Differentiated dysplasia is a frequent precursor or associated lesion in invasive squamous cell carcinoma of the oral cavity and pharynx

The source of precursor lesions of squamous cell carcinoma (SCC) of the oral cavity and pharynx, their classification, and grading are controversial. In contrast, vulvar and penile cancer precursor lesions are known to be related to human papillomavirus or chronic inflammation and can be described using the vulvar intraepithelial neoplasia (VIN) classification system (VIN 1-3) or as differentiated vulvar intraepithelial neoplasia (dVIN), respectively. Oral and pharyngeal SCC precursor lesions are more etiologically diverse, and the spectrum of lesions may thus be wider. No international consensus exists regarding the histological types of precursor lesions or the significance of individual types. We therefore reviewed resection specimens and preceding biopsies of 155 patients with SCC of the oral cavity and pharynx (excluding tonsils) and identified five basic patterns of SCC-associated or precursor lesions: (1) pleomorphic (22/155), (2) basaloid (5/155), (3) differentiated (63/155), (4) mixed (42/155), and (5) verrucous (12/155). Keratinization was a common but variable feature in differentiated, mixed, and verrucous dysplasia. In 11/155 patients, no precursor lesion could be identified. Progression of isolated differentiated dysplasia (ranging from months to years) was documented in 13/155 (8%) of patients. Our data suggest that full-thickness epithelial dysplasia of pleomorphic or basaloid type is present in <20% of oral and pharyngeal SCC, and differentiated dysplasia is a frequent precursor or associated in situ lesion. Failure to recognize differentiated dysplasia results in the underdiagnosis of many patients at risk for invasive carcinoma. These results indicate a need to refine criteria to distinguish differentiated dysplasia from morphologically related lichenoid lesion

Beitrag zur Geschichte plastischer Berechnungsmethoden im Stahlbau

Contribution to the history of plastic analysis methods in steel construction. Jacques Heyman (Fig. lb) has been one of the main contributors to the development of structural theory in the 20th century. After graduating he joined the famous Cambridge Team directed by John Fleetwood Baker (1901-1985) (Fig. la) that established the basis for plastic analysis of steel frame structures. Baker had worked for the Steel Structures Research Committee (SSRC) between 1928 and 1936, with the specific task of writing a rational code for elastic analysis of frames. For the first time real structures were tested. The results were surprising; elastic analysis was not suitable for predicting the actual state of the steel structure, contradicting what was believed at the time. This insight caused Baker to Change the direction of his research. In 1936 Baker traveled to Germany to attend the IABSE Conference, where he met those researchers from central Europe who, for over two decades, had been studying the elasto-plastic behaviour of steel beams. Back in the UK, he continued studying this field at Bristol University; the repeated Hermann Maier-Leibnitz's tests and started a program of tests on frames. The Second World War interrupted the work, which would continue at Cambridge once the war was over and crowned with success by the books,, The steel skeleton" [I], [2] and , Plastic design of portal frames"[3]

Hemophagocytic macrophages constitute a major compartment of heme oxygenase expression in sepsis

Schaer DJ, Schaer CA, Schoedon G, Imhof A, Kurrer MO. Hemophagocytic macrophages constitute a major compartment of heme oxygenase expression in sepsis. Objectives: Uncontrolled macrophage activation with hemophagocytosis is a distinctive feature of hemophagocytic syndromes (HPS). We examined whether lympho-histiocytic infiltration of the bone marrow and liver, as well as hemo-/erythrophagocytosis also occurs during sepsis and whether this process could account for the increased production of anti-inflammatory heme-oxygenase (HO-1) products observed during sepsis. Methods: Hemophagocytosis and expression of CD163, HO-1, ferritin as well as CD8 and granzyme-B were examined in post-mortem bone marrow samples from 28 patients with sepsis and from eight control patients. Results: Comparison of samples from non-septic patients with samples from patients with fatal sepsis revealed that the latter group displayed dense lympho-histiocytic bone marrow infiltration with CD163(+)/HO-1(+)/ferritin(+) macrophages as well as with CD8(+) and granzyme-B(+) T-cells. Hemophagocytosis with prominent phagocytosis of erythroid cells was readily apparent in septic patients, implying that this process is a likely stimulus for the up-regulation of macrophage HO-1 expression. Conclusions: Lympho-histiocytic activation with hemophagocytosis is a shared pathophysiologic mechanism in HPS and sepsis. Furthermore, the association of hemophagocytosis with an increase in HO-1 expression may indicate a novel role for this apparently futile process as a negative regulator of inflammation

Transvenous Biopsy of Cavo-Atrial Tumors with the Quick-Core Needle

A variant application of the renal Quick-Core needle in 3 patients with cavo-atrial tumors is reported. In all 3 patients either a transjugular or transfemoral venous biopsy approach with this device yielded sufficient tissue for histological diagnosis at the first attempt. Bioptic diagnoses were confirmed either by surgery or radiological and clinical response to a specific chemotherapy. There were no procedure-related complication

Zur baustatischen Analyse gewölbter Steinkonstruktionen

Das Gewölbe ist noch immer ein Rätsel der Baustatik. Seit über 300 Jahren versuchten Mathematiker, Naturwissenschaftler, Ingenieure und Architekten, das Tragverhalten von Gewölben durch baustatische Modellierung zu begreifen und zu quantifizieren. In Abschnitt 1 wird die Entwicklungsgeschichte der Gewölbetheorien von den Anfangen bis zur Durchsetzung der Elastizitätstheorie bei der baustatischen Analyse ebener, gewölbter Steinkonstruktionen um 1900 dargestellt

Diagnosis, treatment and long-term outcome of solitary fibrous tumours of the pleura

Objective: Solitary fibrous tumours of the pleura (SFTP) are rare and can histologically be differentiated into benign and malignant forms. The aim of this study is to present new cases, and discuss up-to-date preoperative examinations, the role of video-assisted thoracic surgery and long-term outcome. Methods: Between 1993 and 2006, 27 SFTPs were diagnosed (14 females, mean age±SD, 62.3±9.6 years) at our institution. Medical records were reviewed, and follow-up was obtained by repeated examinations or contact with general practitioners. Results: SFTPs were associated with symptoms in 63% of all cases. In the six patients in which positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) was performed preoperatively, malignant lesions were all found to be positive. Complete resection was achieved by video-assisted thoracic surgery in 15 and anterolateral thoracotomy in 12 patients. Mean hospital stay was shorter for patients operated by video-assisted thoracic surgery compared to thoracotomy, 4.5 (range 3-6) versus 7.5 (range 4-25) days, respectively (p≪0.01). Histology revealed 17 benign and 10 malignant SFTP. Mean±SD tumour diameter of malignant SFTPs was larger than in benign forms, 11.9±7.1 versus 6.1±3.5cm, respectively (p≪0.01). Tumour recurrence was recognised in four patients with malignant SFTPs at a median time interval after surgery of 38 (range 6-122) months, two late deaths occurred resulting from tumour recurrences. Conclusions: SFTPs can be treated minimally invasively by video-assisted thoracic surgery with short hospital stay. Large SFTPs with increased FDG-uptake have a high likelihood for malignancy. Long-term follow-up is mandatory in malignant SFTPs because of late recurrences associated with deat

Selection and immunomagnetic purging of peripheral blood CD34+ cells for autologous transplantation in B-cell non-Hodgkin's lymphomas

Background: Clonogenic tumor cells in the hematopoietic progenitor cell harvest may contribute to relapse after high dose therapy for B-cell malignancies. Purging of the HPC harvest requires large amounts of anti-B-cell antibodies, whereas CD34-selection enriches self renewing HPC's but malignant cells are still detectable in many CD34+ fractions. Patients and methods: We examined the feasability and safety of a CD34-selection followed by purging with anti-B-cell antibodies in 11 patients with B-cell non-Hodgkin's lymphomas undergoing high-dose therapy with cyclophospha-mide, BCNU and etoposide with retransfusion of autologous HPC's. Results: A mean number of 340 × 108 mononuclear cells was used for CD34-selection and immunomagnetic purging. CD34+ cells were enriched from a mean of 1.7% (range 0.2%-4.5%) to a mean of 68% (range 49%-87%) with a mean recovery of 27% (range 15%-43%). The mean number of retransfused CD34+ cells was 1.2× 106/kg (range 0.6-2.2 ×106/kg) body weight with a median of 11 days (range 10-13 days) to neutrophil recovery of 0.5×109/1 and 17 days (range 13-25 days) to platelet recovery of 50 × 109/1. Mean number of intravenous antibiotics and inpatient days were 8 (range 0-14) and 22 (range 19-26) respectively. Major toxicity consisted in four septicemias. Conclusions: CD34-selected and purged HPC's are safe and mediate rapid hematological recovery after high dose therapy for B-cell non-Hodgkin's lymphoma

Dynamics of a Limit Cycle Oscillator under Time Delayed Linear and Nonlinear Feedbacks

We study the effects of time delayed linear and nonlinear feedbacks on the dynamics of a single Hopf bifurcation oscillator. Our numerical and analytic investigations reveal a host of complex temporal phenomena such as phase slips, frequency suppression, multiple periodic states and chaos. Such phenomena are frequently observed in the collective behavior of a large number of coupled limit cycle oscillators. Our time delayed feedback model offers a simple paradigm for obtaining and investigating these temporal states in a single oscillator.We construct a detailed bifurcation diagram of the oscillator as a function of the time delay parameter and the driving strengths of the feedback terms. We find some new states in the presence of the quadratic nonlinear feedback term with interesting characteristics like birhythmicity, phase reversals, radial trapping, phase jumps and spiraling patterns in the amplitude space. Our results may find useful applications in physical, chemical or biological systems.Comment: VERSION 4: Fig. 10(d) added, an uncited reference removed; (To appear in Physica D) (17 pages, 21 figures, two column, aps RevTeX); VERSION 3: Revised. In Section 2, small tau approximation added; Section 3 is divided into subsections; periodic solution discussed in detail; Figs. 7 and 11 discarded; Figs. 12 and 14 altered; three new figures (now Figs. 10, 11 and 21) added. VERSION 2: Figs. 1 and 2 replace