The prognostic relevance of interactions between venous invasion, lymph node involvement and distant metastases in renal cell carcinoma after radical nephrectomy

<p>Abstract</p> <p>Background</p> <p>To investigate a possible prognostic significance of interactions between lymph node invasion (LNI), synchronous distant metastases (SDM), and venous invasion (VI) adjusted for mode of detection, Eastern Cooperative Oncology Group performance status (ECOG PS), erythrocyte sedimentation rate (ESR) and tumour size (TS) in 196 patients with renal cell carcinoma treated with radical nephrectomy.</p> <p>Methods</p> <p>Median follow-up was 5.5 years (mean 6.9 years; range 0.01–19.4). The mode of detection, ECOG PS, ESR and TS were obtained from the patients' records. Vena cava invasion and distant metastases were detected by preoperative imaging. The surgical specimens were examined for pathological stage, LNI and VI.</p> <p>Results</p> <p>The univariate analyses showed significant impact of VI, LNI, SDM, ESR and TS (p < 0.001), as well as mode of detection (p = 0.003) and ECOG PS (p = 0.002) on cancer specific survival. In multivariate analyses LNI was significantly associated with survival only in patients without SDM or VI (p < 0.001) with a hazard ratio of 9.0. LNI lost its prognostic significance when SDM or VI was present.</p> <p>Conclusion</p> <p>Our findings underline the prognostic importance of the status of the lymph nodes. LNI, SDM, ESR, and VI were independently associated with cancer specific survival after radical nephrectomy. LNI provided the strongest prognostic information for patients without SDM or VI whereas SDM and VI had strongest impact on survival when there was no nodal involvement.</p

Evidence for Avian Intrathoracic Air Sacs in a New Predatory Dinosaur from Argentina

Background: Living birds possess a unique heterogeneous pulmonary system composed of a rigid, dorsally-anchored lung and several compliant air sacs that operate as bellows, driving inspired air through the lung. Evidence from the fossil record for the origin and evolution of this system is extremely limited, because lungs do not fossilize and because the bellow-like air sacs in living birds only rarely penetrate (pneumatize) skeletal bone and thus leave a record of their presence. Methodology/Principal Findings: We describe a new predatory dinosaur from Upper Cretaceous rocks in Argentina, Aerosteon riocoloradensis gen. et sp. nov., that exhibits extreme pneumatization of skeletal bone, including pneumatic hollowing of the furcula and ilium. In living birds, these two bones are pneumatized by diverticulae of air sacs (clavicular, abdominal) that are involved in pulmonary ventilation. We also describe several pneumatized gastralia (‘‘stomach ribs’’), which suggest that diverticulae of the air sac system were present in surface tissues of the thorax. Conclusions/Significance: We present a four-phase model for the evolution of avian air sacs and costosternal-driven lung ventilation based on the known fossil record of theropod dinosaurs and osteological correlates in extant birds: (1) Phase I—Elaboration of paraxial cervical air sacs in basal theropods no later than the earliest Late Triassic. (2) Phase II—Differentiation of avian ventilatory air sacs, including both cranial (clavicular air sac) and caudal (abdominal air sac) divisions, in basal tetanurans during the Jurassic. A heterogeneous respiratory tract wit

Enigmatic dinosaur precursors bridge the gap to the origin of Pterosauria

Pterosaurs were the first vertebrates to evolve powered flight1 and comprised one of the main evolutionary radiations in terrestrial ecosystems of the Mesozoic era (approximately 252–66 million years ago), but their origin has remained an unresolved enigma in palaeontology since the nineteenth century2,3,4. These flying reptiles have been hypothesized to be the close relatives of a wide variety of reptilian clades, including dinosaur relatives2,3,4,5,6,7,8, and there is still a major morphological gap between those forms and the oldest, unambiguous pterosaurs from the Upper Triassic series. Here, using recent discoveries of well-preserved cranial remains, microcomputed tomography scans of fragile skull bones (jaws, skull roofs and braincases) and reliably associated postcrania, we demonstrate that lagerpetids—a group of cursorial, non-volant dinosaur precursors—are the sister group of pterosaurs, sharing numerous synapomorphies across the entire skeleton. This finding substantially shortens the temporal and morphological gap between the oldest pterosaurs and their closest relatives and simultaneously strengthens the evidence that pterosaurs belong to the avian line of archosaurs. Neuroanatomical features related to the enhanced sensory abilities of pterosaurs9 are already present in lagerpetids, which indicates that these features evolved before flight. Our evidence illuminates the first steps of the assembly of the pterosaur body plan, whose conquest of aerial space represents a remarkable morphofunctional innovation in vertebrate evolution

A new specimen of Prolacerta broomi from the lower Fremouw Formation (Early Triassic) of Antarctica, its biogeographical implications and a taxonomic revision

Prolacerta broomi is an Early Triassic archosauromorph of particular importance to the early evolution of archosaurs. It is well known from many specimens from South Africa and a few relatively small specimens from Antarctica. Here, a new articulated specimen from the Fremouw Formation of Antarctica is described in detail. It represents the largest specimen of Prolacerta described to date with a nearly fully articulated and complete postcranium in addition to four skull elements. The study of this specimen and the re-evaluation of other Prolacerta specimens from both Antarctica and South Africa reveal several important new insights into its morphology, most notably regarding the premaxilla, manus, and pelvic girdle. Although well-preserved skull material from Antarctica is still lacking for Prolacerta, a detailed comparison of Prolacerta specimens from Antarctica and South Africa corroborates previous findings that there are no characters clearly distinguishing the specimens from these different regions and therefore the Antarctic material is assigned to Prolacerta broomi. The biogeographical implications of these new findings are discussed. Finally, some osteological characters for Prolacerta are revised and an updated diagnosis and phylogenetic analysis are provided

Provenance and tectonic setting of Miocene siliciclastic sediments, Sibuti formation, northwestern Borneo

Provenance and tectonic setting of sandstone and mudstone units of the Miocene Sibuti Formation from northwest Borneo have been studied based on the mineralogy, major and trace element geochemistry data. The X-ray diffraction (XRD) and scanning electron microscopy-energy dispersive spectrometry (SEM-EDS) data revealed that the sandstones and mudstones were abundant in quartz, pyrite, clay, and heavy minerals such as zircon, rutile, and some detrital cassiterite. Geochemically, the sandstones and mudstones are classified into quartz arenite, litharenite, sublitharenite, arkose, and wacke. Quartz arenites are enriched with SiO2, Zr, and Th and depleted in Al2O3, CaO, and other elements compared to other sandstone types, indicating high maturity and intensive weathering. Chemical index of alteration (CIA: 77–90), plagioclase index of alteration (PIA: 86–100), and A-CN-K diagram suggest intense weathering in the source area. Elemental ratios such as La/Sc, Th/Sc, Cr/Th, La/Co, and Th/Co are similar to sediments derived from the felsic rocks. Also, the provenance discrimination diagrams suggest recycled continental nature of these clastic sediments which are mostly derived from metasedimentary source (Rajang Formation). Discriminant-function diagram for the tectonic discrimination of siliciclastic sediments revealed that the sediments of Sibuti Formation were derived from a collision zone, which is consistent with the geology of the study area