Sandbox:Sahar

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acetyl-CoA + acetoacetyl-CoA
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
3-hydroxy-3-methylglutaryl-CoA
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Mevalonic acid
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Absent enzyme
 
 
 
Mevalonate kinase deficiency
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
5-phosphomevalonate
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Multiple enzymaic pathway
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Cholesterol
 
 

Familial Mediterranean Fever Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
system-based symptoms of FMF
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Gastrointestinal system
 
 
 
Reticuloendothelial system
 
 
 
Musculoskeletal system
 
 
 
Axial spine
 
 
 
Cardiovascular system
 
 
 
Pulmonary findings
 
 
 
Dermal findings
 
 
 
Other findings
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
1.Abdominal pain
2.Nause and voimiting
3.Diarrhea or constipation
 
 
 
Lymphadenopathy and early satiety due to splenomegaly
 
 
 
 
 
 
 
 
 
 
 
 
1.chest pain
2.
 
 
 
1.Urticarial rash
2.Diffuse erythema
3.angioneurotic edema
 
 
 
Scrotal pain
 
 
Finding
Growth limited to one or both ovaries,
Growth limited to one ovary; no ascites present containing malignant cells. No tumor on the external surface; capsule intact
Growth limited to one or both ovaries; no ascites present containing malignant cells. No tumor on the external surfaces; capsules intact
Tumor either stage Ia or Ib, but with the tumor on surface of one or both ovaries, or with capsule ruptured, or with ascites present containing malignant cells, or with positive peritoneal washings
Growth involving one or both ovaries with pelvic extension
Extension and/or metastases to the uterus and/or tubes
Extension to other pelvic tissues
Tumor either stage IIa or IIb, but with the tumor on surface of one or both ovaries, or with capsule(s) ruptured, or with ascites present containing malignant cells, or with positive peritoneal washings
Tumor involving one or both ovaries with histologically confirmed peritoneal implants outside the pelvis and/or positive regional lymph nodes. Superficial liver metastases equal stage III. The tumor is limited to the true pelvis, but with histologically proven malignant extension to small bowel or omentum
Tumor grossly limited to the true pelvis with histologically confirmed microscopic seeding of abdominal peritoneal surfaces, or histologic proven extension to small bowel or mesentery with or without positive retroperitoneal lymph nodes
Tumor of one or both ovaries with histologically confirmed implants, peritoneal metastasis of abdominal peritoneal surfaces, none exceeding 2 cm in diameter with or without extension metastasis to the retroperitoneal lymph nodes
Peritoneal metastasis beyond the pelvis >2 cm in diameter with or without metastasis to the retroperitoneal lymph nodes (includes the extension of tumor to the capsule of liver and spleen without parenchymal involvement of either organ)
Growth involving one or both ovaries with distant metastases. If pleural effusion is present, there must be positive cytology to allow a case to stage IV. Parenchymal liver metastasis equals stage IV.
Regional lymph node involvement
No lymph node involvement
Tumor cells are present in regional lymph node(s), no greater than 0.2 mm
Histologically confirmed retroperitoneal lymph nodes
Metastasis <and= 10 mm in greatest dimension
Metastasis more than 10 mm in greatest dimension
Distant metastasis
No distant metastasis
Distant metastasis, including positive cytology of pleural effusion; liver or splenic parenchymal metastasis; metastasis to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside the abdominal cavity); and transmural involvement of intestine
Pleural effusion with positive cytology
Liver or splenic parenchymal metastases; metastases to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside the abdominal cavity); transmural involvement of intestine