bluuebunny/crossref_metadata_2025 huggingface dataset:
Occurrence of Podocotyle Dujardin, 1845 (Opecoelidae, Podocotylinae) in three species of deep-sea macrourids from the Gulf of Mexico and Caribbean Sea with an updated key to species and host-parasite checklist
Authors: BLEND CHARLES K. , DRONEN NORMAN O. , ARMSTRONG HOWARD W.
Published: July 2019

Podocotyle pearsei Manter, 1934 is documented from the intestine of Vaillant’s grenadier, Bathygadus melanobranchus Vaillant (Macrouridae: Bathygadinae), collected from the northeastern and western Gulf of Mexico from 783–841 m depth. The finding of P. pearsei in B. melanobranchus represents the first originally published report of this genus from this host and the fifth documented host species for P. pearsei. We report three unidentified species of Podocotyle, represented by one individual each, from the intestine of the western Atlantic grenadier, Nezumia atlantica (Parr) (Macrouridae: Macrourinae), and from Bathygadus favosus Goode & Bean (Macrouridae: Bathygadinae) found at 637 m, 710 m and 1,143 m depths in the northeastern Gulf of Mexico off Florida and from the Caribbean Sea off Colombia. We provide a checklist of the parasites known from the three macrourid species relevant to this study, comment on the biogeography of the five species of Podocotyle now known from the deep sea and discuss the low host specificity observed across this genus. The high number of fish hosts for Podocotyle (i.e. type hosts include at least 22 piscine families) encompassing a wide phylogenetic diversity and diet makes it unlikely that members of a single genus could evolve such a broad array of life histories (i.e. utilize dissimilar intermediate hosts), and we predict in the future that Podocotyle will be taxonomically divided up. Morphological and especially molecular work is needed for Podocotyle as well as for other digenean genera known to inhabit the deep sea. Podocotyle sp. 1 & 2 represent the first originally published reports of this genus from N. atlantica while Podocotyle sp. 3 represents the first report of this genus from B. favosus. Podocotyle koshari Nagaty, 1973 is declared a species inquirenda, and a dichotomous key to the 27 species of Podocotyle we recognize is provided.
Archaeocerus uenoi n. gen. n. sp. (Coleoptera Leiodidae Catopocerinae) from Albian/Cenomanian age amber of Myanmar
Authors: PERREAU MICHEL
Published: July 2019

The first fossil Catopocerinae: Archaeocerus uenoi n. gen. n. sp. (Coleoptera Leiodidae) is described and figured. It comes from the upper Cretaceous (Albian/Cenomanian) amber deposit of the Hukawng valley, in northern Myanmar. Archaeocerus has developed eyes and flight wings, contrast to all the other genera of the subfamily which are anophthalm and apterous.
Computational Fluid Dynamic Design and Experimental Study of a Temperature Sensor Array Used in Climate Reference Station
Authors: Yang Jie , Liu Qingquan , Dai Wei
Published: July 2019

Accurate air temperature measurements are demanded for climate change research. However, air temperature sensors installed in a screen or a radiation shield have traditionally resisted observation accuracy due to a number of factors, particularly solar radiation. Here we present a novel temperature sensor array to improve the air temperature observation accuracy. To obtain an optimum design of the sensor array, we perform a series of analyses of the sensor array with various structures based on a computational fluid dynamics (CFD) method. Then the CFD method is applied to obtain quantitative radiation errors of the optimum temperature sensor array. For further improving the measurement accuracy of the sensor array, an artificial neural network model is developed to learn the relationship between the radiation error and environment variables. To assess the extent to which the actual performance adheres to the theoretical CFD model and the neural network model, air temperature observation experiments are conducted. An aspirated temperature measurement platform with a forced airflow rate up to 20 m s−1 served as an air temperature reference. The average radiation errors of a temperature sensor equipped with a naturally ventilated radiation shield and a temperature sensor installed in a screen are 0.42° and 0.23°C, respectively. By contrast, the mean radiation error of the temperature sensor array is approximately 0.03°C. The mean absolute error (MAE) between the radiation errors provided by the experiments and the radiation errors given by the neural network model is 0.007°C, and the root-mean-square error (RMSE) is 0.009°C.
Deferral Versus Performance of Revascularization for Coronary Stenosis With Grey Zone Fractional Flow Reserve Values: A Systematic Review and Meta-Analysis
Authors: Du Yu , Liu Yan , Cai Gaojun , Yang Bangguo , Cheng Yujing , Liu Jinxing , Liu Wei , Liu Xiaoli , Zhou Zhiming , Zhao Yingxin , Zhou Yujie
Published: July 2019

We searched PubMed, EMBASE, Cochrane Library, and Web of Science for studies using fractional flow reserve (FFR) to determine whether revascularization should be performed or deferred for patients with coronary stenosis and grey zone FFR. Meta-analysis was performed using the generic inverse variance method, and hazard ratios (HR) were synthesized with a random-effects model. Of 2766 records, 7 nonrandomized studies including 2683 patients were selected. The pooled results demonstrated, during a median follow-up of 32 months, that revascularization significantly reduced the risk of major adverse cardiac events (MACE; 7 studies: HR [95% confidence interval, CI]: 0.65 [0.45-0.93], P = .02) and target vessel revascularization (TVR; 4 studies: HR [95% CI]: 0.52 [0.36-0.76], P < .01). Whereas revascularization was not significantly superior in terms of all-cause death (3 studies: HR [95% CI]: 0.56 [0.26-1.22], P = .14), cardiac death (2 studies: HR [95% CI]: 0.57 [0.16-2.01], P = .38), myocardial infarction (MI; 4 studies: HR [95% CI]: 1.03 [0.26-4.03]), and all-cause death or MI (3 studies: HR [95% CI]: 0.66 [0.20-2.19], P = .50). Therefore, revascularization appeared to be superior to deferral for patients with grey zone FFR in MACE and TVR, while hard end points did not show such significance. This work was registered in PROSPERO (CRD42019118432).
Application of fractional-order voltage controller in building-integrated photovoltaic and wind turbine system
Authors: Gül Ozan , Tan Nusret
Published: July 2019

The share of electricity generation based on clean, inexhaustible and continuous energy sources, such as solar and wind, in total energy production, is rising day by day due to its significant advantages such as having the less negative impact on global climate and environmental pollution and not requiring fuel for energy production. It is reported that commercial and residential buildings correspond to about 20.1% of the world energy consumption, so it is necessary to provide energy needs of buildings with hybrid renewable energy systems. When using non-continuous energy sources such as solar panel and wind turbines, it is important to ensure ensuring a stable and quality power flow to the building while the power demands of building show very sharp variability. This work presents a voltage control system using fractional-order operators in the smart residential building-integrated hybrid renewable power plant (solar + wind). In this research article, fractional-order proportional–integral/proportional–integral–derivative controllers are proposed on a synchronous frame for a pulse-width modulation based three-phase voltage source inverter in residential building-integrated solar panel and wind turbines system (building-integrated photovoltaic/wind turbine system) in order to improve the quality of injected voltage to building. When comparing the effect of closed-loop voltage control system with integer order controllers (proportional–integral and proportional–integral–derivative) on the power quality at the building distribution by analyzing the simulation results for proposed case study, use of fractional-order voltage controllers for nonlinear system such as building integrated with hybrid renewable sources is more suitable than using integer order voltage controllers.
Fibre architecture modification to improve the tensile properties of flax-reinforced composites
Authors: Rayyaan Rishad , Kennon William Richard , Potluri Prasad , Akonda Mahmudul
Published: July 2019

As far as the tensile properties of natural fibres as reinforcements for composites are concerned, flax fibres will stay at the top-end. However, an efficient conversion of fibre properties into their corresponding composite properties has been a challenge, due to the fibre damages through the conventional textile methods utilised to process flax. These techniques impart disadvantageous features onto fibres at both micro- and meso-scale level, which in turn degrade the mechanical performances of flax fibre-reinforced composites (FFRC). Undulation of fibre is one of those detrimental features, which occurs during traditional fibre extraction from plant and fabric manufacturing routes. The undulation or waviness causes micro-compressive defects or ‘kink-bands’ in elementary flax fibres, which significantly undermines the performances of FFRC. Manufacturing flax fabric with minimal undulation could diminish the micro-compressive defects up to a substantial extent. In this research, nonwoven flax tapes of highly aligned flax fibres, blended with a small proportion of polylactic acid have been manufactured deploying a novel technique. Composites reinforced from those nonwoven tapes have been compared with composites reinforced with woven Hopsack fabrics and warp knitted unidirectional fabrics from flax, comprising undulating fibres. The composites reinforced with the highly aligned tapes have shown 33% higher fibre-bundle strength, and 57% higher fibre-bundle stiffness in comparison with the composites reinforced with Hopsack fabric. The results have been discussed in the light of fibre undulation, elementary fibre individualisation, homogeneity of fibre distribution, extent of resin rich areas and impregnation of the fibre lumens.
Structures and dyeing performances of polyethyleneimine-carbamate linked bamboo viscose fibers dyed with lac
Authors: Sombatdee Suthisa , Saikrasun Sunan
Published: July 2019

Polyethyleneimine (PEI)-immobilization of bamboo viscose fibers using carbamate linkages (ABF-PEI) was investigated in order to improve the dyeing properties of the fiber. Results from morphological observation, Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy and thermogravimetric analysis clearly showed the successful carbamate binding of PEI at hydroxyl groups of cellulose fiber. The adsorption studies revealed that fast and efficient adsorption was achieved for ABF-PEI. Under optimum dyeing conditions, the amount of dye adsorbed on ABF-PEI at equilibrium (>100 mg/g) was much higher than that of the unmodified fiber (<10 mg/g). The adsorption behavior of lac dyeing on the PEI-modified bamboo viscose fibers could be described by the pseudo-second-order kinetics and Langmuir isotherm. The proposed mechanism mainly involved the electrostatic ion–dipole interaction between protonated amines of PEI and negative charged sites of lac dye. The color fastness results indicated good resistance of color changes for ABF-PEI, suggesting efficiency of the surface modifying method of PEI-immobilization on bamboo viscose fibers.
Do Sociology Courses Make More Empathetic Students? A Mixed-Methods Study of Empathy Change in Undergraduates
Authors: Rockwell Ashley , Vidmar Chris M. , Harvey Penny , Greenwood Leanna
Published: July 2019

Assessing course goals is often challenging; assessing an abstract goal, like empathy, can be especially so. For many instructors, empathy is central to sociological thinking. As such, fostering empathy in students is a common course goal. In this article, we report the initial findings of a semester-long assessment of empathy change in undergraduate students ( N = 619). We employ a mixed-methods research design that utilizes qualitative instructor data to determine independent instructor-level variables and student surveys to measure student empathy change. We compare empathy change between students enrolled in introductory sociology classes to students not enrolled in sociology classes and test which student and instructor variables predict empathy change. We find that students taking sociology classes have positive empathy change compared to those who do not. We interpret these findings as evidence that study of sociology promotes empathy development and discuss implications for the classroom and further research.
Adaptive tensegrity locomotion: Controlling a compliant icosahedron with symmetry-reduced reinforcement learning
Authors: Surovik David , Wang Kun , Vespignani Massimo , Bruce Jonathan , Bekris Kostas E
Published: July 2019

Tensegrity robots, which are prototypical examples of hybrid soft–rigid robots, exhibit dynamical properties that provide ruggedness and adaptability. They also bring about, however, major challenges for locomotion control. Owing to high dimensionality and the complex evolution of contact states, data-driven approaches are appropriate for producing viable feedback policies for tensegrities. Guided policy search (GPS), a sample-efficient hybrid framework for optimization and reinforcement learning, has previously been applied to generate periodic, axis-constrained locomotion by an icosahedral tensegrity on flat ground. Varying environments and tasks, however, create a need for more adaptive and general locomotion control that actively utilizes an expanded space of robot states. This implies significantly higher needs in terms of sample data and setup effort. This work mitigates such requirements by proposing a new GPS -based reinforcement learning pipeline, which exploits the vehicle’s high degree of symmetry and appropriately learns contextual behaviors that are sustainable without periodicity. Newly achieved capabilities include axially unconstrained rolling, rough terrain traversal, and rough incline ascent. These tasks are evaluated for a small variety of key model parameters in simulation and tested on the NASA hardware prototype, SUPERball. Results confirm the utility of symmetry exploitation and the adaptability of the vehicle. They also shed light on numerous strengths and limitations of the GPS framework for policy design and transfer to real hybrid soft–rigid robots.
Induced by infection? A case of acute myocardial infarction with hypothermia
Authors: Li Liang , Xia Shudong , Feng Chao
Published: July 2019

A 52-year-old man was admitted to our hospital because of abdominal pain, nausea, and vomiting. On arrival, his body temperature was <35°C. Although his other vital signs and electrocardiographic findings were normal, his white blood cell count and C-reactive protein concentration were elevated. He was diagnosed with severe infectious disease and treated with intravenous antibiotics and rewarming therapy. Two hours later, his body temperature had increased to 38.4°C, but his abdominal pain persisted. A repeat electrocardiographic examination showed an elevated ST-segment in leads II, III, and aVF. He was then diagnosed with ST-elevation myocardial infarction. Coronary angiography showed occlusion of the right coronary artery, and he underwent implantation of two stents. His symptoms were relieved soon thereafter, and his body temperature returned to normal without antibiotics.
Malignant Peritoneal Mesothelioma
Authors: de Pangher Manzini Vincenzo
Published: July 2019

Background

The clinical characteristics of malignant peritoneal mesothelioma are not fully known, and it appears as a variable entity with different types of clinical presentation and with a difficult diagnosis.

Patients

Fifteen patients with malignant peritoneal mesothelioma were analyzed for asbestos exposure, clinical presentation, thrombocytosis, X-rays and echotomographic findings, peritoneal fluid cytology, surgical investigations, diagnosis in vita, therapy, cause of death, diagnosis time, and survival time.

Results

Asbestos exposure was present in 12 men. Abdominal pain, ascites, abdominal mass, weight loss and fever were the most common presentation symptoms. In 5 patients, the disease presented as a surgical emergency. Assembling the presenting symptoms, malignant peritoneal mesothelioma was subdivided in 3 types: classical (6 cases), surgical (5 cases) and medical (4 cases). Thrombocytosis was present in 11 cases. Peritoneal fluid cytology was positive for neoplastic mesothelial cells in 8 of 10 cases. Laparotomy (5 patients) and laparoscopy (7 cases) were diagnostic in all cases. Diagnosis in vita was malignant peritoneal mesothelioma for 13 patients, peritoneal carcinomatosis for 1, with only 1 autopsy diagnosis. Seven patients were treated with chemotherapy, showing a progression of the disease. Mean symptoms-to-diagnosis time was 122 days (4-410), and mean symptoms-to-survival time was 345 days (45-1510).

Conclusions

Malignant peritoneal mesothelioma is a very unusual disease characterized by a difficult diagnosis, a rapid evolution, a poor response to therapy, and a very high prevalence of thrombocytosis. A new clinical classification into three types (classical, surgical and medical) may be useful for a correct diagnosis. The early diagnosis of malignant peritoneal mesothelioma remains an important open question.
Primary Pulmonary Lymphoma: Diagnosis and Follow-Up of 6 Cases and Review of an Uncommon Entity
Authors: Varona Jose Felipe , Guerra Juan Manuel , Grande Carlos , Villena Victoria , González-Lois Carmen , Martinez Miguel Angel
Published: July 2019

Aims and background

Primary pulmonary lymphoma is an uncommon disease with a poorly defined management. We reviewed and followed the cases of primary pulmonary lymphoma in our institution to gather an estimation of this entity in our population.

Design and methods

We reviewed the records of all patients with biopsy-proven lymphoma of the lung. The main diagnostic criterion for primary pulmonary lymphoma was the absence of extrapulmonary involvement.

Results

We identified 6 cases of primary pulmonary lymphoma among 33 patients with biopsy-proven lymphoma of the lung evaluated in our center in a 12-year period. A radiological abnormality in an asymptomatic patient was the most common clinical presentation. Four cases were low-grade and two cases high-grade non-Hodgkin PPL. Histopathologic analyses of lung specimens obtained by transbronchial biopsy were sufficient for a diagnosis in 5 of the 6 cases and avoided invasive surgical maneuvers. Most patients followed an indolent course, but with a tendency to relapse.

Conclusions

Although clinical management of this entity is undefined, we feel bronchoscopic study, which is less aggressive than surgery, may be an adequate procedure for a diagnosis. Mono-chemotherapy using alkylating agents and careful clinical observation may be the best therapeutic approach for these patients, since most of them have favorable outcomes, whatever the treatment modalities.
Basaloid Squamous Cell Carcinoma of the Esophagus a Case Report
Authors: Bekavac-Bešlin Miroslav , Mijić August , Matejčić Aljoša , Ferenčić Željko
Published: July 2019

Basaloid squamous cell carcinoma (BSCC) of the esophagus is an extremely rare tumor which should be differentiated from adenoid cystic and small cell undifferentiated carcinoma. We present the case of a 48-year-old male patient with esophageal BSCC. This tumor has specific histological features which may be difficult to recognize by small endoscopic biopsy examination. In our patient the surgical specimen revealed BSCC with an aggressive pattern (invasion of the whole esophageal wall thickness, lymph node metastases and intraneural spread). We proposed chemotherapy and radiotherapy after surgery, which resulted in a survival of 17 months.
Prognostic Factors in Early Glottic Carcinoma Implications for Treatment
Authors: Nur Demiral Ayse , Oguz Cetinayak , Kemal Erdag Taner , Ferhat Eyiler , Sülen Sarıoglu , Emel Ada , Munir Kınay , Ann Cooper Sen Rachel , Mehmet Sen
Published: July 2019

Aim

In this study we aimed to determine the prognostic factors affecting local control (LC) in limited glottic carcinoma treated with definitive radiotherapy (RT).

Material and methods

Between June 1991 and December 2001, 114 patients with early squamous-cell carcinoma of the glottis were treated with definitive RT at our institution. Only four (3.5%) patients were women. The median age was 60 (27-79). Fifteen percent, 72% and 13% of the patients had Tis, T1 and T2 tumors, respectively. Forty-three (37.7%) patients had anterior commissure invasion. Prior to RT 35 (31%) patients had undergone vocal cord stripping and two (2%) cordectomy. A median dose of 66 Gy (50-70.2) was given over a median period of 46 days (20-60). Univariate and multivariate analyses were performed for LC. The prognostic parameters analyzed for LC were T classification, anterior commissure involvement, total RT dose, and overall treatment time.

Results

Five-year local and regional control rates were 84.2% and 97.7%. RTOG grade 3-4 late side effects were observed only in one (0.9%) patient. In 15 patients with local failure, salvage treatment consisted of partial laryngectomy in eight patients and total laryngectomy in five. One of the remaining two patients was medically inoperable, and the other refused salvage surgery. In one of the three patients with regional failure, salvage surgery was applied and the other two were given palliative chemotherapy because of unresectable disease. Following salvage treatments, the ultimate five-year LC rate was 96.9% and the five-year larynx preservation rate was 91.1%. Second primary cancer was diagnosed in 17 (14.9%) patients. Only one patient developed distant metastases and two patients died of laryngeal cancer. While T2 disease and anterior commissure involvement were found to be unfavorable prognostic factors significantly influencing LC in univariate analyses, only T2 disease remained independent in multivariate analysis.

Conclusion

In patients with early glottic carcinoma, T classification proved to be the only independent prognostic factor affecting LC after primary radiotherapy according to the results of this study.
Ifosfamide Encephalopathy: A Case Report
Authors: Pavarana Michele , Nortilli Rolando , Valcamonico Francesca , Romito Silvia , Zanoni Tiziano , Cetto Gianluigi
Published: July 2019

The aim of this short communication is to discuss the mechanism, modality and treatment of ifosfamide encephalopathy. We present the case of a 52-year-old woman treated with this alkylating agent who developed severe neurotoxicity. It was resolved with administration of Methylene blue, abundant intravenous hydration and interruption of ifosfamide.
Metastatic Tumors of the Umbilicus: Report of Two Cases and Review of the Literature
Authors: Coco Claudio , Manno Alberto , Verbo Alessandro , D'Alba Pierfrancesco , Pierconti Francesco , De Gaetano Anna Maria , Pedretti Giorgio , Petito Luigi , Rizzo Gianluca , Masi Antonio , Picciocchi Aurelio
Published: July 2019

An umbilical nodule may be an early or late sign of metastatic spread from an internal malignancy. Usually it appears when the internal malignancy is widely disseminated and has been previously diagnosed. More rarely, such a nodule is the first sign of disease and eventually results in the diagnosis of the primary tumor. We present two cases which document examples of both events, in order to focus on the most relevant aspects of this condition.
A Case of Metastatic Epithelioid Angiosarcoma in the Lamina Propria of a Sigmoid Tubulovillous Adenoma
Authors: Ricchetti Tommaso , Paci Massimiliano , Cavazza Alberto , Ferrari Guglielmo , Annessi Valerio , De Franco Salvatore , Sgarbi Giorgio
Published: July 2019

Epithelioid angiosarcoma is an extremely rare tumor. It is generally a secondary tumor and the preferred sites of such metastases are the heart, pericardium, lung, breast, liver, spleen, bone, and brain. In rare cases the lung has been described as the primary site. The prognosis of this neoplasm is extremely poor. We report a case of epithelioid angiosarcoma with multiple bilateral lung infiltration, bone metastasis, and metastasis of the lamina propria of a tubulovillous adenoma of the colon.
Expression of P53 Protein and Dna Flow Cytometry in Gastric Adenocarcinoma: Implications in Patients Treated with Adjuvant Etoposide, Adriamycin and Cisplatin
Authors: Büyükçelik Abdullah , Onur Handan , Akbulut Hakan , Yalçin Bülent , Ensari Arzu , Utkan Güngör , Önal Binnur Sönmez , İçli Fikri
Published: July 2019

Aims and background

We evaluated the prognostic value of p53 protein, DNA content and S-phase fraction in patients with adenocarcinoma of the stomach or the gastroesophageal junction treated with adjuvant etoposide, doxorubicin and cisplatin.

Methods and study design

Thirty-five consecutive patients with stage II or III gastric or gastroesophagial junction adenocarcinoma treated with at least two cycles of adjuvant etoposide, doxorubicin and cisplatin after curative gastric resection were included. The expression of p53 protein was determined by immunohistochemistry and DNA content by flow cytometry. The presence of p53 expression and DNA content was compared with clinicopathological features.

Results

Median age was 54 years (range, 31–71). P53 expression was detected in 42.9% (15 of 35) of gastric cancer tissues of the patients. Aneuploidy was observed in 31.4% of patients, and S-phase fraction was more than 10% in 22.9%. P53 immunoreactivity (33.3% vs 47.8%) was more common in advanced disease. There was no association among p53 immunoreactivity, DNA content and S-phase fraction. We also found no significant relationship between p53 immunoreactivity, DNA content, S-phase fraction or other clinicopathological parameters. In univariate analysis, the involvement of lymph nodes was a significant predictor of a poor outcome (P = 0.001). Also, p53-positive patients had a poor survival close to the level of significance (P = 0.051). Likewise, p53 immunoreactivity (P = 0.0071), in addition to lymph node involvement (P = 0.0016), were the independent prognostic factors in multivariate analysis.

Conclusions

This trial supports the results of previous reports that p53 immunoreactivity is a prognostic factor for patients with adenocarcinoma of stomach or gastroesophageal junction treated with adjuvant chemotherapy.
Different Clinical Features of Primary and Secondary Tumors in Patients with Multiple Malignancies
Authors: Artac Mehmet , Bozcuk Hakan , Ozdogan Mustafa , Demiral Ayşe Nur , Sarper Alpay , Samur Mustafa , Savas Burhan
Published: July 2019

Clinical features of the first and second primaries in patients with multiple malignancies have not been extensively studied. We compared patient and treatment characteristics of the primary malignancy in 48 consequent multiple primary cancer patients with those of the second primary in the same cohort. The second primaries comprised fewer breast cancers; 29.2% of primaries as opposed to 10.4% of second tumors were breast cancer (P = 0.049). In addition, primary tumors tended to be at a lower TNM stage than secondary tumors (P = 0.060). The median overall survival after the diagnosis of the first primary for the whole cohort was 22.3 years (95% CI, 2.0–42.5) and the median time to presentation of the second malignancy was 38 months after the diagnosis of the first primary (range, 0 to 384). Therefore, the prognosis of cancers in the multiple malignancy group appears to be good and they appear to have an indolent clinical behavior. Thus, we recommend a long screening time for secondary tumors after a curative treatment in patients with common cancers, taking into account the different occurrence patterns of second primaries with respect to first primaries.
Usefulness of Ultrasound-Guided Fine-Needle Aspiration Cytology in the Diagnosis of Non-Palpable Small Thyroid Nodules
Authors: Accurso Antonello , Rocco Nicola , Palumbo Alessio , Leone Francesco
Published: July 2019

Aims and background

Diverse and contradictory approaches have been suggested for the management of non-palpable thyroid nodules. The aim of our study was to evaluate the indications and limits of ultrasound-guided fine-needle aspiration cytology (US-FNAC) in non-palpable infracentimetric thyroid nodules.

Methods and study design

From September 2003 to December 2004 we observed 325 patients with non-palpable thyroid nodules. We divided our series into three groups according to the diameter of the lesion in order to verify the effectiveness of US-FNAC for lesions of less than 1 cm.

Results

We assessed the cases with satisfactory and unsatisfactory results in the three groups into which the sample was divided (4 mm to 1 cm; 10.1 mm to 15 mm, and 15.1 mm to 25.5 mm). Our statistical analysis by means of the z-test showed there was no significant (5%) difference in the percentage distribution of the unsatisfactory results in the three groups.

Conclusions

Fine-needle cytology appears to be a useful diagnostic tool also for nodules of less than one cm because the percentage of unsatisfactory results is not related to the size of the nodule.
Fatal Immunodeficiency in a Patient with Thymoma and Good's Syndrome
Authors: Montella Liliana , Merkabaoui Ghassam , Vitiello Laura , Bulgarelli Goffredo , Sinagra Gianfranco , Masci Anna Maria , Racioppi Luigi , Palmieri Giovannella
Published: July 2019

Thymoma is a rare tumor characterized by an association with autoimmune diseases. Immunological abnormalities are increasingly being recognized in thymoma patients and are the cause of a peculiar susceptibility to infections. The authors present the clinical history of a thymoma patient affected by fatal immunodeficiency.
Recurrence of Pseudomyxoma Peritonei within the Inguinal Canal
Authors: Cabanas Jacobo , da Silva Rodrigo Gomes , Goldstein Paulo , Verghese Mohan , Sugarbaker Paul H.
Published: July 2019

Aim and Background

Tumor appearing in an inguinal hernia sac indicates widespread carcinomatosis with ascites. A new onset hernia is a common clinical presentation of pseudomyxoma peritonei syndrome arising in an appendiceal mucinous tumor. Recurrence of pseudomyxoma peritonei within the inguinal region was previously reported in only a single patient. We present five patients with a recurrence of pseudomyxoma peritonei tumor nodules in the inguinal region following cytoreductive surgery and attempt to understand the etiology of this treatment failure.

Methods and Study Design

From a database of 910 patients with mucinous appendiceal tumors with peritoneal dissemination who had definitive treatment, five patients who had disease recurrence within the inguinal region were identified. The clinical histories were studied and presented in order to make future recommendations regarding the management of these patients.

Results

Five patients with ages ranging 39 to 67 years had a mucinous tumor in the inguinal region as a recurrence after a previous cytoreductive surgery combined with perioperative intraperitoneal chemotherapy. One of them had separate recurrence in both right and left inguinal regions. All these patients were made disease-free by the reoperative surgery with a sacrifice of the testicle in four. None have evidence of a recurrence of an inguinal hernia despite the lack of formal repair.

Conclusion

At the time of initial cytoreductive surgery the surgeon should be aware of the inguinal region as a possible site of relapse. This may be more problematic in patients who have had prior surgery with mucoid fluid in a hernia as the presenting sign of pseudomyxoma peritonei. Inguinal recurrences should be removed with clear margins even if orchiectomy is required.
Postoperative Chemoradiotherapy of Pancreatic Cancer: What is the Appropriate Target Volume of Radiation Therapy?
Authors: Kim Kyubo , Kim Suzy , Chie Eui Kyu , Kim Sun Whe , Bang Yung-Jue , Ha Sung W.
Published: July 2019

Aims and Background

To evaluate the influence of radiation therapy target volume on the treatment outcome of adjuvant chemoradiotherapy for pancreatic cancer after curative resection.

Methods

Between February 1987 and July 2001, 70 patients treated with curative resection and adjuvant chemoradiotherapy for pancreatic adenocarcinoma were analyzed. There were 49 males and 21 females, with a median age of 57 years. Whipple's operation was performed in 44 patients, pylorus-preserving pancreaticoduodenectomy in 14, distal pancreatectomy in 9, and subtotal pancreatectomy in 3. Postoperative adjuvant radiotherapy was given up to 40 Gy at 2 Gy per fraction with a two-week planned rest. Intravenous 5-fluorouracil (500 mg/m2/day) was given on days 1 to 3 of each split course of radiotherapy. Until 1991, whole pancreas or preoperative tumor volume and retroperitoneal lymph nodes were irradiated (extended field, n = 14). Thereafter, the target volume included the retroperitoneal lymph nodes and the involved pancreatic resection margin (limited field, n = 56). The median follow-up period of all the patients was 16 months (range, 2-99).

Results

The overall 2- and 5-year survival rate of all patients was 29.7% and 14.0%, respectively. According to the radiotherapy target volume, the median survival time was 14 months in the extended field group and 16 months in the limited field group ( P = 0.65).

Conclusions

From the viewpoint of the target volume of radiotherapy, a limited field did not worsen the treatment outcome, although the survival rate was poor in both groups.
Molecular Profile and Clinical Variables in Brca1-Positive Breast Cancers. A Population-Based Study
Authors: Musolino Antonino , Michiara Maria , Bella Maria A. , Naldi Nadia , Zanelli Paola , Bortesi Beatrice , Capelletti Marzia , Soldani Linda , Camisa Roberta , Martella Eugenia , Franciosi Vittorio , Savi Mario , Neri Tauro M. , Ardizzoni Andrea , Cascinu Stefano
Published: July 2019

Purpose

To evaluate the clinical features of breast cancer patients with genetic susceptibility to this disease and to investigate the contribution of BRCA1 germline mutations to the phenotype of these tumors.

Patients and Methods

We reviewed the clinical and pathological records of 102 women with suspected inherited susceptibility to breast cancer consecutively seen at the Genetic Oncology Service of Parma, Italy. Sixty-two patients with a high probability of harboring a germline, cancer-predisposing mutation were tested for BRCA1 mutations. Exon 11 was screened using the protein truncation test and detected mutations were confirmed by direct sequencing (DS). All other exons were analyzed by DS.

Results

Among the 62 patients with a completed mutation analysis, 48 (77.4%) had wild-type BRCA1, six (9.6%) had variants of unclear significance, eight (13%) had deleterious mutations. BRCA1-associated breast cancers (BABC) were significantly less likely to be diagnosed at stage I than breast cancers in women without mutations (12.5% vs 51%; P = 0.045), more likely to have a high proliferation rate (100% vs 24%, P<0.001), and more likely to be histological grade 3 (100% vs 14%, P<0.001), estrogen and progesterone receptor negative (87.5% vs 13%, P<0.001; 75% vs 23%, P = 0.004), and p53 positive (87.5% vs 30%, P = 0.023). All tumors with BRCA1 mutations were HER-2/neu negative compared with 57% of the non-BRCA1 tumors ( P = 0.04). There were no significant differences between BABC and non-BABC in 20-year relapse-free survival, 20-year event-free survival, and 20-year overall survival.

Conclusion

In this population-based study, BABC seems to present with adverse molecular features when compared with non-BABC, although the prognosis appears to be similar.
Is Clinical Radiosensitivity a Complex Genetically Controlled Event?
Authors: Filippi Andrea Riccardo , Franco Pierfrancesco , Ricardi Umberto
Published: July 2019

New insights into molecular mechanisms responsible for cellular radiation response are coming from recent basic radiobiological studies. Preliminary data supporting the concept of clinical radiosensitivity as a complex genetically controlled event are available, and it seems reasonable to hypothesize that genes encoding for proteins implicated in known radiation-induced pathways, such as DNA repair, could influence normal tissue and tumor response to radiotherapy. Such genes could be considered as candidates for experimental studies and as targets for innovative therapies. Variants that could influence individual radiosensitivity have been recently identified, and specific Single Nucleotide Polymorphisms have been associated to the development of different radiation effects on normal tissues. Allelic architecture of complex traits able to modify phenotypes is difficult to be established, and different grades of interaction between common or rare genetic determinants may be present and should be considered. Many different experimental strategies could be investigated in the future, such as analysis of multiple genes in large irradiated patient cohorts strictly observed for radiation effects or identification of new candidate genes, with the aim of identifying factors that could be employed in predictive testing and individualization of radiation therapy on a genetic basis.
Tumor Cyclooxygenase-2 Gene Suppresses Local Immune Responses in Patients with Hepatocellular Carcinoma
Authors: Iwamoto Akemi , Ikeguchi Masahide , Matsumoto Sachico , Hukumoto Youji , Inoue Masashi , Ozaki Tomohiro , Ataka Masayuki , Tanida Takashi , Endo Kanenori , Katano Kuniyuki , Hirooka Yasuaki
Published: July 2019

Aims and Background

In several neoplastic diseases including hepatocellular carcinoma (HCC) immunosuppression is correlated with disease stage, progression and outcome. Moreover, recent studies have demonstrated that cyclooxygenase-2 (COX-2) enhances tumor growth in HCCs. The present study analyzed the correlation between local immune responses and COX-2 gene expression levels in patients with primary HCCs.

Methods

Fresh tissues were obtained from 59 patients who underwent resection of an HCC. The COX-2 gene expression levels were quantified by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) and compared with the CD8+ T cell densities detected by immunohistochemistry.

Results

COX-2 gene expression was detected in 35 of the 59 tumors. The CD8+ T cell density in COX-2-expressing tumors (6.1 cells/high-power field (HPF), x200 magnification) was suppressed compared with that in non-COX-2-expressing tumors (13.6 cells/HPF, P = 0.009). Tumor COX-2 gene expression was associated with a poorer disease-free survival rate.

Conclusions

Elevation of the tumor COX-2 level is correlated with the suppression of local immune responses in HCCs, suggesting that COX-2 plays a role in early tumor recurrence in the residual liver in patients after HCC resection.
Nasopharyngeal Carcinoma with Extensive Nodular Skin Metastases: A Case Report
Authors: Caloglu Murat , Uygun Kazim , Altaner Semsi , Uzal Cem , Kocak Zafer , Piskin Suleyman
Published: July 2019

Skin metastasis from nasopharyngeal carcinoma is a rare clinical finding. The most common form of appearance is a few solitary skin nodules. However, massive and extensive nodular dissemination or diffuse dermal lymphatic infiltration is extremely rare. We here present a case of a 40-year-old man with widespread nodular skin metastases from undifferentiated nasopharyngeal carcinoma.
Are Quality Indicators for Radiotherapy Useful in the Evaluation of Service Efficacy in a New Based Radiotherapy Institution?
Authors: Gabriele Pietro , Malinverni Giuseppe , Bona Cristina , Manfredi Manuela , Delmastro Elena , Gatti Marco , Penduzzu Giovanni , Baiotto Barbara , Stasi Michele
Published: July 2019

Aims and background

A number of documents assess the need for quality assurance in radiotherapy, which must be constantly monitored and possibly improved. In this regard, a system that confirms the quality of a department has been suggested and quality indicators have been used to improve the quality of the service. The National Health Service ( Istituto Superiore di Sanità) approved a National Research Project to increase the quality of radiotherapy. The aim of the present study was to analyze the practical feasibility and efficacy of the quality indicators elaborated by the National Health Service study group in a radiotherapy unit.

Patients and methods

The voluntary accredited program was carried out by the Radiotherapy Department of IRCC in Candiolo from June to August 2002. We analyzed 8 of the 13 indicators according to the National Health Service Project. For this purpose, 133 consecutive patients treated in our Unit were analyzed, and the results are reported according to the appropriate indicator (number of staff related to patients treated, waiting list, case history accuracy, multidisciplinary approach, number of treatment plans performed by CT, number of fields per fraction, number of portal imaging performed per overall treatment, and patient satisfaction).

Results

The number of professional staff related to the number of patients treated was easy to calculate and it could be the basis for further evaluation. The overall waiting time was 55.4 days, and it changed for different radiotherapy goals. We obtained 80% conformity in case-history accuracy. The number of multidisciplinary consultations performed ranged between 50% and 100%. The number of CT plans was about 1.6 ± 0.9 plans per patient. The mean number of fields performed per day and per patient is 3.5 ± 1.7 and was in agreement with the fact that more than 50% of treatments in our Center were performed with conformal radiotherapy. An average of 16.7 ±10.0 portal imaging per case was performed. The percentage of patient satisfaction with the staff obtained a very high compliance.

Conclusions

The self evaluation promoted by the National Health Service Project allows the monitoring of the activities of the service in order to asses critical factors and it can be the starting point to improve the quality of the service and to compare national and international quality assurance results.
Different Expression of HER2/neu Oncogene in Breast Carcinoma and in Liver Metastasis. Description of a Case
Authors: Rossi Elisa , Simoncini Edda , Valcamonico Francesca , Marini Giovanni , Grigolato Piergiovanni , Dessy Enrico
Published: July 2019

We report the clinical, morphological and molecular findings regarding a 37-year-old woman with breast cancer metastatic to the liver and describe the different expression of a tumor marker in the primary and secondary lesions and the singular responsiveness to treatment. The patient suffered from a carcinoma of the left breast with metastasis to the liver. High HER-2 protein expression assessed by immunohistochemistry and HER-2/neu amplification determined by FISH were present in the primary tumor, while the liver metastasis showed a lower value of HER-2 protein (2+) and absence of HER-2/neu amplification. The patient was treated with chemotherapy (epirubicin and paclitaxel) followed by trastuzumab and docetaxel. After 5 months, at the completion of chemo-immunotherapy, liver ultrasonography showed a further hepatic response. A second biopsy was performed on the residual liver nodule: immunohistochemistry revealed negative (1+) HER-2 expression and FISH confirmed that the HER-2/neu gene was not amplified. The different amplification of HER-2 and expression of its protein in primary and metastatic carcinoma could be important for planning adequate treatment.
A Renal Cancer with Intermediate Characteristics between Collecting (Bellini) Duct Carcinoma and Urothelial Carcinoma: Case Report and Review of the Literature
Authors: Maestroni Umberto , Ferretti Stefania , Dinale Francesco , Froio Elisabetta , Pilato Francesco Paolo , Ciuffreda Matteo , Mellissari Massimo , Cortellini Pietro
Published: July 2019

Collecting duct carcinoma of the kidney is a rare and aggressive neoplasm of the distal collecting tube, often metastatic at the time of the diagnosis, for which there is no established therapy. We herein describe the case of a 65-year-old man with a renal cancer with a particular immunohistochemical pattern and pathologic aspect. The lesion was diagnosed as a tumor borderline between a urothelial carcinoma with intraductal spreading and a collecting duct carcinoma with caly-ceal and pelvic spreading. The patient is disease-free 11 months after diagnosis, after radical surgery with adjuvant chemotherapy (carboplatine and gemcitabine) and radiotherapy of a local recurrence. Owing to the common embryologic origin of collecting duct and transitional urothelial cells, several authors have reported an association between collecting duct carcinoma and urothelial cancer. The literature is reviewed to evaluate drugs active against urothelial cancer (like ifosfamide, paclitaxel, carboplatin and gemcitabine). This field should be investigated in the future, in the framework of a neoadjuvant or adjuvant chemotherapy able to support radical surgery for local and advanced collecting duct carcinoma.
Small Cell Lung Cancer in a Young Patient with Osteopetrosis
Authors: Fadda Giovanni Maria , Santeufemia Davide Adriano , Rocca Paolo Cossu , Costantino Salvatore , Sanna Giovanni , Sarobba Maria Giuseppa , Putzu Carlo , Rocca Maria Cossu , Pinna Maria Antonietta , Farris Antonio
Published: July 2019

Background

Osteopetrosis or Albers-Schonberg's disease is a heterogeneous group of rare hereditary troubles of the bone characterized by bone sclerosis due to an alteration of the bone reabsorption mediated by osteoclasts. The defect in the osteoclastic activity is responsible for complete or partial medullary cavities occlusion, with consequent reduced hemopoiesis, and for the excessive fragility of the affected bone segments.

Case report

We reported the case of a young man of 31 years affected by osteopetrosis in which a small cell lung cancer developed.

Results

Small cell lung cancer is a particularly rare neoplasm in the young, and even though it is highly sensitive to chemotherapeutic treatment its prognosis remains poor. The greatest clinical problem connected with chemotherapeutic treatment of patients affected by osteopetrosis is the variability of the reduction of their bone marrow reserve, which could expose them to an excessive hematological toxicity caused by the therapy.

Conclusions

The adoption of suitable prophylactic measures, such as the use of growth factors and drugs selected in relation to their toxicity or given in reduced doses, should be appropriately considered in these subjects.
Empire’s accidents: Law, lies, and sovereignty in the “war on terror” in Pakistan
Authors: Hayat Maira
Published: July 2019

This essay tracks the relationship between the legal and the lethal in the Central Intelligence Agency’s operations in Pakistan as part of the U.S.-led war on terror. I juxtapose an account of an automobile accident in Lahore on 26 January 2011 involving the Blackwater employee, Raymond Davis, with a drone strike in the North Waziristan Agency in Pakistan’s (former) Federally Administered Tribal Areas (FATA), the day after Davis was released by a court in Pakistan. I examine these “sovereign accidents” as articulations of the legal, political and democratic, and as sites upon which to (re)build understandings of sovereignty and its flourishes. Contrary to the popular tendency to see FATA as a marginal border region, that quintessential space of exception, I examine the FATA as jurisdiction. I thread together political discourse and practice in the U.S. and Pakistan, and by examining media coverage and litigation around the accidents, I show how a question of freedom of information in one setting is a question of life itself in another setting. At stake is the meaning and valence of law, the political, and the promise of postcolonial sovereignty.