Alpha–fetoprotein elevation in NUT midline carcinoma: a case report

Abstract Background Nuclear protein in testis (NUT) midline carcinoma is a rarely diagnosed and potentially under-recognized type of squamous carcinoma that is considered one of the most aggressive human solid tumors. Alpha-fetoprotein elevation has been associated with chronic liver diseases and a limited number of cancers. In particular, in presence of a mediastinal mass in a young man, alpha-fetoprotein elevation is considered nearly pathognomonic of a non-seminoma germ-cell tumor. Case presentation A 22-year old man without any comorbidity was diagnosed with a large mediastinal mass with skeletal and lymph node metastases. The clinical picture was dominated by a life-threatening superior vena cava syndrome with elevated alpha-fetoprotein and lactate dehydrogenase that supported the diagnostic suspicion of mediastinal germ-cell tumor. However, a biopsy showed a poorly-differentiated and diffusely necrotic carcinoma. We eventually reached the diagnosis of the peculiar entity of NUT midline carcinoma, but the differential diagnosis was quite challenging also because alpha-fetoprotein is not reported as a marker of NUT midline carcinoma. Notably, alpha-fetoprotein levels correlated with disease course. Conclusions The life-threatening aggressiveness of NUT midline carcinoma mandates to reach the right diagnosis in the shortest possible time. In this regard, poorly differentiated carcinomas lacking glandular differentiation mandate testing for NUT expression by immunohistochemistry. Awareness of a potentially misleading tumor marker elevation can help to broaden the differential diagnosis and establish the most appropriate treatment

Effects of Technical and Economical Indexes on the Production Economics of a Power Plant Block.

Bakalářská práce je zaměřena na podrobné zhodnocení jednotlivých vlivů ovlivňující účinnost bloků elektrárny, potřebné pro vyhodnocení ekonomie provozu. V úvodu bakalářské práce je popsán elektrárenský blok jako celek, který se skládá z několika jednotlivých souborů navazujících na sebe. Další část je zaměřená na teorii ekonomie provozu, s rozpracováním největších ztrát bloků, které jsou důležité pro obsluhy elektrárny a pro jejich následné vyhodnocení ekonomie provozu. V závěru je rozpracované týdenní vyhodnocení sledovaných ukazatelů, ekonomické zhodnocení provozu jednotlivých bloků a navržení úprav pro vylepšení ekonomie provozu.This bachelor thesis is focused on the detailed assessment of various factors affecting the efficiency of the power plant block which are needed to evaluate the economics of the operation. At the beginning of the thesis is described the power unit as a whole which consists of several individual files related to each other. Another part is focused on the theory of operation with developing of economics of the largest block of losses, which are important for plant operators. And for their subsequent evaluation of the economics of operation. In the conclusion, progress indicators are monitored weekly evaluation, the economic evaluation of the operation of each loop block propose modifications to improve the economics of operation.545 - Institut ekonomiky a systémů řízenívýborn