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An affordable prosthetic arm was designed to be used in underprivileged areas to allow more upper-limb amputees to have access to prosthetics that can help them regain their independence. The primary user of the prosthesis will be the amputee(s) who receive the device; beneficiaries include the amputee’s family and the community involved in the manufacturing of future prostheses. The customer requirements include cost-effectiveness, the ability to withstand humidity, cleanability, low maintenance, long life, lightweight, and the ability to perform simple tasks independently. A new end-effector was created that meets the range-of-motion required for the user to perform his/her required tasks. The end-effector is comprised of a PVC cap, PVC coupling, wooden ball holding the tool, and two wooden stop rings. The device screws onto the forearm PVC pipe and locks into place. Four end-effectors were created: toothbrush, fork, spoon, and pen. A change-out station was created to allow the user to independently attach and detach the different end-effectors. The total cost of the device was $20.66.

High-dose, continuous infusion interleukin-2 (IL-2) regimens generate greater Lymphokine Activated Killer cell (LAK) cytotoxicity in vitro and a higher rebound lymphocytosis in vivo than do bolus IL-2 regimens. Lymphocytes initially activated by continuous infusion IL-2 then subsequently pulsed with IL-2 have increased cytotoxicity against cancer cells. Famotidine may enhance the lysis of tumors by cytotoxic lymphocytes. Fourteen patients with melanoma were treated with famotidine 20 mg intravenously twice per day and continuous infusion IL-2 (18 MIU/sq m/24 hours) for 72 hours, followed by a 24-hour rest, then IL-2 18 MIU/sq m over 15-30 minutes for 1 dose (12 patients) or daily for 3 doses (2 patients). Most common toxicities were fever, nausea/emesis, hypophosphatemia, hypomagnesemia, and rigors. Nine partial responses (64% response rate; 95% Confidence Interval: 39%-84%) have been seen. Median survival has not been reached at greater than 10 months. Two patients responding to therapy showed an increase in detectable CD 56(+) cells in serial subcutaneous or lymph node biopsies, while 1 patient undergoing progression of disease had no such infiltrate. High-dose, 72-hour continuous infusion plus pulse interleukin-2 with famotidine has activity in melanoma. CD 56(+) cells may play a role in responding patients.

Introduction • Small bowel adenocarcinoma is a rare malignancy with only 6,969 cases reported annually in the US, accounting for approximately 2% of gastrointestinal tumors and less than 0.4% of all malignancies. • Immune thrombocytopenic purpura (ITP) is a common hematological disorder with an incidence of two cases per 100,000 people. While ITP has many clinical manifestations, it uncommonly is the presenting feature of a malignancy.