Lung adenocarcinoma presenting as a solitary gingival metastasis: a case report

<p>Abstract</p> <p>Introduction</p> <p>Gingival metastases are very rare and generally occur in disseminated tumors. We report a case of solitary gingival metastasis of lung cancer.</p> <p>Case presentation</p> <p>We report the case of a 74-year-old asymptomatic Caucasian woman affected by a rapidly growing, painless gingival swelling. Histopathologic examination of the excisional biopsy showed metastasis of poorly differentiated thyroid transcription factor 1-positive adenocarcinoma. A total-body computed tomographic scan revealed a tumor of the right lung lower lobe with ipsilateral, mediastinal lymph node swelling. Moreover, bone scintigraphy revealed no bone metastases. No other metastases were found, so we planned a multi-modal therapeutic approach with a curative intent. However, the tumor proved to be intrinsically resistant and highly aggressive.</p> <p>Conclusion</p> <p>The presentation of solitary gingival metastasis is exceptional. In view of its rapid clinical evolution, our case confirms that gingival metastasis is an important prognostic factor. This behavior raises the question whether the poor prognosis for patients with tumors with oral metastases depends on its diffuse spread or on its highly malignant nature.</p

Effect of saxagliptin on renal outcomes in the SAVOR-TIMI 53 trial.

OBJECTIVE: Dipeptidyl peptidase 4 inhibitors may have a protective effect in diabetic nephropathy. RESEARCH DESIGN AND METHODS: We studied renal outcomes of 16,492 patients with type 2 diabetes, randomized to saxagliptin versus placebo and followed for a median of 2.1 years in the Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus Thrombolysis in Myocardial Infarction 53 trial. RESULTS: At baseline: 9,696 (58.8%) subjects had normoalbuminuria (albumin/creatinine ratio [ACR] 300 mg/g). Treatment with saxagliptin was associated with improvement in and/or less deterioration in ACR categories from baseline to end of trial (EOT) (P = 0.021, P 50 mL/min/BSA, -105 mg/g (P = 0.011) for 50 ≥ eGFR ≥ 30 mL/min/BSA, and -245.2 mg/g (P = 0.086) for eGFR 6.0 mg/dL, were similar as well. CONCLUSIONS: Treatment with saxagliptin improved ACR, even in the normoalbuminuric range, without affecting eGFR. The beneficial effect of saxagliptin on albuminuria could not be explained by its effect on glycemic control

A Simple Separable Exact C*-Algebra not Anti-isomorphic to Itself

We give an example of an exact, stably finite, simple. separable C*-algebra D which is not isomorphic to its opposite algebra. Moreover, D has the following additional properties. It is stably finite, approximately divisible, has real rank zero and stable rank one, has a unique tracial state, and the order on projections over D is determined by traces. It also absorbs the Jiang-Su algebra Z, and in fact absorbs the 3^{\infty} UHF algebra. We can also explicitly compute the K-theory of D, namely K_0 (D) = Z[1/3] with the standard order, and K_1 (D) = 0, as well as the Cuntz semigroup of D.Comment: 16 pages; AMSLaTeX. The material on other possible K-groups for such an algebra has been moved to a separate paper (1309.4142 [math.OA]

Metastatic breast carcinoma in the mandible presenting as a periodontal abscess: a case report

<p>Abstract</p> <p>Introduction</p> <p>Tumors can metastasize to the oral cavity and affect the jaws, soft tissue and salivary glands. Oral cavity metastases are considered rare and represent approximately 1% of all oral malignancies. Because of their rarity and atypical clinical and radiographic appearance, metastatic lesions are considered a diagnostic challenge. The purpose of this report is to present a rare case of a metastatic breast carcinoma mimicking a periodontal abscess in the mandible.</p> <p>Case presentation</p> <p>A 55-year-old Caucasian woman was referred to our clinic for evaluation of bisphosphonate-induced jaw osteonecrosis. She had undergone modified radical mastectomy with axillary lymph node dissection for invasive ductal carcinoma of the left breast. Her clinical examination showed diffuse swelling and a periodontal pocket of 6 mm exhibiting suppuration in the posterior right mandible. Moreover, paresthesia of the lower right lip and chin was noted. There were no significant radiographic findings other than alveolar bone loss due to her periodontal disease. Although the lesion resembled a periodontal abscess, metastatic carcinoma of the breast was suspected on the basis of the patient's medical history. The area was biopsied, and histological analysis confirmed the final diagnosis of metastatic breast carcinoma.</p> <p>Conclusion</p> <p>The general dentist or dental specialist should maintain a high level of suspicion while evaluating patients with a history of cancer. Paresthesias of the lower lip and the chin should be considered ominous signs of metastatic disease. This case highlights the importance of the value of a detailed medical history and thorough clinical examination for the early detection of metastatic tumors in the oral cavity.</p

Intermittent release of transients in the slow solar wind: 2. In situ evidence

In paper 1, we showed that the Heliospheric Imager (HI) instruments on the pair of NASA STEREO spacecraft can be used to image the streamer belt and, in particular, the variability of the slow solar wind which originates near helmet streamers. The observation of intense intermittent transient outflow by HI implies that the corresponding in situ observations of the slow solar wind and corotating interaction regions (CIRs) should contain many signatures of transients. In the present paper, we compare the HI observations with in situ measurements from the STEREO and ACE spacecraft. Analysis of the solar wind ion, magnetic field, and suprathermal electron flux measurements from the STEREO spacecraft reveals the presence of both closed and partially disconnected interplanetary magnetic field lines permeating the slow solar wind. We predict that one of the transients embedded within the second CIR (CIR‐D in paper 1) should impact the near‐Earth ACE spacecraft. ACE measurements confirm the presence of a transient at the time of CIR passage; the transient signature includes helical magnetic fields and bidirectional suprathermal electrons. On the same day, a strahl electron dropout is observed at STEREO‐B, correlated with the passage of a high plasma beta structure. Unlike ACE, STEREO‐B observes the transient a few hours ahead of the CIR. STEREO‐A, STEREO‐B, and ACE spacecraft observe very different slow solar wind properties ahead of and during the CIR analyzed in this paper, which we associate with the intermittent release of transients

Analysis of Policies Supporting Teachers to Tackle Linguistic and Cultural Diversity and Facilitate Inclusion from the Perspectives of Iceland and the Faroe Islands

In today’s fast changing multicultural societies, governments and organisations must use their agency to ensure the contribution and inclusion of all cultures and ethnicities. A key factor for enabling this is ensuring education plays a leading role in facilitating the creation of an inclusive society. In this context, the education of teachers must be a priority given the reach and impact teachers have on a society. Therefore, teacher education with its role in preparing pre-service teachers for teaching in a multicultural setting is uniquely placed to enable focus on and engender a foundation for enabling inclusivity, equality and social justice in education. The purpose of this chapter is to discuss the policy framework needed for preparing preservice teachers to work with learners from diverse linguistic and cultural backgrounds. The aim is to gain knowledge and understanding of how the concepts of inclusion and culturally responsive pedagogy are reflected in teacher education policy in the island nations of Iceland and the Faroe IslandsPeer reviewe

Spontaneous regression in alveolar soft part sarcoma: case report and literature review

<p>Abstract</p> <p>Background</p> <p>Sarcomas are a type of malignant tumors that arise from connective tissue. They are most of the time found in extremities</p> <p>Case presentation</p> <p>We are presenting a case of adult male patient, who was found to have huge abdominal mass and multiple gastric and duodenal polyps. Pathological diagnosis for all lesions was Alveolar soft part sarcoma. Although he complained from metastasis to both lungs and right atrium, all these deposits regressed spontaneously. Patient stated that he used some herbs (Teucrium polium, Cat Thyme) prescribed for him. No chemotherapy or radiotherapy was given. The duration of regression was about 5 months before other lesions appeared. Later on, he died secondary to brain metastasis.</p> <p>Conclusion</p> <p>ASPS is a rare type of sarcomas that affect primarily the lower limbs. This tumor does rarely metastasize to the gastrointestinal tract.</p