Moneychangers, Private Information and Gresham’s Law in Late Medieval Europe

En este artículo retomamos una vieja explicación de la Ley de Gresham, que descansa en el tráfico de monedas protagonizado por los cambistas. Centrándonos en la Edad Media, presentamos materiales que sugieren que los cambistas hacían uso de la información privilegiada de que disponían en relación con el dinero, para hacer beneficios a través de operaciones de arbitraje y de retirada de la circulación de las mejores monedas. En ambos casos, su actividad daba como resultado la desaparición parcial –y a veces total– de las monedas infravaloradas.In this paper we revive an old explanation for Gresham’s law that rests on the trafficking of coins by moneychangers. Focusing on the late Middle Ages, we present material suggesting that moneychangers used their private information on money to make profit through billonnage and arbitrage operations. In both cases their activity led to the partial –sometimes total– disappearance of the undervalued coins.Publicad

Parathyroid scintigraphy findings in chronic kidney disease patients with recurrent hyperparathyroidism

Background Parathyroidectomy (PTX), either subtotal or total with forearm autografting, is a well-established treatment for refractory renal hyperparathyroidism (RHPT). However, 20–30% of patients develop persistent or recurrent disease. Obtaining accurate localization before reoperation is difficult. Patients and methods The study group comprised 21 consecutive adult patients (18 undergoing haemodialysis and 3 with a renal graft) imaged using 99mTc-sestamibi/123I subtraction scintigraphy. Of the 21 patients, 12 had undergone one previous PTX and the other 9 between two and four parathyroid operations. All patients had symptoms and signs of severe RHPT. The mean serum PTH level was 1,142 pg/ml. 99mTc-Sestamibi and 123I images were recorded simultaneously. Imaging views comprised a planar view of the neck and mediastinum, followed by a magnified pinhole view over the thyroid bed area. If parathyroid ectopy was detected, SPECT or SPECT-CT was performed. The forearm was imaged in case of autograft. Results Parathyroid scintigraphy was negative in one patient and positive in the other 20 (sensitivity 95.2%). One patient had uptake corresponding to two unresected parathyroid glands. Recurrence at the site of the partially resected gland or autograft was seen in 11 patients. However, six of them had a second 99mTc-sestamibi focus corresponding to a supernumerary parathyroid gland. Seven other patients had a supernumerary parathyroid gland as the sole cause of relapse. Three of the supernumerary glands showed major ectopy (intrathyroidal, low mediastinal, undescended within the vagus nerve). One patient had parathyromatosis with multiple parathyroid nodules scattered over the left side of the neck. Reoperation was possible in 13 patients, with no false-positive findings. Conclusion Many patients referred with the hypothesis of hyperplasia of a subtotally resected parathyroid gland or autograft were found to harbour a supernumerary parathyroid gland missed at the initial surgery

Sur la formation des prix dans l'économie du haut Moyen Âge

International audienceDuring the Early Middle Ages, market exchange coexists alongside non market exchange. The aim of this paper is to examine how possibly this two great modalities of exchange can be present at the same time in the economic life, in a period in which the existence of marketable surplus is a problem. The presumed deficiencies of the means of production, their presumed unsuitability with the economic development, the postulated incompetence of the élites, make the market exchange, and even the possibility that a profit sector exists in the economy, undervalued, or even denied. The social élites, just as the small scale actors, whatever their activity could be, farming or trading, have beside production, consumption and exchange, very subtle and complex attitudes. We shall see that some cognitive capacities exist within the groups of economic actors, that go far beyond an empirical knowledge and result from a reflection about the finalities of economics, the functions of wealth and about its use in a Christian society. Sixth century monks know how the prices are formed, as they know that there is a difference between price formation and price fixation, and also know how to manage with rules to ensure one's salvation. This knowledge also exists, within a very different framework, and the comparison between the practice of such men as Adalhard of Corbie and saint Benedict's Rule (or with the Master's Rule), give an explanation of their attitude toward prices: for them, things have a value and it is possible to measure it as well as modify it. The attitude of the Carolingian and post-carolingian élites during the famines allows us to understand how social and political authorities understood market exchange rules within a Christian society. At the end, there is a shared but tacit, as well, knowledge about the functioning of exchanges and a clear awareness about the fact that they can take several forms depending on the result aimed at.Durant le haut Moyen Âge, l'échange marchand coexiste avec l'échange non-marchand. Le but de cet article est d'examiner les conditions de possibilité de la présence de ces deux grandes modalités de l'échange au sein de la vie économique durant une période où l'existence même de surplus commerciaux fait question. Les déficiences supposées des moyens de production, leur éventuelle inadéquation avec le développement, l'incompétence elle aussi postulée des élites font que l'échange par le marché et la possibilité qu'il existe un secteur de profit sont le plus souvent sous-évalués voire niés. Les élites sociales tout comme les acteurs de petit niveau, qu'il s'agisse d'agriculteurs ou de commerçants, ont à l'égard de la production, de la consommation et de l'échange des attitudes très nuancées et complexes. On montre qu'il existe des capacités cognitives qui vont au-delà d'un savoir faire empirique mais relèvent d'une réflexion sur les finalités mêmes de la vie économique, sur les fonctions de la richesse et sur leur usage dans un monde chrétien. Les moines savent, au VIe siècle, comment se forment les prix et comprennent la différence entre formation et fixation des prix. Il savent aussi comment il faut jouer avec ces règles pour assurer son salut. Ce savoir existe aussi au IXe siècle, dans un monde très différent, et la comparaison entre les pratiques d'hommes comme Adalhard de Corbie et la règle de saint Benoît (ou celle du Maître) livre l'explication de leur attitude à l'égard des prix : pour eux les choses ont une valeur qu'il est possible de mesurer et de modifier. L'attitude des élites carolingiennes et post-carolingiennes lors des famines permet d'établir comment les autorités ont compris les règles de l'échange marchand à l'intérieur d'un monde chrétien. Il y a au bout du compte un savoir partagé mais tacite sur le fonctionnement des échanges et une conscience de ce que, en fonction des buts poursuivis, ceux-ci peuvent prendre plusieurs formes

Occident méditerranéen au Moyen Âge, 1992-2003

Publications Toubert P. et Sénac Ph. (dir. et collab.), Villa 3 – Histoire et archéologie des sociétés de la vallée de l’Ebre (viie-xie siècles), coll. « Méridiennes », série « Études médiévales ibériques », Presses de l’université de Toulouse-Le Mirail, Toulouse, 2010. Toubert P. et Sénac Ph. (dir. et éd.), Villa 4 – Histoire et archéologie de l’Occident musulman (viie-xie siècles) Al-Andalus, Maghreb, Sicile, collection « Méridiennes », série « Études médiévales ibériques », Presses de l’un..

Distant metastases of differentiated thyroid cancer: diagnosis, treatment and outcome

The remarkably good prognosis and long-term survival in differentiated thyroid cancer (DTC) are significantly reduced in patients with distant metastasis (DM). Multi-site metastases are associated with a high mortality rate reaching 92% at 5 years necessitating early diagnosis and treatment. The most common site of metastases are the lungs, followed by the bone, with the former having better prognosis than the latter due to late detection. A number of factors contribute to the development of DM including large and multifocal primary tumour, extrathyroidal extension, aggressive histology and advanced age. In patients with good 131I uptake, 131I therapy appears highly effective and should be offered up to a cumulative activity of 22 GBq. Other measures such as surgery, radiotherapy, arterial embolisation and cementoplasty may be required. If there is low or no 131I uptake, FDG-PET should be obtained due to its prognostic impact. It may help in selecting patients for other modalities such as cytotoxic chemotherapy and redifferentiation therapy by 13-cis retinoic acid. The development of tyrosine kinase inhibitors has raised hopes in providing alternative therapy for bone metastasis, especially in older age groups with poorly differentiated tumours with no 131I uptake but good uptake of FDG

Colonización feudal y organización del territorio. Mallorca, 1230-1350

Editada en la Fundación Empresa PúblicaTomando como ejemplo la isla de Mallorca, los autores muestran los diversos factores socioambientales, institucionales y económicos que modelaron la colonización feudal de la isla durante los siglos XIII y XIV. Asimismo, el estudio sugiere, a partir de la comparación de este caso con otros, que la fosilización de las estructuras agrarias bajomedievales introducía cierta «senda» (path dependence) que favorecía determinadas pautas de desarrollo en detrimento de otras.Taking as an example the island of Mallorca, the authors identify the different socioenvironmental, institutional and economic factors that influenced the feudal colonization of this island in the thirteenth and fourteenth centuries. This study also suggests, by comparing this case with others, that the petrification of the late medieval agrarian structures introduced a sort of path dependence which favoured certain patterns of development to the detriment of others.Publicad

Późny przerzut do wątroby raka rdzeniastego tarczycy z niskim stężeniem kalcytoniny skutecznie wyleczony metodą radioablacji

  A 28-year-old female consulted in 1994 for a left thyroid nodule known for two years with documented progression. Left lobe resection was performed initially followed by total thyroidectomy without lymph node dissection in September 1994. Pathological examination concluded on unilateral 10 × 40 mm medullary thyroid carcinoma (MTC). RET mutation was negative. Basal and pentagastrin-stimulated CT levels had been normal from 1994 to 2008 when her CT level was found to be elevated at 33 ng/L and increased subsequently to 111 ng/L in 2010. In accordance with guidelines, cervical ultrasound was performed repeatedly with negative results. After discussion in a multidisciplinary meeting and with patient’s consent, an F-Dopa PET scan was proposed in disagreement with guidelines. This scan showed unique uptake in liver segment VI, which was confirmed by MRI. CT levels reached to 253 ng/L when she finally accepted treatment. In February 2013 we performed radiofrequency ablation of the lesion, which allowed normalisation of CT levels. This observation highlights the possibility of late recurrence of MTC. We could propose that for MTC patients with low-calcitonin levels-recurrences F-DOPA-PET/CT is a good diagnostic tool to use in case of repeatedly negative US neck studies. (Endokrynol Pol 2016; 67 (3): 326–329)    Chora w wieku 28 lat zgłosiła się do lekarza w 1994 roku z powodu lewostronnego guzka tarczycy wykrytego 2 lata wcześniej, z potwierdzoną progresją. Wykonano resekcję lewego płata tarczycy. Totalną tyreoidektomię wykonano we wrześniu 1994 roku bez usunięcia węzłów chłonnych. W badaniu patomorfologicznych stwierdzono jednostronnego raka rdzeniastego tarczycy (MTC) o wymiarach 10 × 40 mm. Wynik badania w kierunku mutacji RET był ujemny. Stężenia kalcytoniny (CT, calcitonin), podstawowe i po stymulacji pentagastryną, były prawidłowe od 1994 roku. Do 2008 roku, kiedy stwierdzono podwyższone stężenie CT wynoszące 33 ng/l, a następnie jego dalszy wzrost do 111 ng/l w 2010 roku. Zgodnie z zaleceniami powtórnie wykonano badanie USG szyi, w którym nie stwierdzono nieprawidłowości. Po omówieniu przypadku na spotkaniu wielodyscyplinarnego zespołu i uzyskaniu zgody chorej przeprowadzono badanie F-Dopa PET (niezgodnie z zaleceniami), w którym wykazano pojedyncze ognisko wychwytu w segmencie VI wątroby, co zostało potwierdzone w badaniu MRI. Kiedy chora w końcu zaakceptowała leczenie, stężenia CT zwiększyły się do 253 ng/l. W lutym 2013 roku wykonano ablację zmiany prądem o częstotliwości radiowej, co pozwoliło uzyskać normalizację stężeń CT w 2015 r. Ta obserwacja zwraca uwagę na możliwość późnej wznowy. Autorzy sugerują, że u chorych z MTC z ponownie stwierdzonym niskim stężeniem kalcytoniny wybór F-DOPA-PET/CT jako metody diagnostycznej jest dobrym rozwiązaniem w przypadku powtórnych ujemnych wyników USG szyi. (Endokrynol Pol 2016; 67 (3): 326–329)

Molecular imaging of potential bone metastasis from differentiated thyroid cancer: a case report

<p>Abstract</p> <p>Introduction</p> <p>Molecular imaging of the spine is a rarely used diagnostic method for which only a few case reports exist in the literature. Here, to the best of our knowledge we present the first case of a combination of molecular imaging by single photon emission computer tomography and positron emission tomography used in post-operative spinal diagnostic assessment.</p> <p>Case presentation</p> <p>We present the case of a 50-year-old Caucasian woman experiencing progressive spinal cord compression caused by a vertebral metastasis of a less well differentiated thyroid cancer. Following tumor resection and vertebral stabilization, total thyroidectomy was performed revealing follicular thyroid carcinoma pT2 pNxM1 (lung, bone). During follow-up our patient underwent five radioiodine therapy procedures (5.3 to 5.7 GBq each) over a two-year period. Post-therapeutic I-131 scans showed decreasing uptake in multiple Pulmonary metastases. However, following an initial decrease, stimulated thyroglobulin remained at pathologically increased levels, indicating further neoplastic activity. F18 Fludeoxyglucose positron emission tomography, which was performed in parallel, showed remaining hypermetabolism in the lungs but no hypermetabolism of the spinal lesions correlating with the stable neurological examinations. While on single photon emission computer tomography images Pulmonary hyperfixation of I-131 disappeared (most likely indicating dedifferentiation), there was persistent spinal hyperfixation at the operated level and even higher fixation at the spinal process of L3. Based on the negative results of the spinal F18 fludeoxyglucose positron emission tomography, a decision was made not to operate again on the spine since our patient was completely asymptomatic and the neurological risk seemed to be too high. During further follow-up our patient remained neurologically stable.</p> <p>Conclusions</p> <p>Molecular imaging by F18 fludeoxyglucose positron emission tomography helps to exclude metabolically active spinal metastases and to spare further risky surgery.</p

NKG2D/NKG2-Ligand Pathway Offers New Opportunities in Cancer Treatment

The antitumor functions of NK cells are regulated by the integration of positive and negative signals triggered by numerous membrane receptors present on the NK cells themselves. Among the main activating receptors, NKG2D binds several stress-induced molecules on tumor targets. Engagement of NKG2D by its ligands (NKG2D-Ls) induces NK cell activation leading to production of cytokines and target cell lysis. These effects have therapeutic potential as NKG2D-Ls are widely expressed by solid tumors, whereas their expression in healthy cells is limited. Here, we describe the genetic and environmental factors regulating the NKG2D/NKG2D-L pathway in tumors. NKG2D-L expression is linked to cellular stress and cell proliferation, and has been associated with oncogenic mutations. Tumors have been found to alter their to NKG2D-L expression as they progress, which interferes with the antitumor function of the pathway. Nevertheless, this pathway could be advantageously exploited for cancer therapy. Various cancer treatments, including chemotherapy and targeted therapies, indirectly interfere with the cellular and soluble forms of NKG2D-Ls. In addition, NKG2D introduced into chimeric antigen receptors in T- and NK cells is a promising tumor immunotherapy approach