Sample records for hepatis nodal metastasis


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    Ye. A. Fesik


    Full Text Available This article focuses on issues related to the identification and investigation of the lymph node metastases with bilateral breast cancer. The presence of metastases in the lymph nodes determines the stage of the disease, and introducing a form of tumor progression, characterizes the course and prognosis for the future in a specific patient. Thus, the identification of possible morphological and immunohistochemical characteristics of the tumor tissue and their comparison with the frequency and severity of regional lymph nodes would help to solve the problem of the identification of prognostic factors and markers associated with the risk of nodal metastasis in bilateral breast cancer. This work is relevant due to the fact that the literature on this issue to date are treated ambiguously, and answers to many questions, unfortunately, no.The authors performed a morphological study of the tumor tissue from 600 patients suffering from unilateral and bilateral breast cancer. To avoid false results were studied only cases corresponding to the histological type of invasive carcinoma of non-specific type. The study found that a greater number and a greater percentage of the affected lymph node metastases were observed in patients with bilaterally synchronous tumors. The patients of this group of metastatic lymph nodes was detected more frequently in the presence of infiltrative component of three or more types of structures with the presence of these discrete groups of tumor cells, and the observed maximum degree of inflammatory infiltration of the tumor stroma. In the group of patients with unilateral breast cancer nodal metastasis often detects when triple negative molecular genetic type of the lesion, with large amounts of tumor site, in the presence of infiltrative component of three or more types of structures with the obligatory presence of these microalveolar structures and discretely spaced groups of tumor cells and the highest severity of

  2. Hyoid bone chondrosarcoma with cervical nodal metastasis:

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    Hisham Mostafa Abdel-Fattah


    Conclusions: Although the tumor was low grade, it showed cervical lymph node metastasis months after its surgical excision. This shows the importance of scheduled CT scan of the neck during follow-up of these cases.

  3. Primary glandular melanoma of male breast with nodal metastasis


    Jayabal Pandiaraja


    Malignant melanoma is a malignancy that develops from melanocytes. Breast is an uncommon site for malignant melanoma. Melanoma of the breast occurs in various situations such as primary melanoma of breast skin, metastatic melanoma of breast, in-transit metastasis to the breast, and primary glandular breast melanoma. Most of the melanoma breast either cutaneous melanoma or metastatic melanoma. Primary glandular melanoma of male breast with nodal involvement is rarely reported compared to prima...

  4. Cystic nodal metastasis in patients with oropharyngeal squamous cell carcinoma receiving chemoradiotherapy: Relationship with human papillomavirus status and failure patterns.

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    Yu-Han Huang

    Full Text Available We investigated the relationships of cystic nodal metastasis, human papillomavirus (HPV status, and treatment failure patterns in patients with oropharyngeal squamous cell carcinoma (OPSCC treated with chemoradiotherapy.We retrospectively reviewed pretreatment MRI and clinical courses of patients with OPSCC whose tumors were tested for HPV-induced p16 expression via immunohistochemistry and who completed chemoradiotherapy. Cervical cystic nodal metastasis and necrotic nodal metastasis were classified on MRI.Of 98 patients eligible for analysis, 33 were p16-positive. Cystic nodal metastasis was significantly more prevalent in p16-positive than in p16-negative patients (39.4% versus 18.5%, respectively; p = 0.025. Necrotic nodal metastasis was significantly more prevalent in p16-negative than in p16-positive patients (73.8% versus 51.5%, respectively; p = 0.027. On multivariate analysis, necrotic nodal metastasis (odds ratio [OR] = 7.310, p = 0.011 was an independent predictor of regional failure, while advanced nodal stage (OR = 4.119, p = 0.022 and cystic nodal metastases (OR = 0.087, p = 0.026 were independent positive and negative predictors of distant failure, respectively.Cervical cystic and necrotic nodal metastases are associated with HPV-induced p16-positive and p16-negative OPSCC, respectively. Patients with necrotic nodal metastasis at presentation have an increased risk of regional failure. Distant failure is directly and inversely correlated with advanced nodal stage and cystic nodal metastasis, respectively.

  5. Outcomes of routine ilioinguinal lymph node dissection for palpable inguinal melanoma nodal metastasis. (United States)

    Glover, A R; Allan, C P; Wilkinson, M J; Strauss, D C; Thomas, J M; Hayes, A J


    Patients who present with palpable inguinal melanoma nodal metastasis have two surgical options: inguinal or ilioinguinal lymph node dissection. Indications for either operation remain controversial. This study examined survival and recurrence outcomes following ilioinguinal dissection for patients with palpable inguinal nodal metastasis, and assessed the incidence and preoperative predictors of pelvic nodal metastasis. This was a retrospective clinicopathological analysis of consecutive surgical patients with stage III malignant melanoma. All patients underwent a standardized ilioinguinal dissection at a specialist tertiary oncology hospital over a 12-year period (1998-2010). Some 38.9 per cent of 113 patients had metastatic pelvic nodes. Over a median follow-up of 31 months, the 5-year overall survival rate was 28 per cent for patients with metastatic inguinal and pelvic nodes, and 51 per cent for those with inguinal nodal metastasis only (P = 0.002). The nodal basin control rate was 88.5 per cent. Despite no evidence of pelvic node involvement on preoperative computed tomography (CT), six patients (5.3 per cent) with a single metastatic inguinal lymph node had metastatic pelvic lymph nodes. Logistic regression analysis showed that the number of metastatic inguinal nodes (odds ratio 1.56; P = 0.021) and suspicious CT findings (odds ratio 9.89; P = 0.001) were both significantly associated with metastatic pelvic nodes. The specificity of CT was good (89.2 per cent) in detecting metastatic pelvic nodes, but the sensitivity was limited (57.9 per cent). Metastatic pelvic nodes are common when palpable metastatic inguinal nodes are present. Long-term survival can be achieved following their resection by ilioinguinal dissection. As metastatic pelvic nodes cannot be diagnosed reliably by preoperative CT, patients presenting with palpable inguinal nodal metastasis should be considered for ilioinguinal dissection. © 2014 BJS Society Ltd. Published by John Wiley & Sons

  6. Hyoid bone chondrosarcoma with cervical nodal metastasis: A case ...

    African Journals Online (AJOL)

    The mass was 5.5 cm 7.5 cm and mobile with deglutition. Conclusions: Although the tumor was low grade, it showed cervical lymph node metastasis months after its surgical excision. This shows the importance of scheduled CT scan of the neck during follow-up of these cases. Keywords: Hyoid chondrosarcoma; Radiology; ...

  7. Dynamic Contrast-Enhanced Magnetic Resonance Imaging of Regional Nodal Metastasis in Nasopharyngeal Carcinoma: Correlation with Nodal Staging

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    Bingsheng Huang


    Full Text Available Objective. To determine if the perfusion parameters by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI of regional nodal metastasis are helpful in characterizing nodal status and to understand the relationship with those of primary tumor of nasopharyngeal carcinoma (NPC. Materials and Methods. Newly diagnosed patients imaged between August 2010 and January 2014 and who were found to have enlarged retropharyngeal/cervical lymph nodes suggestive of nodal disease were recruited. DCE-MRI was performed. Three quantitative parameters, Ktrans, ve, and kep, were calculated for the largest node in each patient. Kruskal-Wallis test was used to evaluate the difference in the parameters of the selected nodes of different N stages. Spearman’s correlation was used to evaluate the relationship between the DCE-MRI parameters in nodes and in primary tumors. Results. Twenty-six patients (7 females; 25~67 years old were enrolled. Ktrans was significantly different among the patients of N stages (N1, n=3; N2, n=17; N3, n=6, P=0.015. Median values (range for N1, N2, and N3 were 0.24 min−1 (0.17~0.26 min−1, 0.29 min−1 (0.17~0.46 min−1, and 0.46 min−1 (0.29~0.70 min−1, respectively. There was no significant correlation between the parameters in nodes and primary tumors. Conclusion. DCE-MRI may play a distinct role in characterizing the metastatic cervical lymph nodes of NPC.

  8. Traumatic Neuroma around the Celiac Trunk after Gastrectomy Mimicking a Nodal Metastasis: A Case Report

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    Kwon, Jung Hyeok; Ryu, Seung Wan; Kang, Yu Na [Keimyung University School of Medicine, Daegu (Korea, Republic of)


    Traumatic neuroma is a well-known disorder that occurs after trauma or surgery involving the peripheral nerve and develops from a nonneoplastic proliferation of the proximal end of a severed, partially transected, or injured nerve. However, in the abdomen, traumatic neuromas have been sporadically reported to occur in the bile duct. We present here a case of traumatic neuroma around the celiac trunk after gastrectomy that mimicks a nodal metastasis. In conclusion, the imaging finding of traumatic neuroma around the celiac trunk was a homogeneous hypovascular mass without narrowing or irregularity of encased arteries and without increased uptake on PET-CT. Although from a clinical standpoint, establishing an accurate preoperative diagnosis is difficult to perform, the presence of a traumatic neuroma should be included in the differential diagnosis of a mass around the celiac trunk in a patient that has undergone celiac nodal dissection.

  9. MR findings in peliosis hepatis

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    Saatci, I. [Dept. of Diagnostic Radiology, Hacettepe Univ. Hospital, Ankara (Turkey); Coskun, M. [Dept. of Diagnostic Radiology, Hacettepe Univ. Hospital, Ankara (Turkey); Boyvat, F. [Dept. of Diagnostic Radiology, Hacettepe Univ. Hospital, Ankara (Turkey); Cila, A. [Dept. of Diagnostic Radiology, Hacettepe Univ. Hospital, Ankara (Turkey); Guergey, A. [Dept. of Pediatric Hematology, Hacettepe Univ. Hospital, Ankara (Turkey)


    We report the MR findings of peliosis hepatis in a patient with Fanconi anemia who had been treated with anabolic androgenic steroids for 3 years. The MR examination of the upper abdomen was performed on a 0.5 T system. The signal intensity of the right lobe of the liver was diffusely increased in all sequences. Within the enlarged liver, multiple foci of brighter signal were seen involving both right and left lobes. The lesions showed contrast enhancement. A cystic cavity with an enhancing rim was seen representing a haematoma cavity. The spleen was spared the patient died of sepsis and the postmortem examination confirmed the diagnosis of peliosis hepatis. (orig.)

  10. Predictors of Nodal Metastasis in Parotid Malignancies: A National Cancer Data Base Study of 22,653 Patients. (United States)

    Xiao, Christopher C; Zhan, Kevin Y; White-Gilbertson, Shai J; Day, Terry A


    (1) To identify predictors of nodal disease in parotid malignancies using various clinical and pathologic variables. (2) To examine the effect of nodal disease on overall survival (OS) in parotid cancers Retrospective database review. National Cancer Data Base (1998-2012). We identified all cases of primary parotid malignancies in the United States between 1998 and 2012 in the National Cancer Data Base. Eight histopathologies, constituting >80% of all cases, were examined for nodal metastasis and survival. We identified 22,653 cases of primary parotid cancer. Eight major histologies were studied, with mucoepidermoid carcinoma (31%), acinic cell carcinoma (18%), adenocarcinoma (14%), and adenoid cystic carcinoma (9%) being most common. Regional nodal disease incidence was 24.4% overall and varied by histopathology. Salivary ductal carcinoma had the highest incidence of both nodal metastasis and occult lymph node metastasis. Overall, N0 patients lived significantly longer than N+ (5-year OS, 79% vs 40%; P < .001). Low-grade disease had significantly better survival than high-grade (5-year OS, 88% vs 69%; P < .001). Occult nodal disease was found in 10.2% and varied by histopathology. Regional lymph node metastasis significantly decreases survival in many parotid malignancies. High-grade cancers had higher incidences of regional disease than did low grade. Adenocarcinoma had the highest mortality when regional disease was present. Incidence of occult disease varied by histology, but incidence was <10% for all low-grade disease. High T stage and grade are significant independent predictors of nodal disease for most histopathologies. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2015.

  11. The prognostic value of nodal skip metastasis in resectable thoracic esophageal squamous cell carcinoma

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    Song G


    Full Text Available Ge Song,1,2,* Wang Jing,3,* Song Xue,1,2 Hongbo Guo,4 Jinming Yu1,2 1Department of Radiation Oncology, School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences; 2Department of Radiation Oncology, Shandong Cancer Hospital Affiliated with Shandong University, Jinan, 3Department of Radiation Oncology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 4Department of Thoracic Surgery, Shandong Cancer Hospital Affiliated with Shandong University, Jinan, China *These authors contributed equally to the work Purpose: This study aimed to investigate the incidence of nodal skip metastasis (NSM to identify the risk factors that influence NSM and to assess the prognostic value of NSM in patients with thoracic esophageal squamous cell carcinoma (ESCC.Patients and methods: Between January 2009 and December 2013, 285 patients with ESCC with positive lymph nodes who underwent complete resection were enrolled.Results: For the entire group, NSM occurred in 32.3% (92/285 of patients. The median survival time and 5-year survival rate in the NSM group were 28 months and 12.0%, respectively, compared with 36.3 months and 25.0%, respectively, in the non-NSM group (P=0.008. Both N stage (P=0.001 and T stage (P=0.014 were associated with the incidence of NSM. NSM (P=0.008, T stage (P=0.000, and N stage (P=0.000 were independent prognostic factors for survival. In the NSM group, T stage (P=0.014 and N stage (P=0.000 were independent prognostic factors for survival.Conclusion: It was concluded that NSM is common in ESCC and is associated with poor survival. Keywords: esophageal squamous cell carcinoma, surgery, nodal skip metastasis, incidence, risk factors, prognosis

  12. Tuberculous Lymphadenitis Mimicking Nodal Metastasis in Follicular Variant Papillary Thyroid Carcinoma

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    Marc Gregory Yu


    Full Text Available Tuberculous (TB lymphadenitis can mimic cervical node metastasis from papillary thyroid carcinoma (PTC since the distribution and appearance of affected lymph nodes are similar. We present the case of an asymptomatic 50-year-old Filipino who sought consult for a gradually enlarging anterior neck mass and a single palpable cervical lymph node. Preoperative workup suggested a thyroid malignancy with nodal metastasis. He underwent total thyroidectomy with node dissection where histopathology confirmed follicular variant- (FV- PTC. Lymph node examination, however, revealed TB lymphadenitis, and the patient was given standard antimycobacterial therapy. This is the first documented case in Southeast Asia, a high TB burden region. This is also the first report involving FV-PTC, which has features between those of conventional PTC and follicular thyroid carcinoma. The case suggests that, in endemic areas, TB should be a differential in the etiology of cervical lymphadenopathy in PTC patients. In developed countries, this differential diagnosis is also valuable because of the increasing incidence of HIV and TB coinfection. Proper preoperative evaluation is important and needs to be highlighted in the formulation of local guidelines.

  13. Tumor Budding in Intestinal Type Gastric Adenocarcinoma is Associated with Nodal Metastasis and Recurrence. (United States)

    Olsen, Stephen; Linda, Jin; Fields, Ryan C; Yan, Yan; Nalbantoglu, ILKe


    Gastric adenocarcinoma (GAC) is a common cause of cancer-related death worldwide. GAC can be classified as intestinal or diffuse. Intestinal type cancers are common and reported to have a better prognosis compared to diffuse cancers. Studies have shown the presence and amount of tumor budding in intestinal carcinomas of the colon and esophagus to predict nodal metastasis and recurrence. Our aim is to determine if tumor budding in intestinal type GAC correlates with prognostic features. One hundred four patients treated with primary surgical excision between 1999-2013 were identified. Histologic type (intestinal, diffuse, or mixed), tumor grade, T-stage, and lymph node status were evaluated. Tumor bud scores were assigned to all intestinal type cancers using methods previously described for colorectal adenocarcinoma. Scores of Tumor characteristics were as follows: 52 intestinal (50%), 36 diffuse (35%) and 16 mixed (15%). Of the 52 cases with intestinal histology, 4 were well (8%), 28 were moderately (54%), and 20 were poorly differentiated (38%). Thirty-three (63%) of the intestinal tumors had high tumor bud scores. Cases with high scores were associated with higher T-stage, N-stage, and grade (Ptumor bud scores in intestinal type GAC have higher T-stage, N-stage, grade, and likelihood of recurrence. Assessment of tumor budding may guide clinical management in a subset of patients. Copyright © 2017. Published by Elsevier Inc.

  14. Retroperitoneal nodal metastasis in primary and recurrent granulosa cell tumors of the ovary. (United States)

    Abu-Rustum, Nadeem R; Restivo, Antonella; Ivy, Joseph; Soslow, Robert; Sabbatini, Paul; Sonoda, Yukio; Barakat, Richard R; Chi, Dennis S


    . The median disease-free interval to first recurrence was 63 months (mean,69.4 months; range, 4-170 months). First recurrence sites included pelvis, 24/34 (70%); pelvis and abdomen, 3 (9%); retroperitoneum only, 2 (6%); pelvis and retroperitoneum, 2 (6%); pelvis/abdomen/retroperitoneum, 1(3%); abdomen only, 1 (3%); and bone, 1 (3%). Complete surgical staging was performed in approximately 1/5 women with ovarian granulosa cell tumors; however, in those initially surgically staged, no nodal metastasis was identified. Clinical stage IA disease was the most common original diagnosis in women who recurred, and approximately 15% of first recurrences appear to involve the retroperitoneum.

  15. Irreversible Electroporation for Focal Ablation at the Porta Hepatis

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    Kasivisvanathan, Veeru, E-mail: [Imperial College London, Department of Radiology (United Kingdom); Thapar, Ankur, E-mail:; Oskrochi, Youssof, E-mail: [Imperial College London, Department of Surgery and Cancer (United Kingdom); Picard, John, E-mail: [Imperial College Healthcare NHS Trust, Department of Anaesthesia (United Kingdom); Leen, Edward L. S., E-mail: [Imperial College London, Department of Radiology (United Kingdom)


    Patients with chemotherapy-refractory liver metastases who are not candidates for surgery may be treated with focal ablation techniques with established survival benefits. Irreversible electroporation is the newest of these and has the putative advantages of a nonthermal action, preventing damage to adjacent biliary structures and bowel. This report describes the use of irreversible electroporation in a 61-year-old man with a solitary chemoresistant liver metastasis unsuitable for radiofrequency ablation as a result of its proximity to the porta hepatis. At 3 months, tumor size was decreased on computed tomography from 28 Multiplication-Sign 19 to 20 Multiplication-Sign 17 mm, representing stable disease according to the response evaluation criteria in solid tumors. This corresponded to a decrease in tumor volume size from 5.25 to 3.16 cm{sup 3}. There were no early or late complications. Chemoresistant liver metastases in the proximity of the porta hepatis that are considered to be too high a risk for conventional surgery or thermal ablation may be considered for treatment by the novel ablation technique of irreversible electroporation.

  16. Incidental nodal metastasis of differentiated thyroid carcinoma in neck dissection specimens from head and neck cancer patients. (United States)

    Lenzi, R; Marchetti, M; Muscatello, L


    Occult differentiated thyroid carcinomas are not uncommon. The initial presentation of a thyroid carcinoma is often detection of a metastatic cervical lymph node. A retrospective review was performed of the medical records of 304 patients who underwent neck dissection between 1996 and 2008 for squamous cell carcinoma of the head and neck. Ten patients (3.3 per cent) had nodal metastasis originating from papillary thyroid cancer. All of these patients underwent thyroidectomy and post-operative 131iodine radiometabolic therapy. No patient developed a thyroid tumour after surgery. Despite its metastatic spread, thyroid cancer does not affect the overall prognosis of patients who are already being treated for a more aggressive malignancy. However, in otherwise healthy patients, it is worth treating this second malignancy to avoid potential complications related to local disease or metastatic thyroid cancer.

  17. The need for early detection of neck nodal metastasis in squamous cell carcinoma of oral cavity

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    P Satish Kumaran


    Full Text Available In the Indian subcontinent, the incidence of squamous cell carcinoma of the oral cavity has been constantly increasing despite the improvement in the awareness about squamous cell carcinoma. The patients generally report to us in the period in which the tumor would have undergone metastasis. This article highlights about the grading, staging, and decision-making regarding the surgical management of squamous cell carcinoma of the oral cavity. The article also stresses upon the early detection of the lesion by the practitioner for a definitive successful surgical treatment of the patient.

  18. Nodal Melanoma Metastasis under Infliximab Therapy in a Patient with Nevoid Melanoma First Misdiagnosed as Benign Nevus: A Potentially Dangerous Diagnostic Pitfall in the Era of Biologic Therapies


    Gilles Safa; Sophie Fromentoux; Laure Darrieux; Jean-Anastase Hogenhuis; Laurent Tisseau


    We report the case of a 53-year-old Caucasian woman who developed nodal melanoma metastasis under infliximab therapy 2 years after the removal of a nevoid melanoma, which was initially misdiagnosed as a benign compound nevus. This case illustrates the potential link between tumor necrosis factor (TNF)-α inhibition and the reactivation of latent melanoma. Furthermore, this case highlights the need for a complete skin examination before using anti-TNF-α therapy to rule out atypical malignant le...

  19. Pre-operative prediction of cervical nodal metastasis in papillary thyroid cancer by 99mTc-MIBI SPECT/CT; a pilot study. (United States)

    Tangjaturonrasme, Napadon; Vasavid, Pataramon; Sombuntham, Premsuda; Keelawat, Somboon


    Papillary thyroid cancer has a high prevalence of cervical nodal metastasis. There is no "gold standard" imaging for pre-operative diagnosis. The aim of the present study was to assess the accuracy of pre-operative 99mTc-MBI SPECT/CT in diagnosis of cervical nodal metastasis in patients with papillary thyroid cancer Fifteen patients were performed 99Tc-MlBI SPECT/CT pre-operatively. Either positive pathological report of neck dissection or positive post-treatment I-131 whole body scan with SPECT/CT of neck was concluded for definite neck metastasis. The PPV, NPV, and accuracy of 99mTc-MIBI SPECT/CT were analyzed. The PPV NPV and accuracy were 80%, 88.89%, and 85.71%, respectively. 99mTc-MIBI SPECT/CT could localize the abnormal lymph nodes groups correctly in most cases when compared with pathological results. However the authors found one false positive case with caseating granulomatous lymphadenitis and one false negative case with positive post-treatment 1-131 whole body scan with SPECT/CT of neck on cervical nodes zone II and IV CONCLUSION: 99mTc-MIBI SPECT/CTseem promising for pre-operative staging of cervical nodal involvement in patients with papillary thyroid cancer without the need of using iodinated contrast that may complicate subsequence 1-131 treatment. However, false positive result in granulomatous inflammatory nodes should be aware of especially in endemic areas. 99mTc-MIBI SPECT/CT scan shows a good result when compared with previous study of CT or MRI imaging. The comparative study between different imaging modality and the extension of neck dissection according to MIBI result seems interesting.

  20. Nodal Melanoma Metastasis under Infliximab Therapy in a Patient with Nevoid Melanoma First Misdiagnosed as Benign Nevus: A Potentially Dangerous Diagnostic Pitfall in the Era of Biologic Therapies

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    Gilles Safa


    Full Text Available We report the case of a 53-year-old Caucasian woman who developed nodal melanoma metastasis under infliximab therapy 2 years after the removal of a nevoid melanoma, which was initially misdiagnosed as a benign compound nevus. This case illustrates the potential link between tumor necrosis factor (TNF-α inhibition and the reactivation of latent melanoma. Furthermore, this case highlights the need for a complete skin examination before using anti-TNF-α therapy to rule out atypical malignant lesions or melanomas that can easily be missed because of presentations such as nevoid melanoma.

  1. A Prospective Feasibility Trial to Determine the Significance of the Sentinel Node Gradient in Breast Cancer: A Predictor of Nodal Metastasis Location (United States)

    Bleicher, Richard J.; O'Sullivan, Martin J.; Ciocca, Vincenzo; Ciocca, Robin M.; Perkins, L. Allen; Ross, Eric; Li, Tianyu; Patchefsky, Arthur S.; Sigurdson, Elin R.; Joseph, Natalie E.; Sesa, Linda; Morrow, Monica


    Background Sentinel node (SN) biopsy is standard for breast cancer staging but SN dye gradients and their significance have never been characterized. If predictive of SN metastasis location, their use for focused pathology examination might improve intraoperative imprint cytology sensitivity. Methods This prospective trial enrolled clinically node-negative patients with invasive breast cancer not undergoing neoadjuvant chemotherapy. Surgeons marked SN gradients at their bluest end. Nodal halves were examined separately by imprint cytology and the marked SN half was correlated to metastasis location. Demographic, pathologic, and prognostic features were recorded. Results Mean patient age and tumor size for the 102 patients was 59.6 years and 2.2 cm, respectively. Of 169 SNs, 159 (94.1%) had dye gradients, which varied by tumor quadrant, but not by histology, diagnosis method, grade, or stage. Among 41 marked SNs with metastases, 92.7% were present in the halves marked by the surgeon. Fourteen were confined to 1 nodal half with 11 on the marked side and 3 on the unmarked side (p=0.029). Metastases were smaller when confined to 1 versus both SN halves (0.14 vs. 0.75 cm, p=0.005), and smaller (0.87 vs. 0.13 cm, pmetastases are hardest to detect intraoperatively and are usually confined to the marked SN half. This suggests that marking a SN's bluest half warrants further study to explore whether its correlation to metastasis location may be exploited to focus pathologic examination and decrease the reoperative axillary dissection rate. PMID:18973177

  2. Retroperitoneal nodal metastasis in primary adult type granulosa cell tumor of the ovary: Can routine lymphadenectomy be omitted? (United States)

    Kuru, Oguzhan; Boyraz, Gokhan; Uckan, Hasan; Erturk, Anıl; Gultekin, Murat; Ozgul, Nejat; Salman, Coskun; Yuce, Kunter


    To investigate the incidence of retroperitoneal lymph node metastasis among patients with primary adult type granulosa cell tumor (AGCT) of the ovary. Between January 1982 and February 2017, patients with a pathological diagnosis of AGCT were identified. Clinical and pathological data were obtained from database records. A total of 151 patients with primary AGCT were identified with a mean age of 47.8 years (range, 17-91 years). 98 patients (64.9%) had stage IA, 24 (15.9%) had stage IC, 4 (2.6%) had stage IIB, 2 (1.3%) had stage IIIB, 6 (4.0%) had stage IIIC disease according to International Federation of Gynecology and Obstetrics (FIGO) 1988 criteria. In the remaining 17 patients (11.3%), primary stage was not detected. In 134 (88.7%) patients, pelvic and para-aortic lymphadenectomy was performed at primary staging surgery depending on the frozen section analysis or at re-staging surgery following initial diagnosis. In these patients, six (4.5%) of them had pelvic or paraaortic lymph node metastasis. The median number of lymph nodes removed was 43 (range, 10-96 lymph nodes). Lymph node metastasis in initially staged AGCT is rare. Routine pelvic and paraaortic lymph node dissection may be omitted in these patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Significant association of increased PD-L1 and PD-1 expression with nodal metastasis and a poor prognosis in oral squamous cell carcinoma. (United States)

    Maruse, Y; Kawano, S; Jinno, T; Matsubara, R; Goto, Y; Kaneko, N; Sakamoto, T; Hashiguchi, Y; Moriyama, M; Toyoshima, T; Kitamura, R; Tanaka, H; Oobu, K; Kiyoshima, T; Nakamura, S


    Programmed cell death ligand 1 (PD-L1) and its receptor PD-1 are immune checkpoint molecules that attenuate the immune response. Blockade of PD-L1 enhances the immune response in a variety of tumours and thus serves as an effective anti-cancer treatment. However, the biological and prognostic roles of PD-L1/PD-1 signalling in oral squamous cell carcinoma (OSCC) remain to be elucidated. The purpose of this study was to examine the correlation of PD-L1/PD-1 signalling with the prognosis of OSCC patients to assess its potential therapeutic relevance. The expression of PD-L1 and of PD-1 was determined immunohistochemically in 97 patients with OSCC and the association of this expression with clinicopathological characteristics was examined. Increased expression of PD-L1 was found in 64.9% of OSCC cases and increased expression of PD-1 was found in 61.9%. Univariate and multivariate analysis revealed that increased expression of PD-L1 and PD-1 positively correlated with cervical lymph node metastasis. The expression of CD25, an activated T-cell marker, was negatively correlated with the labelling index of PD-L1 and PD-1. Moreover, the patient group with PD-L1-positive and PD-1-positive expression showed a more unfavourable prognosis than the group with PD-L1-negative and PD-1-negative expression. These data suggest that increased PD-L1 and PD-1 expression is predictive of nodal metastasis and a poor prognosis and is possibly involved in cancer progression via attenuating the immune response. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Prostate-Derived Ets Transcription Factor Overexpression is Associated with Nodal Metastasis, Hormone Receptor Positivity in Invasive Breast Cancer

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    Simon Turcotte


    Full Text Available Prostate-derived Ets transcription factor (PDEF has recently been associated with invasive breast cancer, but no expression profile has been defined in clinical specimens. We undertook a comprehensive PDEF transcriptional expression study of 86 breast cancer clinical specimens, several cell lines, normal tissues. PDEF expression profile was analyzed according to standard clinicopathologic parameters, compared with hormonal receptor, HER-2/neu status, to the expression of the new tumor biomarker Dikkopf-1 (DKK1. Wide ranging PDEF overexpression was observed in 74% of tested tumors, at higher levels than the average expression found in normal breasts. High PDEF expression was associated with hormone receptor positivity (P < .001, moderate to good differentiation (less than grade III, P = .01, dissemination to axillary lymph nodes (P = .002. PDEF was an independent risk factor for nodal involvement (multivariate analysis, odds ratio 1.250, P = .002. It was expressed in a different subgroup compared to DKK1-expressing tumors (P < .001. Our data imply that PDEF mRNA expression could be useful in breast cancer molecular staging. Further insights into PDEF functions at the protein level, possible links with hormone receptors biology, bear great potential for new therapeutic avenues.

  5. Metastasis

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    Weller, R.E.


    Distant metastasis of primary neoplasms is the main factor that limits the success of antineoplastic therapy. It can be regarded as an early or late event in the neoplastic process, and varies considerably with tumor type. The metastatic potential of a given tumor greatly influences prognosis. Tumor metastasis is not a single neoplastic event, rather, it involves several major steps: invasion of cells from the primary tumor into tissue, and penetration of blood and lymph vessels; release of tumor cell emboli into the circulation; arrest of the emboli in capillary beds of distant organs; invasion of the wall of the arresting vessel, infiltration into adjacent tissue, and multiplication; and growth of vascularized stroma into the new tumor as proliferating tumor cells invade the distant organ. Lodgement and invasion are complex events that are not fully defined. Arrest and lodgement appears to require a thromboembolic event in which the metastatic embolis (1 cell) contacts vascular endothelium and adheres to the wall with thrombis formation following aggregation of platelets and fibrin to the tumor cell(s). Invasion may involve: formation of collagenases by tumor cells; mechanical disruption; chemotactic factors. Metastatic patterns depend on the route of metastasis, tumor type, and target organ (favored soil). In general, carcinomas metastasize via lymphatics and sarcomas via hematogenous routes. Others, melanoma, mast cell tumors, etc., show mixed patterns. This knowledge is important when one is attempting to prognostically stage a tumor, especially when thoracic radiographs are negative. The question of enlarged regional lymph nodes will be discussed in lecture relative to specific tumor types. 4 refs., 1 tab.

  6. Peliosis hepatis presenting with massive hepatomegaly in a patient with idiopathic thrombocytopenic purpura

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    Sun Bean Kim


    Full Text Available Peliosis hepatis is a rare condition that can cause hepatic hemorrhage, rupture, and ultimately liver failure. Several authors have reported that peliosis hepatis develops in association with chronic wasting disease or prolonged use of anabolic steroids or oral contraceptives. In this report we describe a case in which discontinuation of steroid therapy improved the condition of a patient with peliosis hepatis. Our patient was a 64-year-old woman with a history of long-term steroid treatment for idiopathic thrombocytopenic purpura . Her symptoms included abdominal pain and weight loss; the only finding of a physical examination was hepatomegaly. We performed computed tomography (CT and magnetic resonance imaging (MRI of the liver and a liver biopsy. Based on these findings plus clinical observations, she was diagnosed with peliosis hepatis and her steroid treatment was terminated. The patient recovered completely 3 months after steroid discontinuation, and remained stable over the following 6 months.

  7. Histologic assessment of tumor budding in preoperative biopsies to predict nodal metastasis in squamous cell carcinoma of the tongue and floor of the mouth. (United States)

    Seki, Mai; Sano, Takaaki; Yokoo, Satoshi; Oyama, Tetsunari


    In squamous cell carcinoma (SCC) of the tongue and the floor of the mouth (FOM), it is important to predict lymph node metastasis, including occult metastasis, before operating. The purpose of this study was for us to determine practical histopathologic parameters as predictive factors for lymph node metastasis in preoperative SCC biopsy specimens. We examined 91 cases of SCC for conventional histopathologic assessment and a new factor, tumor budding, and their relationship with lymph node metastasis. Significant factors via univariate analysis (p budding (score ≥3) and tumor depth (≥3 mm) and these were associated with lymph node metastasis. Moreover, both budding and tumor depth significantly correlated with relapse-free survival; however, evaluating biopsy specimens often proved inaccurate for predicting true tumor depth of cancer invasion. Tumor budding using immunohistochemistry for cytokeratin should be added to routine histologic assessments as a new criterion factoring into the decision as to whether neck dissection is indicated. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1582-E1590, 2016. © 2015 Wiley Periodicals, Inc.

  8. Nodal-knot semimetals (United States)

    Bi, Ren; Yan, Zhongbo; Lu, Ling; Wang, Zhong


    Topological nodal-line semimetals are characterized by one-dimensional lines of band crossing in the Brillouin zone. In contrast to nodal points, nodal lines can be in topologically nontrivial configurations. In this Rapid Communication, we introduce the concept of "nodal-knot semimetals," whose nodal lines form topologically nontrivial knots in the Brillouin zone. We introduce a generic construction of nodal-knot semimetals, which yields the simplest trefoil nodal knot and other more complicated nodal knots. The knotted-unknotted transitions by nodal-line reconnections are also studied. Our work brings the knot theory to the subject of topological semimetals.

  9. Clonal T-Cell Receptor γ-Chain Gene Rearrangements in Differential Diagnosis of Lymphomatoid Papulosis From Skin Metastasis of Nodal Anaplastic Large-Cell Lymphoma (United States)

    Akilov, Oleg E.; Pillai, Raju K.; Grandinetti, Lisa M.; Kant, Jeffrey A.; Geskin, Larisa


    Background In patients with a history of nodal anaplastic large-cell lymphoma (ALCL), differentiation of type C lymphomatoid papulosis from cutaneous involvement of systemic ALCL may be challenging because the 2 entities may exhibit identical histologic features. Although metastatic ALCL generally carries the same clone as the primary lymphoma, expression of a distinct clone likely represents a distinct process. Observations A 54-year-old white man had a history of anaplastic lymphoma kinase 1–negative ALCL in the right inguinal lymph node 6 years ago. A complete response was achieved after 6 cycles of CHOP (cyclophosphamide, doxorubicin, vincristine [Oncovin], and prednisone administered in 21-day cycles) and radiation therapy. After 3½ years, the patient observed waxing and waning papules and nodules. Examination of the biopsy specimen revealed a dense CD30+ lymphocytic infiltrate; no evidence of systemic malignancy was evident on positron emission tomography. Although clinically the presentation was consistent with lymphomatoid papulosis, metastatic ALCL had to be excluded. Polymerase chain reaction analysis with T-cell receptor γ-chain gene rearrangement (TCR-γR) was performed on the original lymph node and new skin lesions. Results of the TCR-γR analysis were positive for clonality in both lesions. However, separate clonal processes were identified. The identification of distinct clones supported the clinical impression of lymphomatoid papulosis. Conclusion Polymerase chain reaction analysis of TCR-γR is a useful method for distinguishing different clonal processes and is recommended when differentiation of primary and secondary lymphoproliferative disorders is required. PMID:21844453

  10. Congenital Portal Vein Aneurysm Associated with Peliosis Hepatis and Intestinal Lymphangiectasia

    Directory of Open Access Journals (Sweden)

    Zeynel Mungan


    Full Text Available Portal vein aneurisym (PVA, peliosis hepatis (PH and intestinal lymphangiectasia (IL all are very uncommon entities. Herein, we presented a unique patient with these three rare entities who was admitted to our hospital because of portal hypertensive ascites rich in protein and lymphocyte. PVA was extrahepatic and associated with coronary vein aneurysm. Peliosis hepatis was of microscopic form. Lymphangiectasia was present in peritoneum and small intestine. Diagnoses of these rare entities were made by imaging techniques and histopathological findings. Patient also had hydronephrosis caused by ureteropelvic junction narrowing. Best of our knowledge, there is no such a case reported previously with the association of PVA, PH and IL. Therefore, we propose PVAPHIL syndrome to define this novel association.

  11. Molecular Diagnosis for Nodal Metastasis in Endoscopically Managed Cervical Cancer: The Accuracy of the APTIMA Test to Detect High-risk Human Papillomavirus Messenger RNA in Sentinel Lymph Nodes. (United States)

    Köhler, Christhardt; Le, Xin; Dogan, Nasuh Utku; Pfiffer, Tatiana; Schneider, Achim; Marnitz, Simone; Bertolini, Julia; Favero, Giovanni


    To evaluate the feasibility and accuracy of a commercially available test to detect E6/E7 mRNA of 14 subtypes of high-risk HPVs (APTIMA; Hologic, Bedford, MA) in the sentinel lymph nodes of CC patients laparoscopically operated. Prospective pilot study. The study was conducted in the Department of Advanced Operative and Oncologic Gynecology, Asklepios Hospital, Hamburg, Germany. 54 women with HPV-positive CC submitted to laparoscopic sentinel node biopsy alone or sentinel node biopsy followed by systematic pelvic and/or para-aortic endoscopic lymphadenectomy. All removed sentinel lymph nodes (SLNs) underwent sample collection by cytobrush for the APTIMA assay before frozen section. Results obtained with the HPV mRNA test were compared with the definitive histopathological analysis of the SLNs and additional lymph nodes removed. A total of 125 SLNs (119 pelvic and 6 paraaortic) were excised with a mean number of 2.3 SLNs per patient. Final histopathologic analysis confirmed nodal metastases in 10 SLNs from 10 different patients (18%). All the histologically confirmed metastatic lymph nodes were also HPV E6/E7 mRNA positive, resulting in a sensitivity of 100%. Four histologically free sentinel nodes were positive for HPV E6/E7 mRNA, resulting in a specificity of 96.4%. The HPV E6/E7 mRNA assay in the SLNs of patients with CC is feasible and highly accurate. The detection of HPV mRNA in 4 women with negative SLNs might denote a shift from microscopic identification of metastasis to the molecular level. The prognostic value of this findings awaits further verification. Copyright © 2016. Published by Elsevier Inc.

  12. Generalised peliosis hepatis mimicking metastases after long-term use of oral contraceptives. (United States)

    Kootte, A M M; Siegel, A M; Koorenhof, M


    Peliosis hepatis (PH) is a rare vascular condition of the liver characterised by the presence of cystic blood-filled cavities distributed randomly throughout the liver parenchyma. PH should be considered in the differential diagnosis of women with a long history of use of oral contraceptives with suspected hypervascular lesions diagnosed by imaging, but with an unknown primary tumour. Because of the extensive use of oral contraceptives in the general female population worldwide, PH should be added to the differential diagnosis of suspected hypervascular liver lesions.

  13. Depicting surgical anatomy of the porta hepatis in living donor liver transplantation. (United States)

    Kelly, Paul; Fung, Albert; Qu, Joy; Greig, Paul; Tait, Gordon; Jenkinson, Jodie; McGilvray, Ian; Agur, Anne


    Visualizing the complex anatomy of vascular and biliary structures of the liver on a case-by-case basis has been challenging. A living donor liver transplant (LDLT) right hepatectomy case, with focus on the porta hepatis, was used to demonstrate an innovative method to visualize anatomy with the purpose of refining preoperative planning and teaching of complex surgical procedures. The production of an animation-enhanced video consisted of many stages including the integration of pre-surgical planning; case-specific footage and 3D models of the liver and associated vasculature, reconstructed from contrast-enhanced CTs. Reconstructions of the biliary system were modeled from intraoperative cholangiograms. The distribution of the donor portal veins, hepatic arteries and bile ducts was defined from the porta hepatis intrahepatically to the point of surgical division. Each step of the surgery was enhanced with 3D animation to provide sequential and seamless visualization from pre-surgical planning to outcome. Use of visualization techniques such as transparency and overlays allows viewers not only to see the operative field, but also the origin and course of segmental branches and their spatial relationships. This novel educational approach enables integrating case-based operative footage with advanced editing techniques for visualizing not only the surgical procedure, but also complex anatomy such as vascular and biliary structures. The surgical team has found this approach to be beneficial for preoperative planning and clinical teaching, especially for complex cases. Each animation-enhanced video case is posted to the open-access Toronto Video Atlas of Surgery (TVASurg), an education resource with a global clinical and patient user base. The novel educational system described in this paper enables integrating operative footage with 3D animation and cinematic editing techniques for seamless sequential organization from pre-surgical planning to outcome.

  14. Nasopharyngeal carcinoma with pericardial metastasis

    Directory of Open Access Journals (Sweden)

    Shang-Wen Chen


    Full Text Available Nasopharyngeal carcinoma (NPC is prevalent in Taiwan and is characterized by a high frequency of nodal metastasis. The most common organs with distal metastases are the bones, lungs, and liver, with extremely rare cases to the pericardium. Herein, we report a rare case with NPC who presented with dyspnea and orthopnea. Serial studies, including pericardial biopsy, revealed NPC with pericardial metastasis and pericardial effusion. The tumor cells of both the original and metastatic tumors were positive for Epstein–Barr virus by in situ hybridization. This is the first histologically confirmed case of NPC with pericardial metastasis.

  15. Association of tumour stiffness on sonoelastography with axillary nodal status in T1 breast carcinoma patients. (United States)

    Yi, Ann; Moon, Woo Kyung; Cho, Nariya; Chang, Jung Min; Bae, Min Sun; Kim, Seung Ja; Han, Wonshik; Park, In-Ae


    To evaluate whether tumour stiffness on sonoelastography is associated with axillary nodal metastasis in T1 breast carcinoma patients. Between May 2006 and December 2010, 200 consecutive women (mean age, 51.6; range, 27 - 81 years) who underwent B-mode ultrasound (US), sonoelastography, and curative surgery with axillary nodal evaluation for clinically node negative T1 breast carcinomas (mean invasive tumour size, 12.4; range, 3 - 20 mm at pathology) were identified. The association between the elasticity score of the tumour and histopathological axillary nodal status was evaluated using a logistic regression model after controlling for imaging and clinicopathological variables of the tumour. The overall incidence of axillary nodal metastasis was 15.5 % (31 of 200). Axillary nodal metastasis was significantly more frequent in tumours with elasticity scores ≥4 than in tumours with elasticity scores elasticity score ≥4 [odds ratio (OR), 6.95; P = 0.004], US size >10 mm (OR, 5.98; P = 0.022), and lymphovascular invasion (OR, 10.68; P breast carcinoma patients. • Prediction of axillary nodal status using imaging techniques is valuable. • High ultrasound elasticity scores of T1 tumours were associated with axillary metastasis • Node-positive T1 tumours frequently had elasticity scores 4 or 5. • Sonoelastography might render axillary surgery unnecessary in T1 breast carcinoma patients.

  16. A Manifesto of Nodalism

    Directory of Open Access Journals (Sweden)

    Monty Adkins


    Full Text Available This paper proposes the notion of Nodalism as a means describing contemporary culture and of understanding my own creative practice in electronic music composition. It draws on theories and ideas from Kirby, Bauman, Bourriaud, Deleuze, Guatarri, and Gochenour, to demonstrate how networks of ideas or connectionist neural models of cognitive behaviour can be used to contextualize, understand and become a creative tool for the creation of contemporary electronic music.

  17. Late (> 5 years) regional lymph node metastasis of oral squamous cell carcinoma (SCC), proven by p53 mutation analysis

    NARCIS (Netherlands)

    Kummer, J. Alain; Van Es, Robert J. J.; Hoekstra, J.W.M.


    Background: A late (>5 years) neck nodal metastasis of oral cancer, poses a problem to the clinician: is it a late metastasis or a metastasis of a (unknown) second primary tumour? Methods: A 50-year-old male was seen with a contralateral lymph node metastasis, 51/2 years after treatment of a pT2N1M0

  18. Visualization of mouse nodal cilia and nodal flow. (United States)

    Nonaka, Shigenori


    The earliest left-right asymmetry in mouse development arises in 7.5 days, at the ventral surface of the embryonic node. The node cells possess monocilia beating in rotatory fashion to generate fluid flow from the right to the left (nodal flow). The direction of nodal flow will determine the side of expression of nodal, the responsible gene for "leftness." Nodal flow is visualized by combination of DIC (differential interference contrast) and microbeads in culture medium. Node cilia movement is visualized by DIC, a high-speed camera, and image processing. Copyright © 2013 Elsevier Inc. All rights reserved.


    NARCIS (Netherlands)


    AV nodal tachycardia may present at any age, but onset in late adulthood is considered uncommon. To evaluate whether onset of AV nodal tachycardias at older age is related to organic heart disease (possibly setting the stage for re-entry due to degenerative structural changes) 32 consecutive

  20. Bone Metastasis (United States)

    ... help reduce pain and other symptoms of bone metastases. Symptoms Sometimes, bone metastasis causes no signs and ... cancers most likely to cause bone metastasis include: Breast cancer Kidney cancer Lung cancer Lymphoma Multiple myeloma Prostate ...

  1. Double helix nodal line superconductor


    Sun, Xiao-Qi; Lian, Biao; Zhang, Shou-Cheng


    Time-reversal invariant superconductors in three dimensions may contain nodal lines in the Brillouin zone, which behave exactly as Wilson loops of 3d momentum-space Chern-Simons theory of the Berry connection. Here we study the conditions of realizing linked nodal lines (Wilson loops), which yield a topological contribution to the thermal magnetoelectric coefficient that is given by the Chern-Simons action. We find the essential conditions are the existence of torus or higher genus fermi surf...

  2. Robot-assisted Retrohepatic Inferior Vena Cava Thrombectomy: First or Second Porta Hepatis as an Important Boundary Landmark. (United States)

    Wang, Baojun; Li, Hongzhao; Huang, Qingbo; Liu, Kan; Fan, Yang; Peng, Cheng; Gu, Liangyou; Li, Xintao; Guo, Gang; Liu, Rong; Hu, Minggen; Zhao, Guodong; Wang, Hongguang; Liu, Fengyong; Xiong, Jiang; Zhang, Xu; Ma, Xin


    Robot-assisted retrohepatic inferior vena cava (IVC) thrombectomy (RA-R-IVCTE) has been reported only for limited series. To describe in detail the techniques for RA-R-IVCTE with regard to the relationship of a proximal thrombus to either the first porta hepatis (FPH) or second porta hepatis (SPH). From May 2013 to July 2016, 22 patients with R-IVC tumor thrombi were admitted to our hospital. RA-R-IVCTE was performed using the Rummel tourniquet technique. For a proximal thrombus inferior to the FPH, we ligated some short hepatic veins (SHVs; typically 1-3). For a thrombus between the FPH and SPH, we mobilized the right lobe of the liver from the IVC by ligating additional SHVs. For a thrombus near or above the SPH but below the diaphragm, we mobilized both the right and left lobes of the liver to obtain high proximal control of the suprahepatic and infradiaphragmatic IVC, and simultaneously clamped the FPH. Detailed techniques were described for various scenarios and perioperative outcomes were recorded. The median operation time was 285min (interquartile range [IQR] 191-390). Intraoperative estimated blood loss was 1350ml (IQR 1000-2075ml). Some 63.6% of patients required an intraoperative blood transfusion and 68% were transferred to the intensive care unit after surgery. Grade IV complications developed in five cases. Vascular injuries (4 cases) were treated with intraoperative endoscopic sutures. An intestinal fistula was found on postoperative day 7 in one case; treatment with gastrointestinal decompression and drainage resolved the condition by 1 mo. Even though the risks involved are high, RA-R-IVCTE is feasible for selected patients. The FPH/SPH is an important boundary landmark for RA-R-IVCTE. The location of proximal IVC tumor thrombi in relation to the FPH or SPH should determine the technique used. Robot-assisted thrombectomy for retrohepatic inferior vena cava tumor thrombus is feasible in selected patients. Copyright © 2017 European Association of

  3. Tumor budding and E-cadherin expression are useful predictors of nodal involvement in T1 esophageal squamous cell carcinoma. (United States)

    Nakagawa, Yasuo; Ohira, Masaichi; Kubo, Naoshi; Yamashita, Yoshito; Sakurai, Katsunobu; Toyokawa, Takahiro; Tanaka, Hiroaki; Muguruma, Kazuya; Shibutani, Masatsune; Yamazoe, Sadaaki; Kimura, Kenjiro; Nagahara, Hisashi; Amano, Ryosuke; Ohtani, Hiroshi; Yashiro, Masakazu; Maeda, Kiyoshi; Hirakawa, Kosei


    Endoscopic treatment has been increasingly used for T1 esophageal squamous cell carcinoma (ESCC). However, this therapy is sometimes incomplete if the depth of the T1 primary tumor reaches the muscularis mucosae or submucosal layer because these tumors have a relatively high incidence of lymph node metastasis. However, to our knowledge, no previous reports on the prediction of nodal metastasis determined by evaluating primary tumor specimens of patients with ESCC are available. A total of 55 patients with T1 ESCC invading as deep as the submucosal layer who underwent curative esophagectomy were examined. We investigated the significance of the immunohistochemical staining of Vascular endothelial growth factor-C (VEGF-C) and E-cadherin in the primary tumor and Tumor budding for prediction of nodal metastasis. Metastasis to the regional lymph nodes was observed in 26 cases (47.3%) in this setting. VEGF-C expression and reduced E-Cadherin expression in the primary tumor was observed in 32 (58.1%) and 38 cases (69.1%), respectively. High-grade tumor budding was observed in 29 cases (52.7%). E-cadherin expression and tumor budding were closely correlated with nodal metastasis (p=0.04 and tumor budding was significantly correlated (ptumor budding and E-cadherin expression for nodal metastasis were 67.3% and 65.4% respectively, comparable with the one of lymphatic involvement (63%). Tumor budding (ptumor budding are observed in primary tumor specimen.

  4. Hyoid bone chondrosarcoma with cervical nodal metastasis: A case ...

    African Journals Online (AJOL)

    Hisham Mostafa Abdel-Fattah


    Nov 18, 2015 ... not fixed to the surrounding structures, mobile with deglutition non-tender and without any inflammatory signs. * Corresponding author. Tel.: +20 1223927397. E-mail addresses:, hany_osama83@ ·, (H.O. Nasef). Peer review under ...

  5. Double Helix Nodal Line Superconductor (United States)

    Sun, Xiao-Qi; Lian, Biao; Zhang, Shou-Cheng


    Time-reversal invariant superconductors in three dimensions may contain nodal lines in the Brillouin zone, which behave as Wilson loops of 3D momentum-space Chern-Simons theory of the Berry connection. Here we study the conditions of realizing linked nodal lines (Wilson loops), which yield a topological contribution to the thermal magnetoelectric coefficient that is given by the Chern-Simons action. We find the essential conditions are the existence of torus or higher genus Fermi surfaces and spiral spin textures. We construct such a model with two torus Fermi surfaces, where a generic spin-dependent interaction leads to double-helix-like linked nodal lines as the superconductivity is developed.

  6. Double Helix Nodal Line Superconductor. (United States)

    Sun, Xiao-Qi; Lian, Biao; Zhang, Shou-Cheng


    Time-reversal invariant superconductors in three dimensions may contain nodal lines in the Brillouin zone, which behave as Wilson loops of 3D momentum-space Chern-Simons theory of the Berry connection. Here we study the conditions of realizing linked nodal lines (Wilson loops), which yield a topological contribution to the thermal magnetoelectric coefficient that is given by the Chern-Simons action. We find the essential conditions are the existence of torus or higher genus Fermi surfaces and spiral spin textures. We construct such a model with two torus Fermi surfaces, where a generic spin-dependent interaction leads to double-helix-like linked nodal lines as the superconductivity is developed.

  7. Status of the Regional Nodal Basin Remains Highly Prognostic in Melanoma Patients with In-Transit Disease. (United States)

    Gonzalez, Alexandra B; Jakub, James W; Harmsen, William S; Suman, Vera J; Markovic, Svetomir N


    The role of SLNB for in-transit (IT) melanoma is controversial. The objective of this study was to determine the rate and prognostic significance of occult nodal disease in patients undergoing surgical nodal staging for IT disease. We conducted a retrospective review of patients with IT melanoma from May 2005 through September 2014. Analysis was limited to patients with a first-time IT event who underwent surgical excision. Associations between clinicopathologic characteristics, patterns of recurrence, and survival were analyzed. A total of 261 patients treated at our center were identified and 157 met inclusion criteria, of which 135 (86%) presented with no evidence of nodal disease. At the time of surgical excision of the IT lesion, 80 (58%) clinically node-negative patients underwent observation of the nodal basin and 55 (41%) surgical nodal staging. Twenty (36%) clinically node-negative but surgically staged patients were found to have nodal disease. Distant metastasis-free survival was 70.8 months for surgically staged node-negative patients, 19.2 months for surgically staged node-positive patients, 22.8 months for those staged node-negative by clinical examination only and 4.8 months for those with clinical nodal disease (p = 0.01). The regional nodal basin was the first site of failure in 14 of 66 (21%) clinically staged patients, 5 of 50 (10%) for those surgically staged, and 6 of 16 (38%) for those with clinical nodal disease. Patients with IT disease are at high risk for occult nodal metastasis. Because clinical staging is unreliable, SLNB should be considered. For patients with IT recurrence, the status of the regional basin is strongly prognostic and stratifies patients into low-, intermediate-, and high-risk groups. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Spinless hourglass nodal-line semimetals (United States)

    Takahashi, Ryo; Hirayama, Motoaki; Murakami, Shuichi


    Nodal-line semimetals, one of the topological semimetals, have degeneracy along nodal lines where the band gap is closed. In many cases, the nodal lines appear accidentally, and in such cases it is impossible to determine whether the nodal lines appear or not, only from the crystal symmetry and the electron filling. In this paper, for spinless systems, we show that in specific space groups at 4 N +2 fillings (8 N +4 fillings including the spin degree of freedom), presence of the nodal lines is required regardless of the details of the systems. Here, the spinless systems refer to crystals where the spin-orbit coupling is negligible and the spin degree of freedom can be omitted because of the SU(2) spin degeneracy. In this case the shape of the band structure around these nodal lines is like an hourglass, and we call this a spinless hourglass nodal-line semimetal. We construct a model Hamiltonian as an example and we show that it is always in the spinless hourglass nodal-line semimetal phase even when the model parameters are changed without changing the symmetries of the system. We also establish a list of all the centrosymmetric space groups, under which spinless systems always have hourglass nodal lines, and illustrate where the nodal lines are located. We propose that Al3FeSi2 , whose space-group symmetry is Pbcn (No. 60), is one of the nodal-line semimetals arising from this mechanism.

  9. Identification of nodal metastases in melanoma using sox-10. (United States)

    Jennings, Charay; Kim, Jinah


    The presence of S100-positive dendritic cells hinders the identification of isolated melanoma tumor cells and micrometastases in sentinel lymph nodes. Sox-10, a transcription factor that plays an important role in schwannian and melanocytic cell development, is not expressed in dendritic cells. We investigated the diagnostic utility of Sox-10 in the identification of metastases in sentinel and nonsentinel lymph nodes for melanoma. We examined the expression pattern of Sox-10, as compared with S100, Melan-A, and HMB-45 in 93 lymph nodes (40 originally reported as positive and 53 originally reported as negative for metastasis) from 33 sentinel lymph node biopsies and regional lymphadenectomies. Sox-10 and S100 both highlighted metastases in 43 of 43 (100%) positive lymph nodes identified in this study; however, Sox-10 immunohistochemical staining significantly improved the detection of nodal metastases. The nuclear staining of Sox-10 promoted improved distinction between heavily pigmented melanophages and melanocytic metastases in 3 positive lymph nodes. In 2 lymph nodes, Sox-10 was critical in distinguishing S100-positive atypical nodal dendritic cells from tumor cells. Also, Sox-10 significantly improved the identification of micrometastases and isolated tumor cells as compared with S100 in 10 positive lymph nodes. Most importantly, Sox-10 identified micrometastases in 2 lymph nodes, originally reported as negative on S100, Melan-A, and HMB-45 immunostains. Therefore, Sox-10 is a comparable marker to S100 in identifying nodal metastases in melanoma and is especially useful in the setting of lymph nodes with heavily pigmented metastases, numerous S100-positive nodal dendritic cells, micrometastases, and isolated tumor cells.

  10. Lymph Node Metastasis of Gastric Cancer

    Directory of Open Access Journals (Sweden)

    Seigo Kitano


    Full Text Available Despite a decrease in incidence in recent decades, gastric cancer is still one of the most common causes of cancer death worldwide [1]. In areas without screening for gastric cancer, it is diagnosed late and has a high frequency of nodal involvement [1]. Even in early gastric cancer (EGC, the incidence of lymph node (LN metastasis exceeds 10%; it was reported to be 14.1% overall and was 4.8 to 23.6% depending on cancer depth [2]. It is important to evaluate LN status preoperatively for proper treatment strategy; however, sufficient results are not being obtained using various modalities. Surgery is the only effective intervention for cure or long-term survival. It is possible to cure local disease without distant metastasis by gastrectomy and LN dissection. However, there is no survival benefit from surgery for systemic disease with distant metastasis such as para-aortic lymph node metastasis [3]. Therefore, whether the disease is local or systemic is an important prognostic indicator for gastric cancer, and the debate continues over the importance of extended lymphadenectomy for gastric cancer. The concept of micro-metastasis has been described as a prognostic factor [4-9], and the biological mechanisms of LN metastasis are currently under study [10-12]. In this article, we review the status of LN metastasis including its molecular mechanisms and evaluate LN dissection for the treatment of gastric cancer.

  11. Inflammation and Tumor Microenvironment in Lymph Node Metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Xuesong; Takekoshi, Tomonori; Sullivan, Ashley; Hwang, Sam T., E-mail: [Department of Dermatology, Medical College of Wisconsin, Milwaukee, WI 53226 (United States)


    In nearly all human cancers, the presence of lymph node (LN) metastasis increases clinical staging and portends worse prognosis (compared to patients without LN metastasis). Herein, principally reviewing experimental and clinical data related to malignant melanoma, we discuss diverse factors that are mechanistically involved in LN metastasis. We highlight recent data that link tumor microenvironment, including inflammation (at the cellular and cytokine levels) and tumor-induced lymphangiogenesis, with nodal metastasis. Many of the newly identified genes that appear to influence LN metastasis facilitate general motility, chemotactic, or invasive properties that also increase the ability of cancer cells to disseminate and survive at distant organ sites. These new biomarkers will help predict clinical outcome and point to novel future therapies in metastatic melanoma as well as other cancers.

  12. Extra-nodal extension is a significant prognostic factor in lymph node positive breast cancer.

    Directory of Open Access Journals (Sweden)

    Sura Aziz

    Full Text Available Presence of lymph node (LN metastasis is a strong prognostic factor in breast cancer, whereas the importance of extra-nodal extension and other nodal tumor features have not yet been fully recognized. Here, we examined microscopic features of lymph node metastases and their prognostic value in a population-based cohort of node positive breast cancer (n = 218, as part of the prospective Norwegian Breast Cancer Screening Program NBCSP (1996-2009. Sections were reviewed for the largest metastatic tumor diameter (TD-MET, nodal afferent and efferent vascular invasion (AVI and EVI, extra-nodal extension (ENE, number of ENE foci, as well as circumferential (CD-ENE and perpendicular (PD-ENE diameter of extra-nodal growth. Number of positive lymph nodes, EVI, and PD-ENE were significantly increased with larger primary tumor (PT diameter. Univariate survival analysis showed that several features of nodal metastases were associated with disease-free (DFS or breast cancer specific survival (BCSS. Multivariate analysis demonstrated an independent prognostic value of PD-ENE (with 3 mm as cut-off value in predicting DFS and BCSS, along with number of positive nodes and histologic grade of the primary tumor (for DFS: P = 0.01, P = 0.02, P = 0.01, respectively; for BCSS: P = 0.02, P = 0.008, P = 0.02, respectively. To conclude, the extent of ENE by its perpendicular diameter was independently prognostic and should be considered in line with nodal tumor burden in treatment decisions of node positive breast cancer.

  13. Nodal basin recurrence following lymph node dissection for melanoma: implications for adjuvant radiotherapy. (United States)

    Lee, R J; Gibbs, J F; Proulx, G M; Kollmorgen, D R; Jia, C; Kraybill, W G


    . Nodal basin failure was predictive of distant metastasis with 87% of patients with nodal basin recurrence developing distant disease compared to 54% of patients without nodal failure (p analysis, number of positive nodes and type of dissection (elective vs. therapeutic) were significant predictors of overall and disease-specific survival. Size of the largest lymph node was also predictive of disease-specific survival. Site of nodal involvement and ECE were significant predictors of nodal basin failure. Malignant melanoma patients with nodal involvement have a significant risk of nodal basin failure after LND if they have cervical involvement, ECE, >3 positive lymph nodes, clinically involved nodes, or any node larger than 3 cm. Patients with these risk factors should be considered for adjuvant radiotherapy to the lymph node basin to reduce the incidence of nodal basin recurrence. Patients with nodal basin failure are at higher risk of developing distant metastases.

  14. [Complete remission after abdominal wall metastasis from uterine cervical cancer on a laparoscopic trochar site: a case report]. (United States)

    Doret, M; De Saint Hilaire, P; Zinzindohoue, C; Bobin, J Y


    Abdominal wall metastasis to laparoscopic trochar sites after preoperative staging procedure is rare for uterine cervix cancer. Prognosis is unfavorable. We report a case of metastasis to a laparoscopic trochar site in a patient with a stage IIB cervical cancer with no nodal involvement who is alive four and a half years after radical surgery and radiotherapy.

  15. Evaluation of protective effect of hydroalcoholic extract of Crocus sativus petals on preventing of gentamicin induced peliosis hepatis and hepatic telangiectasis in rats: short communication

    Directory of Open Access Journals (Sweden)

    Arash Omidi


    Full Text Available Peliosis hepatis is a rare liver disease characterized by blood-filled cavities scattered irregularly throughout the liver. Risk factors for peliosis include chronic illness such as AIDS, tuberculosis, cancer also use of some drugs such as anabolic steroids and azathioprine. The aim of the present study was to evaluate the curative properties of crocus sativus petals on induced peliosis hepatis in rats. Thirty two male Wistar rats (weight: 180-220 g were randomly divided into four equal groups: group 1 (healthy group received only IP normal saline, group2 received IP 80mg/ gentamicin, group3 IP 80mg/ gentamicin+ 40mg/kg crocus sativus petal extract, and group 4 was given IP 80mg/ gentamicin+ 40mg/kg crocus sativus petal extract. At the end of the experiment, the rats were anesthetized and their blood samples were collected through cardiac puncture for AST and ALT measurement.Then, the livers of the subjects were excised and fixed in formalin. It was found that AST significantly increased in gentamicin group (P<0.05 compared to the healthy group and groups treated by means of crocus sativus petal extract .Moreover, there was no significant differences between the groups administered the extract and those given gentamicin. Histologically,heterogeneous multiple blood-filled cavities were observed in gentamicin group (2 and the treatment groups (3 and 4. The results of the present study show that doses of hydroalcoholic extract of crocus sativus do not effect on peliosis hepatic and telangiectasis due to gentamicin sulfate in rats

  16. Gastrointestinal stromal tumor of the stomach with lymph node metastasis

    Directory of Open Access Journals (Sweden)

    Nalbant Olcay


    Full Text Available Abstract Background Lymph node (LN metastasis of gastrointestinal stromal tumors (GIST is unusual. Unlike gastric adenocarcinomas, routine lymphadenectomy is not recommended unless there is no suspicion for LN metastasis. Herein, we report a case of GIST of the stomach with LN metastasis treated with distal gastrectomy with perigastric LN dissection followed by adjuvant imatinib therapy. Case presentation A 32-year-old female presented with anemia. Diagnostic investigations including thoracoabdominopelvic computed tomography (CT scan and gastroscopy revealed a 8 cm gastric antral submucosal tumor without any metastasis. Enlarged periantral LNs were detected during laparotomy and patient underwent distal gastrectomy with en bloc perigastric LN dissection. Pathologic investigation revealed antral stromal tumor with high mitotic and Ki-67 index. Lymph node metastasis was observed in 7 of 12 resected perigastirc nodes. Immunohistochemically, tumor cells were positive for CD117. She was diagnosed as high grade gastric GIST due to the presence of LN metastasis, large tumor size and unfavorable histopathologic features thus underwent adjuvant imatinib treatment (400 mg, daily. No recurrence or metastasis has been detected during a 12-month of postoperative follow-up. Conclusion Surgery remains the mainstay of treatment in patients with localized, resectable GISTs. Although lymphatic metastasis rarely occurs in patients with GIST, LN dissection should be considered for patients with any suspicion of nodal metastasis. Adjuvant imatinib treatment is recommended according to the well defined prognostic factors.

  17. Gastrointestinal stromal tumor of the stomach with lymph node metastasis. (United States)

    Canda, Aras Emre; Ozsoy, Yucel; Nalbant, Olcay Ak; Sagol, Ozgul


    Lymph node (LN) metastasis of gastrointestinal stromal tumors (GIST) is unusual. Unlike gastric adenocarcinomas, routine lymphadenectomy is not recommended unless there is no suspicion for LN metastasis. Herein, we report a case of GIST of the stomach with LN metastasis treated with distal gastrectomy with perigastric LN dissection followed by adjuvant imatinib therapy. A 32-year-old female presented with anemia. Diagnostic investigations including thoracoabdominopelvic computed tomography (CT) scan and gastroscopy revealed a 8 cm gastric antral submucosal tumor without any metastasis. Enlarged periantral LNs were detected during laparotomy and patient underwent distal gastrectomy with en bloc perigastric LN dissection. Pathologic investigation revealed antral stromal tumor with high mitotic and Ki-67 index. Lymph node metastasis was observed in 7 of 12 resected perigastirc nodes. Immunohistochemically, tumor cells were positive for CD117. She was diagnosed as high grade gastric GIST due to the presence of LN metastasis, large tumor size and unfavorable histopathologic features thus underwent adjuvant imatinib treatment (400 mg, daily). No recurrence or metastasis has been detected during a 12-month of postoperative follow-up. Surgery remains the mainstay of treatment in patients with localized, resectable GISTs. Although lymphatic metastasis rarely occurs in patients with GIST, LN dissection should be considered for patients with any suspicion of nodal metastasis. Adjuvant imatinib treatment is recommended according to the well defined prognostic factors.

  18. [Cancer metastasis]. (United States)

    Berner, A; Bryne, M; Thrane, P S


    Despite increasing insight into the biology of tumour development, the number of cancer deaths has not been subsequently reduced. This may be because approximately half of the cancers have metastasized already at the time of initial diagnosis. It seems important therefore, to learn more about the complex metastatic process. This process includes several linked sequential steps, and depends on an intimate interaction between the metastatic cells and the environment. In this review, we discuss these steps with emphasis on recent studies of the various cellular interactions that take place. Understanding these factors should result in diagnostic improvements and more effective treatment of cancer metastasis.

  19. Maternal Nodal inversely affects NODAL and STOX1 expression in the fetal placenta

    Directory of Open Access Journals (Sweden)

    Hari Krishna Thulluru


    Full Text Available Nodal, a secreted signaling protein from the TGFβ-super family plays a vital role during early embryonic development. Recently, it was found that maternal decidua-specific Nodal knockout mice show intrauterine growth restriction (IUGR and preterm birth. As the chromosomal location of NODAL is in the same linkage area as the susceptibility gene STOX1, associated with the familial form of early-onset, IUGR-complicated pre-eclampsia, their potential maternal-fetal interaction was investigated. Pre-eclamptic mothers with children who carried the STOX1 susceptibility allele themselves all carried the NODAL H165R SNP, which causes a 50% reduced activity. Surprisingly, in decidua Nodal knockout mice the fetal placenta showed up-regulation of STOX1 and NODAL expression. Conditioned media of human first trimester decidua and a human endometrial stromal cell line (T-HESC treated with siRNAs against NODAL or carrying the H165R SNP were also able to induce NODAL and STOX1 expression when added to SGHPL-5 first trimester extravillous trophoblast cells. Finally, a human TGFß-BMP-Signaling-Pathway PCR-Array on decidua and the T-HESC cell line with Nodal knockdown revealed upregulation of Activin-A, which was confirmed in conditioned media by ELISA. We show that maternal decidua Nodal knockdown gives upregulation of NODAL and STOX1 mRNA expression in fetal extravillous trophoblast cells, potentially via upregulation of Activin-A in the maternal decidua. As both Activin-A and Nodal have been implicated in pre-eclampsia, being increased in serum of pre-eclamptic women and upregulated in pre-eclamptic placentas respectively, this interaction at the maternal-fetal interface might play a substantial role in the development of pre-eclampsia.

  20. Aircraft Nodal Data Acquisition System (ANDAS) Project (United States)

    National Aeronautics and Space Administration — Development of an Aircraft Nodal Data Acquisition System (ANDAS) is proposed. The proposed methodology employs the development of a very thin (135m) hybrid...

  1. Aircraft Nodal Data Acquisition System (ANDAS) Project (United States)

    National Aeronautics and Space Administration — Development of an Aircraft Nodal Data Acquisition System (ANDAS) based upon the short haul Zigbee networking standard is proposed. It employs a very thin (135 um)...

  2. Nodal signalling determines biradial asymmetry in Hydra. (United States)

    Watanabe, Hiroshi; Schmidt, Heiko A; Kuhn, Anne; Höger, Stefanie K; Kocagöz, Yigit; Laumann-Lipp, Nico; Ozbek, Suat; Holstein, Thomas W


    In bilaterians, three orthogonal body axes define the animal form, with distinct anterior-posterior, dorsal-ventral and left-right asymmetries. The key signalling factors are Wnt family proteins for the anterior-posterior axis, Bmp family proteins for the dorsal-ventral axis and Nodal for the left-right axis. Cnidarians, the sister group to bilaterians, are characterized by one oral-aboral body axis, which exhibits a distinct biradiality of unknown molecular nature. Here we analysed the biradial growth pattern in the radially symmetrical cnidarian polyp Hydra, and we report evidence of Nodal in a pre-bilaterian clade. We identified a Nodal-related gene (Ndr) in Hydra magnipapillata, and this gene is essential for setting up an axial asymmetry along the main body axis. This asymmetry defines a lateral signalling centre, inducing a new body axis of a budding polyp orthogonal to the mother polyp's axis. Ndr is expressed exclusively in the lateral bud anlage and induces Pitx, which encodes an evolutionarily conserved transcription factor that functions downstream of Nodal. Reminiscent of its function in vertebrates, Nodal acts downstream of β-Catenin signalling. Our data support an evolutionary scenario in which a 'core-signalling cassette' consisting of β-Catenin, Nodal and Pitx pre-dated the cnidarian-bilaterian split. We presume that this cassette was co-opted for various modes of axial patterning: for example, for lateral branching in cnidarians and left-right patterning in bilaterians.

  3. Tumor budding is associated with an increased risk of lymph node metastasis and poor prognosis in superficial esophageal adenocarcinoma. (United States)

    Landau, Michael S; Hastings, Steven M; Foxwell, Tyler J; Luketich, James D; Nason, Katie S; Davison, Jon M


    The treatment approach for superficial (stage T1) esophageal adenocarcinoma critically depends on the pre-operative assessment of metastatic risk. Part of that assessment involves evaluation of the primary tumor for pathologic characteristics known to predict nodal metastasis: depth of invasion (intramucosal vs submucosal), angiolymphatic invasion, tumor grade, and tumor size. Tumor budding is a histologic pattern that is associated with poor prognosis in early-stage colorectal adenocarcinoma and a predictor of nodal metastasis in T1 colorectal adenocarcinoma. In a retrospective study, we used a semi-quantitative histologic scoring system to categorize 210 surgically resected, superficial (stage T1) esophageal adenocarcinomas according to the extent of tumor budding (none, focal, and extensive) and also evaluated other known risk factors for nodal metastasis, including depth of invasion, angiolymphatic invasion, tumor grade, and tumor size. We assessed the risk of nodal metastasis associated with tumor budding in univariate analyses and controlled for other risk factors in a multivariate logistic regression model. In all, 41% (24 out of 59) of tumors with extensive tumor budding (tumor budding in ≥3 20X microscopic fields) were metastatic to regional lymph nodes, compared with 10% (12 out of 117) of tumors with no tumor budding, and 15% (5 out of 34) of tumors with focal tumor budding (Ptumor budding remains an independent risk factor for lymph node metastasis in superficial esophageal adenocarcinoma associated with a 2.5-fold increase (95% CI=1.1-6.3, P=0.039) in the risk of nodal metastasis. Extensive tumor budding is also a poor prognostic factor with respect to overall survival and time to recurrence in univariate and multivariate analyses. As an independent risk factor for nodal metastasis and poor prognosis after esophagectomy, tumor budding should be evaluated in superficial (T1) esophageal adenocarcinoma as a part of a comprehensive pathologic risk

  4. Delphian node metastasis in head and neck cancers--oracle or myth? (United States)

    Iyer, N Gopalakrishna; Shaha, Ashok R; Ferlito, Alfio; Thomas Robbins, K; Medina, Jesus E; Silver, Carl E; Rinaldo, Alessandra; Takes, Robert P; Suárez, Carlos; Rodrigo, Juan P; Bradley, Patrick J; Werner, Jochen A


    Delphian node (DN) refers to the pre-laryngeal or pre-cricoid nodal tissue often identified during laryngeal or thyroid surgery. The original nomenclature is based on the assumption that metastasis to this node was predictive of aggressive disease and poor outcome for patients. In this article, we review the existing literature on the topic to determine the significance of DN metastasis in laryngeal, hypopharyngeal and thyroid cancers. (c) 2010 Wiley-Liss, Inc.

  5. Preoperative Imaging Modalities to Predict the Risk of Regional Nodal Recurrence in Well-Differentiated Thyroid Cancers

    Directory of Open Access Journals (Sweden)

    AlNoury, Mohammed K.


    Full Text Available Introduction Thyroid cancer incidence has increased in the previous 2 decades. Preoperative identification of lymph node metastasis is a suggested risk factor associated with recurrence following thyroidectomy. Objectives We aimed to evaluate the accuracy of preoperative radiologic investigations of nodal status in determining the postoperative risk of regional nodal recurrence in cases of well-differentiated thyroid cancer. Methods This is a case series. We retrospectively reviewed data, including preoperative ultrasonography and/or computed tomography results, on patients who underwent total thyroidectomy for thyroid cancer at our hospital between 2006 and 2012. Prognostic factors for predicting recurrence, including age, sex, tumor diameter, and nodal diameter, were evaluated. Results Total thyroidectomy was performed on 24 male and 74 female patients (median age, 43 years. The median follow-up time was 21 months. Sixty-eight patients had papillary thyroid cancer, and 30 had follicular cancer. Nodal recurrence was evident in 30% of patients, and 4% of patients died. Identification of lymph node involvement during preoperative radiologic investigations was strongly prognostic for recurrence: 35.3% of patients with positive preoperative ultrasonography findings and 62.5% of those with positive preoperative computed tomography findings had recurrence (p = 0.01. Conclusions Preoperative identification of lymph node metastasis on radiologic studies was correlated with an increased risk of regional nodal recurrence in well-differentiated thyroid cancer. Computed tomography was superior to ultrasonography in detecting metastatic nodal involvement preoperatively and is therefore recommended for preoperative assessment and postoperative follow-up.

  6. Impact of Nodal Level Distribution on Survival in Oral Cavity Squamous Cell Carcinoma: A Population-Based Study. (United States)

    Marchiano, Emily; Patel, Tapan D; Eloy, Jean Anderson; Baredes, Soly; Park, Richard Chan Woo


    Regional lymph node metastasis is an important prognostic factor in squamous cell carcinoma of the head and neck, decreasing survival by up to 50%. Oral cavity squamous cell carcinoma (OC-SCCa) most commonly spreads to levels I, II, and III. Retrospective analysis of a population-based tumor registry. Academic medical center. The Surveillance, Epidemiology, and End Results (SEER) database was queried for cases of OC-SCCa from 2004 to 2011 (22,973 cases). Resulting data including patient demographics, clinicopathological features, topographical distribution of nodal metastasis, and survival based on lymph node level involvement were analyzed. In total, 8281 patients were identified with OC-SCCa who underwent neck dissection. Level I, closely followed by levels II and III, represented the most commonly involved nodal basins. The 5-year disease-specific survival (DSS) for patients with only level I, II, or III was 42.0% compared with 30.6% for the level IV group (P Oral cavity squamous cell carcinoma most commonly involves nodal levels I, II, and III. Involvement of nodal level IV or V portends a worse prognosis than patients with only level I to III disease, and multimodality therapy should be considered for these patients. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  7. Radiotherapy for esthesioneuroblastoma: is elective nodal irradiation warranted in the multimodality treatment approach? (United States)

    Noh, O Kyu; Lee, Sang-wook; Yoon, Sang Min; Kim, Sung Bae; Kim, Sang Yoon; Kim, Chang Jin; Jo, Kyung Ja; Choi, Eun Kyung; Song, Si Yeol; Kim, Jong Hoon; Ahn, Seung Do


    The role of elective nodal irradiation (ENI) in radiotherapy for esthesioneuroblastoma (ENB) has not been clearly defined. We analyzed treatment outcomes of patients with ENB and the frequency of cervical nodal failure in the absence of ENI. Between August 1996 and December 2007, we consulted with 19 patients with ENB regarding radiotherapy. Initial treatment consisted of surgery alone in 2 patients; surgery and postoperative radiotherapy in 4; surgery and adjuvant chemotherapy in 1; surgery, postoperative radiotherapy, and chemotherapy in 3; and chemotherapy followed by radiotherapy or concurrent chemoradiotherapy in 5. Five patients did not receive planned radiotherapy because of disease progression. Including 2 patients who received salvage radiotherapy, 14 patients were treated with radiotherapy. Elective nodal irradiation was performed in 4 patients with high-risk factors, including 3 with cervical lymph node metastasis at presentation. Fourteen patients were analyzable, with a median follow-up of 27 months (range, 7-64 months). The overall 3-year survival rate was 73.4%. Local failure occurred in 3 patients (21.4%), regional cervical failure in 3 (21.4%), and distant failure in 2 (14.3%). No cervical nodal failure occurred in patients treated with combined systemic chemotherapy regardless of ENI. Three cervical failures occurred in the 4 patients treated with ENI or neck dissection (75%), none of whom received systemic chemotherapy. ENI during radiotherapy for ENB seems to play a limited role in preventing cervical nodal failure. Omitting ENI may be an option if patients are treated with a combination of radiotherapy and chemotherapy. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. Clinical nodal staging scores for prostate cancer: a proposal for preoperative risk assessment. (United States)

    Kluth, L A; Abdollah, F; Xylinas, E; Rieken, M; Fajkovic, H; Seitz, C; Sun, M; Karakiewicz, P I; Schramek, P; Herman, M P; Becker, A; Hansen, J; Ehdaie, B; Loidl, W; Pummer, K; Lee, R K; Lotan, Y; Scherr, D S; Seiler, D; Ahyai, S A; Chun, F K-H; Graefen, M; Tewari, A; Nonis, A; Bachmann, A; Montorsi, F; Gönen, M; Briganti, A; Shariat, S F


    Pelvic lymph node dissection in patients undergoing radical prostatectomy for clinically localised prostate cancer is not without morbidity and its therapeutical benefit is still a matter of debate. The objective of this study was to develop a model that allows preoperative determination of the minimum number of lymph nodes needed to be removed at radical prostatectomy to ensure true nodal status. We analysed data from 4770 patients treated with radical prostatectomy and pelvic lymph node dissection between 2000 and 2011 from eight academic centres. For external validation of our model, we used data from a cohort of 3595 patients who underwent an anatomically defined extended pelvic lymph node dissection. We estimated the sensitivity of pathological nodal staging using a beta-binomial model and developed a novel clinical (preoperative) nodal staging score (cNSS), which represents the probability that a patient has lymph node metastasis as a function of the number of examined nodes. In the development and validation cohorts, the probability of missing a positive lymph node decreases with increase in the number of nodes examined. A 90% cNSS can be achieved in the development and validation cohorts by examining 1-6 nodes in cT1 and 6-8 nodes in cT2 tumours. With 11 nodes examined, patients in the development and validation cohorts achieved a cNSS of 90% and 80% with cT3 tumours, respectively. Pelvic lymph node dissection is the only reliable technique to ensure accurate nodal staging in patients treated with radical prostatectomy for clinically localised prostate cancer. The minimum number of examined lymph nodes needed for accurate nodal staging may be predictable, being strongly dependent on prostate cancer characteristics at diagnosis.

  9. The impact of nodal tumour burden on lymphoscintigraphic imaging in patients with melanomas. (United States)

    Kretschmer, Lutz; Bertsch, Hans Peter; Bardzik, Pawel; Meller, Johannes; Hellriegel, Simin; Thoms, Kai-Martin; Schön, Michael Peter; Sahlmann, Carsten Oliver


    To retrospectively study the influence of nodal tumour burden on lymphoscintigraphic imaging in 509 consecutive patients with melanomas. Bidirectional lymphatic drainage, the clear depiction of an afferent lymphatic vessel, time to depiction of the first sentinel lymph node (SLN) and number of depicted and excised nodes were recorded. Nodal tumour load was classified as SLN-negative, SLN micrometastases or macrometastases. In the overall population, using multivariate regression analysis, a short SLN depiction time was significantly associated with the depiction of a greater number of radioactive nodes, a short distance between the primary tumour site and the nodal basin, younger age and lower nodal tumour burden. The proportion of patients with clear depiction of an afferent lymphatic vessel depended on the nodal tumour load (46% in SLN-negative patients, 57% in SLN positive patients, and 69% in patients with macrometastases; P = 0.009). Macrometastasis was significantly associated with delayed depiction of the first radioactive node and a greater number of depicted hotspots. In patients with clinically nonsuspicious nodes, i.e. the classical target group for SLN biopsy, clear depiction of an afferent vessel was significantly associated with a higher number of SLNs during dynamic acquisition, SLN micrometastasis and a higher overall number of metastatic lymph nodes after SLN biopsy plus completion lymphadenectomy. The excision of more than two SLNs did not increase the metastasis detection rate. In patients with bidirectional or tridirectional lymphatic drainage, the SLN positivity rates for the first, second and third basin were 25.4%, 11.7% and 0.0 %, respectively (P = 0.002). In patients with clinically nonsuspicious lymph nodes, clear depiction of an afferent lymph vessel may be a sign of micrometastasis. Macrometastasis is associated with prominent afferent vessels, delayed depiction of the first radioactive node and a higher number of depicted

  10. The impact of nodal tumour burden on lymphoscintigraphic imaging in patients with melanomas

    Energy Technology Data Exchange (ETDEWEB)

    Kretschmer, Lutz; Bertsch, Hans Peter; Hellriegel, Simin; Thoms, Kai-Martin; Schoen, Michael Peter [Georg August University of Goettingen, Department of Dermatology, Venereology and Allergology, Goettingen (Germany); Bardzik, Pawel; Meller, Johannes; Sahlmann, Carsten Oliver [Georg-August-University of Goettingen, Department of Nuclear Medicine, Goettingen (Germany)


    To retrospectively study the influence of nodal tumour burden on lymphoscintigraphic imaging in 509 consecutive patients with melanomas. Bidirectional lymphatic drainage, the clear depiction of an afferent lymphatic vessel, time to depiction of the first sentinel lymph node (SLN) and number of depicted and excised nodes were recorded. Nodal tumour load was classified as SLN-negative, SLN micrometastases or macrometastases. In the overall population, using multivariate regression analysis, a short SLN depiction time was significantly associated with the depiction of a greater number of radioactive nodes, a short distance between the primary tumour site and the nodal basin, younger age and lower nodal tumour burden. The proportion of patients with clear depiction of an afferent lymphatic vessel depended on the nodal tumour load (46 % in SLN-negative patients, 57 % in SLN positive patients, and 69 % in patients with macrometastases; P = 0.009). Macrometastasis was significantly associated with delayed depiction of the first radioactive node and a greater number of depicted hotspots. In patients with clinically nonsuspicious nodes, i.e. the classical target group for SLN biopsy, clear depiction of an afferent vessel was significantly associated with a higher number of SLNs during dynamic acquisition, SLN micrometastasis and a higher overall number of metastatic lymph nodes after SLN biopsy plus completion lymphadenectomy. The excision of more than two SLNs did not increase the metastasis detection rate. In patients with bidirectional or tridirectional lymphatic drainage, the SLN positivity rates for the first, second and third basin were 25.4 %, 11.7 % and 0.0 %, respectively (P = 0.002). In patients with clinically nonsuspicious lymph nodes, clear depiction of an afferent lymph vessel may be a sign of micrometastasis. Macrometastasis is associated with prominent afferent vessels, delayed depiction of the first radioactive node and a higher number of depicted hotspots

  11. Do demographics and tumour-related factors affect nodal yield at neck dissection? A retrospective cohort study. (United States)

    Lim, R S; Evans, L; George, A P; de Alwis, N; Stimpson, P; Merriel, S; Giddings, C E B; Billah, B; Smith, J A; Safdar, A; Sigston, E


    Nodal metastasis is an important prognostic factor in head and neck squamous cell carcinoma. This study aimed to determine the average nodal basin yield per level of neck dissection, and to investigate if age, gender, body mass index, tumour size, depth of tumour invasion and p16 status influence nodal yield. A retrospective review of 185 patients with head and neck squamous cell carcinoma generated 240 neck dissection specimens. The respective mean nodal yields for levels I, II, III, IV and V were 5.27, 9.43, 8.49, 7.43 and 9.02 in non-cutaneous squamous cell carcinoma patients, and 4.2, 7.57, 9.65, 4.33 and 12.29 in cutaneous squamous cell carcinoma patients. Multiple regression analysis revealed that p16-positive patients with mucosal squamous cell carcinoma yielded, on average, 2.4 more nodes than their p16-negative peers (p = 0.04, 95 per cent confidence interval = 0.116 to 4.693). This figure was 3.84 (p = 0.008, 95 per cent confidence interval = 1.070 to 6.605) for p16-positive patients with oral cavity squamous cell carcinoma. In mucosal squamous cell carcinoma, p16-positive status significantly influenced nodal yield, with the impact being more pronounced in oral cavity squamous cell carcinoma patients.

  12. Isolated cutaneous involvement in a child with nodal anaplastic large cell lymphoma

    Directory of Open Access Journals (Sweden)

    Vibhu Mendiratta


    Full Text Available Non-Hodgkin lymphoma is a common childhood T-cell and B-cell neoplasm that originates primarily from lymphoid tissue. Cutaneous involvement can be in the form of a primary extranodal lymphoma, or secondary to metastasis from a non-cutaneous location. The latter is uncommon, and isolated cutaneous involvement is rarely reported. We report a case of isolated secondary cutaneous involvement from nodal anaplastic large cell lymphoma (CD30 + and ALK + in a 7-year-old boy who was on chemotherapy. This case is reported for its unusual clinical presentation as an acute febrile, generalized papulonodular eruption that mimicked deep fungal infection, with the absence of other foci of systemic metastasis.

  13. Decoding Melanoma Metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Damsky, William E. Jr. [Department of Dermatology, Yale School of Medicine, New Haven, Connecticut (United States); Department of Pathology, University of Vermont College of Medicine, Burlington, Vermont (United States); Rosenbaum, Lara E.; Bosenberg, Marcus, E-mail: [Department of Dermatology, Yale School of Medicine, New Haven, Connecticut (United States)


    Metastasis accounts for the vast majority of morbidity and mortality associated with melanoma. Evidence suggests melanoma has a predilection for metastasis to particular organs. Experimental analyses have begun to shed light on the mechanisms regulating melanoma metastasis and organ specificity, but these analyses are complicated by observations of metastatic dormancy and dissemination of melanocytes that are not yet fully malignant. Additionally, tumor extrinsic factors in the microenvironment, both at the site of the primary tumor and the site of metastasis, play important roles in mediating the metastatic process. As metastasis research moves forward, paradigms explaining melanoma metastasis as a step-wise process must also reflect the temporal complexity and heterogeneity in progression of this disease. Genetic drivers of melanoma as well as extrinsic regulators of disease spread, particularly those that mediate metastasis to specific organs, must also be incorporated into newer models of melanoma metastasis.

  14. DCB - Tumor Metastasis Research (United States)

    Tumor metastasis research examines the mechanisms that allow cancer cells to leave the primary tumor and spread to another part of the body. Learn about recent tumor metastasis research studies supported by the Division of Cancer Biology.

  15. Nodal yield in selective neck dissection

    DEFF Research Database (Denmark)

    Norling, Rikke; Therkildsen, Marianne H; Bradley, Patrick J


    The total lymph node yield in neck dissection is highly variable and depends on anatomical, surgical and pathological parameters. A minimum yield of six lymph nodes for a selective neck dissection (SND) as recommended in guidelines lies in the lower range of the reported clinical nodal yields...

  16. Impacts of Contingency Reserve on Nodal Price and Nodal Reliability Risk in Deregulated Power Systems

    DEFF Research Database (Denmark)

    Zhao, Qian; Wang, Peng; Goel, Lalit


    in reliable operation, the CR commitment should be considered in operational reliability analysis. In this paper, a CR model based on customer reliability requirements has been formulated and integrated into power market settlement. A two-step market clearing process has been proposed to determine generation......The deregulation of power systems allows customers to participate in power market operation. In deregulated power systems, nodal price and nodal reliability are adopted to represent locational operation cost and reliability performance. Since contingency reserve (CR) plays an important role...... and CR allocation. Customers' nodal unit commitment risk and nodal energy interruption have been evaluated through contingency analysis. Customers' reliability cost including reserve service cost and energy interruption cost have also been evaluated....

  17. Nodal prices determination with wind integration for radial ...

    African Journals Online (AJOL)

    In this paper, a distribution system nodal pricing scheme is proposed for radial distribution system with integration of wind power in the system. The main objective of the paper is: (i) an optimal power flow based approach for determination of nodal prices for distribution system, (ii) impact of wind generation on nodal prices.

  18. Unusual metachronous isolated inguinal lymph node metastasis from adenocarcinoma of the sigmoid colon

    Directory of Open Access Journals (Sweden)

    Parodo Giuseppina


    Full Text Available Abstract This study aimed to describe an unusual case of metachronous isolated inguinal lymph nodes metastasis from sigmoid carcinoma. A 62-year-old man was referred to our department because of an obstructing sigmoid carcinoma. Colonoscopy showed the obstructing lesion at 30 cm from the anal verge and abdominal CT revealed a sigmoid lesion infiltrating the left lateral abdominal wall. The patient underwent a colonic resection extended to the abdominal wall. Histology showed an adenocarcinoma of the colon infiltrating the abdominal wall with iuxtacolic nodal involvement. Thirty three months after surgery abdominal CT and PET scan revealed a metastatic left inguinal lymph node involvement. The metastatic lymph node was found strictly adherent to the left iliac-femoral artery and encompassing the origin of the left inferior epigastric artery. Histology showed a metachronous nodal metastasis from colonic adenocarcinoma. Despite metastastic involvement of inguinal lymph node from rectal cancer is a rare but well known clinical entity, to the best of our knowledge, this is the first report of inguinal metastasis from a carcinoma of the left colon. Literature review shows only three other similar reported cases: two cases of inguinal metastasis secondary to adenocarcinoma of the cecum and one case of axillary metastasis from left colonic carcinoma. A metastatic pathway through superficial abdominal wall lymphatic vessels could be possible through the route along the left inferior epigastric artery. The solitary inguinal nodal involvement from rectal carcinoma could have a more favorable prognosis. In the case of nodal metastasis to the body surface lymph nodes from colonic carcinoma, following the small number of such cases reported in the literature, no definitive conclusions can be drawn.

  19. Status and prognosis of lymph node metastasis in patients with cardia cancer – A systematic review

    DEFF Research Database (Denmark)

    Okholm, Cecilie; Svendsen, Lars Bo; Achiam, Michael P


    . Therefore, the optimal treatment of cardia cancer remains controversial. A systematic review of English publications dealing with adenocarcinoma of the cardia was conducted to elucidate patterns of nodal spread and prognostic implications. METHODS: A systematic literature search based on PRISMA guidelines...... identifying relevant studies describing lymph node metastasis and the associated prognosis. Lymph node stations were classified according to the Japanese Gastric Cancer Association guidelines. RESULTS: The highest incidence of metastasis is seen in the nearest regional lymph nodes, station no. 1......-3 and additionally in no. 7, 9 and 11. Correspondingly the best survival is seen when metastasis remain in the most locoregional nodes and survival equally tends to decrease as the metastasis become more distant. Furthermore, the presence of lymph node metastasis significantly correlates to the TNM-stage. Incidences...

  20. Multivariate Analysis of Prognostic Factors Among 2,313 Patients With Stage III Melanoma: Comparison of Nodal Micrometastases Versus Macrometastases (United States)

    Balch, Charles M.; Gershenwald, Jeffrey E.; Soong, Seng-jaw; Thompson, John F.; Ding, Shouluan; Byrd, David R.; Cascinelli, Natale; Cochran, Alistair J.; Coit, Daniel G.; Eggermont, Alexander M.; Johnson, Timothy; Kirkwood, John M.; Leong, Stanley P.; McMasters, Kelly M.; Mihm, Martin C.; Morton, Donald L.; Ross, Merrick I.; Sondak, Vernon K.


    Purpose To determine the survival rates and independent predictors of survival using a contemporary international cohort of patients with stage III melanoma. Patients and Methods Complete clinicopathologic and follow-up data were available for 2,313 patients with stage III disease in an updated and expanded American Joint Committee on Cancer (AJCC) melanoma staging database. Kaplan-Meier and Cox multivariate survival analyses were performed. Results Among all 2,313 patients with stage III disease, 81% had micrometastases, and 19% had clinically detectable macrometastases. The 5-year overall survival was 63%; it was 67% for patients with nodal micrometastases, and it was 43% for those with nodal macrometastases (P < .001). Tremendous heterogeneity in survival was observed, particularly in the microscopically detected nodal metastasis subset (from 23% to 87% for 5-year survival). Multivariate analysis demonstrated that in patients with nodal micrometastases, number of tumor-containing lymph nodes, primary tumor thickness, patient age, ulceration, and anatomic site of the primary independently predicted survival (all P < .01). When added to the model, primary tumor mitotic rate was the second-most powerful predictor of survival after the number of tumor-containing nodes. In contrast, for patients with nodal macrometastases, the number of tumor-containing nodes, primary ulceration, and patient age independently predicted survival (P < .01). Conclusion In this multi-institutional analysis, we demonstrated remarkable heterogeneity of prognosis among patients with stage III melanoma, especially among those with nodal micrometastases. These results should be incorporated into the design and interpretation of future clinical trials involving patients with stage III melanoma. PMID:20368546

  1. Electron transport in nodal-line semimetals (United States)

    Syzranov, S. V.; Skinner, B.


    We study the electrical conductivity in a nodal-line semimetal with charged impurities. The screening of the Coulomb potential in this system is qualitatively different from what is found in conventional metals or semiconductors, with the screened potential ϕ decaying as ϕ ∝1 /r2 over a wide interval of distances r . This unusual screening gives rise to a rich variety of conduction regimes as a function of temperature, doping level, and impurity concentration. In particular, nodal-line semimetals exhibit a diverging mobility ∝1 /|μ | in the limit of vanishing chemical potential μ , a linearly increasing dependence of the conductivity on temperature, σ ∝T , and a large weak-localization correction with a strongly anisotropic dependence on magnetic field.

  2. Integrins and metastasis (United States)

    Ganguly, Kirat Kumar; Pal, Sekhar; Moulik, Shuvojit; Chatterjee, Amitava


    Metastasis is a combination of biological events that makes the difference between cancer and other diseases. Metastasis requires flow of erroneous but precisely coordinated basic cellular activities like cell migration–invasion, cell survival–apoptosis, cell proliferation, etc. All of these processes require efficient regulation of cell attachment and detachment, which recruit integrin receptors in this flow of events. World literatures show several aspects of interrelation of integrins and metastasis. Integrin molecules are being used as prime target to battle metastasis. In this review we are collating the observations showing importance of integrin biology in regulation of metastasis and the strategies where integrin receptors are being used as targets to regulate metastasis. PMID:23563505

  3. Twisted vector bundles on pointed nodal curves

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    DEFINITION 2.5. Let C → S be an n-pointed nodal curve over a k-scheme S and let ξ be a principal G- bundle on Cgen. A chart (U, η, ) for ξ is called balanced, if for each ... branches is via multiplication with primitive roots of unity which are inverse to each other. ...... Condition (16) implies that A0 is a block matrix of the form.

  4. Nodal methods in numerical reactor calculations

    Energy Technology Data Exchange (ETDEWEB)

    Hennart, J.P. [UNAM, IIMAS, A.P. 20-726, 01000 Mexico D.F. (Mexico)]. e-mail:; Valle, E. del [National Polytechnic Institute, School of Physics and Mathematics, Department of Nuclear Engineering, Mexico, D.F. (Mexico)


    The present work describes the antecedents, developments and applications started in 1972 with Prof. Hennart who was invited to be part of the staff of the Nuclear Engineering Department at the School of Physics and Mathematics of the National Polytechnic Institute. Since that time and up to 1981, several master theses based on classical finite element methods were developed with applications in point kinetics and in the steady state as well as the time dependent multigroup diffusion equations. After this period the emphasis moved to nodal finite elements in 1, 2 and 3D cartesian geometries. All the thesis were devoted to the numerical solution of the neutron multigroup diffusion and transport equations, few of them including the time dependence, most of them related with steady state diffusion equations. The main contributions were as follows: high order nodal schemes for the primal and mixed forms of the diffusion equations, block-centered finite-differences methods, post-processing, composite nodal finite elements for hexagons, and weakly and strongly discontinuous schemes for the transport equation. Some of these are now being used by several researchers involved in nuclear fuel management. (Author)

  5. Age at diagnosis and distant metastasis in breast cancer--a surprising inverse relationship. (United States)

    Purushotham, A; Shamil, E; Cariati, M; Agbaje, O; Muhidin, A; Gillett, C; Mera, A; Sivanadiyan, K; Harries, M; Sullivan, R; Pinder, S E; Garmo, H; Holmberg, L


    Predictors for site of distant metastasis and impact on survival in breast cancer are incompletely understood. Clinico-pathological risk factors for site of distant metastasis and survival were analysed in patients with invasive breast cancer treated between 1986 and 2006. Of 3553 patients, with median follow-up 6.32years, 825 (23%) developed distant metastasis. The site of metastasis was bone in 196/825 (24%), viscera in 540/825 (65%) and unknown in 89 (11%). Larger primary invasive tumour size, higher tumour grade and axillary nodal positivity increased risk of metastasis to all sites. Lobular carcinoma was more likely to first metastasise to bone compared to invasive ductal carcinoma (NST). Oestrogen receptor (ER) negative, progesterone receptor (PgR) negative and/or Human epidermal growth factor (HER2) positive tumours were more likely to metastasise to viscera. A striking relationship between increasing age at diagnosis and a reduction in risk of distant metastasis to bone and viscera was observed. Median time to death from onset of metastatic disease was 1.52 (Interquartile range (IQR) 0.7-2.9)years for patients with bone metastasis and 0.7 (IQR 0.2-1.5)years for visceral metastasis. On multivariate analysis, despite the decrease in risk of distant metastasis with increasing age, there was an elevated hazard for death in patients >50years at diagnosis of metastasis if they developed bone metastasis, with a similar trend observed in the >70years age group if they developed visceral metastasis. These findings indicate that there are biological mechanisms underlying the impact of age on the development of distant metastasis and subsequent death. This may have important implications in the treatment of breast cancer. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Exclusion of elective nodal irradiation is associated with minimal elective nodal failure in non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Cox James D


    Full Text Available Abstract Background Controversy still exists regarding the long-term outcome of patients whose uninvolved lymph node stations are not prophylactically irradiated for non-small cell lung cancer (NSCLC treated with definitive radiotherapy. To determine the frequency of elective nodal failure (ENF and in-field failure (IFF, we examined a large cohort of patients with NSCLC staged with positron emission tomography (PET/computed tomography (CT and treated with 3-dimensional conformal radiotherapy (3D-CRT that excluded uninvolved lymph node stations. Methods We retrospectively reviewed the records of 115 patients with non-small cell lung cancer treated at our institution with definitive radiation therapy with or without concurrent chemotherapy (CHT. All patients were treated with 3D-CRT, including nodal regions determined by CT or PET to be disease involved. Concurrent platinum-based CHT was administered for locally advanced disease. Patients were analyzed in follow-up for survival, local regional recurrence, and distant metastases (DM. Results The median follow-up time was 18 months (3 to 44 months among all patients and 27 months (6 to 44 months among survivors. The median overall survival, 2-year actuarial overall survival and disease-free survival were 19 months, 38%, and 28%, respectively. The majority of patients died from DM, the overall rate of which was 36%. Of the 31 patients with local regional failure, 26 (22.6% had IFF, 5 (4.3% had ENF and 2 (1.7% had isolated ENF. For 88 patients with stage IIIA/B, the frequencies of IFF, any ENF, isolated ENF, and DM were 23 (26%, 3 (9%, 1 (1.1% and 36 (40.9%, respectively. The comparable rates for the 22 patients with early stage node-negative disease (stage IA/IB were 3 (13.6%, 1(4.5%, 0 (0%, and 5 (22.7%, respectively. Conclusion We observed only a 4.3% recurrence of any ENF and a 1.7% recurrence of isolated ENF in patients with NSCLC treated with definitive 3D-CRT without prophylactic irradiation of

  7. Physiopathology of Spine Metastasis

    Directory of Open Access Journals (Sweden)

    Giulio Maccauro


    Full Text Available The metastasis is the spread of cancer from one part of the body to another. Two-thirds of patients with cancer will develop bone metastasis. Breast, prostate and lung cancer are responsible for more than 80% of cases of metastatic bone disease. The spine is the most common site of bone metastasis. A spinal metastasis may cause pain, instability and neurological injuries. The diffusion through Batson venous system is the principal process of spinal metastasis, but the dissemination is possible also through arterial and lymphatic system or by contiguity. Once cancer cells have invaded the bone, they produce growth factors that stimulate osteoblastic or osteolytic activity resulting in bone remodeling with release of other growth factors that lead to a vicious cycle of bone destruction and growth of local tumour.

  8. Solitary second metatarsal metastasis as the first site of distant spread in TCC urinary bladder: A case report. (United States)

    Yadav, Siddharth; Kumar, Rajeev


    Metastasis to the skeleton is uncommon in muscle-invasive carcinoma of the urinary bladder. When present, it most commonly involves the axial and proximal appendicular skeleton, and acrometastasis (metastasis to hand and foot) is very rare. We report a patient who developed a solitary metastatic lesion of the left metatarsal 2 weeks after radical cystectomy. The lack of suspicion and magnetic resonance imaging findings suggestive of inflammation led to a diagnosis of tubercular osteomyelitis and antitubercular therapy was started. The patient developed nodal metastasis and, because the foot lesion did not respond to treatment, fine needle aspiration cytology from it revealed poorly differentiated metastatic cancer.

  9. Modification of mouse nodal flow by applying artificial flow. (United States)

    Nonaka, Shigenori


    In mammalian development, the earliest left-right (L-R) asymmetry is nodal flow, which is a cilia-driven leftward fluid flow on the ventral surface of the node. The importance of nodal flow for L-R determination was demonstrated by experiments to modify nodal flow by imposing artificial fluid flow. In this system, cultured mouse embryos developed reversed L-R asymmetry when their node cavity had rightward flow, and normal L-R asymmetry when their node had leftward flow. This chapter describes details of the culture system that can modify nodal flow. Copyright 2009 Elsevier Inc. All rights reserved.

  10. Tumor budding is an independent risk factor for lymph node metastasis in cutaneous squamous cell carcinoma: a single center retrospective study. (United States)

    Fujimoto, Masakazu; Yamamoto, Yuki; Matsuzaki, Ibu; Warigaya, Kenji; Iwahashi, Yoshifumi; Kojima, Fumiyoshi; Furukawa, Fukumi; Murata, Shin-Ichi


    Although tumor budding is acknowledged as a risk factor for lymph node metastasis in certain types of carcinoma, it is not well investigated in cutaneous squamous cell carcinomas (SCCs). In this study, we analyzed the correlation between tumor budding and nodal metastasis in cutaneous SCC. Histopathologic specimens of 15 metastasizing and 144 non-metastasizing cutaneous SCC were retrospectively reviewed. Cut-off point for tumor budding was determined at five or more foci of an isolated cancer cell or a cluster comprising tumor under hematoxylin and eosin sections. Tumor budding was positive in 93.3% of metastasizing cutaneous SCC and 25.7% of non-metastasizing cutaneous SCC, respectively (p tumor budding was an independent risk factor for nodal metastasis among the other risk factors (tumor size, tumor thickness, Clark level and poor differentiation) (p = 0.0021). In combination with tumor thickness >4 mm, tumor budding became a better marker for predicting nodal metastasis (sensitivity 93.3%, specificity 84.7%). In our cohort, tumor budding was an independent risk factor for nodal metastasis. Our data suggests the promising role of tumor budding in risk evaluation of cutaneous SCC. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Retrospective study of predictors of bone metastasis in prostate cancer cases. (United States)

    Ho, Christopher Chee Kong; Seong, Poh Keat; Zainuddin, Zulkifli Md; Abdul Manaf, Mohd Rizal; Parameswaran, Muhilan; Razack, Azad H A


    The purpose of this study was to identify clinical profiles of patients with low risk of having bone metastases, for which bone scanning could be safely eliminated. This retrospective cross sectional study looked at prostate cancer patients seen in the Urology Departments in 2 tertiary centres over the 11 year period starting from January 2000 to May 2011. Patient demographic data, levels of PSA at diagnosis, Gleason score for the biopsy core, T-staging as well as the lymph node status were recorded and analysed. 258 men were included. The mean age of those 90 men (34.9%) with bone metastasis was 69.2 ± 7.3 years. Logistic regression found that PSA level (P=0.000) at diagnosis and patient's nodal-stage (P=0.02) were the only two independent variables able to predict the probability of bone metastasis among the newly diagnosed prostate cancer patients. Among those with a low PSA level less than 20 ng/ml, and less than 10 ng/ml, bone metastasis were detected in 10.3% (12 out of 117) and 9.7% (7 out of 72), respectively. However, by combining PSA level of 10 ng/ml or lower, and nodal negative as the two criteria to predict negative bone scan, a relatively high negative predictive value of 93.8% was obtained. The probability of bone metastasis in prostate cancer can be calculated with this formula: -1.069+0.007(PSA value, ng/ml) +1.021(Nodal status, 0 or 1)=x Probability of bone metastasis=2.718 x/1+2.718 x. Newly diagnosed prostate cancer patients with a PSA level of 10 ng/ml or lower and negative nodes have a very low risk of bone metastasis (negative predictive value 93.8%) and therefore bone scans may not be necessary.

  12. Robust doubly charged nodal lines and nodal surfaces in centrosymmetric systems (United States)

    Bzdušek, Tomáš; Sigrist, Manfred


    Weyl points in three spatial dimensions are characterized by a Z -valued charge—the Chern number—which makes them stable against a wide range of perturbations. A set of Weyl points can mutually annihilate only if their net charge vanishes, a property we refer to as robustness. While nodal loops are usually not robust in this sense, it has recently been shown using homotopy arguments that in the centrosymmetric extension of the AI symmetry class they nevertheless develop a Z2 charge analogous to the Chern number. Nodal loops carrying a nontrivial value of this Z2 charge are robust, i.e., they can be gapped out only by a pairwise annihilation and not on their own. As this is an additional charge independent of the Berry π -phase flowing along the band degeneracy, such nodal loops are, in fact, doubly charged. In this manuscript, we generalize the homotopy discussion to the centrosymmetric extensions of all Atland-Zirnbauer classes. We develop a tailored mathematical framework dubbed the AZ +I classification and show that in three spatial dimensions such robust and multiply charged nodes appear in four of such centrosymmetric extensions, namely, AZ +I classes CI and AI lead to doubly charged nodal lines, while D and BDI support doubly charged nodal surfaces. We remark that no further crystalline symmetries apart from the spatial inversion are necessary for their stability. We provide a description of the corresponding topological charges, and develop simple tight-binding models of various semimetallic and superconducting phases that exhibit these nodes. We also indicate how the concept of robust and multiply charged nodes generalizes to other spatial dimensions.

  13. New Anti-Nodal Monoclonal Antibodies Targeting the Nodal Pre-Helix Loop Involved in Cripto-1 Binding

    Directory of Open Access Journals (Sweden)

    Annalia Focà


    Full Text Available Nodal is a potent embryonic morphogen belonging to the TGF-β superfamily. Typically, it also binds to the ALK4/ActRIIB receptor complex in the presence of the co-receptor Cripto-1. Nodal expression is physiologically restricted to embryonic tissues and human embryonic stem cells, is absent in normal cells but re-emerges in several human cancers, including melanoma, breast, and colon cancer. Our aim was to obtain mAbs able to recognize Nodal on a major CBR (Cripto-Binding-Region site and to block the Cripto-1-mediated signalling. To achieve this, antibodies were raised against hNodal(44–67 and mAbs generated by the hybridoma technology. We have selected one mAb, named 3D1, which strongly associates with full-length rhNodal (KD 1.4 nM and recognizes the endogenous protein in a panel of human melanoma cell lines by western blot and FACS analyses. 3D1 inhibits the Nodal-Cripto-1 binding and blocks Smad2/3 phosphorylation. Data suggest that inhibition of the Nodal-Cripto-1 axis is a valid therapeutic approach against melanoma and 3D1 is a promising and interesting agent for blocking Nodal-Cripto mediated tumor development. These findings increase the interest for Nodal as both a diagnostic and prognostic marker and as a potential new target for therapeutic intervention.

  14. Atrial tachycardia mimicking atrioventricular nodal reentry tachycardia. (United States)

    Eilbert, Wesley P; Patel, Neal


    The term supraventricular tachycardia (SVT) is used to describe tachydysrhythmias that require atrial or atrioventricular nodal tissue for their initiation and maintenance. SVT can be used to describe atrioventricular nodal reentry tachycardia, atrioventricular reentry tachycardia, and atrial tachycardia (AT). AT is the least common of these SVT subtypes, accounting for only 10% of cases. Although the suggested initial management of each SVT subtype is different, they all can present with similar symptoms and electrocardiographic findings. Discuss the pathophysiology, diagnosis, and treatment of AT as compared with other types of SVT. We report a 56-year-old woman with symptoms and electrocardiographic findings consistent with SVT. Although standard treatment with intravenous adenosine failed to convert the SVT, it revealed AT as the cause of the tachydysrhythmia. The AT was successfully terminated with beta-blockade and the patient eventually underwent successful radioablation of three separate AT foci. AT frequently mimics other more common forms of SVT. AT might be recognized only when standard treatment of SVT has failed. Identification of AT in this setting is crucial to allow for more definitive therapy. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Versatility of nodal affiliation to communities. (United States)

    Shinn, Maxwell; Romero-Garcia, Rafael; Seidlitz, Jakob; Váša, František; Vértes, Petra E; Bullmore, Edward


    Graph theoretical analysis of the community structure of networks attempts to identify the communities (or modules) to which each node affiliates. However, this is in most cases an ill-posed problem, as the affiliation of a node to a single community is often ambiguous. Previous solutions have attempted to identify all of the communities to which each node affiliates. Instead of taking this approach, we introduce versatility, V, as a novel metric of nodal affiliation: V ≈ 0 means that a node is consistently assigned to a specific community; V > 0 means it is inconsistently assigned to different communities. Versatility works in conjunction with existing community detection algorithms, and it satisfies many theoretically desirable properties in idealised networks designed to maximise ambiguity of modular decomposition. The local minima of global mean versatility identified the resolution parameters of a hierarchical community detection algorithm that least ambiguously decomposed the community structure of a social (karate club) network and the mouse brain connectome. Our results suggest that nodal versatility is useful in quantifying the inherent ambiguity of modular decomposition.

  16. Efficient in vitro Chrysanthemum morifolium L.) plantlets from nodal ...

    African Journals Online (AJOL)

    Efficient plant regeneration system has been developed from the nodal segments of chrysanthemum (Chrysanthemum morifolium L). Nodal segments, after being sterilized with 1.0% mercuric chloride for three minutes, were inoculated in Murashige and Skoog (MS) media with varied concentrations of indole acetic acid ...

  17. Loco-regional control after postoperative radiotherapy for patients with regional nodal metastases from melanoma. (United States)

    Conill, Carlos; Valduvieco, Izaskun; Domingo-Domènech, Josep; Arguis, Pedro; Vidal-Sicart, Sergi; Vilalta, Antonio


    The role of adjuvant radiation therapy (RT) following nodal surgery in malignant melanoma remains controversial. There are no published randomised trials comparing surgery alone to surgery with postoperative RT. The purpose of the present retrospective study was to review the results of loco-regional control after postoperative RT in patients with nodal metastases of melanoma. Seventy-seven patients with high-risk disease (lymph nodes > or =3 cm, more than three lymph nodes involved, extracapsular extension and recurrent disease) were treated with adjuvant RT. Hypofractionation was used in 65 patients and conventional fractionation in 12 patients. Seventy-seven patients with nodal metastases from melanoma were managed with lymphadenectomy and radiation, with or without systemic therapy. The median age was 56 years old (range: 21-83). There were 47 males (61%) and 30 females (39%). Loco-regional control was observed in 95% of patients (73/77). The actuarial 5-year in-field loco-regional control rate was 90% (mean: 105 months; CI95%: 96-115 months). Median metastasis disease- free survival (MDFS) was 16 months (CI95%: 13-18 months). Median survival time (MST) for the entire group was 26 months (CI95%: 18-34 months). MST according to the localisation of node metastases (groin, axilla and cervical) was also analysed, without statistically significant differences (p=0.08). Concerning the number of risk factors score, analysis of survival did not show statistically significant differences (p=0.055). Despite the high incidence of distant metastases, loco-regional control remains an important goal in the management of melanoma. Surgery and adjuvant RT provides excellent loco-regional control, although distant metastases remain the major cause of mortality.

  18. Impact of multiple lymphatic channel drainage to a single nodal basin on outcomes in melanoma. (United States)

    Wall, James K; Florero, Marilyn; Accortt, Neil A; Allen, Robert; Kashani-Sabet, Mohamed; Morita, Eugene; Leong, Stanley P L


    To determine the impact of multiple lymphatic channels (MLCs) on outcome in melanoma. Retrospective cohort study. Academic tertiary care center. Of 1198 consecutive selective sentinel lymphadenectomies performed from 1995 to 2000 for primary invasive melanoma, 502 patients were identified with extremity or truncal melanoma that drained to a single nodal basin. Three cohorts were formed based on lymphatic channels (none, single, and multiple). Tumors with drainage to multiple nodal basins as well as all head and neck tumors were excluded. Multiple variables, including patterns of lymphatic drainage, were analyzed for impact on disease-free and overall survival. Demographics were similar among groups, with a median follow-up of 5.6 years. Univariate analysis revealed MLCs as an independent risk factor for both disease-free (P = .04) and overall survival (P = .003). Multivariate analysis confirmed that tumor depth, sentinel lymph node status, and MLCs were risk factors for both disease-free and overall survival. Kaplan-Meier analysis showed worse survival in the MLCs group. Our study reveals that MLCs are an independent risk factor for recurrence and mortality in melanoma. Multiple lymphatic channels may facilitate the process of metastasis.


    Directory of Open Access Journals (Sweden)

    Vedran Živanović


    Full Text Available Uneven regional development is characteristic of a large part of the society, from micro to macro regional level. One of  the ways for overcoming this problem is effectively spatially and functionally connection of the largest nodal center of the region, among themselves and with the settlements in its gravitational sphere. In this paper, nodal centers are presented as poles of convergence of the population and functions, from which development impacts – the main factors of socio-economic transformation of the region - are spreading out. It also analyzed the possibilities for achieving balanced regional development presented through the prism of the functional impact of nodal centers in that process. Nodal (functional region is a theoretical basis of the work. Also, nodal region is starting point of functional-process paradigm, resulting from modern processes whose by their functional influence changing the structure of space.

  20. [Biology of cancer metastasis]. (United States)

    Robert, Jacques


    Metastatic dissemination represents the true cause of the malignant character of cancers. Its targeting is much more difficult than that of cell proliferation, because metastasis, like angiogenesis, involves a number of complex interactions between tumour and stroma; the contribution of adhesion and motility pathways is added to that of proliferation and survival pathways. Long distance extension, discontinuous in respect to the primitive tumour, is a major feature of cancer and the main cause of patients' death. Cancer cells use two main dissemination pathways: the lymphatic pathway, leading to the invasion of the lymph nodes draining the organs where the tumour evolves; and the blood pathway, leading to the invasion of distant organs such as liver, brain, bone or lung. Metastasis is inscribed within the properties of the primitive tumour, as shown by the comparative molecular analysis of the primitive tumour and its own metastases: their similarity is always more important than what could be expected from the general activation of "metastasis genes" or the inhibition of "metastasis suppressor genes". Among the signalling pathways involved in metastasis, one can mention the integrin pathway, the transforming growth factor beta (TGFβ) pathway, the chemokine pathway, the dependence receptor pathway and many others. These pathways allow the possibility of therapeutic targeting, thanks to therapeutic antibodies or small molecules inhibiting the kinases involved in these signalling pathways, but not a single properly anti-metastatic drug has yet been proposed: the complexity and the diversity of the processes allowing metastasis emergence, as well as the fact that the activation mechanisms are more often epigenetic than genetic and are generally physiological processes misled by the malignant cell, render especially difficult the therapeutic approach of metastasis.

  1. Genomics screens for metastasis genes (United States)

    Yan, Jinchun; Huang, Qihong


    Metastasis is responsible for most cancer mortality. The process of metastasis is complex, requiring the coordinated expression and fine regulation of many genes in multiple pathways in both the tumor and host tissues. Identification and characterization of the genetic programs that regulate metastasis is critical to understanding the metastatic process and discovering molecular targets for the prevention and treatment of metastasis. Genomic approaches and functional genomic analyses can systemically discover metastasis genes. In this review, we summarize the genetic tools and methods that have been used to identify and characterize the genes that play critical roles in metastasis. PMID:22684367

  2. Topological semimetals with a double-helix nodal link (United States)

    Chen, Wei; Lu, Hai-Zhou; Hou, Jing-Min


    Topological nodal line semimetals are characterized by the crossing of the conduction and valence bands along one or more closed loops in the Brillouin zone. Usually, these loops are either isolated or touch each other at some highly symmetric points. Here, we introduce a different kind of nodal line semimetal, that contains a pair of linked nodal loops. A concrete two-band model was constructed, which supports a pair of nodal lines with a double-helix structure, which can be further twisted into a Hopf link because of the periodicity of the Brillouin zone. The nodal lines are stabilized by the combined spatial inversion P and time reversal T symmetry; the individual P and T symmetries must be broken. The band exhibits nontrivial topology that each nodal loop carries a π Berry flux. Surface flatbands emerge at the open boundary and are exactly encircled by the projection of the nodal lines on the surface Brillouin zone. The experimental implementation of our model using cold atoms in optical lattices is discussed.

  3. Meteorin regulates mesendoderm development by enhancing nodal expression.

    Directory of Open Access Journals (Sweden)

    Yoon-Young Kim

    Full Text Available During gastrulation, distinct lineage specification into three germ layers, the mesoderm, endoderm and ectoderm, occurs through an elaborate harmony between signaling molecules along the embryonic proximo-distal and anterior-posterior axes, and Nodal signaling plays a key role in the early embryonic development governing embryonic axis formation, mesoderm and endoderm specification, and left-right asymmetry determination. However, the mechanism by which Nodal expression is regulated is largely unknown. Here, we show that Meteorin regulates Nodal expression and is required for mesendoderm development. It is highly expressed in the inner cell mass of blastocysts and further in the epiblast and extra-embryonic ectoderm during gastrulation. Genetic ablation of the Meteorin gene resulted in early embryonic lethality, presumably due to impaired lineage allocation and subsequent cell accumulation. Embryoid body culture using Meteorin-null embryonic stem (ES cells showed reduced Nodal expression and concomitant impairment of mesendoderm specification. Meteorin-null embryos displayed reduced levels of Nodal transcripts before the gastrulation stage, and impaired expression of Goosecoid, a definitive endoderm marker, during gastrulation, while the proximo-distal and anterior-posterior axes and primitive streak formation were preserved. Our results show that Meteorin is a novel regulator of Nodal transcription and is required to maintain sufficient Nodal levels for endoderm formation, thereby providing new insights in the regulation of mesendoderm allocation.

  4. Local field radiotherapy without elective nodal irradiation for postoperative loco-regional recurrence of esophageal cancer. (United States)

    Kimoto, Takuya; Yamazaki, Hideya; Suzuki, Gen; Aibe, Norihiro; Masui, Koji; Tatekawa, Kotoha; Sasaki, Naomi; Fujiwara, Hitoshi; Shiozaki, Atsushi; Konishi, Hirotaka; Nakamura, Satoaki; Yamada, Kei


    Radiotherapy is an effective treatment for the postoperative loco-regional recurrence of esophageal cancer; however, the optimal treatment field remains controversial. This study aims to evaluate the outcome of local field radiotherapy without elective nodal irradiation for postoperative loco-regional recurrence of esophageal cancer. We retrospectively investigated 35 patients treated for a postoperative loco-regional recurrence of esophageal cancer with local field radiotherapy between December 2008 and March 2016. The median irradiation dose was 60 Gy (range: 50-67.5 Gy). Thirty-one (88.6%) patients received concurrent chemotherapy. The median follow-up period was 18 months (range: 5-94 months). The 2-year overall survival was 55.7%, with a median survival time of 29.9 months. In the univariate analysis, the maximal diameter ≤20 mm (P = 0.0383), solitary lesion (P = 0.0352), and the complete remission after treatment (P = 0.00411) had a significantly better prognosis. A total of 27 of 35 patients (77.1%) had progressive disease (loco-regional failure [n = 9], distant metastasis [n = 7], and both loco-regional failure and distant metastasis [n = 11]). No patients had Grade 3 or greater mucositis. Local field radiotherapy is a considerable treatment option for postoperative loco-regional recurrence of esophageal cancer.

  5. Probability of axillary lymph node metastasis when sentinel lymph node biopsy is negative in women with clinically node negative breast cancer: a Bayesian approach. (United States)

    Okamoto, Takahiro; Yamazaki, Kiyomi; Kanbe, Masako; Kodama, Hitomi; Omi, Yoko; Kawamata, Akiko; Suzuki, Rumi; Igari, Yuka; Tanaka, Reiko; Iihara, Masatoshi; Ito, Yukio; Sawada, Tatsuo; Nishikawa, Toshio; Maki, Masako; Kusakabe, Kiyoko; Mitsuhashi, Norio; Obara, Takao


    Although sentinel lymph node biopsy(SLNB)is highly accurate in predicting axillary nodal status in patients with breast cancer, it has been shown that the procedure is associated with a few false negative results. The risk of leaving metastatic nodes behind in the axillary basin when SLNB is negative should be estimated for an individual patient if SLNB is performed to avoid conventional axillary lymph node dissection(ALND). A retrospective analysis of 512 women with T1-3N0M0 breast cancer was conducted to derive a prevalence of nodal metastasis by T category as a pre-test(i.e., before SLNB)probability and to examine potential confounders on the relationship between T category and axillary nodal involvement. Probability of nodal metastasis when SLNB was negative was estimated by means of Bayes' theorem which incorporated the pre-test probability and sensitivity and specificity of SLNB. Axillary nodal metastasis was observed in 6.1% of T1a-b, 25.1% of T1c, 28.7% of T2, 35.0% of T3 tumors. Point estimates for the probability of nodal involvement when SLNB was negative ranged from 0.3-1.3% for T1a-b, 1.6-6.3% for T1c, 2.0-7.5% for T2, and 2.6-9.7% for T3 tumors with representative sensitivities of 80%, 85%, 90% and 95%, respectively. The risk may be higher when the tumor involves the upper outer quadrant of the breast, while it may be lower for an underweight woman. The probability of axillary lymph node metastasis when SLNB is negative can be estimated using a Bayesian approach. Presenting the probability to the patient may guide the decision of surgery without conventional ALND.

  6. The nodal crisis in Iron based superconductivity (United States)

    Coleman, Piers; Tzen Ong, T.


    The recent observation of fully gapped high temperature superconductivity in an iron chalcogenide without a hole Fermi surface, combined with the observations that rule out a node-less d-wave state constitute a ``nodal crisis'' in iron based superconductivity, for we do not understand how the underlying singlet state avoids the strong Coulomb interactions on the iron site without some kind of node within the superconducting condensate. In this work, we re-analyze the allowed symmetries of the superconducting condensate in the iron superconductors, taking into account both orbital symmetries between the zx and zy orbitals and the presence of two equivalent Fe sites per unit cell. We argue that the additional orbital degrees of freedom provide for a much richer class of pairing symmetries than normally considered. A particularly interesting possibility, is a p-wave, spin singlet, orbital triplet state that is a fully gapped iron analog of the B-phase of superfluid He-3. We will discuss this interesting possibility. Research supported by Division of Materials Research contract number DE-FG02-99ER45790.

  7. Primary nodal hemangiosarcoma in four dogs. (United States)

    Chan, Catherine M; Zwahlen, Courtney H; de Lorimier, Louis-Philippe; Yeomans, Stephen M; Hoffmann, Karon L; Moore, Antony S


    CASE DESCRIPTION 4 dogs with a slow-growing mass in the cervical region were evaluated. CLINICAL FINDINGS All dogs had no clinical signs at the time of the evaluation. There was no apparent evidence of visceral metastases or other primary tumor based on available CT or MRI data for any dog. TREATMENT AND OUTCOME For each dog, surgery to remove the mass was performed. Histologic examination of the excised tissue revealed a completely excised grade 1 or 2 lymph node hemangiosarcoma. All dogs received adjuvant chemotherapy; 2 dogs underwent curative intent chemotherapy, 1 dog underwent metronomic treatment with cyclophosphamide, and 1 dog underwent metronomic treatment with chlorambucil. The survival time was 259 days in 1 dog; 3 dogs were still alive 615, 399, and 365 days after surgery. CLINICAL RELEVANCE Primary nodal hemangiosarcoma in dogs is a rare and, to the authors' knowledge, previously undescribed disease that appears to develop in the cervical lymph nodes as a slow-growing mass or masses. Surgical excision and adjunct treatment resulted in long survival times for 3 of the 4 dogs of the present report. Given the aggressive biologic behavior of hemangiosarcomas in other body locations, adjunct chemotherapy should be considered for affected dogs, although its role in the cases described in this report was unclear. Additional clinical information is required to further characterize the biologic behavior of this tumor type and determine the expected survival times and associated risk factors in dogs.

  8. In vitro Plant Regeneration of Cyphomandra betacea through Nodal ...

    African Journals Online (AJOL)

    In vitro Plant Regeneration of Cyphomandra betacea through Nodal Culture. Bancy Waweru, Rodrigue Ishimwe, Joëlle Kajuga, Boniface Kagiraneza, Peter Yao Kanze Sallah, Vedaste Ahishakiye, Safia Kalisa, Theodore Asiimwe, Jane Kahia, Daphrose Gahakwa ...

  9. SLN melanoma micrometastasis predictivity of nodal status: a long term retrospective study. (United States)

    Migliano, Emilia; Bellei, Barbara; Govoni, Flavio Andrea; Paolino, Giovanni; Catricalà, Caterina; Bucher, Stefania; Donati, Pietro


    Completion lymph node dissection (CLND) is the gold standard treatment for patients with a positive sentinel lymph node (SLN) biopsy. Considering the morbidity associated with CLND it is important to identify histological features of the primary tumor and/or of SLN metastasis that could help to spare from CLND a subset of patients who have a very low risk of non-SLN metastasis. The objective of this study is to identify patients with a very low risk to develop non-SLNs recurrences and to limit unnecessary CLND. A retrospective long-term study of 80 melanoma patients with positive SLN, undergone CLND, was assessed to define the risk of additional metastasis in the regional nodal basin, on the basis of intranodal distribution of metastatic cells, using the micro-morphometric analysis (Starz classification). This study demonstrates that among the demographic and pathologic features of primary melanoma and of SLN only the Starz classification shows prognostic significance for non-SLN status (p<0.0001). This parameter was also significantly associated with disease-free survival rate (p<0.0013). The Starz classification can help to identify, among SLN positive patients, those who can have a real benefit from CLND. From the clinical point of view this easy and reliable method could lead to a significant reduction of unnecessary CLND in association with a substantial decrease in morbidity. The study results indicate that most of S1 subgroup patients might be safely spared from completion lymphatic node dissection. Furthermore, our experience demonstrated that Starz classification of SLN is a safe predictive index for patient stratification and treatment planning.

  10. Breast Cancer Metastasis (United States)

    Marino, Natascia; Woditschka, Stephan; Reed, L. Tiffany; Nakayama, Joji; Mayer, Musa; Wetzel, Maria; Steeg, Patricia S.


    Despite important progress in adjuvant and neoadjuvant therapies, metastatic disease often develops in breast cancer patients and remains the leading cause of their deaths. For patients with established metastatic disease, therapy is palliative, with few breaks and with mounting adverse effects. Many have hypothesized that a personalized or precision approach (the terms are used interchangeably) to cancer therapy, in which treatment is based on the individual characteristics of each patient, will provide better outcomes. Here, we discuss the molecular basis of breast cancer metastasis and the challenges in personalization of treatment. The instability of metastatic tumors remains a leading obstacle to personalization, because information from a patient’s primary tumor may not accurately reflect the metastasis, and one metastasis may vary from another. Furthermore, the variable presence of tumor subpopulations, such as stem cells and dormant cells, may increase the complexity of the targeted treatments needed. Although molecular signatures and circulating biomarkers have been identified in breast cancer, there is lack of validated predictive molecular markers to optimize treatment choices for either prevention or treatment of metastatic disease. Finally, to maximize the information that can be obtained, increased attention to clinical trial design in the metastasis preventive setting is needed. PMID:23895915

  11. A new nodal solver for the two dimensional Lagrangian hydrodynamics (United States)

    Corot, T.; Mercier, B.


    We describe a cell-centered Godunov type scheme for the Lagrangian hydrodynamic equations on general unstructured meshes with nodal fluxes. The nodal solver only depends on the angular repartition of the physical variables around the node and not on the length of the edges. The scheme verifies a weak consistency property. Numerical results are compared to EUCCLHYD and GLACE schemes which are also cell-centered schemes with node based fluxes for Lagrangian hydrodynamics.

  12. Nodal signaling from the visceral endoderm is required to maintain Nodal gene expression in the epiblast and drive AVE migration (United States)

    Kumar, Amit; Lualdi, Margaret; Lyozin, George T.; Sharma, Prashant; Loncarek, Jadranka; Fu, Xin-Yuan; Kuehn, Michael R.


    In the early mouse embryo, a specialized population of extraembryonic visceral endoderm (VE) cells called the anterior VE (AVE) establishes the anterior posterior (AP) axis by restricting gastrulation-inducing signals to the opposite pole. These cells arise at the distal tip of the egg cylinder stage embryo and then asymmetrically migrate to the prospective anterior following the path of an earlier arising and migrating population called the distal VE (DVE). The Nodal-signaling pathway has been shown to have a critical role in the generation of the DVE and AVE and in their migration. The Nodal gene is expressed in both the VE and in the pluripotent epiblast, which gives rise to the germ layers. Previous findings have provided conflicting evidence as to the relative importance of Nodal signaling from the epiblast vs. VE for AP patterning. Here we show that conditional mutagenesis of the Nodal gene specifically within the VE leads to reduced Nodal expression levels in the epiblast and incomplete or failed AVE migration. These results support a required role for VE Nodal to maintain normal levels of expression in the epiblast, and suggest signaling from both VE and epiblast is important for AVE migration. PMID:25536399

  13. Retrospective analysis of outcome differences in preoperative concurrent chemoradiation with or without elective nodal irradiation for esophageal squamous cell carcinoma. (United States)

    Hsu, Feng-Ming; Lee, Jang-Ming; Huang, Pei-Ming; Lin, Chia-Chi; Hsu, Chih-Hung; Tsai, Yu-Chieh; Lee, Yung-Chie; Chia-Hsien Cheng, Jason


    To evaluate the efficacy and patterns of failure of elective nodal irradiation (ENI) in patients with esophageal squamous cell carcinoma (SCC) undergoing preoperative concurrent chemoradiation (CCRT) followed by radical surgery. We retrospectively studied 118 patients with AJCC Stage II to III esophageal SCC undergoing preoperative CCRT (median, 36 Gy), followed by radical esophagectomy. Of them, 73 patients (62%) had ENI and 45 patients (38%) had no ENI. Patients with ENI received radiotherapy to either supraclavicular (n = 54) or celiac (n = 19) lymphatics. Fifty-six patients (57%) received chemotherapy with paclitaxel plus cisplatin. The 3-year progression-free survival, overall survival, and patterns of failure were analyzed. Distant nodal recurrence was classified into M1a and M1b regions. A separate analysis using matched cases was conducted. The median follow-up was 38 months. There were no differences in pathological complete response rate (p = 0.12), perioperative mortality rate (p = 0.48), or delayed Grade 3 or greater cardiopulmonary toxicities (p = 0.44), between the groups. More patients in the non-ENI group had M1a failure than in the ENI group, with 3-year rates of 11% and 3%, respectively (p = 0.05). However, the 3-year isolated distant nodal (M1a + M1b) failure rates were not different (ENI, 10%; non-ENI, 14%; p = 0.29). In multivariate analysis, pathological nodal status was the only independent prognostic factor associated with overall survival (hazard ratio = 1.78, p = 0.045). The 3-year overall survival and progression-free survival were 45% and 45%, respectively, in the ENI group, and 52% and 43%, respectively, in the non-ENI group (p = 0.31 and 0.89, respectively). Matched cases analysis did not show a statistical difference in outcomes between the groups. ENI reduced the M1a failure rate but was not associated with improved outcomes in patients undergoing preoperative CCRT for esophageal SCC. Pathological nodal metastasis predicted poor

  14. Retrospective Analysis of Outcome Differences in Preoperative Concurrent Chemoradiation With or Without Elective Nodal Irradiation for Esophageal Squamous Cell Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, Feng-Ming [Department of Oncology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan (China); Cancer Research Center, National Taiwan University College of Medicine, Taipei, Taiwan (China); Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan (China); Lee, Jang-Ming; Huang, Pei-Ming [Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan (China); Lin, Chia-Chi; Hsu, Chih-Hung; Tsai, Yu-Chieh [Department of Oncology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan (China); Cancer Research Center, National Taiwan University College of Medicine, Taipei, Taiwan (China); Lee, Yung-Chie [Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan (China); Chia-Hsien Cheng, Jason, E-mail: [Department of Oncology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan (China); Cancer Research Center, National Taiwan University College of Medicine, Taipei, Taiwan (China); Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan (China); Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan (China)


    SCC. Pathological nodal metastasis predicted poor outcome.

  15. Age as a predictor of sentinel node metastasis among patients with localized melanoma: an inverse correlation of melanoma mortality and incidence of sentinel node metastasis among young and old patients. (United States)

    Balch, Charles M; Thompson, John F; Gershenwald, Jeffrey E; Soong, Seng-Jaw; Ding, Shouluan; McMasters, Kelly M; Coit, Daniel G; Eggermont, Alexander M M; Gimotty, Phyllis A; Johnson, Timothy M; Kirkwood, John M; Leong, Stanley P; Ross, Merrick I; Byrd, David R; Cochran, Alistair J; Mihm, Martin C; Morton, Donald L; Atkins, Michael B; Flaherty, Keith T; Sondak, Vernon K


    We have previously reported that older patients with clinical stage I and II primary cutaneous. Melanoma had lower survival rates compared to younger patients. We postulated that the incidence of nodal metastasis would therefore be higher among older melanoma patients. The expanded American Joint Committee on Cancer melanoma staging database contains a cohort of 7,756 melanoma patients who presented without clinical evidence of regional lymph node or distant metastasis and who underwent a sentinel node biopsy procedure as a component of their staging assessment. Although older patients had primary melanoma features associated with more aggressive biology, we paradoxically observed a significant decrease in the incidence of sentinel node metastasis as patient age increased. Overall, the highest incidence of sentinel node metastasis was 25.8 % in patients under 20 years of age, compared to 15.5 % in patients 80 years and older (p metastasis in a multifactorial analysis (p melanoma under 20 years of age had a higher incidence of sentinel lymph node metastasis but, paradoxically, a more favorable survival outcome compared to all other age groups. In contrast, patients >70 years had the most aggressive primary melanoma features and a higher mortality rate compared to all other age groups but a lower incidence of sentinel lymph node metastasis.

  16. A computational study of nodal-based tetrahedral element behavior.

    Energy Technology Data Exchange (ETDEWEB)

    Gullerud, Arne S.


    This report explores the behavior of nodal-based tetrahedral elements on six sample problems, and compares their solution to that of a corresponding hexahedral mesh. The problems demonstrate that while certain aspects of the solution field for the nodal-based tetrahedrons provide good quality results, the pressure field tends to be of poor quality. Results appear to be strongly affected by the connectivity of the tetrahedral elements. Simulations that rely on the pressure field, such as those which use material models that are dependent on the pressure (e.g. equation-of-state models), can generate erroneous results. Remeshing can also be strongly affected by these issues. The nodal-based test elements as they currently stand need to be used with caution to ensure that their numerical deficiencies do not adversely affect critical values of interest.

  17. Recurrent malignant proliferating trichilemmal tumor with lymph node metastasis in a young woman

    Directory of Open Access Journals (Sweden)

    S P Dubhashi


    Full Text Available Malignant proliferating trichilemmal tumor (MPTT is a rare cutaneous tumor predominantly affecting the scalp, eyelids, neck and face of elderly women. It is a large, solitary, multilobulated lesion that may arise within a pilar cyst. These tumors are largely benign, often cystic, and are characterized by trichilemmal keratinization. However, at times, the tumor has an aggressive clinical course and a propensity for nodal and distant metastases. Wide local excision with a 1 cm margin of normal tissue is the treatment of choice. Adjuvant chemotherapy and radiotherapy have been occasionally used to prevent recurrence in MPTT. This is a case report of a recurrent malignant trichilemmal tumor over scalp in a young female patient with nodal metastasis.

  18. Electrodynamics on Fermi Cyclides in Nodal Line Semimetals (United States)

    Ahn, Seongjin; Mele, E. J.; Min, Hongki


    We study the frequency-dependent conductivity of nodal line semimetals (NLSMs), focusing on the effects of carrier density and energy dispersion on the nodal line. We find that the low-frequency conductivity has a rich spectral structure which can be understood using scaling rules derived from the geometry of their Dupin cyclide Fermi surfaces. We identify different frequency regimes, find scaling rules for the optical conductivity in each, and demonstrate them with numerical calculations of the inter- and intraband contributions to the optical conductivity using a low-energy model for a generic NLSM.

  19. Oddness of least energy nodal solutions on radial domains

    Directory of Open Access Journals (Sweden)

    Christopher Grumiau


    Full Text Available In this article, we consider the Lane-Emden problem $$displaylines{ Delta u(x + |{u(x}mathclose|^{p-2}u(x=0, quad hbox{for } xinOmega,cr u(x=0, quad hbox{for } xinpartialOmega, }$$ where $2 < p < 2^{*}$ and $Omega$ is a ball or an annulus in $mathbb{R}^{N}$, $Ngeq 2$. We show that, for p close to 2, least energy nodal solutions are odd with respect to an hyperplane -- which is their nodal surface. The proof ingredients are a constrained implicit function theorem and the fact that the second eigenvalue is simple up to rotations.

  20. PTP4A3 Independently Predicts Metastasis and Survival in Upper Tract Urothelial Carcinoma Treated with Radical Nephroureterectomy. (United States)

    Yeh, Hsin-Chih; Li, Ching-Chia; Huang, Chun-Nung; Hour, Tzyh-Chyuan; Yeh, Bi-Wen; Li, Wei-Ming; Liang, Peir-In; Chang, Lin-Li; Li, Chien-Feng; Wu, Wen-Jeng


    Increasing evidence has shown that protein tyrosine phosphatases have dominant roles in setting the levels of tyrosine phosphorylation and promoting oncogenic processes. PTP4A3 has been implicated in cancer metastasis but to our knowledge the role of PTP4A3 in upper tract urothelial carcinoma is unknown. The aim of this study was to investigate the association of PTP4A3 with disease characteristics, distant metastasis and prognosis of upper tract urothelial carcinoma. The importance of PTP4A3 was initially examined in paired normal urothelium, noninvasive upper tract urothelial carcinoma, invasive upper tract urothelial carcinoma and nodal metastatic tissue. The PTP4A3 transcript level was assessed in another 20 upper tract urothelial carcinoma samples by real-time reverse transcriptase-polymerase chain reaction. PTP4A3 protein expression was determined by immunohistochemistry using the H-score in 340 upper tract urothelial carcinoma samples. It was further correlated with clinicopathological factors, and disease specific and metastasis-free survival. The expression of PTP4A3 significantly increased from normal urothelium, noninvasive upper tract urothelial carcinoma and invasive upper tract urothelial carcinoma to nodal metastatic tissue (p metastasis, lymphovascular invasion and perineural invasion (each p metastasis-free survival on multivariate analysis (each p metastasis in patients with pTa, pT1 and pT2 upper tract urothelial carcinoma. Results imply that PTP4A3 has a role in the carcinogenesis of upper tract urothelial carcinoma. PTP4A3 over expression independently predicted the metastasis and outcome of upper tract urothelial carcinoma, which was even more important in organ confined disease. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  1. Pin site metastasis of meningioma. (United States)

    Ozer, Ercan; Kalemci, Orhan; Acar, Umit Dursun; Canda, Serafettin


    Metastasis of meningiomas due to iatrogenic implantation of tumour cells is extremely rare and only four cases have been reported to date. In this study, we report a 45-year-old female patient who presented with meningioma metastasis at the pin site of head holder applied in the original operation.

  2. Nodal prices determination with wind integration for radial ...

    African Journals Online (AJOL)

    Like transmission pricing, distribution network pricing must also be transparent and must include tile variations based on the change in the operating state of the system, integration of renewable sources and must be real time. In this paper, a distribution system nodal pricing scheme is proposed for radial distribution system ...

  3. Note on the nodal line of the p-Laplacian

    Directory of Open Access Journals (Sweden)

    Abdel R. El Amrouss


    Full Text Available In this paper, we prove that the length of the nodal line of the eigenfunctions associated to the second eigenvalue of the problem $$ -Delta_p u = lambda ho (x |u|^{p-2}u quad hbox{in } Omega $$ with the Dirichlet conditions is not bounded uniformly with respect to the weight.

  4. CRY 1AB trangenic cowpea obtained by nodal electroporation ...

    African Journals Online (AJOL)

    Electroporation-mediated genetic transformation was used to introduce Cry 1 Ab insecticidal gene into cowpea. Nodal buds were electroporated in planta with a plasmid carrying the Cry 1Ab and antibiotic resistance npt II genes driven by a 35S CaMV promoter. T1 seeds derived from electroporated branches were selected ...

  5. Nodal anatomy of eight Nigeria species of Vigna savi (Leguminosae ...

    African Journals Online (AJOL)

    An investigation on the nodal anatomical features of eight Vigna species namely: V. ambacensis, V. gracills, V. racemosa, V. reticulata, V. subterranae, V. triloba, V. unguiculata and V. vexillata that are common in Eastern Nigeria were carried out. The model anatomy showed that these taxa possess useful taxonomic ...

  6. Nodal and FGF coordinate ascidian neural tube morphogenesis. (United States)

    Navarrete, Ignacio A; Levine, Michael


    Formation of the vertebrate neural tube represents one of the premier examples of morphogenesis in animal development. Here, we investigate this process in the simple chordate Ciona intestinalis Previous studies have implicated Nodal and FGF signals in the specification of lateral and ventral neural progenitors. We show that these signals also control the detailed cellular behaviors underlying morphogenesis of the neural tube. Live-imaging experiments show that FGF controls the intercalary movements of ventral neural progenitors, whereas Nodal is essential for the characteristic stacking behavior of lateral cells. Ectopic activation of FGF signaling is sufficient to induce intercalary behaviors in cells that have not received Nodal. In the absence of FGF and Nodal, neural progenitors exhibit a default behavior of sequential cell divisions, and fail to undergo the intercalary and stacking behaviors essential for normal morphogenesis. Thus, cell specification events occurring prior to completion of gastrulation coordinate the morphogenetic movements underlying the organization of the neural tube. © 2016. Published by The Company of Biologists Ltd.

  7. High-frequency shoot regeneration of nodal explants from ...

    African Journals Online (AJOL)

    This paper describes the shoot regeneration of nodal segments from a medicinal plant, Tetrastigma hemsleyanum Diels et Gilg (Vitaceae). The highest number of shoots (7.27 shoots per explant) was observed in MS medium supplemented with 4 mg/l BA after six weeks of inoculation. 2 mg/l BA in combination with 0.1 mg/l ...

  8. Extra nodal growth as a prognostic factor in malignant melanoma

    NARCIS (Netherlands)

    Koopal, SA; Tiebosch, ATMG; Daryanani, D; Plukker, JTM; Hoekstra, HJ

    Aim. Extra nodal growth (ENG) in lymph-node metastases may be an additional. indicator for poor prognosis and increased Loco-regional recurrence in patients with a cutaneous malignant melanoma (CMM). Most studies analyzing prognostic factors tack a proper definition or description of the

  9. High-frequency shoot regeneration of nodal explants from ...

    African Journals Online (AJOL)



    Jun 29, 2011 ... develop a rapid and efficient in vitro multiplication and regeneration system using nodal explants. MATERIALS AND METHODS. Plant material and initiation of in vitro shoot cultures. Young in vivo shoots with six to eight nodes of T. hemsleyanum were collected from wild population in Zhejiang Province, ...

  10. Optical techniques for the intraoperative assessment of nodal status

    NARCIS (Netherlands)

    Grootendorst, Diederik; Steenbergen, Wiendelt; Manohar, Srirang; Ruers, Theo J.M.


    The lymphatic system is an important pathway in the metastatic spread of many malignancies and a key prognostic indicator. Nondestructive assessment of the nodal status during surgery could limit the amount of lymph nodes that need to be resected and allow for immediate regional lymphadenectomy

  11. Rare case of axillary lymph node metastasis in papillary thyroid carcinoma detected using Iodine-131 whole-body scintigraphy and single-photon emission computed tomography/computed tomography. (United States)

    Kamaleshwaran, Koramadai Karuppusamy; Rajan, Firoz; Mohanan, Vyshak; Shinto, Ajit Sugunan


    Differentiated thyroid cancer is, usually, associated with an excellent prognosis and indolent course. Distant metastases are rare events at the onset of thyroid cancer. Among these presentations, metastasis to the axillary lymph nodes is even more unusual. Only few cases of papillary carcinoma with axillary nodal metastasis were previously reported in the literature. We present a 38-year-old female who underwent Iodine-131 whole-body scintigraphy, after total thyroidectomy and bilateral neck lymph node dissection for papillary carcinoma of thyroid, showed intense uptake in the remnant thyroid, lung metastasis, left cervical and left axillary lymph nodes. Excision of left axillary lymph nodes confirmed metastatic papillary carcinoma.

  12. Dual Atrioventricular Nodal Pathways Physiology: A Review of Relevant Anatomy, Electrophysiology, and Electrocardiographic Manifestations


    Mani, Bhalaghuru Chokkalingam; Pavri, Behzad B.


    More than half a century has passed since the concept of dual atrioventricular (AV) nodal pathways physiology was conceived. Dual AV nodal pathways have been shown to be responsible for many clinical arrhythmia syndromes, most notably AV nodal reentrant tachycardia. Although there has been a considerable amount of research on this topic, the subject of dual AV nodal pathways physiology remains heavily debated and discussed. Despite advances in understanding arrhythmia mechanisms and the wides...

  13. Nodal recurrence of sinonasal cancer: does the risk of cervical relapse justify a prophylactic neck treatment? (United States)

    Mirghani, Haïtham; Hartl, Dana; Mortuaire, Geoffrey; Armas, Gian Luca; Aupérin, Anne; Chevalier, Dominique; Lefebvre, Jean Louis


    Sinonasal cancers are rare and no high-level evidence exists to determine their optimal management. Prophylactic neck treatment issue remains controversial. The aim of this study was to analyze the pattern of neck failure and to identify any prognostic factors that may influence neck control. A retrospective review of 155 consecutive patients treated for sinonasal malignancy, without prophylactic neck treatment, between 1995 and 2005 at tertiary cancer center was performed. Demographic, clinical, morphological and pathological parameters were correlated with oncologic outcomes. Eight out of 155 patients (5%) presented initially with neck node metastasis. Complete remission was obtained for 133 patients after treatment completion. During follow up, 16 out of 133 patients (12%) were affected with regional recurrence. Neck failure occurred in 8 out of 51 patients with local failure and in 8 out of 82 patients locally controlled. Isolated nodal failure was observed in 5 patients initially cN0 out of 133 (3.8%) representing 7.3% of all recurrences and 3 of them underwent successful salvage therapy. None of the tested factors were significantly associated with neck control (p>0.05). Lymph node at diagnosis time was significantly and independently associated with poor survival (p=0.0012). Isolated neck relapse, when local control is achieved, is rare and salvage treatment is effective. Routine prophylactic neck treatment has little interest. However, this approach could be profitable to few selected patients, who remain to be defined. Further investigations are needed. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Nodal Status Assessment in Breast Cancer: Strategies of Clinical Grounds and Quality of Life Implications

    Directory of Open Access Journals (Sweden)

    Paolo Orsaria


    Full Text Available Even in the era of gene-expression profiling, the nodal status still remains the primary prognostic discriminant in breast cancer patients. The exclusion of node involvement using noninvasive methods could reduce the rate of axillary surgery, thereby preventing from suffering complications. However, lymphatic mapping with sentinel node biopsy (SNB is one of the most interesting recent developments in surgical oncology. Optimization of procedure could be implemented by dual mapping injection site skills, resection of all hot or blue nodes through tracer combination, and improvement in atypical drainage patterns mapping. This anatomical analysis suggests safety measures in patients with high probability of node metastasis through a renewed interest in surgical management. The perspective of a guided axillary sampling (GAS could represent a potential development of recent anatomical and functional acquisitions, offering a dynamic technique shared according to clinical and anatomical disease parameters. Furthermore, the surgical staging procedures may adopt a conservative approach through the evaluation of upper arm lymphatics, thus defining a functional model aimed at the reduction of short- and long-term adverse events. Quality results in breast cancer surgery need to generate oncological safety devoid of complications through renewed clinical experience.

  15. Meeting report: Metastasis Research Society-Chinese Tumor Metastasis Society joint conference on metastasis. (United States)

    Bankaitis, Katherine; Borriello, Lucia; Cox, Thomas; Lynch, Conor; Zijlstra, Andries; Fingleton, Barbara; Gužvić, Miodrag; Anderson, Robin; Neman, Josh


    During September 16th-20th 2016, metastasis experts from around the world convened for the 16th Biennial Congress of the Metastasis Research Society and 12th National Congress of the Chinese Tumor Metastasis Society in Chengdu, China to share most current data covering basic, translational, and clinical metastasis research. Presentations of the more than 40 invited speakers of the main congress and presentations from the associated Young Investigator Satellite Meeting are summarized in this report by session topic. The congress program also included three concurrent short talk sessions, an advocacy forum with Chinese and American metastatic patient advocates, a 'Meet the Professors Roundtable' session for young investigators, and a 'Meet the Editors' session with editors from Cancer Cell and Nature Cell Biology. The goal of integrating expertise and exchanging the latest findings, ideas, and practices in cancer metastasis research was achieved magnificently, thanks to the excellent contributions of many leaders in the field.

  16. Loss of the cell polarity determinant human Discs-large is a novel molecular marker of nodal involvement and poor prognosis in endometrial cancer. (United States)

    Sugihara, Takeru; Nakagawa, Shunsuke; Sasajima, Yuko; Ichinose, Takayuki; Hiraike, Haruko; Kondo, Fukuo; Uozaki, Hiroshi; Fukusato, Toshio; Ayabe, Takuya


    Recent Drosophila studies showed that Discs-large (Dlg) is critical for regulation of cell polarity and tissue architecture. We investigated the possibility that loss of the human homologue of Drosophila Dlg (DLG1) is involved in endometrial carcinogenesis. We analysed DLG1 expression in 160 endometrial cancers by immunohistochemical staining. Its expression was confirmed by quantitative real-time PCR (RT-PCR). We investigated the roles of DLG1 in growth and invasion by knockdown experiment in endometrial cancer cell lines. Human DLG1 localises at cellular membrane in normal endometrial tissues. Loss of DLG1 was observed in 37 cases (23.1%). Loss of DLG1 was observed in patients with advanced stage and high-grade histology. It was also observed in patients with nodal metastasis, deep myometrial invasion, and negative oestrogen and progesterone receptors. Patients with loss of DLG1 showed poorer overall survival (P=0.0019). Immunohistochemistry data correlated with RT-PCR data. Knockdown of Dlg1 in endometrial cancer cells resulted in accelerated tumour migration and invasion in vitro. Tissue polarity disturbance because of loss of DLG1 was shown to confer more aggressive characteristics to endometrial cancer cells. Our study revealed that DLG1 expression is a novel molecular biomarker of nodal metastasis, high-grade histology, and poor prognosis in endometrial cancer.

  17. Clinical significance of lymph node metastasis in gastric cancer (United States)

    Deng, Jing-Yu; Liang, Han


    Gastric cancer, one of the most common malignancies in the world, frequently reveals lymph node, peritoneum, and liver metastases. Most of gastric cancer patients present with lymph node metastasis when they were initially diagnosed or underwent surgical resection, which results in poor prognosis. Both the depth of tumor invasion and lymph node involvement are considered as the most important prognostic predictors of gastric cancer. Although extended lymphadenectomy was not considered a survival benefit procedure and was reported to be associated with high mortality and morbidity in two randomized controlled European trials, it showed significant superiority in terms of lower locoregional recurrence and disease related deaths compared to limited lymphadenectomy in a 15-year follow-up study. Almost all clinical investigators have reached a consensus that the predictive efficiency of the number of metastatic lymph nodes is far better than the extent of lymph node metastasis for the prognosis of gastric cancer worldwide, but other nodal metastatic classifications of gastric cancer have been proposed as alternatives to the number of metastatic lymph nodes for improving the predictive efficiency for patient prognosis. It is still controversial over whether the ratio between metastatic and examined lymph nodes is superior to the number of metastatic lymph nodes in prognostic evaluation of gastric cancer. Besides, the negative lymph node count has been increasingly recognized to be an important factor significantly associated with prognosis of gastric cancer. PMID:24744586

  18. Ampullary carcinoma with cutaneous metastasis

    Directory of Open Access Journals (Sweden)

    I-Ting Liu


    Full Text Available Carcinoma of the ampulla of Vater is a rare gastrointestinal tumor. Additionally, cutaneous metastasis from such an internal malignancy is also uncommon. We reported the case of a 55-year-old man afflicted with ampullary carcinoma with cutaneous metastasis. The patient did not undergo the standard Whipple procedure but received chemotherapy due to apparent left neck lymph node metastasis noted by initial PET/CT imaging. The skin metastasis presented as a left neck infiltrating purpuric lesion, which was confirmed by skin biopsy approximately one year after the patient's disease was first diagnosed. Thereafter, the patient received further chemotherapy pursuant to his course of medical management. Skin metastasis usually represents a poor patient prognosis. In these cases, treatment of cutaneous metastasis typically includes systemic chemotherapy and local management such as radiation therapy or tumor excision. And when choosing a chemotherapy regimen for the ampullary cancer, the histological subtypes (intestinal or pancreatobiliary should be comprehensively considered. In our review of the literature, the intestinal type seems to have less distant lymph node metastasis, advanced local invasion, as well as recurrence than pancreatobiliary type of ampullary cancer.

  19. Cancer metastasis: issues and challenges. (United States)

    Qian, Chao-Nan; Mei, Yan; Zhang, Jian


    Metastasis is the major cause of treatment failure in cancer patients and of cancer-related deaths. This editorial discusses how cancer metastasis may be better perceived and controlled. Based on big-data analyses, a collection of 150 important pro-metastatic genes was studied. Using The Cancer Genome Atlas datasets to re-analyze the effect of some previously reported metastatic genes-e.g., JAM2, PPARGC1A, SIK2, and TRAF6-on overall survival of patients with renal and liver cancers, we found that these genes are actually protective factors for patients with cancer. The role of epithelial-mesenchymal transition (EMT) in single-cell metastasis has been well-documented. However, in metastasis caused by cancer cell clusters, EMT may not be necessary. A novel role of epithelial marker E-cadherin, as a sensitizer for chemoresistant prostate cancer cells by inhibiting Notch signaling, has been found. This editorial also discusses the obstacles for developing anti-metastatic drugs, including the lack of high-throughput technologies for identifying metastasis inhibitors, less application of animal models in the pre-clinical evaluation of the leading compounds, and the need for adjustments in clinical trial design to better reflect the anti-metastatic efficacy of new drugs. We are confident that by developing more effective high-throughput technologies to identify metastasis inhibitors, we can better predict, prevent, and treat cancer metastasis.

  20. Effects of enhanced parasympathetic tone on atrioventricular nodal conduction during atrioventricular nodal reentrant tachycardia. (United States)

    Belz, M K; Stambler, B S; Wood, M A; Pherson, C; Ellenbogen, K A


    The effects of various physiologic and pharmacologic stimuli on the anterograde slow pathway in patients with atrioventricular nodal reentrant tachycardia are well characterized. We sought to further characterize the nature of anterograde and retrograde conduction during tachycardia and to define the differential input of the parasympathetic nervous system to these pathways. A custom-made neck suction collar was placed to stimulate the carotid body baroreceptors during supraventricular tachycardia. Neck suction at -60 mm Hg was applied and changes in tachycardia cycle length, AH, and ventriculoatrial intervals were measured in 20 patients. These measurements were repeated after intravenous administration of 10 mg of edrophonium to enhance vagal tone. We observed a 15 +/- 6 ms increase in tachycardia cycle length from baseline (p <0.0001) and a 14 +/- 6 ms increase in AH interval (p <0.0001), but no change in the VA interval with neck suction alone. The tachycardia cycle length prolonged 26 +/- 55 ms (p <0.0001) with edrophonium and an additional 12 +/- 43 ms (p <0.001) with neck suction after edrophonium. There was no change in the VA interval before or after edrophonium during neck suction. There were 10 tachycardia terminations in 8 patients during anterograde slow pathway block during neck suction, with tachycardia cycle length prolongation and mean AH prolongation before termination of 45 +/- 37 ms (vs 15 +/- 7 ms increase in AH interval without tachycardia termination, p = 0.10). There were 12 tachycardia terminations in 4 patients with retrograde block during neck suction, only after edrophonium, without any preceding change in tachycardia cycle length during 11 episodes. We conclude that anterograde slow pathway demonstrates gradual conduction slowing with parasympathetic enhancement, whereas retrograde fast pathway responds with abrupt block.

  1. Incidence of cervical lymph node metastasis and its association with outcomes in patients with adenoid cystic carcinoma. An international collaborative study (United States)

    Amit, Moran; Binenbaum, Yoav; Sharma, Kanika; Ramer, Naomi; Ramer, Ilana; Agbetoba, Abib; Glick, Joelle; Yang, Xinjie; Lei, Delin; Bjørndal, Kristine; Godballe, Christian; Mücke, Thomas; Wolff, Klaus-Dietrich; Fliss, Dan; Eckardt, André M.; Copelli, Chiara; Sesenna, Enrico; Palmer, Frank; Ganly, Ian; Patel, Snehal; Gil, Ziv


    Background The patterns of regional metastasis in adenoid cystic carcinoma (ACC) of the head and neck and its association with outcome is not established. Methods We conducted a retrospective multicentered multivariate analysis of 270 patients who underwent neck dissection. Results The incidence rate of neck metastases was 29%. The rate observed in the oral cavity is 37%, and in the major salivary glands is 19% (p = .001). The rate of occult nodal metastases was 17%. Overall 5-year survival rates were 44% in patients undergoing therapeutic neck dissections, and 65% and 73% among those undergoing elective neck dissections, with and without nodal metastases, respectively (p = .017). Multivariate analysis revealed that the primary site, nodal classification, and margin status were independent predictors of survival. Conclusion Our findings support the consideration of elective neck treatment in patients with ACC of the oral cavity. PMID:25060927

  2. Auxiliary diagnosis of lymph node metastasis in early gastric cancer using quantitative evaluation of sentinel node radioactivity. (United States)

    Kamiya, Satoshi; Takeuchi, Hiroya; Nakahara, Tadaki; Niihara, Masahiro; Nakamura, Rieko; Takahashi, Tsunehiro; Wada, Norihito; Kawakubo, Hirofumi; Saikawa, Yoshiro; Omori, Tai; Murakami, Koji; Kitagawa, Yuko


    Sentinel node (SN) mapping using dye and radioisotope (RI) tracer has been reported to be feasible in cases of early gastric cancer. Because accurate diagnosis of micrometastasis is sometimes difficult in the limited time available during surgery, a faster and simpler method of improving the intraoperative diagnostic precision of lymph node metastasis is needed. The amount of tracer deposited in an SN can be determined from its radioactivity; however, the significance of the RI count has not been fully discussed. We investigated the clinical impact of the RI count when used as an adjunct to conventional lymph node dissection when diagnosing lymphatic metastasis in cases of early gastric cancer. From 2008 to 2009, patients with clinically diagnosed T1N0M0 gastric cancers who underwent gastrectomy and SN mapping were enrolled. SNs were examined by intraoperative and postoperative pathology. The RI count was measured for each SN with a handheld gamma probe; the correlation between nodal metastasis and the RI count was assessed. A total of 308 SNs were harvested from 72 patients. Patients with SN metastasis had significantly higher total RI counts than those without SN metastasis (p = 0.007). Among cases with SN metastasis, RI counts were also significantly elevated in metastasis-positive nodes, stations, and basins. In these cases, the most of SNs having the highest RI count in each case had metastasis including isolated tumor cells. In early gastric cancer patients, a high RI count from an SN was correlated with lymph node metastasis. Therefore, RI counting may aid efficient pathological diagnosis and focused lymph node dissection.

  3. Three-dimensional conformal radiation for esophageal squamous cell carcinoma with involved-field irradiation may deliver considerable doses of incidental nodal irradiation

    Directory of Open Access Journals (Sweden)

    Ji Kai


    Full Text Available Abstract Background To quantify the incidental irradiation dose to esophageal lymph node stations when irradiating T1-4N0M0 thoracic esophageal squamous cell carcinoma (ESCC patients with a dose of 60 Gy/30f. Methods Thirty-nine patients with medically inoperable T1–4N0M0 thoracic ESCC were treated with three-dimensional conformal radiation (3DCRT with involved-field radiation (IFI. The conformal clinical target volume (CTV was re-created using a 3-cm margin in the proximal and distal direction beyond the barium esophagogram, endoscopic examination and CT scan defined the gross tumor volume (GTV and a 0.5-cm margin in the lateral and anteroposterior directions of the CT scan-defined GTV. The PTV encompassed 1-cm proximal and distal margins and 0.5-cm radial margin based on the CTV. Nodal regions were delineated using the Japanese Society for Esophageal Diseases (JSED guidelines and an EORTC-ROG expert opinion. The equivalent uniform dose (EUD and other dosimetric parameters were calculated for each nodal station. Nodal regions with a metastasis rate greater than 5% were considered a high-risk lymph node subgroup. Results Under a 60 Gy dosage, the median Dmean and EUD was greater than 40 Gy in most high-risk nodal regions except for regions of 104, 106tb-R in upper-thoracic ESCC and 101, 104-R, 105, 106rec-L, 2, 3&7 in middle-thoracic ESCC and 107, 3&7 in lower-thoracic ESCC. In the regions with an EUD less than 40Gy, most incidental irradiation doses were significantly associated with esophageal tumor length and location. Conclusions Lymph node stations near ESCC receive considerable incidental irradiation doses with involved-field irradiation that may contribute to the elimination of subclinical lesions.

  4. Nodal failure index approach to groundwater remediation design (United States)

    Lee, J.; Reeves, H.W.; Dowding, C.H.


    Computer simulations often are used to design and to optimize groundwater remediation systems. We present a new computationally efficient approach that calculates the reliability of remedial design at every location in a model domain with a single simulation. The estimated reliability and other model information are used to select a best remedial option for given site conditions, conceptual model, and available data. To evaluate design performance, we introduce the nodal failure index (NFI) to determine the number of nodal locations at which the probability of success is below the design requirement. The strength of the NFI approach is that selected areas of interest can be specified for analysis and the best remedial design determined for this target region. An example application of the NFI approach using a hypothetical model shows how the spatial distribution of reliability can be used for a decision support system in groundwater remediation design. ?? 2008 ASCE.

  5. Anomalous contagion and renormalization in networks with nodal mobility (United States)

    Manrique, Pedro D.; Qi, Hong; Zheng, Minzhang; Xu, Chen; Hui, Pak Ming; Johnson, Neil F.


    A common occurrence in everyday human activity is where people join, leave and possibly rejoin clusters of other individuals —whether this be online (e.g. social media communities) or in real space (e.g. popular meeting places such as cafes). In the steady state, the resulting interaction network would appear static over time if the identities of the nodes are ignored. Here we show that even in this static steady-state limit, a non-zero nodal mobility leads to a diverse set of outbreak profiles that is dramatically different from known forms, and yet matches well with recent real-world social outbreaks. We show how this complication of nodal mobility can be renormalized away for a particular class of networks.

  6. Cutaneous metastasis in anorectal adenocarcinoma

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    Krishnendra Varma


    Full Text Available Cutaneous metastasis in anorectal adenocarcinoma is a rare entity. Here, we report the case of a 40-year-old female who presented with yellowish-brown, irregular, solid, elevated rashes over the pubis with a recent history off palliative colostomy for anorectal adenocarcinoma. Clinically, we suspected metastasis that was proved on biopsy. We report this case due to the rare presenting site (i.e., perineum of a metastatic adenocarcinoma.

  7. Imaging the paramagnetic nonlinear Meissner effect in nodal gap superconductor


    Zhuravel, Alexander P.; Bae, Seokjin; Shevchenko, Sergey N.; Omelyanchouk, Alexander N.; Lukashenko, Alexander V.; Ustinov, Alexey V.; Anlage, Steven M.


    Boundary surfaces of nodal gap superconductors can host Andreev bound states (ABS) which develop a paramagnetic response under external RF field in contrast to the bulk diamagnetic response of the bulk superconductor. At low temperature this surface paramagnetic response dominates and enhances the nonlinear RF response of the sample. With a recently developed photoresponse imaging technique, the anisotropy of this "paramagnetic" nonlinear Meissner response, and its current direction (angular)...

  8. Micropropagation of Costus speciosus (Koen. Sm. Using Nodal Segment Culture

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    Kshetrimayum PUNYARANI


    Full Text Available Nodal segments of Costus speciosus (Koen. Sm. containing single axillary buds were cultured on Murashige and Skoog medium (MS medium supplemented with plant growth regulators for inducing plantlets. For breaking of axillary bud dormancy, nodal segments were cultured on 40-70gl-1 sucrose or 1-13 M adenine sulphate (AdS supplemented MS basal medium containing 5 M 6-benzylaminopurine (BAP and 1M ?-naphthalene acetic acid (NAA. The nodal segments cultured on 1-13 M AdS, 5 M BAP, 1 M NAA and 50gl-1 sucrose showed simultaneous production of shoots and roots while those cultured on 5 M BAP, 1 M NAA and 40-70gl-1 sucrose produced shoots only. The most effective media for breaking axillary bud dormancy was 5 M BAP, 1 M NAA, 50 gl-1 sucrose and 10 M AdS supplemented medium. The propagules from 40-70gl-1 sucrose produced roots in shoot multiplication medium, i.e.,10 M AdS, 1 M NAA, 50gl-1 sucrose and 3-11 M BAP supplemented medium. The best response for shoot multiplication was on 10 M AdS, 1 M NAA, 50gl-1 sucrose and 7 M BAP. The well-rooted shoots were hardened and transferred to the soil where they showed 95% survival rate. Results show that axillary bud can be used for micropropagation of Costus speciosus.

  9. Topological Phase Transitions in Line-nodal Superconductors (United States)

    Cho, Gil Young; Han, Sangeun; Moon, Eun-Gook

    Fathoming interplay between symmetry and topology of many-electron wave-functions deepens our understanding in quantum nature of many particle systems. Topology often protects zero-energy excitation, and in a certain class, symmetry is intrinsically tied to the topological protection. Namely, unless symmetry is broken, topological nature is intact. We study one specific case of such class, symmetry-protected line-nodal superconductors in three spatial dimensions (3d). Mismatch between phase spaces of order parameter fluctuation and line-nodal fermion excitation induces an exotic universality class in a drastic contrast to one of the conventional ϕ4 theory in 3d. Hyper-scaling violation and relativistic dynamic scaling with unusually large quantum critical region are main characteristics, and their implication in experiments is discussed. For example, continuous phase transition out of line-nodal superconductors has a linear phase boundary in a temperature-tuning parameter phase-diagram. This work was supported by the Brain Korea 21 PLUS Project of Korea Government and KAIST start-up funding.

  10. Vasculogenic mimicry contributes to lymph node metastasis of laryngeal squamous cell carcinoma

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    Cai Wenjuan


    Full Text Available Abstract Background Survival of laryngeal squamous cell carcinoma (LSCC patients has remained unchanged over recent years due to its uncontrolled recurrence and local lymph node metastasis. Vasculogenic mimicry (VM is an alternative type of blood supplement related to more aggressive tumor biology and increased tumor-related mortality. This study aimed to investigate the unique role of VM in the progression of LSCC. Methods We reviewed clinical pathological data of 203 cases of LSCC both prospectively and retrospectively. VM and endothelium-dependent vessel (EDV were detected by immunohistochemistry and double staining to compare their different clinical pathological significance in LSCC. Survival analyses were performed to assess their prognostic significance as well. Results Both VM and EDV existed in LSCC type of blood supply. VM is related to pTNM stage, lymph node metastasis and pathology grade. In contrust, EDV related to location, pTNM stage, T stage and distant metastasis. Univariate analysis showed VM, pTNM stage, T classification, nodal status, histopathological grade, tumor size, and radiotherapy to be related to overall survival (OS. While, VM, location, tumor size and radiotherapy were found to relate to disease free survival (DFS. Multivariate analysis indicated that VM, but not EDV, was an adverse predictor for both OS and DFS. Conclusions VM existed in LSCC. It contributed to the progression of LSCC by promoting lymph node metastasis. It is an independent predictors of a poor prognosis of LSCC.

  11. Breast Cancer Pathology, Receptor Status, and Patterns of Metastasis in a Rural Appalachian Population

    Directory of Open Access Journals (Sweden)

    Linda Vona-Davis


    Full Text Available Breast cancer patients in rural Appalachia have a high prevalence of obesity and poverty, together with more triple-negative phenotypes. We reviewed clinical records for tumor receptor status and time to distant metastasis. Body mass index, tumor size, grade, nodal status, and receptor status were related to metastatic patterns. For 687 patients, 13.8% developed metastases to bone (n=42 or visceral sites (n=53. Metastases to viscera occurred within five years, a latent period which was shorter than that for bone (P=0.042. More women with visceral metastasis presented with grade 3 tumors compared with the bone and nonmetastatic groups (P=0.0002. There were 135/574 women (23.5% with triple-negative breast cancer, who presented with lymph node involvement and visceral metastases (68.2% versus 24.3%; P=0.033. Triple-negative tumors that metastasized to visceral sites were larger (P=0.007. Developing a visceral metastasis within 10 years was higher among women with triple-negative tumors. Across all breast cancer receptor subtypes, the probability of remaining distant metastasis-free was greater for brain and liver than for lung. The excess risk of metastatic spread to visceral organs in triple-negative breast cancers, even in the absence of positive nodes, was combined with the burden of larger and more advanced tumors.

  12. Hyperthermia combined with re-irradiation for neck node metastasis from head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ohizumi, Yukio; Tamai, Yoshifumi; Imamiya, Satoshi; Akiba, Takeshi [Tokai Univ., Isehara, Kanagawa (Japan). School of Medicine


    The effects of hyperthermia combined with re-irradiation were compared with those of re-irradiation alone using retrospectively matched-pair analysis. Between 1984 and 1997, 12 patients were treated with hyperthermia combined with re-irradiation for neck node metastasis from squamous cell carcinoma of the head and neck. During the same period, 12 patients treated with re-irradiation alone were selected retrospectively using the same anatomical diagnosis, nodal site, and nodal size. Recurrent nodes were heated by a 2450 MHz microwave or 13 MHz radio frequency 4 times on average for 30 to 50 min immediately before radiotherapy. The maximum temperatures were >41 deg C in 83% and >42 deg C in 58% of patients. The median survival and median recurrence periods were 12 months and 6 months, respectively in both groups. The response rate was 83% in both groups. Nodal size and radiation dose, but not heating temperature, were prognostic factors. Five patients in the hyperthermia group experienced skin ulcers or burns as acute complications. Late complications were observed in one patient in the hyperthermia group and 3 patients in the re-irradiation-alone group. Heating induced acute complications and had no significant effect on the tumors. Further advanced in hyperthermic technique are required. (author)

  13. Adenocarcinoma arising at a colostomy site with inguinal lymph node metastasis: report of a case. (United States)

    Iwamoto, Masayoshi; Kawada, Kenji; Hida, Koya; Hasegawa, Suguru; Sakai, Yoshiharu


    Inguinal lymph node metastasis from adenocarcinoma arising at a colostomy site is extremely rare, and the significance of surgical resection for metastatic inguinal lymph nodes has not been established. An 82-year-old woman who had undergone abdominoperineal resection 27 years earlier was admitted to our hospital complaining of bleeding from a colostomy. Physical examination revealed that a tumor at the colostomy site directly invaded into the peristomal skin, and that a left inguinal lymph node was firm and swollen. Positron emission tomography/computed tomography scan demonstrated accumulation of (18)F-fluorodeoxy glucose into both the colostomy tumor and the left swollen inguinal lymph node, while there was no evidence of metastasis to liver or lungs. She underwent open left hemicolectomy with wide local resection of the colostomy, and dissection of left inguinal lymph nodes. Histological diagnosis was a moderately differentiated adenocarcinoma that directly invaded into the surrounding skin and metastasized to the left inguinal lymph node. The patient has been followed up for >5 years without any sign of recurrence. In general, inguinal lymph node metastasis from colorectal cancers is regarded as a systemic disease with a poor prognosis, and so systemic chemotherapy and radiotherapy, but not surgical lymph node dissection, are recommended. Considering the lymphatic drainage route in the present case, inguinal lymph node metastasis does not represent a systemic disease but rather a sentinel nodal metastasis from adenocarcinoma at a colostomy site. Surgical dissection of metastatic inguinal lymph nodes should be considered to enable a favorable prognosis in the absence of distant metastasis to other organs. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email:

  14. Microenvironment Determinants of Brain Metastasis

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    Zhang Chenyu


    Full Text Available Abstract Metastasis accounts for 90% of cancer-related mortality. Brain metastases generally present during the late stages in the natural history of cancer progression. Recent advances in cancer treatment and management have resulted in better control of systemic disease metastatic to organs other than the brain and improved patient survival. However, patients who experience recurrent disease manifest an increasing number of brain metastases, which are usually refractory to therapies. To meet the new challenges of controlling brain metastasis, the research community has been tackling the problem with novel experimental models and research tools, which have led to an improved understanding of brain metastasis. The time-tested "seed-and-soil" hypothesis of metastasis indicates that successful outgrowth of deadly metastatic tumors depends on permissible interactions between the metastatic cancer cells and the site-specific microenvironment in the host organs. Consistently, recent studies indicate that the brain, the major component of the central nervous system, has unique physiological features that can determine the outcome of metastatic tumor growth. The current review summarizes recent discoveries on these tumor-brain interactions, and the potential clinical implications these novel findings could have for the better treatment of patients with brain metastasis.

  15. Radiotherapy studies and extra-nodal non-Hodgkin lymphomas, progress and challenges

    DEFF Research Database (Denmark)

    Specht, L


    for the more common extra-nodal organs, e.g. stomach, Waldeyer's ring, skin and brain, are fairly well known and show significant variation. A few randomised trials have been carried out testing the role of radiotherapy in these lymphomas. However, for most extra-nodal lymphomas, randomised trials have...... not been carried out, and treatment decisions are made on small patient series and extrapolations from nodal lymphomas. Hopefully, wide international collaboration will make controlled clinical trials possible in the less common extra-nodal lymphomas. Modern highly conformal radiotherapy allows better...... coverage of extra-nodal lymphomatous involvement with better sparing of normal tissues. The necessary radiation doses and volumes need to be defined for the different extra-nodal lymphoma entities. The challenge is to optimise the use of radiotherapy in the modern multimodality treatment of extra...

  16. Elsevier Trophoblast Research Award lecture: The multifaceted role of Nodal signaling during mammalian reproduction. (United States)

    Park, C B; Dufort, D


    Nodal, a secreted signaling protein in the transforming growth factor-beta (TGF-β) superfamily, has established roles in vertebrate development. However, components of the Nodal signaling pathway are also expressed at the maternal-fetal interface and have been implicated in many processes of mammalian reproduction. Emerging evidence indicates that Nodal and its extracellular inhibitor Lefty are expressed in the uterus and complex interactions between the two proteins mediate menstruation, decidualization and embryo implantation. Furthermore, several studies have shown that Nodal from both fetal and maternal sources may regulate trophoblast cell fate and facilitate placentation as both embryonic and uterine-specific Nodal knockout mouse strains exhibit disrupted placenta morphology. Here we review the established and prospective roles of Nodal signaling in facilitating successful pregnancy, including recent evidence supporting a potential link to parturition and preterm birth. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. Intracardiac metastasis originated from chondrosarcoma. (United States)

    Maurea, Nicola; Ragone, Gianluca; Coppola, Carmela; Caronna, Antonietta; Tocchetti, Carlo G; Agozzino, Lucio; Apice, Gaetano; Iaffaioli, Rosario V


    Primary cardiac tumors are extremely rare. By comparison, metastatic involvement of the heart is over 20 times more common and has been reported in autopsy series in up to one in five patients dying of cancer. Cardiac metastasis of chondrosarcoma is absolutely not frequent. In the recent literature, a cardiac metastasis from chondrosarcoma has never been described. We report the case of an 18-year-old man with a diagnosis of cardiac metastasis that originated from a left scapular chondrosarcoma. Chondrosarcoma is a skeletal tumor with various grades of malignancy, rapidly evolving, and with a strong tendency to metastasize, with low responsiveness to chemotherapy. The onset of characteristic systemic symptoms in the late stage of the disease led to the diagnosis of a mass localized in the right atrium. Management and differential diagnosis of infective heart lesions were also very complex in a rapidly evolving life-threatening condition.

  18. Micropropagation of Costus speciosus (Koen. Sm. Using Nodal Segment Culture

    Directory of Open Access Journals (Sweden)

    Kshetrimayum PUNYARANI


    Full Text Available Nodal segments of Costus speciosus (Koen. Sm. containing single axillary buds were cultured on Murashige and Skoog medium (MS medium supplemented with plant growth regulators for inducing plantlets. For breaking of axillary bud dormancy, nodal segments were cultured on 40-70gl-1 sucrose or 1-13 �M adenine sulphate (AdS supplemented MS basal medium containing 5 �M 6-benzylaminopurine (BAP and 1�M ?-naphthalene acetic acid (NAA. The nodal segments cultured on 1-13 �M AdS, 5 �M BAP, 1 �M NAA and 50gl-1 sucrose showed simultaneous production of shoots and roots while those cultured on 5 �M BAP, 1 �M NAA and 40-70gl-1 sucrose produced shoots only. The most effective media for breaking axillary bud dormancy was 5 �M BAP, 1 �M NAA, 50 gl-1 sucrose and 10 �M AdS supplemented medium. The propagules from 40-70gl-1 sucrose produced roots in shoot multiplication medium, i.e.,10 �M AdS, 1 �M NAA, 50gl-1 sucrose and 3-11 �M BAP supplemented medium. The best response for shoot multiplication was on 10 �M AdS, 1 �M NAA, 50gl-1 sucrose and 7 �M BAP. The well-rooted shoots were hardened and transferred to the soil where they showed 95% survival rate. Results show that axillary bud can be used for micropropagation of Costus speciosus.

  19. The challenge of targeting metastasis. (United States)

    Fidler, Isaiah J; Kripke, Margaret L


    Metastases that are resistant to conventional therapy are the major cause of death from cancer. In most patients, metastasis has already occurred by the time of diagnosis. Thus, the prevention of metastasis is unlikely to be of therapeutic benefit. The biological heterogeneity of metastases presents a major obstacle to treatment. However, the growth and survival of metastases depend on interactions between tumor cells and host homeostatic mechanisms. Targeting these interactions, in addition to the tumor cells, can produce synergistic therapeutic effects against existing metastases.

  20. Atrioventricular nodal reentrant tachycardia ablation and inferior vena cava agenesis. (United States)

    Galand, Vincent; Pavin, Dominique; Behar, Nathalie; Mabo, Philippe; Martins, Raphaël P


    Congenital anomalies of the inferior vena cava (IVC) are rare and very often diagnosed in asymptomatic patients during computed tomography performed for other purposes. These anomalies can have significant clinical implications, for example if electrophysiology procedures are needed. Diagnostic and ablation procedures are difficult since catheter manipulation and positioning are more complex. We present here a case of successful atrioventricular nodal reentrant tachycardia ablation in a patient with unexpected IVC agenesis, using an azygos route. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. The Nodal Location of Metastases in Melanoma Sentinel Lymph Nodes

    DEFF Research Database (Denmark)

    Riber-Hansen, Rikke; Nyengaard, Jens; Hamilton-Dutoit, Stephen


    BACKGROUND: The design of melanoma sentinel lymph node (SLN) histologic protocols is based on the premise that most metastases are found in the central parts of the nodes, but the evidence for this belief has never been thoroughly tested. METHODS: The nodal location of melanoma metastases in 149...... prospectively analyzed, completely step sectioned, positive SLNs from 96 patients was examined using 3 theoretical protocols, evaluating respectively: (1) the 3 most central step sections only; (2) the 3 most peripheral step sections only; and (3) 3 step sections evenly distributed throughout the individual...

  2. Approximate Schur complement preconditioning of the lowest order nodal discretizations

    Energy Technology Data Exchange (ETDEWEB)

    Moulton, J.D.; Ascher, U.M. [Univ. of British Columbia, Vancouver, British Columbia (Canada); Morel, J.E. [Los Alamos National Lab., NM (United States)


    Particular classes of nodal methods and mixed hybrid finite element methods lead to equivalent, robust and accurate discretizations of 2nd order elliptic PDEs. However, widespread popularity of these discretizations has been hindered by the awkward linear systems which result. The present work exploits this awkwardness, which provides a natural partitioning of the linear system, by defining two optimal preconditioners based on approximate Schur complements. Central to the optimal performance of these preconditioners is their sparsity structure which is compatible with Dendy`s black box multigrid code.

  3. Nodal Langerhans cell histiocytosis with prominent eosinophilic emperipolesis. (United States)

    Chougule, Abhijit; Srivastava, Shreya; Totadri, Sidharth; Srinivasan, Radhika; Trehan, Amita


    Multinucleated giant cells of osteoclastic type are known to occur in nodal and extranodal lesions of Langerhans cell histiocytosis (LCH). These giant cells are thought to be derived from phagocytic histiocytes, which correlate with the degree of necrosis in LCH lesions. Emperipolesis commonly seen in Rosai-Dorfman disease is a distinct phenomenon characterized by intact phagocytosed cells in an intracytoplasmic vacuole protected from proteolytic digestion. We present a case of emperipolesis of inflammatory cells especially of eosinophils by multinucleated giant cells of Langhans type in a lymph node involved by LCH--a finding that has not been described previously in the literature. © 2015 Wiley Periodicals, Inc.

  4. Nodal line optimization and its application to violin top plate design (United States)

    Yu, Yonggyun; Jang, In Gwun; Kim, In Kyum; Kwak, Byung Man


    In the literature, most problems of structural vibration have been formulated to adjust a specific natural frequency: for example, to maximize the first natural frequency. In musical instruments like a violin; however, mode shapes are equally important because they are related to sound quality in the way that natural frequencies are related to the octave. The shapes of nodal lines, which represent the natural mode shapes, are generally known to have a unique feature for good violins. Among the few studies on mode shape optimization, one typical study addresses the optimization of nodal point location for reducing vibration in a one-dimensional beam structure. However, nodal line optimization, which is required in violin plate design, has not yet been considered. In this paper, the central idea of controlling the shape of the nodal lines is proposed and then applied to violin top plate design. Finite element model for a violin top plate was constructed using shell elements. Then, optimization was performed to minimize the square sum of the displacement of selected nodes located along the target nodal lines by varying the thicknesses of the top plate. We conducted nodal line optimization for the second and the fifth modes together at the same time, and the results showed that the nodal lines obtained match well with the target nodal lines. The information on plate thickness distribution from nodal line optimization would be valuable for tailored trimming of a violin top plate for the given performances.

  5. The impact of audit and feedback on nodal harvest in colorectal cancer

    Directory of Open Access Journals (Sweden)

    Bu Jingyu


    Full Text Available Abstract Background Adequate nodal harvest (≥ 12 lymph nodes in colorectal cancer has been shown to optimize staging and proposed as a quality indicator of colorectal cancer care. An audit within a single health district in Nova Scotia, Canada presented and published in 2002, revealed that adequate nodal harvest occurred in only 22% of patients. The goal of this current study was to identify factors associated with adequate nodal harvest, and specifically to examine the impact of the audit and feedback strategy on nodal harvest. Methods This population-based study included all patients undergoing resection for primary colorectal cancer in Nova Scotia, Canada, from 01 January 2001 to 31 December 2005. Linkage of the provincial cancer registry with other databases (hospital discharge, physician claims data, and national census data provided clinicodemographic, diagnostic, and treatment-event data. Factors associated with adequate nodal harvest were examined using multivariate logistic regression. The specific interaction between year and health district was examined to identify any potential effect of dissemination of the previously-performed audit. Results Among the 2,322 patients, the median nodal harvest was 8; overall, 719 (31% had an adequate nodal harvest. On multivariate analysis, audited health district (p Conclusions Improvements in colorectal cancer nodal harvest did occur over time. A published audit demonstrating suboptimal nodal harvest appeared to be an effective knowledge translation tool, though more so for the audited health district, suggesting a potentially beneficial effect of audit and feedback strategies.

  6. Evaluation of the use of nodal methods for MTR neutronic analysis

    Energy Technology Data Exchange (ETDEWEB)

    Reitsma, F.; Mueller, E.Z.


    Although modern nodal methods are used extensively in the nuclear power industry, their use for research reactor analysis has been very limited. The suitability of nodal methods for material testing reactor analysis is investigated with the emphasis on the modelling of the core region (fuel assemblies). The nodal approach`s performance is compared with that of the traditional finite-difference fine mesh approach. The advantages of using nodal methods coupled with integrated cross section generation systems are highlighted, especially with respect to data preparation, simplicity of use and the possibility of performing a great variety of reactor calculations subject to strict time limitations such as are required for the RERTR program.

  7. Charcoal-induced granuloma that mimicked a nodal metastasis on ultrasonography and FDG-PET/CT after neck dissection

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jin Woo; Moon, Won Jin; Choi, Nami; Roh, Hong Gee; Kim, Mi Young; Kim, Na Ra; Moon, Sung Gyu; Chung, Hyun Woo; Lim, So Dug; Yang, Jung Hyun [Konkuk University Medical Center, Konkuk University School of Medicine, Seoul (Korea, Republic of)


    Charcoal can be used for preoperative localization of metastatic lymph nodes in the neck. Charcoal remains stable without causing foreign body reactions during as hort period. However, foreign body reactions may develop if charcoal is left in situ for more than 6 months. We reported a case of charcoal granuloma mimicking local recurrence on fluorodeoxyglucose-positron emission tomography/computed tomography and ultrasonography in a 47-year-old woman who had cervical lymph node dissection due to metastatic invasive ductal carcinoma of the breast.

  8. Identification of methylation markers for the prediction of nodal metastasis in oral and oropharyngeal squamous cell carcinoma

    NARCIS (Netherlands)

    Melchers, L. J.; Clausen, M. J. A. M.; Mastik, M. F.; Slagter-Menkema, L.; van der Wal, J. E.; Wisman, G. B. A.; Roodenburg, J. L. N.; Schuuring, E.


    Hypermethylation is an important mechanism for the dynamic regulation of gene expression, necessary for metastasizing tumour cells. Our aim is to identify methylation tumour markers that have a predictive value for the presence of regional lymph node metastases in patients with oral and

  9. Metastasis genetics, epigenetics, and the tumor microenvironment (United States)

    KISS1 is a member of a family of genes known as metastasis suppressors, defined by their ability to block metastasis without blocking primary tumor development and growth. KISS1 re-expression in multiple metastatic cell lines of diverse cellular origin suppresses metastasis; yet, still allows comple...

  10. Right ventricular metastasis of leiomyosarcoma

    Directory of Open Access Journals (Sweden)

    Stagmo Martin


    Full Text Available Abstract Metastatic presentation of leiomyosarcoma in the heart is very rare. We present transthoracic echocardiography and combined PET/CT images of a case with a large right ventricular metastasis of leiomyosarcoma. The patient was placed on cytostatic drugs for palliative purposes, but passed away one month later because of an untreatable ventricular tackycardia.

  11. Pulmonary Metastasis from Pseudomyxoma Peritonei

    Directory of Open Access Journals (Sweden)

    Toshiyuki Kitai


    Full Text Available Pseudomyxoma peritonei (PMP is a rare clinical condition, where copious mucinous ascites accumulate in the peritoneal cavity due to dissemination of mucin-producing tumor. Because of this disseminating, yet nonmetastasizing, behavior, PMP attracts much interest from surgical oncologists in that aggressive locoregional therapy can give the opportunity of long survival and even cure. Although extra-abdominal metastasis is exceptionally rare, the lung is the most likely site in such a case. In this paper, the clinical findings and treatment of eleven cases with pulmonary metastasis from PMP were reviewed, including ten cases in the literature and one case which we experienced. The clinical features of PMP cases with pulmonary metastasis were similar to cases without pulmonary metastasis. The histological type was low-grade mucinous neoplasm in most cases. Pulmonary lesions were resected in seven cases in which abdominal lesions were controlled by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy or another therapeutic modality. Disease-free state was maintained in five cases at the end of the follow-up period. However, it should be noted that rapid progression after resection was seen in two cases, suggesting that biological features may have changed by surgical intervention.

  12. Nitric oxide in cancer metastasis. (United States)

    Cheng, Huiwen; Wang, Lei; Mollica, Molly; Re, Anthony T; Wu, Shiyong; Zuo, Li


    Cancer metastasis is the spread and growth of tumor cells from the original neoplasm to further organs. This review analyzes the role of nitric oxide (NO), a signaling molecule, in the regulation of cancer formation, progression, and metastasis. The action of NO on cancer relies on multiple factors including cell type, metastasis stage, and organs involved. Various chemotherapy drugs cause cells to release NO, which in turn induces cytotoxic death of breast, liver, and skin tumors. However, NO has also been clinically connected to a poor cancer prognosis because of its role in angiogenesis and intravasation. This supports the claim that NO can be characterized as both pro-metastatic and anti-metastatic, depending on specific factors. The inhibition of cell proliferation and anti-apoptosis pathways by NO donors has been proposed as a novel therapy to various cancers. Studies suggest that NO-releasing non-steroidal anti-inflammatory drugs act on cancer cells in several ways that may make them ideal for cancer therapy. This review summarizes the biological significance of NO in each step of cancer metastasis, its controversial effects for cancer progression, and its therapeutic potential. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. Maxillofacial metastasis from breast cancer. (United States)

    Namad, Tariq; Benbrahim, Zineb; Najib, Rajae; Mohammed, Afif; Baggar, Soufiane; Bouyahia, Nezar; Arifi, Samia; Mellas, Nawfel


    Metastatic tumors to paranasal sinuses are exclusively rare. In this paper, we report a case of breast carcinoma metastasizing to the right maxilla. The metastasis occurred 5 years after radical mastectomy and presented as a primary sinonasal mass. The diagnosis was confirmed with histopathologic and immunohistochemical examination however the patient died before starting any specific treatment because of tumor bleeding.

  14. Hereditary bone dysplasia with pathological fractures and nodal osteoarthropathy

    Energy Technology Data Exchange (ETDEWEB)

    Arendse, Regan [University of Stellenbosch, Department of Medicine, Tygerberg Hospital, Stellenbosch (South Africa); University of Cape Town, Division of Rheumatology, Groote Schuur Hospital, Cape Town (South Africa); Brink, Paul [University of Stellenbosch, Department of Medicine, Tygerberg Hospital, Stellenbosch (South Africa); Beighton, Peter [University of Cape Town, Division of Human Genetics, Faculty of Health Sciences, Cape Town (South Africa)


    A father and daughter both had multiple pathological fractures and nodal osteoarthropathy. The father, aged 50 years, had at least 20 healed fractures of the axial and appendicular skeleton, sustained by minor trauma over his 50-year lifespan, many of which had been surgically fixed prior to his first presentation to us. Fractures of the clavicles, thoracic cage and long bones of the arms and legs, had healed with malalignment and deformity. Healed fractures were complicated by ankylosis of the cervical vertebrae and both elbows. He also had osteoarthritis of the hands, with exuberant osteophytosis, and profound perceptive deafness. His general health was good, his intellect and facies were normal, and his sclerae were white. The daughter, aged 27 years, had sustained at least seven fractures of the axial and appendicular skeleton following trivial injuries, in distribution similar to those of the father. She had also experienced painful swelling of the fingers, which preceded progressive development of nodal osteoarthropathy. Her hearing was normal. In both individuals, biochemical and immunological investigations yielded normal results. It was not possible for molecular studies to be undertaken. Pedigree data were consistent with autosomal dominant transmission, and this disorder appeared to be a previously undocumented heritable skeletal dysplasia. (orig.)

  15. Exact boundary controllability of nodal profile for quasilinear hyperbolic systems

    CERN Document Server

    Li, Tatsien; Gu, Qilong


    This book provides a comprehensive overview of the exact boundary controllability of nodal profile, a new kind of exact boundary controllability stimulated by some practical applications. This kind of controllability is useful in practice as it does not require any precisely given final state to be attained at a suitable time t=T by means of boundary controls, instead it requires the state to exactly fit any given demand (profile) on one or more nodes after a suitable time t=T by means of boundary controls. In this book we present a general discussion of this kind of controllability for general 1-D first order quasilinear hyperbolic systems and for general 1-D quasilinear wave equations on an interval as well as on a tree-like network using a modular-structure construtive method, suggested in LI Tatsien's monograph "Controllability and Observability for Quasilinear Hyperbolic Systems"(2010), and we establish a complete theory on the local exact boundary controllability of nodal profile for 1-D quasilinear hyp...

  16. Dirac Magnon Nodal Loops in Quasi-2D Quantum Magnets. (United States)

    Owerre, S A


    In this report, we propose a new concept of one-dimensional (1D) closed lines of Dirac magnon nodes in two-dimensional (2D) momentum space of quasi-2D quantum magnetic systems. They are termed "2D Dirac magnon nodal-line loops". We utilize the bilayer honeycomb ferromagnets with intralayer coupling J and interlayer coupling J L , which is realizable in the honeycomb chromium compounds CrX3 (X ≡ Br, Cl, and I). However, our results can also exist in other layered quasi-2D quantum magnetic systems. Here, we show that the magnon bands of the bilayer honeycomb ferromagnets overlap for J L  ≠ 0 and form 1D closed lines of Dirac magnon nodes in 2D momentum space. The 2D Dirac magnon nodal-line loops are topologically protected by inversion and time-reversal symmetry. Furthermore, we show that they are robust against weak Dzyaloshinskii-Moriya interaction Δ DM  < J L and possess chiral magnon edge modes.

  17. [Comparison of HER2 gene status between primary breast cancer and synchronous axillary lymph node metastasis]. (United States)

    Liu, Y Y; Wu, S F; Liang, Z Y; Zeng, X


    To investigate the discordant rate of HER2 gene status between primary breast cancer and synchronous axillary lymph node metastasis. One hundred and fifty cases of primary breast cancer with corresponding synchronous lymph node metastases were collected, including 50 cases of HER2 FISH positive, 50 cases of HER2 FISH negative and 50 cases of HER2 FISH equivocal primary tumors, at Peking Union Medical College Hospital between May 2012 and June 2015. The HER2 gene status in lymph node metastatic tumors was analyzed by FISH, and the discordance of HER2 gene status was identified between primary and metastatic tumors. The incidence of discordant HER2 gene status between primary breast cancer and synchronous lymph node metastasis was 20.67%(31/150). Forty-four FISH positive, 3 FISH equivocal and 3 FISH negative cases were found in the first group of 50 patients with HER2 positive results in primary tumor. Forty seven FISH negative, 3 FISH equivocal cases were discovered in the second group of 50 patients with HER2 negative results in primary tumor. Four FISH positive, 18 FISH negative and 28 equivocal cases were observed in the third group of 50 patients with HER2 equivocal results in primary tumor. The discordance of HER2 gene status between primary tumor and lymph node metastasis in the third group of patients was significantly higher than the other two groups (Pgene status between the primary and lymph node metastatic tumors exists. Patients with lymph node metastasis, simultaneous testing of HER2 status may be performed in both primary breast tumor and its lymph node metastasis. HER2 status of nodal metastatic lesion may be more relevant for guiding anti-HER2 target therapy.

  18. Surgery on motor area metastasis. (United States)

    Rossetto, Marta; Ciccarino, Pietro; Lombardi, Giuseppe; Rolma, Giuseppe; Cecchin, Diego; Della Puppa, Alessandro


    The role of surgery on central area metastasis remains unclear, and outcome data are still controversial. The aim of our study is to analyze the predictive value of clinical and surgical data on motor and functional outcome of patients, taking into account new emerging data on boundary irregularity of brain metastasis. We retrospectively analyzed 47 consecutive patients who underwent surgery assisted by neurophysiologic monitoring for a solitary metastasis in central area between 2010 and 2013. Inclusion criteria were as follows: good functional status (Karnofsky Performance Status (KPS) ≥70), controlled systemic disease, and absence of extra-cranial dissemination. At 1-month follow up, motor and functional outcomes were compared with preoperative clinical status, response to corticosteroids, extent of tumor resection, boundary irregularity, and size of tumor. Gross total resection was achieved in 93.6% of cases. In preoperative symptomatic patients, motor outcome (according to Medical Research Council grading scale) improved in 55.5% and worsened in 16.7%, while functional outcome (according to KPS score) improved in 50% and worsened in 14.2% of cases. No worsening occurred in preoperative asymptomatic patients. Motor outcome resulted to be not correlated with preoperative deficits, tumor volume, or preoperative response to corticosteroid treatment. Remarkably, motor outcome and extent of surgical resection appeared strongly correlated with tumor boundary irregularity (p < 0.05). Surgery with neurophysiologic monitoring on motor area metastasis can improve functional and motor condition in selected patients. Tumor volume does not represent a limit in surgery. The high correlation between clinical outcome, resection rate, and tumor boundary irregularity strengthens a new belief on the infiltrative growing pattern of brain metastasis. Motor function was evaluated according to Medical Research Council grading scale (Ott et al. 2014) while functional status was

  19. A Melanoma Lymph Node Metastasis with a Donor-Patient Hybrid Genome following Bone Marrow Transplantation: A Second Case of Leucocyte-Tumor Cell Hybridization in Cancer Metastasis. (United States)

    LaBerge, Greggory S; Duvall, Eric; Grasmick, Zachary; Haedicke, Kay; Pawelek, John


    Metastatic disease is the principal cause of mortality in cancer, yet the underlying mechanisms are not fully understood. Macrophage-cancer cell fusion as a cause of metastasis was proposed more than a century ago by German pathologist Prof. Otto Aichel. Since then this theory has been confirmed in numerous animal studies and recently in a patient with metastatic melanoma. Here we analyzed tumor DNA from a 51-year-old man who, 8 years following an allogeneic BMT from his brother for treatment of chronic myelogenous leukemia (CML), developed a nodular malignant melanoma on the upper back with spread to an axillary sentinal lymph node. We used laser microdissection to isolate FFPE tumor cells free of leucocytes. They were genotyped using forensic short tandem repeat (STR) length-polymorphisms to distinguish donor and patient genomes. Tumor and pre-transplant blood lymphocyte DNAs were analyzed for donor and patient alleles at 15 autosomal STR loci and the sex chromosomes. DNA analysis of the primary melanoma and the nodal metastasis exhibit alleles at each STR locus that are consistent with both the patient and donor. The doses vary between these samples indicative of the relative amounts of genomic DNA derived from the patient and donor. The evidence supports fusion and hybridization between donor and patient cells as the initiator of metastasis in this patient. That this phenomenon has now been seen in a second case suggests that fusion is likely to play a significant role for melanoma and other solid tumor metastasis, perhaps leading to new avenues of treatment for this most problematic disease.

  20. Undertreatment of patients with localized extranodal compared with nodal diffuse large B-cell lymphoma

    NARCIS (Netherlands)

    Kuper-Hommel, M.J.; Schans, S.A. van de; Vreugdenhil, G.; Krieken, J.H.J.M. van; Coebergh, J.W.W.


    Abstract Population-based studies analyzing clinical implications of nodal versus extranodal (EN) presentation of diffuse large B-cell lymphoma (DLBCL) are scarce. We studied clinical differences and trends in incidence, treatment and survival of nodal and EN DLBCL in a population-based cohort. All

  1. LOLA SYSTEM: A code block for nodal PWR simulation. Part. I - Simula-3 Code

    Energy Technology Data Exchange (ETDEWEB)

    Aragones, J. M.; Ahnert, C.; Gomez Santamaria, J.; Rodriguez Olabarria, I.


    Description of the theory and users manual of the SIMULA-3 code, which is part of the core calculation system by nodal theory in one group, called LOLA SYSTEM. SIMULA-3 is the main module of the system, it uses a modified nodal theory, with interface leakages equivalent to the diffusion theory. (Author) 4 refs.

  2. Paediatric nodal marginal zone B cell lymphadenopathy of the neck : a Haemophilus influenzae driven immune disorder?

    NARCIS (Netherlands)

    Kluin, Philip M.; Langerak, Anton W.; Beverdam-Vincent, Jannetta; Geurts-Giele, Willemina R. R.; Visser, Lydia; Rutgers, Bea; Schuuring, Ed; Van Baarlen, Joop; Lam, King H.; Seldenrijk, Kees; Kibbelaar, Robby E.; de Wit, Peter; Diepstra, Arjan; Rosati, Stefano; van Noesel, Max M.; Zwaan, C. Michel; Hunting, Jarmo C. B.; Hoogendoorn, Mels; van der Gaag, Ellen J.; van Esser, Joost W. J.; de Bont, Eveline; Kluin-Nelemans, Hanneke C.; Winter, Rik H.; Lo ten Foe, Jerome R.; van der Zanden, Adri G. M.

    Many hyperplasias and lymphomas of marginal zone B-cells are associated with infection. We identified 6 children and 1 adolescent with cervical lymphadenopathy showing a prominent polyclonal nodal marginal zone hyperplasia (pNMZH) and 4 adolescents with monoclonal paediatric nodal marginal zone

  3. Preoperative axillary lymph node evaluation in breast cancer patients by breast magnetic resonance imaging (MRI): Can breast MRI exclude advanced nodal disease?

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, Su Jeong [Yonsei University College of Medicine, Department of Radiology, Breast Cancer Clinic, Severance Hospital, Research Institute of Radiological Science, Seoul (Korea, Republic of); Hallym University Medical Center, Department of Radiology, Kangnam Sacred Heart Hospital, Seoul (Korea, Republic of); Kim, Eun-Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Kim, Min Jung [Yonsei University College of Medicine, Department of Radiology, Breast Cancer Clinic, Severance Hospital, Research Institute of Radiological Science, Seoul (Korea, Republic of)


    To evaluate the diagnostic performance of breast magnetic resonance imaging (MRI) in preoperative evaluation of axillary lymph node metastasis (ALNM) in breast cancer patients and to assess whether breast MRI can be used to exclude advanced nodal disease. A total of 425 patients were included in this study and breast MRI findings were retrospectively reviewed. The diagnostic performance of breast MRI for diagnosis of ALNM was evaluated in all patients, patients with neoadjuvant chemotherapy (NAC), and those without NAC (no-NAC). We evaluated whether negative MRI findings (cN0) can exclude advanced nodal disease (pN2-pN3) using the negative predictive value (NPV) in each group. The sensitivity and NPV of breast MRI in evaluation of ALNM was 51.3 % (60/117) and 83.3 % (284/341), respectively. For cN0 cases on MRI, pN2-pN3 manifested in 1.8 % (6/341) of the overall patients, 0.4 % (1/257) of the no-NAC group, and 6 % (5/84) of the NAC group. The NPV of negative MRI findings for exclusion of pN2-pN3 was higher for the no-NAC group than for the NAC group (99.6 % vs. 94.0 %, p = 0.039). Negative MRI findings (cN0) can exclude the presence of advanced nodal disease with an NPV of 99.6 % in the no-NAC group. (orig.)

  4. Breast Cancer Metastasis to Pituitary Infandibulum

    Directory of Open Access Journals (Sweden)

    Maryam Poursadegh Fard


    Full Text Available Metastasis from breast cancer to other parts of the body is very common, but the spread of the tumor to pituitary gland, especially to infandibulum, is a rare presentation. At the time of pituitary metastasis, a majority of the patients have clinical and radiological evidence of the disease. It seems that the posterior area of the gland is the most common site of metastasis, probably due to highly rich blood supply through the hypophyseal artery. The present report introduces a case of a 55-years-old woman presented with diabetes insipidus resulting from metastasis of the tumor to pituitary infandibulum, which is a rare site for metastasis, without significant complaint resulting from metastasis to other part of the body, or other primary diseases. Further evaluation revealed that in spite of previous reports, which metastasis usually happens in end stage of cancer, the patients had primary breast cancer. In subsequent evaluations of the case, hypofunction of adenohypophysis was also detected

  5. Nodal signaling from the visceral endoderm is required to maintain Nodal gene expression in the epiblast and drive DVE/AVE migration. (United States)

    Kumar, Amit; Lualdi, Margaret; Lyozin, George T; Sharma, Prashant; Loncarek, Jadranka; Fu, Xin-Yuan; Kuehn, Michael R


    In the early mouse embryo, a specialized population of extraembryonic visceral endoderm (VE) cells called the distal VE (DVE) arises at the tip of the egg cylinder stage embryo and then asymmetrically migrates to the prospective anterior, recruiting additional distal cells. Upon migration these cells, called the anterior VE (AVE), establish the anterior posterior (AP) axis by restricting gastrulation-inducing signals to the opposite pole. The Nodal-signaling pathway has been shown to have a critical role in the generation and migration of the DVE/AVE. The Nodal gene is expressed in both the VE and in the pluripotent epiblast, which gives rise to the germ layers. Previous findings have provided conflicting evidence as to the relative importance of Nodal signaling from the epiblast vs. VE for AP patterning. Here we show that conditional mutagenesis of the Nodal gene specifically within the VE leads to reduced Nodal expression levels in the epiblast and incomplete or failed DVE/AVE migration. These results support a required role for VE Nodal to maintain normal levels of expression in the epiblast, and suggest signaling from both VE and epiblast is important for DVE/AVE migration. Published by Elsevier Inc.

  6. An Unusual Metastasis of a Transglottic Squamous Cell Carcinoma to the Forearm

    Directory of Open Access Journals (Sweden)

    Abdullah Dafir Albeyatti


    Full Text Available Introduction. Each year around 2,200 people in the UK are diagnosed with laryngeal SCC (Office of National Statistics 2009. Compared to pharyngeal carcinoma, it is a highly curable disease with a survival rate of around 60% for all stages and all forms of treatment. Case Presentation. We present the case of a 60-year-old man with a previously treated T4 N2c transglottic squamous cell carcinoma (SCC, who developed an isolated swelling in the extensor compartment of his right forearm at 6 months after radical laryngectomy with bilateral neck dissection. Fine needle aspiration of the forearm lesion revealed SCC consistent with a metastasis from the laryngeal primary. MRI revealed that the lesion was confined to the muscle. Initial staging CT showed no distant metastases or signs of advanced disease, including no evidence of axillary nodal involvement. Conclusion. This case is therefore unusual, as one of only 2 cases reported in the scientific literature of isolated distant muscular metastasis from a laryngeal squamous cell carcinoma. We conclude that any muscular swelling, in the setting of previous head and neck malignancy, should be treated with a high degree of suspicion for metastasis and investigated promptly.

  7. Opposing nodal and BMP signals regulate left-right asymmetry in the sea urchin larva.

    Directory of Open Access Journals (Sweden)

    Yi-Jyun Luo

    Full Text Available Nodal and BMP signals are important for establishing left-right (LR asymmetry in vertebrates. In sea urchins, Nodal signaling prevents the formation of the rudiment on the right side. However, the opposing pathway to Nodal signaling during LR axis establishment is not clear. Here, we revealed that BMP signaling is activated in the left coelomic pouch, specifically in the veg2 lineage, but not in the small micromeres. By perturbing BMP activities, we demonstrated that BMP signaling is required for activating the expression of the left-sided genes and the formation of the left-sided structures. On the other hand, Nodal signals on the right side inhibit BMP signaling and control LR asymmetric separation and apoptosis of the small micromeres. Our findings show that BMP signaling is the positive signal for left-sided development in sea urchins, suggesting that the opposing roles of Nodal and BMP signals in establishing LR asymmetry are conserved in deuterostomes.

  8. Dual atrioventricular nodal pathways physiology: a review of relevant anatomy, electrophysiology, and electrocardiographic manifestations. (United States)

    Mani, Bhalaghuru Chokkalingam; Pavri, Behzad B


    More than half a century has passed since the concept of dual atrioventricular (AV) nodal pathways physiology was conceived. Dual AV nodal pathways have been shown to be responsible for many clinical arrhythmia syndromes, most notably AV nodal reentrant tachycardia. Although there has been a considerable amount of research on this topic, the subject of dual AV nodal pathways physiology remains heavily debated and discussed. Despite advances in understanding arrhythmia mechanisms and the widespread use of invasive electrophysiologic studies, there is still disagreement on the anatomy and physiology of the AV node that is the basis of discontinuous antegrade AV conduction. The purpose of this paper is to review the concept of dual AV nodal pathways physiology and its varied electrocardiographic manifestations.

  9. Dual Atrioventricular Nodal Pathways Physiology: A Review of Relevant Anatomy, Electrophysiology, and Electrocardiographic Manifestations

    Directory of Open Access Journals (Sweden)

    Bhalaghuru Chokkalingam Mani, MD


    Full Text Available More than half a century has passed since the concept of dual atrioventricular (AV nodal pathways physiology was conceived. Dual AV nodal pathways have been shown to be responsible for many clinical arrhythmia syndromes, most notably AV nodal reentrant tachycardia. Although there has been a considerable amount of research on this topic, the subject of dual AV nodal pathways physiology remains heavily debated and discussed. Despite advances in understanding arrhythmia mechanisms and the widespread use of invasive electrophysiologic studies, there is still disagreement on the anatomy and physiology of the AV node that is the basis of discontinuous antegrade AV conduction. The purpose of this paper is to review the concept of dual AV nodal pathways physiology and its varied electrocardiographic manifestations.

  10. Computation of nodal surfaces in fixed-node diffusion Monte Carlo calculations using a genetic algorithm. (United States)

    Ramilowski, Jordan A; Farrelly, David


    The fixed-node diffusion Monte Carlo (DMC) algorithm is a powerful way of computing excited state energies in a remarkably diverse number of contexts in quantum chemistry and physics. The main difficulty in implementing the procedure lies in obtaining a good estimate of the nodal surface of the excited state in question. Although the nodal surface can sometimes be obtained from symmetry or by making approximations this is not always the case. In any event, nodal surfaces are usually obtained in an ad hoc way. In fact, the search for nodal surfaces can be formulated as an optimization problem within the DMC procedure itself. Here we investigate the use of a genetic algorithm to systematically and automatically compute nodal surfaces. Application is made to the computation of excited states of the HCN-(4)He complex and to the computation of tunneling splittings in the hydrogen bonded HCl-HCl complex.

  11. PPFIA1 is upregulated in liver metastasis of breast cancer and is a potential poor prognostic indicator of metastatic relapse. (United States)

    Yang, Jing; Wu, Ning-Ni; Huang, De-Jia; Luo, Yao-Chang; Huang, Jun-Zhen; He, Hai-Yuan; Lu, Hai-Lin; Song, Wen-Ling


    Although the oncogenic role of PPFIA1 (liprin-α1) in breast cancer has been reported, whether its dysregulation is associated with metastasis risk or survival outcomes in breast cancer patients is not clear. Our primary data showed that PPFIA1 expression was significantly higher in liver metastatic breast tumors than in the primary tumors. Then, we tried to pool previous annotated genomic data to assess the prognostic value of PPFIA1 in distant metastasis-free survival, the risk of metastatic relapse, and metastatic relapse-free survival in breast cancer patients by data mining in two large databases, Kaplan-Meier plotter and bc-GenExMiner 4.0. Results from Kaplan-Meier plotter showed that although high PPFIA1 expression was generally associated with decreased distant metastasis-free survival in estrogen receptor+ patients, subgroup analysis only confirmed significant association in estrogen receptor+/N- (nodal negative) group (median survival, high PPFIA1 group vs low PPFIA1 cohort: 191.21 vs 236.22 months; hazard ratio: 2.23, 95% confidence interval: 1.42-3.5, p metastasis-free survival, no matter in Nm (nodal status mixed), N-, or N+ subgroups. In bc-GenExMiner 4.0, Nottingham Prognostic Index- and Adjuvant! Online-adjusted analysis validated the independent prognostic value of PPFIA1 in metastatic risks in estrogen receptor+/N- patients. Based on these findings, we infer that high PPFIA1 expression might be an independent prognostic indicator of increased metastatic relapse risk in patients with estrogen receptor+/N- breast cancer, but not in estrogen receptor+/N+ or estrogen receptor- patients.

  12. Improving the Accuracy of High-Order Nodal Transport Methods

    Energy Technology Data Exchange (ETDEWEB)

    Azmy, Y.Y.; Buscaglia, G.C.; Zamonsky, O.M.


    This paper outlines some recent advances towards improving the accuracy of neutron transport calculations using the Arbitrarily High Order Transport-Nodal (AHOT-N) Method. These advances consist of several contributions: (a) A formula for the spatial weights that allows for the polynomial order to be raised arbitrarily high without suffering adverse effects from round-off error; (b) A reconstruction technique for the angular flux, based upon a recursive formula, that reduces the pointwise error by one ordeq (c) An a posterior error indicator that estimates the true error and its distribution throughout the domain, so that it can be used for adaptively refining the approximation. Present results are mainly for ID, extension to 2D-3D is in progress.

  13. Improving the Accuracy of High-Order Nodal Transport Methods

    Energy Technology Data Exchange (ETDEWEB)

    Azmy, Y.Y.; Buscaglia, G.C.; Zamonsky, O.M.


    This paper outlines some recent advances towards improving the accuracy of neutron calculations using the Arbitrarily High Order Transport-Nodal (AHOT-N) Method. These transport advances consist of several contributions: (a) A formula for the spatial weights that allows for the polynomial order to be raised arbitrarily high without suffering from pollution from round-off, error; (b) A reconstruction technique for the angular flux, based upon a recursive formula, that reduces the pointwise error by one order; (c) An a posterior error indicator that estimates the true error and its distribution throughout the domain, so that it can be used for adaptively reftig the approximation. Present results are mainly for ID, extension to 2D-3D is in progress.

  14. A nonlinear analytic function expansion nodal method for transient calculations

    Energy Technology Data Exchange (ETDEWEB)

    Joo, Han Gyn; Park, Sang Yoon; Cho, Byung Oh; Zee, Sung Quun [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)


    The nonlinear analytic function expansion nodal (AFEN) method is applied to the solution of the time-dependent neutron diffusion equation. Since the AFEN method requires both the particular solution and the homogeneous solution to the transient fixed source problem, the derivation of the solution method is focused on finding the particular solution efficiently. To avoid complicated particular solutions, the source distribution is approximated by quadratic polynomials and the transient source is constructed such that the error due to the quadratic approximation is minimized, In addition, this paper presents a new two-node solution scheme that is derived by imposing the constraint of current continuity at the interface corner points. The method is verified through a series of application to the NEACRP PWR rod ejection benchmark problems. 6 refs., 2 figs., 1 tab. (Author)

  15. Animal Models of Bone Metastasis (United States)

    Simmons, J. K.; Hildreth, B. E.; Supsavhad, W.; Elshafae, S. M.; Hassan, B. B.; Dirksen, W. P.; Toribio, R. E.; Rosol, T. J.


    Bone is one of the most common sites of cancer metastasis in humans and is a significant source of morbidity and mortality. Bone metastases are considered incurable and result in pain, pathologic fracture, and decreased quality of life. Animal models of skeletal metastases are essential to improve the understanding of the molecular pathways of cancer metastasis and growth in bone and to develop new therapies to inhibit and prevent bone metastases. The ideal animal model should be clinically relevant, reproducible, and representative of human disease. Currently, an ideal model does not exist; however, understanding the strengths and weaknesses of the available models will lead to proper study design and successful cancer research. This review provides an overview of the current in vivo animal models used in the study of skeletal metastases or local tumor invasion into bone and focuses on mammary and prostate cancer, lymphoma, multiple myeloma, head and neck squamous cell carcinoma, and miscellaneous tumors that metastasize to bone. PMID:26021553

  16. Pericytes limit tumor cell metastasis

    DEFF Research Database (Denmark)

    Xian, Xiaojie; Håkansson, Joakim; Ståhlberg, Anders


    Previously we observed that neural cell adhesion molecule (NCAM) deficiency in beta tumor cells facilitates metastasis into distant organs and local lymph nodes. Here, we show that NCAM-deficient beta cell tumors grew leaky blood vessels with perturbed pericyte-endothelial cell-cell interactions...... the microvessel wall. To directly address whether pericyte dysfunction increases the metastatic potential of solid tumors, we studied beta cell tumorigenesis in primary pericyte-deficient Pdgfb(ret/ret) mice. This resulted in beta tumor cell metastases in distant organs and local lymph nodes, demonstrating a role...... and deficient perivascular deposition of ECM components. Conversely, tumor cell expression of NCAM in a fibrosarcoma model (T241) improved pericyte recruitment and increased perivascular deposition of ECM molecules. Together, these findings suggest that NCAM may limit tumor cell metastasis by stabilizing...

  17. Nodal wear model: corrosion in carbon blast furnace hearths

    Directory of Open Access Journals (Sweden)

    Verdeja, L. F.


    Full Text Available Criterions developed for the Nodal Wear Model (NWM were applied to estimate the shape of the corrosion profiles that a blast furnace hearth may acquire during its campaign. Taking into account design of the hearth, the boundary conditions, the characteristics of the refractory materials used and the operation conditions of the blast furnace, simulation of wear profiles with central well, mushroom and elephant foot shape were accomplished. The foundations of the NWM are constructed considering that the corrosion of the refractory is a function of the temperature present at each point (node of the liquid metal-refractory interface and the corresponding physical and chemical characteristics of the corrosive fluid.

    Se aplican los criterios del Modelo de Desgaste Nodal (MDN para la estimación de los perfiles de corrosión que podría ir adquiriendo el crisol de un homo alto durante su campaña. Atendiendo al propio diseño del crisol, a las condiciones límites de contorno, a las características del material refractario utilizado y a las condiciones de operación del horno, se consiguen simular perfiles de desgaste con "pozo central", con "forma de seta" ó de "pie de elefante". Los fundamentos del MDN se apoyan en la idea de considerar que la corrosión del refractario es función de la temperatura que el sistema pueda presentar en cada punto (nodo de la intercara refractario-fundido y de las correspondientes características físico-químicas del fluido corrosivo.

  18. Raman spectroscopy of bone metastasis (United States)

    Esmonde-White, Karen A.; Sottnik, Joseph; Morris, Michael; Keller, Evan


    Raman spectroscopy of bone has been used to characterize chemical changes occurring in diseases such as osteoporosis, osteoarthritis and osteomyelitis. Metastasis of cancer into bone causes changes to bone quality that are similar to those observed in osteoporosis, such as decreased bone strength, but with an accelerated timeframe. In particular, osteolytic (bone degrading) lesions in bone metastasis have a marked effect on patient quality of life because of increased risk of fractures, pain, and hypercalcemia. We use Raman spectroscopy to examine bone from two different mouse models of osteolytic bone metastasis. Raman spectroscopy measures physicochemical information which cannot be obtained through standard biochemical and histological measurements. This study was reviewed and approved by the University of Michigan University Committee on the Care and Use of Animals. Two mouse models of prostate cancer bone metastasis, RM1 (n=3) and PC3-luc (n=4) were examined. Tibiae were injected with RM1 or PC3-luc cancer cells, while the contralateral tibiae received a placebo injection for use as controls. After 2 weeks of incubation, the mice were sacrificed and the tibiae were examined by Raman microspectroscopy (λ=785 nm). Spectroscopic markers corresponding to mineral stoichiometry, bone mineralization, and mineral crystallinity were compared in spectra from the cancerous and control tibiae. X-ray imaging of the tibia confirmed extensive osteolysis in the RM1 mice, with tumor invasion into adjoining soft tissue and moderate osteolysis in the PC3-luc mice. Raman spectroscopic markers indicate that osteolytic lesions are less mineralized than normal bone tissue, with an altered mineral stoichiometry and crystallinity.

  19. Cutaneous Metastasis From Sacral Chordoma. (United States)

    Gleghorn, Kristyna; Goodwin, Brandon; Sanchez, Ramon


    Chordoma is a rare primary bone malignancy of notochord origin, representing 1-4% of malignant bone tumors., Typically, chordomas follow a slow progressive course with aggressive local extension, multiple recurrences, and metastases. Of particular interest to this case, cutaneous metastasis is exceedingly rare. Diagnosis of this entity can be a challenge due to the rarity of chordoma, as well as the infrequent presentation of distant cutaneous metastasis and non-specific clinical skin findings. We report a case of a 61-year-old male with a history of sacral chordoma treated by wide local excision 8 years prior to presentation developed a nodule on his scalp for 6 weeks. Physical examination revealed a 1 cm rubbery, pink, shiny dome-shaped nodule on his left occipital scalp. Hematoxylin and eosin sections revealed a lobular dermal proliferation of small ovoid cells and larger physaliferous cells with hyperchromatic, displaced nuclei and finely vacuolated "soap-bubble" cytoplasm in a myxoid stroma. Immunohistochemistry of tumor cells showed positivity for both S-100 protein and pancytokeratin (AE1/AE3), while smooth muscle actin (SMA), P63, and CK7 were negative. Additionally, tumor cells stained positive for brachyury. The medical history, clinical presentation, histopathological appearance and immunohistochemical profile are consistent with cutaneous metastasis from sacral chordoma, known as chordoma cutis. This case illustrates the integral role of dermatopathology in the diagnosis of a rare and critical condition.

  20. Mitochondrial dysfunction and cancer metastasis. (United States)

    Chen, Emily I


    Mitochondria have an essential role in powering cells by generating ATP following the metabolism of pyruvate derived from glycolysis. They are also the major source of generating reactive oxygen species (ROS), which have regulatory roles in cell death and proliferation. Mutations in mitochondrial DNA (mtDNA) and dysregulation of mitochondrial metabolism have been frequently described in human tumors. Although the role of oxidative stress as the consequence of mtDNA mutations and/or altered mitochondrial functions has been demonstrated in carciongenesis, a causative role of mitochondria in tumor progression has only been demonstrated recently. Specifically, the subject of this mini-review focuses on the role of mitochondria in promoting cancer metastasis. Cancer relapse and the subsequent spreading of cancer cells to distal sites are leading causes of morbidity and mortality in cancer patients. Despite its clinical importance, the underlying mechanisms of metastasis remain to be elucidated. Recently, it was demonstrated that mitochondrial oxidative stress could actively promote tumor progression and increase the metastatic potential of cancer cells. The purpose of this mini-review is to summarize current investigations of the roles of mitochondria in cancer metastasis. Future development of diagnostic and therapeutic strategies for patients with advanced cancer will benefit from the new knowledge of mitochondrial metabolism in epithelial cancer cells and the tumor stroma.

  1. [The management of bone metastasis]. (United States)

    Bonetto, Rémi; Tallet, Agnès; Mélot, Anthony; Calderon, Benoît; Barlesi, Fabrice


    Bone metastasis are the most common cause of pain related to cancer, reducing patients' quality of life, and sometimes threatening their life-expectancy. Their management has to be pluridisciplinary, because of all the therapeutic options and the diversity of bone metastasis locations. The aim of this work is to propose a rational decisional algorithm for the treatment strategy of these secondary locations. Anti-resorbtive drugs with systemic action, surgery, conventional or stereotactic radiation therapy, and new techniques of interventional radiology are options that could be used separately or combined. They have shown benefits on symptomatic treatment, improving quality of life. Their indications vary according to the tumor site (short vs. long bones, carrier vs. non-carrier bones), the symptomatology (pain, neurologic symptoms), and the presence of complications (most of all fractures). The diverse presentations lead us to define this decisional algorithm, to guide the practice, while giving the maximal benefit to each patient according to each metastasis. Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  2. Metastasis: an early event in cancer progression. (United States)

    Hu, Yijun; Yu, Xiya; Xu, Guixia; Liu, Shanrong


    Metastasis is the leading cause of death for a majority of cancer patients, and thus the need to understand the biology of metastasis becomes increasingly acute. When metastasis is initiated in tumor progression remains obscure. Better understanding of mechanisms regulating acquisition of metastatic ability in tumor cells will provide novel therapeutic targets and prevention of metastasis in clinics accompanied with the treatment of the primary tumor might be helpful in reducing metastasis-related mortality. A literature search was performed in multiple electronic databases. Research papers from clinical reports to experimental studies on metastasis were analyzed. The article discusses tumor heterogeneity and genomic instability in the context of metastasis and tumor cell dissemination. And then we review biological mechanism of metastasis at an early stage in both intracellular (CSCs and CTCs) and extracellular (microenvironment) context. Finally, current development of anti-metastatic therapies is summarized. Metastasis could be initiated at an early point of tumor progression. Therefore, early intervention on metastasis should be applied among cancer patients in clinical settings.

  3. Reactivation of Embryonic Nodal Signaling is Associated with Tumor Progression and Promotes the Growth of Prostate Cancer Cells (United States)

    Lawrence, Mitchell G.; Margaryan, Naira V.; Loessner, Daniela; Collins, Angus; Kerr, Kris M.; Turner, Megan; Seftor, Elisabeth A.; Stephens, Carson R.; Lai, John; BioResource, APC; Postovit, Lynne-Marie; Clements, Judith A.; Hendrix, Mary J.C.


    Background Nodal is a member of the Transforming Growth Factor β (TGFβ) superfamily that directs embryonic patterning and promotes the plasticity and tumorigenicity of tumor cells, but its role in the prostate is unknown. The goal of this study was to characterize the expression and function of Nodal in prostate cancer and determine whether, like other TGFβ ligands, it modulates androgen receptor (AR) activity. Methods Nodal expression was investigated using immunohistochemistry of tissue microarrays and Western blots of prostate cell lines. The functional role of Nodal was examined using Matrigel and soft agar growth assays. Cross-talk between Nodal and AR signaling was assessed with luciferase reporter assays and expression of endogenous androgen regulated genes. Results Significantly increased Nodal expression was observed in cancer compared with benign prostate specimens. Nodal was only expressed by DU145 and PC3 cells. All cell lines expressed Nodal’s co-receptor, Cripto-1, but lacked Lefty, a critical negative regulator of Nodal signaling. Recombinant human Nodal triggered downstream Smad2 phosphorylation in DU145 and LNCaP cells, and stable transfection of pre-pro-Nodal enhanced the growth of LNCaP cells in Matrigel and soft agar. Finally, Nodal attenuated AR signaling, reducing the activity of a PSA promoter construct in luciferase assays and down-regulating the endogenous expression of androgen regulated genes. Conclusions An aberrant Nodal signaling pathway is re-expressed and functionally active in prostate cancer cells. PMID:21656830

  4. Characterization of the nodal slow pathway in patients with nodal reentrant tachycardia: clinical implications for guiding ablation. (United States)

    Jauregui-Abularach, Miguel E; Bazan, Victor; Martí-Almor, Julio; Cian, Debora; Vallès, Ermengol; Benito, Begoña; Meroño, Oona; Bruguera-Cortada, Jordi


    Nodal slow pathway ablation is the treatment of choice for nodal reentrant tachycardia. No demographic, anatomic, or electrophysiologic variables have been reported to predict an exact location of the slow pathway in the atrioventricular node or its proximity to the fast pathway. The purpose of this study was to analyze these variables. The study prospectively included 54 patients (17 men; mean age, 55 [16] years) who had undergone successful slow pathway ablation. The refractory periods of both pathways and their differential conduction time were measured, and calculations were performed to obtain the distance from the His-bundle region (location of the fast pathway) to the coronary sinus ostium (to estimate the anteroposterior length of the triangle of Koch) and to the slow pathway area. The differential conduction time (139 [98] ms) did not correlate with the His-coronary sinus distance (19 [6] mm; P=.6) or the His-slow pathway distance (14 [4] mm; P=.4). When the His-coronary sinus distance was larger, the His-slow pathway distance was also larger (r=0.652; P<.01) and the anatomic correlation between the triangle dimensions and the separation between the two pathways was confirmed. In patients older than 70 years, smaller triangle sizes and a shorter distance between both pathways were observed (P<.001). A greater anteroposterior dimension of the triangle of Koch is associated with a slow-pathway location farther from the fast pathway. In elderly patients the two pathways are closer together (higher risk of atrioventricular block). Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  5. Type-I and type-II topological nodal superconductors with s -wave interaction (United States)

    Huang, Beibing; Yang, Xiaosen; Xu, Ning; Gong, Ming


    Topological nodal superconductors with protected gapless points in momentum space are generally realized based on unconventional pairings. In this work we propose a minimal model to realize these topological nodal phases with only s -wave interaction. In our model the linear and quadratic spin-orbit couplings along the two orthogonal directions introduce anisotropic effective unconventional pairings in momentum space. This model may support different nodal superconducting phases characterized by either an integer winding number in BDI class or a Z2 index in D class at the particle-hole invariant axes. In the vicinity of the nodal points the effective Hamiltonian can be described by either type-I or type-II Dirac equations, and the Lifshitz transition from type-I nodal phases to type-II nodal phases can be driven by external in-plane magnetic fields. We show that these nodal phases are robust against weak impurities, which only slightly renormalizes the momentum-independent parameters in the impurity-averaged Hamiltonian, thus these phases are possible to be realized in experiments with real semi-Dirac materials. The smoking-gun evidences to verify these phases based on scanning tunneling spectroscopy method are also briefly discussed.

  6. Carcinoma of Gall bladder with distant metastasis to breast parenchyma. Report of a case and review of literature. (United States)

    Kumaran, Damodara; Anamalai, Manikandan; Velu, Umesh; Nambirajan, Aruna; Julka, Pramod Kumar


    Gall bladder carcinoma is one of the most common cancers in India. Gall bladder cancer with metastasis to the breast is very rare. Herein we intend to report a case of carcinoma gall bladder with breast metastasis and a short review of the literature. This report describes an interesting and unusual case of gall bladder carcinoma presenting with breast metastasis. A 38-year lady presented with complaints of right abdominal pain. Bilateral breast examination showed 2×2cm palpable lump in the upper outer quadrant of the left breast. Contrast-enhanced CT of the abdomen and pelvis showed circumferential thickening of gall bladder with the loss of fat plane with the adjacent liver parenchyma. Biopsy from the breast lump was reported as metastatic adenocarcinoma compatible with primary in the gall bladder. Whole body PET-CT showed gall bladder mass with abdominal and pelvic nodes with metastasis to liver, left breast, C7 vertebral body and left supra-clavicular node. She was diagnosed to have disseminated carcinoma gall bladder with liver, breast and supraclavicular nodal metastasis. She received palliative chemotherapy with gemcitabine and carboplatin and radiotherapy to C7 vertebra. After receiving 3 cycles of chemotherapy, chemotherapy was changed to the second line with single agent capecitabine. In spite of two lines of chemotherapy, she succumbed to disease progression and expired. There are limited examples of gall bladder adenocarcinoma with simultaneous metastasis to breast in the English literature. Our case showed an unusual dissemination of gall bladder cancer. Copyright © 2016 National Cancer Institute, Cairo University. Production and hosting by Elsevier B.V. All rights reserved.

  7. Cerberus-Nodal-Lefty-Pitx signaling cascade controls left-right asymmetry in amphioxus. (United States)

    Li, Guang; Liu, Xian; Xing, Chaofan; Zhang, Huayang; Shimeld, Sebastian M; Wang, Yiquan


    Many bilaterally symmetrical animals develop genetically programmed left-right asymmetries. In vertebrates, this process is under the control of Nodal signaling, which is restricted to the left side by Nodal antagonists Cerberus and Lefty. Amphioxus, the earliest diverging chordate lineage, has profound left-right asymmetry as a larva. We show that Cerberus , Nodal , Lefty , and their target transcription factor Pitx are sequentially activated in amphioxus embryos. We then address their function by transcription activator-like effector nucleases (TALEN)-based knockout and heat-shock promoter (HSP)-driven overexpression. Knockout of Cerberus leads to ectopic right-sided expression of Nodal , Lefty , and Pitx , whereas overexpression of Cerberus represses their left-sided expression. Overexpression of Nodal in turn represses Cerberus and activates Lefty and Pitx ectopically on the right side. We also show Lefty represses Nodal , whereas Pitx activates Nodal These data combine in a model in which Cerberus determines whether the left-sided gene expression cassette is activated or repressed. These regulatory steps are essential for normal left-right asymmetry to develop, as when they are disrupted embryos may instead form two phenotypic left sides or two phenotypic right sides. Our study shows the regulatory cassette controlling left-right asymmetry was in place in the ancestor of amphioxus and vertebrates. This includes the Nodal inhibitors Cerberus and Lefty, both of which operate in feedback loops with Nodal and combine to establish asymmetric Pitx expression. Cerberus and Lefty are missing from most invertebrate lineages, marking this mechanism as an innovation in the lineage leading to modern chordates.

  8. Nodal-Dependent Mesendoderm Specification Requires the Combinatorial Activities of FoxH1 and Eomesodermin (United States)

    Slagle, Christopher E.; Aoki, Tsutomu; Burdine, Rebecca D.


    Vertebrate mesendoderm specification requires the Nodal signaling pathway and its transcriptional effector FoxH1. However, loss of FoxH1 in several species does not reliably cause the full range of loss-of-Nodal phenotypes, indicating that Nodal signals through additional transcription factors during early development. We investigated the FoxH1-dependent and -independent roles of Nodal signaling during mesendoderm patterning using a novel recessive zebrafish FoxH1 mutation called midway, which produces a C-terminally truncated FoxH1 protein lacking the Smad-interaction domain but retaining DNA–binding capability. Using a combination of gel shift assays, Nodal overexpression experiments, and genetic epistasis analyses, we demonstrate that midway more accurately represents a complete loss of FoxH1-dependent Nodal signaling than the existing zebrafish FoxH1 mutant schmalspur. Maternal-zygotic midway mutants lack notochords, in agreement with FoxH1 loss in other organisms, but retain near wild-type expression of markers of endoderm and various nonaxial mesoderm fates, including paraxial and intermediate mesoderm and blood precursors. We found that the activity of the T-box transcription factor Eomesodermin accounts for specification of these tissues in midway embryos. Inhibition of Eomesodermin in midway mutants severely reduces the specification of these tissues and effectively phenocopies the defects seen upon complete loss of Nodal signaling. Our results indicate that the specific combinations of transcription factors available for signal transduction play critical and separable roles in determining Nodal pathway output during mesendoderm patterning. Our findings also offer novel insights into the co-evolution of the Nodal signaling pathway, the notochord specification program, and the chordate branch of the deuterostome family of animals. PMID:21637786

  9. Melanoma metastasis: new concepts and evolving paradigms. (United States)

    Damsky, W E; Theodosakis, N; Bosenberg, M


    Melanoma progression is typically depicted as a linear and stepwise process in which metastasis occurs relatively late in disease progression. Significant evidence suggests that in a subset of melanomas, progression is much more complex and less linear in nature. Epidemiologic and experimental observations in melanoma metastasis are reviewed here and are incorporated into a comprehensive model for melanoma metastasis, which takes into account the varied natural history of melanoma formation and progression.

  10. FGFR-1 amplification in metastatic lymph-nodal and haematogenous lobular breast carcinoma

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    Brunello Eleonora


    Full Text Available Abstract Background Lobular breast carcinoma usually shows poor responsiveness to chemotherapies and often lacks targeted therapies. Since FGFR1 expression has been shown to play pivotal roles in primary breast cancer tumorigenesis, we sought to analyze the status of FGFR1 gene in a metastatic setting of lobular breast carcinoma, since promising FGFR1 inhibitors has been recently developed. Methods Fifteen tissue metastases from lobular breast carcinomas with matched primary infiltrative lobular breast carcinoma were recruited. Eleven cases showed loco-regional lymph-nodal and four haematogenous metastases. FGFR-1 gene (8p12 amplification was evaluated by chromogenic in situ hybridization (CISH analysis. Her-2/neu and topoisomerase-IIα gene status was assessed. E-cadherin and Hercept Test were also performed. We distinguished amplification (>6 or cluster of signals versus gains (3–6 signals of the locus specific FGFR-1 gene. Results Three (20% primary lobular breast carcinomas showed >6 or cluster of FGFR1 signals (amplification, six cases (40% had a mean of three (range 3–6 chromogenic signals (gains whereas in 6 (40% was not observed any abnormality. Three of 15 metastasis (20% were amplified, 2/15 (13,4% did not. The ten remaining cases (66,6% showed three chromogenic signals. The three cases with FGFR-1 amplification matched with those primary breast carcinomas showing FGFR-1 amplification. The six cases showing FGFR-1 gains in the primary tumour again showed FGFR-1 gains in the metastases. Four cases showed gains of FGFR-1 gene signals in the metastases and not in the primary tumours. Her-2/neu gene amplification was not observed in all cases but one (6% case. Topoisomerase-IIα was not amplified in all cases. Conclusions 1 a subset of metastatic lobular breast carcinoma harbors FGFR-1 gene amplification or gains of chromogenic signals; 2 a minor heterogeneity has been observed after matching primary and metastatic carcinomas; 3 in the

  11. Is there a requirement for axillary lymph node dissection following identification of micro-metastasis or isolated tumour cells at sentinel node biopsy for breast cancer?

    LENUS (Irish Health Repository)

    Joyce, D P


    INTRODUCTION: Recent decades have seen a significant shift towards conservative management of the axilla. Increasingly, immunohistochemical analysis of sentinel nodes leads to the detection of small tumour deposits, the significance of which remains uncertain. The aims of this study are to examine patients whose sentinel lymph nodes are positive for macro-metastasis, micro-metastasis or isolated tumour cells (ITCs) and to determine the rate of further nodal disease after axillary lymph node dissection (ALND). METHODS: A retrospective analysis of all patients undergoing a sentinel lymph node biopsy (SLNB) between January 2007 and December 2010 in a tertiary referral breast unit was performed. Patients who underwent an axillary lymph node dissection for macro-metastasis, micro-metastasis or ITCs were identified. Demographics, histological data and the rate of further axillary disease were examined. RESULTS: In total, 664 breast cancer patients attended the symptomatic breast unit during the study period, 360 of whom underwent a SLNB. Seventy patients had a SLNB positive for macro-metastasis. All of these patients underwent ALND. A positive SLNB with either micro-metastasis or ITCs was identified in 58 patients. Only 41 of the 58 patients went on to have an ALND, due primarily to variations in surgeons\\' preferences. Nineteen patients with micro-metastasis underwent an ALND. Four patients had further axillary disease (21%). Twenty-two patients had ITCs identified, of whom only one had further disease (4.5%). No statistically significant difference was found between the two groups in terms of tumour size, grade, lymphovascular invasion or oestrogen receptor status. CONCLUSION: ALND should be considered in patients with micro-metastasis at SLNB. It should rarely be employed in the setting of SLNB positive for ITCs.

  12. Assessment of cervical lymph node metastasis for therapeutic decision-making in squamous cell carcinoma of buccal mucosa: a prospective clinical analysis

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    Essig Harald


    Full Text Available Abstract Background Cervical metastasis has a tremendous impact on the prognosis in patients with carcinomas of the head and neck and the frequency of such spread is greater than 20% for most squamous cell carcinomas. With emerging evidence, focus is shifting to conservative neck procedures aimed at achieving good shoulder function without compromising oncologic safety. The purpose of this study was to analyze the pattern of nodal metastasis in patients presenting with squamous cell carcinoma of buccal mucosa. Materials and methods This was a prospective clinical analysis of patients who were histologically diagnosed with squamous cell carcinoma of the buccal cavity and clinically N1 and had not received treatment anywhere else. Patients were analyzed for age and sex distribution, tumor staging, location, and metastasis. Results The incidence of metastatic lymph node in T4 (n=44 was the highest, that is, level I was 100% (44/44, level II was 43.18% (19/44, level III was 15.90% (7/44, and level IV was 4.5% (2/44. Level V was free of metastasis. Among T3 (n=10 lesions, incidence of metastasis in level I was 100% (10/10, level II was 20% (2/10, and level III, IV, and V were free of metastasis. Among T2 (n=6 lesions, incidence of lymph node metastasis in level I was 100% (6/6 and all other levels of lymph nodes were found free of metastasis. Conclusion Lymphatic spread from carcinoma of the buccal mucosa is low. Involvement of level IV is seen in only 3% of patients. A more conservative approach to the neck in patients with carcinoma of the buccal mucosa is recommended.

  13. Deflection and translation of a ray traversing an optical system, nodal rays and the optical axis

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    W. F. Harris


    Full Text Available Expressions are derived for the deflection and transverse translation of a ray as it traverses an arbitrary optical system.  The system may be astigmatic and have relatively decentred refracting elements.  The expressions are in terms of the fundamental properties of the system.  Because nodal rays are rays that undergo no deflection the results lead immediately to expressions that define nodal rays through the system.  An optical axis of an optical system is a nodal ray that is a straight line through the system.  This allows one to write an expression that determines the optical axis of an arbitrary optical system.

  14. [Method for optimal sensor placement in water distribution systems with nodal demand uncertainties]. (United States)

    Liu, Shu-Ming; Wu, Xue; Ouyang, Le-Yan


    The notion of identification fitness was proposed for optimizing sensor placement in water distribution systems. Nondominated Sorting Genetic Algorithm II was used to find the Pareto front between minimum overlap of possible detection times of two events and the best probability of detection, taking nodal demand uncertainties into account. This methodology was applied to an example network. The solutions show that the probability of detection and the number of possible locations are not remarkably affected by nodal demand uncertainties, but the sources identification accuracy declines with nodal demand uncertainties.

  15. Cutaneous Vasculitis: An Unusual Presentation of a Biclonal Nodal Plasma Cell Dyscrasia

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    D. Swan


    Full Text Available We describe an unusual case of a biclonal nodal plasma cell dyscrasia, presenting with a vasculitic rash, end-organ damage, and cytopenias. Serum protein electrophoresis demonstrated a biclonal kappa-restricted paraprotein, with a negative skeletal survey and no bone marrow disease. Fluorodeoxyglucose-PET-CT (FDG-PET-CT revealed nodal involvement, which was not appreciable clinically, and facilitated biopsy, confirming the diagnosis of a nodal plasmacytoma. Complete biochemical response and resolution of the vasculitic rash were achieved with bortezomib-based therapy.

  16. Oral gingival metastasis: A diagnostic dilemma

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    Nalini Aswath


    Full Text Available Oral cavity is a rare target for metastasis with an incidence of 1% among all oral cancers. In 24% of such cases, oral metastasis is the first indication of an undiagnosed primary. Metastatic oral malignancies have been reported in the mandible, tongue, and gingiva. Although gingival metastasis has been reported from lung, prostate, rectal carcinoma in men and carcinoma of breast, adrenal glands, and genitalia in females, gingival metastasis from carcinoma of the penis has not been reported. Herein, a case of metastatic gingival carcinoma that developed after extraction of teeth from primary carcinoma of the penis is presented. An extensive literature search revealed no such similar case reports.

  17. Regional nodal relapse in surgically staged Merkel cell carcinoma

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    Hoeller, Ulrike; Mueller, Thomas; Schubert, Tina; Budach, Volker; Ghadjar, Pirus [Charite Universitaetsmedizin Berlin, Department of Radiation Oncology, Berlin (Germany); Brenner, Winfried [Charite Universitaetsmedizin Berlin, Department of Nuclear Medicine, Berlin (Germany); Kiecker, Felix [Charite Universitaetsmedizin Berlin, Department of Dermatology, Berlin (Germany); Schicke, Bernd [Tumor Center Berlin, Berlin (Germany); Haase, Oliver [Charite Universitaetsmedizin Berlin, Department of Surgery, Berlin (Germany)


    The nodal relapse pattern of surgically staged Merkel cell carcinoma (MCC) with/without elective nodal radiotherapy (RT) was studied in a single institution. A total of 51 patients with MCC, 33 % UICC stage I, 14 % II, 53 % III (4 lymph node metastases of unknown primary) were eligible. All patients had surgical staging: 23 patients sentinel node biopsy (SNB), 22 patients SNB followed by lymphadenectomy (LAD) and 6 patients LAD. In all, 94 % of the primary tumors (PT) were completely resected; 57 % of patients received RT, 51 % of known PT sites, 33 % (8/24 patients) regional RT to snN0 nodes and 68 % (17/27 patients) to pN+ nodes, mean reference dose 51.5 and 50 Gy, respectively. Mean follow-up was 6 years (range 2-14 years). A total of 22 % (11/51) patients developed regional relapses (RR); the 5-year RR rate was 27 %. In snN0 sites (stage I/II), relapse occurred in 5 of 14 nonirradiated vs. none of 8 irradiated sites (p = 0.054), resulting in a 5-year RR rate of 33 % versus 0 % (p = 0.16). The crude RR rate was lower in stage I (12 %, 2/17 patients) than for stage II (43 %, 3/7 patients). In stage III (pN+), RR appeared to be less frequent in irradiated sites (18 %, 3/14 patients) compared with nonirradiated sites (33 %, 3/10 patients, p = 0.45) with 5-year RR rates of 23 % vs. 34 %, respectively. Our data suggest that adjuvant nodal RT plays a major role even if the sentinel nodes were negative. Adjuvant RT of the lymph nodes in patients with stage IIa tumors and RT after LAD in stage III tumors is proposed and should be evaluated prospectively. (orig.) [German] Untersucht wurde das regionaere Rezidivmuster des Merkelzell-Karzinoms (MCC) nach chirurgischem Staging und stadienadaptierter Therapie. Eingeschlossen wurden 51 Patienten mit lokalisiertem MCC: 33 % hatten UICC-Stadium-I-, 14 % -II-, 53 % -III-Tumoren (davon 4 Lymphknotenmetastasen eines unbekannten Primaertumors). Alle Patienten erhielten ein chirurgisches Staging: 23 Waechterlymphknotenbiopsien (SNB

  18. Pancreatic Metastasis from Prostate Cancer

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    Julian Jacob


    Full Text Available The pancreas is an unusual location for metastases from other primary cancers. Rarely, pancreatic metastases from kidney or colorectal cancers have been reported. However, a variety of other cancers may also spread to the pancreas. We report an exceptional case of pancreatic metastasis from prostate cancer. Differences in management between primary and secondary pancreatic tumors make recognition of metastases to the pancreas an objective of first importance. Knowledge of unusual locations for metastatic spread will reduce diagnostic delay and lead to a timely delivery of an appropriate treatment.

  19. Impact of radiation dose and standardized uptake value of (18)FDG PET on nodal control in locally advanced cervical cancer. (United States)

    Ramlov, Anne; Kroon, Petra S; Jürgenliemk-Schulz, Ina M; De Leeuw, Astrid A C; Gormsen, Lars Christian; Fokdal, Lars Ulrik; Tanderup, Kari; Lindegaard, Jacob Christian


    Despite local control now exceeding 90% with image-guided adaptive brachytherapy (IGABT), regional and distant metastases continue to curb survival in locally advanced cervical cancer. As regional lymph nodes often represent first site of metastatic spread, improved nodal control could improve survival. The aim of this study was to examine optimal volume and dose of external beam radiotherapy (EBRT) to maximize regional control including dose contribution from IGABT. In total 139 patients from the EMBRACE study were analyzed. Individual nodal dose was determined by dose-maps from EBRT and IGABT. All PET/CT scans were re-evaluated and nodal maximal standard uptake value (SUVmax) was determined. Nodal failures were registered to planning scans and related to boosted nodes and treated volume. Relation between SUVmax and nodal control as well as the pattern of regional nodal failure were analyzed. Eighty-four patients were node positive. Nine patients had all metastatic nodes surgically removed. Seventy-five patients had 209 nodes boosted with EBRT. Median nodal boost dose was 62 Gy EQD2 (53-69 Gy EQD2). Median SUVmax was 6 (2-22). No patients had persistent nodal disease, but six patients recurred in a boosted node. SUVmax was significantly higher in nodes that recurred (p = 0.02). However, there was no correlation to nodal dose or volume. Twenty-one patients had a nodal failure including para-aortic nodal (PAN) metastases above the irradiated volume. Nine patients had a PAN-only failure. Patients receiving ≤ 4 cycles of weekly cisplatin had higher risk of nodal failure (p < 0.01). Current RT practice provides a high level of control in both boosted nodes and the elective irradiated regional target. However, a high nodal SUVmax is a negative prognostic predictor for nodal control. Attention should be raised to administration of a complete schedule of concurrent chemotherapy as well as treatment of para-aortic nodes.

  20. Leptomeningeal metastasis after surgical resection of brain metastases

    NARCIS (Netherlands)

    T.C. van der Ree; D.W.J. Dippel (Diederik); C.J.J. Avezaat (Cees); C.J. Vecht; M.J. van den Bent (Martin); P.A.E. Sillevis Smitt (Peter)


    textabstractOBJECTIVE: To determine the incidence and risk factors for leptomeningeal metastasis after surgery for brain metastasis of solid tumors. METHODS: Review of the records of all patients operated on for brain metastasis between January 1990 and August 1995.

  1. Hybrid nodal methods in the solution of the diffusion equations in X Y geometry; Metodos nodales hibridos en la solucion de las ecuaciones de difusion en geometria XY

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    Hernandez M, N. [CFE, Carretera Cardel-Nautla Km. 43.5, 91680 Veracruz (Mexico); Alonso V, G.; Valle G, E. del [IPN-ESFM, 07738 Mexico D.F. (Mexico)]. e-mail:


    In 1979, Hennart and collaborators applied several schemes of classic finite element in the numerical solution of the diffusion equations in X Y geometry and stationary state. Almost two decades then, in 1996, himself and other collaborators carried out a similar work but using nodal schemes type finite element. Continuing in this last direction, in this work a group it is described a set of several Hybrid Nodal schemes denominated (NH) as well as their application to solve the diffusion equations in multigroup in stationary state and X Y geometry. The term hybrid nodal it means that such schemes interpolate not only Legendre moments of face and of cell but also the values of the scalar flow of neutrons in the four corners of each cell or element of the spatial discretization of the domain of interest. All the schemes here considered are polynomials like they were it their predecessors. Particularly, its have developed and applied eight different hybrid nodal schemes that its are very nearby related with those developed by Hennart and collaborators in the past. It is treated of schemes in those that nevertheless that decreases the number of interpolation parameters it is conserved the accurate in relation to the bi-quadratic and bi-cubic schemes. Of these eight, three were described and applied in a previous work. It is the bi-lineal classic scheme as well as the hybrid nodal schemes, bi-quadratic and bi-cubic for that here only are described the other 5 hybrid nodal schemes although they are provided numerical results for several test problems with all them. (Author)

  2. Micropropagation Of Merremia Quinquefolia (L. Hallier F. From Nodal Explants

    Directory of Open Access Journals (Sweden)

    Kher Mafatlal M.


    Full Text Available Merremia quinquefolia, is an important medicinal plant of the family Convolvulaceae known for its vasoconstrictor, uterotonic, neurohormonic, sympathicolytic and sedative effects. In the present investigation effect of cytokinins 6-benzylaminopurine (BAP, kinetin (Kn and thidiazuron (TDZ, at concentrations 1.0, 2.0, 3.0, 4.0 and 5.0 mg·dm−3 on in vitro shoot multiplication from nodal explants of M. quinquefolia was evaluated. Bud breaking and emergence of shoots started within 10-15 days of inoculation in all media containing cytokinin. Murashige and Skoog (MS medium supplemented with 4.0 mg·dm−3 BAP resulted in maximum number of shoots from single node within 45 days. In vitro raised shoots were successfully rooted on ½ mineral salts of MS medium with 3% sucrose supplemented with 2.0 mg·dm−3 indole-3-butyric acid (IBA. This is the first report on in vitro propagation of Merremia quinquefolia. This study can be useful for development of micropropagation protocols for related taxa.

  3. Micropropagation of Calophyllum brasiliense (Cambess. from nodal segments

    Directory of Open Access Journals (Sweden)

    S. S. Silveira

    Full Text Available Abstract Micropropagation of Calophyllum brasiliense Cambess. (Clusiaceae is a way to overcome difficulties in achieving large-scale plant production, given the recalcitrant nature of the seeds, irregular fructification and absence of natural vegetative propagation of the species. Cultures were established using nodal segments 2 cm in length, obtained from 1-2 year old seedlings, maintained in a greenhouse. Mercury chloride and Plant Preservative Mixture™ were used in the surface sterilizing stage, better results being achieved with Plant Preservative Mixture™ incorporation in culture medium, at any concentration. Polyvinylpyrrolidone, activated charcoal, cysteine, ascorbic acid or citric acid were added to the culture medium to avoid oxidation. After 30 days of culture, polyvinylpirrolidone and ascorbic acid gave better results, eliminating oxidation in most explants. For shoot multiplication, benzylaminopurine was used in concentrations of 4.4 and 8.8 µM in Woody Plant Medium, resulting in an average of 4.43 and 4.68 shoots per explant, respectively, after 90 days. Indole-3-butyric acid and α-naphthalene acetic acid were used to induce root formation, reaching a maximum rooting rate of 24% with 20µM α-naphthalene acetic acid. For acclimatization. the rooted plants were transferred to Plantmax® substrate and cultured in a greenhouse, reaching 79% of survival after 30 days and 60% after one year.

  4. Application of the SPH method in nodal diffusion analyses of SFR cores

    Energy Technology Data Exchange (ETDEWEB)

    Nikitin, Evgeny; Fridman, Emil [Helmholtz-Zentrum Dresden-Rossendorf e.V., Dresden (Germany). Div. Reactor Safety; Mikityuk, K. [Paul Scherrer Institut, Villigen (Switzerland)


    The current study investigated the potential of the SPH method, applied to correct the few-group XS produced by Serpent, to further improve the accuracy of the nodal diffusion solutions. The procedure for the generation of SPH-corrected few-group XS is presented in the paper. The performance of the SPH method was tested on a large oxide SFR core from the OECD/NEA SFR benchmark. The reference SFR core was modeled with the DYN3D and PARCS nodal diffusion codes using the SPH-corrected few-group XS generated by Serpent. The nodal diffusion results obtained with and without SPH correction were compared to the reference full-core Serpent MC solution. It was demonstrated that the application of the SPH method improves the accuracy of the nodal diffusion solutions, particularly for the rodded core state.

  5. A Hybrid Interpolation Method for Geometric Nonlinear Spatial Beam Elements with Explicit Nodal Force

    Directory of Open Access Journals (Sweden)

    Huiqing Fang


    Full Text Available Based on geometrically exact beam theory, a hybrid interpolation is proposed for geometric nonlinear spatial Euler-Bernoulli beam elements. First, the Hermitian interpolation of the beam centerline was used for calculating nodal curvatures for two ends. Then, internal curvatures of the beam were interpolated with a second interpolation. At this point, C1 continuity was satisfied and nodal strain measures could be consistently derived from nodal displacement and rotation parameters. The explicit expression of nodal force without integration, as a function of global parameters, was founded by using the hybrid interpolation. Furthermore, the proposed beam element can be degenerated into linear beam element under the condition of small deformation. Objectivity of strain measures and patch tests are also discussed. Finally, four numerical examples are discussed to prove the validity and effectivity of the proposed beam element.

  6. Efficacy of neck dissection for locoregional failures versus isolated nodal failures in nasopharyngeal carcinoma. (United States)

    Tsang, Raymond King Yin; Chung, Joseph Chun Kit; Ng, Yiu Wing; To, Victor Shing Howe; Ho, Ambrose Chung Wai; Chan, Jimmy Yu Wai; Ho, Wai Kuen; Wei, William Ignace


    Neck dissection has been shown to be effective in controlling nodal failures in nasopharyngeal carcinoma. Its efficacy in controlling the disease in patients with synchronous locoregional failure is, however, not documented. A retrospective review of all patients who underwent neck dissection for nodal failures with or without treated local failure within 6 months was conducted for this study. The survivals of these 2 groups of patients were analyzed. The 5-year overall survival of the whole cohort was 58%. There was no difference in 5-year disease specific survival (68% vs 40%; p = .121) and 5-year progression free survival (44% vs 36%; p = .334) when comparing patients with isolated nodal failures and synchronous locoregional failures. Multivariate analysis showed that only the initial N classification affects survival. Neck dissection is efficacious in patients with nasopharyngeal carcinoma with nodal failure, with or without synchronous local failures. Copyright © 2011 Wiley Periodicals, Inc.

  7. Emerging nanomedicine approaches fighting tumor metastasis: animal models, metastasis-targeted drug delivery, phototherapy, and immunotherapy. (United States)

    Liang, Chao; Xu, Ligeng; Song, Guosheng; Liu, Zhuang


    Metastasis is directly or indirectly responsible for the majority of cancer deaths. Anti-metastasis treatment is thus the key to cure cancer. Recent development in nanomedicine has shown great promise for tackling cancer metastasis. In recent years, nanoparticle-based drug delivery systems have been extensively explored for improving cancer treatment, showing the ability to reduce the risk of tumor metastasis compared with conventional chemotherapy. Photothermal therapy, by employing nano-theranostic agents, has also been found to be able to inhibit lymphatic tumor metastasis. Moreover, the post-immunological effects of certain types of nano-therapies may also be utilized to treat tumor metastasis, presenting an exciting new avenue towards successful cancer treatment. In this review article, we would like to summarize the latest research advances in the development of various emerging nanomedicine approaches for cancer metastasis treatment, and discuss future prospects in this emerging field as well as the clinical translation potential of these techniques.

  8. A quasi-static polynomial nodal method for nuclear reactor analysis

    Energy Technology Data Exchange (ETDEWEB)

    Gehin, Jess C. [Massachusetts Inst. of Tech., Cambridge, MA (United States)


    Modern nodal methods are currently available which can accurately and efficiently solve the static and transient neutron diffusion equations. Most of the methods, however, are limited to two energy groups for practical application. The objective of this research is the development of a static and transient, multidimensional nodal method which allows more than two energy groups and uses a non-linear iterative method for efficient solution of the nodal equations. For both the static and transient methods, finite-difference equations which are corrected by the use of discontinuity factors are derived. The discontinuity factors are computed from a polynomial nodal method using a non-linear iteration technique. The polynomial nodal method is based upon a quartic approximation and utilizes a quadratic transverse-leakage approximation. The solution of the time-dependent equations is performed by the use of a quasi-static method in which the node-averaged fluxes are factored into shape and amplitude functions. The application of the quasi-static polynomial method to several benchmark problems demonstrates that the accuracy is consistent with that of other nodal methods. The use of the quasi-static method is shown to substantially reduce the computation time over the traditional fully-implicit time-integration method. Problems involving thermal-hydraulic feedback are accurately, and efficiently, solved by performing several reactivity/thermal-hydraulic updates per shape calculation.

  9. Cilia are required for asymmetric nodal induction in the sea urchin embryo. (United States)

    Tisler, Matthias; Wetzel, Franziska; Mantino, Sabrina; Kremnyov, Stanislav; Thumberger, Thomas; Schweickert, Axel; Blum, Martin; Vick, Philipp


    Left-right (LR) organ asymmetries are a common feature of metazoan animals. In many cases, laterality is established by a conserved asymmetric Nodal signaling cascade during embryogenesis. In most vertebrates, asymmetric nodal induction results from a cilia-driven leftward fluid flow at the left-right organizer (LRO), a ciliated epithelium present during gastrula/neurula stages. Conservation of LRO and flow beyond the vertebrates has not been reported yet. Here we study sea urchin embryos, which use nodal to establish larval LR asymmetry as well. Cilia were found in the archenteron of embryos undergoing gastrulation. Expression of foxj1 and dnah9 suggested that archenteron cilia were motile. Cilia were polarized to the posterior pole of cells, a prerequisite of directed flow. High-speed videography revealed rotating cilia in the archenteron slightly before asymmetric nodal induction. Removal of cilia through brief high salt treatments resulted in aberrant patterns of nodal expression. Our data demonstrate that cilia - like in vertebrates - are required for asymmetric nodal induction in sea urchin embryos. Based on these results we argue that the anterior archenteron represents a bona fide LRO and propose that cilia-based symmetry breakage is a synapomorphy of the deuterostomes.

  10. Mechanisms involved in breast cancer liver metastasis. (United States)

    Ma, Rui; Feng, Yili; Lin, Shuang; Chen, Jiang; Lin, Hui; Liang, Xiao; Zheng, Heming; Cai, Xiujun


    Liver metastasis is a frequent occurrence in patients with breast cancer; however, the available treatments are limited and ineffective. While liver-specific homing of breast cancer cells is an important feature of metastasis, the formation of liver metastases is not random. Indeed, breast cancer cell factors contribute to the liver microenvironment. Major breakthroughs have been achieved recently in understanding breast cancer liver metastasis (BCLM). The process of liver metastasis consists of multiple steps and involves various factors from breast cancer cells and the liver microenvironment. A further understanding of the roles of breast cancer cells and the liver microenvironment is crucial to guide future work in clinical treatments. In this review we discuss the contribution of breast cancer cells and the liver microenvironment to liver metastasis, with the aim to improve therapeutic efficacy for patients with BCLM.

  11. Contiguous spinal metastasis mimicking infectious spondylodiscitis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chul Min; Lee, Seung Hun [Dept. of Radiology, Hanyang University Hospital, Seoul (Korea, Republic of); Bae, Ji Yoon [Dept. of Pathology, National Police Hospital, Seoul (Korea, Republic of)


    Differential diagnosis between spinal metastasis and infectious spondylodiscitis is one of the occasional challenges in daily clinical practice. We encountered an unusual case of spinal metastasis in a 75-year-old female breast cancer patient that mimicked infectious spondylodiscitis. Magnetic resonance imaging (MRI) showed diffuse bone marrow infiltrations with paraspinal soft tissue infiltrative changes in 5 contiguous cervical vertebrae without significant compression fracture or cortical destruction. These MRI findings made it difficult to differentiate between spinal metastasis and infectious spondylodiscitis. Infectious spondylodiscitis such as tuberculous spondylodiscitis was regarded as the more appropriate diagnosis due to the continuous involvement of > 5 cervical vertebrae. The patient's clinical presentation also supported the presumptive diagnosis of infectious spondylodiscitis rather than spinal metastasis. Intravenous antibiotics were administered, but clinical symptoms worsened despite treatment. After pathologic confirmation by computed tomography-guided biopsy, we were able to confirm a final diagnosis of spinal metastasis.

  12. Applicability of preoperative nuclear morphometry to evaluating risk for cervical lymph node metastasis in oral squamous cell carcinoma.

    Directory of Open Access Journals (Sweden)

    Masaaki Karino

    Full Text Available BACKGROUND: We previously reported the utility of preoperative nuclear morphometry for evaluating risk for cervical lymph node metastases in tongue squamous cell carcinoma. The risk for lymph node metastasis in oral squamous cell carcinoma, however, is known to differ depending on the anatomical site of the primary tumor, such as the tongue, gingiva, mouth floor, and buccal mucosa. In this study, we evaluated the applicability of this morphometric technique to evaluating the risk for cervical lymph node metastasis in oral squamous cell carcinoma. METHODS: A digital image system was used to measure the mean nuclear area, mean nuclear perimeter, nuclear circular rate, ratio of nuclear length to width (aspect ratio, and nuclear area coefficient of variation (NACV. Relationships between these parameters and nodal status were evaluated by t-test and logistic regression analysis. RESULTS: Eighty-eight cases of squamous cell carcinoma (52 of the tongue, 25 of the gingiva, 4 of the buccal mucosa, and 7 of the mouth floor were included: 46 with positive node classification and 42 with negative node classification. Nuclear area and perimeter were significantly larger in node-positive cases than in node-negative cases; however, there were no significant differences in circular rate, aspect ratio, or NACV. We derived two risk models based on the results of multivariate analysis: Model 1, which identified age and mean nuclear area and Model 2, which identified age and mean nuclear perimeter. It should be noted that primary tumor site was not associated the pN-positive status. There were no significant differences in pathological nodal status by aspect ratio, NACV, or primary tumor site. CONCLUSION: Our method of preoperative nuclear morphometry may contribute valuable information to evaluations of the risk for lymph node metastasis in oral squamous cell carcinoma.

  13. TGF-β promotes glioma cell growth via activating Nodal expression through Smad and ERK1/2 pathways

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Jing [Department of Neurology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang (China); Liu, Su-zhi [Department of Neurology, The Affiliated Taizhou Hospital, Wenzhou Medical University, Taizhou 317000, Zhejiang (China); Lin, Yan; Cao, Xiao-pan [Department of Neurology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang (China); Liu, Jia-ming, E-mail: [School of Environmental Science and Public Health, Wenzhou Medical University, Wenzhou 325035, Zhejiang (China)


    Highlights: •TGF-β promoted Nodal expression in glioma cells. •TGF-β promoted Nodal expression via activating Smad and ERK1/2 pathways. •TGF-β promotes glioma cell growth via activating Nodal expression. -- Abstract: While there were certain studies focusing on the mechanism of TGF-β promoting the growth of glioma cells, the present work revealed another novel mechanism that TGF-β may promote glioma cell growth via enhancing Nodal expression. Our results showed that Nodal expression was significantly upregulated in glioma cells when TGF-β was added, whereas the TGF-β-induced Nodal expression was evidently inhibited by transfection Smad2 or Smad3 siRNAs, and the suppression was especially significant when the Smad3 was downregulated. Another, the attenuation of TGF-β-induced Nodal expression was observed with blockade of the ERK1/2 pathway also. Further detection of the proliferation, apoptosis, and invasion of glioma cells indicated that Nodal overexpression promoted the proliferation and invasion of tumor cells and inhibited their apoptosis, resembling the effect of TGF-β addition. Downregulation of Nodal expression via transfection Nodal-specific siRNA in the presence of TGF-β weakened the promoting effect of the latter on glioma cells growth, and transfecting Nodal siRNA alone in the absence of exogenous TGF-β more profoundly inhibited the growth of glioma cells. These results demonstrated that while both TGF-β and Nodal promoted glioma cells growth, the former might exert such effect by enhancing Nodal expression, which may form a new target for glioma therapy.

  14. Topological nodal superconductivity in the heavy fermion metal UPt3 (United States)

    Nevidomskyy, Andriy

    The concept of topological states of matter has captured the imagination of physicists in the last decade. Traditionally, such topological phases are predicted to occur in fully gapped insulating or superconducting materials and are characterized by topologically protected gapless excitations on the surface. Recently, it has been realized that such protected surface states may also exist in certain classes of metallic materials with gapless bulk excitations. Here, I will demonstrate the application of this concept, focusing in particular on the low-temperature B-phase of the heavy fermion superconductor UPt3. Josephson interferometry measurements provide strong evidence for the triplet, chiral pairing symmetry in UPt3, which endow the Cooper pairs with orbital angular momentum Lz = +/- 2 along the c-axis. Such pairing supports both line and point nodes in the superconducting gap, and we show that both types of nodal quasiparticles possess nontrivial topology in the momentum space. In particular, the point nodes located at the intersections of the closed Fermi surfaces with the c-axis act as the double monopoles and anti-monopoles of the Berry curvature. Consequently, we predict that the B phase of UPt3 should support an anomalous thermal Hall effect, various magneto-electric effects such as the polar Kerr effect, in addition to the topologically protected Majorana Fermi arcs on the (1,0,0) and (0,1,0) surfaces. At the transition from the B-phase to the A-phase upon increasing temperature, the time reversal symmetry is restored, and the surface Fermi arcs disappear. The effect of quenched disorder on the topologically non-trivial B-phase will also be discussed. This research is supported by NSF Grant No. DMR-1350237.

  15. Mathematical embryology: the fluid mechanics of nodal cilia (United States)

    Smith, D. J.; Smith, A. A.; Blake, J. R.


    Left-right symmetry breaking is critical to vertebrate embryonic development; in many species this process begins with cilia-driven flow in a structure termed the `node'. Primary `whirling' cilia, tilted towards the posterior, transport morphogen-containing vesicles towards the left, initiating left-right asymmetric development. We review recent theoretical models based on the point-force stokeslet and point-torque rotlet singularities, explaining how rotation and surface-tilt produce directional flow. Analysis of image singularity systems enforcing the no-slip condition shows how tilted rotation produces a far-field `stresslet' directional flow, and how time-dependent point-force and time-independent point-torque models are in this respect equivalent. Associated slender body theory analysis is reviewed; this approach enables efficient and accurate simulation of three-dimensional time-dependent flow, time-dependence being essential in predicting features of the flow such as chaotic advection, which have subsequently been determined experimentally. A new model for the nodal flow utilising the regularized stokeslet method is developed, to model the effect of the overlying Reichert's membrane. Velocity fields and particle paths within the enclosed domain are computed and compared with the flow profiles predicted by previous `membrane-less' models. Computations confirm that the presence of the membrane produces flow-reversal in the upper region, but no continuous region of reverse flow close to the epithelium. The stresslet far-field is no longer evident in the membrane model, due to the depth of the cavity being of similar magnitude to the cilium length. Simulations predict that vesicles released within one cilium length of the epithelium are generally transported to the left via a `loopy drift' motion, sometimes involving highly unpredictable detours around leftward cilia [truncated

  16. Development of a phenotyping platform for high throughput screening of nodal root angle in sorghum. (United States)

    Joshi, Dinesh C; Singh, Vijaya; Hunt, Colleen; Mace, Emma; van Oosterom, Erik; Sulman, Richard; Jordan, David; Hammer, Graeme


    In sorghum, the growth angle of nodal roots is a major component of root system architecture. It strongly influences the spatial distribution of roots of mature plants in the soil profile, which can impact drought adaptation. However, selection for nodal root angle in sorghum breeding programs has been restricted by the absence of a suitable high throughput phenotyping platform. The aim of this study was to develop a phenotyping platform for the rapid, non-destructive and digital measurement of nodal root angle of sorghum at the seedling stage. The phenotyping platform comprises of 500 soil filled root chambers (50 × 45 × 0.3 cm in size), made of transparent perspex sheets that were placed in metal tubs and covered with polycarbonate sheets. Around 3 weeks after sowing, once the first flush of nodal roots was visible, roots were imaged in situ using an imaging box that included two digital cameras that were remotely controlled by two android tablets. Free software (openGelPhoto.tcl) allowed precise measurement of nodal root angle from the digital images. The reliability and efficiency of the platform was evaluated by screening a large nested association mapping population of sorghum and a set of hybrids in six independent experimental runs that included up to 500 plants each. The platform revealed extensive genetic variation and high heritability (repeatability) for nodal root angle. High genetic correlations and consistent ranking of genotypes across experimental runs confirmed the reproducibility of the platform. This low cost, high throughput root phenotyping platform requires no sophisticated equipment, is adaptable to most glasshouse environments and is well suited to dissect the genetic control of nodal root angle of sorghum. The platform is suitable for use in sorghum breeding programs aiming to improve drought adaptation through root system architecture manipulation.

  17. Ultrasound-guided core biopsy: an effective method of detecting axillary nodal metastases.

    LENUS (Irish Health Repository)

    Solon, Jacqueline G


    BACKGROUND: Axillary nodal status is an important prognostic predictor in patients with breast cancer. This study evaluated the sensitivity and specificity of ultrasound-guided core biopsy (Ax US-CB) at detecting axillary nodal metastases in patients with primary breast cancer, thereby determining how often sentinel lymph node biopsy could be avoided in node positive patients. STUDY DESIGN: Records of patients presenting to a breast unit between January 2007 and June 2010 were reviewed retrospectively. Patients who underwent axillary ultrasonography with or without preoperative core biopsy were identified. Sensitivity, specificity, positive predictive value, and negative predictive value for ultrasonography and percutaneous biopsy were evaluated. RESULTS: Records of 718 patients were reviewed, with 445 fulfilling inclusion criteria. Forty-seven percent (n = 210\\/445) had nodal metastases, with 110 detected by Ax US-CB (sensitivity 52.4%, specificity 100%, positive predictive value 100%, negative predictive value 70.1%). Axillary ultrasonography without biopsy had sensitivity and specificity of 54.3% and 97%, respectively. Lymphovascular invasion was an independent predictor of nodal metastases (sensitivity 60.8%, specificity 80%). Ultrasound-guided core biopsy detected more than half of all nodal metastases, sparing more than one-quarter of all breast cancer patients an unnecessary sentinel lymph node biopsy. CONCLUSIONS: Axillary ultrasonography, when combined with core biopsy, is a valuable component of the management of patients with primary breast cancer. Its ability to definitively identify nodal metastases before surgical intervention can greatly facilitate a patient\\'s preoperative integrated treatment plan. In this regard, we believe our study adds considerably to the increasing data, which indicate the benefit of Ax US-CB in the preoperative detection of nodal metastases.

  18. Churchill regulates cell movement and mesoderm specification by repressing Nodal signaling

    Directory of Open Access Journals (Sweden)

    Mentzer Laura


    Full Text Available Abstract Background Cell movements are essential to the determination of cell fates during development. The zinc-finger transcription factor, Churchill (ChCh has been proposed to regulate cell fate by regulating cell movements during gastrulation in the chick. However, the mechanism of action of ChCh is not understood. Results We demonstrate that ChCh acts to repress the response to Nodal-related signals in zebrafish. When ChCh function is abrogated the expression of mesodermal markers is enhanced while ectodermal markers are expressed at decreased levels. In cell transplant assays, we observed that ChCh-deficient cells are more motile than wild-type cells. When placed in wild-type hosts, ChCh-deficient cells often leave the epiblast, migrate to the germ ring and are later found in mesodermal structures. We demonstrate that both movement of ChCh-compromised cells to the germ ring and acquisition of mesodermal character depend on the ability of the donor cells to respond to Nodal signals. Blocking Nodal signaling in the donor cells at the levels of Oep, Alk receptors or Fast1 inhibited migration to the germ ring and mesodermal fate change in the donor cells. We also detect additional unusual movements of transplanted ChCh-deficient cells which suggests that movement and acquisition of mesodermal character can be uncoupled. Finally, we demonstrate that ChCh is required to limit the transcriptional response to Nodal. Conclusion These data establish a broad role for ChCh in regulating both cell movement and Nodal signaling during early zebrafish development. We show that chch is required to limit mesodermal gene expression, inhibit Nodal-dependant movement of presumptive ectodermal cells and repress the transcriptional response to Nodal signaling. These findings reveal a dynamic role for chch in regulating cell movement and fate during early development.

  19. Patterns of failure after the reduced volume approach for elective nodal irradiation in nasopharyngeal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Seol, Ki Ho; Lee, Jeong Eun [Dept. of Radiation Oncology, Kyungpook National University School of Medicine, Daegu (Korea, Republic of)


    To evaluate the patterns of nodal failure after radiotherapy (RT) with the reduced volume approach for elective neck nodal irradiation (ENI) in nasopharyngeal carcinoma (NPC). Fifty-six NPC patients who underwent definitive chemoradiotherapy with the reduced volume approach for ENI were reviewed. The ENI included retropharyngeal and level II lymph nodes, and only encompassed the echelon inferior to the involved level to eliminate the entire neck irradiation. Patients received either moderate hypofractionated intensity-modulated RT for a total of 72.6 Gy (49.5 Gy to elective nodal areas) or a conventional fractionated three-dimensional conformal RT for a total of 68.4-72 Gy (39.6-45 Gy to elective nodal areas). Patterns of failure, locoregional control, and survival were analyzed. The median follow-up was 38 months (range, 3 to 80 months). The out-of-field nodal failure when omitting ENI was none. Three patients developed neck recurrences (one in-field recurrence in the 72.6 Gy irradiated nodal area and two in the elective irradiated region of 39.6 Gy). Overall disease failure at any site developed in 11 patients (19.6%). Among these, there were six local failures (10.7%), three regional failures (5.4%), and five distant metastases (8.9%). The 3-year locoregional control rate was 87.1%, and the distant failure-free rate was 90.4%; disease-free survival and overall survival at 3 years was 80% and 86.8%, respectively. No patient developed nodal failure in the omitted ENI site. Our investigation has demonstrated that the reduced volume approach for ENI appears to be a safe treatment approach in NPC.

  20. Choroidal metastasis from leiomyosarcoma in two cases

    Directory of Open Access Journals (Sweden)

    Eric Feinstein


    Full Text Available Leiomyosarcoma is a malignant tumor of mesenchymal cells and is the most common soft-tissue sarcoma. Leiomyosarcoma is a notably rare tumor in the ophthalmic region and can be of primary, secondary or metastatic origin. To the best of our knowledge, there has only been one published case of leiomyosarcoma metastasis to the choroid. In this case study, we report two cases of primary leiomyosarcoma with metastasis to the choroid of the eye. Both cases displayed systemic metastasis and showed response to high dose plaque radiotherapy. Despite its prevalence as the leading form of sarcoma, leiomyosarcoma rarely metastasizes to the ocular region.

  1. In chordoma, metastasis, recurrences, Ki-67 index, and a matrix-poor phenotype are associated with patients' shorter overall survival. (United States)

    von Witzleben, Adrian; Goerttler, Lukas T; Lennerz, Jochen; Weissinger, Stephanie; Kornmann, Marko; Mayer-Steinacker, Regine; von Baer, Alexandra; Schultheiss, Markus; Möller, Peter; Barth, Thomas F E


    To establish a chordoma tissue cohort (n = 43) and to correlate localization, size, metastasis, residual disease (R-status), recurrences, histological subtype, matrix content, and Ki-67 proliferation index with patients' overall survival (OS). We used routine histopathology supplemented by immunohistochemistry. In our patient cohort (median age 69 years, range 17 to 84 years) the median OS was 8.25 years. 24 chordomas were localized in the sacrum, 6 in lumbar vertebrae, 7 in thoracic and cervical vertebrae, 5 were limited to the clivus, and one was localized in the nasal septum. Ten patients had metastases, with pulmonary, nodal, and hepatic involvement. 23 patients had recurrent disease. 23 chordomas were classified as 'not otherwise specified' (NOS). Besides NOS, we found the following differentiation patterns: renal cell cancer like in six cases, chondroid in four cases, hepatoid differentiation in three cases, and anaplastic morphology in six cases. Ki-67 index of ≥10 %, presence of metastasis, and the low content of extracellular matrix were statistically linked to poor OS (p metastasis was associated with a higher Ki-67 index in the primary lesion, a positive resection margin, and multiple recurrences (p < 0.05 each). We propose to include these parameters in the final pathologic report of the resected chordoma.

  2. Selective slow pathway ablation does not alter enhancement of vagal tone on sinus and atrioventricular nodal function. (United States)

    Olsovsky, M R; Belz, M K; Stambler, B S; Gilligan, D M; Wood, M A; Ellenbogen, K A


    We studied the effects of edrophonium on sinus cycle length, atrioventricular (AV) nodal fast pathway refractoriness, and AV nodal Wenckebach cycle length in 21 patients with AV nodal reentrant tachycardia (AVNRT) who received edrophonium, and 8 patients who received phenylephrine before and after selective slow pathway ablation. Changes in sinus cycle length, fast pathway conduction, and refractoriness were not altered by radiofrequency ablation of the slow pathway, suggesting that parasympathetic denervation does not occur after slow pathway ablation of AVNRT.

  3. Pathological features of lymph node metastasis for predicting biochemical recurrence after radical prostatectomy for prostate cancer. (United States)

    Carlsson, Sigrid V; Tafe, Laura J; Chade, Daher C; Sjoberg, Daniel D; Passoni, Niccolo; Shariat, Shahrokh F; Eastham, James; Scardino, Peter T; Fine, Samson W; Touijer, Karim A


    Subclassification of nodal stage may have prognostic value in men with lymph node metastasis at radical prostatectomy. We explored the role of extranodal extension, size of the largest metastatic lymph node and the largest metastasis, and lymph node density as predictors of biochemical recurrence. We reviewed pathological material from 261 patients with node positive prostate cancer. We examined the predictive value when adding the additional pathology findings to a base model including extraprostatic extension, seminal vesicle invasion, radical prostatectomy Gleason score, prostate specific antigen and number of positive lymph nodes using the Cox proportional hazards regression and Harrell concordance index. The median number of lymph nodes removed was 14 (IQR 9, 20) and the median number of positive lymph nodes was 1 (IQR 1, 2). At a median followup of 4.6 years (IQR 3.2, 6.0) 155 of 261 patients experienced biochemical recurrence. The mean 5-year biochemical recurrence-free survival rate was 39% (95% CI 33-46). Median diameter of the largest metastatic lymph node was 9 mm (IQR 5, 16). On Cox regression radical prostatectomy specimen Gleason score (greater than 7 vs 7 or less), number of positive lymph nodes (3 or greater vs 1 or 2), seminal vesicle invasion and prostate specific antigen were associated with significantly increased risks of biochemical recurrence. On subset analysis metastasis size significantly improved model discrimination (base model Harrell concordance index 0.700 vs 0.655, p = 0.032). Our study confirms that the number of positive lymph nodes is a predictor of biochemical recurrence in men with node positive disease. The improvement in prognostic value of measuring the metastatic focus warrants further investigation. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  4. The impact of surgical technique on neck dissection nodal yield: making a difference. (United States)

    Lörincz, Balazs B; Langwieder, Felix; Möckelmann, Nikolaus; Sehner, Susanne; Knecht, Rainald


    The nodal yield of neck dissections is an independent prognostic factor in several types of head and neck cancer. The authors aimed to determine whether the applied dissection technique has a significant impact on nodal yield. This is a single-institution, prospective study with internal control group (level of evidence: 2A). Data of 150 patients undergoing 223 neck dissections between February 2011 and March 2013 have been collected in a comprehensive cancer centre. Eighty-two patients underwent neck dissection with unwrapping the cervical fascia from lateral to medial, while 68 patients were operated without specifically unwrapping the fascia, in a caudal to cranial fashion. The standardised, horizontal neck dissection technique along the fascial planes resulted in a significantly higher nodal count in Levels I, II, III and IV, as well as in terms of overall nodal yield (mean: n = 22.53) than that of the vertical dissection applied in the control group (mean: n = 15.00). This is the first publication showing a direct correlation between neck dissection nodal yield and surgical technique. Therefore, it is paramount to optimise the applied surgical concept to maximise the oncological benefit.

  5. Nodalization effects on RELAP5 results related to MTR research reactor transient scenarios

    Directory of Open Access Journals (Sweden)

    Khedr Ahmed


    Full Text Available The present work deals with the anal y sis of RELAP5 results obtained from the evaluation study of the total loss of flow transient with the deficiency of the heat removal system in a research reactor using two different nodalizations. It focuses on the effect of nodalization on the thermal-hydraulic evaluation of the re search reactor. The analysis of RELAP5 results has shown that nodalization has a big effect on the predicted scenario of the postulated transient. There fore, great care should be taken during the nodalization of the reactor, especially when the avail able experimental or measured data are insufficient for making a complete qualification of the nodalization. Our analysis also shows that the research reactor pool simulation has a great effect on the evaluation of natural circulation flow and on other thermal-hydraulic parameters during the loss of flow transient. For example, the on set time of core boiling changes from less than 2000 s to 15000 s, starting from the beginning of the transient. This occurs if the pool is simulated by two vertical volumes in stead of one vertical volume.

  6. Role of Nodal-PITX2C signaling pathway in glucose-induced cardiomyocyte hypertrophy. (United States)

    Su, Dongmei; Jing, Sun; Guan, Lina; Li, Qian; Zhang, Huiling; Gao, Xiaobo; Ma, Xu


    Pathological cardiac hypertrophy is a major cause of morbidity and mortality in cardiovascular disease. Recent studies have shown that cardiomyocytes, in response to high glucose (HG) stimuli, undergo hypertrophic growth. While much work still needs to be done to elucidate this important mechanism of hypertrophy, previous works have showed that some pathways or genes play important roles in hypertrophy. In this study, we showed that sublethal concentrations of glucose (25 mmol/L) could induce cardiomyocyte hypertrophy with an increase in the cellular surface area and the upregulation of the atrial natriuretic peptide (ANP) gene, a hypertrophic marker. High glucose (HG) treatments resulted in the upregulation of the Nodal gene, which is under-expressed in cardiomyocytes. We also determined that the knockdown of the Nodal gene resisted HG-induced cardiomyocyte hypertrophy. The overexpression of Nodal was able to induce hypertrophy in cardiomyocytes, which was associated with the upregulation of the PITX2C gene. We also showed that increases in the PITX2C expression, in response to Nodal, were mediated by the Smad4 signaling pathway. This study is highly relevant to the understanding of the effects of the Nodal-PITX2C pathway on HG-induced cardiomyocyte hypertrophy, as well as the related molecular mechanisms.

  7. Interplay between short-range correlated disorder and Coulomb interaction in nodal-line semimetals (United States)

    Wang, Yuxuan; Nandkishore, Rahul M.


    In nodal-line semimetals, Coulomb interactions and short-range correlated disorder are both marginal perturbations to the clean noninteracting Hamiltonian. We analyze their interplay using a weak-coupling renormalization group approach. In the clean case, the Coulomb interaction has been found to be marginally irrelevant, leading to Fermi liquid behavior. We extend the analysis to incorporate the effects of disorder. The nodal line structure gives rise to kinematical constraints similar to that for a two-dimensional Fermi surface, which plays a crucial role in the one-loop renormalization of the disorder couplings. For a twofold degenerate nodal loop (Weyl loop), we show that disorder flows to strong coupling along a unique fixed trajectory in the space of symmetry inequivalent disorder couplings. Along this fixed trajectory, all symmetry inequivalent disorder strengths become equal. For a fourfold degenerate nodal loop (Dirac loop), disorder also flows to strong coupling, however, the strengths of symmetry inequivalent disorder couplings remain different. We show that feedback from disorder reverses the sign of the beta function for the Coulomb interaction, causing the Coulomb interaction to flow to strong coupling as well. However, the Coulomb interaction flows to strong coupling asymptotically more slowly than disorder. Extrapolating our results to strong coupling, we conjecture that at low energies nodal line semimetals should be described by a noninteracting nonlinear sigma model. We discuss the relation of our results with possible many-body localization at zero temperatures in such materials.

  8. Block-diagonalization of the variational nodal response matrix using the symmetry group theory (United States)

    Li, Zhipeng; Wu, Hongchun; Li, Yunzhao; Cao, Liangzhi


    To further improve the efficiency of the Variational Nodal Method (VNM) for solving the neutron transport equation in hexagonal-z geometry, the nodal response matrix is further block-diagonalized by utilizing the symmetry group theory to decompose the surface basis functions into irreducible components. The block-diagonal property of the nodal response matrix is determined by the symmetry properties of the hexagonal node in geometry, material and basis functions, including both reflection and rotation symmetries. To fully utilize those properties, the symmetry group theory is employed to analyze the symmetry property of the nodal response matrices. It is mathematically proved that the nodal response matrix can be further block-diagonalized into 16 diagonal blocks instead of the current 4 ones by using the symmetry group theory. Numerical comparisons demonstrate that the new approach can reduce the memory storage and computing time by a factor of 2∼3 for P7 angular approximation, compared with the currently employed variables transformation algorithm.

  9. Chemokines in the melanoma metastasis biomarkers portrait. (United States)

    Neagu, Monica; Constantin, Carolina; Longo, Caterina


    Skin tumorigenesis is linked to inflammatory chemokines accumulation that can induce cancer-associated immune-suppression. Deregulation of the CXCR4/CXCL12 axis was reported in melanoma tumorigenesis while also linked to BRAF mutation. Some chemokine-receptor patterns can direct the organ-specific metastasis. CXCL10 can help to prognosticate high-risk patients as it is a chemokine that differentiated patients with vs. metastasis free ones. Besides serum/plasma, chemokine identification in the cerebrospinal fluid of melanoma patients can indicate brain metastasis. Interplay between suppressed and elevated chemokines in cerebrospinal fluid can pinpoint an aggressive melanoma brain metastasis. Chemokines are gaining rapid momentum in the biomarker discovery domain aiding melanoma prognosis and high-risk patients' stratification.

  10. Gastric Metastasis from a Primary Renal Leiomyosarcoma (United States)

    Yodonawa, Satoshi; Ogawa, Isao; Yoshida, Susumu; Ito, Hiromichi; Kato, Akinori; Kubokawa, Ryoko; Tokoshima, Emika; Shimoyamada, Hiroaki


    Primary leiomyosarcoma of the kidney is rare. Here we report a case of metastasis of this tumor to the stomach. A 73-year-old man visited our hospital suffering from general weakness and intermittent tarry stools. He had undergone right nephrectomy for renal leiomyosarcoma 2 years previously. There had been no local recurrence or distant metastasis in the 2-year follow-up period. Endoscopy revealed two submucosal tumors in the stomach. These tumors were diagnosed histologically as leiomyosarcoma and distal gastrectomy was performed. Subsequent histochemical staining confirmed the diagnosis of gastric metastasis from renal leiomyosarcoma. The patient died due to metastases to the liver and bone 9 months after the operation. To the best of our knowledge, this is the first report of gastric metastasis from primary renal leiomyosarcoma. PMID:22754492

  11. Isolated malignant melanoma metastasis to the pancreas

    DEFF Research Database (Denmark)

    Larsen, Anne K; Krag, Christen; Geertsen, Poul


    SUMMARY: Malignant melanomas rarely develop isolated pancreatic metastases. We describe a unique patient who is still alive 22 years following an isolated pancreatic melanoma metastasis, and we review the sparse literature in the field....

  12. SU-F-P-52: A Meta-Analysis of Controlled Clinical Trials Comparing Elective Nodal Irradiation with Involved-Field Irradiation for Conformal Or Intensity-Modulated Radiotherapy in Patients with Esophageal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Bai, W; Zhang, R; Zhou, Z; Qiao, X [The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei (China)


    Purpose: To compare elective nodal irradiation with involved-field irradiation for three-dimensional conformal radiotherapy or intensity-modulated radiotherapy in patients with esophageal cancer by a metaanalysis. Methods: Wanfang, CNKI, VIP, CBM databases, PubMed, Embase and Cochrane Library were searched to identify the controlled clinical trials of elective nodal irradiation with involved-field irradiation for three-dimensional conformal radiotherapy or intensity-modulated radiotherapy in patients with esophageal cancer. The obtained data were analyzed using Stata 11.0. The difference between two groups was estimated by calculating the odds ratio (OR) with 95% confidence interval (95% CI). Results: A total of 12 controlled clinical trials involving 1095 esophageal cancer patients, which were selected according to inclusion and exclusion criteria, were included in this meta-analysis. The meta-analysis showed that the elective nodal irradiation group reduced the rates of out-field failure comparing with involved-field irradiation group (OR=3.727, P=0.007). However, the rates of ≥grades 3 acute radiation pneumonitis and esophagitis were significantly higher in the elective nodal irradiation group than in the involved-field irradiation group (OR=0.348, P=0.001, OR=0.385, P=0.000). 1-, 2-, 3-year local control rates (OR=0.966, P=0.837, OR=0.946, P=0.781; OR=0.732P=0.098) and 1-, 3-, 5-year survival rates were similar in the two groups ( OR=0.966, P=0.837; OR=0.946, P=0.781; OR=0.732, P=0.098; OR=0.952, P=0.756; OR=1.149, P=0.422; OR=0.768, P=0.120). It is the same with the rates of distant metastasis (OR=0.986, P=0.937). Conclusion: Compared with involved-field irradiation, the elective nodal irradiation can reduce the rates of out-field failure for three-dimensional conformal radiotherapy or intensity-modulated radiotherapy in patients with esophageal cancer. However, its advantage of local control and survival rates is not obvious and it increases the incidence

  13. Osthole inhibits bone metastasis of breast cancer


    Wu, Chunyu; Sun, Zhenping; Guo, Baofeng; Ye, Yiyi; Han, Xianghui; Qin, Yuenong; Liu, Sheng


    Bone is one of the most common sites for breast cancer metastasis, which greatly contributes to patient morbidity and mortality. Osthole, a major extract from Cnidium monnieri (L.), exhibits many biological and pharmacological activities, however, its potential as a therapeutic agent in the treatment of breast cancer bone metastases remain poorly understood. In this study, we set out to investigate whether osthole could inhibit breast cancer metastasis to bone in mice and clarified the potent...

  14. Metastasis Suppressors and the Tumor Microenvironment (United States)

    Cook, Leah M.; Hurst, Douglas R.; Welch, Danny R.


    The most lethal and debilitating attribute of cancer cells is their ability to metastasize. Throughout the process of metastasis, tumor cells interact with other tumor cells, host cells and a variety of molecules. Tumor cells are also faced with a number of insults, such as hemodynamic sheer pressure and immune selection. This brief review explores how metastasis suppressor proteins regulate interactions between tumor cells and the microenvironments in which tumor cells find themselves. PMID:21168504

  15. Fatty Acid Synthase and Acetyl-CoA Carboxylase Are Expressed in Nodal Metastatic Melanoma But Not in Benign Intracapsular Nodal Nevi. (United States)

    Saab, Jad; Santos-Zabala, Maria Laureana; Loda, Massimo; Stack, Edward C; Hollmann, Travis J


    Melanoma is a potentially lethal form of skin cancer for which the current standard therapy is complete surgical removal of the primary tumor followed by sentinel lymph node biopsy when indicated. Histologic identification of metastatic melanoma in a sentinel node has significant prognostic and therapeutic implications, routinely guiding further surgical management with regional lymphadenectomy. While melanocytes in a lymph node can be identified by routine histopathologic and immunohistochemical examination, the distinction between nodal nevus cells and melanoma can be morphologically problematic. Previous studies have shown that malignant melanoma can over-express metabolic genes such as fatty acid synthase (FASN) and acetyl-CoA carboxylase (ACC). This immunohistochemical study aims to compare the utility of FASN and ACC in differentiating sentinel lymph nodes with metastatic melanomas from those with benign nodal nevi in patients with cutaneous melanoma. Using antibodies against FASN and ACC, 13 sentinel lymph nodes from 13 patients with metastatic melanoma and 14 lymph nodes harboring benign intracapsular nevi from 14 patients with cutaneous malignant melanoma were examined. A diagnosis of nodal melanoma was based on cytologic atypia and histologic comparison with the primary melanoma. All nodal nevi were intracapsular and not trabecular. Immunohistochemistry for Melan-A, S100, human melanoma black 45 (HMB45), FASN, and ACC were performed. The percentage of melanocytes staining with HMB45, FASN, and ACC was determined and graded in 25% increments; staining intensity was graded as weak, moderate, or strong. All metastatic melanomas tested had at least 25% tumor cell staining for both FASN and ACC. Greater than 75% of the tumor cells stained with FAS in 7/13 cases and for ACC in 5/12 cases. Intensity of staining was variable; strong staining for FASN and ACC was observed in 69% and 50% of metastatic melanoma, respectively. HMB45 was negative in 40% of nodal

  16. Ion Channels in Brain Metastasis. (United States)

    Klumpp, Lukas; Sezgin, Efe C; Eckert, Franziska; Huber, Stephan M


    Breast cancer, lung cancer and melanoma exhibit a high metastatic tropism to the brain. Development of brain metastases severely worsens the prognosis of cancer patients and constrains curative treatment options. Metastasizing to the brain by cancer cells can be dissected in consecutive processes including epithelial-mesenchymal transition, evasion from the primary tumor, intravasation and circulation in the blood, extravasation across the blood-brain barrier, formation of metastatic niches, and colonization in the brain. Ion channels have been demonstrated to be aberrantly expressed in tumor cells where they regulate neoplastic transformation, malignant progression or therapy resistance. Moreover, many ion channel modulators are FDA-approved drugs and in clinical use proposing ion channels as druggable targets for future anti-cancer therapy. The present review article aims to summarize the current knowledge on the function of ion channels in the different processes of brain metastasis. The data suggest that certain channel types involving voltage-gated sodium channels, ATP-release channels, ionotropic neurotransmitter receptors and gap junction-generating connexins interfere with distinct processes of brain metastazation.

  17. Ion Channels in Brain Metastasis

    Directory of Open Access Journals (Sweden)

    Lukas Klumpp


    Full Text Available Breast cancer, lung cancer and melanoma exhibit a high metastatic tropism to the brain. Development of brain metastases severely worsens the prognosis of cancer patients and constrains curative treatment options. Metastasizing to the brain by cancer cells can be dissected in consecutive processes including epithelial–mesenchymal transition, evasion from the primary tumor, intravasation and circulation in the blood, extravasation across the blood–brain barrier, formation of metastatic niches, and colonization in the brain. Ion channels have been demonstrated to be aberrantly expressed in tumor cells where they regulate neoplastic transformation, malignant progression or therapy resistance. Moreover, many ion channel modulators are FDA-approved drugs and in clinical use proposing ion channels as druggable targets for future anti-cancer therapy. The present review article aims to summarize the current knowledge on the function of ion channels in the different processes of brain metastasis. The data suggest that certain channel types involving voltage-gated sodium channels, ATP-release channels, ionotropic neurotransmitter receptors and gap junction-generating connexins interfere with distinct processes of brain metastazation.

  18. SIRIUS - A one-dimensional multigroup analytic nodal diffusion theory code

    Energy Technology Data Exchange (ETDEWEB)

    Forslund, P. [Westinghouse Atom AB, Vaesteraas (Sweden)


    In order to evaluate relative merits of some proposed intranodal cross sections models, a computer code called Sirius has been developed. Sirius is a one-dimensional, multigroup analytic nodal diffusion theory code with microscopic depletion capability. Sirius provides the possibility of performing a spatial homogenization and energy collapsing of cross sections. In addition a so called pin power reconstruction method is available for the purpose of reconstructing 'heterogeneous' pin qualities. consequently, Sirius has the capability of performing all the calculations (incl. depletion calculations) which are an integral part of the nodal calculation procedure. In this way, an unambiguous numerical analysis of intranodal cross section models is made possible. In this report, the theory of the nodal models implemented in sirius as well as the verification of the most important features of these models are addressed.

  19. Single Nodal Loop of Accidental Degeneracies in Minimal Symmetry: Triclinic CaAs3 (United States)

    Quan, Y.; Yin, Z. P.; Pickett, W. E.


    The existence of closed loops of degeneracies in crystals has been intimately connected with associated crystal symmetries, raising the following question: What is the minimum symmetry required for topological character, and can one find an example? Triclinic CaAs3 , in the space group P 1 ¯ with only a center of inversion, has been found to display, without need for tuning, a nodal loop of accidental degeneracies with topological character, centered on one face of the Brillouin zone that is otherwise fully gapped. The small loop is very flat in energy, yet is cut four times by the Fermi energy, a condition that results in an intricate repeated touching of inversion related pairs of Fermi surfaces at Weyl points. Spin-orbit coupling lifts the fourfold degeneracy along the loop, leaving trivial Kramers pairs. With its single nodal loop that emerges without protection from any point group symmetry, CaAs3 represents the primal "hydrogen atom" of nodal loop systems.

  20. Evaluation of nodal reliability risk in a deregulated power system with photovoltaic power penetration

    DEFF Research Database (Denmark)

    Zhao, Qian; Wang, Peng; Goel, Lalit


    Owing to the intermittent characteristic of solar radiation, power system reliability may be affected with high photovoltaic (PV) power penetration. To reduce large variation of PV power, additional system balancing reserve would be needed. In deregulated power systems, deployment of reserves...... simulation technique has been proposed to evaluate the reserve deployment and customers' nodal reliability with high PV power penetration. The proposed method can effectively model the chronological aspects and stochastic characteristics of PV power and system operation with high computation efficiency...... considered in the proposed method. Nodal reliability indices and reserve deployment have been evaluated by applying the proposed method to the Institute of Electrical and Electronics Engineers reliability test system....

  1. [Does nodal irradiation (clavicular and internal mammary chains) increase the toxicity of adjuvant breast radiotherapy?]. (United States)

    Riou, O; Bourgier, C; Fenoglietto, P; Azria, D


    Treatment volume is a major risk factor of radiation-induced toxicity. As nodal irradiation increases treatment volume, radiation toxicity should be greater. Nevertheless, scientific randomised data do not support this fact. However, a radiation-induced toxicity is possible outside tangential fields in the nodal volumes not related to breast-only treatment. Treatment should not be adapted only to the disease but personalized to the individual risk of toxicity for each patient. Copyright © 2015 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  2. Dual AV Nodal Nonreentrant Tachycardia Resulting in Inappropriate ICD Therapy in a Patient with Cardiac Sarcoidosis

    Directory of Open Access Journals (Sweden)

    Ankur A. Karnik, MD


    Full Text Available Dual atrioventricular nodal nonreentrant tachycardia (DAVNNT occurs due to concurrent antegrade conduction over fast and slow atrioventricular nodal pathways and is treated by slow pathway modification. We describe a unique case of a patient with cardiac sarcoidosis who received inappropriate ICD shocks for DAVNNT. Atrial and ventricular device electrograms satisfied both rate and V>A criteria for ventricular tachycardia. We postulate that alterations in refractoriness and conduction as is seen in cardiac sarcoidosis (CS may have contributed to occurrence of DAVNNT.

  3. An evidence-based knowledgebase of metastasis suppressors to identify key pathways relevant to cancer metastasis. (United States)

    Zhao, Min; Li, Zhe; Qu, Hong


    Metastasis suppressor genes (MS genes) are genes that play important roles in inhibiting the process of cancer metastasis without preventing growth of the primary tumor. Identification of these genes and understanding their functions are critical for investigation of cancer metastasis. Recent studies on cancer metastasis have identified many new susceptibility MS genes. However, the comprehensive illustration of diverse cellular processes regulated by metastasis suppressors during the metastasis cascade is lacking. Thus, the relationship between MS genes and cancer risk is still unclear. To unveil the cellular complexity of MS genes, we have constructed MSGene (, the first literature-based gene resource for exploring human MS genes. In total, we manually curated 194 experimentally verified MS genes and mapped to 1448 homologous genes from 17 model species. Follow-up functional analyses associated 194 human MS genes with epithelium/tissue morphogenesis and epithelia cell proliferation. In addition, pathway analysis highlights the prominent role of MS genes in activation of platelets and coagulation system in tumor metastatic cascade. Moreover, global mutation pattern of MS genes across multiple cancers may reveal common cancer metastasis mechanisms. All these results illustrate the importance of MSGene to our understanding on cell development and cancer metastasis.

  4. Dosimetric evaluation of the feasibility of stereotactic body radiotherapy for primary lung cancer with lobe-specific selective elective nodal irradiation. (United States)

    Komatsu, Tetsuya; Kunieda, Etsuo; Kitahara, Tadashi; Akiba, Takeshi; Nagao, Ryuta; Fukuzawa, Tsuyoshi


    More than 10% of all patients treated with stereotactic body radiotherapy (SBRT) for primary lung cancer develop regional lymph node recurrence. We evaluated the dosimetric feasibility of SBRT with lobe-specific selective elective nodal irradiation (ENI) on dose-volume histograms. A total of 21 patients were treated with SBRT for Stage I primary lung cancer between January 2010 and June 2012 at our institution. The extents of lobe-specific selective ENI fields were determined with reference to prior surgical reports. The ENI fields included lymph node stations (LNS) 3 + 4 + 11 for the right upper lobe tumors, LNS 7 + 11 for the right middle or lower lobe tumors, LNS 5 + 11 for the left upper lobe tumors, and LNS 7 + 11 for the left lower lobe tumors. A composite plan was generated by combining the ENI plan and the SBRT plan and recalculating for biologically equivalent doses of 2 Gy per fraction, using a linear quadratic model. The V20 of the lung, D(1cm3) of the spinal cord, D(1cm3) and D(10cm3) of the esophagus and D(10cm3) of the tracheobronchial wall were evaluated. Of the 21 patients, nine patients (43%) could not fulfill the dose constraints. In all these patients, the distance between the planning target volume (PTV) of ENI (PTVeni) and the PTV of SBRT (PTVsrt) was ≤2.0 cm. Of the three patients who developed regional metastasis, two patients had isolated lymph node failure, and the lymph node metastasis was included within the ENI field. When the distance between the PTVeni and PTVsrt is >2.0 cm, SBRT with selective ENI may therefore dosimetrically feasible. © The Author 2015. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology.

  5. Impact of radiation dose and standardized uptake value of (18)FDG PET on nodal control in locally advanced cervical cancer

    DEFF Research Database (Denmark)

    Ramlov, Anne; Kroon, Petra S; Jürgenliemk-Schulz, Ina M


    . Nine patients had a PAN-only failure. Patients receiving ≤ 4 cycles of weekly cisplatin had higher risk of nodal failure (p level of control in both boosted nodes and the elective irradiated regional target. However, a high nodal SUVmax...

  6. Dynamic multi-echo DCE- and DSC-MRI in rectal cancer: Low primary tumor Ktransand ΔR2* peak are significantly associated with lymph node metastasis. (United States)

    Grøvik, Endre; Redalen, Kathrine Røe; Storås, Tryggve Holck; Negård, Anne; Holmedal, Stein Harald; Ree, Anne Hansen; Meltzer, Sebastian; Bjørnerud, Atle; Gjesdal, Kjell-Inge


    To implement a dynamic contrast-based multi-echo MRI sequence in assessment of rectal cancer and evaluate associations between histopathologic data and the acquired dynamic contrast-enhanced (DCE) and dynamic susceptibility contrast (DSC) -MRI parameters. This pilot study reports results from 17 patients with resectable rectal cancer. Dynamic contrast-based multi-echo MRI (1.5T) was acquired using a three-dimensional multi-shot EPI sequence, yielding both DCE- and DSC-data following a single injection of contrast agent. The Institutional Review Board approved the study and all patients provided written informed consent. Quantitative analysis was performed by pharmacokinetic modeling on DCE data and tracer kinetic modeling on DSC data. Mann-Whitney U-test and receiver operating characteristics curve statistics was used to evaluate associations between histopathologic data and the acquired DCE- and DSC-MRI parameters. For patients with histologically confirmed nodal metastasis, the primary tumor demonstrated a significantly lower K trans and peak change in R2*, R2*-peak enh , than patients without nodal metastasis, showing a P-value of 0.010 and 0.005 for reader 1, and 0.043 and 0.019 for reader 2, respectively. This study shows the feasibility of acquiring DCE- and DSC-MRI in rectal cancer by dynamic multi-echo MRI. A significant association was found between both K trans and R2*-peak enh in the primary tumor and histological nodal status of the surgical specimen, which may improve stratification of patients to intensified multimodal treatment. 4 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:194-206. © 2016 The Authors Journal of Magnetic Resonance Imaging published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.

  7. Tumour exosome integrins determine organotropic metastasis. (United States)

    Hoshino, Ayuko; Costa-Silva, Bruno; Shen, Tang-Long; Rodrigues, Goncalo; Hashimoto, Ayako; Tesic Mark, Milica; Molina, Henrik; Kohsaka, Shinji; Di Giannatale, Angela; Ceder, Sophia; Singh, Swarnima; Williams, Caitlin; Soplop, Nadine; Uryu, Kunihiro; Pharmer, Lindsay; King, Tari; Bojmar, Linda; Davies, Alexander E; Ararso, Yonathan; Zhang, Tuo; Zhang, Haiying; Hernandez, Jonathan; Weiss, Joshua M; Dumont-Cole, Vanessa D; Kramer, Kimberly; Wexler, Leonard H; Narendran, Aru; Schwartz, Gary K; Healey, John H; Sandstrom, Per; Labori, Knut Jørgen; Kure, Elin H; Grandgenett, Paul M; Hollingsworth, Michael A; de Sousa, Maria; Kaur, Sukhwinder; Jain, Maneesh; Mallya, Kavita; Batra, Surinder K; Jarnagin, William R; Brady, Mary S; Fodstad, Oystein; Muller, Volkmar; Pantel, Klaus; Minn, Andy J; Bissell, Mina J; Garcia, Benjamin A; Kang, Yibin; Rajasekhar, Vinagolu K; Ghajar, Cyrus M; Matei, Irina; Peinado, Hector; Bromberg, Jacqueline; Lyden, David


    Ever since Stephen Paget's 1889 hypothesis, metastatic organotropism has remained one of cancer's greatest mysteries. Here we demonstrate that exosomes from mouse and human lung-, liver- and brain-tropic tumour cells fuse preferentially with resident cells at their predicted destination, namely lung fibroblasts and epithelial cells, liver Kupffer cells and brain endothelial cells. We show that tumour-derived exosomes uptaken by organ-specific cells prepare the pre-metastatic niche. Treatment with exosomes from lung-tropic models redirected the metastasis of bone-tropic tumour cells. Exosome proteomics revealed distinct integrin expression patterns, in which the exosomal integrins α6β4 and α6β1 were associated with lung metastasis, while exosomal integrin αvβ5 was linked to liver metastasis. Targeting the integrins α6β4 and αvβ5 decreased exosome uptake, as well as lung and liver metastasis, respectively. We demonstrate that exosome integrin uptake by resident cells activates Src phosphorylation and pro-inflammatory S100 gene expression. Finally, our clinical data indicate that exosomal integrins could be used to predict organ-specific metastasis.

  8. Brain metastasis: Unique challenges and open opportunities. (United States)

    Lowery, Frank J; Yu, Dihua


    The metastasis of cancer to the central nervous system (CNS) remains a devastating clinical reality, carrying an estimated survival time of less than one year in spite of recent therapeutic breakthroughs for other disease contexts. Advances in brain metastasis research are hindered by a number of factors, including its complicated nature and the difficulty of modeling metastatic cancer growth in the unique brain microenvironment. In this review, we will discuss the clinical challenge, and compare the merits and limitations of the available models for brain metastasis research. Additionally, we will specifically address current knowledge on how brain metastases take advantage of the unique brain environment to benefit their own growth. Finally, we will explore the distinctive metabolic and chemical characteristics of the brain and how these paradoxically represent barriers to establishment of brain metastasis, but also provide ample supplies for metastatic cells' growth in the brain. We envision that multi-disciplinary innovative approaches will open opportunities for the field to make breakthroughs in tackling unique challenges of brain metastasis. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Tumour exosome integrins determine organotropic metastasis (United States)

    Hoshino, Ayuko; Costa-Silva, Bruno; Shen, Tang-Long; Rodrigues, Goncalo; Hashimoto, Ayako; Mark, Milica Tesic; Molina, Henrik; Kohsaka, Shinji; Di Giannatale, Angela; Ceder, Sophia; Singh, Swarnima; Williams, Caitlin; Soplop, Nadine; Uryu, Kunihiro; Pharmer, Lindsay; King, Tari; Bojmar, Linda; Davies, Alexander E.; Ararso, Yonathan; Zhang, Tuo; Zhang, Haiying; Hernandez, Jonathan; Weiss, Joshua M.; Dumont-Cole, Vanessa D.; Kramer, Kimberly; Wexler, Leonard H.; Narendran, Aru; Schwartz, Gary K.; Healey, John H.; Sandstrom, Per; Labori, Knut Jørgen; Kure, Elin H.; Grandgenett, Paul M.; Hollingsworth, Michael A.; de Sousa, Maria; Kaur, Sukhwinder; Jain, Maneesh; Mallya, Kavita; Batra, Surinder K.; Jarnagin, William R.; Brady, Mary S.; Fodstad, Oystein; Muller, Volkmar; Pantel, Klaus; Minn, Andy J.; Bissell, Mina J.; Garcia, Benjamin A.; Kang, Yibin; Rajasekhar, Vinagolu K.; Ghajar, Cyrus M.; Matei, Irina; Peinado, Hector; Bromberg, Jacqueline; Lyden, David


    Ever since Stephen Paget’s 1889 hypothesis, metastatic organotropism has remained one of cancer’s greatest mysteries. Here we demonstrate that exosomes from mouse and human lung-, liver- and brain-tropic tumour cells fuse preferentially with resident cells at their predicted destination, namely lung fibroblasts and epithelial cells, liver Kupffer cells and brain endothelial cells. We show that tumour-derived exosomes uptaken by organ-specific cells prepare the pre-metastatic niche. Treatment with exosomes from lung-tropic models redirected the metastasis of bone-tropic tumour cells. Exosome proteomics revealed distinct integrin expression patterns, in which the exosomal integrins α6β4 and α6β1 were associated with lung metastasis, while exosomal integrin αvβ5 was linked to liver metastasis. Targeting the integrins α6β4 and αvβ5 decreased exosome uptake, as well as lung and liver metastasis, respectively. We demonstrate that exosome integrin uptake by resident cells activates Src phosphorylation and pro-inflammatory S100 gene expression. Finally, our clinical data indicate that exosomal integrins could be used to predict organ-specific metastasis. PMID:26524530

  10. Selective sentinel lymph node biopsy in papillary thyroid carcinoma in patients with no preoperative evidence of lymph node metastasis. (United States)

    González, Óscar; Zafon, Carles; Caubet, Enric; García-Burillo, Amparo; Serres, Xavier; Fort, José Manuel; Mesa, Jordi; Castell, Joan; Roca, Isabel; Ramón Y Cajal, Santiago; Iglesias, Carmela


    Lymphadenectomy is recommended during surgery for papillary thyroid carcinoma when there is evidence of cervical lymph node metastasis (therapeutic) or in high-risk patients (prophylactic) such as those with T3 and T4 tumors of the TNM classification. Selective sentinel lymph node biopsy may improve preoperative diagnosis of nodal metastases. To analyze the results of selective sentinel lymph node biopsy in a group of patients with papillary thyroid carcinoma and no evidence of nodal involvement before surgery. A retrospective, single-center study in patients with papillary thyroid carcinoma and no clinical evidence of lymph node involvement who underwent surgery between 2011 and 2013. The sentinel node was identified by scintigraphy. When the sentinel node was positive, the affected compartment was removed, and when sentinel node was negative, central lymph node dissection was performed. Forty-three patients, 34 females, with a mean age of 52.3 (±17) years, were enrolled. Forty-six (27%) of the 170 SNs resected from 24 (55.8%) patients were positive for metastasis. In addition, 94 (15.6%) out of the 612 lymph nodes removed in the lymphadenectomies were positive for metastases. Twelve of the 30 (40%) low risk patients (cT1N0 and cT2N0) changed their stage to pN1, whereas 12 of 13 (92%) high risk patients (cT3N0 and cT4N0) changed to pN1 stage. Selective sentinel lymph node biopsy changes the stage of more than 50% of patients from cN0 to pN1. This confirms the need for lymph node resection in T3 and T4 tumors, but reveals the presence of lymph node metastases in 40% of T1-T2 tumors. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

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    Lifescience Database Archive (English)

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  16. File list: NoD.ALL.20.NA.AllCell [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  17. MicroRNA expression in nodal and extranodal Diffuse Large B-cell Lymphoma

    DEFF Research Database (Denmark)

    Mandrup, Charlotte; Petersen, Anders; Højfeldt, Anne Dirks

    of the manifestations, and no way to predict the potential progression from nodal to extranodal disease. miRNA are small regulatory RNA molecules with core function to repress/cleave sequence complementary mRNA targets. Abnormalities in miRNA genetics and expression are known to affect initiation and development...

  18. A difference-equation formalism for the nodal domains of separable billiards

    Energy Technology Data Exchange (ETDEWEB)

    Manjunath, Naren; Samajdar, Rhine [Indian Institute of Science, Bangalore 560012 (India); Jain, Sudhir R., E-mail: [Nuclear Physics Division, Bhabha Atomic Research Centre, Mumbai 400085 (India)


    Recently, the nodal domain counts of planar, integrable billiards with Dirichlet boundary conditions were shown to satisfy certain difference equations in Samajdar and Jain (2014). The exact solutions of these equations give the number of domains explicitly. For complete generality, we demonstrate this novel formulation for three additional separable systems and thus extend the statement to all integrable billiards.

  19. Effects of plant growth regulators on in vitro cultured nodal explants ...

    African Journals Online (AJOL)



    Jul 9, 2014 ... Smith et al. (1986) and Konan et al. (1997) were the first to report success in the production of an average of 5 to 6 shoots per bud from in vitro culture of ... also succeeded in in vitro nodal culture of cassava. (Konan et al., 2006; Medina et al., 2006; Escobar et al.,. 2009). Despite these reported successes, ...

  20. The Apelin receptor enhances Nodal/TGF beta signaling to ensure proper cardiac development

    NARCIS (Netherlands)

    Deshwar, Ashish R.; Chng, Serene C.; Ho, Lena; Reversade, Bruno; Scott, Ian C.


    The Apelin receptor (Apinr) is essential for heart development, controlling the early migration of cardiac progenitors. Here we demonstrate that in zebrafish Apinr modulates Nodal/TGF beta signaling, a key pathway essential for mesendoderm induction and migration. Loss of Apinr function leads to a

  1. Transport evidence of 3D topological nodal-line semimetal phase in ZrSiS (United States)

    Zhang, Junran; Gao, Ming; Zhang, Jinglei; Wang, Xuefeng; Zhang, Xiaoqian; Zhang, Minhao; Niu, Wei; Zhang, Rong; Xu, Yongbing


    Topological nodal-line semimetal is a new emerging material, which is viewed as a three-dimensional (3D) analog of graphene with the conduction and valence bands crossing at Dirac nodes, resulting in a range of exotic transport properties. Herein, we report on the direct quantum transport evidence of the 3D topological nodal-line semimetal phase of ZrSiS with angular-dependent magnetoresistance (MR) and the combined de Hass-van Alphen (dHvA) and Shubnikov-de Hass (SdH) oscillations. Through fitting by a two-band model, the MR results demonstrate high topological nodal-line fermion densities of approximately 6 × 1021 cm-3 and a perfect electron/hole compensation ratio of 0.94, which is consistent with the semi-classical expression fitting of Hall conductance G xy and the theoretical calculation. Both the SdH and dHvA oscillations provide clear evidence of 3D topological nodal-line semimetal characteristic.

  2. File list: NoD.ALL.50.NA.AllCell [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  3. File list: NoD.ALL.50.NA.AllCell [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  4. Nodal Green’s Function Method Singular Source Term and Burnable Poison Treatment in Hexagonal Geometry

    Energy Technology Data Exchange (ETDEWEB)

    A.A. Bingham; R.M. Ferrer; A.M. ougouag


    An accurate and computationally efficient two or three-dimensional neutron diffusion model will be necessary for the development, safety parameters computation, and fuel cycle analysis of a prismatic Very High Temperature Reactor (VHTR) design under Next Generation Nuclear Plant Project (NGNP). For this purpose, an analytical nodal Green’s function solution for the transverse integrated neutron diffusion equation is developed in two and three-dimensional hexagonal geometry. This scheme is incorporated into HEXPEDITE, a code first developed by Fitzpatrick and Ougouag. HEXPEDITE neglects non-physical discontinuity terms that arise in the transverse leakage due to the transverse integration procedure application to hexagonal geometry and cannot account for the effects of burnable poisons across nodal boundaries. The test code being developed for this document accounts for these terms by maintaining an inventory of neutrons by using the nodal balance equation as a constraint of the neutron flux equation. The method developed in this report is intended to restore neutron conservation and increase the accuracy of the code by adding these terms to the transverse integrated flux solution and applying the nodal Green’s function solution to the resulting equation to derive a semi-analytical solution.

  5. Nodal-line entanglement entropy: Generalized Widom formula from entanglement Hamiltonians (United States)

    Pretko, Michael


    A system of fermions forming a Fermi surface exhibits a large degree of quantum entanglement, even in the absence of interactions. In particular, the usual case of a codimension one Fermi surface leads to a logarithmic violation of the area law for entanglement entropy as dictated by the Widom formula. We here generalize this formula to the case of arbitrary codimension, which is of particular interest for nodal lines in three dimensions. We first re-derive the standard Widom formula by calculating an entanglement Hamiltonian for Fermi-surface systems, obtained by repurposing a trick commonly applied to relativistic theories. The entanglement Hamiltonian will take a local form in terms of a low-energy patch theory for the Fermi surface, although it is nonlocal with respect to the microscopic fermions. This entanglement Hamiltonian can then be used to derive the entanglement entropy, yielding a result in agreement with the Widom formula. The method is then generalized to arbitrary codimension. For nodal lines, the area law is obeyed, and the magnitude of the coefficient for a particular partition is nonuniversal. However, the coefficient has a universal dependence on the shape and orientation of the nodal line relative to the partitioning surface. By comparing the relative magnitude of the area law for different partitioning cuts, entanglement entropy can be used as a tool for diagnosing the presence and shape of a nodal line in a ground-state wave function.

  6. Prognostic value of nodal micrometastases in patients with cancer of the gastro-oesophageal junction

    NARCIS (Netherlands)

    Heeren, PAM; Kelder, W; Blondeel, [No Value; van Westreenen, HL; Hollema, H; Plukker, JT

    Aims. Aim of this study was to examine the presence and the prognostic impact of immunohistochemically identified nodal micrometastases in patients with astro-oesophageal junction (GEJ) carcinomas. Methods. Between January 1988 and December 2000, 148 patients underwent a radical (R0) resection with

  7. Existence of infinitely many nodal solutions for a superlinear Neumann boundary value problem

    Directory of Open Access Journals (Sweden)

    Aixia Qian


    Full Text Available We study the existence of a class of nonlinear elliptic equation with Neumann boundary condition, and obtain infinitely many nodal solutions. The study of such a problem is based on the variational methods and critical point theory. We prove the conclusion by using the symmetric mountain-pass theorem under the Cerami condition.

  8. Photoacoustic intra-operative nodal staging using clinically approved superparamagnetic iron oxide nanoparticles

    NARCIS (Netherlands)

    Grootendorst, Diederik; Fratila, R.M.; Visscher, M.; ten Haken, Bernard; van Wezel, Richard Jack Anton; Steenbergen, Wiendelt; Manohar, Srirang; Ruers, Theo J.M.


    Detection of tumor metastases in the lymphatic system is essential for accurate staging of various malignancies, however fast, accurate and cost-effective intra-operative evaluation of the nodal status remains difficult to perform with common available medical imaging techniques. In recent years,

  9. Photoacoustic intra-operative nodal staging using clinically approved superparamagnetic iron oxide nanoparticles (United States)

    Grootendorst, Diederik J.; Fratila, Raluca M.; Visscher, Martijn; Ten Haken, Bennie; van Wezel, Richard; Steenbergen, Wiendelt; Manohar, Srirang; Ruers, Theo J. M.


    Detection of tumor metastases in the lymphatic system is essential for accurate staging of various malignancies, however fast, accurate and cost-effective intra-operative evaluation of the nodal status remains difficult to perform with common available medical imaging techniques. In recent years, numerous studies have confirmed the additional value of superparamagnetic iron oxide dispersions (SPIOs) for nodal staging purposes, prompting the clearance of different SPIO dispersions for clinical practice. We evaluate whether a combination of photoacoustic (PA) imaging and a clinically approved SPIO dispersion, could be applied for intra-operative nodal staging. Metastatic adenocarcinoma was inoculated in Copenhagen rats for 5 or 8 days. After SPIO injection, the lymph nodes were photoacoustically imaged both in vivo and ex vivo whereafter imaging results were correlated with MR and histology. Results were compared to a control group without tumor inoculation. In the tumor groups clear irregularities, as small as 1 mm, were observed in the PA contrast pattern of the nodes together with an decrease of PA response. These irregularities could be correlated to the absence of contrast in the MR images and could be linked to metastatic deposits seen in the histological slides. The PA and MR images of the control animals did not show these features. We conclude that the combination of photoacoustic imaging with a clinically approved iron oxide nanoparticle dispersion is able to detect lymph node metastases in an animal model. This approach opens up new possibilities for fast intra-operative nodal staging in a clinical setting.

  10. Ultrasonography or palpation for detection of melanoma nodal invasion: a meta-analysis. (United States)

    Bafounta, Marie-Lise; Beauchet, Alain; Chagnon, Sophie; Saiag, Philippe


    Because treatment of distant melanoma metastases is not very effective, nodal spread should be diagnosed early so that therapeutic lymphadenectomy can be started as early as possible. Physical examination alone often does not detect nodal metastases and palpable nodes cannot be clasified unambiguously. Whether lymph-node ultrasonography-an inexpensive procedure-improves detection of nodal invasion during the initial staging and follow-up of patients with melanoma is controversial. We used meta-analysis techniques for diagnostic tests to assess the merit of ultrasonography and palpation in detection of nodal invasion in patients with melanoma. Five databases were screened until December, 2003. 12 studies, including 6642 patients and 18?610 paired palpation and ultrasound examinations, were eligible. The main limitations were variations in the definition of false negatives, and verification bias. Ultrasonography had a higher discriminatory power (odds ratio 1755; 95% CI 726-4238) than did palpation (21 [4-111]; p=0.0001). Furthermore, positive-likelihood ratios were 41.9 (95% CI 29-75) for ultrasonography and 4.55 (2-18) for palpation; negative-likelihood ratios were 0.024 (0.01-0.03) and 0.22 (0.06-0.31), respectively. Our results showed clearly that ultrasonography detects lymph-node invasion more accurately than palpation, and should therefore probably be used routinely in patients with melanoma.

  11. Analysis of nodal aberration properties in off-axis freeform system design. (United States)

    Shi, Haodong; Jiang, Huilin; Zhang, Xin; Wang, Chao; Liu, Tao


    Freeform surfaces have the advantage of balancing off-axis aberration. In this paper, based on the framework of nodal aberration theory (NAT) applied to the coaxial system, the third-order astigmatism and coma wave aberration expressions of an off-axis system with Zernike polynomial surfaces are derived. The relationship between the off-axis and surface shape acting on the nodal distributions is revealed. The nodal aberration properties of the off-axis freeform system are analyzed and validated by using full-field displays (FFDs). It has been demonstrated that adding Zernike terms, up to nine, to the off-axis system modifies the nodal locations, but the field dependence of the third-order aberration does not change. On this basis, an off-axis two-mirror freeform system with 500 mm effective focal length (EFL) and 300 mm entrance pupil diameter (EPD) working in long-wave infrared is designed. The field constant aberrations induced by surface tilting are corrected by selecting specific Zernike terms. The design results show that the nodes of third-order astigmatism and coma move back into the field of view (FOV). The modulation transfer function (MTF) curves are above 0.4 at 20 line pairs per millimeter (lp/mm) which meets the infrared reconnaissance requirement. This work provides essential insight and guidance for aberration correction in off-axis freeform system design.

  12. Bifurcation from infinity and nodal solutions of quasilinear elliptic differential equations

    Directory of Open Access Journals (Sweden)

    Bian-Xia Yang


    Full Text Available In this article, we establish a unilateral global bifurcation theorem from infinity for a class of $N$-dimensional p-Laplacian problems. As an application, we study the global behavior of the components of nodal solutions of the problem $$\\displaylines{ \\operatorname{div}(\\varphi_p(\

  13. Computation of Steady State Nodal Voltages for Fast Security Assessment in Power Systems

    DEFF Research Database (Denmark)

    Møller, Jakob Glarbo; Jóhannsson, Hjörtur; Østergaard, Jacob


    Development of a method for real-time assess-ment of post-contingency nodal voltages is introduced. Linear network theory is applied in an algorithm that utilizes Thevenin equivalent representation of power systems as seen from every voltage-controlled node in a network. The method is evaluated...

  14. 5-Hydroxymethylcytosine expression in metastatic melanoma versus nodal nevus in sentinel lymph node biopsies. (United States)

    Lee, Jonathan J; Granter, Scott R; Laga, Alvaro C; Saavedra, Arturo P; Zhan, Qian; Guo, Weimin; Xu, Shuyun; Murphy, George F; Lian, Christine G


    Sentinel lymph node biopsies are conducted to stage patients with newly diagnosed melanomas that have histopathological attributes conferring defined levels of metastatic potential. Because benign nevic cells may also form 'deposits' in lymph nodes (nodal nevus), the pathological evaluation for metastatic melanoma within sentinel lymph nodes can be challenging. Twenty-eight sentinel lymph node biopsy cases containing either metastatic melanoma (N=18) or nodal nevi (N=10) were retrieved from the archives of the Brigham and Women's Hospital, Department of Pathology (2011-2014). In addition, two sentinel lymph node cases that were favored to represent metastatic disease but whose histopathological features were viewed as equivocal, with melanoma favored, were also included. Dual labeling for the melanocyte lineage marker, MART-1, and the epigenetic marker, 5-hydroxymethylcytosine, a functionally significant indicator that has been shown to distinguish benign nevi from melanoma, was performed on all cases using immunohistochemistry and/or direct immunofluorescence. All (18 of 18) metastatic melanoma cases showed complete loss of 5-hydroxymethylcytosine nuclear staining in MART-1-positive cells, and all (10 of 10) nodal nevus cases demonstrated 5-hydroxymethylcytosine nuclear staining in MART-1-positive cells. In addition, 5-hydroxymethylcytosine staining confirmed the favored diagnoses of metastatic melanoma in the two 'equivocal' cases. Thus, 5-hydroxymethylcytosine may be a useful adjunctive marker to distinguish between benign nodal nevi and metastatic melanoma during the evaluation of sentinel lymph node biopsies for metastatic melanoma.

  15. Activin/nodal signaling switches the terminal fate of human embryonic stem cell-derived trophoblasts. (United States)

    Sarkar, Prasenjit; Randall, Shan M; Collier, Timothy S; Nero, Anthony; Russell, Teal A; Muddiman, David C; Rao, Balaji M


    Human embryonic stem cells (hESCs) have been routinely treated with bone morphogenetic protein and/or inhibitors of activin/nodal signaling to obtain cells that express trophoblast markers. Trophoblasts can terminally differentiate to either extravillous trophoblasts or syncytiotrophoblasts. The signaling pathways that govern the terminal fate of these trophoblasts are not understood. We show that activin/nodal signaling switches the terminal fate of these hESC-derived trophoblasts. Inhibition of activin/nodal signaling leads to formation of extravillous trophoblast, whereas loss of activin/nodal inhibition leads to the formation of syncytiotrophoblasts. Also, the ability of hESCs to form bona fide trophoblasts has been intensely debated. We have examined hESC-derived trophoblasts in the light of stringent criteria that were proposed recently, such as hypomethylation of the ELF5-2b promoter region and down-regulation of HLA class I antigens. We report that trophoblasts that possess these properties can indeed be obtained from hESCs. © 2015 by The American Society for Biochemistry and Molecular Biology, Inc.

  16. Activin/Nodal Signaling Switches the Terminal Fate of Human Embryonic Stem Cell-derived Trophoblasts* (United States)

    Sarkar, Prasenjit; Randall, Shan M.; Collier, Timothy S.; Nero, Anthony; Russell, Teal A.; Muddiman, David C.; Rao, Balaji M.


    Human embryonic stem cells (hESCs) have been routinely treated with bone morphogenetic protein and/or inhibitors of activin/nodal signaling to obtain cells that express trophoblast markers. Trophoblasts can terminally differentiate to either extravillous trophoblasts or syncytiotrophoblasts. The signaling pathways that govern the terminal fate of these trophoblasts are not understood. We show that activin/nodal signaling switches the terminal fate of these hESC-derived trophoblasts. Inhibition of activin/nodal signaling leads to formation of extravillous trophoblast, whereas loss of activin/nodal inhibition leads to the formation of syncytiotrophoblasts. Also, the ability of hESCs to form bona fide trophoblasts has been intensely debated. We have examined hESC-derived trophoblasts in the light of stringent criteria that were proposed recently, such as hypomethylation of the ELF5-2b promoter region and down-regulation of HLA class I antigens. We report that trophoblasts that possess these properties can indeed be obtained from hESCs. PMID:25670856

  17. Vector bundles with a fixed determinant on an irreducible nodal curve

    Indian Academy of Sciences (India)

    sheaves with a fixed determinant in the moduli space of torsion-free sheaves on Y. The relation to Seshadri–Nagaraj conjecture is studied. Keywords. Nodal curves; torsion-free sheaves; fixed determinant. 1. Introduction. Generalized parabolic vector bundles (GPBs) on a smooth curve X are vector bundles on. X together ...

  18. Vector bundles with a fixed determinant on an irreducible nodal curve

    Indian Academy of Sciences (India)

    Using the correspondence between GPBs on and torsion-free sheaves on a nodal curve of which is a desingularization, we show that M L ¯ can be regarded as the compactified moduli scheme of vector bundles on with fixed determinant. We get a natural scheme structure on the closure of the subset consisting of ...

  19. Photoacoustic Nodal Metastases detection in a rat model using a clinical superparamagnetic iron oxide nanoparticle dispersion

    NARCIS (Netherlands)

    Grootendorst, Diederik; Fratila, R.M.; Visscher, M.; ten Haken, Bernard; van Wezel, Richard Jack Anton; Steenbergen, Wiendelt; Manohar, Srirang; Ruers, Theo J.M.


    Background: Detection of tumor metastases in the lymphatic system is essential for accurate staging of different malignancies, however fast and accurate pre- or intra-operative evaluation of the nodal status remains difficult to perform with common available medical imaging techniques. In recent

  20. Control of Metastasis by NK Cells. (United States)

    López-Soto, Alejandro; Gonzalez, Segundo; Smyth, Mark J; Galluzzi, Lorenzo


    The metastatic spread of malignant cells to distant anatomical locations is a prominent cause of cancer-related death. Metastasis is governed by cancer-cell-intrinsic mechanisms that enable neoplastic cells to invade the local microenvironment, reach the circulation, and colonize distant sites, including the so-called epithelial-to-mesenchymal transition. Moreover, metastasis is regulated by microenvironmental and systemic processes, such as immunosurveillance. Here, we outline the cancer-cell-intrinsic and -extrinsic factors that regulate metastasis, discuss the key role of natural killer (NK) cells in the control of metastatic dissemination, and present potential therapeutic approaches to prevent or target metastatic disease by harnessing NK cells. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Oral-aboral axis specification in the sea urchin embryo, IV: hypoxia radializes embryos by preventing the initial spatialization of nodal activity. (United States)

    Coffman, James A; Wessels, Abigail; DeSchiffart, Carolyn; Rydlizky, Katarina


    The oral-aboral axis of the sea urchin embryo is specified conditionally via a regulated feedback circuit involving the signaling gene nodal and its antagonist lefty. In normal development nodal activity becomes localized to the prospective oral side of the blastula stage embryo, a process that requires lefty. In embryos of Strongylocentrotus purpuratus, a redox gradient established by asymmetrically distributed mitochondria provides an initial spatial input that positions the localized domain of nodal expression. This expression is perturbed by hypoxia, leading to development of radialized embryos lacking an oral-aboral axis. Here we show that this radialization is not caused by a failure to express nodal, but rather by a failure to localize nodal activity to one side of the embryo. This occurs even when embryos are removed from hypoxia at late cleavage stage when nodal is first expressed, indicating that the effect involves the initiation phase of nodal activity, rather than its positive feedback-driven amplification and maintenance. Quantitative fluorescence microscopy of MitoTracker Orange-labeled embryos expressing nodal-GFP reporter gene revealed that hypoxia abolishes the spatial correlation between mitochondrial distribution and nodal expression, suggesting that hypoxia eliminates the initial spatial bias in nodal activity normally established by the redox gradient. We propose that absent this bias, the initiation phase of nodal expression is spatially uniform, such that the ensuing Nodal-mediated community effect is not localized, and hence refractory to Lefty-mediated enforcement of localization. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. An approach to model reactor core nodalization for deterministic safety analysis

    Energy Technology Data Exchange (ETDEWEB)

    Salim, Mohd Faiz, E-mail:; Samsudin, Mohd Rafie, E-mail: [Nuclear Energy Department, Regulatory Economics & Planning Division, Tenaga Nasional Berhad (Malaysia); Mamat Ibrahim, Mohd Rizal, E-mail: [Prototypes & Plant Development Center, Malaysian Nuclear Agency (Malaysia); Roslan, Ridha, E-mail:; Sadri, Abd Aziz [Nuclear Installation Divisions, Atomic Energy Licensing Board (Malaysia); Farid, Mohd Fairus Abd [Reactor Technology Center, Malaysian Nuclear Agency (Malaysia)


    Adopting good nodalization strategy is essential to produce an accurate and high quality input model for Deterministic Safety Analysis (DSA) using System Thermal-Hydraulic (SYS-TH) computer code. The purpose of such analysis is to demonstrate the compliance against regulatory requirements and to verify the behavior of the reactor during normal and accident conditions as it was originally designed. Numerous studies in the past have been devoted to the development of the nodalization strategy for small research reactor (e.g. 250kW) up to the bigger research reactor (e.g. 30MW). As such, this paper aims to discuss the state-of-arts thermal hydraulics channel to be employed in the nodalization for RTP-TRIGA Research Reactor specifically for the reactor core. At present, the required thermal-hydraulic parameters for reactor core, such as core geometrical data (length, coolant flow area, hydraulic diameters, and axial power profile) and material properties (including the UZrH{sub 1.6}, stainless steel clad, graphite reflector) have been collected, analyzed and consolidated in the Reference Database of RTP using standardized methodology, mainly derived from the available technical documentations. Based on the available information in the database, assumptions made on the nodalization approach and calculations performed will be discussed and presented. The development and identification of the thermal hydraulics channel for the reactor core will be implemented during the SYS-TH calculation using RELAP5-3D{sup ®} computer code. This activity presented in this paper is part of the development of overall nodalization description for RTP-TRIGA Research Reactor under the IAEA Norwegian Extra-Budgetary Programme (NOKEBP) mentoring project on Expertise Development through the Analysis of Reactor Thermal-Hydraulics for Malaysia, denoted as EARTH-M.

  3. Pig epiblast stem cells depend on activin/nodal signaling for pluripotency and self-renewal. (United States)

    Alberio, Ramiro; Croxall, Nicola; Allegrucci, Cinzia


    Activin/Nodal signaling is required for maintaining pluripotency and self-renewal of mouse epiblast stem cells and human embryonic stem cells (hESC). In this study, we investigated whether this signaling mechanism is also operative in cultured epiblasts derived from Days 10.5-12 pig embryos. Pig epiblast stem cell lines (pEpiSC) were established on mouse feeder layers and medium supplemented with basic fibroblast growth factor (bFGF). pEpiSC express the core pluripotency factors OCT4 (or POU5F1), NANOG, SOX2, and NODAL, but they do not express REX1 or alkaline phosphatase activity. Blocking leukemia inhibitory factor (LIF)/JAK/STAT3 pathway by adding the specific JAK I inhibitor 420099 and an anti-LIF antibody over 3 passages did not affect pluripotency of pEpiSC. In contrast, cells grown with the Alk-5 inhibitor SB431542, which blocks Activin/Nodal pathway, differentiated readily toward the neural lineage. pEpiSC are pluripotent, as established by their differentiation potential to ectoderm, mesoderm, and endoderm. These cells can be induced to differentiate toward trophectoderm and to germ cell precursors in response to bone morphogenetic protein 4 (BMP-4). In conclusion, our study demonstrates that pig epiblasts express the core pluripotency genes and that the capacity for maintaining self-renewal in pEpiSC depends on Activin/Nodal signaling. This study provides further evidence that maintenance of pluripotency via Activin/Nodal signal is conserved in mammals.

  4. Prediction of Metastasis Using Second Harmonic Generation (United States)


    and high F/B (representing a three-column version of the cartoon in Figure 5): Low F/B Medium F/B High F/B Coeff P- value Coeff P- value Coeff P...predict time to metastasis in ER+ IDC patients that received hormonal therapy? Aim 1a. Use a training set of F/B values to derive a predictive... values to test the ability of the F/B algorithm to predict time to metastasis. Test this F/B algorithm against, and in combination with, the predictive

  5. Duodenal Metastasis of Malignant Pleural Mesothelioma

    Directory of Open Access Journals (Sweden)

    Huang-Chi Chen


    Full Text Available Metastatic malignant mesothelioma of the pleura is uncommon at the time of initial diagnosis. The gastrointestinal lumen is rarely found at autopsy in patients with widespread disease. Here, we describe an extremely rare case of isolated duodenal metastasis of sarcomatoid mesothelioma of the pleura in a 73-year-old man, without memory of any direct exposure to asbestos. The possibility of gastrointestinal tract metastasis should be considered in the presence of anemia or positive occult blood test in patients with malignant pleural mesothelioma.

  6. A link between inflammation and metastasis

    DEFF Research Database (Denmark)

    Hansen, M. T.; Forst, B.; Cremers, N.


    S100A4 is implicated in metastasis and chronic inflammation, but its function remains uncertain. Here we establish an S100A4-dependent link between inflammation and metastatic tumor progression. We found that the acute-phase response proteins serum amyloid A (SAA) 1 and SAA3 are transcriptional....... Furthermore, coordinate expression of S100A4 and SAA in tumor samples from colorectal carcinoma patients significantly correlated with reduced overall survival. These data show that SAA proteins are effectors for the metastasis-promoting functions of S100A4, and serve as a link between inflammation and tumor...

  7. Popliteal lymph node metastasis of tibial osteoblastic osteosarcoma

    Directory of Open Access Journals (Sweden)

    Yalın Dirik


    CONCLUSION: Lymph node metastasis of osteosarcoma is a rare entity and metastatic patterns could not be clearly explained. On the other hand, the effects of lymph node metastasis on prognosis are also not clearly defined and further studies are needed.

  8. Muc1 promotes migration and lung metastasis of melanoma cells


    Wang, Xiaoli; Lan, Hongwen; LI, Jun; Su,Yushu; Xu, Lijun


    Early stages of melanoma can be successfully treated by surgical resection of the tumor, but there is still no effective treatment once it is progressed to metastatic phases. Although growing family of both melanoma metastasis promoting and metastasis suppressor genes have been reported be related to metastasis, the molecular mechanisms governing melanoma metastatic cascade are still not completely understood. Therefore, defining the molecules that govern melanoma metastasis may aid the devel...

  9. Metastasis in renal cell carcinoma: Biology and implications for therapy

    Directory of Open Access Journals (Sweden)

    Jun Gong


    Full Text Available Although multiple advances have been made in systemic therapy for renal cell carcinoma (RCC, metastatic RCC remains incurable. In the current review, we focus on the underlying biology of RCC and plausible mechanisms of metastasis. We further outline evolving strategies to combat metastasis through adjuvant therapy. Finally, we discuss clinical patterns of metastasis in RCC and how distinct systemic therapy approaches may be considered based on the anatomic location of metastasis.

  10. Invasive cancer cells and metastasis (United States)

    Mierke, Claudia Tanja


    The physics of cancer is a relatively new emerging field of cancer research. In the last decade it has become a focus of biophysical research as well as becoming a novel focus for classical cancer research. This special section of Physical Biology focusing on invasive cancer cells and metastasis (physical oncology) will give greater insight into the different subfields where physical approaches are being applied to cancer research. This focus on the physical aspects of cancer is necessary because novel approaches in the field of genomics and proteomics have not altered the field of cancer research dramatically, due to the fact that few breakthroughs have been made. It is still not understood why some primary tumors metastasize and thus have a worse outcome compared to others that do not metastasize. As biophysicists, we and others suggest that the mechanical properties of the cancer cells, which possess the ability to transmigrate, are quite different compared to non-metastatic and non-invasive cancer cells. Furthermore, we hypothesize that these cancer cells undergo a selection process within the primary tumor that enables them to weaken their cell-cell adhesions and to alter their cell-matrix adhesions in order to be able to cross the outermost boundary of the primary tumor, as well as the surrounding basement membrane, and to invade the connective tissue. This prerequisite may also help the cancer cells to enter blood or lymph vessels, get transported with the vessel flow and form secondary tumors either within the vessel, directly on the endothelium, or in a different organ after crossing the endothelial lining a second time. This special section begins with a paper by Mark F Coughlin and Jeffrey J Fredberg on the changes in cytoskeletal dynamics and nonlinear rheology due to the metastatic capability of cancer cells from different cancer tissue types such as skin, bladder, prostate and kidney [1]. The hypothesis was that the metastatic outcome is impacted by

  11. Nodal signaling is required for mesodermal and ventral but not for dorsal fates in the indirect developing hemichordate, Ptychodera flava (United States)

    Röttinger, Eric; DuBuc, Timothy Q.; Amiel, Aldine R.; Martindale, Mark Q.


    ABSTRACT Nodal signaling plays crucial roles in vertebrate developmental processes such as endoderm and mesoderm formation, and axial patterning events along the anteroposterior, dorsoventral and left-right axes. In echinoderms, Nodal plays an essential role in the establishment of the dorsoventral axis and left-right asymmetry, but not in endoderm or mesoderm induction. In protostomes, Nodal signaling appears to be involved only in establishing left-right asymmetry. Hence, it is hypothesized that Nodal signaling has been co-opted to pattern the dorsoventral axis of deuterostomes and for endoderm, mesoderm formation as well as anteroposterior patterning in chordates. Hemichordata, together with echinoderms, represent the sister taxon to chordates. In this study, we analyze the role of Nodal signaling in the indirect developing hemichordate Ptychodera flava. In particular, we show that during gastrulation nodal transcripts are detected in a ring of cells at the vegetal pole that gives rise to endomesoderm and in the ventral ectoderm at later stages of development. Inhibition of Nodal function disrupts dorsoventral fates and also blocks formation of the larval mesoderm. Interestingly, molecular analysis reveals that only mesodermal, apical and ventral gene expression is affected while the dorsal side appears to be patterned correctly. Taken together, this study suggests that the co-option of Nodal signaling in mesoderm formation and potentially in anteroposterior patterning has occurred prior to the emergence of chordates and that Nodal signaling on the ventral side is uncoupled from BMP signaling on the dorsal side, representing a major difference from the molecular mechanisms of dorsoventral patterning events in echinoderms. PMID:25979707

  12. Accidente cerebrovascular isquémico asociado con ablación por radiofrecuencia de reentrada nodal Ischemic stroke associated with radio frequency ablation for nodal reentry

    Directory of Open Access Journals (Sweden)

    Juan C Díaz Martínez


    Full Text Available La taquicardia por reentrada nodal es la causa más común de taquicardia supraventricular paroxística; en aquellos pacientes en quienes el manejo farmacológico no es efectivo o deseado la ablación por radiofrecuencia es un excelente método terapéutico dada su alta tasa de curación. Aunque en términos generales dichos procedimientos son rápidos y seguros, se han descrito varias complicaciones entre las que sobresale el accidente cerebrovascular isquémico. Se presenta el caso de una paciente de 41 años con episodios de taquicardia por reentrada nodal a repetición, que fue llevada a ablación por radiofrecuencia. En el post-operatorio inmediato se evidenció déficit neurológico focal con isquemia en el territorio de la arteria cerebral media derecha, tras lo cual se realizó angiografía con intento de angioplastia y abxicimab y posteriormente infusión local de activador de plasminógeno tisular (rtPA con adecuado resultado clínico y angiográfico.Atrioventricular nodal reentry tachycardia is the most common type of paroxismal supraventricular tachycardia. In those patients in whom drug therapy is not effective or not desired, radio frequency ablation is an excellent therapeutic method. Although overall these procedures are fast and safe, several complications among which ischemic stroke stands out, have been reported. We present the case of a 41 year old female patient with repetitive episodes of tachycardia due to nodal reentry who was treated with radiofrequency ablation. Immediately after the procedure she presented focal neurologic deficit consistent with ischemic stroke in the right medial cerebral artery territory. Angiography with angioplastia and abxicimab was performed and then tissue plasminogen activator (rtPA was locally infused, with appropriate clinical and angiographic outcome.

  13. Corepressor metastasis-associated protein 3 modulates epithelial-to-mesenchymal transition and metastasis. (United States)

    Du, Liang; Ning, Zhifeng; Zhang, Hao; Liu, Fuxing


    Worldwide, metastasis is the leading cause of more than 90% of cancer-related deaths. Currently, no specific therapies effectively impede metastasis. Metastatic processes are controlled by complex regulatory networks and transcriptional hierarchy. Corepressor metastasis-associated protein 3 (MTA3) has been confirmed as a novel component of nucleosome remodeling and histone deacetylation (NuRD). Increasing evidence supports the theory that, in the recruitment of transcription factors, coregulators function as master regulators rather than passive passengers. As a master regulator, MTA3 governs the target selection for NuRD and functions as a transcriptional repressor. MTA3 dysregulation is associated with tumor progression, invasion, and metastasis in various cancers. MTA3 is also a key regulator of E-cadherin expression and epithelial-to-mesenchymal transition. Elucidating the functions of MTA3 might help to find additional therapeutic approaches for targeting components of NuRD.

  14. [Diagnosis of the metastasis of cranial tumors]. (United States)

    Kuckein, D


    Ependymal and meningeal metastases of brain tumors may frequently be demonstrated by computerized tomography. The mode of metastasis formation and appearance of some CT findings are described. Essential criteria in the differential diagnosis of neoplastic, metastatic, inflammatory and vascular changes are discussed.

  15. Diagnosis of bone metastasis from thyroid carcinoma

    DEFF Research Database (Denmark)

    Bechsgaard, Thor; Lelkaitis, Giedrius; Jensen, Karl E


    (MRI), but histology revealed a metastasis from thyroid carcinoma, although the patient had no previous history of thyroid malignancy and resection of the thyroid gland was without malignancy. Ultrasound-guided biopsy was possible due to cortical destruction and the multidisciplinary approach with re...

  16. Osthole inhibits bone metastasis of breast cancer. (United States)

    Wu, Chunyu; Sun, Zhenping; Guo, Baofeng; Ye, Yiyi; Han, Xianghui; Qin, Yuenong; Liu, Sheng


    Bone is one of the most common sites for breast cancer metastasis, which greatly contributes to patient morbidity and mortality. Osthole, a major extract from Cnidium monnieri (L.), exhibits many biological and pharmacological activities, however, its potential as a therapeutic agent in the treatment of breast cancer bone metastases remain poorly understood. In this study, we set out to investigate whether osthole could inhibit breast cancer metastasis to bone in mice and clarified the potential mechanism of this inhibition. In the murine model of breast cancer osseous metastasis, mice that received osthole developed significantly less bone metastases and displayed decreased tumor burden when compared with mice in the control group. Osthole inhibited breast cancer cell growth, migration, and invasion, and induced apoptosis of breast cancer cells. Additionally, it also regulated OPG/RANKL signals in the interactions between bone cells (osteoblasts and osteoclasts) and cancer cells. Besides, it also inhibited TGF-β/Smads signaling in breast cancer metastasis to bone in MDA-231BO cells. The results of this study suggest that osthole has real potential as a therapeutic candidate in the treatment of breast cancer patients with bone metastases.

  17. Angiogenesis in wound healing and tumor metastasis

    NARCIS (Netherlands)

    Ruiter, D. J.; Schlingemann, R. O.; Westphal, J. R.; Denijn, M.; Rietveld, F. J.; de Waal, R. M.


    Formation of new blood vessels is essential for several physiological and pathological events, e.g. embryogenesis, wound healing and tumor growth and metastasis. In order to increase the insight into the mechanisms of angiogenesis we have visualized the different components of the microvasculature

  18. Macrophage Efferocytosis and Prostate Cancer Bone Metastasis (United States)


    efferocytosis. The translation of this functional role during pathophysiological states such as tumor metastasis to the skeleton is unknown. The purpose of this...COLLABORATING ORGANIZATIONS What individuals have worked on the project? Name: L.C. Hofbauer Institution: Department of Endocrinology, Diabetes , and Bone

  19. Altered tumor cell glycosylation promotes metastasis

    Directory of Open Access Journals (Sweden)

    Irina eHäuselmann


    Full Text Available Malignant transformation of cells is associated with aberrant glycosylation presented on the cell-surface. Commonly observed changes in glycan structures during malignancy encompasses aberrant expression and glycosylation of mucins; abnormal branching of N-glycans; and increased presence of sialic acid on proteins and glycolipids. Accumulating evidence supports the notion that the presence of certain glycan structures correlates with cancer progression by affecting tumor cell invasiveness, ability to disseminate through the blood circulation and to metastasize in distant organs. During metastasis tumor cell-derived glycans enable binding to cells in their microenvironment including endothelium and blood constituents through glycan-binding receptors - lectins. In this review we will discuss current concepts how tumor cell-derived glycans contribute to metastasis with the focus on three types of lectins: siglecs, galectins and selectins. Siglecs are present on virtually all hematopoetic cells and usually negatively regulate immune responses. Galectins are mostly expressed by tumor cells and support tumor cell survival. Selectins are vascular adhesion receptors that promote tumor cell dissemination. All lectins facilitate interactions within the tumor microenvironment and thereby promote cancer progression. The identification of mechanisms how tumor glycans contribute to metastasis may help to improve diagnosis, prognosis and aid to develop clinical strategies to prevent metastasis.


    Turkoglu, Elif B; Lally, Sara E; Shields, Carol L


    To report a case of choroidal sarcoid granuloma simulating choroidal metastasis in a patient with prostate carcinoma. Case report. A 66-year-old man was found to have an asymptomatic choroidal mass in his left eye. He had known history of pulmonary sarcoidosis without systemic involvement and prostate carcinoma without metastasis. On examination, visual acuity was 20/20 in each eye. Anterior segment was normal, without inflammatory sign in either eye. The right fundus was healthy. The left fundus revealed a yellow choroidal mass of 2 mm diameter, temporal to the foveola and without subretinal fluid, retinitis, or vitritis. Optical coherence tomography demonstrated a homogenous hyporeflective choroidal mass with intact retinal pigment epithelium and compression of choroidal vascular structures. Given the medical history and rarity of prostate metastasis to the uvea, choroidal sarcoid granuloma was considered and oral prednisone with a slow taper was given. After 2 months of therapy, tumor resolution with reduction in size was confirmed on optical coherence tomography. Choroidal sarcoid granuloma is a rare condition that can simulate choroidal metastasis. Treatment with prednisone can assist in establishing the diagnosis.

  1. The protein C pathway in cancer metastasis

    NARCIS (Netherlands)

    Spek, C. Arnold; Arruda, Valder R.


    Cancer is frequently associated with activation of blood coagulation, which in turn has been suggested to promote tumor growth and metastasis. Indeed, low molecular weight heparin treatment significantly prolongs the survival of a wide variety of patients with cancer. Based on this notion that

  2. Detection of cancer before distant metastasis

    NARCIS (Netherlands)

    Coumans, Frank A. W.; Siesling, Sabine; Terstappen, Leon W. M. M.


    Background: To establish a distant metastasis (DM) cells must disseminate from the primary tumor and overcome a series of obstacles, the metastatic cascade. In this study we develop a mathematical model for this cascade to estimate the tumor size and the circulating tumor cell (CTC) load before the

  3. Isolated Pancreatic Metastasis from Malignant Melanoma: Is ...

    African Journals Online (AJOL)

    Isolated pancreatic metastasis from malignant melanoma (IPMMM) is rare because most melanoma patients already have a widespread disease at diagnosis. No adjuvant systemic treatment is known to be effi cient in this setting. Experience with pancreatic resection for IPMMM is limited and controversial. We report here ...

  4. Cardiac Metastasis in Renal Cell Carcinoma

    African Journals Online (AJOL)



    Oct 21, 2015 ... &Corresponding author: Zairi Ihsen, Department of Cardiology, Habib Thameur Public Hospital, Bab El Fallah, Tunis, Tunisia. Key words: .... Journal of Clinical. Pathology. 2007; 60(1): 27-34. PubMed | Google Scholar. 5. Roigas J et al. Renal cell cancer with a symptomatic heart metastasis. BJU Int. 2002 ...

  5. Mapping of selected markets with Nodal pricing or similar systems. Australia, New Zealand and North American power markets

    Energy Technology Data Exchange (ETDEWEB)

    Mathiesen, Vivi (ed.)


    This report shows that the principals of nodal pricing can be implemented in different ways. A common denominator for markets with nodal pricing is a central market based nodal dispatch, where prices and flows are determined simultaneously close to real time. This stands apart from the European market design, which is based on a highly simplified version of the grid, and a physical point auction day ahead. Congestion management is handled by the TSO during the operational hour and not through the market as is the case in nodal pricing systems. Nodal pricing yields optimal dispatch and congestion management through the market, and as such an optimal utilisation of energy generation and network. However, whether this short term optimisation delivers the highest overall efficiency for the market in terms of competition in the wholesale and retail market, price discovery, possibilities for hedging, long term price signals etc. is difficult to determine. The markets investigated handle issues such as market power, risk management, investment signals and retail markets in very different ways. New Zealand and PJM are examples of markets with full nodal pricing, i.e. both generators and the demand side are exposed to nodal prices. The PJM market has more 'additional features' than the New Zealand market. Examples of these are separate capacity market to trigger investments in generation and generator price caps to deal with situations of market power. In addition PJM offers liquid and mature markets for risk management, such as aggregates of nodes where market participant can chose to be settled (rather than to be settled directly at the node). A general finding though, seems to be that risk management at peripheral nodes is challenging in nodal markets, particularly for independent retailers. In New Zealand generators and retailers were permitted to 'reintegrate' in order to cope with the nodal prices. The Australian market has central market based

  6. Analysis of Risk Factors for Lymph Nodal Involvement in Early Stages of Rectal Cancer: When Can Local Excision Be Considered an Appropriate Treatment? Systematic Review and Meta-Analysis of the Literature

    Directory of Open Access Journals (Sweden)

    Alessandro Carrara


    Full Text Available Background. Over the past ten years oncological outcomes achieved by local excision techniques (LETs as the sole treatment for early stages of rectal cancer (ESRC have been often disappointing. The reasons for these poor results lie mostly in the high risk of the disease's diffusion to local-regional lymph nodes even in ESRC. Aims. This study aims to find the correct indications for LET in ESRC taking into consideration clinical-pathological features of tumours that may reduce the risk of lymph node metastasis to zero. Methods. Systematic literature review and meta-analysis of casistics of ESRC treated with total mesorectal excision with the aim of identifying risk factors for nodal involvement. Results. The risk of lymph node metastasis is higher in G≥2 and T≥2 tumours with lymphatic and/or vascular invasion. Other features which have not yet been sufficiently investigated include female gender, TSM stage >1, presence of tumour budding and/or perineural invasion. Conclusions. Results comparable to radical surgery can be achieved by LET only in patients with T1 N0 G1 tumours with low-risk histological features, whereas deeper or more aggressive tumours should be addressed by radical surgery (RS.

  7. Enhanced Ovarian Cancer Tumorigenesis and Metastasis by the Macrophage Colony-Stimulating Factor

    Directory of Open Access Journals (Sweden)

    Eugene P. Toy


    Full Text Available Coexpression of the macrophage colony-stimulating factor (CSF-1 and its receptor (CSF-1R in metastatic ovarian cancer specimens is a predictor of poor outcome in epithelial ovarian cancer. This suggests that an autocrine loop is produced by which ovarian tumors can secrete CSF-1 stimulating the CSF-1R resulting in a more aggressive phenotype. Our current work sought to validate this autocrine stimulation model using stable transfection of a 4-kb CSF-1 construct into otherwise nonvirulent Bix3 ovarian cancer cells. A representative clone, Bix3T8.2, produced a 72-fold increase in CSF-1 gene transcription rate (by nuclear run-off assays and a 57-fold increase in secreted CSF-1 protein (by sandwich ELISA, compared to parent cells. Comparison of Bix3T8.2 invasion, adhesion, and motility in vitro and metastasis in vivo were made to parental and transfectant controls. Up to 12-fold higher invasiveness was seen with Bix3T8.2 and 2- and 6-fold higher adhesion and motility, respectively, over controls in vitro. In nude mice, i.p. injection of Bix3T8.2 produced a wide array of visceral, nodal, and distant metastasis with a degree of enhanced tumor burden not seen in any of the 10 mice inoculated with transfectant control cells. Complete absence of tumor take distinguished 40% of mice implanted with transfectant control cells. Disruption of this autocrine loop using antisense oligomer therapy against CSF-1R and 3′ untranslated region knockdown of CSF-1 protein resulted in reversal of in vitro and in vivo tumor phenotypes. This CSF-1 feedback loop offers a model by which novel biologic therapies can potentially target multiple levels of this pathway.

  8. Inguinal sentinel node dissection versus standard inguinal node dissection in patients with vulvar cancer: A comparison of the size of metastasis detected in inguinal lymph nodes. (United States)

    Robison, Katina; Steinhoff, Margaret M; Granai, C O; Brard, Laurent; Gajewski, Walter; Moore, Richard G


    The emergence of sentinel lymph node (SLN) technology has provided the ability for an in depth pathologic evaluation for the detection of metastasis to lymph nodes through the use of ultra-staging. The SLN has been shown to be predictive of the metastatic status of its nodal basin. More recently, SLN dissections have been employed in the evaluation of the inguinal lymphatic basins in patients with vulvar malignancies. We hypothesize that the average size of metastasis detected in non-palpable inguinal lymph nodes is smaller when detected through the use of SLN dissection and ultra-staging versus complete inguinal node dissection (CND). This was an IRB approved retrospective study. The tumor registry database was searched to identify all patients diagnosed with a vulvar malignancy from 1990 to 2004. The records were reviewed to identify patients with inguinal lymph node metastasis. Only patients with non-palpable inguinal lymph nodes (metastasis 1 cm or less) were included in the analysis. All pathology slides were reviewed. The smallest metastatic foci of cells were measured from lymph nodes obtained through the traditional complete inguinal lymph node dissection (CND) and compared with the largest metastatic foci of cells detected in sentinel lymph node dissections. The mean size and standard deviation for each group was calculated and analyzed with a Mann-Whitney test. There were 336 inguinal node dissections performed in patients identified with a vulvar malignancy. SLN dissections were performed in 52 groins and CND in 284 groins. Fifty-eight patients were found to have metastatic disease to the inguinal lymph nodes. Thirty of these patients had no evidence of lymph node metastasis on clinical exam or at the time of their EUA. There were 7 groins with metastasis detected through an SLN and 23 groins through a CND. The mean size of the metastatic foci detected in the SLN group was 2.52 mm (SD 1.55) and in the CND group was 4.35 mm (SD 2.63). This was not

  9. A case report of thyroid gland metastasis associated with lung metastasis from colon cancer. (United States)

    Nakamura, Keisuke; Nozawa, Keijiro; Aoyagi, Yoshiko; Ishihara, Soichiro; Matsuda, Keiji; Fukushima, Junichi; Watanabe, Toshiaki


    Thyroid gland metastasis of malignant tumors is observed in 1.9% to 9.5% of histologically examined autopsy cases. Thyroid metastasis from colon cancer is extremely rare and the prognosis is poor. Here we report a case of lung metastasis and thyroid gland metastasis following sigmoid colon cancer surgery. In 2000, a 58-year-old woman underwent a sigmoid colectomy for sigmoid colon cancer. In 2005, a metastatic lung tumor was detected by chest CT. The patient underwent a partial thoracoscopic resection of the left lung in April 2005. On a CT scan taken 3 years and 4 months after the lung resection, a tumor mass was observed in the left lung and a low-absorption region with an unclear border was seen in the left lobe of the thyroid gland. Thyroid aspiration cytology showed adenocarcinoma, and a diagnosis of thyroid gland metastasis from sigmoid colon cancer was made. In April 2008 a subtotal thyroidectomy was performed. Following surgery, the patient underwent chemotherapy with mFOLFOX6 and bevacizumab. Nevertheless a number of lung metastases and expressions of lung metastasis were subsequently observed. Histopathological examination revealed a number of metastases of differentiated papillary adenocarcinoma in the thyroid gland from colon cancer.

  10. Genomic Alteration During Metastasis of Lung Adenocarcinoma. (United States)

    Tan, Qiang; Cui, Jian; Huang, Jia; Ding, Zhengping; Lin, Hao; Niu, Xiaomin; Li, Zhiming; Wang, Guan; Luo, Qingquan; Lu, Shun


    Recurrent gene mutation has been identified by the analysis of exonic DNA from lung adenocarcinoma, but its progression has not been extensively profiled. The investigation of the mutational landscape of tumors provides new insights into cancer genome evolution and further discovers the interplay of somatic mutation, adaptation of clones to their environment and natural selection. Cancer development involves cycles of genomic damage, epigenetic deregulation, and increased cellular proliferation that eventually culminate in the carcinoma phenotype. Comparative whole exome sequencing of both primary and metastatic tumor tissues from four patients of stage IV lung adenocarcinoma patients with chest wall metastasis was performed. Both primary and metastatic tumors were diagnosed through biopsy followed by surgical resection. All tumor specimens were cut into several pieces to assess potential heterogenic clones within the tumor tissue. Adjacent normal lung tissue was also obtained to provide germline mutation background. By modeling and analyzing progression of the cancer metastasis based on non-synonymous variants, we defined the extent of heterogeneity of cancer genomes and identified similar cancer evolution pattern in the four patients: metastasis was an early event occurring right after the primary cancer formation and evolution in the metastatic tumor was continuously and simultaneously in progression with that in the primary tumor. By characterizing the clonal hierarchy of genetic lesions, we further charted a pathway of oncogenic events along which genes may drive lung adenocarcinoma metastasis, such as TAS2R31 and UMODL1, involving in G-protein coupled receptor protein signaling pathway. The candidate genes identified in this study may become targets for the treatment of lung adenocarcinoma metastasis. © 2016 S. Karger AG, Basel.

  11. Study on the impact of electric vehicle charging load on nodal voltage deviation

    Directory of Open Access Journals (Sweden)

    Ma Gang


    Full Text Available The promotion and application of electric vehicles will contribute to the solution of several problems, such as energy shortage and environmental pollution, and the achievement of country economy and energy security. But a large-scale vehicle-to-grid system may cause adverse effects in the distribution network operation, the power network planning and such other parts. First, this paper collects the factors that influence the electric vehicle charging load and establishes the EV charging load model with a Monte-Carlo method. Then, we analyze the effect that the EV charging load made on the nodal voltage deviation under different permeability based on the IEEE30 node system. At last, this research gets the conclusion that the nodal voltage deviation is closely related to EV permeability, node type and node location. This research conclusion will provide practical guidance to the charging station planning.

  12. Radiofrequency Catheter Ablation of Coexistent Idiopathic Left Ventricular Tachycardia and Atrioventricular Nodal Reentrant Tachycardia

    Directory of Open Access Journals (Sweden)

    Ken-Pen Weng


    Full Text Available A healthy 15-year-old male patient presented with a 6-month history of recurrent attacks of palpitations. On multiple emergency room visits, a sustained wide QRS complex tachycardia with a right bundle branch block and northwest axis deviation was documented. The tachycardia was not terminated by intravenous adenosine, but was suppressed with intravenous verapamil. There was no evidence of structural heart disease, myocarditis, long QT syndrome, or electrolyte imbalance after a series of standard examinations. Idiopathic left ventricular tachycardia (ILVT was suspected. Electrophysiologic studies revealed 2 inducible tachycardias, which were shown to represent atrioventricular nodal reentrant tachycardia (AVNRT and ILVT. Transformation from AVNRT to ILVT occurred spontaneously following atrial pacing. Successful ablation of ILVT and the slow atrioventricular nodal pathway resulted in cure of the double tachycardia.

  13. Probabilistic modeling of nodal electric vehicle load due to fast charging stations

    DEFF Research Database (Denmark)

    Tang, Difei; Wang, Peng; Wu, Qiuwei


    In order to reduce greenhouse gas emission and fossil fuel dependence, Electric Vehicle (EV) has drawn increasing attention due to its zero emission and high efficiency. However, new problems such as range anxiety, long charging duration and high charging power may threaten the safe and efficient...... operation of both traffic and power systems. This paper proposes a probabilistic approach to model the nodal EV load at fast charging stations in integrated power and transport systems. Following the introduction of the spatial-temporal model of moving EV loads, we extended the model by taking fast charging......-temporal varying arrival and service rates. The time-varying nodal EV loads are obtained by the number of operating fast chargers at each node of the power system. System studies demonstrate that the combination of AC normal and DC charging may share the EV charging demand and alleviate the impact to power system...

  14. Engineering topological phases with a three-dimensional nodal-loop semimetal (United States)

    Li, Linhu; Yap, Han Hoe; Araújo, Miguel A. N.; Gong, Jiangbin


    A three-dimensional (3D) nodal-loop semimetal phase is exploited to engineer a number of intriguing phases featuring different peculiar topological surface states. In particular, by introducing various two-dimensional gap terms to a 3D tight-binding model of a nodal-loop semimetal, we obtain a rich variety of topological phases of great interest to ongoing theoretical and experimental studies, including a chiral insulator, degenerate-surface-loop insulator, and second-order topological insulator, as well as a Weyl semimetal with tunable Fermi arc profiles. The unique concept underlying our approach is to engineer topological surface states that inherit their dispersion relations from a gap term. The results provide one rather unified principle for the creation of novel topological phases and can guide the search for new topological materials. Two-terminal transport studies are also carried out to distinguish the engineered topological phases.

  15. Error estimation and adaptive order nodal method for solving multidimensional transport problems

    Energy Technology Data Exchange (ETDEWEB)

    Zamonsky, O.M.; Gho, C.J. [Bariloche Atomic Center, Rio Negro (Argentina). Instituto Balseiro; Azmy, Y.Y. [Oak Ridge National Lab., TN (United States)


    The authors propose a modification of the Arbitrarily High Order Transport Nodal method whereby they solve each node and each direction using different expansion order. With this feature and a previously proposed a posteriori error estimator they develop an adaptive order scheme to automatically improve the accuracy of the solution of the transport equation. They implemented the modified nodal method, the error estimator and the adaptive order scheme into a discrete-ordinates code for solving monoenergetic, fixed source, isotropic scattering problems in two-dimensional Cartesian geometry. They solve two test problems with large homogeneous regions to test the adaptive order scheme. The results show that using the adaptive process the storage requirements are reduced while preserving the accuracy of the results.

  16. Animal models of colorectal cancer with liver metastasis. (United States)

    Oh, Bo Young; Hong, Hye Kyung; Lee, Woo Yong; Cho, Yong Beom


    Liver metastasis is a leading cause of death in patients with colorectal cancer. Investigating the mechanisms of liver metastasis and control of disease progression are important strategies for improving survival of these patients. Liver metastasis is a multi-step process and relevant models representing these steps are necessary to understand the mechanism of liver metastasis and establish appropriate treatments. Recently, the development of animal models for use in metastasis research has greatly increased; however, there is still a lack of models that sufficiently represent human cancer. Thus, in order to select an optimal model for of a given study, it is necessary to fully understand the characteristics of each animal model. In this review, we describe the mouse models currently used for colorectal cancer with liver metastasis, their characteristics, and their pros and cons. This may help us specify the mechanism of liver metastasis and provide evidence relevant to clinical applications. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. File list: NoD.ALL.20.NA.AllCell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available NoD.ALL.20.NA.AllCell sacCer3 No description NA All cell types SRX826027,ERX594029,...5827,ERX585840,ERX585843,ERX585818,ERX585821,ERX585788,ERX585769,SRX332069,ERX585857 ...

  18. The role of elective nodal irradiation for esthesioneuroblastoma patients with clinically negative neck. (United States)

    Jiang, Wen; Mohamed, Abdallah S R; Fuller, Clifton David; Kim, Betty Y S; Tang, Chad; Gunn, G Brandon; Hanna, Ehab Y; Frank, Steven J; Su, Shirley Y; Diaz, Eduardo; Kupferman, Michael E; Beadle, Beth M; Morrison, William H; Skinner, Heath; Lai, Stephen Y; El-Naggar, Adel K; DeMonte, Franco; Rosenthal, David I; Garden, Adam S; Phan, Jack


    Although adjuvant radiation to the tumor bed has been reported to improve the clinic outcomes of esthesioneuroblastoma (ENB) patients, the role of elective neck irradiation (ENI) in clinically node-negative (N0) patients remains controversial. Here, we evaluated the effects of ENI on neck nodal relapse risk in ENB patients treated with radiation therapy as a component of multimodality treatment. Seventy-one N0 ENB patients irradiated at the University of Texas MD Anderson Cancer Center between 1970 and 2013 were identified. ENI was performed on 22 of these patients (31%). Survival analysis was performed with focus on comparative outcomes of those patients who did and did not receive ENI. The median follow-up time for our cohort is 80.8 months (range, 6-350 months). Among N0 patients, 13 (18.3%) developed neck nodal relapses, with a median time to progression of 62.5 months. None of these 13 patients received prophylactic neck irradiation. ENI was associated with significantly improved regional nodal control at 5 years (regional control rate of 100% for ENI vs 82%, P ENI developed isolated neck recurrences. All had further treatment for their neck disease, including neck dissection (n = 10), radiation (n = 10), or chemotherapy (n = 5). Six of these 11 patients (54.5%) demonstrated no evidence of further recurrence with a median follow-up of 55.5 months. ENI significantly reduces the risk of cervical nodal recurrence in ENB patients with clinically N0 neck, but this did not translate to a survival benefit. Multimodality treatment for isolated neck recurrence provides a reasonable salvage rate. The greatest benefit for ENI appeared to be among younger patients who presented with Kadish C disease. Further studies are needed to confirm these findings. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  19. Clinical nodal staging scores for prostate cancer: a proposal for preoperative risk assessment


    Kluth, L A; Abdollah, F; Xylinas, E; Rieken, M; Fajkovic, H; Seitz, C.; Sun, M.; P. I. Karakiewicz; Schramek, P; Herman, M P; Becker, A.; Hansen, J.; Ehdaie, B; Loidl, W; Pummer, K


    Background: Pelvic lymph node dissection in patients undergoing radical prostatectomy for clinically localised prostate cancer is not without morbidity and its therapeutical benefit is still a matter of debate. The objective of this study was to develop a model that allows preoperative determination of the minimum number of lymph nodes needed to be removed at radical prostatectomy to ensure true nodal status. Methods: We analysed data from 4770 patients treated with radical prostatectomy and ...

  20. High critical temperature nodal superconductors as building block for time-reversal invariant topological superconductivity


    Trani, Fabio; Campagnano, Gabriele; Tagliacozzo, Arturo; Lucignano, Procolo


    We study possible applications of high critical temperature nodal superconductors for the search for Majorana bound states in the DIII class. We propose a microscopic analysis of the proximity effect induced by d-wave superconductors on a semiconductor wire with strong spin-orbit coupling. We characterize the induced superconductivity on the wire employing a numerical self-consistent tight-binding Bogoliubov-de Gennes approach, and analytical considerations on the Green's function. The order ...

  1. Nodal collocation approximation for the multidimensional PL equations applied to transport source problems

    Energy Technology Data Exchange (ETDEWEB)

    Verdu, G. [Departamento de Ingenieria Quimica Y Nuclear, Universitat Politecnica de Valencia, Cami de Vera, 14, 46022. Valencia (Spain); Capilla, M.; Talavera, C. F.; Ginestar, D. [Dept. of Nuclear Engineering, Departamento de Matematica Aplicada, Universitat Politecnica de Valencia, Cami de Vera, 14, 46022. Valencia (Spain)


    PL equations are classical high order approximations to the transport equations which are based on the expansion of the angular dependence of the angular neutron flux and the nuclear cross sections in terms of spherical harmonics. A nodal collocation method is used to discretize the PL equations associated with a neutron source transport problem. The performance of the method is tested solving two 1D problems with analytical solution for the transport equation and a classical 2D problem. (authors)

  2. Molecular characterization and patient outcome of melanoma nodal metastases and an unknown primary site. (United States)

    Gos, Aleksandra; Jurkowska, Monika; van Akkooi, Alexander; Robert, Caroline; Kosela-Paterczyk, Hanna; Koljenović, Senada; Kamsukom, Nyam; Michej, Wanda; Jeziorski, Arkadiusz; Pluta, Piotr; Verhoef, Cornelis; Siedlecki, Janusz A; Eggermont, Alexander M M; Rutkowski, Piotr


    Melanoma of unknown primary site (MUP) is not a completely understood entity with nodal metastases as the most common first clinical manifestation. The aim of this multicentric study was to assess frequency and type of oncogenic BRAF/NRAS/KIT mutations in MUP with clinically detected nodal metastases in relation to clinicopathologic features and outcome. We analyzed series of 103 MUP patients (period: 1992-2010) after therapeutic lymphadenectomy (LND): 40 axillary, 47 groin, 16 cervical, none treated with BRAF inhibitors. We performed molecular characterization of BRAF/NRAS/KIT mutational status in nodal metastases using direct sequencing of respective coding sequences. Median follow-up time was 53 months. BRAF mutations were detected in 55 cases (53 %) (51 V600E, 93 %; 4 others, 7 %), and mutually exclusive NRAS mutations were found in 14 cases (14 %) (7 p.Q61R, 4 p.Q61K, 2 p.Q61H, 1 p.Q13R). We have not detected any mutations in KIT. The 5-year overall survival (OS) was 34 %; median was 24 months. We have not found significant correlation between mutational status (BRAF/NRAS) and OS; however, for BRAF or NRAS mutated melanomas we observed significantly shorter disease-free survival (DFS) when compared with wild-type melanoma patients (p = .04; 5-year DFS, 18 vs 19 vs 31 %, respectively). The most important factor influencing OS was number of metastatic lymph nodes >1 (p = .03). Our large study on molecular characterization of MUP with nodal metastases showed that MUPs had molecular features similar to sporadic non-chronic-sun-damaged melanomas. BRAF/NRAS mutational status had negative impact on DFS in this group of patients. These observations might have potential implication for molecular-targeted therapy in MUPs.

  3. Elective nodal irradiation is not necessary in chemoradiotherapy for postoperative loco-regional recurrent esophageal cancer. (United States)

    Jingu, Keiichi; Umezawa, Rei; Yamamoto, Takaya; Matsushita, Haruo; Ishikawa, Youjirou; Kozumi, Maiko; Kubozono, Masaki; Takahashi, Noriyoshi; Kadoya, Noriyuki; Takeda, Ken


    The purposes of the present study were to evaluate prognostic factors for patients with postoperative loco-regional recurrent esophageal cancer treated with chemoradiotherapy by multivariate analysis and to determine which irradiation is better, involved field irradiation or elective nodal irradiation, by matched-pair analysis. We reviewed records for 80 patients with postoperative loco-regional recurrent esophageal cancer treated by chemoradiotherapy between 2000 and 2014. The median follow-up period was 62.0 months. Thirty-one cases were treated with elective nodal irradiation and were randomly matched by risk factors to 49 cases treated with involved field irradiation (1:1). Fifty-one patients had disease recurrence again, and irradiated-field failure was observed in 26 patients. The 5-year overall survival rate was 30.5% with a median survival period of 26.5 months. Grade 3 or higher late toxicity was observed in only one patient. In multivariate analysis, short disease-free interval and anastomotic recurrence were statistically significant unfavorable prognostic factors for overall survival (hazard ratios: 2.1 and 2.5, respectively). Matched-pair analysis including disease-free interval, pattern of recurrence and number of recurrent regions revealed that overall survival rate and irradiated-field control rate in patients treated with involved field irradiation were significantly better than those in patients treated with elective nodal irradiation (P = 0.016 and P = 0.014, respectively). Short disease-free interval and anastomotic recurrence are unfavorable factors and elective nodal irradiation is not necessary in chemoradiotherapy for patients with postoperative loco-regional recurrent esophageal cancer.

  4. [Inhibition of the sodium inactivation of the nodal membrane by anemonia sulcata toxin II]. (United States)

    Bergman, C; Dubois, J M; Rojas, E; Rathmayer, W


    A neurotoxin (ATX-II) extracted from the tentacles of Anemonia sulcata has been found to interact with the sodium channel of the nodal membrane in myelinated nerve fibres from Rana esculenta. If externally applied at low concentration (Kd = 20 muM), it reduces considerably the rate of inactivation of the sodium conductance without affecting the activation. At such concentrations, the potassium conductance is not affected. If internally applied ATX-II does not affect the membrane conductance.

  5. Disrupted nodal and hub organization account for brain network abnormalities in Parkinson’s disease

    Directory of Open Access Journals (Sweden)

    Yuko Koshimori


    Full Text Available The recent application of graph theory to brain networks promises to shed light on complex diseases such as Parkinson’s disease. This study aimed to investigate functional changes in sensorimotor and cognitive networks in parkinsonian patients, with a focus on inter- and intra-connectivity organization in the disease-associated nodal and hub regions using the graph theoretical analyses. Resting-state functional MRI data of a total of 65 participants, including 23 healthy controls and 42 patients, were investigated in 120 nodes for local efficiency, betweenness centrality, and degree. Hub regions were identified in the healthy control and patient groups. We found nodal and hub changes in patients compared with healthy controls, including the right pre-supplementary motor area, left anterior insula, bilateral mid-insula, bilateral dorsolateral prefrontal cortex, and right caudate nucleus. In general, nodal regions within the sensorimotor network (i.e. right pre-supplementary motor area and right mid-insula displayed weakened connectivity, with the former node associated with more severe bradykinesia, and impaired integration with default mode network regions. The left mid-insula also lost its hub properties in patients. Within the executive networks, the left anterior insular cortex lost its hub properties in patients, while a new hub region was identified in the right caudate nucleus, paralleled by an increased level of inter- and intra-connectivity in the bilateral dorsolateral prefrontal cortex possibly representing compensatory mechanisms. These findings highlight the diffuse changes in nodal organization and regional hub disruption accounting for the distributed abnormalities across brain networks and the clinical manifestations of Parkinson’s disease.

  6. Effect of antibiotics selection on survival rate of nodal explant and gene transformation in Anthurium andraeanum cv. Sonate

    Directory of Open Access Journals (Sweden)

    Te-chato, S.


    Full Text Available The effects of various concentrations of hygromycin antibiotic supplemented in modified Murashige and Skoog (MMS on the survival rate of nodal explant of Anthurium andraeanum cv. Sonate were determined.The use of hygromycin at 50 mg/l caused absolute death of nodal tissue after 4 weeks of culture. Dipping nodal explant with agrobacterium, EHA 105 containing pCAMBIA1301 for 15 min followed by co-cultureon filter paper laid on MMS with 0.5 mg/l benzyladenine (BA, 0.5 mg/l thidiazuron (TDZ and 200 mg/l cefotaxime for 2 days then transferring the explant to culture on MMS supplemented with the abovephytohormones and 50 mg/l hygromycin resulted in the highest survival rate at 26.6% with 4 shoots/callus. Histochemical analysis of gus activity was found in callus after 6 weeks of nodal culture and in leaf fromshoot derived from the callus.

  7. Effects of beta-blockade on atrial and atrioventricular nodal refractoriness, and atrial fibrillatory rate during atrial fibrillation in pigs

    NARCIS (Netherlands)

    van den Berg, MP; van de Ven, LLM; Witting, W; Crijns, JGM; Haaksma, J; Bel, KJ; de Langen, CDJ; Lie, KI


    Despite their widespread use in atrial fibrillation, the effects of beta-adrenoceptor blockers on atrial and atrioventricular (AV) nodal refractoriness, and atrial fibrillatory rate during atrial fibrillation have been incompletely characterised. In particular, it is unknown whether additional

  8. Theoretical and experimental evidence for a nodal energy gap in MgB2 (United States)

    Agassi, Y. Dan; Oates, Daniel E.


    We present a phenomenological model that strongly suggests that the smaller of the two energy gaps in MgB2, the so-called π gap, contains nodal lines with a six-fold symmetry (i-wave). The model also indicates that the larger gap, the so-called σ gap, is conventional s-wave. The model is an extension of the BCS gap equation that accounts for the elastic anisotropy in MgB2 and the Coulomb repulsion. It is based on a phononic pairing mechanism and assumes no coupling between the two energy gaps in MgB2 at zero temperature. All of the parameters of the model, such as sound velocities and masses, are independently determined material constants. The results agree with a previous ad-hoc hypothesis that the π energy gap has six nodal lines. That hypothesis was motivated by low-temperature measurements of the surface impedance and intermodulation distortion in high-quality thin films. We briefly review experimental evidence in the literature that is relevant to the energy-gap symmetry. We find that the evidence from the literature for s-wave is inconclusive. Our finding is that the π gap has six nodal lines.

  9. Elective nodal irradiation (ENI) in definitive chemoradiotherapy (CRT) for squamous cell carcinoma of the thoracic esophagus. (United States)

    Onozawa, Masakatsu; Nihei, Keiji; Ishikura, Satoshi; Minashi, Keiko; Yano, Tomonori; Muto, Manabu; Ohtsu, Atsushi; Ogino, Takashi


    There are some reports indicating that prophylactic three-field lymph node dissection for esophageal cancer can lead to improved survival. But the benefit of ENI in CRT for thoracic esophageal cancer remains controversial. The purpose of the present study is to retrospectively evaluate the efficacy of elective nodal irradiation (ENI) in definitive chemoradiotherapy (CRT) for thoracic esophageal cancer. Patients with squamous cell carcinoma (SCC) of the thoracic esophagus newly diagnosed between February 1999 and April 2001 in our institution was recruited from our database. Definitive chemoradiotherapy consisted of two cycles of cisplatin/5FU repeated every 5 weeks, with concurrent radiation therapy of 60 Gy in 30 fractions. Up to 40 Gy radiation therapy was delivered to the cervical, periesophageal, mediastinal and perigastric lymph nodes as ENI. One hundred two patients were included in this analysis, and their characteristics were as follows: median age, 65 years; male/female, 85/17; T1/T2/T3/T4, 16/11/61/14; N0/N1, 48/54; M0/M1, 84/18. The median follow-up period for the surviving patients was 41 months. Sixty patients achieved complete response (CR). After achieving CR, only one (1.0%; 95% CI, 0-5.3%) patient experienced elective nodal failure without any other site of recurrence. In CRT for esophageal SCC, ENI is effective for preventing regional nodal failure. Further evaluation of whether ENI leads to an improved overall survival is needed.

  10. Disappearance of nodal gap across the insulator-superconductor transition in a copper-oxide superconductor. (United States)

    Peng, Yingying; Meng, Jianqiao; Mou, Daixiang; He, Junfeng; Zhao, Lin; Wu, Yue; Liu, Guodong; Dong, Xiaoli; He, Shaolong; Zhang, Jun; Wang, Xiaoyang; Peng, Qinjun; Wang, Zhimin; Zhang, Shenjin; Yang, Feng; Chen, Chuangtian; Xu, Zuyan; Lee, T K; Zhou, X J


    The parent compound of the copper-oxide high-temperature superconductors is a Mott insulator. Superconductivity is realized by doping an appropriate amount of charge carriers. How a Mott insulator transforms into a superconductor is crucial in understanding the unusual physical properties of high-temperature superconductors and the superconductivity mechanism. Here we report high-resolution angle-resolved photoemission measurement on heavily underdoped Bi₂Sr₂-xLaxCuO(₆+δ) system. The electronic structure of the lightly doped samples exhibit a number of characteristics: existence of an energy gap along the nodal direction, d-wave-like anisotropic energy gap along the underlying Fermi surface, and coexistence of a coherence peak and a broad hump in the photoemission spectra. Our results reveal a clear insulator-superconductor transition at a critical doping level of ~0.10 where the nodal energy gap approaches zero, the three-dimensional antiferromagnetic order disappears, and superconductivity starts to emerge. These observations clearly signal a close connection between the nodal gap, antiferromagnetism and superconductivity.

  11. Observation of nodal line in non-symmorphic topological semimetal InBi (United States)

    Adhitia Ekahana, Sandy; Wu, Shu-Chun; Jiang, Juan; Okawa, Kenjiro; Prabhakaran, Dharmalingam; Hwang, Chan-Cuk; Mo, Sung-Kwan; Sasagawa, Takao; Felser, Claudia; Yan, Binghai; Liu, Zhongkai; Chen, Yulin


    Topological nodal semimetal (TNS), characterized by its touching conduction and valence bands, is a newly discovered state of quantum matter which exhibits various exotic physical phenomena. Recently, a new type of TNS called topological nodal line semimetal (TNLS) is predicted where its conduction and valence band form a degenerate one-dimension line which is further protected by its crystal symmetry. In this work, we systematically investigated the bulk and surface electronic structure of the non-symmorphic, TNLS in InBi (which is also a type II Dirac semimetal) with strong spin-orbit coupling by using angle resolved photoemission spectroscopy. By tracking the crossing points of the bulk bands at the Brillouin zone boundary, we discovered the nodal-line feature along the {{k}}{z} direction, in agreement with the ab initio calculations and confirmed it to be a new compound in the TNLS family. Our discovery provides a new material platform for the study of these exotic topological quantum phases and paves the way for possible future applications.

  12. An effective method for the linearization of nodal stress components to apply ASME criteria

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae Wan; Choi, Suhn; Park, Keun Bae; Chang, Moon Hee [Korea Atomic Energy Research Institute, Taejeon (Korea)


    The code of ASME Sec. III prescribes the general rules upon the design of a NSSS (nuclear steam supply system). The code provides further flexibility to the design of the nuclear structures by introducing a design by analysis concept. But it still preserves the conservatisms in design works by imposing strict failure mechanism and controlling material properties in use. A designer should prove the integrity of a structure under consideration by comparing the stress intensity, which was driven from the linearization of stress at concerning section, with the prescribed one. The recent development in computing system has enabled the commercial finite element programs to be a prevailing way to structural analysis field. But only few programs provide the procedure for stress linearization through the post-processing stage. Therefore, the simplified method which uses nodal stresses over the concerning section is introduced instead. But the issues related to the accuracy of nodal stress and the stability of linearized results according to the number of nodes on a section are raised so far. In this report, an effective method utilizing the sub-structuring technique is proposed to resolve the inherent problems emerged from the linearization process using the nodal stress. 7 refs., 16 figs., 3 tabs. (Author)

  13. Identification of a proliferation signature related to survival in nodal peripheral T-cell lymphomas. (United States)

    Cuadros, Marta; Dave, Sandeep S; Jaffe, Elaine S; Honrado, Emiliano; Milne, Roger; Alves, Javier; Rodríguez, Jose; Zajac, Magdalena; Benitez, Javier; Staudt, Louis M; Martinez-Delgado, Beatriz


    Nodal peripheral T-cell lymphomas (PTCLs) constitute a heterogeneous group of neoplasms, suggesting the existence of molecular differences contributing to their histologic and clinical variability. Initial expression profiling studies of T-cell lymphomas have been inconclusive in yielding clinically relevant insights. We applied DNA microarrays to gain insight into the molecular signatures associated with prognosis. We analyzed the expression profiles of 35 nodal PTCLs (23 PTCLs unspecified and 12 angioimmunoblastic) using two different microarray platforms, the cDNA microarray developed at the Spanish National Cancer Centre and an oligonucleotide microarray. We identified five clusters of genes, the expression of which varied significantly among the samples. Genes in these clusters seemed to be functionally related to different cellular processes such as proliferation, inflammatory response, and T-cell or B-cell lineages. Regardless of the microarray platform used, overexpression of genes in the proliferation signature was associated significantly with shorter survival of patients. This proliferation signature included genes commonly associated with the cell cycle, such as CCNA, CCNB, TOP2A, and PCNA. Moreover the PTCL proliferation signature showed a statistically significant inverse correlation with clusters of the inflammatory response (P < .0001), as well as with the percentage of CD68(+) cells. Our findings indicate that proliferation could be an important factor in evaluating nodal PTCL outcome and may help to define a more aggressive phenotype.

  14. Least squares principle unifying finite element, finite difference and nodal methods for diffusion theory

    Energy Technology Data Exchange (ETDEWEB)

    Ackroyd, R.T.


    A least squares principle is described which uses a penalty function treatment of boundary and interface conditions. Appropriate choices of the trial functions and vectors employed in a dual representation of an approximate solution established complementary principles for the diffusion equation. A geometrical interpretation of the principles provides weighted residual methods for diffusion theory, thus establishing a unification of least squares, variational and weighted residual methods. The complementary principles are used with either a trial function for the flux or a trial vector for the current to establish for regular meshes a connection between finite element, finite difference and nodal methods, which can be exact if the mesh pitches are chosen appropriately. Whereas the coefficients in the usual nodal equations have to be determined iteratively, those derived via the complementary principles are given explicitly in terms of the data. For the further development of the connection between finite element, finite difference and nodal methods, some hybrid variational methods are described which employ both a trial function and a trial vector.

  15. Isolated perifacial lymph node metastasis in oral squamous cell carcinoma with clinically node-negative neck. (United States)

    Agarwal, Sangeet Kumar; Arora, Sowrabh Kumar; Kumar, Gopal; Sarin, Deepak


    The incidence of occult perifacial nodal disease in oral cavity squamous cell carcinoma is not well reported. The purpose of this study was to evaluate the incidence of isolated perifacial lymph node metastasis in patients with oral squamous cell carcinoma with a clinically node-negative neck. The study will shed light on current controversies and will provide valuable clinical and pathological information in the practice of routine comprehensive removal of these lymph node pads in selective neck dissection in the node-negative neck. Prospective analysis. This study was started in August 2011 when intraoperatively we routinely separated the lymph node levels from the main specimen for evaluation of the metastatic rate to different lymph node levels in 231 patients of oral squamous cell cancer with a clinically node-negative neck. The current study demonstrated that 19 (8.22%) out of 231 patients showed ipsilateral isolated perifacial lymph node involvement. The incidence of isolated perifacial nodes did not differ significantly between the oral tongue (7.14%) and buccal mucosa (7.75%). Incidence was statistically significant in cases with lower age group (oral squamous cell carcinoma with a clinically node-negative neck. The incidence of isolated perifacial involvement is high in cases of buccal mucosal and tongue cancers. A meticulous dissection of the perifacial nodes seems prudent when treating the neck in oral cavity squamous cell carcinoma. 4 Laryngoscope, 126:2252-2256, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  16. The Clinical Value of Axillary Ultrasonogra- phy for Detection of Axillary Lymph Node Metastasis in Cases with Breast Cancer

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    Sedigheh Tahmasebi


    Full Text Available Background: The axillary lymph node stage is one of the single most important determinants in the prognosis of breast cancer patients. The disadvantages of the two previous methods used for evaluating axillary node metastasis, i.e., axillary lymph node dissection and sentinel lymph node biopsy, have directed researchers to investigate new techniques for this purpose. The aim of the current study was to evaluate the clinical usefulness of axillary ultrasonography in detecting axillary metastasis. Methods: This study was conducted during a 12-month period. The breast cancer cases included in this study were all clinically diagnosed as stages I and II, with no prior treatment to the axillary region by surgery and/or chemo-radiotherapy. Excluded from the study group were patients with palpable axillary lymph nodes, those who had major organ failure or concomitant malignancy. All included patients with non-palpable axillary lymph nodes underwent axillary ultrasound examination. An ultrasound- guided core needle biopsy was performed on patients with suspected metastasis. Results: There were 125 female patients with a mean age of 49.6 years included in this study. From these, 16 (12.8% cases had positive axillary sonographic findings. Pathologic evaluation of tissue specimens (taken by ultrasound-guided core needle biopsy in 10 (62.5% out of 16 patients were positive, and in the patient group of 6 (37.5% cases, studies were negative. Axillary ultrasonography had a sensitivity of 35.7%, specificity of 93.8%, positive predictive value of 62.5%, and negative predictive value of 83.5%. Conclusion: The axillary ultrasonogram is a reliable technique in the determination of axillary nodal metastatic involvement in breast cancer patients. By use of this method a significant amount of complications and costs related to the previous techniques can be avoided.

  17. A nomogram to predict distant metastasis after neoadjuvant chemoradiotherapy and radical surgery in patients with locally advanced rectal cancer. (United States)

    Sun, Yanwu; Lin, Huiming; Lu, Xingrong; Huang, Ying; Xu, Zongbin; Huang, Shenghui; Wang, Xiaojie; Chi, Pan


    To compare distant metastasis (DM) in locally advanced rectal cancer (LARC) patients treated with neoadjuvant chemoradiotherapy (nCRT) and surgery alone, and to develop a predictive nomogram for DM following nCRT. Propensity-scoring match analysis was performed to compare DM in LARC treated with nCRT (n = 375) and surgery alone (n = 375). Cox regression was performed to identify predictors of DM following nCRT. A nomogram was developed and validated by internal (n = 425) and external validation (n = 97). The 5-year local recurrence rate was significantly lower in the nCRT group (5.6% vs. 10.4%; P = 0.020). The 5-year DM rates (nCRT vs. surgery alone: 25.3% vs. 24.4%; P = 0.235) were similar between groups. Cox regression showed that the post-nCRT pathologic stage (ypTNM stage, OR = 2.022, P = 0.002), IMA nodal metastasis (OR = 2.171, P = 0.023), and CRM involvement (OR = 2.535, P = 0.016) were independently associated with DM following nCRT. A predictive nomogram was developed with a C-index of 0.70 on internal validation, and 0.71 on the external validation. NCRT improved local control, but not distant metastasis. A nomogram to predict 3- and 5-year DM rates, using clinicopathological parameters, was successfully developed. This prognostic tool could support decision-making in clinical practice and follow-up strategies. © 2017 Wiley Periodicals, Inc.

  18. Long-term outcomes of patients with lymph node metastasis treated with radical prostatectomy without adjuvant androgen-deprivation therapy. (United States)

    Touijer, Karim A; Mazzola, Clarisse R; Sjoberg, Daniel D; Scardino, Peter T; Eastham, James A


    The presence of lymph node metastasis (LNM) at radical prostatectomy (RP) is associated with poor outcome, and optimal treatment remains undefined. An understanding of the natural history of node-positive prostate cancer (PCa) and identifying prognostic factors is needed. To assess outcomes for patients with LNM treated with RP and lymph node dissection (LND) alone. We analyzed data from a consecutive cohort of 369 men with LNM treated at a single institution from 1988 to 2010. RP and extended LND. Our primary aim was to model overall survival, PCa-specific survival, metastasis-free progression, and freedom from biochemical recurrence (BCR). We used univariate Cox proportional hazard regression models for survival outcomes. Multivariable Cox proportional hazard regression models were used for freedom from metastasis and freedom from BCR, with prostate-specific antigen, Gleason score, extraprostatic extension, seminal vesical invasion, surgical margin status, and number of positive nodes as predictors. Sixty-four patients with LNM died, 37 from disease. Seventy patients developed metastasis, and 201 experienced BCR. The predicted 10-yr overall survival and cancer-specific survival were 60% (95% confidence interval [CI], 49-69) and 72% (95% CI, 61-80), respectively. The 10-yr probability of freedom from distant metastasis and freedom from BCR were 65% (95% CI, 56-73) and 28% (95% CI, 21-36), respectively. Higher pathologic Gleason score (>7 compared with ≤ 7; hazard ratio [HR]: 2.23; 95% CI, 1.64-3.04; p < 0.0001) and three or more positive lymph nodes (HR: 2.61; 95% CI, 1.81-3.76; p < 0.0001) were significantly associated with increased risk of BCR on multivariable analysis. The retrospective nature and single-center source of data are study limitations. A considerable subset of men with LNM remained free of disease 10 yr after RP and extended LND alone. Patients with pathologic Gleason score <8 and low nodal metastatic burden represent a favorable group. Our data

  19. Analysis of NEA-NSC PWR Uncontrolled Control Rod Withdrawal at Zero Power Benchmark Cases with NODAL3 Code

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    Tagor Malem Sembiring


    Full Text Available The in-house coupled neutronic and thermal-hydraulic (N/T-H code of BATAN (National Nuclear Energy Agency of Indonesia, NODAL3, based on the few-group neutron diffusion equation in 3-dimensional geometry using the polynomial nodal method, has been verified with static and transient PWR benchmark cases. This paper reports the verification of NODAL3 code in the NEA-NSC PWR uncontrolled control rods withdrawal at zero power benchmark. The objective of this paper is to determine the accuracy of NODAL3 code in solving the continuously slow and fast reactivity insertions due to single and group of control rod bank withdrawn while the power and temperature increment are limited by the Doppler coefficient. The benchmark is chosen since many organizations participated using various methods and approximations, so the calculation results of NODAL3 can be compared to other codes’ results. The calculated parameters are performed for the steady-state, transient core averaged, and transient hot pellet results. The influence of radial and axial nodes number was investigated for all cases. The results of NODAL3 code are in very good agreement with the reference solutions if the radial and axial nodes number is 2 × 2 and 2 × 18 (total axial layers, respectively.

  20. Tumour thickness as a predictor of nodal metastases in oral cancer: comparison between tongue and floor of mouth subsites. (United States)

    Balasubramanian, Deepak; Ebrahimi, Ardalan; Gupta, Ruta; Gao, Kan; Elliott, Michael; Palme, Carsten E; Clark, Jonathan R


    To identify whether tumour thickness as a predictor of nodal metastases in oral squamous cell carcinoma differs between tongue and floor of mouth (FOM) subsites. Retrospective review of 343 patients treated between 1987 and 2012. The neck was considered positive in the presence of pathologically proven nodal metastases on neck dissection or during follow-up. There were 222 oral tongue and 121 FOM tumours. In patients with FOM tumours 2.1-4mm thick, the rate of nodal metastases was 41.7%. In contrast, for tongue cancers of a similar thickness the rate was only 11.2%. This increased to 38.5% in patients with tongue cancers that were 4.1-6mm thick. Comparing these two subsites, FOM cancers cross the critical 20% threshold of probability for nodal metastases between 1 and 2mm whereas tongue cancers cross the 20% threshold just under 4mm thickness. On logistic regression adjusting for relevant covariates, there was a significant difference in the propensity for nodal metastases based on tumour thickness according to subsite (p=0.028). Thin FOM tumours (2.1-4mm) have a high rate of nodal metastases. Elective neck dissection is appropriate in FOM tumours ⩾2mm thick and in tongue tumours ⩾4mm thick. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Potential Pitfall in the Assessment of Lung Cancer with FDG-PET/CT: Talc Pleurodesis Causes Intrathoracic Nodal FDG Avidity

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    Yingbing Wang


    Full Text Available Objective. Talc pleurodesis is a common procedure performed to treat complications related to lung cancer. The purpose of our study was to characterize any thoracic nodal findings on FDG PET/CT associated with prior talc pleurodesis. Materials and Methods. The electronic medical record identified 44 patients who underwent PET/CT between January 2006 and December 2010 and had a history of talc pleurodesis. For each exam, we evaluated the distribution pattern, size, and attenuation of intrathoracic lymph nodes and the associated standardized uptake value. Results. High-attenuation intrathoracic lymph nodes were noted in 11 patients (25%, and all had corresponding increased FDG uptake (range 2–9 mm. Involved nodal groups were anterior peridiaphragmatic (100%, paracardiac (45%, internal mammary (25%, and peri-IVC (18% nodal stations. Seven of the 11 patients (63% had involvement of multiple lymph nodal groups. Mean longitudinal PET/CT and standalone CT followups of 15±11 months showed persistence of both high-attenuation and increased uptake at these sites, without increase in nodal size suggesting metastatic disease involvement. Conclusions. FDG avid, high-attenuation lymph nodes along the lymphatic drainage pathway for parietal pleura are a relatively common finding following talc pleurodesis and should not be mistaken for nodal metastases during the evaluation of patients with history of lung cancer.

  2. Crosstalk between Nodal/Activin and MAPK p38 Signaling Is Essential for Anterior-Posterior Axis Specification (United States)

    Clements, Melanie; Pernaute, Barbara; Vella, Francis; Rodriguez, Tristan A.


    Summary Nodal/activin signaling plays a key role in anterior-posterior (A-P) axis formation by inducing the anterior visceral endoderm (AVE), the extraembryonic signaling center that initiates anterior patterning in the embryo. Here we provide direct evidence that the mitogen-activated protein kinase (MAPK) p38 regulates AVE specification through a crosstalk with the Nodal/activin signaling pathway. We show that p38 activation is directly stimulated by Nodal/activin and fails to be maintained upon inhibition of this pathway both in vivo and in vitro. In turn, p38 strengthens the Nodal signaling response by phosphorylating the Smad2 linker region and enhancing the level of Smad2 activation. Furthermore, we demonstrate that this p38 amplification loop is essential for correct specification of the AVE in two ways: first, by showing that inhibiting p38 activity in 5.5 days postcoitum embryo cultures leads to a switch from AVE to an extraembryonic visceral endoderm cell identity, and second, by demonstrating that genetically reducing p38 activity in a Nodal-sensitive background leads to a failure of AVE specification in vivo. Collectively, our results reveal a novel role for p38 in regulating the threshold of Nodal signaling and propose a new mechanism by which A-P axis development can be reinforced during early embryogenesis. PMID:21802298

  3. High nodal positivity rates even in good clinical responders after chemoradiation of rectal cancer: is organ preservation feasible? (United States)

    Vallam, K C; Engineer, R; Desouza, A; Patil, P; Saklani, A


    Local excision (LE) is emerging as a treatment option for rectal cancer responding well to chemoradiation. However, it does not address the mesorectal nodal burden. We aimed to identify the factors influencing nodal positivity and subsequently defined a low-risk group by including only patients at low risk. A single-centre, retrospective database analysis was carried out of patients with radically resected rectal cancer after neoadjuvant chemoradiation. This study included 524 patients with predominantly low rectal tumours. Nodal positivity among ypT0, T1 and T2 groups was 14.7%, 28% and 30%, respectively. Multivariate analysis with stepwise logistic regression identified the following low-risk features: age ≥ 40 years, nonsignet ring cell carcinoma (SRCC) histology and pathological complete response (pCR). Sixty-nine patients fulfilling all three criteria were analysed and the nodal positivity was found to be 10.1%, which implies that, if these patients had been selected for LE, one in 10 would have had positive mesorectal nodes. Even in patients with low-risk criteria (pCR, non-SRCC histology and age ≥ 40 years), the residual positive nodal disease burden is 10%. Whether this high incidence of residual nodal disease translates into a similar risk of locoregional recurrence if an organ-preservation strategy is adopted is unclear. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.

  4. Melanoma patients with unknown primary site or nodal recurrence after initial diagnosis have a favourable survival compared to those with synchronous lymph node metastasis and primary tumour.

    Directory of Open Access Journals (Sweden)

    Benjamin Weide

    Full Text Available BACKGROUND: A direct comparison of prognosis between patients with regional lymph node metastases (LNM detected synchronously with the primary melanoma (primary LNM, patients who developed their first LNM subsequently (secondary LNM and those with initial LNM in melanoma with unknown primary site (MUP is missing thus far. PATIENTS AND METHODS: Survival of 498 patients was calculated from the time point of the first macroscopic LNM using Kaplan Meier and multivariate Cox hazard regression analysis. RESULTS: Patients with secondary LNM (HR = 0.67; p = 0.009 and those with initial LNM in MUP (HR = 0.45; p = 0.008 had a better prognosis compared to patients with primary LNM (median survival time 52 and 65 vs. 24 months, respectively. A high number of involved nodes, the presence of in-transit/satellite metastases and male gender had an additional independent unfavourable effect. CONCLUSIONS: Survival of patients with LNM in MUP and with secondary LNM is similar and considerably more favourable compared to those with primary LNM. This difference needs to be considered during patient counselling and for stratification purposes in clinical trials. The assumption of an immune privilege of patients with MUP which is responsible for rejection of the primary melanoma, and results in a favourable prognosis is not supported by our data.

  5. Melanoma metastasis to the spleen: Laparoscopic approach

    Directory of Open Access Journals (Sweden)

    Trindade Manoel Roberto


    Full Text Available We report a case of minimally invasive surgery in the management of metastasis to the spleen. A 67-year-old male patient with possible splenic soft tissue melanoma metastasis was referred to our hospital. He had a history of an excised soft tissue melanoma from his back eight months earlier, and the control abdominal computer tomography (CT scan revealed a hypodense spleen lesion. The patient underwent laparoscopic surgery to diagnose and treat the splenic lesion. The splenectomy was performed and the histological examination revealed a melanoma. The patient had a good postoperative course and was discharged on the second postoperative day. On his 12-month follow-up there was no sign of recurrence. The laparoscopic approach is a safe and effective alternative for treatment of splenic metastases.

  6. Enhancer Reprogramming Promotes Pancreatic Cancer Metastasis. (United States)

    Roe, Jae-Seok; Hwang, Chang-Il; Somerville, Tim D D; Milazzo, Joseph P; Lee, Eun Jung; Da Silva, Brandon; Maiorino, Laura; Tiriac, Hervé; Young, C Megan; Miyabayashi, Koji; Filippini, Dea; Creighton, Brianna; Burkhart, Richard A; Buscaglia, Jonathan M; Kim, Edward J; Grem, Jean L; Lazenby, Audrey J; Grunkemeyer, James A; Hollingsworth, Michael A; Grandgenett, Paul M; Egeblad, Mikala; Park, Youngkyu; Tuveson, David A; Vakoc, Christopher R


    Pancreatic ductal adenocarcinoma (PDA) is one of the most lethal human malignancies, owing in part to its propensity for metastasis. Here, we used an organoid culture system to investigate how transcription and the enhancer landscape become altered during discrete stages of disease progression in a PDA mouse model. This approach revealed that the metastatic transition is accompanied by massive and recurrent alterations in enhancer activity. We implicate the pioneer factor FOXA1 as a driver of enhancer activation in this system, a mechanism that renders PDA cells more invasive and less anchorage-dependent for growth in vitro, as well as more metastatic in vivo. In this context, FOXA1-dependent enhancer reprogramming activates a transcriptional program of embryonic foregut endoderm. Collectively, our study implicates enhancer reprogramming, FOXA1 upregulation, and a retrograde developmental transition in PDA metastasis. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Modeling tumor invasion and metastasis in Drosophila

    Directory of Open Access Journals (Sweden)

    Wayne O. Miles


    Full Text Available Conservation of major signaling pathways between humans and flies has made Drosophila a useful model organism for cancer research. Our understanding of the mechanisms regulating cell growth, differentiation and development has been considerably advanced by studies in Drosophila. Several recent high profile studies have examined the processes constraining the metastatic growth of tumor cells in fruit fly models. Cell invasion can be studied in the context of an in vivo setting in flies, enabling the genetic requirements of the microenvironment of tumor cells undergoing metastasis to be analyzed. This Perspective discusses the strengths and limitations of Drosophila models of cancer invasion and the unique tools that have enabled these studies. It also highlights several recent reports that together make a strong case for Drosophila as a system with the potential for both testing novel concepts in tumor progression and cell invasion, and for uncovering players in metastasis.

  8. Thyroid gland metastasis of rectal cancer. (United States)

    Ozawa, Tsuyoshi; Saito, Shinsuke; Matsuura, Sohei; Kishi, Hirohisa; Maeda, Mamoru; Watanabe, Toshiaki


    A 72-year-old woman with a history of rectal cancer was admitted to our hospital to undergo thyroidectomy and left adrenalectomy. She had undergone low anterior resection and regional lymph node dissection for rectal cancer 52 months pre-admission (T3 N1 M0, stage IIIb according to International Union Against Cancer tumor-node-metastasis), and she had also undergone metastasectomy for lung metastases and right adrenal gland metastasis after the rectal surgery. Follow-up computed tomography scans detected nodules in the bilateral lobes of the thyroid gland and in the left adrenal gland. Subtotal thyroidectomy and left adrenalectomy were performed, and pathological examination revealed metastases of rectal cancer to the thyroid gland and left adrenal gland. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2015.

  9. MRI of metastasis-permissive microenvironments. (United States)

    Penet, Marie-France; Chen, Zhihang; Bhujwalla, Zaver M


    One of the earliest documented observations of the importance of the microenvironment in metastasis was made by Stephen Paget in 1889. More than a century later, the metastatic cascade remains a major cause of mortality from cancer. Cancer meets the criterion of a successful organization that is able to survive by adapting to changing environments. In fact, the tumor microenvironment and stroma are co-opted and shaped by cancer cells to derive a survival advantage. Cohesive strategies integrating advances in molecular biology and chemistry, with noninvasive multimodality imaging, provide new insights into the role of the tumor microenvironment in promoting metastasis from primary tumors as well as insights into environments that attract and permit cancer cells to establish colonies in distant organs. This article provides an overview of molecular and functional imaging characterization of microenvironments that can promote or permit cancer cells to metastasize and the microenvironmental characteristics of distant metastases.

  10. Macroscopic stiffness of breast tumors predicts metastasis. (United States)

    Fenner, Joseph; Stacer, Amanda C; Winterroth, Frank; Johnson, Timothy D; Luker, Kathryn E; Luker, Gary D


    Mechanical properties of tumors differ substantially from normal cells and tissues. Changes in stiffness or elasticity regulate pro-metastatic behaviors of cancer cells, but effects have been documented predominantly in isolated cells or in vitro cell culture systems. To directly link relative stiffness of tumors to cancer progression, we combined a mouse model of metastatic breast cancer with ex vivo measurements of bulk moduli of freshly excised, intact tumors. We found a high, inverse correlation between bulk modulus of resected tumors and subsequent local recurrence and metastasis. More compliant tumors were associated with more frequent, larger local recurrences and more extensive metastases than mice with relatively stiff tumors. We found that collagen content of resected tumors correlated with bulk modulus values. These data establish that relative differences in tumor stiffness correspond with tumor progression and metastasis, supporting further testing and development of tumor compliance as a prognostic biomarker in breast cancer.

  11. Analysis of the asymmetrically expressed Ablim1 locus reveals existence of a lateral plate Nodal-independent left sided signal and an early, left-right independent role for nodal flow

    Directory of Open Access Journals (Sweden)

    Hilton Helen


    Full Text Available Abstract Background Vertebrates show clear asymmetry in left-right (L-R patterning of their organs and associated vasculature. During mammalian development a cilia driven leftwards flow of liquid leads to the left-sided expression of Nodal, which in turn activates asymmetric expression of the transcription factor Pitx2. While Pitx2 asymmetry drives many aspects of asymmetric morphogenesis, it is clear from published data that additional asymmetrically expressed loci must exist. Results A L-R expression screen identified the cytoskeletally-associated gene, actin binding lim protein 1 (Ablim1, as asymmetrically expressed in both the node and left lateral plate mesoderm (LPM. LPM expression closely mirrors that of Nodal. Significantly, Ablim1 LPM asymmetry was detected in the absence of detectable Nodal. In the node, Ablim1 was initially expressed symmetrically across the entire structure, resolving to give a peri-nodal ring at the headfold stage in a flow and Pkd2-dependent manner. The peri-nodal ring of Ablim1 expression became asymmetric by the mid-headfold stage, showing stronger right than left-sided expression. Node asymmetry became more apparent as development proceeded; expression retreated in an anticlockwise direction, disappearing first from the left anterior node. Indeed, at early somite stages Ablim1 shows a unique asymmetric expression pattern, in the left lateral plate and to the right side of the node. Conclusion Left LPM Ablim1 is expressed in the absence of detectable LPM Nodal, clearly revealing existence of a Pitx2 and Nodal-independent left-sided signal in mammals. At the node, a previously unrecognised action of early nodal flow and Pkd2 activity, within the pit of the node, influences gene expression in a symmetric manner. Subsequent Ablim1 expression in the peri-nodal ring reveals a very early indication of L-R asymmetry. Ablim1 expression analysis at the node acts as an indicator of nodal flow. Together these results make

  12. Analysis of the asymmetrically expressed Ablim1 locus reveals existence of a lateral plate Nodal-independent left sided signal and an early, left-right independent role for nodal flow (United States)


    Background Vertebrates show clear asymmetry in left-right (L-R) patterning of their organs and associated vasculature. During mammalian development a cilia driven leftwards flow of liquid leads to the left-sided expression of Nodal, which in turn activates asymmetric expression of the transcription factor Pitx2. While Pitx2 asymmetry drives many aspects of asymmetric morphogenesis, it is clear from published data that additional asymmetrically expressed loci must exist. Results A L-R expression screen identified the cytoskeletally-associated gene, actin binding lim protein 1 (Ablim1), as asymmetrically expressed in both the node and left lateral plate mesoderm (LPM). LPM expression closely mirrors that of Nodal. Significantly, Ablim1 LPM asymmetry was detected in the absence of detectable Nodal. In the node, Ablim1 was initially expressed symmetrically across the entire structure, resolving to give a peri-nodal ring at the headfold stage in a flow and Pkd2-dependent manner. The peri-nodal ring of Ablim1 expression became asymmetric by the mid-headfold stage, showing stronger right than left-sided expression. Node asymmetry became more apparent as development proceeded; expression retreated in an anticlockwise direction, disappearing first from the left anterior node. Indeed, at early somite stages Ablim1 shows a unique asymmetric expression pattern, in the left lateral plate and to the right side of the node. Conclusion Left LPM Ablim1 is expressed in the absence of detectable LPM Nodal, clearly revealing existence of a Pitx2 and Nodal-independent left-sided signal in mammals. At the node, a previously unrecognised action of early nodal flow and Pkd2 activity, within the pit of the node, influences gene expression in a symmetric manner. Subsequent Ablim1 expression in the peri-nodal ring reveals a very early indication of L-R asymmetry. Ablim1 expression analysis at the node acts as an indicator of nodal flow. Together these results make Ablim1 a candidate for

  13. Metastasis of Colon Cancer to the Breast

    Directory of Open Access Journals (Sweden)

    Swei H. Tsung


    Full Text Available Breast metastases from extramammary neoplasms are extremely rare, and even more so is metastasis of colon cancer to the breast. Despite its rarity, metastatic disease to the breast is an important diagnostic issue because its treatment differs greatly from that of primary cancer. Proper diagnosis of this rare event requires an accurate clinical history, proper immunohistochemical workup, and a high level of suspicion.

  14. On the Origin of Cancer Metastasis


    Seyfried, Thomas N.; Huysentruyt, Leanne C.


    Metastasis involves the spread of cancer cells from the primary tumor to surrounding tissues and to distant organs and is the primary cause of cancer morbidity and mortality. In order to complete the metastatic cascade, cancer cells must detach from the primary tumor, intravasate into the circulatory and lymphatic systems, evade immune attack, extravasate at distant capillary beds, and invade and proliferate in distant organs. Currently, several hypotheses have been advanced to explain the or...

  15. Breast carcinoma metastasis to the lacrimal gland

    DEFF Research Database (Denmark)

    Nickelsen, Marie N.; Von Holstein, Sarah; Hansen, Alastair B.


    A 77-year-old female, with proptosis, reduced eye motility and diplopia which had developed over two to three months and a 69-year-old female with proptosis, oedema of the eyelid, reduced motility and ptosis, which had developed over three weeks, are presented in the present study. Computed tomog...... study aimed to describe two such cases and draw attention to breast carcinomas as a differential diagnosis and the most frequent cause of lacrimal gland metastasis....

  16. Isolated penile metastasis from bladder carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Demuren, O.A. [Department of Radiology and Imaging, Armed Forces Hospital, Riyadh (Saudi Arabia); Koriech, O. [Department of Oncology, Armed Forces Hospital, Riyadh (Saudi Arabia)


    Metastases of the penis are uncommon, with only approximately 300 cases reported since 1870. In up to 70 % of patients, the primary tumour is located in the urogenital tract. Furthermore, isolated metastases of the penis are exceptionally rare. We report a case of solitary squamous cell metastasis of the penis presenting with painful swelling initially thought to be inflammatory in origin. The CT and MR imaging findings are presented with a short review of the literature. (orig.) With 2 figs., 9 refs.

  17. Mandibular metastasis of cholangiocarcinoma: A case report

    Energy Technology Data Exchange (ETDEWEB)

    You, Tae Min [Dept. of Advanced General Dentistry, Dankook University, Cheonan (Korea, Republic of); Kim, Kee Dong; Jeong, Ho Gui; Park, Won Se [Advanced General Dentistry, Dankook University, Cheonan (Korea, Republic of)


    Tumors metastasizing from distant regions to the oral and maxillofacial region are uncommon, comprising only 1%-2% of all malignancies. Cholangiocarcinoma is a malignancy that arises from cholangiocytes, which are epithelial cells that line the bile ducts. These cancers are difficult to diagnose and have a poor prognosis. In this paper, we report a rare case of mandibular metastasis of cholangiocarcinoma diagnosed at the primary site and discuss the radiographic findings observed in this case.

  18. Heparanase Mechanisms in Melanoma Brain Metastasis (United States)


    An established role for heparanase is the release of growth and angiogenic factors which are avidly bound to extracellular matrix HS (1, 2). HPSE...are endosome-derived, 30–100nm small membrane vesicles released by most cell types including tumor cells. Of note, they possess capabilities to...metastasis onset. Electron microscopy was performed to characterize the quality of the vesicles . Membrane-bound particles with a characteristic

  19. pH-Responsive Wormlike Micelles with Sequential Metastasis Targeting Inhibit Lung Metastasis of Breast Cancer. (United States)

    He, Xinyu; Yu, Haijun; Bao, Xiaoyue; Cao, Haiqiang; Yin, Qi; Zhang, Zhiwen; Li, Yaping


    Cancer metastasis is the main cause for the high mortality in breast cancer patients. Herein, we first report succinobucol-loaded pH-responsive wormlike micelles (PWMs) with sequential targeting capability to inhibit lung metastasis of breast cancer. PWMs can in a first step be delivered specifically to the sites of metastases in the lungs and then enable the intracellular pH-stimulus responsive drug release in cancer cells to improve the anti-metastatic effect. PWMs are identified as nanofibrillar assemblies with a diameter of 19.9 ± 1.9 nm and a length within the 50-200 nm range, and exhibited pH-sensitive drug release behavior in response to acidic intracellular environments. Moreover, PWMs can obviously inhibit the migration and invasion abilities of metastatic 4T1 breast cancer cells, and reduce the expression of the metastasis-associated vascular cell adhesion molecule-1 (VCAM-1) at 400 ng mL(-1) of succinobucol. In particular, PWMs can induce a higher specific accumulation in lung and be specifically delivered to the sites of metastases in lung, thereby leading to an 86.6% inhibition on lung metastasis of breast cancer. Therefore, the use of sequentially targeting PWMs can become an encouraging strategy for specific targeting and effective treatment of cancer metastasis. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  20. Spinal Intramedullary Metastasis of Breast Cancer

    Directory of Open Access Journals (Sweden)

    Recep Basaran


    Full Text Available Objective. Breast cancer accounts for approximately one-third of all cancers in females. Approximately 8.5 % of all central nervous system metastases are located in the spinal cord. These patients have rapidly progressing neurological deficits and require immediate examination. The aim of surgery is decompression of neural tissue and histological evaluation of the tumor. In this paper, we present a case of breast cancer metastasis in thoracic spinal intramedullary area which had been partially excised and then given adjuvant radiotherapy. Case. A 43-year-old female patient with breast cancer for 8 years was admitted to our hospital with complaints of weakness in both legs. Eight years ago, she received chemotherapy and radiotherapy. On her neurological examination, she had paraparesis (left lower extremity: 2/5, right lower extremity: 3/5 and urinary incontinence. Spinal MRI revealed a gadolinium enhancing intramedullary lesion. Pathologic examination of the lesion was consistent with breast carcinoma metastasis. The patient has been taken into radiotherapy. Conclusion. Spinal intramedullary metastasis of breast cancer is an extremely rare situation, but it has a high morbidity and mortality rate. Microsurgical resection is necessary for preservation or amelioration of neurological state and also for increased life expectancy and quality.

  1. Pathobiology of cancer metastasis: a short account

    Directory of Open Access Journals (Sweden)

    Feller Liviu


    Full Text Available Abstract Cancer-initiating cells display aberrant functional and phenotypic characteristics of normal stem cells from which they evolved by accumulation of multiple cytogenetic and/or epigenetic alterations. Signal transduction pathways which are essential for normal stem cell function are abnormally expressed by cancer cells, with a cancer cell phenotype playing an essential role in cancerization and metastasis. Local tumour progression, metastasis and metastatic tumour growth are mediated by direct cell-to-cell and paracrine reciprocal interactions between cancer cells and various stromal cells including fibroblasts, macrophages, bone marrow derived stem cells and progenitor cells. These interactions mediate breakdown of basement membrane barriers and angiogenesis both locally at the invasive front of the primary tumour and at the distant metastatic site; attract primary tumour cells to the candidate metastatic site; and promote proliferation, survival and growth of primary tumour cells and of metastatic cells at their distant site. It is the purpose of this article to highlight the analogies between some of the genetic programs of normal stem cells, and of cancer cells participating in the process of metastasis.

  2. Renal medullary carcinoma with an ophthalmic metastasis

    Directory of Open Access Journals (Sweden)

    Christine Ibilibor


    Full Text Available Renal medullary carcinoma (RMC is a rare, aggressive primary renal malignancy that classically occurs in adolescent males with sickle cell trait and universally presents with metastatic disease at presentation. We report a case of medullary carcinoma in a young man with likely ophthalmic metastasis. We also review relevant literature available to date. The patient is a 20-year-old African-American male with a past medical history significant to for sickle cell trait who presented to the University Medical Center with cough and the right eye pain for 1 month as well as painless gross hematuria for 1 week. A chest and abdominal computed tomography showed a 7 cm hypodense right renal mass with bilateral hilar adenopathy, and multiple bilateral pulmonary nodules. A renal biopsy was performed and showed RMC. Ophthalmic exam revealed the right retinal hemorrhage concerning for a metastatic lesion. Palliative chemotherapy was offered to the patient, however, he and his family chose to enroll in hospice care considering his poor prognosis. He subsequently passed away 33 days after presentation. To our knowledge, there is only one other case of ophthalmic metastasis in a patient with metastatic RMC. Thus, we present this case to contribute to current literature regarding orbital metastasis in this largely fatal disease.

  3. Extra-nodal lymphoma. A survey of Japan lymphoma radiation therapy group

    Energy Technology Data Exchange (ETDEWEB)

    Oguchi, Masahiko [Japanese Foundation for Cancer Research, Tokyo (Japan). Hospital; Ikeda, Hiroshi [National Cancer Center, Kashiwa, Chiba (Japan). East Hospital; Nakamura, Shigeo [Aichi Cancer Center, Nagoya (Japan). Hospital] [and others


    The purpose of this study was to examine, retrospectively, national-wide clinical data of patients with localized extranodal non-Hodgkin's lymphoma (NHL) who were treated by radiation therapy with or without chemotherapy. The survey was carried out at 25 radiation oncology institutions in Japan in 1998. In 1999, according to the Revised European American Lymphoma (REAL) classification, central pathological review conducted at Aichi cancer center was carried out for the data from 7 radiation oncology institutions. The 5-year progression free survival rates (PFS) were calculated to identify prognostic factors. Survey: Data from 1, 141 patients with stage I and II NHL were recruited from 1988 through 1992. Of them, 787 patients, who were treated using definitive radiotherapy with or without chemotherapy for intermediate and high-grade lymphomas in Working Formulation, constituted the core of this study. Primary tumors arose mainly from extra-nodal organs (71%) in the head and neck (Waldeyer's ring: 41%, thyroid gland: 7%, nasal cavities: 5%, oral cavities: 4%, sinus: 3%, orbital structures: 3%, skin: 2% and etc.). The median age of 60 years for patients with extra-nodal NHL was higher than that of 56 years for patients with nodal NHL (p<0.01). Female were dominant in incidence of extra-nodal NHL arising from the thyroid gland, skin and gastrointestinal tract. The percentage of stage I to the extra-nodal NHL from orbit, sino-nasal presentation was higher than that of other NHLs. The percentage of stage II to the extra-nodal NHL from Waldeyer's ring and thyroid gland was higher than that of other NHLs. Central pathological review was carried out for pathological data from 79 patients (Waldeyer's ring: 45, thyroid gland: 19, sinonasal cavities: 15). Of these, diffuse large B cell lymphoma (DLBCL) composed 63% of all patients, mucosa associated lyumphoid tissue lymphoma (MALT-L): 16%, Natural Killer/T cell lymphoma (NK/T-L): 11%, and mantle cell

  4. Gastric Metastasis of Ectopic Breast Cancer Mimicking Axillary Metastasis of Primary Gastric Cancer

    Directory of Open Access Journals (Sweden)

    Selami Ilgaz Kayılıoğlu


    Full Text Available Ectopic breast tissue has the ability to undergo all the pathological changes of the normal breast, including breast cancer. Gastrointestinal metastasis of breast cancer is rarely observed and it is very difficult to differentiate gastric metastases from primary gastric cancer. We present a case of 52-year-old female, who suffered from abdominal pain. Physical examination showed a palpable mass in the left anterior axilla and computerized tomography revealed gastric wall thickening with linitis plastica. When gastroscopic biopsy showed no signs of malignancy, excisional biopsy was performed in the left axilla. Histological examination revealed invasive lobular carcinoma of the breast, consistent with ectopic breast cancer. Further gastroscopic submucosal biopsies and immunohistochemical studies revealed gastric metastases of invasive lobular carcinoma. Axillary ectopic breast tissue carcinomas can mimic axillary lymphadenopathies. Additionally, gastric metastasis of breast cancer is an uncommon but possible condition. To the best of our knowledge, this is the first report of ectopic breast cancer with gastric metastasis.

  5. Solution of the Boltzmann-Fokker-Planck transport equation using exponential nodal schemes; Solucion de la ecuacion de transporte de Boltzmann-Fokker-Planck usando esquemas nodales exponenciales

    Energy Technology Data Exchange (ETDEWEB)

    Ortega J, R.; Valle G, E. del [IPN-ESFM, 07738 Mexico D.F. (Mexico)]. e-mail:


    There are carried out charge and energy calculations deposited due to the interaction of electrons with a plate of a certain material, solving numerically the electron transport equation for the Boltzmann-Fokker-Planck approach of first order in plate geometry with a computer program denominated TEOD-NodExp (Transport of Electrons in Discreet Ordinates, Nodal Exponentials), using the proposed method by the Dr. J. E. Morel to carry out the discretization of the variable energy and several spatial discretization schemes, denominated exponentials nodal. It is used the Fokker-Planck equation since it represents an approach of the Boltzmann transport equation that is been worth whenever it is predominant the dispersion of small angles, that is to say, resulting dispersion in small dispersion angles and small losses of energy in the transport of charged particles. Such electrons could be those that they face with a braking plate in a device of thermonuclear fusion. In the present work its are considered electrons of 1 MeV that impact isotropically on an aluminum plate. They were considered three different thickness of plate that its were designated as problems 1, 2 and 3. In the calculations it was used the discrete ordinate method S{sub 4} with expansions of the dispersion cross sections until P{sub 3} order. They were considered 25 energy groups of uniform size between the minimum energy of 0.1 MeV and the maximum of 1.0 MeV; the one spatial intervals number it was considered variable and it was assigned the values of 10, 20 and 30. (Author)

  6. Role of Akt2 in regulation of metastasis suppressor 1 expression and colorectal cancer metastasis. (United States)

    Agarwal, E; Robb, C M; Smith, L M; Brattain, M G; Wang, J; Black, J D; Chowdhury, S


    Survival signaling is critical for the metastatic program of cancer cells. The current study investigated the role of Akt survival proteins in colorectal cancer (CRC) metastasis and explored potential mechanisms of Akt-mediated metastasis regulation. Using an orthotopic implantation model in mice, which uniquely recapitulates the entire multistep process of CRC metastasis, combined with an inducible system of short hairpin RNA-mediated Akt isoform knockdown in human CRC cells, our studies confirm a role of Akt2 in CRC cell dissemination to distant organs in vivo. Akt2 deficiency profoundly inhibited the development of liver lesions in mice, whereas Akt1 had no effect under the experimental conditions used in the study. Array analysis of human metastatic genes identified the scaffolding protein metastasis suppressor 1 (MTSS1) as a novel Akt2-regulated gene. Inducible loss of Akt2 in CRC cells robustly upregulated MTSS1 at the messenger RNA and protein level, and the accumulated protein was functionally active as shown by its ability to engage an MTSS1-Src-cortactin inhibitory axis. MTSS1 expression led to a marked reduction in levels of functional cortacin (pcortactin Y421), an actin nucleation-promoting factor that has a crucial role in cancer cell invasion and metastasis. MTSS1 was also shown to mediate suppressive effects of Akt2 deficiency on CRC cell viability, survival, migration and actin polymerization in vitro. The relevance of these findings to human CRC is supported by analysis of The Cancer Genome Atlas (TCGA) and NCBI GEO data sets, which demonstrated inverse changes in expression of Akt2 and MTSS1 during CRC progression. Taken together, the data identify MTSS1 as a new Akt2-regulated gene, and point to suppression of MTSS1 as a key step in the metastasis-promoting effects of Akt2 in CRC cells.

  7. Características morfológicas y posibles implicaciones clínicas de las arterias nodales Morphological characteristics and potential clinical implications of nodal arteries

    Directory of Open Access Journals (Sweden)

    Luis E Ballesteros


    Full Text Available La expresión morfológica de las arterias nodales es relevante en el diagnóstico y manejo de eventos clínicos y en abordajes quirúrgicos del corazón. Se estudiaron 88 arterias nodales de corazones obtenidos como material de autopsia. Las arterias coronarias se inyectaron con resina poliéster pigmentada de color rojo. Se registraron las formas de presentación de las arterias nodales y sus características morfométricas. La arteria del nodo sinoatrial se originó de la coronaria derecha en 52 casos (59,1%, de la circunfleja en 33 corazones (37,35% y de ambas en 3 (3,4%. Su calibre proximal fue de 1,31 mm (± 0,3, correspondiente a las arterias originadas de la coronaria derecha de 1,25 mm (± 0,3 mientras que las que se originaron de la arteria circunfleja obtuvieron un calibre de 1,42 mm (± 0,3, siendo esta diferencia significativa (p= 0,01. Se originó con mayor frecuencia en el tercio anteromedial, tanto de la coronaria derecha como de la circunfleja (54,6% y 61,2% respectivamente. En su segmento final cruzó por delante de la desembocadura de la vena cava superior en la mayoría de los casos (44%, mientras que en 22 corazones (24,5% cursó alrededor de la cava. Se observó arteria en forma de «S» en 14 casos (15,9% del total de la muestra y 42,4% de las originadas de la arteria circunfleja. La arteria del nodo atrioventricular se originó del segmento en «U» invertida de la coronaria derecha, al nivel de la cruz cardiaca, en 81 corazones (92%, y presentó un calibre proximal de 1,06 mm (± 0,22. Con relación al calibre y al origen se evidencian hallazgos que coinciden con estudios previos. Se destaca la alta prevalencia de la arteria en forma de «S» y de la trayectoria de la arteria sinoatrial alrededor de la vena cava superior.The morphological expression of nodal arteries is important in the diagnosis and management of cardiac clinical events and surgical approaches. 88 nodal arteries of hearts obtained from autopsies were

  8. MicroRNA-421 inhibits breast cancer metastasis by targeting metastasis associated 1. (United States)

    Pan, Yongqin; Jiao, Genlong; Wang, Cunchuan; Yang, Jingge; Yang, Wah


    Dysregulation of microRNAs is involved in the initiation and progression of several human cancers, including breast cancer, as strong evidence of miRNAs acting as oncogenes or tumour suppressor genes has been found. This study was performed to investigate the biological functions of microRNA-421 (miR-421) in breast cancer and the underlying mechanisms. The expression level of miR-421 was detected in 50 pairs of surgical specimens and human breast cancer cell lines. The results showed that miR-421 is downregulated in breast cancer tissues and metastatic cell lines. In addition, the decrease in miR-421 levels was significantly associated with lymph node metastasis, recurrence/metastasis, or pTNM stage. Functions of miR-421 in cell migration and invasion were assessed through its silencing and overexpression. The results showed that miR-421 knockdown promotes invasion and metastasis in MCF-7 cells and its overexpression suppresses invasion and metastasis in MDA-MB-231 cells. The specific target genes of miR-421 were predicted by TargetScan algorithm and determined by dual luciferase reporter assay, quantitative reverse transcriptase PCR, and western blot analysis. miR-421 could suppress luciferase activity of the reporter containing 3'-untranslated region of metastasis associated 1 (MTA1), a potent oncogene. miR-421 overexpression or knockdown had no effect on the mRNA expression of MTA1, but it could modulate MTA1 protein level. Furthermore, MTA1 knockdown receded the effect of miR-421 inhibitor on invasion and metastasis of MCF-7 cells, and its overexpression receded the effect of miR-421 on invasion and metastasis of MDA-MB-231 cells. Our findings clearly demonstrate that miR-421 suppresses breast cancer metastasis by directly inhibiting MTA1 expression. The present study provides a new insight into the tumour suppressor roles of miR-421 and suggests that miR-421/MTA1 pathway is a putative therapeutic target in breast cancer. Copyright © 2016 Elsevier Masson SAS

  9. Molecular Mechanism Underlying Lymphatic Metastasis in Pancreatic Cancer

    Directory of Open Access Journals (Sweden)

    Zhiwen Xiao


    Full Text Available As the most challenging human malignancies, pancreatic cancer is characterized by its insidious symptoms, low rate of surgical resection, high risk of local invasion, metastasis and recurrence, and overall dismal prognosis. Lymphatic metastasis, above all, is recognized as an early adverse event in progression of pancreatic cancer and has been described to be an independent poor prognostic factor. It should be noted that the occurrence of lymphatic metastasis is not a casual or stochastic but an ineluctable and designed event. Increasing evidences suggest that metastasis-initiating cells (MICs and the microenvironments may act as a double-reed style in this crime. However, the exact mechanisms on how they function synergistically for this dismal clinical course remain largely elusive. Therefore, a better understanding of its molecular and cellular mechanisms involved in pancreatic lymphatic metastasis is urgently required. In this review, we will summarize the latest advances on lymphatic metastasis in pancreatic cancer.

  10. Idiopathic extensive peliosis hepatis treated with liver transplantation

    DEFF Research Database (Denmark)

    Hyodo, Masanobu; Mogensen, Anne Mellon; Larsen, Peter Nørgaard


    complicating liver cirrhosis. Extensive peliosis with liver cirrhosis is a rare condition. Only two cases, caused by contraceptives and treated by liver transplantation, are reported in the English-language literature. We could find no cause other than alcohol abuse lasting several years in this patient...

  11. Immune Response and Immunolmodulation in Chronic Hepatiitis B Virus Infection

    NARCIS (Netherlands)

    D. Sprengers (Dave)


    textabstractDespite the presence of an effective vaccine since 1982, chronic hepatitis B virus infection (CHB) still ranks among the highest causes of mortality from infectious diseases worldwide. The studies presented in this thesis were performed to get a better insight into the

  12. Choroid Melanoma Metastasis to Spine: A Rare Case Report


    Hiren Mandaliya; Nandini Singh; Sanila George; Mathew George


    Metastatic choroid melanoma is a highly malignant disease with a limited life expectancy. The liver is the most common site for metastasis of uveal melanoma followed by lung, bone, skin, and subcutaneous tissue. Metastasis from choroidal melanoma usually occurs within the first five years of treatment for primary tumours. Metastatic choroid melanoma to the spine/vertebrae is extremely rare. We report the first case of spinal metastasis from choroid melanoma in a 61-year-old man who had been t...

  13. Regulation of Prostate Cancer Bone Metastasis by DKK1 (United States)


    blocks the formation of osteoblastic bone lesions in animal models of bone metastasis. We have now shown that human prostate cancer cell lines...that produce osteolytic, but not osteoblastic, bone lesions in animal models of bone metastasis express significant amounts of DKK1 and this expression...cancer bone metastasis typically results in massive osteolysis from the secretion of osteoclast-activating factors, such as parathyroid hormone-related

  14. [Mandibular metastasis disclosing a papillary carcinoma of the thyroid gland]. (United States)

    Essakalli, L; Jazouli, N; Kzadri, M


    The thyroïd well differentiated carcinoma could be originate of the osseous metastasis and/or pulmonary or others. Sometimes, the cancer of the thyroïd stay latent, discovered by the occasion of secondary osseous localisations. We bring back a personally observation of papillary cancer of the thyroïd discovered by the occasion of mandibular metastasis. Helping ourselves by literary datum, we will comment on essentially the diagnostic and therapeutic problems breeded by this kind of metastasis.

  15. Contralateral solitary adrenal metastasis after radical nephrectomy: Case reports

    Directory of Open Access Journals (Sweden)

    Muhammed Tosun


    Full Text Available Renal cell carcinoma is the most common malignant parenchymal tumor of the kidney. Renal cell carcinoma is often metastasis to the lung, liver, lymph node and bone but after surgery opposite side of solitary adrenal metastasis of this tumor is very rare. Aggressive surgical approach is often preferred in treatment of metastasis. We presented in the literature a case of a 46-year-old man patient who underwent radical surgery due to left renal cell carcinoma with contralaterally solitary adrenal metastasis and management in the fourth year control.

  16. The role of GAGE cancer/testis antigen in metastasis

    DEFF Research Database (Denmark)

    Gjerstorff, Morten Frier; Terp, Mikkel Green; Hansen, Malene Bredahl


    with migratory and invasive properties and were found to be upregulated in cancer cells with metastasizing potential in a gastric cancer model. METHODS: We have addressed the direct role of GAGE proteins in supporting metastasis using an isogenic metastasis model of human cancer, consisting of 4 isogenic cell......) and moderately metastatic clones (LM3), stable downregulation of GAGE expression did not affect the ability of CL16 cells to establish primary tumors and form metastasis in the lungs of immunodeficient mice. CONCLUSIONS: These results suggest that GAGE proteins per se do not support metastasis and that further...

  17. Comparison between 18F-Fluorodeoxyglucose Positron Emission Tomography and Sentinel Lymph Node Biopsy for Regional Lymph Nodal Staging in Patients with Melanoma: A Review of the Literature

    Directory of Open Access Journals (Sweden)

    Paoletta Mirk


    Full Text Available Aim. to compare 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET to sentinel lymph node biopsy (SLNB for regional lymph nodal staging in patients with melanoma. Methods. We performed a literature review discussing original articles which compared FDG-PET to SLNB for regional lymph nodal staging in patients with melanoma. Results and Conclusions. There is consensus in the literature that FDG-PET cannot replace SLNB for regional lymph nodal staging in patients with melanoma.

  18. SU-E-T-119: Analysis the Efficacy of Different Radiotherapy Methods and Failure Mode in No-Metastasis Esophageal Squamous Cell Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Yankun, C; Zhihui, T; Runxiao, L; Shen, W [The Forth Hospital of Hebei Medical University, Shijiangzhuang, Hebei (China)


    Purpose: To evaluate the curative effect of radio (chemo) therapy and mode of treatment failure in no-metastasis and lesion length ≤ 5.0cm esophageal squamous cell carcinoma (ESCC). Methods: There were 158 eligible patients were retrospectively analyzed, to analysis the curative effect of radio (chemo) therapy, prognosis factors, toxicity and prognostic index model. Results: To all patients the 1, 3, 5 overall survival rate were 83.54%, 52.53%, 32.58%, the local recurrence rate were 15.08%, 33.60% and 38.14%; distant metastasis rate were 10.64%, 25.21% and 36.06%; tumor specific survival rate were 76.64%, 54.07% and 44.51%. Multivariate analysis showed that patients with ECOG grade (χ2=13.945, P=0.000), short-term effect (χ2=19.360, P=0.000) and different radiotherapy methods (χ2=9.866, P=0.002) as the independent prognostic factors. Prognostic index model showed that the survival rate was significantly higher in the lower value of PI group than in the larger value of PI group (χ2=49.19, P=0.0000). In our whole group, there were simple locoregional recurrence (LR) 40 cases (25.3%), simple Distant metastasis (DM) 31 cases (19.6%), LR and DM in 14 cases (8.9%) after treatment. The chi-square test showed that there were no significant difference in the incidence of Elective Nodal Irradiation (ENI )and Involved Field Irradiation (IFI) patients with LR and DM ( χ2=2.363, 2.950, P=0.124, 0.085). Conclusion: Radio (chemo) therapy has a good curative effect in no-metastasis and lesion length ≤ 5.0cm ESCC patients.

  19. Delineation of Internal Mammary Nodal Target Volumes in Breast Cancer Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Jethwa, Krishan R.; Kahila, Mohamed M. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Hunt, Katie N. [Department of Radiology, Mayo Clinic, Rochester, Minnesota (United States); Brown, Lindsay C.; Corbin, Kimberly S.; Park, Sean S.; Yan, Elizabeth S. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Boughey, Judy C. [Department of Surgery, Mayo Clinic, Rochester, Minnesota (United States); Mutter, Robert W., E-mail: [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States)


    Purpose: The optimal clinical target volume for internal mammary (IM) node irradiation is uncertain in an era of increasingly conformal volume-based treatment planning for breast cancer. We mapped the location of gross internal mammary lymph node (IMN) metastases to identify areas at highest risk of harboring occult disease. Methods and Materials: Patients with axial imaging of IMN disease were identified from a breast cancer registry. The IMN location was transferred onto the corresponding anatomic position on representative axial computed tomography images of a patient in the treatment position and compared with consensus group guidelines of IMN target delineation. Results: The IMN location in 67 patients with 130 IMN metastases was mapped. The location was in the first 3 intercostal spaces in 102 of 130 nodal metastases (78%), whereas 18 of 130 IMNs (14%) were located caudal to the third intercostal space and 10 of 130 IMNs (8%) were located cranial to the first intercostal space. Of the 102 nodal metastases within the first 3 intercostal spaces, 54 (53%) were located within the Radiation Therapy Oncology Group consensus volume. Relative to the IM vessels, 19 nodal metastases (19%) were located medially with a mean distance of 2.2 mm (SD, 2.9 mm) whereas 29 (28%) were located laterally with a mean distance of 3.6 mm (SD, 2.5 mm). Ninety percent of lymph nodes within the first 3 intercostal spaces would have been encompassed within a 4-mm medial and lateral expansion on the IM vessels. Conclusions: In women with indications for elective IMN irradiation, a 4-mm medial and lateral expansion on the IM vessels may be appropriate. In women with known IMN involvement, cranial extension to the confluence of the IM vein with the brachiocephalic vein with or without caudal extension to the fourth or fifth interspace may be considered provided that normal tissue constraints are met.

  20. Molecular Staging of Sentinel Lymph Nodes Identifies Melanoma Patients at Increased Risk of Nodal Recurrence. (United States)

    Kimbrough, Charles W; Egger, Michael E; McMasters, Kelly M; Stromberg, Arnold J; Martin, Robert C G; Philips, Prejesh; Scoggins, Charles R


    Molecular staging of sentinel lymph nodes (SLNs) may identify patients who are node-negative by standard microscopic staging but are at increased risk for regional nodal recurrence; such patients may benefit from completion lymph node dissection (CLND). In a multicenter, randomized clinical trial, patients with tumor-negative SLNs by standard pathology (hematoxylin and eosin [H and E] serial sections and immunohistochemistry [IHC]) underwent reverse transcriptase polymerase chain reaction (PCR) analysis of SLNs for melanoma-specific mRNA. Microscopically negative/PCR+ patients were randomized to observation, CLND, or CLND with high-dose interferon (HDI). For this post-hoc analysis, clinicopathologic features and survival outcomes, including overall survival (OS) and disease-free survival (DFS), were compared between PCR+ patients who underwent CLND vs observation. Microscopic and molecular node-negative (PCR-) patients were included for comparison. A total of 556 patients were PCR+: 180 underwent observation, and 376 underwent CLND. An additional 908 PCR- patients were observed. Median follow-up was 72 months. Disease-free survival (DFS) was significantly better for PCR+ patients who underwent CLND compared with observation (p = 0.0218). No statistically significant differences in OS or distant disease-free survival (DDFS) were seen. Regional lymph node recurrence-free survival (LNRFS) was improved in PCR+ patients with CLND compared to observation (p = 0.0065). The PCR+ patients in the observation group had the worst DFS; those with CLND had similar DFS to that in the PCR- group (p = 0.9044). Patients with microscopically negative/PCR+ SLN have an increased risk of nodal recurrence that was mitigated by CLND. Although CLND did not affect OS, these data suggest that molecular detection of melanoma-specific mRNA in the SLN predicts a greater risk of nodal recurrence and deserves further study. Copyright © 2016 American College of Surgeons. Published by Elsevier

  1. Online single-factor measured active nodal load forecasting in an electric power system (United States)

    Chernenko, Pavlo O.; Shevchenko, Sviatoslav Yu.; Smolarz, Andrzej; Karnakova, Gaini; Kozhambardiyeva, Miergul; Iskakova, Aigul


    Two techniques for online nodal load (NL) forecasting using preliminary classification of training set data are proposed. In the first one, a pattern recognition method, the rate evaluation algorithm (REM), is applied to measured load values of the previous day to classify load diagram that is being forecasted. Diagrams from resulting class are used to calculate load predictions. In the second technique, measured load values of a diagram from training set, which is the closest to the one being predicted, are used as estimates of predicted load values. Online NL forecasting using the mentioned above methods has been conducted. The corresponding mean square errors are given.

  2. A Posteriori Error Estimation for a Nodal Method in Neutron Transport Calculations

    Energy Technology Data Exchange (ETDEWEB)

    Azmy, Y.Y.; Buscaglia, G.C.; Zamonsky, O.M.


    An a posteriori error analysis of the spatial approximation is developed for the one-dimensional Arbitrarily High Order Transport-Nodal method. The error estimator preserves the order of convergence of the method when the mesh size tends to zero with respect to the L{sup 2} norm. It is based on the difference between two discrete solutions that are available from the analysis. The proposed estimator is decomposed into error indicators to allow the quantification of local errors. Some test problems with isotropic scattering are solved to compare the behavior of the true error to that of the estimated error.

  3. Direct Load Control (DLC) Considering Nodal Interrupted Energy Assessment Rate (NIEAR) in Restructured Power Systems

    DEFF Research Database (Denmark)

    Wu, Qiuwei; Wang, Peng; Goel, Lalit


    is used as the bids from the ACL customers, is utilized to determine the direct monetary compensation to the ACL customers. The proposed scheme was investigated for the PoolCo electricity market. The optimal DLC scheme is determined based on the minimum system operating cost which is comprised......A direct load control (DLC) scheme of air conditioning loads (ACL) considering direct monetary compensation to ACL customers for the service interruption caused by the DLC program is proposed in this paper for restructured power systems. The nodal interrupted energy assessment rate (NIEAR), which...

  4. Nodal DG-FEM solution of high-order Boussinesq-type equations

    DEFF Research Database (Denmark)

    Engsig-Karup, Allan Peter; Hesthaven, Jan S.; Bingham, Harry B.


    We present a discontinuous Galerkin finite element method (DG-FEM) solution to a set of high-order Boussinesq-type equations for modelling highly nonlinear and dispersive water waves in one and two horizontal dimensions. The continuous equations are discretized using nodal polynomial basis...... and convergence of the model with both h (grid size) and p (order) refinement are verified for the linearized equations, and calculations are provided for two nonlinear test cases in one horizontal dimension: harmonic generation over a submerged bar; and reflection of a steep solitary wave from a vertical wall...

  5. The top-level global research system, 1997-99: Centres, networks and nodality

    DEFF Research Database (Denmark)

    Matthiessen, C. W.; Schwarz, Annette Winkel; Find, Søren


    of the global research centres. The data are records in the Science Catation Index 1997-99 of papers produced by authors from the 40 largest `greater' urban regions of the world as measured by research output. The network of research co-operation depends on nationality, distance and other factors. The top......The importance of the knowledge-base in regional and urban competition is generally recognised, although causal relations between urban and regional economic growth and knowledge level are far from clear. This paper presents the first analysis of the strength, interrelations and nodality...

  6. Nodal quasi-particles of the high-Tc superconductors as carriers of heat

    Directory of Open Access Journals (Sweden)

    K. Behnia


    Full Text Available   In the quest for understanding correlated electrons, high-temperature superconductivity remains a formidable challenge and a source of insight. This paper briefly recalls the central achievement by the study of heat transport at low temperatures. At very low temperatures, nodal quasi-particles of the d-wave superconducting gap become the main carriers of heat. Their thermal conductivity is unaffected by disorder and reflects the fine structure of the superconducting gap. This finding had led to new openings in the exploration of other unconventional superconductors

  7. Spectral Method with the Tensor-Product Nodal Basis for the Steklov Eigenvalue Problem

    Directory of Open Access Journals (Sweden)

    Xuqing Zhang


    Full Text Available This paper discusses spectral method with the tensor-product nodal basis at the Legendre-Gauss-Lobatto points for solving the Steklov eigenvalue problem. A priori error estimates of spectral method are discussed, and based on the work of Melenk and Wohlmuth (2001, a posterior error estimator of the residual type is given and analyzed. In addition, this paper combines the shifted-inverse iterative method and spectral method to establish an efficient scheme. Finally, numerical experiments with MATLAB program are reported.

  8. Micropropagation of Phytolacca dodecandra through shoot-tip and nodal cultures. (United States)

    Demeke, T; Hughes, H G


    A procedure for micropropagation of endod (Phytolacca dodecandra) is described. BA at 0.44 μM produced 3.1 new shoots per expiant in six weeks using shoot tips. Nodal expiants, however, produced up to 4.7 shoots per explant on medium with 0.44 μM BA and 0.27 μM GA,. IBA at 0.49 μM induced 90% rooting with minimal callus. Plantlets were successfully transferred to the greenhouse and some staminate clones produced flowers after six months.

  9. Pig Epiblast Stem Cells Depend on Activin/Nodal Signaling for Pluripotency and Self-Renewal


    Alberio, Ramiro; Croxall, Nicola; Allegrucci, Cinzia


    Activin/Nodal signaling is required for maintaining pluripotency and self-renewal of mouse epiblast stem cells and human embryonic stem cells (hESC). In this study, we investigated whether this signaling mechanism is also operative in cultured epiblasts derived from Days 10.5–12 pig embryos. Pig epiblast stem cell lines (pEpiSC) were established on mouse feeder layers and medium supplemented with basic fibroblast growth factor (bFGF). pEpiSC express the core pluripotency factors OCT4 (or POU5...

  10. Clinical implementation of coverage probability planning for nodal boosting in locally advanced cervical cancer

    DEFF Research Database (Denmark)

    Ramlov, Anne; Assenholt, Marianne S; Jensen, Maria F


    PURPOSE: To implement coverage probability (CovP) for dose planning of simultaneous integrated boost (SIB) of pathologic lymph nodes in locally advanced cervical cancer (LACC). MATERIAL AND METHODS: CovP constraints for SIB of the pathological nodal target (PTV-N) with a central dose peak...... regression during EBRT. Total EBRT and BT D98 was >57 GyEQD2 in 98% of the visible nodes. Compared to treatment plans aiming for full PTV-N coverage, CovP significantly reduced V50 of body, bones and bowel (pclinically feasible for SIB of pathological nodes and significantly...

  11. Fluorodeoxyglucose-positron emission tomography/computed tomography performs better than contrast-enhanced computed tomography for metastasis evaluation in the initial staging of pancreatic adenocarcinoma. (United States)

    Santhosh, Sampath; Mittal, Bhagwant Rai; Bhasin, Deepak Kumar; Rana, Surinder Singh; Gupta, Rajesh; Das, Ashim; Nada, Ritambhra


    To evaluate the additional role of FDG-PET/CT to the conventional multiphasic CECT in the initial staging of pancreatic adenocarcinoma. 54 patients diagnosed with pathologically proven pancreatic malignancy underwent FDG-PET/CECT. The sensitivity, specificity, PPV, NPV, and accuracy of PET/CT and CECT for nodal and metastatic staging were calculated. The statistical difference was calculated by McNemar's test. Of 54 patients, 15 had distal metastasis. The sensitivity, specificity, PPV, NPV, and accuracy of PET/CT and CECT for nodal staging were 33 vs 89%, 84 vs 100%, 67 vs 100%, 60 vs 90%, and 59 vs 95%, respectively, p < 0.001. The sensitivity, specificity, PPV, NPV, and accuracy of CECT for metastatic staging were 73, 87, 69, 89, and 83%, whereas the accuracy of PET/CT was 100%, p = 0.01. By correctly characterizing unsuspected distant lesions, PET/CT could change management in 19% of patients. FDG-PET/CT can contribute to change in the management in almost one of every five patients of PA evaluated with the standard investigations during the initial staging.

  12. The Verification of Coupled Neutronics Thermal-Hydraulics Code NODAL3 in the PWR Rod Ejection Benchmark

    Directory of Open Access Journals (Sweden)

    Surian Pinem


    Full Text Available A coupled neutronics thermal-hydraulics code NODAL3 has been developed based on the few-group neutron diffusion equation in 3-dimensional geometry for typical PWR static and transient analyses. The spatial variables are treated by using a polynomial nodal method while for the neutron dynamic solver the adiabatic and improved quasistatic methods are adopted. In this paper we report the benchmark calculation results of the code against the OECD/NEA CRP PWR rod ejection cases. The objective of this work is to determine the accuracy of NODAL3 code in analysing the reactivity initiated accident due to the control rod ejection. The NEACRP PWR rod ejection cases are chosen since many organizations participated in the NEA project using various methods as well as approximations, so that, in addition to the reference solutions, the calculation results of NODAL3 code can also be compared to other codes’ results. The transient parameters to be verified are time of power peak, power peak, final power, final average Doppler temperature, maximum fuel temperature, and final coolant temperature. The results of NODAL3 code agree well with the PHANTHER reference solutions in 1993 and 1997 (revised. Comparison with other validated codes, DYN3D/R and ANCK, shows also a satisfactory agreement.

  13. Fully Regressive Melanoma: A Case Without Metastasis. (United States)

    Ehrsam, Eric; Kallini, Joseph R; Lebas, Damien; Khachemoune, Amor; Modiano, Philippe; Cotten, Hervé


    Fully regressive melanoma is a phenomenon in which the primary cutaneous melanoma becomes completely replaced by fibrotic components as a result of host immune response. Although 10 to 35 percent of cases of cutaneous melanomas may partially regress, fully regressive melanoma is very rare; only 47 cases have been reported in the literature to date. AH of the cases of fully regressive melanoma reported in the literature were diagnosed in conjunction with metastasis on a patient. The authors describe a case of fully regressive melanoma without any metastases at the time of its diagnosis. Characteristic findings on dermoscopy, as well as the absence of melanoma on final biopsy, confirmed the diagnosis.

  14. Isolated Abdominal Wall Metastasis of Endometrial Carcinoma

    Directory of Open Access Journals (Sweden)

    Rita Luz


    Full Text Available A woman in her mid-60s presented with a bulky mass on the anterior abdominal wall. She had a previous incidental diagnosis of endometrial adenocarcinoma FIGO stage IB following a vaginal hysterectomy. Physical exam and imaging revealed a well circumscribed bulging tumour at the umbilical region, measuring 10 × 9 × 9 cm, with overlying intact skin and subcutaneous tissue. Surgical resection was undertaken, and histological examination showed features of endometrial carcinoma. She began chemotherapy and is alive with no signs of recurrent disease one year after surgery. This case brings up to light an atypical location of a solitary metastasis of endometrial carcinoma.

  15. Panax notoginseng saponins (PNS) inhibits breast cancer metastasis. (United States)

    Wang, Peiwei; Cui, Jingang; Du, Xiaoye; Yang, Qinbo; Jia, Chenglin; Xiong, Minqi; Yu, Xintong; Li, Li; Wang, Wenjian; Chen, Yu; Zhang, Teng


    Panax notoginseng (Burkill) F.H. Chen (Araliaceae) has been extensively used as a therapeutic agent to treat a variety of diseases. Panax notoginseng saponins (PNS) consist of major therapeutically active components of Panax notoginseng. PNS inhibit the growth of a variety of tumor cells in vitro and in vivo. The aim of the study is to investigate the effects and underlying mechanisms of PNS on breast cancer metastasis. 4T1 cell, a highly metastatic mouse breast carcinoma cell line, was utilized for in vitro and in vivo assays. In vitro assays were first performed to examine the effects of PNS on 4T1 cell viability, migration and invasion, respectively. Real-time PCR analyses were also performed to examine the effects of PNS on the expression of genes associated with tumor metastasis. The effect of PNS on 4T1 tumor cell metastasis was further assessed in spontaneous and experimental metastasis models in vivo. PNS treatment exhibited a dose-dependent effect on impairing 4T1 cell viability in vitro. However, when examined at a lower dose that did not affect cell viability, the migration and invasion of 4T1 cell was remarkably inhibited in vitro. Meanwhile, PNS treatment led to upregulated expression of genes known to inhibit metastasis and downregulated expression of genes promoting metastasis in cultured 4T1 cells. These results suggested a selective effect of PNS on 4T1 migration and invasion. This hypothesis was further addressed in 4T1 metastasis models in vivo. The results showed that the lung metastasis was significantly inhibited by PNS treatment in both spontaneous and experimental metastasis models. Taken together, our results demonstrated an inhibitory effect of PNS on 4T1 tumor metastasis, warranting further evaluation of PNS as a therapeutic agent for treating breast cancer metastasis. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Diagnostic value of lymph node metastasis by diffusion-weighted magnetic resonance imaging in cervical cancer

    Directory of Open Access Journals (Sweden)

    Xiang-Qin He


    Conclusion: The ADC values in CC tissues with LN metastasis were significantly lower than those without LN metastasis, suggesting that DWI appears to improve diagnostic performance and can be a useful adjunct imaging for identifying LN metastasis in CC patients.

  17. Solitary Spinal Epidural Metastasis from Gastric Cancer

    Directory of Open Access Journals (Sweden)

    Taisei Sako


    Full Text Available Solitary epidural space metastasis of a malignant tumor is rare. We encountered a 79-year-old male patient with solitary metastatic epidural tumor who developed paraplegia and dysuria. The patient had undergone total gastrectomy for gastric cancer followed by chemotherapy 8 months priorly. The whole body was examined for suspected metastatic spinal tumor, but no metastases of the spine or important organs were observed, and a solitary mass was present in the thoracic spinal epidural space. The mass was excised for diagnosis and treatment and was histopathologically diagnosed as metastasis from gastric cancer. No solitary metastatic epidural tumor from gastric cancer has been reported in English. Among the Japanese, 3 cases have been reported, in which the outcome was poor in all cases and no definite diagnosis could be made before surgery in any case. Our patient developed concomitant pneumonia after surgery and died shortly after the surgery. When a patient has a past medical history of malignant tumor, the possibility of a solitary metastatic tumor in the epidural space should be considered.

  18. Regulation of salt marsh mosquito populations by the 18.6-yr lunar-nodal cycle. (United States)

    Rochlin, Ilia; Morris, James T


    The 18.6-yr lunar-nodal cycle drives changes in tidal amplitude globally, affecting coastal habitat formation, species and communities inhabiting rocky shores, and salt marsh vegetation. However, the cycle's influence on salt marsh fauna lacked sufficient long-term data for testing its effect. We circumvented this problem by using salt marsh mosquito records obtained over a period of over four decades in two estuaries in the northeastern USA. Salt marsh mosquito habitat is near the highest tide level where the impact of the nodal cycle on flood frequency is greatest. Wavelet spectral and cross-correlation analyses revealed periodicity in salt marsh mosquito abundance that was negatively correlated with tidal amplitude. Tidal amplitude was a significant predictor of salt marsh mosquito abundance with the cycle maxima coinciding with lower mosquito populations, possibly due to access by predatory fish. However, these effects were detected only at the location with extensive salt marsh habitat and astronomical tides and were weakened or lacked significance at the location with small microtidal salt marshes and wind-driven tides. Mosquitoes can serve as proxy indicators for numerous invertebrate species on the salt marsh. These predictable cycles and their effects need to be taken into consideration when investigating, restoring, or managing intertidal communities that are also facing sea-level rise. © 2017 by the Ecological Society of America.

  19. Robotic infrarenal paraaortic and pelvic nodal staging for endometrial cancer: feasibility and lymphatic complications. (United States)

    Geppert, Barbara; Persson, Jan


    This study was designed to evaluate the feasibility and lymphatic complications of robotic pelvic and infrarenal paraaortic lymphadenectomy in endometrial cancer patients. All patients diagnosed with high risk endometrial cancer during the study period were identified (n = 212). Clinical prospective data, with reassessment of lymphatic complications, was analysed for all cases (n = 140) planned for a complete robotic nodal staging. The outcome measures were: success rate of infrarenal paraaortic lymphadenectomy, the rate of lymphatic complications and factors associated with nodal yield. Of the 212 women, an open or restricted robotic procedure was performed in 57 women (27%) and no operation in 15 (7%), the latter due to disseminated disease or comorbidity. In 140 women (66%) in whom staging was intended, the lymphadenectomy included the infrarenal area in 70%, was restricted to the inframesenteric area in 21% and aborted or incomplete in 9%. The median number of paraaortic nodes was 10 (range 2-39). An unsuccessful staging was associated with high BMI and the surgeon's inexperience. At 1 year, three patients (2%) had developed a grade two lower limb lymphedema. Eleven women (8%) demonstrated pelvic lymphocysts; seven (64%) resolved spontaneously. Only one paraaortic lymphocyst was found; this required drainage. No cases of chylous ascites occurred. An infrarenal robotic paraaortic lymphadenectomy is feasible in 70% of high risk endometrial cancer cases when intended (88% in non-obese patients operated by experienced surgeons), but is restricted in obese patients and by surgeon's inexperience. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  20. In Vitro Regeneration of Shoots From Nodal Explants of Dendrobium Chrysotoxum Lindl

    Directory of Open Access Journals (Sweden)

    Kaur Saranjeet


    Full Text Available Transverse sections (2 mm thickness of stem-nodes from in vitro raised seedlings had morphogenic potential on semisolid and liquid Murashige and Skoog medium supplemented with cytokinins N6-benzyladenine (BA 4.44 μM, furfurylaminopurine (KIN 4.65 μM and auxin α-naphthalene acetic acid (NAA 5.37 μM individually and in combinations. The regeneration response was influenced by both the type of growth regulator and physical state of the medium. The explants produced either shoot buds on cytokinincontaining media or protocorm-like bodies (PLBs on NAA containing media both solid and liquid. More neo-formations were produced on liquid media, especially those containing only NAA. They were formed at nodal and inter-nodal regions. The secondary buds were produced on the surface of primary PLBs. The plantlets were developed on MS medium containing banana homogenate 50 g·dm-3. The current study is the first ever report on successful regeneration of Dendrobium chrysotoxum from stem-node segments.

  1. Time-dependent boundary source term for advanced nodal diffusion theory

    Energy Technology Data Exchange (ETDEWEB)

    Jatuff, F.E.; Gho, C.J


    An extension to nodal diffusion theory was developed to deal with time-dependent boundary source terms. It is shown that this extension is easily introduced in advanced, full-functional diffusion theory by means of Dirac's delta spatially-dependent functions at the nodal boundaries, and allows the evaluation of reactor transients showing the propagation of neutron waves or the effects of pulsed neutron sources. A model problem with exact solutions for both the diffusion and the P{sub 1} (telegrapher's) equations was developed to test the capabilities of the theoretical extension. The larger discrepancies occur at the earliest times computed showing, at t=50 {mu}s, mean-square deviations between the exact diffusion solution and the numerical approximations of 2.95, 1.72, 0.32, and 0.16% for the fourth, sixth, eighth, and tenth polynomial expansion order, respectively. The availability of the exact telegrapher's solution, however, demonstrates that improved accuracy is meaningless since the mean-square deviation between the exact diffusion and exact telegrapher's solution is very similar to the mean-square deviation between the exact diffusion and the poorer (fourth-order) diffusion approximation.

  2. Topological nodal points in two coupled Su-Schrieffer-Heeger chains (United States)

    Li, C.; Lin, S.; Zhang, G.; Song, Z.


    We study a two coupled Su-Schrieffer-Heeger (SSH) chains system, which is shown to contain rich quantum phases associated with topological invariants protected by symmetries. In the weak coupling region, the system supports two nontrivial topological insulating phases, characterized by winding number N =±1 , and two types of edge states. The boundary between the two topological phases arises from two band closing points, which exhibit topological characteristics in one-dimensional k space. By mapping Bloch states on a vector field in k space, the band degenerate points correspond to a pair of kinks of the field, with opposite topological charges. Two topological nodal points move and merge as the interchain coupling strength varies. This topological invariant is protected by the translational and inversion symmetries, rather than the antiunitary operation. Furthermore, we find that when a pair of nodal points is created, a second order quantum phase transition (QPT) occurs, associating with a gap closing and spontaneously symmetry breaking. This simple model demonstrates several central concepts in the field of quantum materials and provides a theoretical connection between them.

  3. Obtention of Moringa oleifera Lam. cv. `PKM criolla' in vitro plants from nodal segments

    Directory of Open Access Journals (Sweden)

    Daniel Agramonte


    Full Text Available Moringa oleifera L. is considered a perennial plant that has exceptional nutritional qualities. This species is very rich in protein, vitamins and minerals; that is why it is an important complement to the food and feed. Among the strategic goals of Cuba is its introduction on a commercial scale, but there is insufficient availability of plants for planting in the field. The in vitro propagation could help to solve the growing demand for planting material. The objective of this work was to obtain in vitro plants of Moringa oleifera L. var. `PKM criolla' from nodal segments. In the establishment phase with 1.5% sodium hypochlorite the highest values of number of sprouted buds with low microbial contamination and necrosis of the explants were obtained. In the multiplication stage the largest multiplication coefficient was achieved when at the culture medium was added 2.22 µM 6-benzylaminopurine. Growing conditions were defined to establish and in vitro multiplication of Moringa oleifera L. nodal segments as a useful tool for future in vitro propagation of this specie. Key words: establishment, 6-benzylaminopurine (BA, multiplication

  4. Nodal/Cripto signaling in fetal male germ cell development: implications for testicular germ cell tumors. (United States)

    Spiller, Cassy M; Bowles, Josephine; Koopman, Peter


    Testicular cancer is the most frequent cancer in young men aged 15-40 years and accounts for 1% of all cancer diagnosed in males. Testicular germ cell tumors (TGCT) encompass a broad group of cancers, each displaying different levels of pluripotency and differentiation as well as malignancy potential. The TGCT cell of origin is thought to be a fetal germ cell that failed to correctly differentiate during development: this is known as the ‘fetal origins hypothesis’. This theory predicts that developmental pathways that control germ cell pluripotency or differentiation may be involved in the malignant transformation of these cells. Recently the Nodal/Cripto signaling pathway, known to control pluripotency and differentiation in embryonic stem (ES) cells, was implicated in regulating normal male fetal germ cell pluripotency. Although genes of this pathway are not normally expressed in germ cells during adult life, ectopic expression of this pathway was detected in several sub-groups of TGCTs. In this review, we consider the evidence for the fetal origins of TGCT and discuss the implications of Nodal/Cripto signaling in various aspects of germ cell development and cancer progression.

  5. Nuclear movement regulated by non-Smad Nodal signaling via JNK is associated with Smad signaling during zebrafish endoderm specification. (United States)

    Hozumi, Shunya; Aoki, Shun; Kikuchi, Yutaka


    Asymmetric nuclear positioning is observed during animal development, but its regulation and significance in cell differentiation remain poorly understood. Using zebrafish blastulae, we provide evidence that nuclear movement towards the yolk syncytial layer, which comprises extraembryonic tissue, occurs in the first cells fated to differentiate into the endoderm. Nodal signaling is essential for nuclear movement, whereas nuclear envelope proteins are involved in movement through microtubule formation. Positioning of the microtubule-organizing center, which is proposed to be crucial for nuclear movement, is regulated by Nodal signaling and nuclear envelope proteins. The non-Smad JNK signaling pathway, which is downstream of Nodal signaling, regulates nuclear movement independently of the Smad pathway, and this nuclear movement is associated with Smad signal transduction toward the nucleus. Our study provides insight into the function of nuclear movement in Smad signaling toward the nucleus, and could be applied to the control of TGFβ signaling. © 2017. Published by The Company of Biologists Ltd.

  6. Ex vivo Live Imaging of Lung Metastasis and Their Microenvironment

    NARCIS (Netherlands)

    Bijgaart, R.J.E. van den; Kong, N.; Maynard, C.; Plaks, V.


    Metastasis is a major cause for cancer-related morbidity and mortality. Metastasis is a multistep process and due to its complexity, the exact cellular and molecular processes that govern metastatic dissemination and growth are still elusive. Live imaging allows visualization of the dynamic and

  7. Oral melanoma with pulmonary metastasis in a Nigerian local dog ...

    African Journals Online (AJOL)

    Melanomas are the most commonly diagnosed neoplasm of the canine oral cavity accounting for about 7% of all malignant tumours in the dog. Less frequently, metastasis via regional lymph nodes and to the lungs and other organs may occur. A case report of oral melanoma with pulmonary metastasis in a Nigerian local ...

  8. Orbital Metastasis of Hepatocellular Carcinoma: A Case Report ...

    African Journals Online (AJOL)

    Background: Hepatocellular carcinoma is one of the commonest malignancies in Nigeria, however metastasis to the orbit is a rare presentation. Objective: To present a rare case of orbital metastasis of hepatocellular carcinoma. Case Report: A 25-year-old man presented with a 3-month history of pain, progressive swelling ...

  9. Curcumin inhibits invasion and metastasis in the human ovarian ...

    African Journals Online (AJOL)

    Curcumin inhibits invasion and metastasis in the human ovarian cancer cells SKOV3 by CXCL12–CXCR4 axis. ... African Journal of Biotechnology ... on invasion and metastasis in the human ovarian cancer cells SKOV3 and approach if this inhibitory effects are related with CXCL12–CXCR4 axis were carefully studied.

  10. Metastasis: objections to the same-gene model

    NARCIS (Netherlands)

    Bernards, R.A.; Weinberg, R.A.


    Sir— The model of cancer metastasis suggested by René Bernards and Robert A. Weinberg in their Concepts essay (Nature 418, 823; 2002) is, in my view, a tautology. The suggestion that the same genes are exclusively responsible both for cancer-cell metastasis and for the emergence

  11. Vaginal metastasis of pancreatic cancer | Benhayoune | Pan African ...

    African Journals Online (AJOL)

    Vaginal metastasis from pancreatic cancer is an extreme case and often indicates a poor prognosis. We present a case of pancreatic carcinoma with metastasis to the vagina that was discovered by vaginal bleeding. To our knowledge, this is the third case in the world of a primary pancreatic adenocarcinoma discovered of ...

  12. Post site metastasis of breast cancer after video-assisted thoracic surgery for pulmonary metastasis of breast cancer: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Mee Hyun; Hwang, Ji Young; Hyun, Su Jeong; Lee, Yul; Woo, Ji Young; Yang, Ik; Hong, Hye Sook; Kim, Han Myun [Dept. of Radiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul (Korea, Republic of)


    We reported a case of port site metastasis in a 57-year-old patient who underwent video-assisted thoracic surgery (VATS) resection of pulmonary metastasis from breast cancer. Port site metastasis after VATS is very rare in patients with breast cancer. However, when suspicious lesions are detected near the port site in patients who have undergone VATS for pulmonary metastasis, port site metastasis should be considered in the differential diagnosis.

  13. Nodal Solutions of the SP{sub N} Transport Equation for the DeCART Code

    Energy Technology Data Exchange (ETDEWEB)

    Cho, J. Y.; Kim, K. S.; Joo, H. G


    This report discusses how to improve the axial solution of the DeCART code and how to introduce the transport solution effectively. This report includes: (1) The conventional solution using radial CMFD and axial NEM kernel for the diffusion approximation and its extension to the SPN transport equation. (2) The axial SANM kernel for the diffusion approximation within the conventional CMFD framework. This work is performed for the future application of the SANM solution to the SPN approximation (3) The axial lower order polynomial expansion nodal (LPEN) kernel for the diffusion and the SP3 transport equations. This work is performed to reduce the memory requirement and to remove the transverse leakage effect. (4) A new transverse leakage approximation using intra-nodal flux distribution to improve NEM and SANM solution accuracy. (5) Sub-plane scheme to obtain the DeCART solutions efficiently. (6) Radial MOC solution without the transverse leakage and its application to obtain the equivalent parameters. This work is performed to eliminate the negative scalar flux and finally to remove convergence problem of the DeCART code. (7) Examination of the DeCART solution for a demonstrative problem and the C5G7MOX 3-D Extension problems. The results of the examination can be summarized as: (1) The SANM solution with a new transverse leakage approximation shows a very good accuracy when comparing with the NEM solution. (2) Introduction of the sub-plane scheme eliminates most of the nodal error with a little bit increased computational burden. (3) Introduction of the NEM solution for the SP3 transport equation eliminate most of the diffusion effect. (4) NEM solution for the SP3 transport equation by using a few sub-planes and a new transverse leakage approximation produces a compatible solution with the MCNP code. (5) LPEN kernel requires about 3 times more sub-planes than the NEM or SANM kernels to remove the nodal errors. However, this method requires less computational memory

  14. The Lunar Nodal Cycle and the Bidecadal Climate Variability in Precipitation and Tropospheric Circulation Over Southern South America (United States)

    Agosta, E.


    The present work will show for first time some statistical evidences that the lunar nodal cycle can influence the low-frequency variability of summer rainfalls in the plains to the east of subtropical Andes, a region known as 'Nuevo Cuyo' (NC) in South America. The link can be established through the sea surface temperature (SST) modulation that is induced by the nodal amplitudes of diurnal tides over the southwestern South Atlatnci (SWSA) region. In years of strong (weak) diurnal tides, nodal tide-induced diapycnical mixing makes SST cooler (warmer) that are accompanied by negative (positive) sea level pressure (SLP) anomalies affecting the mid-latitudes low-level tropospheric circulation. The SST variations would presumably affect the lower tropospheric baroclinicity in the surroundings of the Malvinas/Falklands Islands in the SWSA, which in turn would induce shifts of mid-latitude stormtracks. Tropospheric circulation anomalies being located over the SWSA directly affect the interannual variability of summer rainfalls in NC. It is further shown that such an influence can be extended to the bidecadal variability observed in the summer rainfalls owing to the nodal modulation effect. The identification of the nodal periodicity in the NC summer rainfall variability is statistically robust. Although the 1976/77 climate shift has mitigated the bidecadal component of the summer rainfalls until the early 2000s, the nodal cycle has always been present. Hence it could improve the interdecadal predictability of the mean conditions of summer rainfalls and of those socio-economic variables being sensitive to precipitation such as grape yield in the Mendoza Province.

  15. An unusual metastasis of lung adenocarcinoma: Biceps brachii muscle

    Directory of Open Access Journals (Sweden)

    Muzaffer Sariaydin


    Full Text Available Skeletal muscle metastasis of nonsmall cell lung carcinoma (NSCLC is a rare occurrence, and the most effective treatment modality is currently unknown. In this case presentation, we report a patient with NSCLC who underwent palliative radiotherapy for biceps muscle metastasis of NSLCS. Our case was a 49-year-old woman who had lung adenocarcinoma with biceps muscle metastasis. She had been followed up for 2 years due to Stage IV lung adenocarcinoma from whom a biopsy was taken from a painful mass in right arm that was found to be compatible with metastasis of lung adenocarcinoma. She had palliative radiotherapy for her painful mass and systemic chemotherapy was planned. After palliative radiotherapy, the pain originating from the metastatic mass in right biceps muscle alleviated. Palliative radiotherapy can be a valuable treatment option for cases with skeletal muscle metastasis.

  16. Potential Anti-metastasis Natural Compounds for Lung Cancer. (United States)

    Chanvorachote, Pithi; Chamni, Supakarn; Ninsontia, Chuanpit; Phiboonchaiyanan, Preeyaporn Plaimee


    As lung cancer is the most common malignancy worldwide and high mortalities are the result of metastasis, novel information surpassing the treatment strategies and therapeutic agents focusing on cancer dissemination are of interest. Lung cancer metastasis involves increased motility, survival in circulation and ability to form new tumors. Metastatic cells increase their aggressive features by utilizing several mechanisms to overcome hindrances of metastasis, including epithelial to mesenchymal transition (EMT), increased in cellular survival and migratory signals. Sufficient amounts of natural product-derived compounds have been shown to have promising anti-metastasis activities by suppressing key molecular features upholding such cell aggressiveness. The knowledge regarding molecular mechanisms rendering cell dissemination together with the anti-metastasis information of natural product-derived compounds may lead to development of novel therapeutic strategies. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  17. Bone marrow metastasis presenting as bicytopenia originating from hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Young Mi Hong


    Full Text Available The bone is a common site for metastasis in hepatocellular carcinoma (HCC. However, bone marrow metastasis from HCC is rarely reported, and its frequency is unclear. Here we report a rare case of bone marrow metastasis that presented as bicytopenia originating from HCC without bone metastasis. A 58-year-old man was admitted for investigation of a liver mass with extensive lymph node enlargement that was detected when examining his general weakness and weight loss. Laboratory findings revealed anemia, thrombocytopenia, mild elevated liver enzymes, normal prothrombin time percentage and high levels of tumor markers (α-fetoprotein and des-γ-carboxyprothrombin. Abdominal computed tomography showed multiple enhanced masses in the liver and multiple enlarged lymph nodes in the abdomen. A bone marrow biopsy revealed only a few normal hematopoietic cells and abundant tumor cells. Despite its rarity, bone marrow metastasis should always be suspected in HCC patients even if accompanied by cirrhosis.

  18. Cell lineage determinants as regulators of breast cancer metastasis. (United States)

    Lu, Wei; Kang, Yibin


    The mammary epithelium is organized in a hierarchy of mammary stem cells (MaSCs), progenitors, and differentiated cells. The development and homeostasis of mammary gland are tightly controlled by a complex network of cell lineage regulators. These determinants of cellular hierarchy are frequently deregulated in breast tumor cells and closely associated with cancer progression and metastasis. They also contribute to the diversity of breast cancer subtypes and their distinct metastatic patterns. Cell fate regulators that normally promote stem/progenitor activities can serve as drivers for epithelial-mesenchymal transition and metastasis whereas regulators that promote terminal differentiation generally suppress metastasis. In this review, we discuss how some of the key factors function in normal mammary lineage determination and how these processes are hijacked by tumor cells to enhance metastasis. Understanding the molecular connections between normal development and cancer metastasis will enable the development of more specific and effective therapeutic approaches targeting metastatic tumor cells.

  19. Cervical carcinoma with skin metastasis – case report

    Directory of Open Access Journals (Sweden)



    Full Text Available Although cervical carcinoma is common, cutaneous metastasis is rare. In advanced disease, metastases may be present in the adnexa, abdomen, lungs, bone, liver and lymph nodes or. elsewhere. Cutaneous metastasis is uncommon. Unusual sites of metastasies seems to be skin, brain, heart and spleen. In this case, a 45 years old female was diagnosed to have squamous cell carcinoma of cervix on february 2013, who took radiotherapy treatment presented with cutaneous metastasis after a year. She received 4400 cGy/22 fractions of Extended Beam radiotherapy, followed by 4 doses of 700 cGy Cavity Radiotherapy (Brachytherapy. She completed her treatment on march, 6, 2013 with complete remission, without any complication. She was considered cured by the oncologists until after a year when she presented with cutaneous metastasis, which was proven with skin biopsy. The case is reported as this kind of case seems to be rare as far as our knowledge is concerned.

  20. Choroid Melanoma Metastasis to Spine: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Hiren Mandaliya


    Full Text Available Metastatic choroid melanoma is a highly malignant disease with a limited life expectancy. The liver is the most common site for metastasis of uveal melanoma followed by lung, bone, skin, and subcutaneous tissue. Metastasis from choroidal melanoma usually occurs within the first five years of treatment for primary tumours. Metastatic choroid melanoma to the spine/vertebrae is extremely rare. We report the first case of spinal metastasis from choroid melanoma in a 61-year-old man who had been treated for primary ocular melanoma three years earlier with radioactive plaque brachytherapy. Synchronously, at the time of metastasis, he was also diagnosed as having a new primary lung adenocarcinoma as well. The only other case reported on vertebral metastasis from malignant melanoma of choroid in literature in which primary choroid melanoma was enucleated.

  1. Gastric Metastasis of Triple Negative Invasive Lobular Carcinoma. (United States)

    Geredeli, Caglayan; Dogru, Osman; Omeroglu, Ethem; Yilmaz, Farise; Cicekci, Faruk


    Invasive lobular carcinomas are the second most common type (5% to 15%) of invasive breast carcinomas. The most frequent sites of breast cancer metastasis are the local and distant lymph nodes, brain, lung, liver, and bones; metastasis to the gastrointestinal system, especially to the stomach, is rare. When a mass is detected in an unusual place in a patient with invasive lobular carcinoma, it should be kept in mind that such a mass may be either a second primary carcinoma or the metastasis of an invasive lobular carcinoma. In this report, we present a case of gastric metastasis from triple-negative invasive lobular breast cancer. It is important to make an accurate diagnosis by distinguishing gastric metastasis from breast cancer in order to select the best initial treatment for systemic diseases of breast cancer. Considering our case, healthcare professionals should take into account that cases with invasive lobular breast cancer may experience unusual metastases.

  2. Survival after bone metastasis by primary cancer type

    DEFF Research Database (Denmark)

    Svensson, Elisabeth; Christiansen, Christian F; Ulrichsen, Sinna P


    between 1994 and 2010, subsequently diagnosed with BM until 2012. We followed patients from date of bone metastasis diagnosis until death, emigration or 31 December 2012, whichever came first. We computed 1-year, 3-year and 5-year survival (%) and the corresponding 95% CIs stratified on primary cancer...... type. Comparing patients with bone metastasis only and patients with other synchronous metastases, we estimated crude and adjusted HRs and corresponding 95% CI for mortality. RESULTS: We included 17 251 patients with bone metastasis. The most common primary cancer types with bone metastasis were...... prostate (34%), breast (22%) and lung (20%). One-year survival after bone metastasis diagnosis was lowest in patients with lung cancer (10%, 95% CI 9% to 11%) and highest in patients with breast cancer (51%, 50% to 53%). At 5 years of follow-up, only patients with breast cancer had over 10% survival (13...

  3. Nodal Disease in Rectal Cancer Patients With Complete Tumor Response After Neoadjuvant Chemoradiation: Danger Below Calm Waters. (United States)

    Baucom, Rebeccah B; Maguire, Lillias H; Kavalukas, Sandra L; Geiger, Timothy M; Ford, Molly M; Muldoon, Roberta L; Hopkins, M Benjamin; Hawkins, Alexander T


    A subset of patients with rectal cancer who undergo neoadjuvant chemoradiation therapy will develop a complete pathologic tumor response. Complete nodal response is not universal in these patients and is difficult to assess clinically. Quantifying the risk of nodal disease would allow for targeted therapy with either radical resection or "watchful waiting." This study aimed to identify risk factors for residual nodal disease in ypT0 rectal adenocarcinoma. This is a retrospective case control study. The National Cancer Database 2006 to 2014 was used to identify patients for this study. Patients with stage II/III rectal adenocarcinoma who completed chemoradiation therapy followed by resection and who had ypT0 tumors were included. Patients with metastatic disease and <2 lymph nodes evaluated were excluded. Patients were divided into 2 groups: node positive and node negative. The main outcome was nodal disease. The secondary outcome was overall survival. A total of 42,257 patients with stage II/III rectal cancer underwent chemoradiation therapy and radical resection; 4170 (9.9%) patients had ypT0 tumors and 395 (9.5%) were node positive. Of patients with clinically node-negative disease (ie, pretreatment imaging), 6.2% were node positive after chemoradiation therapy and resection. In multivariable analysis, factors predictive of nodal disease included increasing (pretreatment) clinical N-stage, high tumor grade (3/4), perineural invasion, and lymphovascular invasion. Higher clinical T-stage was inversely associated with residual nodal disease. Overall 5-year survival was significantly different between patients with ypN0, ypN1, and ypN2 disease (87.4%, 82.2%, and 62.5%, p = 0.002). This study was limited by the lack of clinical detail in the database and the inability to assess recurrence. Ten percent of patients with ypT0 tumors had positive nodes after chemoradiation therapy and resection. Factors associated with residual nodal disease included clinical nodal

  4. Impact of receptor phenotype on nodal burden in patients with breast cancer who have undergone neoadjuvant chemotherapy

    LENUS (Irish Health Repository)

    Boland, M. R.


    Optimal evaluation and management of the axilla following neoadjuvant chemotherapy(NAC) in patients with node-positive breast cancer remains controversial. The aim of this study wasto examine the impact of receptor phenotype in patients with nodal metastases who undergo NAC to seewhether this approach can identify those who may be suitable for conservative axillary management.Methods: Between 2009 and 2014, all patients with breast cancer and biopsy-proven nodal diseasewho received NAC were identied from prospectively developed databases. Details of patients who hadaxillary lymph node dissection (ALND) following NAC were recorded and rates of pathological completeresponse (pCR) were evaluated for receptor phenotype.

  5. Mixed adenoneuroendocrine carcinoma with brain metastasis

    Directory of Open Access Journals (Sweden)

    Xiao-ling YAN


    Full Text Available Objective To study clinicopathological features, diagnosis, differential diagnosis and prognosis of mixed adenoneuroendocrine carcinoma (MANEC.  Methods One case of MANEC with brain metastasis was reported focusing on the following aspects: clinical manifestations, histopathological features and immunophenotypes, and the relevant literatures were reviewed.  Results A 35-year-old male presented headache and vomiting, and his head CT scan showed a lesion located in the right temporal lobe. The tumor was detected after separating the cerebral cortex during the surgery. The tumor diameter was 3 cm. The tumor was soft and rubbery with ill-defined margins, and rich in blood supply. Under optical microscopy, the tumor was consisted of small round cells of the same size, with focal tumor cells arranged around blood vessels in a pseudorosette manner or papillary manner with brisk mitotic activity. The boundary between tumor and brain tissue was ill-defined. By using immunohistochemical staining, the tumor cells were diffusely positive for synaptophysin (Syn and CD56, and negative for glial fibrillary acidic protein (GFAP, pan cytokeratin (PCK, CD3, CD20, vimentin (Vim, leukocyte common antigen (LCA, thyroid transcription factor-1 (TTF-1, S-100 protein (S-100, neurofilament (NF, nestin (Nes, CK5/6, CK8/18 and CD99. Ki-67 labeling index was about 62%. Sigmoidoscopy was performed later in another hospital and showed a mass in the patient's colon. The colon tumor was biphasic in appearance, and was consisted of two distinct components: isomorphic small round cells and low-middle differentiated adenocarcinoma cells. The small round tumor cells were diffusely positive for Syn and CD56, and negative for PCK. The adenocarcinoma cells showed opposite results.  Conclusions MANEC is a rare tumor, which is defined in 2010 by WHO Classification of Digestive, and to the best of our knowledge, MANEC of the colon with brain metastasis has never been described

  6. Implications of para-aortic lymph node metastasis in patients with endometrial cancer without pelvic lymph node metastasis. (United States)

    Todo, Yukiharu; Takeshita, Sho; Okamoto, Kazuhira; Yamashiro, Katsushige; Kato, Hidenori


    The aim of this study was to confirm the incidence and implications of a lymphatic spread pattern involving para-aortic lymph node (PAN) metastasis in the absence of pelvic lymph node (PLN) metastasis in patients with endometrial cancer. We carried out a retrospective chart review of 380 patients with endometrial cancer treated by surgery including PLN dissection and PAN dissection at Hokkaido Cancer Center between 2003 and 2016. We determined the probability of PAN metastasis in patients without PLN metastasis and investigated survival outcomes of PLN-PAN+ patients. The median numbers of PLN and PAN removed at surgery were 41 (range: 11-107) and 16 (range: 1-65), respectively. Sixty-four patients (16.8%) had lymph node metastasis, including 39 (10.3%) with PAN metastasis. The most frequent lymphatic spread pattern was PLN+PAN+ (7.9%), followed by PLN+PAN- (6.6%), and PLN-PAN+ (2.4%). The probability of PAN metastasis in patients without PLN metastasis was 2.8% (9/325). The 5-year overall survival rates were 96.5% in PLN-PAN-, 77.6% in PLN+PAN-, 63.4% in PLN+PAN+, and 53.6% in PLN-PAN+ patients. The likelihood of PAN metastasis in endometrial cancer patients without PLN metastasis is not negligible, and the prognosis of PLN-PAN+ is likely to be poor. The implications of a PLN-PAN+ lymphatic spread pattern should thus be taken into consideration when determining patient management strategies.

  7. Risk of isolated nodal failure for non-small cell lung cancer (NSCLC) treated with the elective nodal irradiation (ENI) using 3D-conformal radiotherapy (3D-CRT) techniques--a retrospective analysis. (United States)

    Kepka, Lucyna; Bujko, Krzysztof; Zolciak-Siwinska, Agnieszka


    To estimate retrospectively the rate of isolated nodal failures (INF) in NSCLC patients treated with the elective nodal irradiation (ENI) using 3D-conformal radiotherapy (3D-CRT). One hundred and eighty-five patients with I-IIIB stage treated with 3D-CRT in consecutive clinical trials differing in an extent of the ENI were analyzed. According to the extent of the ENI, two groups were distinguished: extended (n = 124) and limited (n = 61) ENI. INF was defined as regional nodal failure occurring without local progression. Cumulative Incidence of INF (CIINF) was evaluated by univariate and multivariate analysis with regard to prognostic factors. With a median follow up of 30 months, the two-year actuarial overall survival was 35%. The two-year CIINF rate was 12%. There were 16 (9%) INF, eight (6%) for extended and eight (13%) for limited ENI. In the univariate analysis bulky mediastinal disease (BMD), left side, higher N stage, and partial response to RT had a significant negative impact on the CIINF. BMD was the only independent predictor of the risk of incidence of the INF (p = 0.001). INF is more likely to occur in case of more advanced nodal status.

  8. Transport and optics at the node in a nodal loop semimetal (United States)

    Mukherjee, S. P.; Carbotte, J. P.


    We use a Kubo formalism to calculate both AC conductivity and DC transport properties of a dirty nodal loop semimetal. The optical conductivity as a function of photon energy Ω exhibits an extended flat background σBG as in graphene provided the scattering rate Γ is small as compared to the radius of the nodal ring b (in energy units). Modifications to the constant background arise for Ω ≤Γ and the minimum DC conductivity σDC, which is approached as Ω2/Γ2 as Ω →0 , is found to be proportional to √{Γ/2+b2 }vF with vF the Fermi velocity. For b =0 we recover the known three-dimensional point node Dirac result σDC˜Γ/vF while for b >Γ , σDC becomes independent of Γ (universal) and the ratio σ/DCσBG=8/π2 where all reference to material parameters has dropped out. As b is reduced and becomes of the order Γ , the flat background is lost as the optical response evolves towards that of a three-dimensional point node Dirac semimetal which is linear in Ω for the clean limit. For finite Γ there are modifications from linearity in the photon region Ω ≤Γ . When the chemical potential μ (temperature T ) is nonzero the DC conductivity increases as μ2/Γ2 (T2/Γ2 ) for μ/Γ (T/Γ )≤1 . Such laws apply as well for thermal conductivity and thermopower with coefficients of the quadratic law only slightly modified from their value in the three-dimensional point node Dirac case. However in the μ =T =0 limit both have the same proportionality factor of √{Γ2+b2 } as does σDC. Consequently the Lorentz number is largely unmodified. For larger values of μ >Γ away from the nodal region the conductivity shows a Drude-like contribution about Ω ≊0 which is followed by a dip in the Pauli blocked region Ω ≤2 μ after which it increases to merge with the flat background (two-dimensional graphene like) for μ b .

  9. Ureteral metastasis of occult breast cancer. (United States)

    Hudolin, T; Nola, N; Milas, I; Nola, M; Juretic, A


    We report the case of a 59-year-old woman who presented with right flank pain and fever. Diagnostic investigations revealed stenosis of the right ureter extending over about 1cm. Since a double-J prosthesis could not be passed through it, a percutaneous nephrostomy was constructed and surgical exploration and excision of the stenotic ureteral segment were then carried out. Histopathological analysis of the segment removed showed diffuse infiltration with epithelial tumor cells. On immunohistochemistry, these cells were found to be positive for cytokeratin and for estrogen and progesterone receptors. No primary cancer and no additional metastases were detected. Eleven months later a primary tumor with a metastasis in the left supraclavicular region was found in the patient's right breast.

  10. Axillary node metastasis from primary ovarian carcinoma

    Directory of Open Access Journals (Sweden)

    Trupti S Patel


    Full Text Available Metastasization and distinction from mammary carcinoma is of great clinical importance because of different treatment modalities. Here, we discuss a case of stage IIIC ovarian serous carcinoma, presenting with bilateral axillary nodes metastasis after 25 months interval of its initial presentation. Increased serum CA-125 level caused clinical suspicion. Computed tomography scan of abdomen and pelvis showed no residual disease or any abdominal lymphadenopathy. Mammography of both breast were normal. Bilateral axillary nodes were noted. Guided fine needle aspiration cytology (FNAC and biopsy of ovarian carcinoma to axillary node is a rare event. Its recogn done. Cytomorphology revealed poorly differentiated carcinoma, compatible to that of primary ovarian tumor. Thus, metastatic carcinoma to axillary node from ovary was confirmed. This case illustrates a rare metastatic presentation of ovarian carcinoma and unequivocal role of FNAC to provide rapid diagnosis and preferred to be first line diagnostic procedure.

  11. Ventricular metastasis resulting in disseminated intravascular coagulation

    Directory of Open Access Journals (Sweden)

    Davis Ian D


    Full Text Available Abstract Background Disseminated Intravascular Coagulation (DIC complicates up to 7% of malignancies, the commonest solid organ association being adenocarcinoma. Transitional Cell Carcinoma (TCC has rarely been associated with DIC. Case presentation A 74-year-old woman with TCC bladder and DIC was found to have a cardiac lesion suspicious for metastatic disease. The DIC improved with infusion of plasma and administration of Vitamin K, however the cardiac lesion was deemed inoperable and chemotherapy inappropriate; given the patients functional status. We postulate that direct activation of the coagulation cascade by the intraventricular metastasis probably triggered the coagulopathy in this patient. Conclusion Cardiac metastases should be considered in cancer patients with otherwise unexplained DIC. This may influence treatment choices.

  12. Prediction of axillary lymph node metastasis in primary breast cancer patients using a decision tree-based model

    Directory of Open Access Journals (Sweden)

    Takada Masahiro


    Full Text Available Abstract Background The aim of this study was to develop a new data-mining model to predict axillary lymph node (AxLN metastasis in primary breast cancer. To achieve this, we used a decision tree-based prediction method—the alternating decision tree (ADTree. Methods Clinical datasets for primary breast cancer patients who underwent sentinel lymph node biopsy or AxLN dissection without prior treatment were collected from three institutes (institute A, n = 148; institute B, n = 143; institute C, n = 174 and were used for variable selection, model training and external validation, respectively. The models were evaluated using area under the receiver operating characteristics (ROC curve analysis to discriminate node-positive patients from node-negative patients. Results The ADTree model selected 15 of 24 clinicopathological variables in the variable selection dataset. The resulting area under the ROC curve values were 0.770 [95% confidence interval (CI, 0.689–0.850] for the model training dataset and 0.772 (95% CI: 0.689–0.856 for the validation dataset, demonstrating high accuracy and generalization ability of the model. The bootstrap value of the validation dataset was 0.768 (95% CI: 0.763–0.774. Conclusions Our prediction model showed high accuracy for predicting nodal metastasis in patients with breast cancer using commonly recorded clinical variables. Therefore, our model might help oncologists in the decision-making process for primary breast cancer patients before starting treatment.

  13. Hand1 overexpression inhibits medulloblastoma metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Asuthkar, Swapna; Guda, Maheedhara R. [Department of Cancer Biology and Pharmacology, University of Illinois College of Medicine at Peoria, Peoria, IL 61656 (United States); Martin, Sarah E. [Department of Pathology, University of Illinois College of Medicine at Peoria, Peoria, IL 61656 (United States); Antony, Reuben; Fernandez, Karen [Department of Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, IL 61656 (United States); Lin, Julian [Department of Neurosurgery, University of Illinois College of Medicine at Peoria, Peoria, IL 61656 (United States); Tsung, Andrew J. [Department of Cancer Biology and Pharmacology, University of Illinois College of Medicine at Peoria, Peoria, IL 61656 (United States); Department of Neurosurgery, University of Illinois College of Medicine at Peoria, Peoria, IL 61656 (United States); Illinois Neurological Institute, Peoria, IL 61656 (United States); Velpula, Kiran K., E-mail: [Department of Cancer Biology and Pharmacology, University of Illinois College of Medicine at Peoria, Peoria, IL 61656 (United States); Department of Neurosurgery, University of Illinois College of Medicine at Peoria, Peoria, IL 61656 (United States)


    Medulloblastoma (MB) is the most frequent malignant pediatric brain tumor. Current treatment includes surgery, radiation and chemotherapy. However, ongoing treatment in patients is further classified according to the presence or absence of metastasis. Since metastatic medulloblastoma are refractory to current treatments, there is need to identify novel biomarkers that could be used to reduce metastatic potential, and more importantly be targeted therapeutically. Previously, we showed that ionizing radiation-induced uPAR overexpression is associated with increased accumulation of β-catenin in the nucleus. We further demonstrated that uPAR protein act as cytoplasmic sequestration factor for a novel basic helix-loop-helix transcription factor, Hand1. Among the histological subtypes classical and desmoplastic subtypes account for the majority while large cell/anaplastic variant is most commonly associated with metastatic disease. In this present study using immunohistochemical approach and patient data mining for the first time, we demonstrated that Hand1 expression is observed to be downregulated in all the subtypes of medulloblastoma. Previously we showed that Hand1 overexpression regulated medulloblastoma angiogenesis and here we investigated the role of Hand1 in the context of Epithelial-Mesenchymal Transition (EMT). Moreover, UW228 and D283 cells overexpressing Hand1 demonstrated decreased-expression of mesenchymal markers (N-cadherin, β-catenin and SOX2); metastatic marker (SMA); and increased expression of epithelial marker (E-cadherin). Strikingly, human pluripotent stem cell antibody array showed that Hand1 overexpression resulted in substantial decrease in pluripotency markers (Nanog, Oct3/4, Otx2, Flk1) suggesting that Hand1 expression may be essential to attenuate the EMT and our findings underscore a novel role for Hand1 in medulloblastoma metastasis. - Highlights: • Hand1 expression is downregulated in Medulloblastoma. • Hand1 over expression reduce

  14. Ocular metastasis of cutaneous malignant melanoma. (United States)

    Ullah, Tehseena; Gurwood, Andrew S; Myers, Marc D


    Metastatic melanoma to the eye and orbit are rare. Patients at greatest risk often have disseminated metastases in the setting of advanced disease. Because the prognosis for orbital metastatic disease is poor, emphasis must be placed on early detection and prevention. Although cutaneous malignancies include basal cell carcinoma, squamous cell carcinoma, sebaceous cell carcinoma, and malignant melanoma, the majority of cases that result in metastasis, ocular morbidity, and mortality are from sebaceous cell carcinoma and malignant melanoma. A 72-year-old white woman presented emergently with a chief complaint of sudden, painless vision loss in her left eye of 2 weeks' duration. Her best-corrected visual acuities measured 20/30 in the right eye and 20/400 in the left eye with no improvement on refraction. Her systemic medical history was significant for the diagnosis of a cutaneous malignant melanoma. Examination of the left eye found grade II disc edema with all other posterior pole and peripheral structures intact and unremarkable. Magnetic resonance imaging confirmed the diagnosis of metastatic lesions involving structures of the left orbit ultimately causing reduced visual ability. The patient opted to avoid aggressive care and "hope for the best." Denying significant medical intervention, the woman lived in hospice where she died 6 months later. The primary care optometric setting, by the way a patient's visual symptoms present or the appearance of fundus abnormalities, can offer the capability of first detection and referral for the discovery of metastatic lesions. Although orbital metastasis is considered a terminal finding in these cases, timely diagnosis enables, while limited, the best options for management.

  15. Brain metastasis in gastroesophageal adenocarcinoma and HER2 status. (United States)

    Limon, Dror; Gal, Omer; Gordon, Noa; Katz, Lior; Perl, Gali; Purim, Ofer; Amit, Limor; Stemmer, Salomon M; Kundel, Yulia; Ben-Aharon, Irit; Brenner, Baruch; Siegal, Tali; Yust-Katz, Shlomit


    The increased survival of patients with gastroesophageal adenocarcinoma (GAD) following improvements in treatment has been accompanied by a rising incidence of secondary brain metastasis. HER2 amplification/overexpression, which has been associated with an increased risk of brain metastasis in breast cancer, is found in about 20% of patients with GAD. The aim of this study was to evaluate the effect of HER2 status on brain metastasis in GAD. The database of a tertiary cancer center was searched for patients with GAD diagnosed in 2011-2015, and data were collected on clinical characteristics, brain metastasis, HER2 status, and outcome. We identified 404 patients with a confirmed diagnosis of GAD. HER2 results were available for 298: 69 (23.2%) positive and 227 negative. Brain metastasis developed in 15 patients with GAD (3.7%); HER2 results, available in 13, were positive in 6, negative in 6, and equivocal in 1. The brain metastasis rate was significantly higher in HER2-positive than HER2-negative patients with GAD (6/69, 8.7% vs. 6/227, 2.6%; RR = 3.3, 95% CI 1.1-9.9, p = 0.034). Median overall survival from diagnosis of brain metastasis was 2.3 months, with no significant difference by HER2 status. HER2 positive GAD patients may be at increased risk to develop BM. Clinicians should maintain a lower threshold for performing brain imaging in patients with HER2-positive GAD given their increased risk of brain metastasis. The role of anti-HER2 agents in the development and treatment of brain metastasis in GAD warrants further study.

  16. Dissecting Tumor-Stromal Interactions in Breast Cancer Bone Metastasis

    Directory of Open Access Journals (Sweden)

    Yibin Kang


    Full Text Available Bone metastasis is a frequent occurrence in breast cancer, affecting more than 70% of late stage cancer patients with severe complications such as fracture, bone pain, and hypercalcemia. The pathogenesis of osteolytic bone metastasis depends on cross-communications between tumor cells and various stromal cells residing in the bone microenvironment. Several growth factor signaling pathways, secreted micro RNAs (miRNAs and exosomes are functional mediators of tumor-stromal interactions in bone metastasis. We developed a functional genomic approach to systemically identified molecular pathways utilized by breast cancer cells to engage the bone stroma in order to generate osteolytic bone metastasis. We showed that elevated expression of vascular cell adhesion molecule 1 (VCAM1 in disseminated breast tumor cells mediates the recruitment of pre-osteoclasts and promotes their differentiation to mature osteoclasts during the bone metastasis formation. Transforming growth factor β (TGF-β is released from bone matrix upon bone destruction, and signals to breast cancer to further enhance their malignancy in developing bone metastasis. We furthered identified Jagged1 as a TGF-β target genes in tumor cells that engaged bone stromal cells through the activation of Notch signaling to provide a positive feedback to promote tumor growth and to activate osteoclast differentiation. Substantially change in miRNA expression was observed in osteoclasts during their differentiation and maturation, which can be exploited as circulating biomarkers of emerging bone metastasis and therapeutic targets for the treatment of bone metastasis. Further research in this direction may lead to improved diagnosis and treatment strategies for bone metastasis.

  17. Decompositions of injection patterns for nodal flow allocation in renewable electricity networks (United States)

    Schäfer, Mirko; Tranberg, Bo; Hempel, Sabrina; Schramm, Stefan; Greiner, Martin


    The large-scale integration of fluctuating renewable power generation represents a challenge to the technical and economical design of a sustainable future electricity system. In this context, the increasing significance of long-range power transmission calls for innovative methods to understand the emerging complex flow patterns and to integrate price signals about the respective infrastructure needs into the energy market design. We introduce a decomposition method of injection patterns. Contrary to standard flow tracing approaches, it provides nodal allocations of link flows and costs in electricity networks by decomposing the network injection pattern into market-inspired elementary import/export building blocks. We apply the new approach to a simplified data-driven model of a European electricity grid with a high share of renewable wind and solar power generation.

  18. Dynamic Analysis of Offshore Oil Pipe Installation Using the Absolute Nodal Coordinate Formulation

    DEFF Research Database (Denmark)

    Nielsen, Jimmy D; Madsen, Søren B; Hyldahl, Per Christian


    The Absolute Nodal Coordinate Formulation (ANCF) has shown promising results in dynamic analysis of structures that undergo large deformation. The method relaxes the assumption of infinitesimal rotations. Being based in a fixed inertial reference frame leads to a constant mass matrix and zero...... of offshore submerged oil pipes using oceangoing vessels. In this investigation such an oil pipe is modeled using ANCF beam elements to simulate the dynamic behavior of the pipe during the installation process. Multiple physical effects such as gravity, buoyancy, seabed contact, and fluid damping......, are included to mimic the external forces acting on the pipe during installation. The scope of this investigation is to demonstrate the ability using the ANCF to analyze the dynamic behavior of an offshore oil pipe during installation...

  19. The Titan -1:0 Nodal Bending Wave in Saturn's Ring C. (United States)

    Rosen, P A; Lissauer, J J


    The most prominent oscillatory feature observed in the Voyager 1 radio occultation of Saturn's rings is identified as a one-armed spiral bending wave excited by Titan's -1:0 nodal inner vertical resonance. Ring partides in a bending wave move in coherently inclined orbits, warping the local mean plane of the rings. The Titan -1:0 wave is the only known bending wave that propagates outward, away from Saturn, and the only spiral wave yet observed in which the wave pattern rotates opposite to the orbital direction of the ring particles. It is also the first bending wave identified in ring C. Modeling the observed feature with existing bending wave theory gives a surface mass density of approximately 0.4 g/cm(2) outside the wave region and a local ring thickness of [unknown]5 meters, and suggests that surface mass density is not constant in the wave region.

  20. A stabilised nodal spectral element method for fully nonlinear water waves

    DEFF Research Database (Denmark)

    Engsig-Karup, Allan Peter; Eskilsson, C.; Bigoni, Daniele


    the numerical implementation differs greatly. Features of the proposed spectral element method include: nodal Lagrange basis functions, a general quadrature-free approach and gradient recovery using global L2 projections. The quartic nonlinear terms present in the Zakharov form of the free surface conditions......We present an arbitrary-order spectral element method for general-purpose simulation of non-overturning water waves, described by fully nonlinear potential theory. The method can be viewed as a high-order extension of the classical finite element method proposed by Cai et al. (1998) [5], although...... can cause severe aliasing problems and consequently numerical instability for marginally resolved or very steep waves. We show how the scheme can be stabilised through a combination of over-integration of the Galerkin projections and a mild spectral filtering on a per element basis. This effectively...

  1. Exotic Phenomena in Quantum limit in nodal-line semimetal ZrSiS

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Jin [Tulane Univ., New Orleans, LA (United States); Liu, Jinyu [Tulane Univ., New Orleans, LA (United States); Mao, Zhiqiang [Tulane Univ., New Orleans, LA (United States); Jaime, Marcelo [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Weickert, Dagmar Franziska [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)


    In quantum limit, all carriers condense to the lowest Landau level, leading to possible exotic quantum phenomena such as Lifshitz transition and density waves. Usually, quantum limit is not easily achieved due to relatively large Fermi surface in metals. Fortunately, the nodal-line semimetal ZrSiS possesses a very small Fermi pocket with a characteristic quantum oscillation frequency of 8.4T, which represents the 2D Dirac states protected by non-symmorphic symmetry. The quantum limit of such Dirac bands can be reached in moderate magnetic field ~25T, indicating that ZrSiS could be a nice platform to explore the novel quantum phenomena of Dirac fermions in quantum limit.

  2. Dynamic analysis of the tether transportation system using absolute nodal coordinate formulation (United States)

    Sun, Xin; Xu, Ming; Zhong, Rui


    Long space tethers are becoming a rising concern as an alternate way for transportation in space. It benefits from fuel economizing. This paper focuses on the dynamics of the tether transportation system, which consists of two end satellites connected by a flexible tether, and a movable vehicle driven by the actuator carried by itself. The Absolute Nodal Coordinate Formulation is applied to the establishment of the equation of motion, so that the influence caused by the distributed mass and elasticity of the tether is introduced. Moreover, an approximated method for accelerating the calculation of the generalized gravitational forces on the tether is proposed by substituting the volume integral every step into summation of finite terms. Afterwards, dynamic evolutions of such a system in different configurations are illustrated using numerical simulations. The deflection of the tether and the trajectory of the crawler during the transportation is investigated. Finally, the effect on the orbit of the system due to the crawler is revealed.

  3. Quantum criticality and nodal superconductivity in the FeAs-based superconductor KFe2As2. (United States)

    Dong, J K; Zhou, S Y; Guan, T Y; Zhang, H; Dai, Y F; Qiu, X; Wang, X F; He, Y; Chen, X H; Li, S Y


    The in-plane resistivity rho and thermal conductivity kappa of the FeAs-based superconductor KFe2As2 single crystal were measured down to 50 mK. We observe non-Fermi-liquid behavior rho(T) approximately T{1.5} at H{c{2}}=5 T, and the development of a Fermi liquid state with rho(T) approximately T{2} when further increasing the field. This suggests a field-induced quantum critical point, occurring at the superconducting upper critical field H{c{2}}. In zero field, there is a large residual linear term kappa{0}/T, and the field dependence of kappa_{0}/T mimics that in d-wave cuprate superconductors. This indicates that the superconducting gaps in KFe2As2 have nodes, likely d-wave symmetry. Such a nodal superconductivity is attributed to the antiferromagnetic spin fluctuations near the quantum critical point.

  4. Dirac Nodal Lines and Tilted Semi-Dirac Cones Coexisting in a Striped Boron Sheet. (United States)

    Zhang, Honghong; Xie, Yuee; Zhang, Zhongwei; Zhong, Chengyong; Li, Yafei; Chen, Zhongfang; Chen, Yuanping


    The enchanting Dirac fermions in graphene stimulated us to seek other 2D Dirac materials, and boron monolayers may be a good candidate. So far, a number of monolayer boron sheets have been theoretically predicted, and three have been experimentally prepared. However, none of intrinsic sheets possess Dirac electrons near the Fermi level. Herein, by means of density functional theory computations, we identified a new boron monolayer, namely, hr-sB, with two types of Dirac fermions coexisting in the sheet: One type is related to Dirac nodal lines traversing Brillouin zone (BZ) with velocities approaching 106 m/s, and the other is related to tilted semi-Dirac cones with strong anisotropy. This newly predicted boron monolayer consists of hexagon and rhombus stripes. With an exceptional stability comparable to the experimentally achieved boron sheets, it is rather optimistic to grow hr-sB on some suitable substrates such as the Ag (111) surface.

  5. Brushless Slip-Power Recovery System Simulation by Using Modified Nodal Analysis (United States)

    Kato, Shinji; Hoshi, Nobukazu; Oguchi, Kuniomi

    A novel simulation model for multiphase induction machines formulated by the modified nodal analysis is proposed. In the proposed model, the voltage and the torque equations for an elementary induction machine are used to formulate a multiphase induction machine. It is not necessary to derive the state equations for the multiphase induction machine corresponding to the conduction modes of a power electronics circuit. Thus, it is easy to simulate the complex systems including the multiphase induction machines and many power devices. Two brushless slip-power recovery systems are discussed in this paper to verify the effectiveness of the proposed model. The simulation results show good agreements with the experimental results. The proposed model enables to simulate the systems consisting of the multiphase induction machines and many power devices without derivations of the state equations for multiphase induction machines corresponding to the conduction modes of a power electronics circuit.

  6. Comment on "Magnetotransport signatures of a single nodal electron pocket constructed from Fermi arcs" (United States)

    Chakravarty, Sudip; Wang, Zhiqiang


    We comment on the recent work [N. Harrison et al., Phys. Rev. B 92, 224505 (2015), 10.1103/PhysRevB.92.224505] which attempts to explain the sign reversal and quantum oscillations of the Hall coefficient observed in cuprates from a single-nodal diamond-shaped electron pocket with concave arc segments. Given the importance of this work, it calls for closer scrutiny. Their conclusion of sign reversal of the Hall coefficient depends on a nongeneric rounding of the sharp vertices. Moreover, their demonstration of quantum oscillation in the Hall coefficient from a single pocket is unconvincing. We maintain that at least two pockets with different scattering rates is necessary to explain the observed quantum oscillations of the Hall coefficient.

  7. Micropropagation of Dianthus deltoides L. through shoot tip and nodal cuttings culture

    Directory of Open Access Journals (Sweden)

    Marković Marija


    Full Text Available Micropropagation (shoot tip and nodal cuttings culture was used for the rapid propagation of the non-invasive, decorative, native plants of maiden pink (Dianthus deltoides L. in order to preserve their genetic diversity. In vitro culture was successfully established on Murashige and Skoog medium (MS using seeds as the initial material. In the shoot multiplication phase, the explants were cultured on MS medium supplemented with different concentrations of 6-benzylaminopurine (BAP and naphthaleneacetic acid (NAA. The highest multiplication rate was achieved on a medium containing 0.1 mgL-1 of BAP and 0.1 mgL-1 of NAA. The rooting was successful on a hormone-free medium (100%, and the highest percentage of microplant acclimatization (97% was recorded in a 4: 1 mixture of peat and sand. [Projekat Ministarstva nauke Republike Srbije, br. TR 31041: Establishment of wood plantations intended for a forestation of Serbia

  8. A Stabilised Nodal Spectral Element Method for Fully Nonlinear Water Waves

    CERN Document Server

    Engsig-Karup, Allan Peter; Bigoni, Daniele


    We present an arbitrary-order spectral element method for general-purpose simulation of non-overturning water waves, described by fully nonlinear potential theory. The method can be viewed as a high-order extension of the classical finite element method proposed by Cai et al (1998) \\cite{CaiEtAl1998}, although the numerical implementation differs greatly. Features of the proposed spectral element method include: nodal Lagrange basis functions, a general quadrature-free approach and gradient recovery using global $L^2$ projections. The quartic nonlinear terms present in the Zakharov form of the free surface conditions can cause severe aliasing problems and consequently numerical instability for marginally resolved or very steep waves. We show how the scheme can be stabilised through a combination of over-integration of the Galerkin projections and a mild spectral filtering on a per element basis. This effectively removes any aliasing driven instabilities while retaining the high-order accuracy of the numerical...

  9. Higher order analytical nodal methods in response-matrix formulation for the multigroup neutron diffusion equations

    Energy Technology Data Exchange (ETDEWEB)

    Guessous, N. E-mail:; Akhmouch, M


    A higher analytical nodal method for the multigroup neutron diffusion equations, based on the transverse integration procedure, is presented. The discrete 1D equations are cast with the interface partial current techniques in response matrix formalism. The remaining Legendre coefficients of the transverse leakage moment are determined exactly in terms of the different neutron flux moments order in the reference node. In the weighted balance equations, the transverse leakage moments are linearly written in terms of the partial currents, facial and centered fluxes moments. The self-consistent is guaranteed. Furthermore, as the order k increase the neutronic balance in each node and the copulate between the adjacent cell are reinforced. The convergence order in L{sup 2}-norm is of O(h{sup k+3-{delta}k{sub 0}}) under smooth assumptions. The efficacy of the method is showed for 2D-PWR, 2D-IAEA LWR and 2D-LMFBR benchmark problems.

  10. Verification of the Advanced Nodal Method on BWR Core Analyses by Whole-Core Heterogeneous Transport Calculations

    Energy Technology Data Exchange (ETDEWEB)

    Shinya Kosaka


    Recent boiling water reactor (BWR) core and fuel designs have become more sophisticated and heterogeneous to improve fuel cycle cost, thermal margin, etc. These improvements, however, tend to lead to a strong interference effect among fuel assemblies, and it my cause some inaccuracies in the BWR core analyses by advanced nodal codes. Furthermore, the introduction of mixed-oxide (MOX) fuel will lead to a much stronger interference effect between MOX and UO{sub 2} fuel assemblies. However, the CHAPLET multiassembly characteristics transport code was developed recently to solve two-dimensional cell-heterogeneous whole-core problems efficiently, and its results can be used as reference whole-core solutions to verify the accuracy of nodal core calculations. In this paper, the results of nodal core calculations were compared with their reference whole-core transport solutions to verify their accuracy (in k{sub eff}, assembly power and pin power via pin power reconstruction) of the advanced nodal method on both UO{sub 2} and MOX BWR whole-core analyses. Especially, it was investigated if there were any significant differences in the accuracy between MOX and UO{sub 2} results.

  11. Detection of Melanoma Nodal Metastases; Differences in Detection Between Elderly and Younger Patients Do Not Affect Survival

    NARCIS (Netherlands)

    Kruijff, S.; Bastiaannet, E.; Suurmeijer, A. J. H.; Hoekstra, H. J.


    Background. Melanoma lymph nodes metastases may be detected by patients or by physicians. Understanding the outcomes of self-detection or physician detection is essential for the design of follow-up studies. We evaluated the role of the method of detection in nodal disease in the prognosis of

  12. The Effects of Test Order and Nodal Distance on the Emergence and Stability of Derived Discriminative Stimulus Functions (United States)

    Rehfeldt, Ruth Anne; Dymond, Simon


    The present study examined the effects of equivalence test order and nodal distance on the emergence and stability of derived discriminative stimulus functions. Participants in 1 group were exposed to a transfer of functions test following a symmetry and equivalence test, another group of participants completed a symmetry and equivalence test…

  13. Treatment of local and nodal recurrences in carcinoma of the larynx; Leczenie nowotworow miejscowych i wezlowych raka krtani

    Energy Technology Data Exchange (ETDEWEB)

    Kowalska, B.; Bulinska, H.; Debniak, E. [Akademia Medyczna, Gdansk (Poland)


    Methods of treatment in 93 cases of post surgery recurrences of laryngeal carcinoma have been presented. Treatment prospects and results in 80 patients with local and/or nodal recurrence have been discussed. Among those patients, 12 (15%) displayed a long-term survival rate with no symptoms. (author)

  14. Nodal Control and Surgical Salvage after Primary Radiotherapy in 1,782 Patients with Laryngeal and Pharyngeal Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Vendelbo Johansen, Lars; Grau, Cai; Overgaard, Jens [Aarhus Univ. Hospital (Denmark). Dept. of Experimental Clinical Oncology


    The purpose of this study was to evaluate the ultimate neck control after primary radiotherapy and surgical salvage in laryngeal and pharyngeal cancer patients. Some 1,782 consecutive patients with squamous cell carcinoma were treated by radiotherapy. At presentation 26% of the patients had metastatic lymph nodes. A total of 298 primary or secondary nodal recurrences were seen, 159 were treated, and 53 ({approx}18%) were controlled. Isolated N-recurrence was fatal in 2.7% (36/1,324) of the N0 patients. Univariate actuarial analysis of nodal control demonstrated that the region of origin, T-classification, T-size, N-classification, tumor stage, differentiation, hemoglobin, and radiation time were significant prognostic factors. In a Cox analysis the independent significant parameters were gender, region of origin, N-classification, and differentiation. The conclusions were that in patients with nodal recurrence a little over half were treated and of these a third of the nodal recurrences were controlled. Significant prognostic factors in multivariate analysis were gender, region of origin, N-classification, and tumor differentiation.

  15. Improvement of neutron kinetics module in TRAC-BF1code: one-dimensional nodal collocation method

    Energy Technology Data Exchange (ETDEWEB)

    Jambrina, Ana; Barrachina, Teresa; Miro, Rafael; Verdu, Gumersindo, E-mail:, E-mail:, E-mail:, E-mail: [Universidade Politecnica de Valencia (UPV), Valencia (Spain); Soler, Amparo, E-mail: [SEA Propulsion S.L., Madrid (Spain); Concejal, Alberto, E-mail: [Iberdrola Ingenieria y Construcion S.A.U., Madrid (Spain)


    The TRAC-BF1 one-dimensional kinetic model is a formulation of the neutron diffusion equation in the two energy groups' approximation, based on the analytical nodal method (ANM). The advantage compared with a zero-dimensional kinetic model is that the axial power profile may vary with time due to thermal-hydraulic parameter changes and/or actions of the control systems but at has the disadvantages that in unusual situations it fails to converge. The nodal collocation method developed for the neutron diffusion equation and applied to the kinetics resolution of TRAC-BF1 thermal-hydraulics, is an adaptation of the traditional collocation methods for the discretization of partial differential equations, based on the development of the solution as a linear combination of analytical functions. It has chosen to use a nodal collocation method based on a development of Legendre polynomials of neutron fluxes in each cell. The qualification is carried out by the analysis of the turbine trip transient from the NEA benchmark in Peach Bottom NPP using both the original 1D kinetics implemented in TRAC-BF1 and the 1D nodal collocation method. (author)

  16. Immunohistochemical profiling of caspase signaling pathways predicts clinical response to chemotherapy in primary nodal diffuse large B-cell lymphomas

    NARCIS (Netherlands)

    Muris, JJF; Cillessen, SAGM; Vos, W; van Houdt, IS; Kummer, JA; van Krieken, JHJM; Jiwa, NM; Jansen, PM; Kluin-Nelemans, HC; Ossenkoppele, GJ; Gundy, C; Meijer, CJLM; Oudejans, JJ


    We used biopsy specimens of primary nodal diffuse large B-cell lymphoma (DLBCL) to investigate whether the inhibition of caspase 8 and/or 9 apoplosis signaling pathways predicts clinical outcome. Expression levels of cellular FLICE inhibitory protein (c-Flip) and numbers of active caspase 3-positive

  17. LOLA SYSTEM: A code block for nodal PWR simulation. Part. II - MELON-3, CONCON and CONAXI Codes

    Energy Technology Data Exchange (ETDEWEB)

    Aragones, J. M.; Ahnert, C.; Gomez Santamaria, J.; Rodriguez Olabarria, I.


    Description of the theory and users manual of the MELON-3, CONCON and CONAXI codes, which are part of the core calculation system by nodal theory in one group, called LOLA SYSTEM. These auxiliary codes, provide some of the input data for the main module SIMULA-3; these are, the reactivity correlations constants, the albe does and the transport factors. (Author) 7 refs.

  18. Remarks on Consistent Development of Plant Nodalizations: An Example of Application to the ROSA Integral Test Facility

    Directory of Open Access Journals (Sweden)

    J. Freixa


    Full Text Available Experimental results obtained at integral test facilities (ITFs are used in the validation process of system codes for the transient analyses of light water reactors (LWRs. The expertise and guidelines derived from this work are later applied to transient analyses of nuclear power plants (NPPs. However, the boundary conditions at the NPPs will always differ from those at the ITF, and hence, the soundness of the ITF model needs to be maximized. An unaltered ITF nodalization should prove to be able to simulate as many tests as possible, before any conclusion is derived to NPP analyses. The STARS group at the Paul Scherrer Institut (PSI actively participates in several international programs, where ITFs are being used (e.g., ROSA, PKL. Several tests carried out at the ROSA large-scale test facility operated by the Japan Atomic Energy Agency (JAEA have been simulated in recent years by using the United States Nuclear Regulatory Commission (US-NRC system code TRACE. In this paper, 5 different posttest analyses are presented, along with the evolution of the employed TRACE nodalization and the process followed to track the consistency of the nodalization modifications. The ROSA TRACE nodalization provided results in a reasonable agreement with all 5 experiments.

  19. [Lung metastasis surgery, yesterday and now]. (United States)

    Le Pimpec Barthes, F; Fabre-Guillevin, E; Foucault, C; Cazes, A; Dujon, A; Riquet, M


    Surgical resection of lung metastases may prolong survival as a part of multimodality treatment. Our aim was to review how the indications and practice of this type of surgery have evolved over time. We included in the study all patients who were operated for this indication between 1983 and 2006 in two different surgical departments. A retrospective review was conducted including the following criteria: age, sex, type of primary cancer, type of pulmonary resection, histology of metastases, perioperative chemotherapy. Four hundred and seventy-two operations were performed in 225 men and 145 women: 448 were complete resections (wedge resection: 221, segmentectomy: 47, lobectomy: 148, pneumonectomy: 32), and 24 incomplete resections. Most metastases were from colorectal (n=129), renal (n=73), and sarcoma origin (n=34); the survival rate was 38.5% and 24.3% at 5 and 10 years. The following criteria were markers of poor prognosis: incomplete or large excision (whole lung or lobar excision), size, nodal status, intravascular microemboli. Factors that did not influence prognosis were: disease free interval, location and number of metastases. Prognosis showed a significant improvement since 1998, and with the use of neoadjuvant chemotherapy (77 patients). The survival rate for isolated metastases that were potentially candidates for radiofrequency ablation was 48% at 5 years. The prognosis of lung metastases has been notably improved by better understanding of the disease and the adoption of a multidisciplinary approach, integrating recent advances in systemic treatments. The efficacy of other forms of local surgical treatment have yet to be demonstrated. Copyright © 2010. Published by Elsevier Masson SAS.

  20. Elective unilateral nodal irradiation in head and neck squamous cell carcinoma: A paradigm shift. (United States)

    Al-Mamgani, A; Verheij, M; van den Brekel, M W M


    There is a long-standing convention to irradiate the great majority of head and neck squamous cell carcinoma (HNSCC) electively to both sides of the neck, to reduce the theoretically increased risk of contralateral regional failure (cRF). With the currently available diagnostic imaging techniques this treatment paradigm means, in our opinion, an overtreatment in considerable proportion of these patients. From all the published studies (n = 11, with 1116 patients treated in total), the incidence of cRF in patients with oropharyngeal cancer treated to one side of the neck is 2.4%. The incidence was higher in patients with tumours involving the midline (12.1%). The low incidence of cRF was also seen in patients with HNSCC treated by local excision combined with unilateral neck dissection or sentinel node procedure. It seems clear from the aggregated data of these studies that a less conservative approach with regard to the selection of patients for unilateral elective nodal irradiation is justified. The fear of leaving the contralateral neck untreated in well-selected groups of patients with HNSCC needs nowadays to be mitigated since the incidence of cRF in lateralised tumours extending to but not crossing the midline is low. Furthermore, the obviously improved diagnostic imaging nowadays could help us to guide the selection of considerable proportion of patients with lateralised HNSCC for unilateral elective nodal irradiation with significant reduction of radiation-related toxicity and improved quality of life. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Myelin Organization in the Nodal, Paranodal, and Juxtaparanodal Regions Revealed by Scanning X-Ray Microdiffraction (United States)

    Makowski, Lee; Palmisano, Marilena; Burghammer, Manfred; Riekel, Christian; Kirschner, Daniel A.


    X-ray diffraction has provided extensive information about the arrangement of lipids and proteins in multilamellar myelin. This information has been limited to the abundant inter-nodal regions of the sheath because these regions dominate the scattering when x-ray beams of 100 µm diameter or more are used. Here, we used a 1 µm beam, raster-scanned across a single nerve fiber, to obtain detailed information about the molecular architecture in the nodal, paranodal, and juxtaparanodal regions. Orientation of the lamellar membrane stacks and membrane periodicity varied spatially. In the juxtaparanode-internode, 198–202 Å-period membrane arrays oriented normal to the nerve fiber axis predominated, whereas in the paranode-node, 205–208 Å-period arrays oriented along the fiber direction predominated. In parts of the sheath distal to the node, multiple sets of lamellar reflections were observed at angles to one another, suggesting that the myelin multilayers are deformed at the Schmidt-Lanterman incisures. The calculated electron density of myelin in the different regions exhibited membrane bilayer profiles with varied electron densities at the polar head groups, likely due to different amounts of major myelin proteins (P0 glycoprotein and myelin basic protein). Scattering from the center of the nerve fibers, where the x-rays are incident en face (perpendicular) to the membrane planes, provided information about the lateral distribution of protein. By underscoring the heterogeneity of membrane packing, microdiffraction analysis suggests a powerful new strategy for understanding the underlying molecular foundation of a broad spectrum of myelinopathies dependent on local specializations of myelin structure in both the PNS and CNS. PMID:24984037

  2. TAQUICARDIA POR REENTRADA DEL NODO AURÍCULO-VENTRICULAR / Atrioventricular nodal reentrant tachycardia

    Directory of Open Access Journals (Sweden)

    Jéssica Mirella Mercedes


    Full Text Available Resumen La taquicardia por reentrada del nodo aurículo–ventricular representa una parte significativa de las taquiarritmias que los médicos asisten en los servicios de urgencias. Constituye la taquicardia paroxística más frecuente, y es característico que se presente sobre todo en mujeres entre la cuarta y la quinta década de la vida. El diagnóstico puede hacerse con alta fiabilidad mediante el electrocardiograma de superficie y algunos casos complejos o dudosos, mediante los estudios electrofisiológicos. Su tratamiento debe ser dirigido hacia la curación definitiva mediante la técnica de ablación endocavitaria, pero de acuerdo a su disponibilidad o las preferencias del paciente se puede indicar tratamiento farmacológico. En este artículo se resumen las técnicas diagnósticas, los tipos de taquicardia por reentrada intranodal y los principales aspectos del tratamiento. / Abstract Atrioventricular nodal reentrant tachycardia represents a significant part of tachyarrhythmias seen by attending physicians in emergency departments. It is the most common paroxysmal tachycardia, and it occurs primarily in women between their fourth and fifth decades of life. Diagnosis can be made with high reliability by surface electrocardiogram and complex or borderline cases by electrophysiological studies. Its treatment should be aimed towards definitive healing by endocardial ablation technique, but depending on availability or patient preferences drug treatment may be indicated. This article summarizes the diagnostic techniques, types of atrioventricular nodal reentrant tachycardia and major aspects of treatment.

  3. Assessment of atrioventricular conduction following cryoablation of atrioventricular nodal reentrant tachycardia in children. (United States)

    Kiplapinar, Neslihan; Ergul, Yakup; Akdeniz, Celal; Saygi, Murat; Ozyilmaz, Isa; Gul, Enes E; Tuzcu, Volkan


    Early-onset transient atrioventricular block (AVB) is a rare occurrence following cryoablation of atrioventricular nodal reentrant tachycardia (AVNRT), despite lack of any AVB at the end of the procedure. The purpose of this prospective study was to assess AVB shortly after successful cryoablation of AVNRT in children. A 6-mm-tip cryocatheter was used in 39 procedures. An 8-mm-tip catheter was used in 11 procedures. Twelve-lead electrocardiograms (ECGs) and 24-hour ambulatory ECGs were performed 24 hours prior to the procedure and immediately following the procedure. All procedures were done using the EnSite system (St. Jude Medical, St. Paul, MN, USA) without fluoroscopy. Although nine (18%) patients developed variable degrees of transient AVB during the procedure, all of them had normal atrioventricular (AV) conduction at the end of the procedure and did not require any intervention. Four of these patients had variable degrees of transient AVB following the procedure despite having normal AV conduction at the end of the procedure. One developed Mobitz type I AVB, which lasted for 11.5 hours, and the other three experienced 2:1 AVB, which lasted for 2, 8, and 24 hours, respectively. All patients had complete resolution of the AVB, which was also documented with the 24-hour ambulatory ECGs after the procedure. Early transient AVB can develop following AVNRT cryoablation even if AV conduction is normal at the end of the procedure. Despite the transient AVB in the initial 24 hours after the procedure in some cases, there is no evidence for ongoing AV nodal dysfunction. ©2014 Wiley Periodicals, Inc.

  4. Portal Vein Tumor Thrombus of Liver Metastasis from Lung Cancer

    Directory of Open Access Journals (Sweden)

    Ryoko Ogawa


    Full Text Available We report a case of liver metastasis of lung carcinoma with portal vein tumor thrombus (PVTT. Although the primary lesion of lung tumor remained unchanged, the patient rapidly developed wide-spread metastases and formed PVTT of liver metastasis. The primary lesion showed features of mixed Clara and bronchial surface epithelial cell component type adenocarcinoma with small foci of micropapillary pattern. Micropapillary pattern was observed in the metastatic lesions in the liver and PVTT. Micropapillary pattern lung adenocarcinoma may develop rapid metastases and cause PVTT associated with liver metastasis. We should perform a detailed examination to establish correct diagnosis.

  5. Massive bilateral mandibular metastasis from papillary thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Siti Asmat Md Arepen


    Full Text Available Papillary thyroid carcinoma (PTC comprises almost eighty percent of differentiated thyroid malignancy. It affects female more than male in the age range between 40–50 years old. It usually metastasizes to ipsilateral regional lymph nodes of neck and rarely have distant metastasis. Common route of dissemination of tumour is through lymphatic system. We reported a rare case of bilateral mandibular metastasis from incomplete resection of follicular variant of PTC. Keywords: Papillary thyroid carcinoma, Metastasis, Mandible

  6. Renal Cell Carcinoma Presenting with Cutaneous Metastasis: A Case Report

    Directory of Open Access Journals (Sweden)

    Nilufer Onak Kandemir


    Full Text Available Renal cell carcinoma is the most common kidney tumor in adults. Cutaneous metastasis is a rare first symptom of the disease. This paper describes the diagnosis of a renal cell carcinoma that was indicated by cutaneous metastasis in the head and neck region, and considers the etiopathogenesis of such cases. A careful skin examination is important to detect cutaneous metastasis associated with renal cell carcinomas. Metastatic skin lesions in the head and neck region must be taken into consideration during a differential diagnosis.

  7. Renal Cell Carcinoma Presenting with Cutaneous Metastasis: A Case Report (United States)

    Onak Kandemir, Nilufer; Barut, Figen; Yılmaz, Kıvanç; Tokgoz, Husnu; Hosnuter, Mubin; Ozdamar, Sukru Oguz


    Renal cell carcinoma is the most common kidney tumor in adults. Cutaneous metastasis is a rare first symptom of the disease. This paper describes the diagnosis of a renal cell carcinoma that was indicated by cutaneous metastasis in the head and neck region, and considers the etiopathogenesis of such cases. A careful skin examination is important to detect cutaneous metastasis associated with renal cell carcinomas. Metastatic skin lesions in the head and neck region must be taken into consideration during a differential diagnosis. PMID:20811607

  8. Diagnostic performance of {sup 18}F-fluorothymidine PET/CT for primary colorectal cancer and its lymph node metastasis: comparison with {sup 18}F-fluorodeoxyglucose PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Nakajo, Masatoyo [Kagoshima University, Graduate School of Medical and Dental Sciences, Department of Radiology, Kagoshima (Japan); Nanpuh Hospital, Department of Radiology, Kagoshima (Japan); Nakajo, Masayuki; Jinguji, Megumi; Fukukura, Yoshihiko [Kagoshima University, Graduate School of Medical and Dental Sciences, Department of Radiology, Kagoshima (Japan); Kajiya, Yoriko; Tani, Atushi [Nanpuh Hospital, Department of Radiology, Kagoshima (Japan); Nishimata, Nobuaki; Shimaoka, Shunji; Nihara, Tohru [Nanpuh Hospital, Department of Gastroenterology, Kagoshima (Japan); Aridome, Kuniaki [Nanpuh Hospital, Department of Surgery, Kagoshima (Japan); Tanaka, Sadao [Nanpuh Hospital, Department of Pathology, Kagoshima (Japan); Koriyama, Chihaya [Kagoshima University, Graduate School of Medical and Dental Sciences, Department of Epidemiology and Preventive Medicine, Kagoshima (Japan)


    To examine the diagnostic performance of {sup 18}F-fluorothymidine (FLT) PET/CT in primary and metastatic lymph node colorectal cancer foci in comparison with {sup 18}F-fluorodeoxyglucose (FDG) PET/CT. The study population comprised 28 patients with 30 newly diagnosed colorectal cancers who underwent surgical resection of the primary lesion and regional lymph nodes after both FLT and FDG PET/CT. The associations between SUVmax levels and pathological factors were evaluated using the Mann-Whitney U or Kruskal-Wallis test. Differences in diagnostic indexes for detecting nodal metastasis between the two tracers were estimated using the McNemar exact or {chi} {sup 2} test. All 30 primary cancers (43.0 {+-} 20.0 mm, range 14 - 85 mm) were visualized by both tracers, but none of the FLT SUVmax values exceeded the FDG SUVmax values in any of the primary cancers (6.6 {+-} 2.4 vs. 13.6 {+-} 5.8, p < 0.001). The sensitivity, specificity and accuracy for detecting nodal metastasis were 41 % (15/37), 98.8 % (493/499) and 94.8 % (508/536) for FDG PET/CT, and 32 % (12/37), 98.8 % (493/499) and 94.2 % (505/536) for FLT PET/CT, respectively. The sensitivity (p = 0.45), specificity (p = 0.68) and accuracy (p = 0.58) were not different between the tracers. Nodal uptake of FLT and FDG was discordant in 7 (19 %) of 37 metastatic nodes. There were ten concordant true-positive nodes of which six showed higher FDG SUVmax and four showed higher FLT SUVmax, but the difference between FDG and FLT SUVmax was not significant (5.56 {+-} 3.55 and 3.62 {+-} 1.45, respectively; p = 0.22). FLT has the same potential as FDG in PET/CT for the diagnosis of primary and nodal foci of colorectal cancer despite significantly lower FLT uptake in primary foci. (orig.)

  9. Intrapancreatic bile duct metastasis from colon cancer after resection of liver metastasis with intrabiliary growth: a case report. (United States)

    Kawakatsu, Shoji; Kaneoka, Yuji; Maeda, Atsuyuki; Takayama, Yuichi; Fukami, Yasuyuki; Onoe, Shunsuke


    An extremely rare case of intrapancreatic bile duct metastasis from sigmoid colon adenocarcinoma is herein presented. Sigmoid colon cancer (T3, N0, M0, stage IIA) had been diagnosed and treated by sigmoidectomy in October 1993. In December 2002, a liver metastasis with intrabiliary growth was found, and this was treated by extended right hepatic lobectomy and caudate lobectomy with extrahepatic bile duct resection. In February 2014, intrapancreatic bile duct metastasis was found, and this was treated by subtotal stomach-preserving pancreatoduodenectomy. The intrapancreatic metastasis was judged to have arisen from cancer cell implantation, either by spontaneous shedding of cancer cells or as a complication of percutaneous transhepatic biliary drainage. Twelve months have passed since the last surgical intervention, and there has been no sign of local recurrence or distant metastasis. Differential diagnosis between intrahepatic cholangiocarcinoma and intrabiliary growth of a liver metastasis originating from colorectal adenocarcinoma is difficult but very important for determining the therapeutic strategy. Careful examination is needed to diagnose intrahepatic biliary dilatation, especially for patients with a history of carcinoma in the digestive tract and even if years have passed since curative resection of the digestive tract cancer. Aggressive surgical management for localized recurrence of a hepatic metastasis from colorectal adenocarcinoma may improve patient survival.

  10. File list: ALL.Bld.10.AllAg.Lymph_node_metastasis [Chip-atlas[Archive

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  14. File list: ALL.Bld.50.AllAg.Lymph_node_metastasis [Chip-atlas[Archive

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    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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  18. The analytic nodal diffusion solver ANDES in multigroups for 3D rectangular geometry: Development and performance analysis

    Energy Technology Data Exchange (ETDEWEB)

    Lozano, Juan-Andres [Departamento de Ingenieria Nuclear, Universidad Politecnica de Madrid (UPM), ETS Ingenieros Industriales, Jose G. Abascal, 2, 28006 Madrid (Spain)], E-mail:; Garcia-Herranz, Nuria; Ahnert, Carol; Aragones, Jose-Maria [Departamento de Ingenieria Nuclear, Universidad Politecnica de Madrid (UPM), ETS Ingenieros Industriales, Jose G. Abascal, 2, 28006 Madrid (Spain)


    In this work we address the development and implementation of the analytic coarse-mesh finite-difference (ACMFD) method in a nodal neutron diffusion solver called ANDES. The first version of the solver is implemented in any number of neutron energy groups, and in 3D Cartesian geometries; thus it mainly addresses PWR and BWR core simulations. The details about the generalization to multigroups and 3D, as well as the implementation of the method are given. The transverse integration procedure is the scheme chosen to extend the ACMFD formulation to multidimensional problems. The role of the transverse leakage treatment in the accuracy of the nodal solutions is analyzed in detail: the involved assumptions, the limitations of the method in terms of nodal width, the alternative approaches to implement the transverse leakage terms in nodal methods - implicit or explicit -, and the error assessment due to transverse integration. A new approach for solving the control rod 'cusping' problem, based on the direct application of the ACMFD method, is also developed and implemented in ANDES. The solver architecture turns ANDES into an user-friendly, modular and easily linkable tool, as required to be integrated into common software platforms for multi-scale and multi-physics simulations. ANDES can be used either as a stand-alone nodal code or as a solver to accelerate the convergence of whole core pin-by-pin code systems. The verification and performance of the solver are demonstrated using both proof-of-principle test cases and well-referenced international benchmarks.

  19. Neutron transport in hexagonal reactor cores modeled by trigonal-geometry diffusion and simplified P{sub 3} nodal methods

    Energy Technology Data Exchange (ETDEWEB)

    Duerigen, Susan


    The superior advantage of a nodal method for reactor cores with hexagonal fuel assemblies discretized as cells consisting of equilateral triangles is its mesh refinement capability. In this thesis, a diffusion and a simplified P{sub 3} (or SP{sub 3}) neutron transport nodal method are developed based on trigonal geometry. Both models are implemented in the reactor dynamics code DYN3D. As yet, no other well-established nodal core analysis code comprises an SP{sub 3} transport theory model based on trigonal meshes. The development of two methods based on different neutron transport approximations but using identical underlying spatial trigonal discretization allows a profound comparative analysis of both methods with regard to their mathematical derivations, nodal expansion approaches, solution procedures, and their physical performance. The developed nodal approaches can be regarded as a hybrid NEM/AFEN form. They are based on the transverse-integration procedure, which renders them computationally efficient, and they use a combination of polynomial and exponential functions to represent the neutron flux moments of the SP{sub 3} and diffusion equations, which guarantees high accuracy. The SP{sub 3} equations are derived in within-group form thus being of diffusion type. On this basis, the conventional diffusion solver structure can be retained also for the solution of the SP{sub 3} transport problem. The verification analysis provides proof of the methodological reliability of both trigonal DYN3D models. By means of diverse hexagonal academic benchmark and realistic detailed-geometry full-transport-theory problems, the superiority of the SP{sub 3} transport over the diffusion model is demonstrated in cases with pronounced anisotropy effects, which is, e.g., highly relevant to the modeling of fuel assemblies comprising absorber material.

  20. Chick CFC controls Lefty1 expression in the embryonic midline and nodal expression in the lateral plate. (United States)

    Schlange, T; Schnipkoweit, I; Andrée, B; Ebert, A; Zile, M H; Arnold, H H; Brand, T


    Members of the EGF-CFC family of proteins have recently been implicated as essential cofactors for Nodal signaling. Here we report the isolation of chick CFC and describe its expression pattern, which appears to be similar to Cfc1 in mouse. During early gastrulation, chick CFC was asymmetrically expressed on the left side of Hensen's node as well as in the emerging notochord, prechordal plate, and lateral plate mesoderm. Subsequently, its expression became confined to the heart fields, notochord, and posterior mesoderm. Implantation experiments suggest that chick CFC expression in the lateral plate mesoderm is dependent on BMP signaling, while in the midline its expression depends on an Activin-like signal. The asymmetric expression domain within Hensen's node was not affected by application of FGF8, Noggin, or Shh antibody. Implantation of cells expressing human or mouse CFC2, or chick CFC on the right side of Hensen's node randomized heart looping without affecting expression of genes involved in left-right axis formation, including SnR, Nodal, Car, or Pitx2. Application of antisense oligodeoxynucleotides to the midline of Hamburger-Hamilton stage 4-5 embryos also randomized heart looping, but in contrast to the overexpression experiments, antisense oligodeoxynucleotide treatment resulted in bilateral expression of Nodal, Car, Pitx2, and NKX3.2, whereas Lefty1 expression in the midline was transiently lost. Application of the antisense oligodeoxynucleotides to the lateral plate mesoderm abolished Nodal expression. Thus, chick CFC seems to have a dual function in left-right axis formation by maintaining Nodal expression in the lateral plate mesoderm and controlling expression of Lefty1 expression in the midline territory. Copyright 2001 Academic Press.