Óriási, a hátsó mediastinumot és a retroperitoneumot részben kitöltő schwannoma műtéti kezelése = Surgical excision of a giant schwannoma located in the posterior mediastinum and partially in the retroperitoneum

Absztrakt: A mediastinum kórképeinek jellemzője, hogy az életfontosságú képletek anatómiai koncentrációja egyszerre jelent diagnosztikus és sebésztechnikai kihívást. Az itt jelentkező térfoglaló folyamatok növekedésük során hosszú ideig tünetszegények vagy tünetmentesek lehetnek, s ezért nemegyszer extrém méretet elérve kerülnek műtétre. Az 58 éves férfi beteg 15 éve ismert, légzési panaszokat okozó, a bal hátsó mediastinumban és retroperitoneumban lévő kiterjedt térfoglaló folyamat és mellkasi folyadékgyülem miatt került klinikánkra felvételre. A mellkasi fluidum citológiai vizsgálatával malignitást nem tudtunk igazolni. CT- és MR-vizsgálatokkal nem lehetett egyértelműen eldönteni, hogy a folyamat a mediastinalis térből (Th. IX–X. csigolya területe) vagy a bal mellékveséből indult ki. Hormonális aktivitást nem észleltünk. Thoracolaparotomiából 20,2 × 11,1 × 10,8 cm átmérőjű, gerinceredetű tumort exstirpáltunk, rekeszrekonstrukciót végeztünk. A szövettani vizsgálat schwannomát igazolt. A hosszas kompresszió miatt komprimált bal tüdő a megszakított légzésrehabilitációs kezelés hatására csak részlegesen expandált. Az általában csak előrehaladott állapotban felismerésre kerülő, nagyméretű mediastinalis térfoglalásoknál, más terápiás modalitások hiányában, kizárólag műtéti megoldás eredményezhet gyógyulást. Ezek a műtétek csak multidiszciplináris összefogással, kellő jártassággal rendelkező központokban végezhetők. Orv Hetil. 2019; 160(37): 1476–1479. | Abstract: A characteristics of mediastinal disorders is that the high anatomical density of vital structures in this region represents a challenge for diagnosis and surgical treatment. Space-occupying lesions can grow without causing overt manifestations – or can progress symptom-free – hence they can reach an extreme size by the time of surgery. A 58-year-old male patient was hospitalized for pleural effusion and an extensive, space-occupying mediastinal lesion, which had been causing respiratory symptoms for 15 years. Cytology of the pleural effusion did not confirm malignancy. The CT scan depicted progression manifested as an increase in the size of the lesion with a likely site of origin in the left adrenal gland. According to the MRI, by contrast, the lesion might have originated in the region of vertebrae Th9–10, as suggested by the lack of dural continuity. However, its adrenal origin could not be excluded either; endocrine activity was not detected. An operation was performed with a neurosurgeon included in the surgical team. A spinal tumor of the size of 20.2 by 11.1 by 10.8 cm was removed through thoraco-laparotomy, and reconstruction of the diaphragm was performed. Histology confirmed a schwannoma. Postoperatively, the expansion of the lung was only partial, because the patient discontinued respiratory rehabilitation. The follow-up CT scan depicted local recurrence. In the lack of alternative therapeutic modalities, surgical resection is usually the sole option for the management of large, mediastinal space-occupying lesions diagnosed at an advanced stage. Such operations should only be performed in specialist surgical centers and with multidisciplinary collaboration. Orv Hetil. 2019; 160(37): 1476–1479

Preparation and characterization of Thioflavin T doped silica nanoparticles

Fluorescent silica nanoparticles with diameters of about 300 nm were synthesized based on Stöber´s method, using Thioflavin T as fluorescent co-reagent. The particles were characterized via transmission electron microscopy and fluorimetry measurements. Fluorescence intensity of the sols was ten times higher than that of the ethanol phase solutions of Thioflavin T. Release of dye molecules in stable alcosols was investigated by measuring UV-Vis absorbance spectrum of the supernatant. To try an alternative route, we investigated accumulation of dye molecules in native silica particles. No release effect was detected, and slow accumulation was observed. Water contact angles of the particles were assessed from analyzing the Langmuir films, and were found to be 18\r , very similar to native silica particles. Langmuir-Blodgett films of the particles were deposited on a glass substrate and were examined via UV-Vis spectrophotometry, fluorimetry and scanning electron microscopy. Presence of the film was revealed; the particles formed a continuous, well-packed monolayer

A gastrointestinalis traktusból migrált, lenyelt idegen testek esetei = Cases of migration of swallowed foreign bodies from the gastrointestinal tract

Absztrakt: A lenyelt idegen test gastrointestinalis traktusból való kilépése és migrációja az idegentest-nyelések számához képest ritka jelenség. Bemutatott két esetünkben a súlyos szeptikus állapot sürgős sebészeti beavatkozást igényelt. Az egyik esetben a máj állományába és a retroperitoneumba, a másik esetben a máj bal lebenyén keresztül a pericardiumba hatoltak a hónapokkal korábban lenyelt drótdarabok. Első esetünknél a retroperitoneumban, majd a femoralis régióban, a második esetnél a máj és pericardium területén észleltünk a feltárás során suppurativ szövődményt. Az extrakció után első esetünkben ismételt műtétre kényszerültünk a retroperitonealis phlegmonének a femoralis régióra terjedése miatt. A tályogrendszerek kiürítése után mindkét esetben gyógyulást sikerült elérnünk. Az esetek diagnosztikus problémái tanulságosak a mindennapi gyakorlat számára. Orv Hetil. 2019; 160(42): 1677–1681. | Abstract: Migration of swallowed foreign bodies from the gastrointestinal tract is a rare phenomenon compared with the total number of ingestions. In the reported two cases, the serious septic condition indicated urgent surgical intervention. We found a piece of wire swallowed a few months earlier in the right lobe of the liver and the retroperitoneum in case one, and a piece of wire in the pericardium, which migrated from the stomach through the left lobe of the liver, in case two. Abscesses and phlegmonae were found in the retroperitoneum and then in the femoral region requiring a reoperation in case one, and in the liver and pericardium in case two. After the evacuation of abscesses, both patients made full recovery. Diagnostic difficulties and therapeutic challenges served the reasons to present these cases. Orv Hetil. 2019; 160(42): 1677–1681

Seed germination and seedling survival of Drosera rotundifolia (L.) cultivated on Sphagnum: Influence of cultivation methods and conditions, seed density, Sphagnum species and vascular plant cover

Round-leaved sundew (Drosera rotundifolia L.) is a rare bog species that is commonly collected for the European herbal market in the wild, leading to the destruction of its natural populations. The aim of this study is to compare sundew cultivation methods on Sphagnum lawn that meet the requirements of the pharmaceutical industry and could promote a sustainable commercial cultivation. Seed germination and seedling survival of D. rotundifolia were studied in biodegradable cellulose pots, paper mesh bags or directly sown (cultivation methods) in a natural, a semi-natural Sphagnum farming and a greenhouse environment (cultivation conditions); using different seed densities. Drosera was cultivated on Sphagnum palustre or S. papillosum lawn and with or without co-occurring vascular plants. Best seed germination for all cultivation methods was recorded in the greenhouse, most successful were cellulose pots (≤ 26 %). Cellulose pots were also most successful under semi-natural (≤ 15 %) and natural (≤ 7 %) conditions. Lowest seed germination rates (< 1 %) were found for direct sowing under semi-natural and natural conditions, indicating that large-scale cultivation by direct sowing requires large quantities of seeds. High survival rates were observed for all cultivation methods in the second year of growth (mean 70 %). The removal of co-occurring vascular plants showed a positive correlation with the number of Drosera seedlings in the first year and led to a higher number of surviving Drosera plants in the second year. Cultivation of D. rotundifolia in biodegradable cellulose pots and direct seed sowing on Sphagnum lawns meet the cultivation requirements of the pharmaceutical industry and have many ecological benefits compared to collection in the wild

Larger Groups, Smaller Enantioselectivity? Two Anthracene-Containing, Pyridino-Crown Ether-Based Fluorescent Sensor Molecules

(R,R)- and (S,S)-enantiomers of anthracene-containing pyridino-18-crown-6 ether having tert-butyl groups at the stereogenic centers were prepared with the aim of achieving higher enantioselectivity than for the reported (S,S)-analogue having isobutyl groups. The enantiomeric recognition abilities of the new sensor molecules toward chiral protonated primary amines and amino acid esters were studied in acetonitrile by UV–vis and fluorescence spectroscopies. The pKa values of these pyridino-crown ethers and their reported (S,S)-analogues having methyl or isobutyl groups have also been determined in acetonitrile

Monetary Policy and Green Transition

One of the biggest challenges in the coming decades is the achievement and maintenance of environmental sustainability, regarding which the central banks have also shown an increasingly active and supportive attitude in recent years. A new monetary policy approach is emerging, but it is unclear how central banks can participate in the green transition. In this paper, we briefly present the most relevant issues in this regard, namely how price stability, which is the most important objective of central banks, is affected by climate change and the green economic transformation; what follows from the potential conflict between the goals of green transition and price stability in terms of the green activity of central banks; and what challenges are faced as a result by central banks that also have the sustainability goal in mind

WOˇˇ3ˇˇˇ photocatalysts: Influence of structure and composition

Hexagonal (h-) and monoclinic (m-) WO 3 nanoparticles with controlled composition (oxidized/yellow color or partially reduced/blue color) were prepared through annealing (NH 4) x WO 3- y . The formation, structure, composition, morphology, and optical properties of the samples were analyzed by powder X-ray diffraction, scanning and transmission electron microscopy combined with electron diffraction, and Raman, X-ray photoelectron, 1H magic angle spinning nuclear magnetic resonance, diffuse reflectance ultraviolet-visual, and photoluminescence spectroscopy. Their photocatalytic properties were tested by decomposing methyl orange in the aqueous phase and acetone in the gas phase. Oxidized m-WO 3 (m-WO 3 ox) was the most active photocatalyst both in the aqueous and in the gas phase, followed by the oxidized h-WO 3 (h-WO 3 ox) sample. Reduced h-WO 3 (h-WO 3 red) and m-WO 3 (m-WO 3 red) exhibited much lower activity. Thus, in contrast to TiO 2, where crystalline structure (rutile or anatase) plays a key effect in photocatalysis, for WO 3, it is the composition that is of greatest importance: the more oxidized the WO 3 sample, the better a photocatalyst it is. The crystal structure of WO 3 has only an indirect effect, in that it influences the composition of WO 3 samples. While oxidized m-WO 3 is completely oxidized, oxidized h-WO 3 is always in a partially reduced state due to the presence of stabilizing positive ions in its hexagonal channels. Consequently, an oxidized monoclinic WO 3 material will always provide better photocatalytic activity than an oxidized hexagonal one. © 2012 Elsevier Inc. All rights reserved

The supramolecular chemistry of gold and l-cysteine: Formation of photoluminescent, orange-emitting assemblies with multilayer structure

The protein mediated approach is a common method for the synthesis of photoluminescent gold quantum clusters (GQCs), where proteins, acting as reducing and stabilizing agents, react with gold salts through cysteine residues. For the better understanding of the phenomenon, the aqueous phase reaction of HAuCl_4 and L-cysteine has been investigated at the supramolecular level by various experimental techniques and molecular mechanics simulations. We have observed the formation of a novel photoluminescent product, (AuCys)_n^β, which shows emission in the orange region of the spectrum. Small- and wide-angle X-ray scattering (SWAXS) measurements have revealed the presence of nanosized lamellae, which have an internal multilayer superlattice structure with a characteristic periodic distance of 1.3 nm. Based on the results, the layers are built up by zigzag shaped (AuCys)_n polymer chains connected through aurophilic bonds. The aurophilic network is stabilized via salt bridges and hydrogen bonds, which are also responsible for the interlayer interactions. Here, the evolution of the multilayer structure has been monitored by the combined application of photoluminescence spectroscopy and time-resolved SAXS. It has been concluded that there is a strong correlation between the emission and the scattering intensity, which suggests that the two- and three-dimensional aggregation of the building blocks to form sheets and multilayers are simultaneous processes. Furthermore, we have revealed that the formation and behavior of (AuCys)_n^β show significant differences to that of Au-L-glutathione compounds desrcibed earlier despite the similarity of L-cysteine and L-glutathione. These results evidence that L-cysteine and gold species form building blocks that can be applied expansively in supramolecular and cluster chemistry

Identification of a claudin-4 and E-cadherin score to predict prognosis in breast cancer

The elevated expression of claudins (CLDN) and E-cadherin (CDH-1) was found to correlate with poor prognostic features. Our aim was to perform a comprehensive analysis to assess their potential to predict prognosis in breast cancer. The expression of CLDN-1, -3-5, -7, -8, -10, -15, -18, and E-cadherin at the mRNA level was evaluated in correlation with survival in datasets containing expression measurements of 1809 breast cancer patients. The breast cancer tissues of 197 patients were evaluated with tissue microarray technique and immunohistochemical method for CLDN-1-5, -7, and E-cadherin protein expression. An additional validation set of 387 patients was used to test the accuracy of the resulting prognostic score. Based on the bioinformatic screening of publicly-available datasets, the metagene of CLDN-3, -4, -7, and E-cadherin was shown to have the most powerful predictive power in the survival analyses. An immunohistochemical protein profile consisting of CLDN-2, -4, and E-cadherin was able to predict outcome in the most effective manner in the training set. Combining the overlapping members of the above two methods resulted in the claudin-4 and E-cadherin score (CURIO), which was able to accurately predict relapse-free survival in the validation cohort (P=0.029). The multivariate analysis, including clinicopathological variables and the CURIO, showed that the latter kept its predictive power (P=0.040). Furthermore, the CURIO was able to further refine prognosis, separating good versus poor prognosis subgroups in luminal A, luminal B, and triple-negative breast cancer intrinsic subtypes. In breast cancer, the CURIO provides additional prognostic information besides the routinely utilized diagnostic approaches and factors. © 2011 Japanese Cancer Association