Metastatic pheochromocytoma to liver without elevation of metanephrines and catecholamines

AbstractIntroductionMalignant pheochromocytoma represents 10% of all patients with pheochromocytoma. Of these cases, only 5–9% presents without elevation of metanephrines and catecholamines.Presentation of caseA 43-year-old female patient presented with an abdominal tumor. An exploratory laparotomy was performed and the final report was a pheochromocytoma. After ten years, multiple liver lesions were detected and surgical treatment was performed. Pathological evaluation revealed a malignant pheochromocytoma with negative margins after 5 years of follow-up without evidence of disease.DiscussionThe recurrence rate of malignant pheochromocytoma is 15–20% at ten years and a 5-year survival rate that ranges from 50% to 80%. The presence of synchronous metastases is rare (10–27%), but have been reported until 20 years later with the most common metastatic sites being the local lymph nodes, bone (50%), liver (50%) and lung (30%). The prognostic factor such as size >6cm, age over 45 years, synchronous metastasis and no tumor excision are related with poor prognosis.ConclusionSurgical treatment offers the best survival rate and the only chance of cure so far and the goal is an R0 resection as in our case. So it should be the treatment of choice

A grid based IMS learning design player: the ELeGI case study

This paper illustrates the work done and the results achieved within the ELeGI project about the orchestration and the delivery of Learning Services lying in the GRID inside an IMS Learning Design (IMS-LD) Unit of Learning and running under an enhanced version of the CopperCore Player. The added value of GRID technologies for the creation and the execution of dynamic learning experiences is evidenced as well as the experimentation performed to overcome the original IMS-LD limitation on running services is presented. The aim of the ELeGI project is to promote and support a learning paradigm centred on the knowledge construction using experiential based and collaborative learning approaches in a contextualised, personalised and ubiquitous way through the definition and implementation of a service oriented Grid based software architecture

A Grid Based IMS Learning Design Player: the ELeGI Case Study

This paper illustrates the work done and the results achieved within the ELeGI project about the orchestration and the delivery of Learning Services lying in the GRID inside an IMS Learning Design (IMS-LD) Unit of Learning and running under an enhanced version of the CopperCore Player. The added value of GRID technologies for the creation and the execution of dynamic learning experiences is evidenced as well as the experimentation performed to overcome the original IMS-LD limitation on running services is presented. The aim of the ELeGI project is to promote and support a learning paradigm centred on the knowledge construction using experiential based and collaborative learning approaches in a contextualised, personalised and ubiquitous way through the definition and implementation of a service oriented Grid based software architecture

Medullary colonic carcinoma with microsatellite instability has lower survival compared with conventional colonic adenocarcinoma with microsatellite instability

Introduction: Colorectal medullary carcinoma (MC) is a rare subtype of poorly differentiated adenocarcinoma (PDA) with unclear prognostic significance. Microsatellite instable (MSI) colorectal carcinomas have demonstrated better prognosis in clinical stage II. Aim: To analyze the survival and clinicopathological characteristics of MCs versus PDAs with MSI in clinical stage III. Material and methods: We studied 22 cases of PDAs with MSI versus 10 MCs. Results : Of the 10 MCs, 7 patients were men; the mean age was 57.8 ±5.6 years. The mean tumor size was 9.6 ±4.1 cm, and the primary site was the right colon in 9; 7 patients showed lymph node metastases (LNM) and lymphovascular invasion (LVI). Of the 22 PDA cases, 12 (54.5%) were women with a mean age of 75 ±16.1 years. The mean tumor size was 6.4 ±3.2 cm. Twelve (54.5%) presented in the right colon, 21 (95.5%) showed LNM and 7 (31.8%) LVI. Follow-up was 32 ±8 months, with a 5-year overall survival of 42.9% for MCs and 76.6% for PDAs (p = 0.048). Univariate analysis found local recurrence (p = 0.001) and medullary subtype (p = 0.043) associated with lower survival. Conclusions : Medullary carcinomas were of greater tumor size and associated with more LVI and worse survival versus PDAs with MSI in stage III

Li-rich Li1+xMn2-xO4 spinel electrode materials : an operando neutron diffraction study during Li+ extraction/insertion

In situ neutron diffraction (ND) during battery operation is becoming a promising technique for the study of electrode materials in Li-ion batteries. We recently designed an electrochemical cell for operando ND studies and demonstrated that it can deliver powder patterns of good quality for Rietveld structural refinements. Herein we used such a cell to study the deintercalation process occurring in manganese spinels of general formula Li1+xMn2–xO4. Three samples with increasing Li/Mn ratio (x = 0, x = 0.05, and x = 0.10) were synthesized and measured on the D20 high-flux powder diffractometer at ILL. We found fundamental differences between the phase diagrams of the three samples, intimately related to their electrochemical features. Upon charge, the study revealed a sequence of two biphasic reactions for LiMn2O4 (with an intermediate phase of composition close to Li0.6Mn2O4), a solid solution followed by a biphasic reaction for Li1.05Mn1.95O4, and a full solid solution for Li1.10Mn1.90O4. Moreover, Rietveld refinement led to key parameters such as cell parameters, oxygen’s fractional atomic coordinates, and more importantly, lithium’s site occupancy factors, whose rate of variation is found to be related to the state of charge of the electrode