. Smallpox lesions are also said to be more numerous on the face and extremities rather than the trunk, unlike chickenpox. The case fatality rate in unvaccinated patients is 15 to 40%. In vaccinated people, the fatality rate is <1%. Patients with smallpox are infectious as soon as a rash is evident and remain infectious until their scabs fall off— a duration of about 3 weeks.3... 

Van Gelder Presumably feeding patterns are also rhythmic in the SCN lesioned animals that are masked, yet they don t seem to synchronize peripheral gene expression. 

The contention that the thalamocortical system is essential to the synchronous activation of the forebrain and hence to consciousness is supported by the loss of consciousness in subjects with disease destruction of the thalamus and by the capacity to restore consciousness by activating the thalamocortical system if that system (and of course, the cortex) is intact. The case of Karen Ann Quinlan is well known her profound coma was caused by a very small, restricted thalamic lesion and was irreversible because the thalamocortical system could not be activated by any known means. 

Sugiyama M, Patierno SR, Cantoni O, et al. 1986. Characterization of DNA lesions induced by CaCr04 in synchronous and asynchronous cultured mammalian cells. Mol Pharmacol 29 606-613. 

Rash. Whereas fever is characteristic in many different infectious and noninfectious processes, the concomitant occurrence of a rash should provoke further clinical evaluation. In particular, clinicians should he familiar with the characteristic rash produced hy smallpox and the features that distinguish it from the rash produced by varicella (Henderson et al., 1999). The initial vesicular lesions of smallpox progress to large, firm pustules. The lesions are synchronous, that is, at the same stage of development, and centrifugal, that is, more numerous on the face and extremities than on the trunk. This pattern of lesions is a key feature for clinical recognition of smallpox (Henderson et al., 1999). 

The characteristic rash of smallpox is described as synchronous and centrifugal. What does that mean with regard to the pattern of lesions on an affected individual ... 

Physical examination may be normal or show a blue or red mass behind the tympanic membrane. There is no significant lateralization to either ear. Bilateral lesions, either synchronous or asynchronous, have been described but are exceptional and should always arouse suspicion of Von-Hippel-Lindau disease (VHLD). Preliminary data indicate that at least 15% of all ELSTs are associated with VHLD and that the ELST is just another expanding list of lesions associated with this syndrome. ... 

Fig. 27-1. This series of photographs illustrates the evolution of skin lesions in an unvaccinated infant with the classic form of variola major, (a) The third day of rash shows synchronous eruption of skin lesions some are becoming vesiculated. (b) On the fifth day of rash, almost all papules are vesicular or pustular, (c) On the seventh day of rash, many lesions are umbilicated, and all lesions are in the same general stage of development. Photographs Reprinted with permission from Fenner F, Henderson DA, Arita I, Jezek Z, Ladnyi ID. Smallpox and Its Eradication. Geneva, Switzerland World Health Organization 1988 10-14. Photographs by I. Arita.

Although contemporary anti-cancer drugs are only moderately selective, their selectivity is increased in the clinic by enforcing a selective distribution, or by synchronizing them with the cell cycle (Section 5.1). At no time has interest in the chemotherapy of cancer stood higher than today, and this enthusiasm reflects current achievements (see Section 1.1, p. 15). This use of drugs enables the physician to function beyond what surgery and radiation can accomplish. Patients with widespread metastatic cancers can have these lesions reached and cured by chemotherapy even in situations where their presence is unsuspected and undetectable. 

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