A novel combination of multiple primary carcinomas: Urinary bladder transitional cell carcinoma, prostate adenocarcinoma and small cell lung carcinoma- report of a case and review of the literature

BACKGROUND: The incidence of multiple primary malignant neoplasms increases with age and they are encountered more frequently nowadays than before, the phenomenon is still considered to be rare. CASE PRESENTATION: We report a case of a man in whom urinary bladder transitional cell carcinoma, metachronous prostate adenocarcinoma and small cell lung carcinoma were diagnosed within an eighteen-month period. The only known predisposing factor was that he was heavy smoker (90–100 packets per year). The literature on the phenomenon of multiple primary malignancies in a single patient is reviewed and the data is summarized. CONCLUSION: It is important for the clinicians to keep in mind the possibility of a metachronous (successive) or a synchronous (simultaneous) malignancy in a cancer patient. It is worthy mentioning this case because clustering of three primary malignancies (synchronous and metachronous) is of rare occurrence in a single patient, and, to our knowledge, this is the first report this combination of three carcinomas appearing in the same patient

A unified and automated approach to attractor reconstruction

We present a fully automated method for the optimal state space reconstruction from univariate and multivariate time series. The proposed methodology generalizes the time delay embedding procedure by unifying two promising ideas in a symbiotic fashion. Using non-uniform delays allows the successful reconstruction of systems inheriting different time scales. In contrast to the established methods, the minimization of an appropriate cost function determines the embedding dimension without using a threshold parameter. Moreover, the method is capable of detecting stochastic time series and, thus, can handle noise contaminated input without adjusting parameters. The superiority of the proposed method is shown on some paradigmatic models and experimental data from chaotic chemical oscillators

Prospective comparison of low-fluence photodynamic therapy combined with intravitreal bevacizumab versus bevacizumab monotherapy for choroidal neovascularization in age-related macular degeneration

Purpose: To evaluate combination treatment with reduced-fluence photodynamic therapy (RDPDT) with Verteporfin and intravitreal bevacizumab, compared to bevacizumab alone, for choroidal neovascularization (CNV) in age-related macular degeneration. Methods: This was a prospective, randomized comparative study comprising 95 patients with CNV. 49 patients received RDPDT (25J/cm2) followed by intravitreal bevacizumab 1.25mg one hour later, while 46 received intravitreal bevacizumab alone. Patients were followed for 12 months at four-week intervals with visual acuity (VA) assessment and Optical Coherence Tomography (OCT) of the macula. Bevacizumab re-injections were performed as needed. Results: On average, patients were re-injected 4.45 times in the combination group and 6.96 times in the bavacizumab group (p<0.001). At 12 months, VA improved by 8.64 letters in the bevacizumab group and by 8.37 letters in the combination group (p=0.922). Conclusion: Adding a reduced-fluence PDT arm in combination with bevacizumab offers similar results to those of intravitreal bevacizumab alone with significantly reduced number of injection repetitions. © 2015 Informa Healthcare

Argumentation and Public Deliberation on the Internet

89 σ.Σκοπός της παρούσας διπλωματικής εργασίας είναι η ανάλυση αδόμητων διαλόγων του διαδικτύου από τη σκοπιά της Δομημένης Επιχειρηματολογίας. Μέσα από την ανάλυση αυτή στοχεύουμε στον εντοπισμό Επιχειρηματολογικών Σχημάτων, στην δόμηση και παρουσίαση του αδόμητου διαλόγου με τη χρήση ενός Γράφου Επιχειρηματολογίας, στον εντοπισμό των δυσκολιών που παρουσιάζει η διαδικασία και στον προσδιορισμό του ιδανικού Γράφου Επιχειρηματολογίας. Στα πλαίσια της εργασίας γίνεται επίσης και σχολιασμός της πιθανότητας, στο μέλλον, τη διαδικασία αυτή να την αναλάβει αποκλειστικά κάποιο σύστημα εξελιγμένης Τεχνητής Νοημοσύνης. Στο 1ο Κεφάλαιο δίνονται κάποια βασικά θεωρητικά στοιχεία για τη Δομημένη Επιχειρηματολογία Στο 2ο Κεφάλαιο γίνεται μία περιληπτική αναφορά της επικρατούσας κατάστασης όσον αφορά το Δημόσιο Διάλογο στο διαδίκτυο Στο 3ο Κεφάλαιο παρουσιάζεται η ανάλυση των διαλόγων, η μεθοδολογία με την οποία αυτή πραγματοποιήθηκε καθώς και δίνονται πληροφορίες σχετικά με το τι είναι και πως χρησιμοποιείται ένας Γράφος Επιχειρηματολογίας Στο 4ο Κεφάλαιο σημειώνονται οι δυσκολίες της διαδικασίας, οι παρατηρήσεις και τα συμπεράσματα που προέκυψαν, ενώ επίσης προσδιορίζεται και ο ιδανικός Γράφος Επιχειρηματολογίας.The purpose of this diploma thesis is to analyze unstructured Internet dialogues using Structured Argumentation. The aim of the analysis is tο find which Argumentation Schemes are used in the aforementioned dialogues, to reconstruct and present the dialogues using an Argument Graph, to state out the difficulties of the process and to define the ideal Argument Graph. The possibility, in the future, to realize the same process via Artificial Intelligence systems is also discussed. In Chapter 1, some basic information and fundamentals of Structured Argumentation. In Chapter 2, a brief report on what is the situation on Public Deliberation on the Internet nowadays. In Chapter 3, the analysis of the dialogues, the methodology which was used and presentation of the Argument Graphs and their use. In Chapter 4, presentation of the difficulties of the process, conclusions and comments on the process and definition of the Ideal argument.Δατσέρης Ι. Εμμανουή

Anatomical and Functional Changes in the Coexistence of Vitreomacular Traction and Epiretinal Membrane: A Spectral-Domain Optical Coherence Tomography Study

Purpose: The purpose of this study was to evaluate the anatomical and functional findings in patients with vitreomacular traction (VMT) combined with epiretinal membrane (ERM) in the same eye. Methods: In this retrospective, cross-sectional study, we studied 65 patients with VMT and ERM. In 36 of them, ERM/VMT had a 'unified' appearance (group Ι) but in 29, VMT and ERM coexisted without an interrelationship (group ΙΙ). All patients were examined with spectral-domain optical coherence tomography (SD-OCT). We recorded the macular thickness, the presence, type and location of macular edema, the horizontal diameter of VMT, ellipsoid zone/external limiting membrane (EZ/ELM) status, the vitreofoveal angle of VMT nasally and temporally and the best corrected visual acuity (BCVA). Results: Group Ι presented with increased macular thickness, a broader adhesion diameter, extensive EZ/ELM defect and decreased BCVA compared to those where VMT and ERM were not intercorrelated. In group I ('unified' VMT and ERM), cystoid macular edema was found at a greater percentage (41.7%), while in patients where the 2 entities were not intercorrelated, diffuse macular edema was more evident (69%). There was no statistically significant difference between the 2 groups in the vitreofoveal angle temporally and nasally. Conclusions: Macular thickness, type of macular edema, adhesion diameter, the extent of the EZ/ELM defect and BCVA appeared different in cases where VMT and ERM were unified compared to cases where ERM and VMT coexisted but were not intercorrelated. © 2016 S. Karger AG, Basel

Spontaneous resolution of vitreomacular traction demonstrated by spectral-domain optical coherence tomography

Purpose To evaluate the natural course of idiopathic vitreomacular traction (VMT) with spectral-domain optical coherence tomography (SDOCT) from the vitreomacular adhesion (VMA) stage to the spontaneous resolution of VMT. Design Prospective observational case series. Methods We studied the natural course of idiopathic VMT in 46 eyes (46 patients), divided into those that proceeded to spontaneous VMT resolution (12 cases) and those that remained at the VMT stage (34 cases). All patients were examined with SDOCT at regular 3-month intervals. We recorded the vitreomacular angle of VMA nasally and temporally, the horizontal diameter of VMA, macular thickness, visual acuity, photoreceptor layer, and external limiting membrane. Results In the 12 eyes that proceeded to spontaneous resolution, the vitreous adhesion angle had a mean increase of 38 degrees at VMT, compared to the angle at the VMA stage. In the 34 eyes that remained at the VMT stage, the mean angle of traction increased by only 1 degree throughout follow-up. In all 46 patients, the angle at the VMT stage was significantly associated with traction resolution (nasally P =.001, temporally P <.001). The likelihood of resolution was more than 99% lower for patients with a VMT diameter >400 μm compared with that of eyes with a VMT diameter <400 μm. Patients with broad-type VMT remained at the same stage, whereas patients with V-type VMT had 80% probability of resolution. Conclusions Spontaneous VMT resolution is negatively associated with the horizontal adhesion diameter. The strength of the traction exerted by the vitreous on the fovea seems to be positively related to the size of the vitreomacular angle. © 2014 BY ELSEVIER INC. ALL RIGHTS RESERVED

Comparison of macular findings due to vitreomacular traction alone or in association with epiretinal membrane

Purpose: To evaluate the anatomical and functional findings in patients with vitreomacular traction (VMT) alone or in combination with epiretinal membrane (ERM). Methods: In this retrospective, cross-sectional study, we studied 102 patients with VMT, either alone (n = 37) or combined with ERM (n = 65). All patients were examined with spectral-domain optical coherence tomography (SD-OCT). We recorded the vitreofoveal angle of VMT nasally and temporally, the horizontal diameter of VMT, macular thickness, the presence, type, and location of macular edema, the ellipsoid zone (ΕΖ)/external limiting membrane (ELM) status, and the visual acuity. Results: Patients with VMT combined with ERM presented smaller vitreofoveal angle nasally and temporally, broader adhesion diameter, and a greater extent of EZ defect compared to patients with VMT alone, although there was no statistically significant difference in EZ and ELM condition regarding the number of affected cases. There is also no statistically significant difference between the 2 groups concerning the visual acuity. In the majority of patients with VMT alone, cystoid macular edema was present mainly at the foveal area. In cases where VMT coexisted with ERM, macular edema was mostly found to be diffuse, while cystoid or mixed type, extending to the whole macular area, was also present. Conclusions: Patients with VMT in association with ERM have different characteristics in SD-OCT compared to those with VMT alone regarding the type and location of macular edema, the extent of EZ defect, as well as the vitreofoveal angle and the VMT diameter. Moreover, they presented worse visual acuity compared to those with VMT alone, although the difference did not reach statistical significance. © 2016 Wichtig Publishing

Photoreceptor layer changes overlying drusen in eyes with age-related macular degeneration associated with vitreomacular traction

Purpose: To investigate by spectral-domain optical coherence tomography (SD-OCT) changes of photoreceptor layers over drusen in cases of dry type age-related macular degeneration associated with vitreomacular traction (VMT). Methods: Clinical examination, fluorescein angiography, fundus photography, and SD-OCT data were retrospectively studied for a consecutive series of 27 patients with drusen, pseudodrusen, and VMT. Control groups of 32 patients with VMT without drusen and 34 patients with drusen and pseudodrusen without VMT were also studied. Results: The examination revealed disruption of the line corresponding to the inner segment ellipsoid (ISel), previously called inner segment/outer segment junction, of photoreceptor layer, and development of cystoid edema in significantly higher incidence in VMT associated with drusen group. 22 out of 32 eyes with VMT and drusen (68.75%) had disrupted ISel, compared to 8 out of 37 (21.6%) control eyes with drusen only and to 12 out of 37 (32.4%) control eyes with VMT only. Chi-square analysis showed significant association between drusen and pseudodrusen on fovea, VMT, and localization of ISel disruption. The changes of the ISel were mainly found in the area that corresponded to VMT. The SD-OCT revealed drusen throughout the macula and discontinuation of ISel only in the fovea in 4 of 32 (12.5%) eyes with VMT, whereas none of 37 control eyes with drusen only had similar appearance. Conclusions: The drusen in association with the cystoid macular edema induced by vitreous traction contribute to the photoreceptor layer defect overlying drusen in the fovea. In addition, the number of drusen and pseudodrusen was increased in the area of the vitreous traction compared to the peripheral retina. © 2013 Wichtig Editore

Complications of intravitreal ocriplasmin for vitreomacular traction and macular hole: a prospective spectral-domain optical coherence tomography study

Objective: The purpose of this study was to evaluate the safety of intravitreal ocriplasmin prospectively, reporting potential complications in patients with vitreomacular traction (VMT) alone or associated with macular hole (MH). Materials and methods: Participants in this prospective, multicenter study, were 24 patients with VMT (17 with VMT alone and seven with MH combined with VMT). All patients were treated with a single ocriplasmin injection and followed-up prospectively at baseline, day 7, 28 and the last examination of the follow-up for each patient (mean ± SD: 64.2 ± 24.4 d, range: 40–145 d). Best-corrected visual acuity (BCVA) was assessed, and spectral-domain optical coherence tomography was performed at each visit while the percentage of resolution of VMT and the association with various potential adverse events were recorded and analyzed. Results: 66.7% of patients presented VMT release at the end of the follow-up, while 28.6% exhibited MH closure. Severe adverse events, such as enlargement of preexisting MH and formation of lamellar MH, were observed in one and four cases, respectively and remained till the end of the follow-up. Moderate adverse events, such as ellipsoid zone disruption and subretinal fluid development, became evident seven days after injection, in four cases. Formation of cystoid macular edema (CME), not evident at baseline, was noticed in three cases at day 28 after injection. Mild adverse events, like vitreous floaters, photopsias, eye pain and foreign body sensation, were noticed at day 7 and resolved till the end of the follow-up. Conclusions: Mild and moderate adverse events occurred mainly during the first week of the follow-up, while severe adverse events, such as the lamellar MH formation and CME at day 28 post injection were seen. © 2015 Taylor & Francis