Surgical approach to medullary thyroid carcinoma associated with multiple endocrine neoplasia type 2

We briefly review the surgical approaches to medullary thyroid carcinoma associated with multiple endocrine neoplasia type 2 (medullary thyroid carcinoma/multiple endocrine neoplasia type 2). The recommended surgical approaches are usually based on the age of the affected carrier/patient, tumor staging and the specific rearranged during transfection codon mutation. We have focused mainly on young children with no apparent disease who are carrying a germline rearranged during transfection mutation. Successful management of medullary thyroid carcinoma in these cases depends on early diagnosis and treatment. Total thyroidectomy should be performed before 6 months of age in infants carrying the rearranged during transfection 918 codon mutation, by the age of 3 years in rearranged during transfection 634 mutation carriers, at 5 years of age in carriers with level 3 risk rearranged during transfection mutations, and by the age of 10 years in level 4 risk rearranged during transfection mutations. Patients with thyroid tumor >5 mm detected by ultrasound, and basal calcitonin levels >40 pg/ml, frequently have cervical and upper mediastinal lymph node metastasis. In the latter patients, total thyroidectomy should be complemented by extensive lymph node dissection. Also, we briefly review our data from a large familial medullary thyroid carcinoma genealogy harboring a germline rearranged during transfection Cys620Arg mutation. All 14 screened carriers of the rearranged during transfection Cys620Arg mutation who underwent total thyroidectomy before the age of 12 years presented persistently undetectable serum levels of calcitonin (<2 pg/ml) during the follow-up period of 2–6 years. Although it is recommended that preventive total thyroidectomy in rearranged during transfection codon 620 mutation carriers is performed before the age of 5 years, in this particular family the surgical intervention performed before the age of 12 years led to an apparent biochemical cure

Multiferroic (Nd,Fe)-doped PbTiO3 ceramics with coexistent ferroelectricity and magnetism at room temperature

We report the structural, dielectric, elastic, ferroelectric and ferromagnetic properties of multiferroic (Nd, Fe)-doped PbTiO3 perovskite ceramics with composition (Pb 0.88 Nd 0.08 )(Ti 0.94 Fe 0.04 Mn 0.02 )O 3 , prepared by different solid state reaction methods: the first one based on a single-stage calcination (Method I) and the second based on a double-stage calcination (Method II). Structural, dielectric and anelastic measurements evidenced a double phase transition for samples prepared by Method I, which has been attributed to phase separation. This phase separation has been confirmed also by TEM and HRTEM investigations. Samples prepared by Method II showed a single phase transition from paraelectric to ferroelectric phase. We found coexistent ferroelectric and ferromagnetic properties, also at room-temperature, but only for ceramics prepared by Method II. The crucial role of calcination process for avoiding phase separation and obtaining homogeneous structures with ferroelectric and ferromagnetic order is underlined

Invasión ósea del carcinoma de células escamosas de la cavidad oral, análisis clínico-patológico de 62 casos

Prognosis for patients with squamous cell carcinoma (SCC) in oral cavity with bone invasion presence is concerning. Bone invasion patterns can be used to indicate aggressiveness and can be correlated with tumor clinical behavior. Objective: To evaluate bone invasion histopathological patterns in patients with oral cavity SCC and correlate them with the survival rate. Materials and methods: 62 patients with presence of SCC in the oral cavity as well as bone invasion were recruited for this study. Epidemiological and histopathological characteristics were tabulated and analyzed. Fischer's Square and Exact Tests were used to verify any statistical associations between the data. Results: More men were affected, especially in the fifth decade of life, and a strong association with smoking and chronic alcoholism was observed. Deaths were reported in 58% of patients, over a period of 5 years. The most prevalent histological pattern was the infiltrative, associated with lower survival rates. Conclusion: An analysis of the histopathological patterns of oral cavity SCC can be used as a prognostic factor thereby assisting with the decision of which oncological treatment approach to use.El pronóstico de pacientes con carcinoma de células escamosas (CEC) de la cavidad oral con presencia de invasión ósea continua sombrío. El patrón de invasión ósea puede ser usado como indicador de agresividad y correlacionado con el comportamiento clínico del tumor. Objetivo: Evaluar los patrones histopatológicos de invasión ósea en pacientes con CEC de la cavidad oral y correlacionarlos con la tasa de sobrevida. Material y métodos: La muestra fue constituida por 62 pacientes con presencia de CEC en la cavidad oral e invasión ósea. Las características epidemiológicas e histopatológicas fueron tabuladas y analizadas. Los Test Chi- cuadrado y exacto de Fischer fueron empleados para verificar las asociaciones estadísticas entre los datos. Resultados: Fueron afectados más hombres en la quinta década de vida y observada una fuerte asociación con tabaquismo y etilismo crónico. Fueron relatadas muertes en 58% de los pacientes, en un periodo de 5 años. El patrón histológico más prevalente fue el infiltrativo, asociado a menores tasas de sobrevida. Conclusión: El análisis del patrón histopatológico de los CEC de la cavidad oral, puede ser usado como factor pronóstico auxiliando en la decisión del abordaje del tratamiento oncológico. &nbsp; &nbsp