Das schilddrüsenähnliche follikuläre Nierenzellkarzinom

Das schilddrüsenähnliche follikuläre Nierenzellkarzinom wurde auf der Grundlage von bisher 9 Fallbeschreibungen als eigenständige Nierentumorentität postuliert. Diese neue Tumorentität ist bis dato nicht in der Tumorklassifikation der World Health Organisation (WHO) aufgeführt. Wir beschreiben hier einen weiteren Fall, der als Zufallsbefund bei der Autopsie eines 58-jährigen Patienten identifiziert wurde. Der Patient verstarb an den Folgen einer akuten myeloischen Leukämie nach Chemotherapie und hatte zusätzlich ein Adenokarzinom der Prostata. Der Nierentumor war im Nierenoberpol links lokalisiert und hatte einen Durchmesser von 3 cm bei grau-brauner Schnittfläche. Histologisch zeigte der Tumor das typische schilddrüsenähnliche mikro- und makrofollikuläre Bild sowie eosinophiles intrafollikuläres kolloidähnliches Material mit teils multifokalen Verkalkungsherden. Immunhistologisch war er CD10-positiv sowie TTF1- (thyroidaler Transkriptionsfaktor-1-) und Thyreoglobulin-negativ. Die Zusammenschau der publizierten Fälle zeigt, dass diese Tumoren ein geringes Metastasierungsrisiko besitzen. Die bisherigen Erfahrungen mit diesem Tumor sind allerdings zu gering, um das schilddrüsenähnliche follikuläre Nierenzellkarzinom als eigenständige Tumorentität für die nächste WHO-Klassifikation uneingeschränkt empfehlen zu können. = Thyroid-like follicular carcinoma of the kidney is postulated as a potentially new entity of renal tumor based on nine previously published case reports. This tumor entity is not yet integrated into the classification of tumors of the World Health Organization (WHO). In this article a new case of thyroid-like follicular carcinoma of kidney is described which was incidentally detected at autopsy. The 58-year-old patient died of complications of acute myeloid leukemia after chemotherapy and also had prostatic adenocarcinoma. The renal tumor in the left kidney had a diameter of 3 cm and showed a grey-brown cut surface. Histologically, the tumor presented with a typical thyroid-like microfollicular and macrofollicular structure filled with eosinophilic, colloid-like material with calcification. Immunohistologically the renal tumor was CD 10 positive and negative for thyroid transcription factor 1 (TTF1) and thyroglobulin. A synopsis of the published case reports indicates that thyroid-like follicular carcinoma of the kidney has a low risk of metastasis. More experience with further cases of thyroid-like follicular renal carcinoma is necessary before a recommendation of a separate tumor entity in the next WHO classification is justified

Das schilddrüsenähnliche follikuläre Nierenzellkarzinom: Eine eigene Tumorentität?

Zusammenfassung: Das schilddrüsenähnliche follikuläre Nierenzellkarzinom wurde auf der Grundlage von bisher 9 Fallbeschreibungen als eigenständige Nierentumorentität postuliert. Diese neue Tumorentität ist bis dato nicht in der Tumorklassifikation der World Health Organisation (WHO) aufgeführt. Wir beschreiben hier einen weiteren Fall, der als Zufallsbefund bei der Autopsie eines 58-jährigen Patienten identifiziert wurde. Der Patient verstarb an den Folgen einer akuten myeloischen Leukämie nach Chemotherapie und hatte zusätzlich ein Adenokarzinom der Prostata. Der Nierentumor war im Nierenoberpol links lokalisiert und hatte einen Durchmesser von 3cm bei grau-brauner Schnittfläche. Histologisch zeigte der Tumor das typische schilddrüsenähnliche mikro- und makrofollikuläre Bild sowie eosinophiles intrafollikuläres kolloidähnliches Material mit teils multifokalen Verkalkungsherden. Immunhistologisch war er CD10-positiv sowie TTF1- (thyroidaler Transkriptionsfaktor-1-) und Thyreoglobulin-negativ. Die Zusammenschau der publizierten Fälle zeigt, dass diese Tumoren ein geringes Metastasierungsrisiko besitzen. Die bisherigen Erfahrungen mit diesem Tumor sind allerdings zu gering, um das schilddrüsenähnliche follikuläre Nierenzellkarzinom als eigenständige Tumorentität für die nächste WHO-Klassifikation uneingeschränkt empfehlen zu können

The Glass Transition Temperature of Water: A Simulation Study

We report a computer simulation study of the glass transition for water. To mimic the difference between standard and hyperquenched glass, we generate glassy configurations with different cooling rates and calculate the $T$ dependence of the specific heat on heating. The absence of crystallization phenomena allows us, for properly annealed samples, to detect in the specific heat the simultaneous presence of a weak pre-peak (``shadow transition''), and an intense glass transition peak at higher temperature. We discuss the implications for the currently debated value of the glass transition temperature of water. We also compare our simulation results with the Tool-Narayanaswamy-Moynihan phenomenological model.Comment: submitted to Phys. Re

Elastin is Localised to the Interfascicular Matrix of Energy Storing Tendons and Becomes Increasingly Disorganised With Ageing

Tendon is composed of fascicles bound together by the interfascicular matrix (IFM). Energy storing tendons are more elastic and extensible than positional tendons; behaviour provided by specialisation of the IFM to enable repeated interfascicular sliding and recoil. With ageing, the IFM becomes stiffer and less fatigue resistant, potentially explaining why older tendons become more injury-prone. Recent data indicates enrichment of elastin within the IFM, but this has yet to be quantified. We hypothesised that elastin is more prevalent in energy storing than positional tendons, and is mainly localised to the IFM. Further, we hypothesised that elastin becomes disorganised and fragmented, and decreases in amount with ageing, especially in energy storing tendons. Biochemical analyses and immunohistochemical techniques were used to determine elastin content and organisation, in young and old equine energy storing and positional tendons. Supporting the hypothesis, elastin localises to the IFM of energy storing tendons, reducing in quantity and becoming more disorganised with ageing. These changes may contribute to the increased injury risk in aged energy storing tendons. Full understanding of the processes leading to loss of elastin and its disorganisation with ageing may aid in the development of treatments to prevent age related tendinopathy

Comparison of different methods for delayed post-mortem diagnosis of falciparum malaria

<p>Abstract</p> <p>Background</p> <p>Between 10,000 and 12,000 cases of imported malaria are notified in the European Union each year. Despite an excellent health care system, fatalities do occur. In case of advanced autolysis, the post-mortem diagnostic is impaired. Quicker diagnosis could be achieved by using rapid diagnostic malaria tests.</p> <p>Methods</p> <p>In order to evaluate different methods for the post-mortem diagnosis of <it>Plasmodium falciparum </it>malaria in non-immunes, a study was performed on the basis of forensic autopsies of corpses examined at variable intervals after death in five cases of fatal malaria (with an interval of four hours to five days), and in 20 cases of deaths unrelated to malaria. Detection of parasite DNA by PCR and an immunochromatographic test (ICT) based upon the detection of <it>P. falciparum </it>histidine-rich protein 2 (PfHRP2) were compared with the results of microscopic examination of smears from cadaveric blood, histopathological findings, and autopsy results.</p> <p>Results</p> <p>In all cases of fatal malaria, post-mortem findings were unsuspicious for the final diagnosis, and autoptic investigations, including histopathology, were only performed because of additional information by police officers and neighbours. Macroscopic findings during autopsy were unspecific. Histopathology confirmed sequestration of erythrocytes and pigment in macrophages in most organs in four patients (not evaluable in one patient due to autolysis). Microscopy of cadaveric blood smears revealed remnants of intraerythrocytic parasites, and was compromised or impossible due to autolysis in two cases. PCR and ICT performed with cadaveric blood were positive in all malaria patients and negative in all controls.</p> <p>Conclusion</p> <p>In non-immune fatalities with unclear anamnesis, ICT can be recommended as a sensitive and specific tool for post-mortem malaria diagnosis, which is easier and faster than microscopy, and also applicable when microscopic examination is impossible due to autolysis. PCR is more expensive and time-consuming, but may be used as confirmatory test. In highly endemic areas where asymptomatic parasitaemia is common, confirmation of the diagnosis of malaria as the cause of death has to rely on histopathological findings.</p

Gastric Emphysema: An Etiologic Classification

I Gas within the wall of the stomach is a rare radiologic finding. The stomach has been the least often reported site of intramural gas in the hollow viscera. Based on etiology, gas in the wall of the stomach can be classified as either gastric emphysema or emphysematous gastritis. Gastric emphysema may be classified into traumatic, pulmonary or obstructive types depending upon the mechanism and pathogenesis. Three cases of gastric emphysema, each of different etiology, are presented to emphasize the subclassification of gastric emphysema. The clinical and prognostic significance of this classification is emphasized.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72543/1/j.1440-1673.1984.tb02363.x.pd

Recent progress on univariate and multivariate polynomial and spline quasi-interpolants

Polynomial and spline quasi-interpolants (QIs) are practical and effective approximation operators. Among their remarkable properties, let us cite for example: good shape properties, easy computation and evaluation (no linear system to solve), uniform boundedness independently of the degree (polynomials) or of the partition (splines), good approximation order. We shall emphasize new results on various types of univariate and multivariate polynomial or spline QIs, depending on the nature of coefficient functionals, which can be differential, discrete or integral. We shall also present some applications of QIs to numerical methods

Electronic and Lattice Dynamics in The Photoinduced Ionic-to-Neutral Phase Transition in a One-Dimensional Extended Peierls-Hubbard Model

Real-time dynamics of charge density and lattice displacements is studied during photoinduced ionic-to-neutral phase transitions by using a one-dimensional extended Peierls-Hubbard model with alternating potentials for the one-dimensional mixed-stack charge-transfer complex, TTF-CA. The time-dependent Schr\"odinger equation and the classical equation of motion are solved for the electronic and lattice parts, respectively. We show how neutral domains grow in the ionic background. As the photoexcitation becomes intense, more neutral domains are created. Above threshold intensity, the neutral phase is finally achieved. After the photoexcitation, ionic domains with wrong polarization also appear. They quickly reduce the averaged staggered lattice displacement, compared with the averaged ionicity. As the degree of initial lattice disorder increases, more solitons appear between these ionic domains with different polarizations, which obstruct the growth of neutral domains and slow down the transition.Comment: 9 pages, 10 figures, submitted to J. Phys. Soc. Jp

Melanoma cells break down LPA to establish local gradients that drive chemotactic dispersal.

The high mortality of melanoma is caused by rapid spread of cancer cells, which occurs unusually early in tumour evolution. Unlike most solid tumours, thickness rather than cytological markers or differentiation is the best guide to metastatic potential. Multiple stimuli that drive melanoma cell migration have been described, but it is not clear which are responsible for invasion, nor if chemotactic gradients exist in real tumours. In a chamber-based assay for melanoma dispersal, we find that cells migrate efficiently away from one another, even in initially homogeneous medium. This dispersal is driven by positive chemotaxis rather than chemorepulsion or contact inhibition. The principal chemoattractant, unexpectedly active across all tumour stages, is the lipid agonist lysophosphatidic acid (LPA) acting through the LPA receptor LPAR1. LPA induces chemotaxis of remarkable accuracy, and is both necessary and sufficient for chemotaxis and invasion in 2-D and 3-D assays. Growth factors, often described as tumour attractants, cause negligible chemotaxis themselves, but potentiate chemotaxis to LPA. Cells rapidly break down LPA present at substantial levels in culture medium and normal skin to generate outward-facing gradients. We measure LPA gradients across the margins of melanomas in vivo, confirming the physiological importance of our results. We conclude that LPA chemotaxis provides a strong drive for melanoma cells to invade outwards. Cells create their own gradients by acting as a sink, breaking down locally present LPA, and thus forming a gradient that is low in the tumour and high in the surrounding areas. The key step is not acquisition of sensitivity to the chemoattractant, but rather the tumour growing to break down enough LPA to form a gradient. Thus the stimulus that drives cell dispersal is not the presence of LPA itself, but the self-generated, outward-directed gradient