273 research outputs found

    Neuroendocrine (Merkel cell) carcinoma of the retroperitoneum with no identifiable primary site

    Get PDF
    <p>Abstract</p> <p>Background</p> <p>Neuroendocrine carcinoma is an aggressive neoplasm that mainly affects elderly Caucasians and typically arises in sun-exposed areas of the skin. The disease is rather rare and only a relatively few cases present with no apparent primary lesion.</p> <p>Case presentation</p> <p>We report a case of an 81-year-old Caucasian male with neuroendocrine carcinoma, which initially presented as a large retroperitoneal mass. Pathological and immunohistochemical analysis of the transabdominal CT-guided biopsy specimen revealed tissue consistent with neuroendocrine carcinoma. The patient underwent exploratory laparotomy and the mass was successfully excised along with an associated mesenteric lymph node.</p> <p>Discussion</p> <p>There are currently two possible explanations for what occurred in our patient. First, the retroperitoneal mass could be a massively enlarged lymph node where precursor cells became neoplastic. This would be consistent with a presumptive diagnosis of primary nodal disease. Alternatively, an initial skin lesion could have spontaneously regressed and the retroperitoneal mass represents a single site of metastasis. Since Merkel cell precursors have never been identified within lymph nodes, the latter theory seems more befitting. Moreover, metastasis to the retroperitoneal lymph nodes has been reported as relatively common when compared to other sites such as liver, bone, brain and skin.</p> <p>Conclusion</p> <p>Wide local excision of the primary tumor is the surgical treatment of choice for localized disease. We propose that further studies are needed to elucidate the true efficacy of chemotherapy in conventional as well as unconventional patients with neuroendocrine carcinoma.</p

    Everything is Clear: All Perceptual Experiences are Transparent

    Get PDF
    The idea that perceptual experience is transparent is generally used by naïve realists and externalist representationalists to promote an externalist account of the metaphysics of perceptual experience. It is claimed that the phenomenal character of our perceptual experience can be explained solely with reference to the externally located objects and properties which (for the representationalist) we represent, or which (for the naïve realist) partly constitute our experience. Internalist qualia theorists deny this and claim that the phenomenal character of our perceptual experience is internally constituted. However, my concern in this paper is not with the metaphysical debate but with transparency as a phenomenological feature of perceptual experience. Qualia theorists have presented a number of examples of perceptual experiences which, they claim, do not even seem to be transparent; these experiences involve objects or properties which seem to be internally realized. I argue, contrary to the qualia theorist's claim, that the phenomenal character of perceptual experience can in fact be characterized solely with reference to externally located objects and properties, and the sense in which some features of our perceptual experiences do not seem external is due to cognitive, not perceptual, phenomenology

    Bioactivity, biocompatibility and antimicrobial properties of a chitosan-mineral composite for periodontal tissue regeneration

    Get PDF
    A composite membrane of the polymer, chitosan, and the silver-exchanged mineral phase, tobermorite, was prepared by solvent casting and characterised by scanning electron microscopy and Fourier transform infrared spectroscopy. The in vitro bioactivity, cytocompatibility and antimicrobial activity of the composite were evaluated with respect to its potential application as a guided tissue regeneration (GTR) membrane. The in vitro bioactivity was verified by the formation of hydroxyapatite on the surface of the membrane in simulated body fluid and its cytocompatibility was established using MG63 human osteosarcoma cells. The presence of silver ions conferred significant antimicrobial activity against S. aureus, P. aeruginosa and E. coli. The findings of this investigation have indicated that the chitosansilver-tobermorite composite is a prospective candidate for GTR applications
    corecore