Ultrasound diagnosis of serous surface papillary borderline ovarian tumor: A case series with a review of the literature

Serous surface papillary borderline ovarian tumors (SSPBOTs) are a rare morphologic variant of serous ovarian tumors that are typically confined to the ovarian surface, while the ovaries themselves tend to appear normal in size and shape. In this report, we describe the findings from five premenopausal women diagnosed with SSPBOTs, in whom ultrasound showed grossly normal ovaries that were partially or wholly covered with irregular solid tumors. In all five cases, histologic examination showed evidence of borderline serous tumors. These findings demonstrate that SSPBOTs can be diagnosed on a preoperative sonographic examination, which could facilitate conservative, fertility-sparing surgery in young women affected by this condition. © 2015 Wiley Periodicals, Inc. J Clin Ultrasound, 2015

On Rationality

Rationality is an enduring topic of interest across the disciplines and has become even more so, given the current crises that are unfolding in our society. The four books reviewed here, which are written by academics working in economics, political science, political theory and philosophy, provide an interdisciplinary engagement with the idea of rationality and the way it has shaped the institutional frameworks and global political economy of our time. Rational choice theory has certainly proved to be a useful analytic tool in certain contexts, and instrumental reason has been a key tenet of human progress in several periods of history, including the industrial revolution and the modernity that emerged in the nineteenth century. Given the complexity of our current challenges, however, is it time to ask whether this paradigm might be better complemented by more holistic and heterodox approaches? Hindmoor A and Taylor TY (2015) Rational Choice (Political Analysis), 2nd edn. London; New York: Palgrave Macmillan. Massumi (2015) The Power at the End of the Economy. Durham: Duke University Press. Brown (2015) Undoing the Demos: Neoliberalism’s Stealth Revolution. New York: Zone Books. Ludovisi SG (ed.) (2015) Critical Theory and the Challenge of Praxis: Beyond Reification. Farnham; Burlington, VT: Ashgate

Enhanced B-cell differentiation and reduced proliferative capacity in chronic hepatitis C and chronic hepatitis B virus infections

BACKGROUND & AIMS: Chronic microial infections aare frequently associated with B-cell activation and polyclonal proliferation, potentially leading to autoimmunity and lymphoproliferative disorders. We assessed B-cell phenotype and function in chronic hepatitis B (HBV) and chronic hepatitis C (HCV) virus infection. METHODS: We studied 70 patients with chronic HCV infection, 34 with chronic HBV infection and 54 healthy controls, B-cell phenotype was assessed by flow cytometry using monoclonal antibodies specific for CD27, the CD69, CD71, and CD86 activation markers and the chemokine receptor CXCR3. Differentiation into immunoglobulin-producing cells (IPC) was analysed by ELISpot upon stimulation and with CD40 ligand+IL-10 as surrogate bystander T-cell help or CpG oligodeoxynucleotide+IL-2, as innate immunity signal. Proliferation was examined by cytometry using carboxyfluorescein diacetate succinimidyl ester (CFSE) after stimulation with CpG. RESULTS: A significantly higher proportion of B cells from both HCV-and HBV-infected patients expressed activation markers compared with controls and a positive correlation was found between CXCR3(+) B cells and HCV RNA values. Memory B cells from patients with chronic HCV and HBV infections showed enhanced differentiation into IPC compared with controls, although this was restricted to IgG and at a lower level in HCV-compared with HBV-infected patients. Moreover, patients' activated B cells displayed significantly lower proliferative ability compared to healthy donors despite low expression of the FcRL4 exhaustin marker. CONCLUSIONS: B-cell activation, but not exhaustion, is common in chronic viral hepatitis. However, enhanced B-cell differentiation and deficient proliferative capacity were not associated with commitment to terminal differentiation

Clinical and ultrasound characteristics of surgically removed adnexal lesions with largest diameter ≤ 2.5 cm: a pictorial essay

Objectives: To describe the ultrasound characteristics, indications for surgery and histological diagnoses of surgically removed adnexal masses with a largest diameter of ≤ 2.5 cm (very small tumors), to estimate the sensitivity and specificity of diagnosis of malignancy by subjective assessment of ultrasound images of very small tumors and to present a collection of ultrasound images of surgically removed very small tumors, with emphasis on those causing diagnostic difficulty. Methods: Information on surgically removed adnexal tumors with a largest diameter of ≤ 2.5 cm was retrieved from the ultrasound databases of seven participating centers. The ultrasound images were described using the International Ovarian Tumor Analysis terminology. The original diagnosis, based on subjective assessment of the ultrasound images by the ultrasound examiner, was used to calculate the sensitivity and specificity of diagnosis of malignancy. Results: Of the 129 identified adnexal masses with largest diameter ≤ 2.5 cm, 104 (81%) were benign, 15 (12%) borderline malignant and 10 (8%) invasive tumors. The main indication for performing surgery was suspicion of malignancy in 22% (23/104) of the benign tumors and in all 25 malignant tumors. None of the malignant tumors was a unilocular cyst (vs 50% of the benign tumors), all malignancies contained solid components (vs 43% of the benign tumors), 80% of the borderline tumors had papillary projections (vs 21% of the benign tumors and 20% of the invasive malignancies) and all invasive tumors and 80% of the borderline tumors were vascularized on color/power Doppler examination (vs 44% of the benign tumors). The ovarian crescent sign was present in 85% of the benign tumors, 80% of the borderline tumors and 50% of the invasive malignancies. The sensitivity of diagnosis of malignancy by subjective assessment of ultrasound images was 100% (25/25) and the specificity was 86% (89/104). Excluding unilocular cysts, the specificity was 71% (37/52). Analysis of images illustrated the difficulty in distinguishing benign from borderline very small cysts with papillations and benign from malignant very small well vascularized (color score 3 or 4) solid adnexal tumors. Conclusions: Very small malignant tumors manifest generally accepted ultrasound signs of malignancy. Small unilocular cysts are usually benign, while small non-unilocular masses, particularly ones with solid components, incur a risk of malignancy and pose a clinical dilemma

Ecosistemi di acque interne e di transizione

In questo contributo la vulnerabilità degli ecosistemi acquatici ai cambiamenti climatici è analizzata in relazione ai meccanismi di organizzazione e mantenimento della biodiversità e dei processi ecosistemici. Dai processi degli ecosistemi derivano funzioni che forniscono una serie di benefici o servizi per il genere umano (Daily et al., 2009). Tali servizi sono in larga misura dipendenti dalle componenti biologiche degli ecosistemi86. Negli ecosistemi acquatici i processi biogeochimici (ad es. denitrificazione batterica e assimilazione da parte della vegetazione acquatica), garantiscono l’abbattimento dei nutrienti, una funzione ecosistemica che produce il servizio di depurazione dell’acqua. Altri servizi sono la laminazione delle piene, la ricarica degli acquiferi, la regolazione del microclima locale, la produzione di risorse alimentari quali pesci, crostacei, ecc. (Jones, 2013). Le alterazioni degli ecosistemi, in particolare la perdita di specie e la diminuzione della biodiversità danneggiano questi servizi, con ricadute anche di tipo economico(si pensi, ad esempio, ai costi della depurazione dell’acqua destinata al consumo umano)

Epidemiological surveillance for <i>Trichinella britovi</i> infection in free-ranging pigs of Sardinia

The aim of the present work was to investigate on Trichinella sp. infection in free-ranging pigs of the Orgosolo municipality

A metastable equilibrium model for the relative abundances of microbial phyla in a hot spring

Many studies link the compositions of microbial communities to their environments, but the energetics of organism-specific biomass synthesis as a function of geochemical variables has rarely been assessed. We describe a thermodynamic model that integrates geochemical and metagenomic data for biofilms sampled at five sites along a thermal and chemical gradient in the outflow channel of the hot spring known as ‘‘Bison Pool’’ in Yellowstone National Park. The relative abundances of major phyla in individual communities sampled along the outflow channel are modeled by computing metastable equilibrium among model proteins with amino acid compositions derived from metagenomic sequences. Geochemical conditions are represented by temperature and activities of basis species, including pH and oxidation-reduction potential quantified as the activity of dissolved hydrogen. By adjusting the activity of hydrogen, the model can be tuned to closely approximate the relative abundances of the phyla observed in the community profiles generated from BLAST assignments. The findings reveal an inverse relationship between the energy demand to form the proteins at equal thermodynamic activities and the abundance of phyla in the community.Although the metabolisms used by many members of these communities are driven by chemical disequilibria, the results support the possibility that higher-level patterns of chemotrophic microbial ecosystems are shaped by metastable equilibrium states that depend on both the composition of biomass and the environmental conditions