Sample records for lymph glands refusing

  1. [Lymph node and distant metastases of thyroid gland cancer. Metastases in the thyroid glands]. (United States)

    Schmid, K W


    The different biological features of the various major entities of thyroid cancer, e.g. papillary, follicular, poorly differentiated, anaplastic and medullary, depend to a large extent on their different metastatic spread. Papillary thyroid cancer (PTC) has a propensity for cervical lymphatic spread that occurs in 20-50 % of patients whereas distant metastasis occurs in thyroid cancer (FTC) has a marked propensity for vascular but not lymphatic invasion and 10-20 % of FTC develop distant metastases. At the time of diagnosis approximately one third of medullary thyroid cancer (MTC) cases show lymph node metastases, in 10-15 % distant metastases and 25 % develop metastases during the course of the disease. Poorly differentiated (PDTC) and anaplastic thyroid cancer (ATC) spread via both lymphatic and vascular invasion. Thus distant metastases are relatively uncommon in DTC and when they occur, long-term stable disease is the typical clinical course. The major sites of distant metastases are the lungs and bone. Metastases to the brain, breasts, liver, kidneys, muscle and skin are relatively rare or even rare. The thyroid gland itself can be a site of metastases from a variety of other tumors. In autopsy series of patients with disseminated cancer disease, metastases to the thyroid gland were found in up to 10 % of cases. Metastases from other primary tumors to the thyroid gland have been reported in 1.4-3 % of patients who have surgery for suspected cancer of the thyroid gland. The most common primary cancers that metastasize to the thyroid gland are renal cell (48.1 %), colorectal (10.4 %), lung (8.3 %) and breast cancer (7.8 %) and surprisingly often sarcomas (4.0 %).

  2. Stem cell injury and restitution after ionizing irradiation in intestine, liver, salivary gland, mesenteric lymph node

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae Hyun; Cho, Kyung Ja; Lee, Sun Joo; Jang, Won Suk [Korea Cancer Center Hospital, Seoul (Korea, Republic of)


    There is little information about radiation injury on stem cell resident in other organs. In addition there is little experimental model in which radiation plays a role on proliferation stem cell in adult organ. This study was carried out to evaluate the early response of tissue injury and restitution in intestine, liver, salivary gland and lymph node, and to develop in vivo model to investigate stem cell biology by irradiation. The study is to assay the early response to radiation and setup an animal model for radiation effect on cellular response. Duodenal intestine, liver, submandibular salivary gland and mesenteric lymph node were selected to compare apoptosis and proliferating cell nuclear antigen (PCNA) expression to radiosensitivity. For the effect of radiation on cellular responses, rats were irradiated during starvation. Conclusionly, this study showed the value of apoptosis in detection system for evaluating cellular damage against radiation injury. Because apoptosis was regularly inducted depending on tissue-specific pattern, dose and time sequence as well as cellular activity. Furthermore in vivo model in the study will be helped in the further study to elucidate the relationship between radiation injury and starvation or malnutrition. (author). 22 refs., 6 figs

  3. Kimura′s disease - An unusual presentation involving subcutaneous tissue, parotid gland and lymph node

    Directory of Open Access Journals (Sweden)

    Parul Sah


    Full Text Available Kimura′s disease is a rare chronic inflammatory condition of uncertain etiology which has an affinity for the Asian population. It primarily involves the head and neck region, presenting as deep subcutaneous masses and is often accompanied by regional lymphadenopathy and salivary gland involvement. Peripheral blood eosinophilia and elevated serum immunoglobulin E (IgE levels are characteristic features and the microscopic picture reveals lymphoid proliferation with eosinophilic infiltration. For years, Kimura′s disease was believed to be identical to or part of the same disease spectrum as angiolymphoid hyperplasia with eosinophilia (ALHE. Recent reports, however, have confirmed that the two are, in fact, separate entities. We report a case of Kimura′s disease in a 22-year-old Indian male who presented with a subcutaneous mass, parotid enlargement and lymphadenopathy. The clinical presentation was suggestive of Kimura′s disease and microscopic examination following biopsy of the lesion allowed us to make a definitive diagnosis.

  4. School Refusal (United States)

    Wimmer, Mary


    School attendance is an ongoing concern for administrators, particularly in middle level and high school. Frequent absences affect student learning, test scores, and social development. Absenteeism is often the result of emotional disorders, such as anxiety or depression. Administrators who understand the causes of school refusal behavior and are…

  5. Medullary and papillary carcinoma of the thyroid gland occurring as a collision tumor with lymph node metastasis: A case report

    Directory of Open Access Journals (Sweden)

    Sadat Alavi Mehr


    Full Text Available Abstract Introduction Papillary thyroid carcinoma and medullary thyroid carcinoma are two different thyroid neoplasia. The simultaneous occurrence of medullary thyroid carcinoma and papillary thyroid carcinoma as a collison tumor with metastases from both lesions in the regional lymph nodes is a rare phenomenon. Case presentation A 32-year-old Iranian man presented with a fixed anterior neck mass. Ultrasonography revealed two separate thyroid nodules as well as a suspicious neck mass that appeared to be a metastatic lesion. The results of thyroid function tests were normal, but the preoperative calcitonin serum value was elevated. Our patient underwent a total thyroidectomy with neck exploration. Two separate and ill-defined solid lesions grossly in the right lobe were noticed. Histological and immunohistochemical studies of these lesions suggested the presence of medullary thyroid carcinoma and papillary thyroid carcinoma. The lymph nodes isolated from a neck dissection specimen showed metastases from both lesions. Conclusions The concomitant occurrence of papillary thyroid carcinoma and medullary thyroid carcinoma and the exact diagnosis of this uncommon event are important. The treatment strategy should be reconsidered in such cases, and genetic screening to exclude multiple endocrine neoplasia 2 syndromes should be performed. For papillary thyroid carcinoma, radioiodine therapy and thyroid-stimulating hormone suppressive therapy are performed. However, the treatment of medullary thyroid carcinoma is mostly radical surgery with no effective adjuvant therapy.

  6. Parathyroid glands are differentiated from lymph node by activated-carbon particles%纳米碳在鉴别甲状腺周围淋巴结和甲状旁腺中的作用

    Institute of Scientific and Technical Information of China (English)

    王晓雷; 吴跃煌; 徐震纲; 倪松; 刘杰


    Objective To probe into an new methods preserving parathyroid gland of patients with thyroid carcinoma. Methods Thirty-six patients with thyroid carcinoma that primary treated were random divided into two groups:trial group and control group. Emulsion of activated-carbon particles was injected into the thyroid gland of trial group patients. After thirty minutes, central compartment dissection was performed in the all patients. The black stained tissue in the dissection specimen of trial group was separated. Total lymph node, metastasis lymph node and parathyroid gland in the black stained tissue, and non-black stained tissue in the central compartment dissection specimen of trial group and central compartment dissection specimen of control group were counted respectively. Results Nineteen and twenty central compartment dissection was performed in trial group and control group respectively. There are 177 lymph nodes included 83 metastasis lymph nodes in the black-stained tissue of central compartment dissection specimen of trial group. No parathyroid gland was found in the black-stained tissue. Nine lymph nodes included 2 metastasis lymph nodes and 7 parathyroid glands were found in the non-black stained tissue of central compartment dissection specimen of trial group. There were 124 lymph nodes included 80 metastasis lymph nodes and 8 parathyroid glands in central compartment dissection specimen of control group. There are statistic difference between the amount of lymph node in black stain tissue and that of control group (t=0.340, P=0.003). Rate of staining lymph node were 95.2 percent. Conclusions Lymph node of Ⅵ group can be stained black by activated carbon particles, and parathyroid gland cannot be stained black. Maybe, parathyroid gland can be preserved by removing the black stain lymph node and retaining the non-black stained tissue.%目的 探讨保留甲状旁腺的新方法.方法 36例初治甲状腺癌的患者随机分为试验组和对照组.试

  7. Administration of probiotics Lactobacillus rhamnosus GG and Lactobacillus gasseri K7 during pregnancy and lactation changes mouse mesenteric lymph nodes and mammary gland microbiota. (United States)

    Treven, P; Mrak, V; Bogovič Matijašić, B; Horvat, S; Rogelj, I


    The milk and mammary gland (MG) microbiome can be influenced by several factors, such as mode of delivery, breastfeeding, maternal lifestyle, health status, and diet. An increasing number of studies show a variety of positive effects of consumption of probiotics during pregnancy and breastfeeding on the mother and the newborn. The aim of this study was to investigate the effect of oral administration of probiotics Lactobacillus gasseri K7 (LK7) and Lactobacillus rhamnosus GG (LGG) during pregnancy and lactation on microbiota of the mouse mesenteric lymph nodes (MLN), MG, and milk. Pregnant FVB/N mice were fed skim milk or probiotics LGG or LK7 resuspended in skim milk during gestation and lactation. On d 3 and 8 postpartum, blood, feces, MLN, MG, and milk were analyzed for the presence of LGG or LK7. The effects of probiotics on MLN, MG, and milk microbiota was evaluated by real-time PCR and by 16S ribosomal DNA 454-pyrosequencing. In 5 of 8 fecal samples from the LGG group and in 5 of 8 fecal samples from the LK7 group, more than 1 × 10(3) of live LGG or LK7 bacterial cells were detected, respectively, whereas no viable LGG or LK7 cells were detected in the control group. Live lactic acid bacteria but no LGG or LK7 were detected in blood, MLN, and MG. Both probiotics significantly increased the total bacterial load as assessed by copies of 16S ribosomal DNA in MLN, and a similar trend was observed in MG. Metagenomic sequencing revealed that both probiotics increased the abundance of Firmicutes in MG, especially the abundance of lactic acid bacteria. The Lactobacillus genus appeared exclusively in MG from probiotic groups. Both probiotics influenced MLN microbiota by decreasing diversity (Chao1) and increasing the distribution of species (Shannon index). The LGG probiotic also affected the MG microbiota as it increased diversity and distribution of species and proportions of the genera Lactobacillus and Bifidobacterium. These results provide evidence that

  8. Histological changes in hilar lymph glands in relation to coal workers` progressive massive fibrosis and lung coal and quartz contents. Evidence in support of the `central` hypothesis

    Energy Technology Data Exchange (ETDEWEB)

    Leigh, J.; Todorovic, M.; Driscoll, T. [National Institute of Occupational Health and Safety, Sydney, NSW (Australia)


    The pathogenesis of progressive massive fibrosis (PMF) in coal workers is still not fully understood. Principal mechanisms include total dust load, quartz and rheumatoid diathesis. Recently, Seal et al. proposed a further possible mechanism whereby dust and necrotic material in central (hilar) lymph nodes is released into bronchi or vessels (or both) by rupture of the node capsule and erosion through bronchial or vessel walls and then transported to the lung parenchyma where it may act as a `seed` for PMF development. Seal et al. found a statistically significant association between severity of central lymph node pathology grade and presence of PMF lesions {gt} 5 cm diameter and that lungs having smaller areas of PMF also had capsular rupture of central lymph nodes. In an earlier report, where the authors studied only lungs with PMF, no association could be found between the magnitude of PMF and the severity of central lymph node changes. The authors have now extended this study to a larger series of post mortem coal workers` lungs, with and without PMF, and have examined lymph node pathology, PMF lesions and, in a subset, have also analysed lung coal and quartz content. Studies were undertaken on pulmonary tissue from deceased New South Wales coal workers. 6 refs.

  9. Incidental findings of the kidneys, adrenal glands, adnexa uteri, gastrointestinal tract, mesentery and lymph nodes. Assessment and management recommendations; Zufallsbefunde von Niere, Nebenniere, Adnexen, Gastrointestinaltrakt, Mesenterium und Lymphknoten. Bewertung und Managementempfehlung

    Energy Technology Data Exchange (ETDEWEB)

    Scharitzer, M.; Tamandl, D.; Ba-Ssalamah, A. [Medizinische Universitaet Wien, Universitaetsklinik fuer Radiologie und Nuklearmedizin, Wien (Austria)


    Besides the upper abdominal parenchymal organs, the increasing application of cross-sectional imaging has also led to a rising number of incidental findings in the kidneys, adrenal glands, adnexa uteri, the gastrointestinal tract, mesentery and abdominal lymph nodes. Abdominal computed tomography investigations often show unexpected findings without any correlating symptoms. The growing clinical relevance is due to the large number of incidental findings as well as an increasing awareness of ethical and socioeconomic factors. When interpreting radiological findings not only morphological criteria but also individual risk factors of the patient and the clinical context are of great importance. The aims of this article are the description and evaluation of frequent incidental findings detected by computed tomography and to provide information about management recommendations. (orig.) [German] Neben den parenchymatoesen Oberbauchorganen hat der zunehmende Einsatz von Schnittbildverfahren zu einer vermehrten Anzahl von Zufallsbefunden der Nieren, Nebennieren, Adnexe, des Gastrointestinaltrakts, Mesenteriums und der intraabdominellen Lymphknoten gefuehrt. Abdominelle CT-Untersuchungen zeigen haeufig unerwartete Befunde ohne korrelierende Symptomatik. Die steigende klinische Relevanz ist einerseits auf die Zunahme inzidenteller Pathologien und andererseits auf ein wachsendes Bewusstsein ethischer und soziooekonomischer Faktoren zurueckzufuehren. Bei der radiologischen Interpretation sind neben morphologischen Kriterien sowohl die Einbeziehung der individuellen Risikofaktoren des Patienten als auch der klinische Gesamtkontext von grosser Bedeutung. Das Ziel dieses Artikels ist eine Beschreibung und Bewertung der in der Computertomographie detektierten genannten Zufallsbefunde sowie weiterer Managementempfehlungen. (orig.)

  10. Lymph system (United States)

    Lymphatic system ... neck, under the arms, and groin. The lymph system includes the: Tonsils Adenoids Spleen Thymus ... JE, Flynn JA, Solomon BS, Stewart RW. Lymphatic system. In: Ball JW, Dains JE, Flynn JA, Solomon ...

  11. Refusal to medical interventions. (United States)

    Palacios, G; Herreros, B; Pacho, E


    Refusal to medical interventions is the not acceptance, voluntary and free, of an indicated medical intervention. What the physician should do in case of refusal? It is understandable that the rejection of a validated medical intervention is difficult to accept by the responsible physician when raises the conflict protection of life versus freedom of choice. Therefore it is important to follow some steps to incorporate the most relevant aspects of the conflict. These steps include: 1) Give complete information to patients, informing on possible alternatives, 2) determine whether the patient can decide (age, competency and level of capacity), 3) to ascertain whether the decision is free, 4) analyze the decision with the patient, 5) to persuade, 6) if the patient kept in the rejection decision, consider conscientious objection, 7) take the decision based on the named criteria, 8) finally, if the rejection is accepted, offer available alternatives. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  12. Sentinel Lymph Node Biopsy (United States)

    ... Ask about Your Diagnosis Research Sentinel Lymph Node Biopsy On This Page What are lymph nodes? What ... lymph node? What is a sentinel lymph node biopsy? What happens during an SLNB? What are the ...

  13. Lymph node biopsy (United States)

    Biopsy - lymph nodes; Open lymph node biopsy; Fine needle aspiration biopsy; Sentinel lymph node biopsy ... A lymph node biopsy is done in an operating room in a hospital. Or, it is done at an outpatient surgical center. The ...

  14. Refusing What We Are

    DEFF Research Database (Denmark)

    McIlvenny, Paul

    In an interview, Michel Foucault (1983: 336) said that the target today perhaps “is not to discover what we are but to refuse what we are… to promote new forms of subjectivity”. Protest actions by a range of new social movements have been studied extensively, but few studies have focused...... on the communicative practices and mediated actions in which new identities and forms of subjectivity are discursively produced, contingently achieved and made visible in situ. This paper investigates what Foucault called ‘counter-conducts’, practices in which alternative modes of subjectivation and of being governed...

  15. 甲状腺癌术中淋巴示踪剂应用对于甲状旁腺保护作用的研究%Protective effect of lymphatic tracer on parathyroid glands in lymph node dissection in thyroid carcinoma

    Institute of Scientific and Technical Information of China (English)

    曾玉剑; 钱军; 程若川; 马云海; 刘霜


    目的 研究纳米炭淋巴示踪剂的应用在甲状腺癌淋巴结清扫时对于甲状旁腺的保护价值.方法 80例甲状腺癌患者随机平均分为常规组和纳米炭组,比较两组中央区淋巴结脂肪组织中误切的甲状旁腺检获情况及术后血钙、甲状旁腺素(PTH)改变的情况.结果 80 例患者全部由同组手术者施行甲状腺全切和中央区淋巴结清扫术或甲状腺全切和改良式颈部淋巴结清扫术;其中常规组误切甲状旁腺11枚,纳米炭组没有甲状旁腺误切.两组都没有永久性低钙血症及PTH降低.一过性低钙血症症状发生常规组为14例,纳米炭组为1例.PTH暂时性减低的发生常规组为18例,纳米炭组为3例.结论 甲状腺和甲状旁腺的淋巴引流无交通现象.纳米炭的应用有助于将甲状旁腺组织与甲状腺组织及淋巴脂肪组织区分开来,极大地降低了甲状腺癌淋巴清扫术中甲状旁腺的损伤概率.%Objective To evaluate the protective effect of lymphatic tracer on parathyroid glands in lymph node dissection in thyroid carcinoma .Methods Eighty patients with thyroid carcinoma were randomly divided into the routine method group and carbon nanoparticle group .Parathyroid glands in adipose tissue dissected ,blood calcium ,and PTH of two groups were contrasted and analyzed .Results All 80 cases underwent total thyroidectomy and lymph node dissection performed by a same team .11 parathyroid glands were examined in routine method group ^while none in carbon nanoparticle group .Jnone permanent hypocalcemia and PT H were observed in both groups .There were 14 cases with temple hypocalcemia and 18 cases with temple PTH decrease respectively in routine method group ,and there were 1 and 3 cases respectively in carbon nanoparticle group .Conclusion There is no lymph communication between thyroid gland and parathyroid gland .Application of nanoparticle in lymph node dissection in thyroid carcinoma can separate parathyroid

  16. Canine mammary gland tumors. (United States)

    Sorenmo, Karin


    The National Consensus Group recommends that all women with tumors larger than 1 cm be offered chemotherapy regardless of tumor histology of lymph node status. This recommendation is to ensure that everyone at risk for failing, even though the risk may be low in women with relatively small tumors and favorable histology, has a choice and receives the benefit of adjuvant chemotherapy. This type of treatment recommendation may also be made in dogs based on recognized, well-accepted prognostic factors such as tumor size, stage, type, and histologic differentiation. Based on the limited clinical information available in veterinary medicine, the drugs that are effective in human breast cancer, such as cyclophosphamide, 5-fluorouracil, and doxorubicin, may also have a role in the treatment of malignant mammary gland tumors in dogs. Randomized prospective studies are needed, however, to evaluate the efficacy of chemotherapy in dogs with high-risk mammary gland tumors and to determine which drugs and protocols are the most efficacious. Until such studies are performed, the treatment of canine mammary gland tumors will be based on the individual oncologist's understanding of tumor biology, experience, interpretation of the available studies, and a little bit of gut-feeling. Table 2 is a proposal for treatment guidelines for malignant canine mammary gland tumors according to established prognostic factors, results from published veterinary studies, and current recommendations for breast cancer treatment in women.

  17. Endocrine glands (United States)

    ... Diabetes Gigantism Diabetes insipidus Cushing Disease Watch this video about: Pituitary gland Testes and ovaries: Lack of sex development (unclear genitalia) Thyroid: Congenital hypothyroidism Myxedema Goiter ...

  18. Recovery methods in municipal refuse management

    Energy Technology Data Exchange (ETDEWEB)

    Affholder, M.; Gony, J.N.; Colardeau, J.


    Various refuse screening tecniques and methods for organizing selective collection of paper, cardboard, and glass are described. Recovery of incinerated refuse developed by USBM and the French Bureau of Geological and Mining Research is detailed. The economics of municipal refuse recovery methods are examined. The sale of recovered material is explored.

  19. Blood and Lymph Diseases (United States)

    ... and Disease [Internet]. Bethesda (MD): National Center for Biotechnology Information (US); 1998-. Blood and Lymph Diseases. PDF version of this page ( ... On Blood and Lymph Diseases - Genes and Disease Blood and Lymph Diseases - Genes and Disease Your browsing ... Biotechnology Information , U.S. National Library of Medicine 8600 Rockville ...

  20. School Refusal: Clinical Features, Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Kayhan Bahali


    Full Text Available Children regularly and voluntarily go to school in order to fulfill the expectations of society from them to continue their education or schooling. School continuation has been made compulsory by laws. Nonetheless, contrary to popular belief, for some children it is distressing to go to school. These children have difficulty continuing school and/or refuse to go to school. Today school refusal is defined as a child’s inability to continue school for reasons, such as anxiety and depression. The prevalence of school refusal has been reported to be approximately 1% in school-age children and 5% in child psychiatry samples. The prevalence of school refusal is similar among boys and girls. School refusal can occur at any time throughout the child’s academic life and at all socio-economic levels. School refusal is considered a symptom rather than a clinical diagnosis and can manifest itself as a sign of many psychiatric disorders, with anxiety disorders predominant. Separation anxiety disorder, generalized anxiety disorder, social phobia, specific phobia, and adjustment disorder with anxiety symptoms are the most common disorders co-occurring with school refusal. While separation anxiety disorder is associated with school refusal in younger children, other anxiety disorders, especially phobias, are associated with school refusal in adolescents. Children who have parents with psychiatric disorders have a higher incidence of school refusal, and psychiatric disorders are more frequently seen in adult relatives of children with school refusal, which supports a significant role of genetic and environmental factors in th etiology of school refusal. School refusal is a emergency state for child mental health. As it leads to detrimental effects in the short term and the long term, it should be regarded as a serious problem. The long-lasting follow-up studies of school refusing children have revealed that these children have a higher incidence of

  1. [Refuse disposal at the hospital]. (United States)

    Knoll, K H


    For the classification of hospital-wastes in the categories infectious-contaminate or special waste are only significant views of the prevention by nosocomial infection in the hospital. Solely infectious waste become removed hospital-intern and -extern on conditions of hygienic prevention, namely through secure packing during the transport, combustion or desinfection. Special wastes to be defeated by special-conditions. The hygienist of the hospital is only competent for the classification of the wastes in the hospital as well as for their refuse.

  2. Intramammary lymph nodes. (United States)

    Egan, R L; McSweeney, M B


    Radiographic, gross, and histopathologic studies on 158 whole breasts with primary operable carcinoma revealed intramammary lymph nodes in 28%, and of these breasts, 10% contained a metastatic deposit of carcinoma. Cancerous and noncancerous nodes were found in all quadrants of the breast with the positive ones being in the same quadrant as the carcinoma only 50% of the time. There was no demonstrable connection with the usual lymphatic drainage of the breast. With Stage II carcinoma, positive intramammary lymph nodes had no direct effect on prognosis, merely representing advanced disease and indicating a greater likelihood of axillary metastatic disease. There was a trend toward poorer prognosis in Stage I lesions with positive intramammary lymph nodes. This may indicate the Stage I carcinomas that have a similar prognosis as Stage II tumors. Conceivably, a Stage Ia, positive intramammary lymph node(s) but normal axillary lymph nodes, could be defined and used.

  3. Myeloid sarcoma of submandibular salivary gland

    Directory of Open Access Journals (Sweden)

    Federico Dagna


    Full Text Available Objective: To report a rare case of a myeloid sarcoma of submandibular salivary gland. Methods: A 65-year-old woman with a history of successfully treated myelodysplastic syndrome, presenting with periodic painful swelling of her right submandibular area. Results: Physical evaluation, ultrasound and CT scan revealed the presence of a 3-cm mass contiguous to the submandibular salivary gland. A core needle biopsy confirmed the diagnosis of myeloid sarcoma. Bone marrow biopsy was still showing complete remission and the submandibular gland was the only extramedullary site involved. The patient was submitted to chemotherapy. Conclusion: Myeloid sarcoma is a rare extramedullary neoplasm. It can virtually involve any anatomic site, but it usually involves lymph nodes, paranasal sinuses, skin, soft tissue and periostium. Myeloid sarcomas of salivary glands are very rare and ENTs should be aware of this disease in order to include it in the differential diagnosis of a solitary neck mass.


    Directory of Open Access Journals (Sweden)

    Pomar-Blanco P


    Full Text Available Lymphoepitheliomas are malignant tumours with a characteristic histological growth pattern, mixing undifferentiated epithelial cells and a predominant T cell lymphoid infiltrate. Nasopharynx is the main site for this lesion but also can affect salivary glands, so is named lymphoepithelioma-like carcinoma (LELC. These are aggressive tumours and they could metastasize into the lymph neck nodes, bones, lung and liver. The treatment for these tumours is the surgery over the parotid gland, homolateral neck nodes dissection and postoperative radiotherapy. The prognosis is determined by distant metastases, related with advanced neck node disease.We report a case of a patient diagnosed of a salivary gland lymphoepithelioma, which consults for located mass into the parotid gland, with almost three years evolution.

  5. Personal values and cancer treatment refusal

    NARCIS (Netherlands)

    Huijer, Marli; Leeuwen, Evert van


    This pilot study explores the reasons patients have for refusing chemotherapy, and the ways oncologists respond to them. Our hypothesis, generated from interviews with patients and oncologists, is that an ethical approach that views a refusal as an autonomous choice, in which patients are informed a

  6. Swollen lymph nodes (United States)

    ... gingivitis ) Mononucleosis Mouth sores Sexually transmitted illness (STI) Tonsillitis Tuberculosis Skin infections Immune or autoimmune disorders that ... goes away in a couple of days, without treatment. The lymph node may not return to its ...

  7. Lymph node culture (United States)

    Culture - lymph node ... or viruses grow. This process is called a culture. Sometimes, special stains are also used to identify specific cells or microorganisms before culture results are available. If needle aspiration does not ...

  8. The Legal Ethical Backbone of Conscientious Refusal. (United States)

    Munthe, Christian; Nielsen, Morten Ebbe Juul


    This article analyzes the idea of a legal right to conscientious refusal for healthcare professionals from a basic legal ethical standpoint, using refusal to perform tasks related to legal abortion (in cases of voluntary employment) as a case in point. The idea of a legal right to conscientious refusal is distinguished from ideas regarding moral rights or reasons related to conscientious refusal, and none of the latter are found to support the notion of a legal right. Reasons for allowing some sort of room for conscientious refusal for healthcare professionals based on the importance of cultural identity and the fostering of a critical atmosphere might provide some support, if no countervailing factors apply. One such factor is that a legal right to healthcare professionals' conscientious refusal must comply with basic legal ethical tenets regarding the rule of law and equal treatment, and this requirement is found to create serious problems for those wishing to defend the idea under consideration. We conclude that the notion of a legal right to conscientious refusal for any profession is either fundamentally incompatible with elementary legal ethical requirements, or implausible because it undermines the functioning of a related professional sector (healthcare) or even of society as a whole.

  9. Legal briefing: conscience clauses and conscientious refusal. (United States)

    Pope, Thaddeus Mason


    This issue's "Legal Briefing" column covers legal developments pertaining to conscience clauses and conscientious refusal. Not only has this topic been the subject of recent articles in this journal, but it has also been the subject of numerous public and professional discussions. Over the past several months, conscientious refusal disputes have had an unusually high profile not only in courthouses, but also in legislative and regulatory halls across the United States. Healthcare providers' own moral beliefs have been obstructing and are expected to increasingly obstruct patients' access to medical services. For example, some providers, on ethical or moral grounds, have denied: (1) sterilization procedures to pregnant patients, (2) pain medications in end-of-life situations, and (3) information about emergency contraception to rape victims. On the other hand, many healthcare providers have been forced to provide medical treatment that is inconsistent with their moral beliefs. There are two fundamental types of conscientious objection laws. First, there are laws that permit healthcare workers to refuse providing - on ethical, moral, or religious grounds healthcare services that they might otherwise have a legal or employer-mandated obligation to provide. Second, there are laws directed at forcing healthcare workers to provide services to which they might have ethical, moral, or religious objections. Both types of laws are rarely comprehensive, but instead target: (1) certain types of healthcare providers, (2) specific categories of healthcare services, (3) specific patient circumstances, and (4) certain conditions under which a right or obligation is triggered. For the sake of clarity, I have grouped recent legal developments concerning conscientious refusal into eight categories: 1. Abortion: right to refuse 2. Abortion: duty to provide 3. Contraception: right to refuse 4. Contraception: duty to provide 5. Sterilization: right to refuse 6. Fertility, HIV, vaccines

  10. The Legal Ethical Backbone of Conscientious Refusal

    DEFF Research Database (Denmark)

    Munthe, Christian; Nielsen, Morten Ebbe Juul


    This article analyzes the idea of a legal right to conscientious refusal for healthcare professionals from a basic legal ethical standpoint, using refusal to perform tasks related to legal abortion (in cases of voluntary employment) as a case in point. The idea of a legal right to conscientious...... identity and the fostering of a critical atmosphere might provide some support, if no countervailing factors apply. One such factor is that a legal right to healthcare professionals’ conscientious refusal must comply with basic legal ethical tenets regarding the rule of law and equal treatment...

  11. Reclamation of acid coal refuse

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, F.J.; Chong, S.K. (Southern Illinois Univ., Carbondale, IL (USA))


    Slurry (coal refuse), which contains pyritic materials, produces sulfuric acid when wetted and oxidized. The acidity, together with droughtiness and high surface temperatures, create a complex problem for revegetation. Four grasses, orchardgrass (Dactylis glomerata L.), redtop (Agrostis alba L.), reed canarygrass (Phalaris arundinacea L.) and tall fescue (Festuca arundinacea Shreb.), were planted on an acid slurry site at Captain Mine, Arch of Illinois Inc., Perry County, IL, USA, to evaluate the effects of soil amendments. Organic material from composted garbage (0, 112, 224 and 336 Mg/ha), limestone (0, 45, 90 and 135 Mg/ha) and a mixture of organic material and limestone (56/22.5, 112/45 and 168/67.5 Mg/ha) were incorporated into the slurry. All the grasses established succesfully and persisted best on treatments involving the addition of limestone. Tall fescue and reed canarygrass were the grasses best suited for the revegetation of the acid slurry impoundments. The grasses did not accumulate heavy metals to levels considered potentially toxic to livestock. The application of limestone with or without organic material appears to be a possible alternative method for revegetating acid slurry without the addition of a soil cover. 6 tabs., 12 refs.

  12. Ethical considerations of refusing nutrition after stroke. (United States)

    Sandman, Lars; Agren Bolmsjö, Ingrid; Westergren, Albert


    The aim of this article is to analyse and discuss the ethically problematic conflict raised by patients with stroke who refuse nutritional treatment. In analysing this conflict, the focus is on four different aspects: (1) Is nutritional treatment biologically necessary? (2) If necessary, is the reason for refusal a functional disability, lack of appetite or motivation, misunderstanding of the situation or a genuine conflict of values? (3) If the latter, what values are involved in the conflict? (4) How should we deal with the different kinds of refusal of nutritional treatment? We argue that patients' autonomy should be respected as far as possible, while also considering that those who have suffered a stroke might re-evaluate their life as a result of a beneficial prognosis. However, if patients persist with their refusal, health care professionals should force nutritional treatment only when it is clear that the patients will re-evaluate their future life.

  13. Thymus Gland Anatomy (United States)

    ... historical Searches are case-insensitive Thymus Gland, Adult, Anatomy Add to My Pictures View /Download : Small: 720x576 ... Large: 3000x2400 View Download Title: Thymus Gland, Adult, Anatomy Description: Anatomy of the thymus gland; drawing shows ...

  14. Salivary Gland Cancer Treatment (United States)

    ... and Oropharyngeal Cancer Screening Research Salivary Gland Cancer Treatment (PDQ®)–Patient Version General Information About Salivary Gland ... in diagnosing salivary gland cancer. Certain factors affect treatment options and prognosis (chance of recovery). The treatment ...

  15. Adrenal Gland Tumors: Statistics (United States)

    ... Gland Tumor: Statistics Request Permissions Adrenal Gland Tumor: Statistics Approved by the Cancer.Net Editorial Board , 03/ ... primary adrenal gland tumor is very uncommon. Exact statistics are not available for this type of tumor ...

  16. 30 CFR 77.215-4 - Refuse piles; abandonment. (United States)


    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Refuse piles; abandonment. 77.215-4 Section 77... MINES Surface Installations § 77.215-4 Refuse piles; abandonment. When a refuse pile is to be abandoned... refuse pile shall be abandoned in accordance with a plan submitted by the operator and approved by...

  17. Degradation of Refuse in Hybrid Bioreactor Landfill

    Institute of Scientific and Technical Information of China (English)



    Objectivess To explore the process of refuse decomposition in hybrid bioreactor landfill. Methods The bioreactor landfill was operated in sequencing of facultative-anaerobic and aerobic conditions with leachate recireulation, pH, COD, and ammonia in the leachate and pH, biodegradable organic matter (BDM), and cation exchange capacity (CEC) in refuse were detected. Results CEC increased gradually with the degradation of refuse, which was negatively correlad, With BDM. COD and ammonia in the leachate was declined to 399.2 mg L-1 and 20.6 mg N L-1, respectively, during the 357-day operation. The respective concentrations of ammonia and COD were below the second and the third levels of current discharge standards in China. Conclusion The refuse is relatively stable at the end of hybrid bioreactor landfill operation. Most of the readily biodegradable organic matter is mineralized in the initial phase of refuse degradation, whereas the hard-biodegradable organic matter is mainly humidified in the maturity phase of refuse degradation.

  18. Parathyroid gland removal (United States)

    Removal of parathyroid gland; Parathyroidectomy; Hyperparathyroidism - parathyroidectomy; PTH - parathyroidectomy ... and pain-free) for this surgery. Usually the parathyroid glands are removed using a 2- to 4-inch ( ...

  19. Salivary duct carcinoma of the parotid gland

    Directory of Open Access Journals (Sweden)

    Mona Mlika


    Full Text Available Salivary duct carcinoma of the parotid gland is an uncommon tumor, highly aggressive. About 200 cases have been reported in the English literature. Pathomorphologically, these tumors showed great similarities to ductal carcinoma of the female breast, which is why they described this tumor as "salivary duct carcinoma." The authors describe a new case of salivary duct carcinoma of the parotid gland. We present the case of a 50-year-old patient with progressive facial paralysis. The MRI examination of the head showed two ill-defined formations. A malignant tumor was strongly suspected, so that a total left parotidectomy with excision of the adjacent facial nerve and left lymph node dissection was performed. Microscopic examination concluded to a salivary duct carcinoma of the left parotid gland negative with Her2/neu antibody with lymph node metastasis. There were no recurrences or metastases within 3 years of follow-up. Salivary duct carcinoma of the parotid gland is a rare tumor with an aggressive behavior. This is due to its propensity to infiltrate distant organs. The diagnosis is based on microscopic examination. Treatment modalities are non-consensual, but some authors advocate the necessity of aggressive approach, especially in tumors negative with Heur2/neu antibody. This is due to the fact that the overexpression of this antigen was reported to be associated with a poor prognosis.

  20. Disorders of lymph flow. (United States)

    Witte, C L; Witte, M H


    Disturbances in blood capillary exchange of fluid, macromolecules, and cells across intact and abnormal microvessels and deranged lymphatic transport are integral, interacting components in disorders of tissue swelling. Lymphedema or low-output failure of the lymph circulation is often indolent for many years before lymphatic insufficiency (failure) and tissue swelling emerge and persist. Superimposed occult or overt infection (lymphangitis) are probably major contributors to progressive limb deformity (elephantiasis). Long-standing lymphedema is characterized by trapping in the skin and subcutaneous tissue of fluid, extravasated plasma proteins, and other macromolecules: impaired immune cell trafficking; abnormal processing of autologous and foreign antigens; heightened susceptibility to superimposed infection; local immunodysregulation; defective lymphatic (lymphangion) propulsion from an imbalance of mediators regulating vasomotion; soft-tissue overgrowth; scarring and hypertrophy; and exuberant angiogenesis occasionally culminating in vascular tumors (Fig. 8). In contrast to the blood circulation, where flow depends primarily on the propulsive force of the myocardium, lymph propulsion depends predominately on intrinsic truncal contraction, a phylogenetic vestige of amphibian lymph hearts. Whereas venous "plasma" flows rapidly (2-3 l/min) against low vascular resistance, lymph flows slowly (1-2 ml/min) against high vascular resistance. On occasion, impaired transport of intestinal lymph may be associated with reflux and accumulation and leakage of intestinal chyle in a swollen leg. Although the term "lymphedema" is usually reserved for extremity swelling, the pathogenesis of a wide variety of visceral disorders also may be traceable to defective tissue fluid and macromolecular circulation and impaired cell trafficking of lymphocytes and macrophages. Thus, lymph stasis, with impaired tissue fluid flow, underlies or complicates an indolent subclinical course with

  1. Mistakes in ultrasound examination of salivary glands (United States)

    Jakubowski, Wiesław


    Ultrasonography is the first imaging method applied in the case of diseases of the salivary glands. The article discusses basic mistakes that can be made during an ultrasound examination of these structures. The reasons for these mistakes may be examiner-dependent or may be beyond their control. The latter may include, inter alia, difficult conditions during examination (technical or patient-related), similarity of ultrasound images in different diseases, the lack of clinical and laboratory data as well as the lack of results of other examinations, their insufficient number or incorrectness. Doctor-related mistakes include: the lack of knowledge of normal anatomy, characteristics of ultrasound images in various salivary gland diseases and statistical incidence of diseases, but also attaching excessive importance to such statistical data. The complex anatomical structures of the floor of the oral cavity may be mistaken for benign or malignant tumors. Fragments of correct anatomical structures (bones, arterial wall fibrosis, air bubbles in the mouth) can be wrongly interpreted as deposits in the salivary gland or in its excretory duct. Correct lymph nodes in the parotid glands may be treated as pathologic structures. Lesions not being a simple cyst, e.g. lymphoma, benign or malignant tumors of the salivary glands or metastatic lymph nodes, can be mistaken for one. The image of disseminated focal changes, both anechoic and solid, is not pathognomonic for specific diseases in the salivary glands. However, in part, it occurs typically and requires an extended differential diagnosis. Small focal changes and infiltrative lesions pose a diagnostic problem because their etiology cannot be safely suggested on the basis of an ultrasound examination itself. The safest approach is to refer patients with abnormal focal changes for an ultrasoundguided fine-needle aspiration biopsy. PMID:27446603

  2. Mistakes in ultrasound examination of salivary glands

    Directory of Open Access Journals (Sweden)

    Ewa J. Białek


    Full Text Available Ultrasonography is the first imaging method applied in the case of diseases of the salivary glands. The article discusses basic mistakes that can be made during an ultrasound examination of these structures. The reasons for these mistakes may be examiner-dependent or may be beyond their control. The latter may include, inter alia, difficult conditions during examination (technical or patient-related, similarity of ultrasound images in different diseases, the lack of clinical and laboratory data as well as the lack of results of other examinations, their insufficient number or incorrectness. Doctor-related mistakes include: the lack of knowledge of normal anatomy, characteristics of ultrasound images in various salivary gland diseases and statistical incidence of diseases, but also attaching excessive importance to such statistical data. The complex anatomical structures of the floor of the oral cavity may be mistaken for benign or malignant tumors. Fragments of correct anatomical structures (bones, arterial wall fibrosis, air bubbles in the mouth can be wrongly interpreted as deposits in the salivary gland or in its excretory duct. Correct lymph nodes in the parotid glands may be treated as pathologic structures. Lesions not being a simple cyst, e.g. lymphoma, benign or malignant tumors of the salivary glands or metastatic lymph nodes, can be mistaken for one. The image of disseminated focal changes, both anechoic and solid, is not pathognomonic for specific diseases in the salivary glands. However, in part, it occurs typically and requires an extended differential diagnosis. Small focal changes and infiltrative lesions pose a diagnostic problem because their etiology cannot be safely suggested on the basis of an ultrasound examination itself. The safest approach is to refer patients with abnormal focal changes for an ultrasoundguided fine-needle aspiration biopsy.

  3. Cubicle Refusal in Norwegian Dairy Herds

    Directory of Open Access Journals (Sweden)

    Myren HJ


    Full Text Available In order to survey the behaviour of choosing the alley area instead of a cubicle as a lying place (cubicle refusal, a questionnaire was sent to the 273 dairy farms in Norway known to keep cows in cubicle housing systems. Sixty-six percent of the farmers contacted were included in the study. The median herd size was 18 cows (range 7–118. More than 85% of the herds had sheds providing one or more cubicles per cow. The mean herd occurrence of cubicle refusal was 6%, but showed great variation (range 0–55%. Regression analysis showed a significant association between rearing heifers in slatted floor pens and an increased cubicle refusal occurrence (p = 0.02, R2 = 0.05, while herd size, use of litter, or cubicle-to-animal ratio were not found to be associated with cubicle refusal. The practice of rearing heifers in slatted floor pens accounted for about one half of the observed cubicle refusal (etiologic fraction = 0.51.

  4. Refusal Strategies Among Omani EFL Students

    Directory of Open Access Journals (Sweden)

    Rahma Al-Mahrooqi


    Full Text Available The main objective of this study was to investigate the refusal speech act among Omani EFL college students. It examined how they refused in various situations and whether their responses were appropriate in terms of culture and accurate in terms of language. Forty-one English as foreign language (EFL learners completed a Discourse Completion Test (DCT consisting of 12 scenarios by supplying written refusals to three requests, three suggestions, three invitations, and three offers. Students’ responses were rated by two professors: one a native English speaker and the other not. A convenient sampling procedure was employed. The findings indicated that students’ responses were largely inappropriate and inaccurate. Further examination showed that they were heavily influenced by the students’ culture, many being mere translations of refusal responses in Omani Arabic. Others were inappropriate because they were too direct, due to students’ lack of knowledge of the role of social status when issuing refusals to a person of high status. Language mistakes were mainly in the sentence structure, which affected the meaning clarity. Findings suggest that, to help students become better communicators in English, it is important to teach them directly the most common speech acts, especially those they might frequently use in their everyday conversations with professors and classmates.

  5. Causes of family refusal for organ donation. (United States)

    Ghorbani, F; Khoddami-Vishteh, H R; Ghobadi, O; Shafaghi, S; Louyeh, A Rostami; Najafizadeh, K


    Family refusal represents a barrier for organ donation together with other cultural and religious factors possible ignorance and clinical obstacles. We performed this retrospective study by phone employing our organ procurement unit database, using a list of families of potential organ donors who had refused organ donation. In 2009, 146 potential organ donor families refused donation. We contacted 81 families. The main reason expressed by there families to justify the refusal to donate the deceased's organs was denial and rejection of brain-death criteria (44.4%). Other causes were believing in a miracle (13.6%); fear about organ trade and unknown organ destination (9.9%); religious beliefs (8.6%); insecutrity about the brain-death diagnosis (6.2%); unstable family mood (6.2%); unknown donor wishes about donation (4.9%); belief in body integrity after death (3.7%); and fear of objection by other family members (2.5%). Our findings showed several reasons for family refusal for organ donation; among the main cause is poor acceptance of brain death. It seems that increasing the knowledge of people about brain death and organizing strategies to confirm brain death for families are necessary to meet the organ shortage. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. Personal values and cancer treatment refusal. (United States)

    Huijer, M; van Leeuwen, E


    This pilot study explores the reasons patients have for refusing chemotherapy, and the ways oncologists respond to them. Our hypothesis, generated from interviews with patients and oncologists, is that an ethical approach that views a refusal as an autonomous choice, in which patients are informed about the pros and cons of treatment and have to decide by weighing them, is not sufficient. A different ethical approach is needed to deal with the various evaluations that play a role in treatment refusal. If patients forgo further treatment, while curative or palliative methods are available, there is no perspective from which to integrate the weighing of pros and cons of treatment and the preferences and values of individual cancer patients. A discrepancy thus results as regards what "good reasons" are, evoking misunderstandings or even breaking off communication. Suggestions are given for follow up research.

  7. Conscientious refusal to assist with abortion. (United States)

    Dooley, D


    Abortion is a moral issue affecting the identity and integrity of physicians and nurses. Ethical reasoning helps reasonable and sincere people who do not agree on abortion to understand the sources of disagreement and to explore shared principles in the differences. Discussions of abortion cannot be limited to the conflict between the rights of a woman to control her reproduction and the rights of a fetus to live. Religious, cultural, feminist, and political beliefs must also be considered. This complexity must be considered when examining whether physicians and nurses have rights to refuse to assist in abortion on conscientious grounds. People with fundamentally different moral outlooks already determine what is morally right or wrong, good or evil. Health professionals who refuse to assist in abortion base their decision on beliefs about moral duties, injunctions of natural law, and the essentially nonnegotiable rights of people to be protected from intentional harm. They know and regret the adverse effects for pregnant women but there is no compelling motivation to change their opposition to abortion. There is no morally neutral position from which to judge conscientious refusals in abortion. Society should develop a position that respects autonomy of belief and grants the right to physicians and nurses to conscientiously refuse to assist in abortions. In those countries where the abortion law grants physicians the right to refuse but not nurses, society needs to reflect on why nurses have been accorded second class professional and moral status. In those countries which have not yet formulated an abortion law, the government should consider how it can find enough health workers who will in good conscience assist in abortions. Governments must first seriously consider a presumptive right to conscientious refusal in abortion before health systems can redistribute sectors of responsibility among health workers and implement changes in recruitment policies for

  8. Thymus in experimental carcinogenesis of the prostate gland. (United States)

    Borodin, Yu I; Lomshakov, A A; Astashov, V V; Kazakov, O V; Mayorov, A P; Larionov, P M


    We studied structural changes in the prostate gland, thymus, and lymph nodes in CBA mice after transplantation of Ehrlich ascites tumor cells into the prostate gland. On experimental day 5, the number of blood and lymph vessels decreased in the gland; the percentage of connective tissue elements and glandular tissue and the number of immunoblasts in the thymus increased. On day 18, the number of blood vessels in the tumor decreased; the width of the cortex and glandular tissue increased in the thymus, while the number of immunoblasts was reduced. On day 28, tumor infiltration and increased number of lymphatic vessels in its stroma were observed; parenchyma was reduced, and the area of the connective tissue increased in the thymus. These structural changes indicated the development of accidental involution of the thymus during carcinogenesis of the prostate.

  9. [Comparative rate of regional metastasis of high differentiated carcinoma of the thyroid gland]. (United States)

    Konstantinova, N N; Evmenova, T D; Drozdova, D É


    The rate of metastasis of high differentiated carcinoma of the thyroid glands to the neck lymph nodes was studied in people of Kemerovo Region. The metastatic lesions of pretracheal lymph nodes (VI group) were detected in 49.5% patients with papillary carcinoma and 21.0% of patients with follicular cancer. Metastases in jungular lymph nodes were revealed in 37.3% patients with papillary carcinoma. It was noted that an extension of metastatic lesions of regional lymph nodes was observed in the case of primary tumour foci spread beyond borders of the capsula glandularis in patients with papillary carcinoma. There wasn't such a relation in a case of follicular cancer. Metastases in regional lymph nodes were detected more often (67.6%) in the case of papillary carcinoma in uncontaminated zone of the thyroid gland compared with other thyroid pathology (31.7%).

  10. Marketization of refuse collection in Denmark

    DEFF Research Database (Denmark)

    Busck, Ole Gunni


      Danish municipalities' outsourcing and contracting of refuse collection are framed by a complex set of ideologies and objectives, besides regulation. Both at EU-level and at national level extreme demands for marketization of the public sector are counter-weighed by demands for social and envir......  Danish municipalities' outsourcing and contracting of refuse collection are framed by a complex set of ideologies and objectives, besides regulation. Both at EU-level and at national level extreme demands for marketization of the public sector are counter-weighed by demands for social...

  11. Effect of Health Education on Refuse Disposal Practices of Women ...

    African Journals Online (AJOL)

    Effect of Health Education on Refuse Disposal Practices of Women in Jos, Plateau State. ... and practices of proper domestic refuse handling and factors affecting same ... Conclusion: Health education intervention was found to be effective in ...

  12. 30 CFR 77.215-3 - Refuse piles: certification. (United States)


    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Refuse piles: certification. 77.215-3 Section... COAL MINES Surface Installations § 77.215-3 Refuse piles: certification. (a) Within 180 days following written notification by the District Manager that a refuse pile can present a hazard, the person...

  13. 30 CFR 77.215-1 - Refuse piles; identification. (United States)


    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Refuse piles; identification. 77.215-1 Section... COAL MINES Surface Installations § 77.215-1 Refuse piles; identification. A permanent identification marker, at least six feet high and showing the refuse pile identification number as assigned by...

  14. 30 CFR 77.214 - Refuse piles; general. (United States)


    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Refuse piles; general. 77.214 Section 77.214... Installations § 77.214 Refuse piles; general. (a) Refuse piles constructed on or after July 1, 1971, shall be..., tipples, or other surface installations and such piles shall not be located over abandoned openings...

  15. 30 CFR 77.215-2 - Refuse piles; reporting requirements. (United States)


    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Refuse piles; reporting requirements. 77.215-2... COAL MINES Surface Installations § 77.215-2 Refuse piles; reporting requirements. (a) The proposed location of a new refuse pile shall be reported to and acknowledged in writing by the District...

  16. 30 CFR 77.215 - Refuse piles; construction requirements. (United States)


    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Refuse piles; construction requirements. 77.215... COAL MINES Surface Installations § 77.215 Refuse piles; construction requirements. (a) Refuse deposited on a pile shall be spread in layers and compacted in such a manner so as to minimize the flow of...

  17. 20 CFR 229.81 - Refusal to accept vocational rehabilitation. (United States)


    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Refusal to accept vocational rehabilitation... Refusal to accept vocational rehabilitation. The DIB O/M is not payable for any month in which the disabled employee refuses, without good reason, to accept vocational rehabilitation services...

  18. 48 CFR 807.304-77 - Right of first refusal. (United States)


    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Right of first refusal... Right of first refusal. (a) In addition to the Right of First Refusal of Employment clause specified in... workers who are adversely affected by the contract award and who are qualified for the jobs the...

  19. Parathyroid glands (image) (United States)

    The 4 parathyroid glands are located near or attached to the back side of the thyroid gland and produce pararthyroid hormone (PTH). Parathyroid hormone regulates calcium, phosphorus, and magnesium balance within ...

  20. Adrenal Gland Cancer (United States)

    ... either benign or malignant. Benign tumors aren't cancer. Malignant ones are. Most adrenal gland tumors are ... and may not require treatment. Malignant adrenal gland cancers are uncommon. Types of tumors include Adrenocortical carcinoma - ...

  1. Oncocytoma of Parotid Gland

    Directory of Open Access Journals (Sweden)

    Meena N. Jadhav


    Full Text Available Oncocytomas of salivary gland are benign tumors composed exclusively of oncocytic cells. Majority of them occur in parotid gland and have excellent prognosis following complete excision. They should be differentiated from other salivary gland tumors with more prominent oncocytic component and nodular oncocytic hyperplasia. Herein we present a case of oncocytoma of parotid gland in a 48 year old male patient who has no recurrence four years after excision.

  2. Maspin and MCM2 immunoprofiling in salivary gland carcinomas

    Directory of Open Access Journals (Sweden)

    Helmy Iman M


    Full Text Available Abstract Background The pathogenesis of salivary gland carcinomas is very complex and prognostic markers are difficult to find in these carcinomas of which the different subtypes have varying malignant potential. The study was conducted to examine the cellular distribution of maspin and MCM2 in salivary gland carcinomas and their value to predict lymph node metastasis. Materials and methods Fifty three paraffin blocks of different lesions (15 muco-epidermoid carcinoma, 14 adenoid cystic carcinoma, 3 epi-myoepithelial carcinoma, 5 salivary duct carcinoma, 5 malignant pleomorphic adenoma, 6 polymorphous low grade adenocarcinoma and 5 acinic cell carcinoma were prepared for immunohistochemical staining with maspin and MCM2 antibodies. ANOVA and Pearson correlation tests were used for the statistical analysis of the results. Results All salivary gland carcinomas express maspin and MCM2 with variable cellular localization. There was a significant difference in the expression of each antibody between mucoepidermoid carcinoma, adenoid cystic carcinoma and polymorphous low grade adenocarcinoma. No association was found between examined markers and lymph node metastasis. Conclusions Salivary gland carcinomas express maspin and MCM2 with variable levels and cellular localization, consisting important markers of biological behavior in these tumors. The level of MCM2 expression can be used in the differential diagnosis of adenoid cystic carcinoma and polymorphous low grade adenocarcinoma. Further study with large sample size is recommended to assess their value in prediction of lymph node metastasis.

  3. Adenocarcinoma of the paraurethral glands: a case report. (United States)

    Massari, Francesco; Ciccarese, Chiara; Modena, Alessandra; Maines, Francesca; Segala, Diego; Luchini, Claudio; Marcolini, Lisa; Cavicchioli, Francesca; Cavalleri, Stefano; Bria, Emilio; Brunelli, Matteo; Martignoni, Guido; Artibani, Walter; Tortora, Giampaolo


    Adenocarcinoma of the paraurethral glands represents a very rare neoplasm of the urinary tract. Due to the rarity of this disease, there is no standard therapeutic approach. We report a case of adenocarcinoma of the paraurethral glands in a 56-year-old woman, presenting with abnormal serous vaginal discharges. The radiologic examination revealed a 5-cm mass around the urethra, which underwent surgical resection. After surgical resection, the histology revealed a moderately differentiated adenocarcinoma, probably arising from the paraurethral glands. One month later, a pelvic recurrent mass was radiologically diagnosed; consequently, an anterior pelvic exenteration with lymph node dissection was performed. Histological examination revealed a moderately differentiated adenocarcinoma, with glandular and micropapillary architecture, with multiple lymph node metastases. The absence of modifications such as urethritis cystic glandularis on the urethral mucosa, as well as the lack of a lesion in situ, associated with the immunohistochemical expression of PAX8 and negativity for GATA3 and S100p, suggested that the adenocarcinoma originated from the paraurethral glands rather than from the urethral mucosa. Post-surgery CT scans revealed no evidence of metastatic disease. The patient received 6 courses of adjuvant chemotherapy with carboplatin and paclitaxel. One year after the pelvic exenteration, because of inguinal lymph node progression, an inguinal lymphadenectomy was performed. Four months later, a TC-PET revealed a multidistrectual lymph node and a lung micronodule disease progression. Invasive micropapillary carcinomas have been characterized as a rare distinctive variant of carcinomas in several anatomic sites and are distinguished by a marked tendency to lymphovascular invasion, justifying the association with high-stage disease and poor prognosis. In the present case, both the poor prognosis connected with micropapillary structure and the lymph node involvement

  4. Children of divorce: the differential diagnosis of contact refusal. (United States)

    Freeman, Bradley W


    Contact refusal is a common phenomenon that can occur during the course of, or after, divorce, which affects the relationship between a child and the parent. This article defines the concept of contact refusal and discusses the importance of its recognition. The concept is further narrowed to focus on the child as the one refusing contact, not the parent, which can happen as well. Various types of contact refusals are illustrated in the article through clinical vignettes, and an approach to categorizing the various types of contact refusal is presented.

  5. Myoepithelial carcinoma of the salivary glands: behavior and management

    Institute of Scientific and Technical Information of China (English)

    俞光岩; 马大权; 孙开华; 李铁军; 张晔


    Objective To investigate the biological behavior and proper management of myoepithelial carcinomas of salivary glands. Methods Twenty-seven cases of myoepithelial carcinoma of salivary glands were retrospec tively studied and their detailed clinical and follow-up data were presented. Results The subjects consisted of 17 men and 10 women aged 16 to 73 years (mean age: 51 years). The parotid gland was the most common site (n=14) of cancer. Clinical features included extensive local growth, invasion of the surrounding tissues, infrequent cervical lymph node metastasis but high rates of distant metastasis, f requent/multiple recurrences and poor prognosis. Conclusions Myoepithelial carcinomas of the salivary gland should be classified as high-grade malignancies. Early and radical surgery with close follow-up are essential for achieving favorable outcomes. Radiotherapy appears to be non-sensitive and elective neck dissection is generally unnecessary.

  6. Benign müllerian glandular inclusions in men undergoing pelvic lymph node dissection. (United States)

    Gallan, Alexander J; Antic, Tatjana


    Benign müllerian-type glandular inclusions in lymph nodes are commonly seen in women, but to our knowledge, there have only been 4 reported cases in men. Distinction of these glandular structures from metastatic adenocarcinoma is crucial for proper staging, prognosis, and treatment of the patient. We report 3 cases of benign müllerian-type glandular inclusions in men undergoing either prostatectomy or cystoprostatectomy with lymph node dissection for treatment of prostatic adenocarcinoma and/or urothelial carcinoma. None of the patients were receiving hormonal therapy. All 3 cases showed benign glands with ciliated cuboidal to columnar cells and rare secretory cells, morphologically comparable with endosalpingiosis in women. These glands were diffusely positive for PAX-8, WT-1, estrogen receptor, and progesteron receptor consistent with müllerian origin. Our study is the first to confirm müllerian origin of these glands by PAX-8 and WT-1 positivity. This finding of müllerian glands in men identical to endosalpingiosis in women supports the theory that this entity can result from müllerian metaplasia of the peritoneal mesothelium rather than displacement of tubal-type epithelium. Pathologists should also be aware that müllerian-type glands can rarely occur in men to prevent the incorrect diagnosis of metastatic adenocarcinoma involving a lymph node.

  7. Assessment of musculoskeletal load in refuse collectors

    Directory of Open Access Journals (Sweden)

    Zbigniew W. Jóźwiak


    Full Text Available Background: The aim of this work was to assess the load on the musculoskeletal system and its effects in the collectors of solid refuse. The rationale behind this study was to formulate proposals how to reduce excessive musculoskeletal load in this group of workers. Material and Methods: The study group comprised 15 refuse collectors aged 25 to 50 years. Data about the workplace characteristics and subjective complaints of workers were collected by the free interview and questionnaire. During the survey the photorecording of the workpostures, the distance and velocity by GPS recorders, measurements of forces necessary to move containers, energy expenditure (lung ventilation method, workload estimation using the Firstbeat system and REBA method and stadiometry were done. Results: The distance walked daily by the collectors operating in terms of 2 to 3 in urban areas was about 15 km, and in rural areas about 18 km. The most frequent musculoskeletal complaints concerned the feet (60% subjects, knees, wrists and shoulders (over 40% subjects. After work-shift all examined workers had vertebral column shorter by 10 to 14 mm (11.4 mm mean. Conclusions: The results of our study show that the refuse collectors are subjected to a very high physical load because of the work organization and the way it is performed. To avoid adverse health effects and overload it is necessary to undertake ergonomic interventions, involving training of workers to improve the way of their job performance, active and passive leisure, technical control of the equipment and refuse containers, as well as the renegotiation of contracts with clients, especially those concerning non-standard containers. Med Pr 2013;64(4:507–519

  8. Microbial ecology of coal mine refuse

    Energy Technology Data Exchange (ETDEWEB)

    Cameron, R. E.; Miller, R. M.


    Baseline microbial and ecological studies of samples obtained from two abandoned coal mine refuse sites in the State of Illinois indicate that the unfavorable nature of refuse materials can be a very limiting factor for survival and growth of organisms. Despite the ''foothold'' obtained by some microorganisms, especially acidophilic fungi and some acidotolerant algae, the refuse materials should be amended or ameliorated to raise the pH, provide needed nutrients, especially nitrogen, and provide biodegradable organic matter, both for physical and biological purposes. Finally, the role of microbial populations, responses, and interactions in acid mine wastes must be put into larger perspective. Acid mine drainage amounts to over 4 million tons per year of acidity from active and abandoned mines. Microorganisms appear to be significantly responsible for this problem, but they also can play a beneficial and significant role in the amelioration or alleviation of this detrimental effect as abandoned mines are reclaimed and returned to useful productivity.

  9. Conscientious refusal in healthcare: the Swedish solution. (United States)

    Munthe, Christian


    The Swedish solution to the legal handling of professional conscientious refusal in healthcare is described. No legal right to conscientious refusal for any profession or class of professional tasks exists in Sweden, regardless of the religious or moral background of the objection. The background of this can be found in strong convictions about the importance of public service provision and related civic duties, and ideals about rule of law, equality and non-discrimination. Employee's requests to change work tasks are handled on a case-by-case basis within the frames of labour law, ensuring full voluntariness, and also employer's privilege regarding the organisation and direction of work, and duties of public institutions to provide services. Two complicating aspects of this solution related to the inclusion of 'alternative medical' service providers in a national health service, and professional insistence on conscientious refusal rights to accept legalised assisted dying are discussed. The latter is found to undermine the pragmatic reasons behind recent attempts by prolife groups to challenge the Swedish solution related to legal abortion in courts.

  10. Advanced reclamation of coal refuse ponds

    Energy Technology Data Exchange (ETDEWEB)

    Honaker, R.Q.; Chugh, Y.P.; Patwardhan, A. [Southern Illinois Univ., Carbondale, IL (United States). Dept. of Mining and Mineral Resources Engineering


    A vast number of coal refuse ponds represent a significant economical resource base that may also be considered to be environmentally harmful. The fine coal fraction in a preparation plant consists of the purest particles in the entire preparation plant and, thus, if recovered, could enhance the quality of the plant product. However, until recently, the ability to effectively recover fine coal has been limited due to the lack of efficient fine particle separation technologies. As a result, a large portion of the fine coal produced in the US during this century has been disposed into refuse pond along with the acid producing components of the associated gangue material. Research conducted by Southern Illinois University scientists has found that advanced fine coal cleaning technologies can be used to recover high quality coal from refuse ponds while also utilizing a novel technique for neutralizing the acid generation potential of the pyrite-rich reject stream. Various circuitry arrangements will be discussed and metallurgical results presented in this publication.

  11. [Anatomo-topographic features of parasternal lymph nodes in adult humans]. (United States)

    Shvedavchenko, A I


    The parasternal lymph nodes have been revealed in corpses of person died at the age 22-85 years by the method of preparation after Gerota's blue had been interstitially injected into the tissue of the mammary gland, the diaphragm, the diaphragmal surface of the liver, the pleura and the pericardium. The mass has also been injected into the lymph nodes and vessels revealed by means of the interstitial injection. Most of the parasternal lymph nodes are situated in interposal places, their number varying from 2 to 20 in the parasternal lymphatic chain. At the level of the costal cartilage they are found much more seldom. Maximal number of the parasternal lymph nodes situating behind one costal cartilage is 4. Behind the IV and the V costal cartilage, left to the sternum no lymph nodes have been revealed. The most removed from the sternal edge, the lymph nods in the V and the VI intercostal spaces, both to the left and to the right have been found. As to the position of blood vessels, the lymph nodes occur mostly medially and laterally but not anterior or posterior to them or between them. The size of the lymph nodes varies from 1 to 25 mm.

  12. [A bilateral epithelial myoepithelial carcinoma of the parotid gland]. (United States)

    Tauziède-Espariat, Arnault; Raffoul, Johnny; Sun, Shan Rong; Monnin, Christine; Lassabe, Catherine; Costes, Valérie


    We report the case of a 52-year-old man, who was admitted in the department of otorhinolaryngology for a mass of the right parotid gland. The radiological and clinical hypothesis was a squamous cell carcinoma. Histopathological examination revealed a biphasic proliferation composed of epithelial cells arranged in a tubular pattern stained with cytokeratins 5-6 and 7 and EMA surrounded by clear myoepithelial cells stained with smooth muscle actin and p63. Ki-67 labeling index was low. The diagnosis of epithelial myoepithelial carcinoma was proposed. One year after, the patient noticed a centimetric mass of the left parotid gland. The radiological hypothesis was the presence of an intraparotidian lymph node. Histopathological examination showed a second epithelial myoepithelial carcinoma. This is an uncommon neoplasm comprising approximately 1% of all salivary gland tumours, affecting mainly the parotid gland. It is occurring preferably in patients older than 60years old. This is a low-grade malignant tumour with tendency to local recurrence and lymph node metastatic potential. We describe an exceptional bilateral epithelial myoepithelial carcinoma of the parotid gland.

  13. Corrosion of boiler tube alloys in refuse firing: Shredded vs bulk refuse

    Energy Technology Data Exchange (ETDEWEB)

    Krause, H.H. (Battelle, Columbus, OH (United States)); Daniel, P.L.; Blue, J.D. (Babcock Wilcox, Barberton, OH (United States))


    Results of corrosion probe exposures at two mass burning incinerators were compared with those conducted in a unit burning refuse-derived fuel. Tests were conducted with carbon steel, low-alloy steels, stainless steels, and high nickel-chromium alloys. Corrosion rates at similar metal and gas temperatures were essentially the same for both types of fuel. Boiler tube performance in the waterwalls of other incinerators confirmed these results. Boiler design and operating conditions appear to be more important factors in tube wastage than the extent of refuse processing.

  14. Incidentally detected carcinoma ex pleomorphic adenoma of parotid gland by F-18 FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Kong, Eun Jung; Chun, Kyung Ah; Cho, Ihn Ho [Yeungnam Univ. Hospital, Daegu (Korea, Republic of)


    A 62-year-old man underwent FDG PET/CT to determine the initial stage of gastric carcinoma, and the scan revealed an incidental FDG-avid mass in the left parotid gland. He subsequently underwent surgery, and the final diagnosis was of carcinoma ex pleomorphic adenoma with cervical lymph node metastasis. The patient underwent left total parotidectomy with left selective neck dissection 2 months later, and the histopathologic report confirmed carcinoma ex pleomorphic adenoma with cervical lymph node metastasis.

  15. Tuberculosis of the parotid salivary gland in a kudu Tragelaphus strepsiceros

    Directory of Open Access Journals (Sweden)

    A. Weber


    Full Text Available Tuberculosis is a bacterial disease which has a worldwide distribution and affects most animal and bird species. In the eastern Cape this disease has been known to affect the kudu since the turn of the century. Pre-existing lesions on the ears become infected with mycobacteria which causes swelling of the parotid gland and lymph nodes draining the area. In this article a case of tuberculosis is described affecting the parotid salivary gland and surrounding pre-auricular lymph nodes. The importance of tracing these lesions is stressed in order to prevent infection of people consuming the meat.

  16. Pituitary Gland Disorders Overview (United States)

    ... hormone ( TSH) - TSH stimulates the thyroid gland to produce thyroid hormones, which regulate the body's metabolism, energy balance, growth, and nervous system activity. Read about TSH-secreting ...

  17. Conscientious refusals and reason-giving. (United States)

    Marsh, Jason


    Some philosophers have argued for what I call the reason-giving requirement for conscientious refusal in reproductive healthcare. According to this requirement, healthcare practitioners who conscientiously object to administering standard forms of treatment must have arguments to back up their conscience, arguments that are purely public in character. I argue that such a requirement, though attractive in some ways, faces an overlooked epistemic problem: it is either too easy or too difficult to satisfy in standard cases. I close by briefly considering whether a version of the reason-giving requirement can be salvaged despite this important difficulty.

  18. Combustion characteristics of coal and refuse from passenger trains. (United States)

    Fu-min, Ren; Feng, Yue; Ming, Gao; Min, Yu


    Refuse from passenger trains is becoming a significant issue with the development of the Chinese railway. Co-firing is regarded as a promising thermal technology, both environmentally and economically, in reducing the quantity of refuse. The co-firing property of passenger train refuse with coal, however, may differ due to the differences in the composition of the refuse. In the present study, combustion properties of refuse from passenger train samples and the mixture of refuse with coal were studied in a tube furnace. Thermo analysis methods, such as thermogravimetry (TG), differential scanning calorimetry (DSC), differential thermal analysis (DTA) and derivative thermogravimetry (DTG) analyses were employed to evaluate combustion performance. We found that the mixture of passenger train refuse and coal at a ratio of 1:1 has a lower ignition and burnout temperature than the coal-only sample. Moreover, refuse from railway passenger trains has more reactive combustion properties than the coal-only sample, and the addition of railway passenger train refuse to coal can promote the reactivity of coal.

  19. Physicians' evaluations of patients' decisions to refuse oncological treatment (United States)

    van Kleffens, T; van Leeuwen, E


    Objective: To gain insight into the standards of rationality that physicians use when evaluating patients' treatment refusals. Design of the study: Qualitative design with indepth interviews. Participants: The study sample included 30 patients with cancer and 16 physicians (oncologists and general practitioners). All patients had refused a recommended oncological treatment. Results: Patients base their treatment refusals mainly on personal values and/or experience. Physicians mainly emphasise the medical perspective when evaluating patients' treatment refusals. From a medical perspective, a patient's treatment refusal based on personal values and experience is generally evaluated as irrational and difficult to accept, especially when it concerns a curative treatment. Physicians have a different attitude towards non-curative treatments and have less difficulty accepting a patient's refusal of these treatments. Thus, an important factor in the physician's evaluation of a treatment refusal is whether the treatment refused is curative or non-curative. Conclusion: Physicians mainly use goal oriented and patients mainly value oriented rationality, but in the case of non-curative treatment refusal, physicians give more emphasis to value oriented rationality. A consensus between the value oriented approaches of patient and physician may then emerge, leading to the patient's decision being understood and accepted by the physician. The physician's acceptance is crucial to his or her attitude towards the patient. It contributes to the patient's feeling free to decide, and being understood and respected, and thus to a better physician–patient relationship. PMID:15738431

  20. The Sentinel Lymph Node Concept

    Institute of Scientific and Technical Information of China (English)


    The sentinel lymph node concept is meeting with steadily growing interest and is being extended to the different sites of the primaries. In addition, the concept is being applied in an increasingly sophisticated manner. In this book the practical

  1. Mesenteric lymph node cavitation syndrome

    Institute of Scientific and Technical Information of China (English)

    Hugh; James; Freeman


    The mesenteric lymph node cavitation syndrome consists of central necrosis of mesenteric lymph nodes and may occur with either celiac disease or a sprue-like intestinal disease that fails to respond to a gluten-free diet. Splenic hypofunction may also be present. The cause is not known but its development during the clinical course of celiac disease is usually indicative of a poor prognosis for the intestinal disorder, a potential for signif icant compli-cations including sepsis and malignancy, particularly...

  2. Adrenal Gland Disorders (United States)

    ... t live without, including sex hormones and cortisol. Cortisol helps you respond to stress and has many other important functions. With adrenal gland disorders, your glands make too much or not enough hormones. In Cushing's ... too much cortisol, while with Addison's disease, there is too little. ...

  3. Salivary Gland Cancer (United States)

    ... contains antibodies that can kill germs. Salivary gland cancer is a type of head and neck cancer. It is rare. It may not cause any ... pain in your face Doctors diagnose salivary gland cancer using a physical exam, imaging tests, and a ...

  4. Salivary Gland Secretion. (United States)

    Dorman, H. L.; And Others


    Describes materials and procedures for an experiment utilizing a live dog to demonstrate: (1) physiology of the salivary gland; (2) parasympathetic control of the salivary gland; (3) influence of varying salivary flow rates on sodium and potassium ions, osmolarity and pH; and (4) salivary secretion as an active process. (DS)

  5. Lacrimal gland ductal carcinomas

    DEFF Research Database (Denmark)

    Andreasen, Simon; Grauslund, Morten; Heegaard, Steffen


    HER2 amplification was found in cases 2 and 3. CONCLUSION: This study identified a spectrum of genetic events and pattern of protein expression in DC of the lacrimal gland similar to a subset of carcinomas of the breast and ductal carcinomas of the salivary glands. For therapeutic purposes...

  6. [Clinico-pathological analysis of 45 parotid gland cysts]. (United States)

    Wang, Zhi-ming; Ye, Ming; Yang, Dong-sheng; Ma, Ying; Guan, Qiao-dan


    To discuss the clinical and pathological characteristics and management of parotid gland cyst. Forty-five resected samples of parotid gland tumors were selected from Shengjing Hospital of China Medical University from January 2000 to June 2014 whose postoperative pathological diagnosis were parotid gland cysts. The clinico-pathological characteristics in different types of parotid gland cysts were analyzed. Of 45 cases of parotid gland cyst, 25 were males, 20 were females. The median age was 51 years old. 21 cases were located on the left side of parotid gland, while 24 on the right side. The main clinical symptom was painless swelling in parotid gland region. The sizes varied from 0.8 cm×0.6 cm×0.5 cm to 10 cm×2.8 cm×0.6 cm. Nine cases were accompanied with pain, and 36 without. 4 cases were seen with lymph node enlargement, and 41 without pain. The main treatment modality was simple resection of cyst without any injury of facial nerve. No recurrence was seen after following up for 1-10 years. Of the 45 postoperative histopathological results, 29 cases (64.4%) were simple cysts, 9 cases (20.0%) were polycystic disease cysts, and 7 cases (15.6%) were lymphoepithelial cysts. Besides the above-stated pathological manifestations, some non-specific microscopic changes were accompanied with parotid gland cysts, including tumor-like hyperplasia of fibrous tissue, inflammations, calcifications, synovial cyst-like changes, foreign-body giant cell reactions and granulomatous changes. The main symptom of parotid gland cyst is progressive enlargement, and simple resection of cyst is the first-line treatment without facial nerve injury or reoccurrence. The main pathological classifications are simple cysts,lymphoepithelial cysts and polycystic disease cysts.

  7. Carcinoma of the anal sac glands in ranch mink. (United States)

    Hadlow, W J


    During a 14-year period, carcinoma of the anal sac apocrine glands was found in 52 pastel and 8 sapphire mink (Mustela vison) kept for studies on slow viral diseases. The pastel mink varied in age from 72 to 135 months (mean age 108 months), the sapphire mink from 63 to 100 months (mean age 81 months). All but one pastel mink were females. The primary tumor varied in size from masses that caused bulges in the perineum to those that were found only after microscopic examination of the anal sac glands. Although the primary tumor grew mainly by expansion with little local infiltration, 41 of the 60 tumors had metastasized to the regional lymph nodes and sometimes also to more distant sites. The striking propensity of the carcinoma to metastasize while still small, even microscopic, often resulted in massive secondary growths, notably in the iliac lymph nodes. Hypercalcemia did not accompany the carcinoma. Its varied microscopic appearance included solid, glandular, squamous cell, and spindle or round cell components. Combinations of them formed mixed or complex histologic patterns, no doubt largely attributable to neoplastic proliferation of myoepithelial cells and squamous metaplasia of the apocrine gland epithelium. Although its cause remains obscure, the carcinoma appeared to arise from small foci of hyperplastic apocrine glands, sometimes in relation to both anal sacs. The tumor is a common and distinctive expression of neoplasia in older ranch mink.

  8. Metastatic apocrine sweat gland adenocarcinoma in a terrier dog

    Institute of Scientific and Technical Information of China (English)

    Akhtardanesh Baharak; Kheirandish Reza; Dabiri Shahriar; Azari Omid; Vosoogh Daruoosh; Askari Nasrin


    This report describes the clinical and pathological aspects of an apocrine sweat gland carcinoma with distant metastasis in an aged dog. A 7-year-old male terrier dog was referred to small animal hospital of Shahid Bahonar University of Kerman with a 5.5×3.5 centimeter pedunculated mass on its head near left auricular region which had been progressively growing since three months ago. The radiography showed no local and distant metastasis. Surgical excision and histological evaluation was done. Histologically, the mass was composed of epithelial cells arranged in glandular and solid patterns. The morphologic findings suggested either a primary or metastatic apocrine-gland carcinoma. Immunohistochemically, the tumor cells were intensely positive for cytokeratin 7 and 20 and negative for S100 protein. On the basis of histopathological and clinical findings, the tumor was diagnosed as a malignant apocrine gland tumor, arising from apocrine sweat glands of the skin. Local tumor recurrence with anorexia and weight loss was reported by the owner nine month later. Severe submandibular and prescapular lymphadenomegaly was noted in clinical examination. Several large pulmonary nodules were noted in chest radiographs resembling mediastinal lymph node metastasis. Second surgery and chemotherapy was rejected by the owner due to grave prognosis of the patient. The animal was died 45 days later due to respiratory complications. Tumors of apocrine sweat glands are relatively uncommon in dogs whereas apocrine gland adenocarcinoma with distant metastasis is extremely rare.

  9. Intraoperative near-infrared autofluorescence imaging of parathyroid glands. (United States)

    Ladurner, Roland; Sommerey, Sandra; Arabi, Nora Al; Hallfeldt, Klaus K J; Stepp, Herbert; Gallwas, Julia K S


    To identify parathyroid glands intraoperatively by exposing their autofluorescence using near-infrared light. Fluorescence imaging was carried out during minimally invasive and open parathyroid and thyroid surgery. After identification, the parathyroid glands as well as the surrounding tissue were exposed to near-infrared (NIR) light with a wavelength of 690-770 nm using a modified Karl Storz near-infrared/indocyanine green (NIR/ICG) endoscopic system. Parathyroid tissue was expected to show near-infrared autofluorescence, captured in the blue channel of the camera. Whenever possible the visual identification of parathyroid tissue was confirmed histologically. In preliminary investigations, using the original NIR/ICG endoscopic system we noticed considerable interference of light in the blue channel overlying the autofluorescence. Therefore, we modified the light source by interposing additional filters. In a second series, we investigated 35 parathyroid glands from 25 patients. Twenty-seven glands were identified correctly based on NIR autofluorescence. Regarding the extent of autofluorescence, there were no noticeable differences between parathyroid adenomas, hyperplasia and normal parathyroid glands. In contrast, thyroid tissue, lymph nodes and adipose tissue revealed no substantial autofluorescence. Parathyroid tissue is characterized by showing autofluorescence in the near-infrared spectrum. This effect can be used to distinguish parathyroid glands from other cervical tissue entities.

  10. The movement of lymph in the system of lymph node-lymph vessel and its regulation

    Directory of Open Access Journals (Sweden)

    Myrzakhanov Nurken


    Full Text Available Background This article presents the results of studying the specific features (rat, pig, sheep, cow of spontaneous rhythmic contractile activity of the lymph nodes of internal organs and body, the role of intranode pressure in the genesis of a node reduction of the lymph nodes activity regulation under the influence of biologically active substances, and the drug immunal and feed additives – polfamix on spontaneous contractile activity of a lymphatic node. Aims So far, well researched are the thin structural-topographic formation and innervation of the lymph circulation machine, the main functions (drainage, immunological, protein transport, etc. of the lymphatic system are set, which ensure the preservation of endoecological homeostasis of the organism environments. Methods We used the technique of recording contractions of isolated solitary lymph nodes of the body and internal organs, placed in an oxygenized chamber with Krebs medium. Results We found a direct link between the spontaneous rhythmic contractile activity of a lymph node and its internal pressure. A direct relationship is established: the higher within certain limits micronodular pressure is, the more intense is the reduction node (r+0,879. Conclusion As well as giving data from the manuscript there will be presentation of the main points of lymph node’s values in the organism.

  11. 50 CFR 14.53 - Detention and refusal of clearance. (United States)


    ... 50 Wildlife and Fisheries 1 2010-10-01 2010-10-01 false Detention and refusal of clearance. 14.53... PLANTS IMPORTATION, EXPORTATION, AND TRANSPORTATION OF WILDLIFE Inspection and Clearance of Wildlife § 14.53 Detention and refusal of clearance. (a) Detention. Any Service officer, or Customs officer...

  12. The Functional Profiles of School Refusal Behavior: Diagnostic Aspects (United States)

    Kearney, Christopher A.; Albano, Anne Marie


    School refusal behavior is a common problem seen by mental health professionals and by educators but little consensus is available as to its classification, assessment, and treatment. This study assessed 143 youth with primary school refusal behavior and their parents to examine diagnoses that are most commonly associated with proposed functions…

  13. 24 CFR 906.13 - Right of first refusal. (United States)


    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Right of first refusal. 906.13... DEVELOPMENT PUBLIC HOUSING HOMEOWNERSHIP PROGRAMS Purchaser Requirements § 906.13 Right of first refusal. (a... housing unit, to offer the unit for sale first to the current resident of the unit....

  14. 25 CFR 135.6 - Refusal of water delivery. (United States)


    ... 25 Indians 1 2010-04-01 2010-04-01 false Refusal of water delivery. 135.6 Section 135.6 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL ACTIVITIES CONSTRUCTION ASSESSMENTS, CROW INDIAN IRRIGATION PROJECT Charges Assessed Against Irrigation District Lands § 135.6 Refusal of water...

  15. 49 CFR 105.55 - Refusal to obey a subpoena. (United States)


    ... 49 Transportation 2 2010-10-01 2010-10-01 false Refusal to obey a subpoena. 105.55 Section 105.55 Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS MATERIALS SAFETY... PROGRAM DEFINITIONS AND GENERAL PROCEDURES General Procedures Subpoenas § 105.55 Refusal to obey a...

  16. 14 CFR 121.586 - Authority to refuse transportation. (United States)


    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Authority to refuse transportation. 121.586 Section 121.586 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... transportation. (a) No certificate holder may refuse transportation to a passenger on the basis that, because...

  17. 47 CFR 73.4005 - Advertising-refusal to sell. (United States)


    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Advertising-refusal to sell. 73.4005 Section 73.4005 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES RADIO BROADCAST SERVICES Rules Applicable to All Broadcast Stations § 73.4005 Advertising—refusal to sell. See...

  18. 36 CFR 1002.14 - Sanitation and refuse. (United States)


    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Sanitation and refuse. 1002.14 Section 1002.14 Parks, Forests, and Public Property PRESIDIO TRUST RESOURCE PROTECTION, PUBLIC USE AND RECREATION § 1002.14 Sanitation and refuse. (a) The following are prohibited: (1) Disposing...

  19. 36 CFR 2.14 - Sanitation and refuse. (United States)


    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Sanitation and refuse. 2.14 Section 2.14 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR RESOURCE PROTECTION, PUBLIC USE AND RECREATION § 2.14 Sanitation and refuse. (a) The following...

  20. Empirical Examination of a Multicomponent Treatment for Pediatric Food Refusal. (United States)

    Hoch, Theodore A.; Babbitt, Roberta L.; Farrar-Schneider, Debra; Berkowitz, Merrill J.; Owens, J. Carl; Knight, Terry L.; Snyder, Angela M.; Rizol, Laura M.; Wise, David T.


    This paper reports on assessment and treatment of food refusal for four inpatient boys (ages 2,3,3, and 9) receiving tube feedings. It used a contingency contacting procedure extended by a component analysis. Data suggest that food refusal appeared to be maintained primarily by negative reinforcement contingencies. Caregiver responses indicated a…

  1. Cytodiagnosis of lesions presenting as salivary gland swellings: a report of seven cases. (United States)

    Chan, M K; McGuire, L J


    The cytologic and histologic findings of seven cases presenting clinically as salivary gland swellings are described. These included two cases of pilomatrixoma of skin in the parotid region, two cases of neurilemmoma in the submandibular area, a case of Kimura's disease in the peri-mandibular gland lymphoid tissue, a case of Castleman's disease in intraparotid lymph node, and a case of branchial cleft cyst in the parotid region. It is important to recognize lesions that masquerade as salivary gland tumors so that misdiagnosis and overdiagnosis on smears can be avoided and the patients can be treated appropriately.

  2. Resíduos hospitalares Hospital refuse

    Directory of Open Access Journals (Sweden)

    Francisco Xavier Ribeiro da Luz


    Full Text Available Foram relatadas informações diversas sobre resíduos sólidos hospitalares: volumes produzidos, formas de acondicionamento no local de produção, de transporte interno, de armazenamento para a coleta, de remoção e de destinação final usuais em estabelecimentos especialmente norte-americanos. Soluções foram analisadas e apresentadas sugestões para as condições brasileiras.Information on solid waste handling specially in American hospitals: volumes and kinds of refuse, conditioning forms, internal transportation, is reported. Comments are presented on them and suggestions are made having in mind Brasilian conditions.

  3. Method of extracting coal from a coal refuse pile (United States)

    Yavorsky, Paul M.


    A method of extracting coal from a coal refuse pile comprises soaking the coal refuse pile with an aqueous alkali solution and distributing an oxygen-containing gas throughout the coal refuse pile for a time period sufficient to effect oxidation of coal contained in the coal refuse pile. The method further comprises leaching the coal refuse pile with an aqueous alkali solution to solubilize and extract the oxidized coal as alkali salts of humic acids and collecting the resulting solution containing the alkali salts of humic acids. Calcium hydroxide may be added to the solution of alkali salts of humic acid to form precipitated humates useable as a low-ash, low-sulfur solid fuel.

  4. Intraoperative Identification of the Parathyroid Gland with a Fluorescence Detection System. (United States)

    Shinden, Yoshiaki; Nakajo, Akihiro; Arima, Hideo; Tanoue, Kiyonori; Hirata, Munetsugu; Kijima, Yuko; Maemura, Kosei; Natsugoe, Shoji


    Intraoperative identification of the difficult-to-spot parathyroid gland is critical during surgery for thyroid and parathyroid disease. Recently, intrinsic fluorescence of the parathyroid gland was identified, and a new method was developed for intraoperative detection of the parathyroid with an original fluorescent detection apparatus. Here, we describe a method for intraoperative detection of the parathyroid using a ready-made photodynamic eye (PDE) system without any fluorescent dye or contrast agents. Seventeen patients who underwent surgical treatment for thyroid or parathyroid disease at Kagoshima University Hospital were enrolled in this study. Intrinsic fluorescence of various tissues was detected with the PDE system. Intraoperative in vivo and ex vivo intrinsic fluorescence of the parathyroid, thyroid, lymph nodes and fat tissues was measured and analyzed. The parathyroid gland had a significantly higher fluorescence intensity than the other tissues, including the thyroid glands, lymph nodes and fat tissues, and we could identify them during surgery using the fluorescence-guided method. Our method could be applicable for two intraoperative clinical procedures: ex vivo tissue identification of parathyroid tissue and in vivo identification of the location of the parathyroid gland, including ectopic glands. The PDE system may be an easy and highly feasible method to identify the parathyroid gland during surgery.

  5. Pediatric salivary gland imaging

    Energy Technology Data Exchange (ETDEWEB)

    Boyd, Zachary T. [University of Missouri-Kansas City School of Medicine, Kansas City, MO (United States); Goud, Asha R. [University of California Irvine Medical Center, Department of Radiology, Orange, CA (United States); Lowe, Lisa H. [Children' s Mercy Hospitals and Clinics and the University of Missouri-Kansas City, Department of Radiology, Kansas City, MO (United States); Shao, Lei [Children' s Mercy Hospitals and Clinics and the University of Missouri-Kansas City, Department of Pathology, Kansas City, MO (United States)


    A variety of lesions occur in the pediatric salivary glands. With modern imaging techniques such as Doppler sonography, helical CT, and MRI, identification of a specific etiology is often possible. Knowledge of clinical information, normal anatomy, and imaging characteristics of salivary gland pathology are essential for appropriate radiologic evaluation. This review illustrates the various congenital, neoplastic, and inflammatory entities that can occur within the parotid, submandibular, and sublingual spaces. (orig.)

  6. Intraoperative Sentinel Lymph Node Evaluation

    DEFF Research Database (Denmark)

    Shaw, Richard; Christensen, Anders; Java, Kapil;


    BACKGROUND: Intraoperative analysis of sentinel lymph nodes would enhance the care of early-stage oral squamous cell carcinoma (OSCC). We determined the frequency and extent of cytokeratin 19 (CK19) expression in OSCC primary tumours and surrounding tissues to explore the feasibility of a "clinic......-ready" intraoperative diagnostic test (one step nucleic acid amplification-OSNA, sysmex). METHODS: Two cohorts were assembled: cohort 1, OSCC with stage and site that closely match cases suitable for sentinel lymph node biopsy (SLNB); cohort 2, HNSCC with sufficient fresh tumour tissue available for the OSNA assay (>50...

  7. Radionuclide salivary gland imaging

    Energy Technology Data Exchange (ETDEWEB)

    Mishkin, F.S.


    Salivary gland imaging with 99mTc as pertechnetate provides functional information concerning trapping and excretion of the parotid and submandibular glands. Anatomic information gained often adds little to clinical evaluation. On the other hand, functional information may detect subclinical involvement, which correlates well with biopsy of the minor labial salivary glands. Salivary gland abnormalities in systemic disease such as sarcoidosis, rheumatoid arthritis, lupus erythematosus, and other collagenvascular disorders may be detected before they result in the clinical manifestaions of Sjoegren's syndrome. Such glands, after initially demonstrating increased trapping in the acute phase, tend to have decreased trapping and failure to discharge pertechnetate in response to an appropriate physiologic stimulus. Increased uptake of gallium-67 citrate often accompanies these findings. Inflammatory parotitis can be suspected when increased perfusion is evident on radionuclide angiography with any agent. The ability of the salivary gland image to detect and categorize mass lesions, which result in focal areas of diminished activity such as tumors, cysts, and most other masses, is disappointing, while its ability to detect and categorize Warthin's tumor, which concentrates pertechnetate, is much more valuable, although not specific.

  8. Mammary gland development. (United States)

    Macias, Hector; Hinck, Lindsay


    The mammary gland develops through several distinct stages. The first transpires in the embryo as the ectoderm forms a mammary line that resolves into placodes. Regulated by epithelial–mesenchymal interactions, the placodes descend into the underlying mesenchyme and produce the rudimentary ductal structure of the gland present at birth. Subsequent stages of development—pubertal growth, pregnancy, lactation, and involution—occur postnatally under the regulation of hormones. Puberty initiates branching morphogenesis, which requires growth hormone (GH) and estrogen, as well as insulin-like growth factor 1 (IGF1), to create a ductal tree that fills the fat pad. Upon pregnancy, the combined actions of progesterone and prolactin generate alveoli, which secrete milk during lactation. Lack of demand for milk at weaning initiates the process of involution whereby the gland is remodeled back to its prepregnancy state. These processes require numerous signaling pathways that have distinct regulatory functions at different stages of gland development. Signaling pathways also regulate a specialized subpopulation of mammary stem cells that fuel the dramatic changes in the gland occurring with each pregnancy. Our knowledge of mammary gland development and mammary stem cell biology has significantly contributed to our understanding of breast cancer and has advanced the discovery of therapies to treat this disease.

  9. Recycling of aged refuse from a closed landfill. (United States)

    Zhao, Youcai; Song, Liyan; Huang, Renhua; Song, Lijie; Li, Xiong


    In this study, refuse excavated from a typical refuse landfill in Shanghai after 8-10 years of placement was characterized in terms of particle size, total nitrogen, total phosphorus, and biodegradable matter. The refuse contained a large and diverse population of micro-organisms with a high capacity for decomposing refractory organic matter present in some wastewaters, including leachate. It was found that the aged refuse was quite stable after about a decade of decomposition in the warm, humid climate of southern China. The fine fractions resembled and had the properties of black soil, a medium that is suitable for green construction, organic fertilizer, or as bioreactor media for biological treatment of organic wastewaters. Excavation of the aged refuse would make about 50% of the space available for fresh refuse. The plastics, glass, textiles, and cans can be readily mechanically separated and recycled after cleaning. It is estimated that at least 200 millions tonnes of such aged refuse are available in China alone, and at least 10 times that much is buried worldwide. Hence, the evaluation of mined landfill waste and consideration of its potential uses is of great significance.

  10. Incidental detection of filarial worm in metastatic axillary lymph node from ductal carcinoma breast

    Directory of Open Access Journals (Sweden)

    Ranjan Agrawal


    Full Text Available Filariasis is a major disease of the tropics. Frequently, lymphatics of the lower limbs, retroperitoneal tissues, spermatic cord, epididymis, and mammary glands are involved. Simultaneous filariasis along with another underlying disease is rare. We present a rare case of filariasis of the axillary lymph node in a modified radical mastectomy specimen, which also showed metastatic deposits of ductal carcinoma breast. The case is presented due to its rarity.

  11. Occult supraclavicular lymph node metastasis identified by FDG-PET in patients with carcinoma of the uterine cervix. (United States)

    Tran, Binh N; Grigsby, Perry W; Dehdashti, Farrokh; Herzog, Thomas J; Siegel, Barry A


    The objective was to evaluate the frequency and prognostic significance of occult supraclavicular lymph node metastases identified by 2-[(18)F]fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET) in patients with cervical carcinoma. Between March 1998 and January 2002, 186 patients with a new diagnosis of cervical cancer underwent whole-body FDG-PET before therapy. Fourteen patients had abnormal FDG uptake in left supraclavicular lymph nodes without palpable disease. All 14 patients underwent sonographically guided fine-needle aspiration of the left supraclavicular lymph nodes. One patient refused therapy, 6 were treated with palliative intent, and 7 received definitive irradiation and concurrent chemotherapy. Survival was calculated by the Kaplan-Meier method. The overall frequency of FDG-positive left supraclavicular lymph nodes was 8% (14/186). Metastasis was pathologically confirmed in all 14 patients. Therefore, the positive predictive value of abnormal FDG uptake in left supraclavicular lymph nodes was 100%. Nineteen percent of all patients (35/186) had abnormal FDG uptake in para-aortic lymph nodes. The frequency of positive FDG uptake in the left supraclavicular lymph nodes was 40% (14/35) in those with para-aortic lymph node uptake and 15% in those with stage IIIb disease. The median overall survival was 7.5 months. At last follow-up, 11 patients were dead and 3 were alive with disease. All patients developed metastatic disease, most commonly to bone and lung. The positive predictive value of abnormal FDG uptake in left supraclavicular lymph nodes was 100%. Prognosis for these patients was dismal despite aggressive therapy.

  12. Cervical Lymph Node Metastasis: Unusual Presentation of Adenoid Cystic Carcinoma - Diagnosed By FNAC

    Directory of Open Access Journals (Sweden)

    Archana Buch


    Full Text Available Adenoid cystic carcinoma (ACC is a rare neoplasm that usually arises from minor salivary glands. It is characteristically locally infiltrative, exhibiting perineural invasion, has a tendency for local recurrence and prolonged clinical course. A 60 year old male, chronic smoker presented with swelling of the left cervical lymph node since two months. Examination revealed a solitary firm, non tender, non mobile left cervical swelling measuring 2 x 1 cm. Fine Needle Aspiration Cytology (FNAC was done from the cervical lymph node. The diagnosis of metastatic deposits of ACC was given. Detail examination of the oral cavity revealed a small swelling at the floor of the mouth. Biopsy of the swelling confirmed ACC on histopathological examination. An unusual feature of adenoid cystic carcinoma is the low incidence of metastases to regional lymph nodes. The case is presented to highlight its unusual presentation and utility of FNAC in rapid diagnosis.

  13. Gasification of Refuse-Derived Fuel (RDF

    Directory of Open Access Journals (Sweden)

    Haydary Juma


    Full Text Available In this work, the gasification of a fraction of municipal solid waste, MSW, generally separated from inorganic materials and biodegradable components, the so-called refuse-derived fuel (RDF, was studied using material characterisation methods, and the modelling of an industrial scale process was presented. The composition of RDF was determined by the separation of a representative sample into its basic components (paper, foils, hard plastics, textiles. All RDF components as well as a representative mixed sample of the RDF were studied using a thermogravimetric analysis (TGA, elemental analysis and bomb calorimetry to determine their proximate and elemental compositions, and a higher heating value. An industrial scale gasification process was studied by mathematical modelling and computer simulations. All techniques, gasification with air, gasification with oxygen, and gasification with both oxygen and steam were investigated under different conditions. The RDF conversion of 100 % was achieved by the gasification with air at the air to RDF mass ratio of 3.2. The gas heating value was 4.4 MJ/Nm3. The gasification of RDF using oxygen enables the production of gas with the heating value of around 10 MJ/Nm3 at the oxygen to RDF mass ratio of 0.65. By increasing the steam to the RDF mass ratio, the contents of H2 and CO2 increased, while the content of CO, reactor temperature and the gas heating value decreased.

  14. Problems and prospects of refuse disposal in nigerian urban centres ...

    African Journals Online (AJOL)

    Refuse disposal is one of the major environmental problems that developing countries are faced with. Health hazard, traffic ... The problem of waste management has two parts, that of collection and that of disposal. Communal collection, block ...

  15. Combining stimulus fading, reinforcement, and extinction to treat food refusal.


    Freeman, K A; Piazza, C C


    The food refusal of a 6-year-old girl with destructive behavior was treated using stimulus fading, reinforcement, and escape extinction. Intake increased and compliance with prompting procedures remained relatively stable despite the increased consumption requirement.

  16. Leaching refuse after sphalerite mineral for extraction zinc and cobalt

    Directory of Open Access Journals (Sweden)

    S. Brožová


    Full Text Available The paper deals with a possibility of zinc and cobalt extraction from refuse after sphalerite mineral leaching. It contains theoretic analysis of hydrometallurgical processes. Practical part describes samples and their leaching in 10 % and 20 % sulphuric acid. In the end of the paper it is evaluated under which conditions the highest yield of zinc and cobalt from refuse after sulphide ore leaching is reached.

  17. Refusal of emergency caesarean section in Ireland: a relational approach. (United States)

    Wade, Katherine


    This article examines the issue of emergency caesarean section refusal. This raises complex legal and ethical issues surrounding autonomy, capacity, and the right to refuse treatment. In Ireland, the situation is complicated further by the constitutional right to life of the unborn. While cases involving caesarean section refusal have occurred in other jurisdictions, a case of this nature has yet to be reported in Ireland. This article examines possible ways in which the interaction of a woman's right to refuse treatment and the right to life of the unborn could be approached in Ireland in the context of caesarean section refusal. The central argument of the article is that the liberal individualistic approach to autonomy evident in the caesarean section cases in England and Wales is difficult to apply in the Irish context, due to the conflicting constitutional rights of the woman and foetus. Thus, alternative visions of autonomy which take the interests and rights of others into account in medical decision-making are examined. In particular, this article focuses on the concept of relational consent, as developed by Alasdair Maclean and examines how such an approach could be applied in the context of caesarean section refusal in Ireland. The article explains why this approach is particularly appropriate and identifies mechanisms through which such a theory of consent could be applied. It is argued that this approach enhances a woman's right to autonomy, while at the same time allows the right to life of the unborn to be defended.

  18. Salivary gland myoepithelial carcinoma. (United States)

    Vilar-González, S; Bradley, K; Rico-Pérez, J; Vogiatzis, P; Golka, D; Nigam, A; Sivaramalingam, M; Kazmi, S


    Salivary gland myoepithelial carcinoma (MC) or malignant myoepithelioma is a rare entity. MC usually presents as a slow-growing painless mass arising in the parotid gland, but may involve other salivary glands. This tumour may be particularly locally aggressive, but its clinical and biological features are not yet fully understood. MC may arise from pre-existing benign lesions, such as pleomorphic adenomas or benign myoepitheliomas, or may arise de novo. It usually affects patients over 50 years old, with no gender preference. Because it is often asymptomatic, the presentation and diagnosis can be delayed by months, even years. The current WHO classification considers MC to be an intermediate- to high-grade malignancy. Other published data suggest it is likely to be a high-grade neoplasm, consistent with its aggressive behaviour. Its epidemiology, histopathological features, immunohistochemical profile, clinical behaviour and optimal management are not well understood. Following review of the current literature we aim to address these.

  19. Malignant salivary gland tumours

    Energy Technology Data Exchange (ETDEWEB)

    Thompson, S.H. (University of the Witwatersrand, Johannesburg (South Africa). Dept. of Oral Pathology)


    The most frequent malignant salivary gland tumours are the mucoepidermoid tumour, adenoid cystic carcinoma and adenocarcinoma. The major salivary glands and the minor glands of the mouth and upper respiratory tract may potentially develop any of these malignant lesions. Malignant lesions most frequently present as a palpable mass and tend to enlarge more rapidly than benign neoplasms. Pain, paresthesia, muscle paralysis and fixation to surrounding tissue are all ominous signs and symptoms. The only reliable means of differential diagnosis of these lesions is biopsy and histologic analysis. Therapy involves surgery or a combination of surgery and radiation therapy. The ultimate prognosis is governed by the intrinsic biologic behaviour of the neoplasms, the extent of disease and adequate clinical therapy.

  20. Mammary gland stem cells

    DEFF Research Database (Denmark)

    Fridriksdottir, Agla J R; Petersen, Ole W; Rønnov-Jessen, Lone


    Distinct subsets of cells, including cells with stem cell-like properties, have been proposed to exist in normal human breast epithelium and breast carcinomas. The cellular origins of epithelial cells contributing to gland development, tissue homeostasis and cancer are, however, still poorly...... understood. The mouse is a widely used model of mammary gland development, both directly by studying the mouse mammary epithelial cells themselves and indirectly, by studying development, morphogenesis, differentiation and carcinogenesis of xenotransplanted human breast epithelium in vivo. While in early...... studies, human or mouse epithelium was implanted as fragments into the mouse gland, more recent technical progress has allowed the self-renewal capacity and differentiation potential of distinct cell populations or even individual cells to be interrogated. Here, we review and discuss similarities...

  1. Undifferentiated salivary gland carcinomas

    DEFF Research Database (Denmark)

    Herbst, H.; Hamilton-Dutoit, S.; Jakel, K.T.;


    Undifferentiated salivary gland carcinomas may be divided into small cell and large cell types. Among large cell undifferentiated carcinomas, lymphoepithelial carcinomas have to be distinguished, the latter of which are endemic in the Arctic regions and southern China where virtually all cases...... of these tumors are associated with the Epstein-Barr virus (EBV). Association with EBV may also be observed in sporadic cases, and detection of EBV gene products may aid their diagnosis. Immunohistology may be employed to resolve the differential diagnosis of undifferentiated salivary gland carcinomas, comprising...... malignant lymphomas, amelanotic melanomas, Merkel cell carcinomas, and adenoid cystic carcinomas, in particular in small biopsy materials. Because of the rarity of undifferentiated salivary gland carcinomas, the differential diagnosis should always include metastases of undifferentiated carcinomas arising...

  2. Decellularized Lymph Nodes as Scaffolds for Tissue Engineered Lymph Nodes (United States)

    Cuzzone, Daniel A.; Albano, Nicholas J.; Aschen, Seth Z.; Ghanta, Swapna


    Abstract Background: The lymphatic system is commonly injured during cancer treatment. However, despite the morbidity of these injuries, there are currently no options for replacing damaged lymphatics. The purpose of this study was to optimize methods for decellularization of murine lymph nodes (LN) and to determine if these scaffolds can be used to tissue engineer lymph node-like structures. Methods and Results: LNs were harvested from adult mice and subjected to various decellularization protocols. The degree of decellularization and removal of nuclear material was analyzed histologically and quantitatively using DNA isolation. In addition, we analyzed histological architecture by staining for matrix proteins. After the optimal method of decellularization was identified, decellularized constructs were implanted in the renal capsule of syngeneic or allogeneic recipient mice and analyzed for antigenicity. Finally, to determine if decellularized constructs could deliver lymphocytes to recipient animals, the matrices were repopulated with splenocytes, implanted in submuscular pockets, and harvested 14 days later. Decellularization was best accomplished with the detergent sodium dodecyl sulfate (SDS), resulting in negligible residual cellular material but maintenance of LN architecture. Implantation of decellularized LNs into syngeneic or allogeneic mice did not elicit a significant antigenic response. In addition, repopulation of decellularized LNs with splenocytes resulted in successful in vivo cellular delivery. Conclusions: We show, for the first time, that LNs can be successfully decellularized and that these matrices have preserved extracellular matrix architecture and the potential to deliver leukocytes in vivo. Future studies are needed to determine if tissue engineered lymph nodes maintain immunologic function. PMID:25144673

  3. [Case of papillary carcinoma of the thyroid gland with concurrent tuberculous lymphadenitis]. (United States)

    Ishinaga, Hajime; Hamaguchi, Noriko; Suzuki, Hiroshi; Miyamura, Tomotaka; Nakamura, Satoshi; Otsu, Kazuya; Takeuchi, Kazuhiko


    We report a case of papillary carcinoma of the thyroid gland and cervical lymph node metastases with concurrent tuberculous lymphadenitis that was diagnosed preoperatively. A 35-year-old woman presented with multiple lymph node swellings and an anterior neck mass. No findings suggesting the coexistence of pulmonary tuberculosis were present. The patient underwent a total thyroidectomy with bilateral neck dissection together with medication. Measures to prevent tuberculosis were undertaken during the perioperative period. The histopathological diagnosis was papillary carcinoma with both metastatic and tuberculous lymphadenitis of the lymph nodes in the neck. The possible coexistence of tuberculous lymphadenitis must be ruled out when lymph node swellings are observed in patients with head and neck cancer, including thyroid carcinoma.

  4. Arsenic burden survey among refuse incinerator workers

    Directory of Open Access Journals (Sweden)

    Chao Chung-Liang


    Full Text Available Background: Incinerator workers are not considered to have arsenic overexposure although they have the risk of overexposure to other heavy metals. Aim: To examine the relationship between arsenic burden and risk of occupational exposure in employees working at a municipal refuse incinerator by determining the concentrations of arsenic in the blood and urine. Settings and Design: The workers were divided into three groups based on their probability of contact with combustion-generated residues, namely Group 1: indirect contact, Group 2: direct contact and Group 3: no contact. Healthy age- and sex-matched residents living in the vicinity were enrolled as the control group. Materials and Methods: Heavy metal concentrations were measured by atomic absorption spectrophotometer. Downstream rivers and drinking water of the residents were examined for environmental arsenic pollution. A questionnaire survey concerning the contact history of arsenic was simultaneously conducted. Statistical analysis: Non-parametric tests, cross-tabulation and multinomial logistic regression. Results: This study recruited 122 incinerator workers. The urine and blood arsenic concentrations as well as incidences of overexposure were significantly higher in the workers than in control subjects. The workers who had indirect or no contact with combustion-generated residues had significantly higher blood arsenic level. Arsenic contact history could not explain the difference. Airborne and waterborne arsenic pollution were not detected. Conclusion: Incinerator workers run the risk of being exposed to arsenic pollution, especially those who have incomplete protection in the workplace even though they only have indirect or no contact with combustion-generated pollutants.

  5. Lymph node staging in prostate cancer. (United States)

    Sankineni, Sandeep; Brown, Anna M; Fascelli, Michele; Law, Yan Mee; Pinto, Peter A; Choyke, Peter L; Turkbey, Baris


    Nodal staging is important in prostate cancer treatment. While surgical lymph node dissection is the classic method of determining whether lymph nodes harbor malignancy, this is a very invasive technique. Current noninvasive approaches to identifying malignant lymph nodes are limited. Conventional imaging methods rely on size and morphology of lymph nodes and have notoriously low sensitivity for detecting malignant nodes. New imaging techniques such as targeted positron emission tomography (PET) imaging and magnetic resonance lymphography (MRL) with iron oxide particles are promising for nodal staging of prostate cancer. In this review, the strengths and limitations of imaging techniques for lymph node staging of prostate cancer are discussed.

  6. Salivary gland carcinomas

    DEFF Research Database (Denmark)

    Therkildsen, M H; Andersen, L J; Christensen, M;


    The prognosis of salivary gland carcinomas is difficult to assess. Simple mucin-type carbohydrates (T and sialosyl-T antigens, Tn and sialosyl-Tn antigens) have been shown to be of value in predicting prognosis for carcinomas in other locations. We studied the prognostic significance...... of the expression of these structures in a retrospective study of 133 patients with salivary gland carcinomas, using immunohistochemistry and a panel of well-defined monoclonal antibodies (MAbs) on formalin-fixed paraffin-embedded tissues. Sialosyl-Tn, T and sialosyl-T antigens were not correlated with prognosis...

  7. General Information about Salivary Gland Cancer (United States)

    ... Research Salivary Gland Cancer Treatment (PDQ®)–Patient Version General Information About Salivary Gland Cancer Go to Health ... These glands are found below the jawbone. Enlarge Anatomy of the salivary glands. The three main pairs ...

  8. Intraoperative Sentinel Lymph Node Evaluation

    DEFF Research Database (Denmark)

    Shaw, Richard; Christensen, Anders; Java, Kapil


    BACKGROUND: Intraoperative analysis of sentinel lymph nodes would enhance the care of early-stage oral squamous cell carcinoma (OSCC). We determined the frequency and extent of cytokeratin 19 (CK19) expression in OSCC primary tumours and surrounding tissues to explore the feasibility of a "clinic...... mg). CK19 assays included qRT-PCR, RNA in situ hybridisation (ISH), and immunohistochemistry (IHC), as well as OSNA. RESULTS: CK19 mRNA expression was detected with variable sensitivity, depending on method, in 60-80% of primary OSCC tumours, while protein expression was observed in only 50......% of tumours. Discordance between different techniques indicated that OSNA was more sensitive than qRT-PCR or RNA-ISH, which in turn were more sensitive than IHC. OSNA results showed CK19 expression in 80% of primary cases, so if used for diagnosis of lymph node metastasis would lead to a false-negative result...


    Directory of Open Access Journals (Sweden)

    Laura eSantambrogio


    Full Text Available The lymphatic fluid originates from the interstitial fluid which bathes every parenchymal organ and reflects the omic composition of the tissue from which it originates in its physiological or pathological signature. Several recent proteomic analyses have mapped the proteome-degradome and peptidome of this immunologically relevant fluid pointing to the lymph as an important source of tissue-derived self-antigens. A vast array of lymph-circulating peptides have been mapped deriving from a variety of processing pathways including caspases, cathepsins, MMPs, ADAMs, kallikreins, calpains and granzymes, among others. These self peptides can be directly loaded on circulatory dendritic cells and expand the self-antigenic repertoire available for central and peripheral tolerance.

  10. Salivary gland choristoma in the buccinator muscle: A case report and literature review (United States)

    Sotorra-Figuerola, Dídac; Almendros-Marqués, Nieves; Espana-Tost, Antonio-Jesús; Valmaseda-Castellón, Eduard; Gay-Escoda, Cosme


    Salivary gland choristoma (SGCh) is defined as the presence of normal salivary tissue in an abnormal location. It is a rare entity in oral and maxillofacial region and its ethiology is unknown. The typical presentation of salivary gland heterotopia is an asymptomatic mass that may or may not produce saliva. Some examples of ectopic salivary tissue in the pituitary gland, in the lymph nodes, in the middle ear, in the neck, in the jaw, in the thyroid gland, in the mediastinum and in the rectum have been documented in literature. We report the case of a 61-year-old male presented with a bilateral tumorlike mass in the cheek. The mass was painless, of fibrous consistency and had size change with time. The histological diagnosis was salivary gland choristoma in the buccinator muscle. In this article, we will revise the characteristic of salivary gland heterotopias and we present a report case that has not been described in literature: a bilateral choristoma of salivary gland in the buccinator muscle, which should be included in the differential diagnosis of head and neck masses. Key words:Choristoma, heterotopias, ectopic tissue, salivary gland, buccinator muscle. PMID:26535104

  11. [The lymphotropic marking and biopsy of sentinel lymph nodes in T1 tumors--a new approach to the staging of axillary lymphatic metastasis in breast cancer]. (United States)

    Deliĭski, T; Baĭchev, G; Popovska, S; Penkova, R


    It is the purpose of the study to assay the possibility of demonstrating axillary lymph status through marking and biopsy of sentinel lymph nodes. Preoperative lymphotropic marking of sentinel lymph nodes is performed in 48 female patients presenting mammary gland carcinoma, measuring up to two centimeters. Drimaren 0.5 ml (in 18 cases), Mitoxantrone (17 cases) or Patent Blue (13 cases) each are perineoplastically injected in two points. Intraoperatively, in 34 patients blue stained lymph nodes (from Patent Blue and Mitoxantrone mainly) are identified, and compared with the results of axillary dissection. Metastases in sentinel nodes are documented in seven instances. In the remainder (30) which are histologically negative, lymph node metastasis II level is discovered in one case (false negative = 3.3 per cent). As shown by the initial observations perioperative marking of lymph nodes with Patent Blue and Mitoxantrone contribute to demonstrate sentinel nodes, and by biopsy study of the latter it is possible to judge about the pattern of lymph metastasizing of mammary gland carcinoma.

  12. Anatomy of the thymus gland. (United States)

    Safieddine, Najib; Keshavjee, Shaf


    In the case of the thymus gland, the most common indications for resection are myasthenia gravis or thymoma. The consistency and appearance of the thymus gland make it difficult at times to discern from mediastinal fatty tissues. Having a clear understanding of the anatomy and the relationship of the gland to adjacent structures is important.

  13. Human Lacrimal Gland Gene Expression (United States)

    Aakalu, Vinay Kumar; Parameswaran, Sowmya; Maienschein-Cline, Mark; Bahroos, Neil; Shah, Dhara; Ali, Marwan; Krishnakumar, Subramanian


    Background The study of human lacrimal gland biology and development is limited. Lacrimal gland tissue is damaged or poorly functional in a number of disease states including dry eye disease. Development of cell based therapies for lacrimal gland diseases requires a better understanding of the gene expression and signaling pathways in lacrimal gland. Differential gene expression analysis between lacrimal gland and other embryologically similar tissues may be helpful in furthering our understanding of lacrimal gland development. Methods We performed global gene expression analysis of human lacrimal gland tissue using Affymetrix ® gene expression arrays. Primary data from our laboratory was compared with datasets available in the NLM GEO database for other surface ectodermal tissues including salivary gland, skin, conjunctiva and corneal epithelium. Results The analysis revealed statistically significant difference in the gene expression of lacrimal gland tissue compared to other ectodermal tissues. The lacrimal gland specific, cell surface secretory protein encoding genes and critical signaling pathways which distinguish lacrimal gland from other ectodermal tissues are described. Conclusions Differential gene expression in human lacrimal gland compared with other ectodermal tissue types revealed interesting patterns which may serve as the basis for future studies in directed differentiation among other areas. PMID:28081151

  14. Submandibular gland excision

    DEFF Research Database (Denmark)

    Springborg, Line Kanstrup; Møller, Martin Nue


    cosmetic result and all scars were ≤6 on the Vancouver Scar Scale. Problems with scarring were more common if there had been postoperative infection. We continue to use the lateral transcervical approach as standard in our institution for patients who cannot be managed by gland-sparing procedures....

  15. Does the polystomatic gland exist? (United States)

    Imai, M; Shibata, T; Moriguchi, K; Kinbara, M


    According to the P.N.A., the N.A.J. and some scholars, the sublingual gland has the ductus sublingualis major and ductus sublinguales minores. This means that the gland is a polystomatic gland. We intended to determine whether the so-called polystomatic gland exists or not. 1. According to the P.N.A., the N.A.J. and some scholars, the gl. sublingualis has the ductus sublingualis major and ductus sublinguales minores. This means the gland is a polystomatic gland. However, the formation of one gland with plural excretory ducts is embryologically impossible, in other words, the polystomatic gland does not exist. 2. Many scholars described that the gl. sublingualis was composed of the gl. sublingualis major and g11. sublinguales minores. However, they are completely different kinds of glands. Accordingly, we suggest the terms for these glands: the g1. sublingualis and its ductus sublingualis ("major" is useless), the g11. sublinguales minores and their ductus sublinguales minores. 3. The N.A.V.J. and some scholars use the term g1. sublingualis polystomatica or parvicanalaris. However, this is a group of a number of independent glands each of which has its own excretory duct. Such a gland should not be regarded as a single gland. We suggest that the term g11. sublinguales minores and their excretory ducts should be replaced with the term the ductus sublinguales minores. 4. The g1. lingualis anterior, g1. retromolaris and g1. lacrimalis are not single glands but a group of several independent glands each of which has its own excretory duct. Accordingly, they should be termed the g11. linguales anteriores, g11. retromolares and g11. lacrimales such as the g11. labiales, g11. buccales and g11. palatinae.

  16. Sarcoidosis of the lacrimal gland as a first manifestation. (United States)

    Peralta-Gómez, M Y; Ávila-Ocampo, K A; Huerta-Velázquez, S; Rivera-Salgado, M I


    The first manifestation of sarcoidosis is usually at the pulmonary level. The case is described of a 40-year-old female patient, who presented with an increased volume of the lacrimal gland and mechanical ptosis of upper left eyelid as the first expression of this disease. The diagnosis of systemic sarcoidosis with primary presentation of the lacrimal gland was made after performing several immunological studies with negative results, imaging studies, and taking of glandular and lymph node biopsies. A favourable response was achieved with oral methotrexate treatment. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Tumors of the lacrimal gland

    DEFF Research Database (Denmark)

    Von Holstein, Sarah Linéa; Rasmussen, Peter Kristian; Heegaard, Steffen


    Tumors of the lacrimal gland comprise a wide spectrum, of which the most common demonstrate epithelial and lymphoid differentiation. The diagnosis of lacrimal gland tumors depends primarily on histological evaluation, as do the choice of treatment and prognosis. For some lacrimal gland neoplasms......, such as adenoid cystic carcinoma, the outlook is grave. Optimal treatment for several lacrimal gland tumors is also a matter of controversy. However, recent progress has been made in the molecular and genetic understanding of tumorigenesis for such lesions. This article presents an overview of the histopathology...... of lacrimal gland tumors, together with their epidemiological features, clinical characteristics, and treatment strategies....

  18. Tumors of the sublingual gland

    DEFF Research Database (Denmark)

    Andreasen, Simon; Bjørndal, K; Agander, T K


    Tumors of the salivary glands are a heterogeneous group of diseases most often originating in the major salivary glands. Only a minor proportion of mainly malignant tumors arise in the sublingual gland. Due to the rarity of sublingual gland tumors (SGTs), little is known about the clinicopathologic...... (ACC). Patient demography was similar to salivary gland tumors in other locations. All fine needle aspiration cytologies (FNACs) interpreted as benign were from ACCs. Metastatic disease was found in 12.5 % of ACCs at diagnosis with one third of all ACC patients having metastases at the end of follow...

  19. Unplanned irradiation of internal mammary lymph nodes in breast cancer. (United States)

    Kanyilmaz, Gul; Aktan, Meryem; Koc, Mehmet; Demir, Hikmettin; Demir, Lütfi Saltuk


    To evaluate the incidental dose to the internal mammary chain (IMC) in patients treated with three-dimensional conformal radiotherapy, to estimate the predictors affecting the magnitude of IMC receiving dose and to determine the predictive role of clinical parameters on survival. Between 2009 and 2015, 348 patients undergoing RT for breast cancer were retrospectively analyzed. All patients underwent our department's routine procedure for breast cancer. The internal mammary lymph nodes were contoured according to Radiation Therapy Oncology Group (RTOG) concensus. Based on each patient's dose-volume histograms, the mean doses (D mean) to internal mammary gland were analyzed. Overall survival and disease-free survival were also evaluated. The median follow-up time was 38 (range 3-80) months. The D mean to IMC was 32.8 Gy and the dose delivered to IMC showed a greater coverage in modified radical mastectomy (MRM) group compared with breast conserving surgery (34.6 vs 26.7 Gy). The T-stage of tumor and the N-stage of tumor affected the incidental dose to IMC. The tumor size, the number of involved lymph nodes, the percentage of involved lymph nodes, hormonal status, advanced T-stage and advanced N-stage were the prognostic factors that affect survival. The IMC received meaningful incidental irradiation dose when treated with two opposite tangential fields and ipsilateral supraclavicular fossa with a single anterior field. The real effect of incidental dose on survival and the hypothesis about the benefit of incidental irradiation of IMC should be examined in clinical studies.

  20. Production of premium fuels from coal refuse pond material

    Energy Technology Data Exchange (ETDEWEB)

    Honaker, R.Q.; Patil, D.P.; Sirkeci, A.; Patwardhan, A. [University of Kentucky, Lexington, KY (United States). Dept. of Mining Engineering


    Because of increasing production of fine coal during mining over the past century and because of inefficient fine-coal recovery technologies, a vast reserve of high-quality coal now exists in refuse ponds. A novel fine-coal circuit, consisting of a hindered-bed classifier, an enhanced gravity concentrator and a flotation column, was evaluated for the recovery of fine coal from refuse ponds. The treatment of a pond derived from Pittsburgh No. 8 seam coal resulted in the production of a premium fuel containing less than 5 % ash and a calorific value of about 30,170 kJ/kg with 60% mass yield. Results from the treatment of two refuse pond materials are presented.

  1. Knowledge-based fault diagnosis system for refuse collection vehicle (United States)

    Tan, CheeFai; Juffrizal, K.; Khalil, S. N.; Nidzamuddin, M. Y.


    The refuse collection vehicle is manufactured by local vehicle body manufacturer. Currently; the company supplied six model of the waste compactor truck to the local authority as well as waste management company. The company is facing difficulty to acquire the knowledge from the expert when the expert is absence. To solve the problem, the knowledge from the expert can be stored in the expert system. The expert system is able to provide necessary support to the company when the expert is not available. The implementation of the process and tool is able to be standardize and more accurate. The knowledge that input to the expert system is based on design guidelines and experience from the expert. This project highlighted another application on knowledge-based system (KBS) approached in trouble shooting of the refuse collection vehicle production process. The main aim of the research is to develop a novel expert fault diagnosis system framework for the refuse collection vehicle.

  2. Energy and pollution characteristics of refuse-derived fuel

    Energy Technology Data Exchange (ETDEWEB)

    Chung, H.I.; Choo, J.; Yu, J. [Korea Inst. of Construction Technology (Korea, Republic of)


    This abstract presented energy, heat value, and pollution concentration characteristics for waste- and refuse-derived fuel. Studies have shown that while recycling and waste-to-energy projects are economically feasible, the impacts of solid waste pre-sorting on the cost of waste-to-energy facilities is uncertain due to the inherent complexity of solid waste composition. Combustible waste is sorted from municipal waste, construction waste, and industrial waste, and used as a raw material for refuse-derived fuel. A heat value evaluation was conducted for products generated at a typical refuse-derived fuel plant. The results of the study will be used to co-ordinate waste-to-energy facilities.

  3. Knowledge-based fault diagnosis system for refuse collection vehicle

    Energy Technology Data Exchange (ETDEWEB)

    Tan, CheeFai; Juffrizal, K.; Khalil, S. N.; Nidzamuddin, M. Y. [Centre of Advanced Research on Energy, Universiti Teknikal Malaysia Melaka, Hang Tuah Jaya, Durian Tunggal, Melaka (Malaysia)


    The refuse collection vehicle is manufactured by local vehicle body manufacturer. Currently; the company supplied six model of the waste compactor truck to the local authority as well as waste management company. The company is facing difficulty to acquire the knowledge from the expert when the expert is absence. To solve the problem, the knowledge from the expert can be stored in the expert system. The expert system is able to provide necessary support to the company when the expert is not available. The implementation of the process and tool is able to be standardize and more accurate. The knowledge that input to the expert system is based on design guidelines and experience from the expert. This project highlighted another application on knowledge-based system (KBS) approached in trouble shooting of the refuse collection vehicle production process. The main aim of the research is to develop a novel expert fault diagnosis system framework for the refuse collection vehicle.

  4. Labial salivary gland tumors. (United States)

    Neville, B W; Damm, D D; Weir, J C; Fantasia, J E


    A study was conducted on labial salivary gland tumors from four oral pathology laboratories. Of the 103 identified tumors, 87 (84.5%) were from the upper lip, whereas 16 (15.5%) were from the lower lip. Of the 87 upper lip tumors, 80 (92.0%) were benign. Forty-three of these were monomorphic adenomas and 37 were pleomorphic adenomas. Seven malignant tumors of the upper lip were as follows: four adenoid cystic carcinomas, two acinic cell carcinomas, and one adenocarcinoma. Of the 16 lower lip tumors, 15 (93.8%) were malignant. Thirteen of these were mucoepidermoid carcinomas and two were acinic cell carcinomas. The only benign lower lip tumor was an intraductal papilloma. These results confirm the findings of previous investigations, showing that minor salivary gland tumors are much more common in the upper lip than the lower lip, but that lower lip tumors are more likely to be malignant.

  5. [Increasing immunization coverage by intervening on determinants of refusal]. (United States)

    Brunelli, M; Valsecchi, M; Speri, L; Simeoni, L; Campara, P; Porchia, S; Bolzonello, E; Russo, F; Bonavina, M G; Bovo, C


    With the regional decree 3664/2008, the Veneto Region adopted measures for improvements in the immunization program, among which the "Investigation into determinants for vaccine refusal in the Veneto Region", entrusted by the Department of Prevention Local Health Unit 20 (Ulss 20) of Verona. The objective of the study was to understand which type of parent that accessed immunization services (total adherent, partial adherent or complete refusals) and what factors lead to their choice regarding immmunizations in order to better plan strategies to maintain vaccination coverage.

  6. Mechanisms of cyst formation in metastatic lymph nodes of head and neck squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Mokhtari Sepideh


    Full Text Available Abstract Cystic change in metastatic lymph nodes occurs in certain types of tumors and mostly in squamous cell carcinoma of the head and neck. In the majority of cases, psuedocystic change is the mechanism of cyst formation. However, sometimes a true cyst cavity is formed. This occurrence is unexplained and some theories are introduced to explain it. In this paper, related articles and introduced concepts are reviewed and the best conclusions of present hypotheses are provided. Cystic SCC in cervical lymph node is now considered as a typical presentation of metastatic SCC arising in the oro/nasopharynx. True cystic cavities have eosinophilic fluid content and present active transport mechanism across the epithelium; Cytokeratin7 is also expressed in the lining of these cysts, which is an accepted marker of ductal differentiation. These are all strong evidences that show salivary gland type cells are present among tumor cells. In fact, some squamous cell carcinomas, especially those arising in Waldeyer's ring, originate from minor salivary glands. The other probability is that these tumors are cancers of transitional type and arise from transformed keratinocytes, which have intrinsic property for cyst formation. These malignant cells in lymph nodes, rather than primary sites, found the opportunity to express their parental property. Virtual slides The virtual slide(s for this article can be found here:

  7. Adenoid cystic carcinoma of the Bartholin's gland:a case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Jing Dongzhen; Yin Juan; Liu Yang; Shao Yi; Yang Xingsheng; Zhang Tingguo


    Adenoid cystic carcinoma (ACC) of the Bartholin's gland is a rare malignant tumor of vulvar which is characterized by slow growth,local invasion and perineural infiltration.The survival rates for 10 years range from 50% to 100%.The disease free interval for 10 years range from 33% to 38%.Currently,there is no consensus on the treatment of ACC of the Bartholin's gland.Primary surgery includes wide local excision or radical vulvectomy with or without lymph node dissection.Adjuvant radiotherapy and chemotherapy are advocated for the treatment of this cancer.Work is still needed to identify an effective systemic therapy.

  8. Tin cans and refuse incineration: upgrading the scrap

    NARCIS (Netherlands)

    Dapper, G.; Dijkstra, S.J.; Loon, van A.P.M.


    In the series of investigations whether and how it is possible to reclaim the iron and tin constituents after incineration, several experiments were performed with the refuse incinerator of Amsterdam. The operating conditions were varied and the influence on the behaviour of the tin cans were determ

  9. [Anorexia and refusal to eat in the elderly]. (United States)

    Hazif-Thomas, Cyril; Thomas, Philippe


    The question of the links between anorexia and the refusal to eat in the elderly is often the cause of major difficulties with regard to therapeutic strategies within caregiving teams. Likewise, few studies have been carried out into the diachronic links between teenage anorexia and that of the elderly. The role of the multi-disciplinary team is essential.

  10. 19 CFR 12.114 - Release or refusal of delivery. (United States)


    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Release or refusal of delivery. 12.114 Section 12.114 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF... delivery. If the completed Notice of Arrival directs the port director to release the shipment...

  11. 30 CFR 816.83 - Coal mine waste: Refuse piles. (United States)


    .... Critical construction periods shall include at a minimum: (i) Foundation preparation including the removal... revegetated upon completion of construction. (c) Placement. (1) All vegetative and organic materials shall be... professional engineer, shall inspect the refuse pile during construction. The professional engineer...

  12. 30 CFR 817.83 - Coal mine waste: Refuse piles. (United States)


    .... Critical construction periods shall include at a minimum: (i) Foundation preparation including the removal... revegetated upon completion of construction. (c) Placement. (1) All vegetative and organic materials shall be... professional engineer, shall inspect the refuse pile during construction. The professional engineer...

  13. Can a physician refuse to help a patient? American perspective. (United States)

    Hood, Virginia L


    Refusal to help means for most people declining to accept the duty to treat. The reasons for refusing to help and how we think about these reasons from an ethical and professional viewpoint are outlined by considering ethical principles, an historical perspective, the law, societal contracts, medicine as a moral enterprise, professional codes, a physician's personal beliefs, reasons for refusing to help and physician discretion. Refusing to help a patient is not consistent with the ethical principle of beneficence, the concept of the primacy of patient welfare or the obligation of the profession to care for the sick. However duty to treat should not be exploited by institutions or place physicians in circumstances that they consider morally, psychologically or physically unacceptable. Following the principle of distributive justice, physicians are obligated to participate in the public debate to ensure that all patients have their needs met by developing or improving health care systems and addressing the new ethical questions that are likely to be generated.

  14. 25 CFR 135.23 - Refusal of water delivery. (United States)


    ... 25 Indians 1 2010-04-01 2010-04-01 false Refusal of water delivery. 135.23 Section 135.23 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL ACTIVITIES CONSTRUCTION ASSESSMENTS, CROW INDIAN IRRIGATION PROJECT Charges Assessed Against Non-Indian Lands Not Included in an Irrigation...

  15. Understanding Excessive School Absenteeism as School Refusal Behavior (United States)

    Dube, Shanta R.; Orpinas, Pamela


    Understanding excessive absenteeism is important to ameliorating the negative outcomes associated with the behavior. The present study examined behavioral reinforcement profiles of school refusal behavior: negative reinforcement (avoidance) and positive reinforcement (gaining parental attention or receiving tangible benefits from not attending…

  16. Domestic Refuse Handling Practices Among Adult Females in a ...

    African Journals Online (AJOL)

    It was an interventional/community-based study involving a total of 436 adult ... Health education was given on domestic refuse handling and reinforcement by ... to the various challenges faced by them particularly the absence of community sanitation members. ... Key words: Solid waste, practices, female adults, obstacles.

  17. Improvement of refuse collection in Kitwe: A participatory approach

    NARCIS (Netherlands)

    B. Kazimbaya-Senkwe (Barbara); K.M. Sankwe; J. Frijns (Jos)


    textabstractThis project set out to define the refuse collection problem in Kitwe and to propose ways of improving the same. Through a household survey, interviews with relevant institutions and a physical survey of the town, it was established that the Kitwe City Council is not able to provide an a

  18. Magnetometric Studies of Catalyst Refuses in Nanocarbon Materials

    Directory of Open Access Journals (Sweden)

    Eklund Peter


    Full Text Available AbstractIt is shown that magnetometry can be employed as an effective tool to control the content of a ferromagnetic constituent in nanocarbon materials. We propose a thermochemical treatment protocol to achieve extensive cleaning of the source nanocarbon materials from ferromagnetic refuses.

  19. 9 CFR 93.806 - Animals refused entry. (United States)


    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Animals refused entry. 93.806 Section 93.806 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE EXPORTATION AND IMPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS IMPORTATION...

  20. Causes of organ donation refusal in southern Iran. (United States)

    Dehghani, S M; Gholami, S; Bahador, A; Nikeghbalian, S; Eshraghian, A; Salahi, H; Kazemi, K; Shamsaei, A; Malek-Hosseini, S A


    Family refusal is an important factor that limits the number of organ donations. Some studies from different centers have reported various reasons for family decisions of organ donation refusal. This study evaluated the reasons for organ donation refusal by family members covered in our organ procurement organization. This cross-sectional study was performed among families of potential organ donors who satisfied brain death criteria as identified between March 2009 and March 2010. Among 125 potential donors 73 (58.4%) families refused donation. Their main reasons were as follows: lack of acceptance of brain death n=26 (35.6%), belief in miracle and patient recovery (n=22; 30.1), fear of gossip regarding sale rather than autonomous organ donation (n=11; 15.1%), and fear about deformation of the donor's body (n=9; 12.3%). Family members play an important role in the final decision for organ donation. The general public should be encouraged to register their donation preferences in the case of brain death. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. 7 CFR 322.19 - Inspection; refusal of entry. (United States)


    ... 7 Agriculture 5 2010-01-01 2010-01-01 false Inspection; refusal of entry. 322.19 Section 322.19 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT Importation...

  2. 7 CFR 322.10 - Inspection; refusal of entry. (United States)


    ... 7 Agriculture 5 2010-01-01 2010-01-01 false Inspection; refusal of entry. 322.10 Section 322.10 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT Importation...

  3. 7 CFR 322.34 - Inspection; refusal of entry. (United States)


    ... 7 Agriculture 5 2010-01-01 2010-01-01 false Inspection; refusal of entry. 322.34 Section 322.34 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT Importation...

  4. A Genre-based Analysis of English Refusal Letters

    Institute of Scientific and Technical Information of China (English)



    The present study analyzes ten English refusal letters of two subcategories based on Swales ’genre analysis model and finds that difference exists in the generic features of the two subcategorized types. Teachers should reveal the underlying rationale behind linguistic features of a specific genre so that students can not only identify genre but also apply it appropriately.

  5. insect vectors of pathogens in selected undisposed refuse dumps in ...

    African Journals Online (AJOL)



    Jun 23, 2012 ... insects and their role in disease transmission are highlighted. Proper disposal of ... Keywords: Insects, refuse dumps, diseases, Kaduna, Nigeria. INTRODUCTION ..... further noted that at present, only individual solutions are used at the household .... to endemic cholera in Douala, Cameroon. PubMed. gov ( ...

  6. Invitation Refusals in Cameroon French and Hexagonal French (United States)

    Farenkia, Bernard Mulo


    Descriptions of regional pragmatic variation in French are lacking to date the focus has been on a limited range of speech acts, including apologies, requests, compliments and responses to compliments. The present paper, a systematic analysis of invitation refusals across regional varieties of French, is designed to add to the research on…

  7. Lacrimal glands: Size does matter!

    Directory of Open Access Journals (Sweden)

    Suyash Mohan


    Full Text Available A 40-year-old woman presented with vague headaches and blurred vision. Contrast-enhanced magnetic resonance imaging of the brain revealed bilaterally symmetrical diffuse enlargement of the lacrimal glands. A fine needle biopsy of the lacrimal gland was consistent with sarcoidosis. Although, isolated lacrimal gland involvement is rare, it may be the initial clinical presentation of sarcoidosis, as seen in this patient. Imaging plays a vital role in these unsuspected cases and careful evaluation of the lacrimal glands with dedicated thin section, fat suppressed, axial and coronal orbital imaging, may help identify a pathological cause and avoid a delay in diagnosis.

  8. Contrast enhanced ultrasound of sentinel lymph nodes

    Directory of Open Access Journals (Sweden)

    XinWu Cui


    Full Text Available Sentinel lymph nodes are the first lymph nodes in the region that receive lymphatic drainage from a primary tumor. The detection or exclusion of sentinel lymph node micrometastases is critical in the staging of cancer, especially breast cancer and melanoma because it directly affects patient’s prognosis and surgical management. Currently, intraoperative sentinel lymph node biopsies using blue dye and radioisotopes are the method of choice for the detection of sentinel lymph node with high identification rate. In contrast, conventional ultrasound is not capable of detecting sentinel lymph nodes in most cases. Contrast enhanced ultrasound with contrast specific imaging modes has been used for the evaluation and diagnostic work-up of peripherally located suspected lymphadenopathy. The method allows for real-time analysis of all vascular phases and the visualization of intranodal focal “avascular” areas that represent necrosis or deposits of neoplastic cells. In recent years, a number of animal and human studies showed that contrast enhanced ultrasound can be also used for the detection of sentinel lymph node, and may become a potential application in clinical routine. Several contrast agents have been used in those studies, including albumin solution, hydroxyethylated starch, SonoVue®, Sonazoid® and Definity®. This review summarizes the current knowledge about the use of ultrasound techniques in detection and evaluation of sentinel lymph node.

  9. Localized Lymph Node Light Chain Amyloidosis

    Directory of Open Access Journals (Sweden)

    Binod Dhakal


    Full Text Available Immunoglobulin-derived light chain amyloidosis can occasionally be associated with localized disease. We present a patient with localized lymph node light chain amyloidosis without an underlying monoclonal protein or lymphoproliferative disorder and review the literature of lymph node amyloidosis discussing work-up and risk factors for systemic progression.

  10. A resected case of neuroendocrine carcinoma of the stomach with unusual lymph node metastasis. (United States)

    Taguchi, Jun; Shinozaki, Koji; Baba, Shinji; Kurogi, Junichi; Nakane, Tomoyuki; Kinoshita, Yoshihiro; Ishii, Kunihide; Ueno, Takato; Torimura, Takuji; Yano, Hirohisa


    Gastric endocrine cell carcinoma is a relatively rare tumor. We experienced a case of early gastric cancer in which an endocrine cell carcinoma was identified within a differentiated adenocarcinoma, and a component of this endocrine cell carcinoma had metastasized to lymph nodes of the stomach. In its 2010 revision regarding digestive system tumors, WHO classified cancer cells with characteristics of both glandular system cells and neuroendocrine cells as mixed adeno neuroendocrine carcinoma (MANEC) under the neuroendocrine carcinoma (NEC) category. In this case, we observed an endocrine cell carcinoma continuous with an intramucosal differentiated adenocarcinoma, and cancer cells with an irregular gland duct structure were observed in the proliferative portion of the submucosal tissue. In addition, there was a 35 mm size lymph node metastasis in the lesser curvature of the stomach consisting entirely of poorly differentiated cancer cells with polymorphic, highly atypical nuclei and scant cytoplasm. Immunohistological analysis showed that the endocrine carcinoma in the gastric mucosa was chromogranin A positive and the infiltrated area of the submucosal tissue was also chromogranin A positive. The lymph node metastasis was positive not only for chromogranin A, but also for Synaptophysin and CD56. Furthermore, the Ki67 labeling index was high at approximately 80 % for the gastric endocrine cell carcinoma and approximately 90 % for the lymph node metastases. Until now, there are no reports related to the patients with early gastric cancer accompanied with lymph node metastasis of MANEC. This case is very interested in considering the mechanism of lymph node metastasis of MANEC. The patient has shown no sign of recurrence for 1 year and 4 months after postoperative chemotherapy.

  11. Metastatic, papillary cystadenocarcinoma of the mammary gland in a black-footed ferret (United States)

    Carpenter, J.W.; Davidson, J.P.; Novilla, M.N.; Huang, J.C.M.


    A simple, papillary cystic adenocarcinoma of the mammary gland with metastases to the internal iliac and mesenteric lymph nodes, liver, and spleen was observed in a 12 to 13 year old female black-footed ferret (Mustela nigripes). Histologically, the tumor was aggressive, and lymphatic invasion was found. Attempts at virus isolation were negative. Other findings were bilateral infarcts in the kidneys, apparently resulting in acute renal shutdown and death, multiple thrombi in the right atrium, aortic arteriosclerosis, and focal interstitial pneumonia.

  12. Extended lymph node dissection for prostate cancer. (United States)

    Jeschke, Stephan; Burkhard, Fiona C; Thurairaja, Ramesh; Dhar, Nivedita; Studer, Urs E


    Lymph node status is an important determinant for the management of patients with newly diagnosed prostate cancer. Given the significant limitations of cross-sectional and functional preoperative imaging in the detection of small metastases, pelvic lymph node dissection remains the only reliable staging method in clinically localized prostate cancer. Although lymph node dissection is a well-established form of staging in prostate cancer, controversy remains about indications and the surgical extent of the procedure. Reported practices vary from omitting pelvic lymph node dissection in low-risk disease to routine pelvic lymph node dissection in all radical prostatectomy patients. This review highlights the recent literature concerning pelvic lymphadenectomy in prostate cancer with respect to anatomical extent and oncologic outcome.

  13. 37 CFR 1.295 - Review of decision finally refusing to publish a statutory invention registration. (United States)


    ... refusing to publish a statutory invention registration. 1.295 Section 1.295 Patents, Trademarks, and... decision finally refusing to publish a statutory invention registration. (a) Any requester who is dissatisfied with the final refusal to publish a statutory invention registration for reasons other than...

  14. 48 CFR 52.207-3 - Right of First Refusal of Employment. (United States)


    ... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Right of First Refusal of....207-3 Right of First Refusal of Employment. As prescribed in 7.305(c), insert the following clause: Right of First Refusal of Employment (MAY 2006) (a) The Contractor shall give Government personnel...

  15. 78 FR 38340 - Federal Acquisition Regulation; Submission for OMB Review; Right of First Refusal of Employment (United States)


    ... Regulation; Submission for OMB Review; Right of First Refusal of Employment AGENCY: Department of Defense...: Submit comments identified by Information Collection 9000- 0114, Right of First Refusal of Employment, by... corresponds with ``Information Collection 9000-0114, Right of First Refusal of Employment''. Follow...

  16. 78 FR 17670 - Federal Acquisition Regulation; Information Collection; Right of First Refusal of Employment (United States)


    ... Regulation; Information Collection; Right of First Refusal of Employment AGENCY: Department of Defense (DoD... comments identified by Information Collection 9000- 0114, Right of First Refusal of Employment, by any of... corresponds with ``Information Collection 9000-0114, Right of First Refusal of Employment''. Follow...

  17. 75 FR 4565 - Federal Acquisition Regulation; Submission for OMB Review; Right of First Refusal of Employment (United States)


    ... Regulation; Submission for OMB Review; Right of First Refusal of Employment AGENCIES: Department of . SUPPLEMENTARY INFORMATION: A. Purpose Right of First Refusal of Employment is a..., DC 20405, telephone (202) 501-4755. Please cite OMB Control No. 9000-0114, Right of First Refusal...

  18. Absorption of phosphorus from wastewater by aged refuse excavated from municipal solid waste landfill

    Institute of Scientific and Technical Information of China (English)

    ZHAO You-cai; SHAO Fang


    Municipal solid waste(refuse) landfill stabilizes as the refuse degrades. After years of biodegradation, the refuse in the landfill becomes stabilized and aged, which may vary with the local climate, humidity, and composition of refuse placed. In this work, it is found that the refuse with an age of over 8 years at Shanghai Refuse Landfill has been significantly stabilized and sufficiently aged and is thus suitable for excavation. The 8-year old aged refuse is mechanically screened, and the fine fractions of refuse(aged refuse) with a diameter less than 2 cm are then used as a biological absorbent for removal of both inorganic and organic phosphorus in livestock wastewater and prepared aqueous solution. It is proved that the aged refuse is very effective for the quantitative removal of both types of phosphorus. The absorption mechanism is proposed. It is considered that phosphorus is firstly absorbed onto the surface of the aged refuse and then used as a substrate for the growth of microorganisms which ultimately leave the aged refuse as sludge.

  19. Imaging of salivary gland tumours

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Y.Y.P.; Wong, K.T.; King, A.D. [Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong (Hong Kong); Ahuja, A.T. [Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong (Hong Kong)], E-mail:


    Salivary gland neoplasms account for <3% of all tumors. Most of them are benign and parotid gland is the commonest site. As a general rule, the smaller the involved salivary gland, the higher is the possibility of the tumor being malignant. The role of imaging in assessment of salivary gland tumour is to define intra-glandular vs. extra-glandular location, detect malignant features, assess local extension and invasion, detect nodal metastases and systemic involvement. Image guided fine needle aspiration cytology provides a safe means to obtain cytological confirmation. For lesions in the superficial parotid and submandibular gland, ultrasound is an ideal tool for initial assessment. These are superficial structures accessible by high resolution ultrasound and FNAC which provides excellent resolution and tissue characterization without a radiation hazard. Nodal involvement can also be assessed. If deep tissue extension is suspected or malignancy confirmed on cytology, an MRI or CT is mandatory to evaluate tumour extent, local invasion and perineural spread. For all tumours in the sublingual gland, MRI should be performed as the risk of malignancy is high. For lesions of the deep lobe of parotid gland and the minor salivary glands, MRI and CT are the modalities of choice. Ultrasound has limited visualization of the deep lobe of parotid gland which is obscured by the mandible. Minor salivary gland lesions in the mucosa of oral cavity, pharynx and tracheo-bronchial tree, are also not accessible by conventional ultrasound. Recent study suggests that MR spectroscopy may differentiate malignant and benign salivary gland tumours as well as distinguishing Warthin's tumor from pleomorphic adenoma. However, its role in clinical practice is not well established. Similarly, the role of nuclear medicine and PET scan, in imaging of parotid masses is limited. Sialography is used to delineate the salivary ductal system and has limited role in assessment of tumour extent.

  20. Treatment Options by Stage (Salivary Gland Cancer) (United States)

    ... and Oropharyngeal Cancer Screening Research Salivary Gland Cancer Treatment (PDQ®)–Patient Version General Information About Salivary Gland ... in diagnosing salivary gland cancer. Certain factors affect treatment options and prognosis (chance of recovery). The treatment ...

  1. Penile Cancer: Contemporary Lymph Node Management. (United States)

    O'Brien, Jonathan S; Perera, Marlon; Manning, Todd; Bozin, Mike; Cabarkapa, Sonja; Chen, Emily; Lawrentschuk, Nathan


    In penile cancer, the optimal diagnostics and management of metastatic lymph nodes are not clear. Advances in minimally invasive staging, including dynamic sentinel lymph node biopsy, have widened the diagnostic repertoire of the urologist. We aimed to provide an objective update of the recent trends in the management of penile squamous cell carcinoma, and inguinal and pelvic lymph node metastases. We systematically reviewed several medical databases, including the Web of Science® (with MEDLINE®), Embase® and Cochrane databases, according to PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) guidelines. The search terms used were penile cancer, lymph node, sentinel node, minimally invasive, surgery and outcomes, alone and in combination. Articles pertaining to the management of lymph nodes in penile cancer were reviewed, including original research, reviews and clinical guidelines published between 1980 and 2016. Accurate and minimally invasive lymph node staging is of the utmost importance in the surgical management of penile squamous cell carcinoma. In patients with clinically node negative disease, a growing body of evidence supports the use of sentinel lymph node biopsies. Dynamic sentinel lymph node biopsy exposes the patient to minimal risk, and results in superior sensitivity and specificity profiles compared to alternate nodal staging techniques. In the presence of locoregional disease, improvements in inguinal or pelvic lymphadenectomy have reduced morbidity and improved oncologic outcomes. A multimodal approach of chemotherapy and surgery has demonstrated a survival benefit for patients with advanced disease. Recent developments in lymph node management have occurred in penile cancer, such as minimally invasive lymph node diagnosis and intervention strategies. These advances have been met with a degree of controversy in the contemporary literature. Current data suggest that dynamic sentinel lymph node biopsy provides excellent

  2. Parathyroid gland adenoma: Case report


    Bojković Gradimir; Čaparević Zorica; Stojanović Dragoš Lj.; Lalošević Đorđe J.; Stojanović Mirjana


    Introduction Primary hyperparathyroidism is a generalized disorder resulting from excessive secretion of parathyroid hormone involving one or more parathyroid glands. Both familial and sporadic forms exist. Histologic examination reveals parathyroid adenoma in about 90% of patients, although it is sometimes difficult to distinguish an adenoma from a normal gland. Primary hyperparathyroidism is commonly characterized by hypercalcaemia, hypophosphatemia and excessive bone resorption. Case repor...

  3. Management of salivary gland tumors

    NARCIS (Netherlands)

    Andry, Guy; Hamoir, Marc; Locati, Laura D.; Licitra, Lisa; Langendijk, Johannes A.


    Surgery after proper imaging (MRI or CT scan) is the main stay of treatment for salivary gland tumors. Although excision margins should be >= 5 mm for malignant tumors in cases of parotid gland carcinoma, the facial nerve should be preserved whenever it is not infiltrated. Adjuvant external radiatio

  4. Lymph node involvement in multicystic peritoneal mesothelioma. (United States)

    Engohan-Aloghe, Corinne; Anaf, Vincent; Noël, Jean Christophe


    Multicystic peritoneal mesothelioma is an uncommon lesion most frequently encountered in women of reproductive age. Although the pathologic characteristics have been documented, the lymph node status associated with this pathology, the etiopathogenesis and prognosis of which remain unclear, is unknown. We report here the case of a 35-year-old woman with a 5.5 cm multicystic mesothelioma affecting the pelvic peritoneum of the rectum. Involvement by multicystic mesothelioma was observed within two lymph nodes simultaneously resected with the tumor. To the best of our knowledge, lymph node involvement has not been described in previous studies.

  5. Isolated Langerhans cell histiocytosis of the sublingual gland in an adult (United States)

    Yang, Shaodong; Chen, Xinming; Zhang, Jiali; Fang, Qiong


    Langerhans cell histiocytosis (LCH) is a rare disorder characterized by the proliferation of pathologic Langerhans cells. Its clinical presentation is highly variable, that range from single-system, limited disease to severe, multi-organ disease with high mortality. LCH usually affects children and young adults. The most frequent sites for LCH are the bone, skin, lung, pituitary gland, and lymph nodes. Salivary gland involvement by LCH is extremely rare, and only a few cases of LHC involving the parotid glands have been reported in the English literature. To our knowledge, the involvement of the sublingual gland as a part of single or multisystem LCH has not been previously described. Herein we reported the first case of primary LCH of the sublingual gland. A 40-year-old woman presented with a 2-month history of a painless mass on the right sublingual area. Excision of the lesion including the right sublingual gland was performed. Histopathological diagnosis of LCH was rendered. The patient remains free of symptoms 17 months after surgery. PMID:26722591

  6. Parental Refusal of Vitamin K and Neonatal Preventive Services: A Need for Surveillance. (United States)

    Marcewicz, Lauren H; Clayton, Joshua; Maenner, Matthew; Odom, Erika; Okoroh, Ekwutosi; Christensen, Deborah; Goodman, Alyson; Warren, Michael D; Traylor, Julie; Miller, Angela; Jones, Timothy; Dunn, John; Schaffner, William; Grant, Althea


    Objectives Vitamin K deficiency bleeding (VKDB) in infants is a coagulopathy preventable with a single dose of injectable vitamin K at birth. The Tennessee Department of Health (TDH) and Centers for Disease Control and Prevention (CDC) investigated vitamin K refusal among parents in 2013 after learning of four cases of VKDB associated with prophylaxis refusal. Methods Chart reviews were conducted at Nashville-area hospitals for 2011-2013 and Tennessee birthing centers for 2013 to identify parents who had refused injectable vitamin K for their infants. Contact information was obtained for parents, and they were surveyed regarding their reasons for refusing. Results At hospitals, 3.0% of infants did not receive injectable vitamin K due to parental refusal in 2013, a frequency higher than in 2011 and 2012. This percentage was much higher at birthing centers, where 31% of infants did not receive injectable vitamin K. The most common responses for refusal were a belief that the injection was unnecessary (53%) and a desire for a natural birthing process (36%). Refusal of other preventive services was common, with 66% of families refusing vitamin K, newborn eye care with erythromycin, and the neonatal dose of hepatitis B vaccine. Conclusions for Practice Refusal of injectable vitamin K was more common among families choosing to give birth at birthing centers than at hospitals, and was related to refusal of other preventive services in our study. Surveillance of vitamin K refusal rates could assist in further understanding this occurrence and tailoring effective strategies for mitigation.

  7. Project Startup: Evaluating the Performance of Hydraulic Hybrid Refuse Vehicles

    Energy Technology Data Exchange (ETDEWEB)


    The Fleet Test and Evaluation Team at the National Renewable Energy Laboratory (NREL) is evaluating the in-service performance of 10 next-generation hydraulic hybrid refuse vehicles (HHVs), 8 previous-generation HHVs, and 8 comparable conventional diesel vehicles operated by Miami-Dade County's Public Works and Waste Management Department in southern Florida. The HHVs under study - Autocar E3 refuse trucks equipped with Parker Hannifin's RunWise Advanced Series Hybrid Drive systems - can recover as much as 70 percent of the energy typically lost during braking and reuse it to power the vehicle. NREL's evaluation will assess the performance of this technology in commercial operation and help Miami-Dade County determine the ideal routes for maximizing the fuel-saving potential of its HHVs.

  8. Organizing the thymus gland. (United States)

    Muñoz, Juan José; García-Ceca, Javier; Alfaro, David; Stimamiglio, Marco Augusto; Cejalvo, Teresa; Jiménez, Eva; Zapata, Agustín G


    Eph receptors and their ligands, ephrins, are molecules involved in the morphogenesis of numerous tissues, including the central nervous system in which they play a key role in determining cell positioning and tissue domains containing or excluding nerve fibers. Because common features have been suggested to occur in the microenvironmental organization of brain and thymus, a highly compartmentalized organ central for T cell differentiation, we examined the expression and possible role of Eph/ephrins in the biology of the thymus gland. We reviewed numerous in vivo and in vitro results that confirm a role for Eph and ephrins in the maturation of the thymic epithelial cell (TEC) network and T cell differentiation. Their possible involvement in different steps of early thymus organogenesis, including thymus primordium branching, lymphoid colonization, and thymocyte-TEC interactions, that determine the organization of a mature three-dimensional thymic epithelial network is also analyzed.

  9. Cryopreservation of Parathyroid Glands

    Directory of Open Access Journals (Sweden)

    Marlon A. Guerrero


    Full Text Available The risk of permanent hypoparathyroidism following thyroid and parathyroid surgery is around 1% in the hands of experienced endocrine surgeons. Although this complication is rare, rendering a patient permanently aparathyroid has significant consequences on the health and quality of life of the patient. Immediate autotransplantation of parathyroid glands that are injured or unintentionally removed offers the best possibility of graft viability and functionality. However, since the majority of cases of hypoparathyroidism are transient, immediate autotransplantation can complicate postoperative surveillance in certain patients, especially those with primary hyperparathyroidism. Cryopreservation of parathyroid tissue is an alternate technique that was developed to treat patients with permanent hypoparathyroidism. This method allows for parathyroid tissue to be stored and then autotransplanted in a delayed fashion once permanent hypoparathyroidism is confirmed. This article provides a contemporary review on cryopreservation of parathyroid tissue and its current role in thyroid and parathyroid surgery.

  10. Pituitary gland tumors; Hypophysentumoren

    Energy Technology Data Exchange (ETDEWEB)

    Jesser, J.; Schlamp, K.; Bendszus, M. [Radiologische Klinik, Universitaetsklinikum Heidelberg, Abteilung fuer Neuroradiologie, Heidelberg (Germany)


    This article gives an overview of the most common tumors of the pituitary gland and the differential diagnostics with special emphasis on radiological diagnostic criteria. A selective search of the literature in PubMed was carried out. Pituitary adenomas constitute 10-15 % of all intracranial tumors and are the most common tumors of the sellar region. Tumors smaller than 1 cm in diameter are called microadenomas while those larger than 1 cm in diameter are called macroadenomas. Approximately 65 % of pituitary gland adenomas secrete hormones whereby approximately 50 % secrete prolactin, 10 % secrete growth hormone (somatotropin) and 6 % secrete corticotropin. Other tumors located in the sella turcica can also cause endocrinological symptoms, such as an oversecretion of pituitary hormone or pituitary insufficiency by impinging on the pituitary gland or its stalk. When tumors spread into the space cranial to the sella turcica, they can impinge on the optic chiasm and cause visual disorders. A common differential diagnosis of a sellar tumor is a craniopharyngeoma. In children up to 10 % of all intracranial tumors are craniopharyngeomas. Other differential diagnoses for sellar tumors are metastases, meningiomas, epidermoids and in rare cases astrocytomas, germinomas or Rathke cleft cysts As these tumors are located in an anatomically complex region of the skull base and are often very small, a highly focused imaging protocol is required. The currently favored modality is magnetic resonance imaging (MRI) with the administration of a contrast agent. The sellar region should be mapped in thin slices. In cases of suspected microadenoma the imaging protocol should also contain a sequence with dynamic contrast administration in order to assess the specific enhancement characteristics of the tumor and the pituitary gland. (orig.) [German] Diese Arbeit ist eine Uebersicht ueber die haeufigsten Hypophysentumoren und deren Differenzialdiagnosen mit Augenmerk auf die

  11. Heuristic methods for a refuse collection vehicle routing problem

    Energy Technology Data Exchange (ETDEWEB)

    Mourao, M.C.; Almeida, M.T.


    The problem of generating the set of routes that minimizes the total time required to collect the household refuse in a particular quarter of Lisbon can be formulated as a Capacitated Arc Routing Problem with some side constraints. Our aim is to obtain approximate solutions, as the problem is known to be NP-hard. We present heuristic methods to generate feasible solutions and report their performance over a set of test problems.

  12. Short term outcome in babies refused perinatal intensive care.


    Sidhu, H.; Heasley, R. N.; Patterson, C C; Halliday, H L; Thompson, W.


    OBJECTIVE--To compare the mortality in babies refused admission to a regional perinatal centre with that in babies accepted for intensive care in the centre. DESIGN--Retrospective study with group comparison. SETTING--Based at the Royal Maternity Hospital, Belfast, with follow up of patients in all obstetric units in Northern Ireland. PATIENTS--Requests for transfer of 675 babies to the regional perinatal centre (prenatally and postnatally) were made from hospitals in Northern Ireland between...

  13. Refusal as a democratic catalyst for mathematics education development

    Directory of Open Access Journals (Sweden)

    Dalene Swanson


    Full Text Available Discussions about the connections between mathematics and democracy amongst the general populace have not been explicitly well rehearsed. A critical relationship with democracy for mathematics education may involve directing and redirecting its purposes. But, we ask, what if the ‘choice’ to not participate in experiences of mathematics education, or in its (redirection, were itself also a critical relationship with mathematics education? What if this refusal and disobedience to the evocative power of mathematics were a democratic action? We argue that consideration of mathematics education for democracy and development must take seriously specific acts of refusal that directly confront the construction of inequality common in most development contexts. Globalisation and development discourses, via citizenship and nationalism, construct relationships with learners and mathematics education in very specific ways that delimit possibilities for egalitarianism and democratic action. But, might such action not be recognised, not as refusal to participate per se, but as a refusal to participate in mathematics education’s colonising and/or globalising neo-liberal gaze? In arguing for the opening of a position of radical equality, we introduce Jacques Rancière to mathematics education theory, noting that for Rancière emancipation is the intentional disregard for ideological narratives such as the ones produced by mathematics education discourses. Thus, we provoke serious reconsideration of the assumptions behind most school improvement and professional development projects, as well as mathematics education policies and practices framed by globalising development discourses, and in the process we challenge our colleagues to consider ‘refusal’ not as deficit or failure, but as a critical position of radical equality in relation to mathematics education.

  14. Energetic utilisation of refuse derived fuels from landfill mining. (United States)

    Rotheut, Martin; Quicker, Peter


    The residence of municipal solid waste within a landfill body results in a significant change of material properties. Experiences with the energetic utilisation of the burnable fractions from formerly landfilled waste are hardly documented, the influence of refuse derived fuels (RDF) from such materials on the performance of modern waste-to-energy plants is not sufficiently described in scientific literature. Therefore this study focuses on the energetic utilisation of refuse derived fuel from landfilled waste, processed in a mechanical waste treatment facility, and the impact of the material on the operation of the incineration plant. Additionally, the possibility of direct combustion of non-pre-treated excavated landfill material has been evaluated in the same facility. First, sampling and analysis of the fuel has been carried out. Based on this, a large-scale combustion experiment was planned and conducted in an industrial waste-to-energy plant. Steam mass flow rate, concentration of harmful substances in the raw gas, as well as total emissions of the facility have been monitored in detail. Furthermore, the influence of the landfilled material on the additive consumption has been determined. The combustion residues (bottom ash) were also sampled and analysed. Based on the evaluation of operating data and analysis of both fuel and residue, suitable thermal treatment approaches for the refuse-derived fuel and the non-pre-treated excavated material have been assessed.

  15. Ambiguities and Asymmetries in Consent and Refusal: Reply to Manson. (United States)

    Lawlor, Rob


    John Harris claims that is it 'palpable nonsense' to suggest that 'a child (or anyone) might competently consent to a treatment but not be competent to refuse it.' In 'Transitional Paternalism: How Shared Normative Powers Give Rise to the Asymmetry of Adolescent Consent and Refusal' Neil Manson aims to explain away the apparent oddness of this asymmetry of consent and refusal, by appealing to the idea of shared normative powers, presenting joint bank accounts as an example. In this article, I will argue that Manson's account fails to explain away the oddness. Rather, I will argue that there are ambiguities to which Manson has not paid sufficient attention. In fact, as odd as it may sound, I argue that Manson actually agrees with Harris (at least in relation to the asymmetry of competence). He fails to recognize that he agrees with Harris because he is not careful enough to distinguish between different asymmetries, which I have labelled the asymmetries of choice, permissibility and competence.

  16. Trinko and Re-Grounding the Refusal to Deal Doctrine

    Directory of Open Access Journals (Sweden)

    Adam Candeub


    Full Text Available Verizon Communications Inc. v. Law Offices of Curtis V. Trinko, LLP (“Trinko”, the most important Supreme Court antitrust review of the refusal to deal antitrust doctrine in twenty years, pitted a local incumbent monopolist telephone company (“ILEC”, Verizon, against a class of competitive local exchange companies (“CLECs”, the new entrants to local telephone service spawned by the 1996 Telecommunications Act (“1996 Act” or “Telecom Act”, and their customers. The Supreme Court rejected the CLECs’ claim that Verizon violated the antitrust laws by failing to provide interconnection services as the Act required. The CLECs based their claim upon two antitrust doctrines: “refusal to deal” and “essential facilities,” both of which require monopolists to provide vital vertical inputs to their downstream competitors. Here, the input was interconnection or “access” on a wholesale level to Verizon’s telephone network that its competitors needed in order to provide retail phone service. The Court ruled that if a legal mechanism exists, as with the 1996 Act, to compel access to the putative monopolist’s resource, the refusal to deal doctrine has nothing to remedy and, therefore, plaintiffs did not state an antitrust claim.

  17. Quantification of lymph nodes in the central compartment of the neck: a cadaveric study. (United States)

    Ofo, Enyinnaya; Thavaraj, Selvam; Cope, Daron; Barr, James; Kapoor, Karan; Jeannon, Jean-Pierre; Oakley, Richard; Lock, Claire; Odell, Edward; Simo, Ricard


    Differentiated thyroid cancer (DTC) accounts for over 90 % of thyroid malignancies, and is frequently associated with central neck compartment nodal metastasis that requires a therapeutic central compartment neck dissection (CCND) for clinically evident nodes. Current knowledge on the expected lymph node yield from a CCND is limited, compared with data on the lateral neck. The aim of our study was to accurately quantify nodal yield from the cadaveric central neck compartment. Twenty-eight cadaveric necks were dissected and the central neck compartment was subdivided into four regions: pre-laryngeal (delphian), pre-tracheal, right and left para-tracheal regions. Each cadaver had a thyroid gland, which was also removed, and the CCND tissue in each compartment was processed and examined by a consultant histopathologist. Only lymphoid tissue with a defined microscopic fibrous capsule and subcapsular sinus was included in the node count. The median total lymph node count per cadaver was four (range 1-16), with a median of one node detectable in each para-tracheal region (range 0-7) and the pre-tracheal region (range 0-8). The median pre-laryngeal node count was 0 (range 0- 2). The average lymph node size across all compartments was 2.9 mm. This is the first European study to assess cadaveric central neck lymph nodes and establish baseline counts for nodal yield. If a prophylactic or therapeutic CCND is required during thyroid surgery, those involved in DTC management must recognise that there is a wide range, and low median yield of central neck compartment lymph nodes.

  18. [Inflammation of the parathyroid glands]. (United States)

    Ting, S; Synoracki, S; Sheu, S-Y; Schmid, K W


    Inflammation of the parathyroid glands is rare when compared to other endocrine organs. This leads to the use of descriptive terms as well as the lack of a generally accepted classification for inflammatory disorders of the parathyroid glands. This review article proposes that parathyroid inflammation be subdivided morphologically into (a) non-specific lymphocytic infiltration, which is more an expression of damage to small vessels, due to e. g. severe systemic inflammation or myocardial infarction, (b) autoimmunogenic lymphocytic parathyroiditis, (c) nonimmunogenic inflammation caused by granulomatous diseases or infections and (d) invasive sclerosing (peri) parathyroiditis. As only parathyroid glands removed due to hyperparathyroidism and normal parathyroid glands incidentally removed during thyroid surgery are seen almost exclusively in routine histopathology, virtually no information about the morphological correlate of hypoparathyroidism is available.

  19. Stages of Salivary Gland Cancer (United States)

    ... following stages are used for major salivary gland cancers: Enlarge Tumor sizes. The size of a tumor may be compared to the size of a pea (1 cm), peanut (2 cm), grape (3 cm), walnut (4 cm), lime (5 cm), ...

  20. Calcium signaling in lacrimal glands. (United States)

    Putney, James W; Bird, Gary S


    Lacrimal glands provide the important function of lubricating and protecting the ocular surface. Failure of proper lacrimal gland function results in a number of debilitating dry eye diseases. Lacrimal glands secrete lipids, mucins, proteins, salts and water and these secretions are at least partially regulated by neurotransmitter-mediated cell signaling. The predominant signaling mechanism for lacrimal secretion involves activation of phospholipase C, generation of the Ca(2+)-mobilizing messenger, IP3, and release of Ca(2+) stored in the endoplasmic reticulum. The loss of Ca(2+) from the endoplasmic reticulum then triggers a process known as store-operated Ca(2+) entry, involving a Ca(2+) sensor in the endoplasmic reticulum, STIM1, which activates plasma membrane store-operated channels comprised of Orai subunits. Recent studies with deletions of the channel subunit, Orai1, confirm the important role of SOCE in both fluid and protein secretion in lacrimal glands, both in vivo and in vitro.

  1. Intrasellar Symptomatic Salivary Gland Rest

    Directory of Open Access Journals (Sweden)

    Chih-Hao Chen


    Full Text Available Ectopic salivary gland tissue in sellar turcica is frequently observed in microscopic examination at autopsy. This tissue is considered clinically silent. Only 2 symptomatic cases have been previously reported. Here we report a 28-year-old woman presenting with galactorrhea and hyperprolactinemia. Magnetic resonance imaging revealed a 6×5-mm nodule in the posterior aspect of the pituitary gland. This nodule showed isointensity on T1- and T2-weighted images and less enhancement on post-contrast T1-weighted images. Transsphenoidal exploration revealed a cystic lesion within the pituitary gland, which consisted of a grayish gelatinous content. The pathologic examination confirmed the diagnosis of salivary gland rest.

  2. [Applied embryology of parathyroid glands]. (United States)

    Henry, J F; Sebag, F


    The article describes the normal structure of the parathyroid glands (PTG) and their development, anomalies of migration in the process of embryogenesis and congenital ectopias of PTG as well as possible supplementary PTG and their congenital ectopias.

  3. Prognostic Factors and Treatment Outcomes of Parotid Gland Cancer: A 10-Year Single-Center Experience. (United States)

    Chang, Jae Won; Hong, Hyun Jun; Ban, Myung Jin; Shin, Yoo Seob; Kim, Won Shik; Koh, Yoon Woo; Choi, Eun Chang


    To investigate the treatment outcomes of parotid gland cancer at a single center over a 10-year period and to evaluate the prognostic significance of maximum standardized uptake value. Retrospective case series with chart review. Academic care center. Ninety-eight patients with primary parotid gland cancer who were surgically treated at Yonsei University Head & Neck Cancer Clinic between January 1999 and December 2008 were analyzed. Patient data were collected retrospectively from medical charts. The investigators analyzed the association of clinicopathological factors and maximum standardized uptake value on (18)F-fluorodeoxyglucose positron emission tomography-computed tomography scan with disease-specific survival. Mean patient age was 49.7 years. Mean follow-up was 48.8 months. Thirty-three, 40, 30, and 23 patients had stage I, II, III, and IVA disease, respectively. Mucoepidermoid carcinoma was the most common histologic type (34.7%), followed by acinic cell carcinoma (27.6%). Eighteen patients (18.4%) experienced recurrences (mean recurrence gap, 20.6 months; range, 2-87 months). Five- and 10-year disease-specific survival rates were 93.6% and 81.8%, respectively. In the univariate analysis, pathologic T stage, pathologic lymph node status, resection margin, external parenchymal extension, and maximum standardized uptake value were significantly associated with disease-specific survival. Pathologic lymph node status and maximum standardized uptake value were independent prognostic factors in the multivariate analysis. Our single-center experience with parotid gland cancer treatment is consistent with the literature. Cervical lymph node metastasis and high maximum standardized uptake value are associated with poor survival in parotid gland cancer. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  4. Scent glands in legume flowers. (United States)

    Marinho, C R; Souza, C D; Barros, T C; Teixeira, S P


    Scent glands, or osmophores, are predominantly floral secretory structures that secrete volatile substances during anthesis, and therefore act in interactions with pollinators. The Leguminosae family, despite being the third largest angiosperm family, with a wide geographical distribution and diversity of habits, morphology and pollinators, has been ignored with respect to these glands. Thus, we localised and characterised the sites of fragrance production and release in flowers of legumes, in which scent plays an important role in pollination, and also tested whether there are relationships between the structure of the scent gland and the pollinator habit: diurnal or nocturnal. Flowers in pre-anthesis and anthesis of 12 legume species were collected and analysed using immersion in neutral red, olfactory tests and anatomical studies (light and scanning electron microscopy). The main production site of floral scent is the perianth, especially the petals. The scent glands are distributed in a restricted way in Caesalpinia pulcherrima, Anadenanthera peregrina, Inga edulis and Parkia pendula, constituting mesophilic osmophores, and in a diffuse way in Bauhinia rufa, Hymenaea courbaril, Erythrostemon gilliesii, Poincianella pluviosa, Pterodon pubescens, Platycyamus regnellii, Mucuna urens and Tipuana tipu. The glands are comprised of cells of the epidermis and mesophyll that secrete mainly terpenes, nitrogen compounds and phenols. Relationships between the presence of osmophores and type of anthesis (diurnal and nocturnal) and the pollinator were not found. Our data on scent glands in Leguminosae are original and detail the type of diffuse release, which has been very poorly studied.

  5. Telocytes in parotid glands. (United States)

    Nicolescu, Mihnea I; Bucur, Alexandru; Dinca, Octavian; Rusu, Mugurel C; Popescu, Laurentiu M


    The parotid histological structure includes acinar, ductal, and myoepithelial cells, surrounded by a connective stromal component. The parotid stroma is mostly regarded as an inert shell, consisting of septa, which divide the parenchyma. Telocytes were recently identified as a new stromal cell type in various organs, including exocrine pancreas. We aimed to evaluate telocytes presence in parotid stroma and whether their topographical features might support an involvement in parotid function modulation. Serial ultrathin sections of human and rat parotid glands were studied and compared by transmission electron microscopy. Two-dimensional concatenation of sequenced micrographs allowed the ultrastructural identification of parotid telocytes, with their specific long, thin, and moniliform prolongations (telopodes). Telocyte location appeared frequently as a strategic one, in close contact or vicinity of both secretory (acini and ducts) and regulatory (nerves and blood vessels) apparatuses. They were also found in the interacinar and the subductal stroma. Two previously reported telocyte markers (c-kit/CD117 and vimentin) were assayed by immunohistochemistry. Actin expression was also evaluated. Telocytes are making a network, especially by branching of their long telopodes. Elements of this telocyte network are interacting with each other (homocellular connections) as well as with other cell types (heterocellular connections). These interactions are achieved either by direct contact (stromal synapse), or mediated via shed microvesicles/exosomes. Since telocyte connections include both neurovascular and exocrine elements (e.g., acini and ducts), it is attractive to think that telocytes might mediate and integrate neural and/or vascular input with parotid function.

  6. Prognostic Implications of Lymph Node Yield and Lymph Node Ratio in Papillary Thyroid Carcinoma

    NARCIS (Netherlands)

    Nunes, Jonathan H. Vas; Clark, Jonathan R.; Gao, Kan; Chua, Elizabeth; Campbell, Peter; Niles, Navin; Gargya, Ash; Elliott, Michael S.


    Background: The lymph node yield (LNY) and the lymph node ratio (LNR) have been shown to be important prognostic factors in oral, colon, and gastric cancers. The role of the LNY and LNR in papillary thyroid cancer (PTC) is unclear. The aims of this study were to determine if a high LNR and a low LNY

  7. Energy Recycling in Municipal Refuse and Its Pollution Control in Combustion

    Institute of Scientific and Technical Information of China (English)

    吴发勇; 段丽平; 陈红; 谢茂清


    Recycling the energy in municipal refuse and controlling the secondary pollution are common concerns.After analyzing the status and disposal of the municipal refuse in China, this paper proposes a technique of refuse incineration, using a fluid-bed incinerator, which converts refuse into energy.The technique of controlling secondary pollution in combustion is also discussed.In this paper, the technique of incineration using a fluid-bed incinerator is introduced.During the combustion process, the refuse is mixed with coal and remover and a noxious gas removal system is installed, which helps to decrease the generation and emission of noxious material, such as dioxins.The result shows that the secondary pollution in refuse incineration is efficiently controlled.

  8. Vaccination refusal: ethics, individual rights, and the common good. (United States)

    Schwartz, Jason L; Caplan, Arthur L


    Among the obstacles to the success of vaccination programs is the apparent recent increase in hesitancy and outright resistance to the recommended vaccination schedule by some parents and patients. This article reviews the spectrum of patient or parental attitudes that may be described as vaccine refusal, explores related ethical considerations in the context of the doctor-patient relationship and public health, and evaluates the possible responses of physicians when encountering resistance to vaccination recommendations. Health care providers should view individuals hesitant about or opposed to vaccines not as frustrations or threats to public health, but as opportunities to educate and inform.

  9. Refuse-derived Fuel Energy Recovery by Plasma Technology

    Directory of Open Access Journals (Sweden)

    Marián LÁZÁR


    Full Text Available The paper reports the results of experiments focused upon high temperature gasification of waste with a significant proportion of combustibles. This is refuse-derived fuel (RDF obtained by sorting the combustible components of communal waste. During the gasification of this waste in a plasma reactor (with a waste humidity of circa 24.9 %, when calculated per 1 kg of waste, syngas was obtained in an amount of 1.35 to 1.84 m3∙kg-1. Apart from gas, the gasification process also creates slag of a glassy structure suitable for further use.

  10. Adenoid cystic carcinoma of the sublingual gland: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ji Young [Dept. of Oral and Maxillofacial Surgery, School of Medicine, Jeju National University, Jeju (Korea, Republic of)


    Adenoid cystic carcinoma (ACC) of the sublingual gland is an extremely rare neoplasm. The clinicopathological characteristics of ACC are slow-growing swelling with or without ulceration, perineural spread, local recurrence, and distant metastasis. This report describes a 58-year-old male who had a slowly growing swelling without ulceration on the right side of the mouth floor that had been present for 1 month. In a radiological examination, the mass showed multilocular cystic features and no bony or tongue muscle invasion. No enlarged cervical lymph nodes were detected. Excisional biopsy and histological analysis showed that the lesion was ACC. In addition to reporting a rare case of ACC, this report also discusses the differential diagnosis and treatment of ACC with a review of the relevant literature.

  11. Colorectal cancer lymph node staining by activated carbon nanoparticles suspension in vivo or methylene blue in vitro

    Institute of Scientific and Technical Information of China (English)

    Hong-Ke Cai; Hai-Fei He; Wei Tian; Mei-Qi Zhou; Yue Hu; Yong-Chuan Deng


    AIM:To investigate whether activated carbon nanoparticles suspension (ACNS) or methylene blue (MB)can increase the detected number of lymph nodes in colorectal cancer.METHODS:Sixty-seven of 72 colorectal cancer patients treated at our hospital fulfilled the inclusion criteria of the study which was conducted from December 2010 to February 2012.Seven patients refused to participate.Eventually,60 patients were included,and randomly assigned to three groups (20 in each group):ACNS group (group A),MB group (group B) and non-stained conventional surgical group (group C).In group A,patients received subserosal injection of 1 mL ACNS in a 4-quadrant region around the mass.In group B,the main artery of specimen was identified and isolated after the specimen was removed,and 2 mL MB was slowly injected into the isolated,stretched and fixed vessel.In group C,no ACNS and MB were injected.All the mesentery lymph nodes were isolated and removed systematically by visually inspecting and palpating the adipose tissue.RESULTS:No difference was observed among the three groups in age,gender,tumor location,tumor diameter,T-stage,degree of differentiation,postoperative complications and peritoneal drainage retention time.The total number of detected lymph nodes was 535,476 and 223 in the three groups,respectively.The mean number of detected lymph nodes per patient was significantly higher in group A than in group C (26.8 ±8.4 vs 12.2-3.2,P < 0.001).Similarly,there were significantly more lymph nodes detected in group B than in group C (23.8 ± 6.9 vS12.2 ± 3.2,P < 0.001).However,there was no significant difference between group A and group B.There were 50,46 and 32 metastatic lymph nodes dissected in 13 patients of group A,10 patients of group B and 11 patients of group C,without significant differences among the three groups.Eleven of the 60 patients had insufficient number of detected lymph nodes (< 12).Only one patient with T4a rectal cancer had 10 lymph nodes detected in

  12. Adrenal gland and bone. (United States)

    Hardy, Rowan; Cooper, Mark S


    The adrenal gland synthesizes steroid hormones from the adrenal cortex and catecholamines from the adrenal medulla. Both cortisol and adrenal androgens can have powerful effects on bone. The overproduction of cortisol in Cushing's disease leads to a dramatic reduction in bone density and an increase risk of fracture. Overproduction of adrenal androgens in congenital adrenal hyperplasia (CAH) leads to marked changes in bone growth and development with early growth acceleration but ultimately a significant reduction in final adult height. The role of more physiological levels of glucocorticoids and androgens on bone metabolism is less clear. Cortisol levels measured in elderly individuals show a weak correlation with measures of bone density and change in bone density over time with a high cortisol level associated with lower bone density and more rapid bone loss. Cortisol levels and the dynamics of cortisol secretion change with age which could also explain some age related changes in bone physiology. It is also now clear that adrenal steroids can be metabolized within bone tissue itself. Local synthesis of cortisol within bone from its inactive precursor cortisone has been demonstrated and the amount of cortisol produced within osteoblasts appears to increase with age. With regard to adrenal androgens there is a dramatic reduction in levels with aging and several studies have examined the impact that restoration of these levels back to those seen in younger individuals has on bone health. Most of these studies show small positive effects in women, not men, but the skeletal sites where benefits are seen varies from study to study.

  13. Metastases in small lymph nodes from colon cancer. (United States)

    Herrera-Ornelas, L; Justiniano, J; Castillo, N; Petrelli, N J; Stulc, J P; Mittelman, A


    Lymph node metastases are important determinants in the prognosis of primary colorectal cancer. Although it has been established that enlarged, palpable lymph nodes contain metastases in less than half of the cases, no definitive data concerning the incidence of metastases in lymph nodes measuring 5 mm or less are available. We treated the surgical specimens of 52 consecutive patients who had colon cancer with a lymph node clearance technique at the Roswell Park Memorial Institute, Buffalo. We found 2699 lymph nodes in the 52 specimens, with a mean of 52 lymph nodes per specimen (range, five to 151). Sixty-four lymph nodes were found with metastases in 21 (40%) of the 52 patients. Fifty-nine of 64 of the lymph nodes were reexamined and remeasured. Thirty-nine lymph node metastases measured less than 5 mm, 13 were between 5 and 10 mm, and eight were larger than 10 mm. We concluded that lymph node metastases in colon cancer occur most frequently in lymph nodes measuring less than 5 mm (small lymph nodes). The use of lymph node clearing techniques in surgical specimens improves detection of small lymph node metastases and thereby diminishes understaging.

  14. Salivary Heparanase Level Is a Potential Biomarker to Diagnose and Prognose the Malignant Salivary Gland Tumor.

    Directory of Open Access Journals (Sweden)

    Xiangbing Wu

    Full Text Available Upregulation of heparanase has been reported in an increasing number of human cancer tissues. However, the level of salivary heparanase and its clinical significance in patients with salivary gland tumors remain unclear.Salivary heparanase levels in patients with salivary gland tumors were detected using enzyme-linked immunosorbent assays (ELISAs and the clinical significance was evaluated by analyzing the correlations among salivary heparanase levels, clinicopathological parameters, and clinical outcomes.The levels of salivary heparanase were significantly higher in patients with malignant salivary gland tumors than in benign tumors and normal controls (P<0.0001. High salivary heparanase levels were positively correlated with increased lymph node metastasis (P = 0.0235 and poorer tumor node metastasis stage (TNM (P = 0.0183. Survival analyses revealed that high salivary heparanase levels were associated with worse overall survival (P = 0.0023 and disease-free survival (DFS (P = 0.0025.The study shows that salivary heparanase levels, as detected by the ELISAs, can be used to diagnose and provide an accurate prognosis for malignant salivary gland tumors. Salivary heparanase level was an independent predictor in patients with malignant salivary gland tumors.

  15. Warthin-Like Papillary Carcinoma of the Thyroid Gland: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Panagiotis Paliogiannis


    Full Text Available We present a case of Warthin-like papillary thyroid carcinoma in a 22-year-old woman and a review of the literature on the topic. The patient had the occasional discovery of a hypoechoic thyroid nodule of approximately 18 mm, characterized by irregular margins, hyperechoic spots, rich intra- and perilesional vascularization, and a suspicious enlarged right laterocervical lymph node. Fine-needle aspiration was performed for both lesions and the diagnosis of papillary thyroid carcinoma without lymph node involvement was made. The patient underwent thyroidectomy and central neck lymphadenectomy without complications. Histopathological examination suggested a Warthin-like papillary carcinoma of the thyroid gland, with all the removed lymph nodes being free of disease. The patient subsequently underwent iodine ablative therapy and she remains free of disease one year after surgery. Warthin-like papillary thyroid carcinoma is a recently described variant of papillary thyroid cancer that is frequently associated with lymphocytic thyroiditis. Morphologically, it resembles Warthin tumors of the salivary glands, with T and B lymphocytes infiltrating the stalks of papillae lined with oncocytic cells. Surgical and postoperative management is identical to that of classic differentiated thyroid cancer, while prognosis seems to be favourable.

  16. Immunology of the mammary gland

    Directory of Open Access Journals (Sweden)

    Lazarević Miodrag


    Full Text Available The mammary gland is an organ of specific structure whose elementary task is to supply offspring with nutritive and other biologically active substances during the first weeks, or, depending on the species, the first months of life. This prolongs the period of close contact between the mother and her young, which is necessary for their regular growth. Most mammal offspring are born with physiological agammaglobulinaemia, because of the specific structure of the placenta, so that they receive the first specific protection against pathogenic microorganisms through colostrum. Furthermore, this gland is in direct contact with the outer environment through the secretary ducts, so that there are great possibilities for the occurrence of infections. It is therefore necessary to secure protective mechanisms which would prevent such infections. It is clear that there is a distinct connection between the immunological system and the mammary gland, and that link is the central topic of this paper. It presents the basic mechanisms of mammary gland defense which are divided into two categories: nonspecific (innate and specific immune response. The mammary gland secretion contains several types of leukocytes, such as lymphocytes, macrophages, and neutrophiles, as well as 2% epithelial cells. On the average, there are 0.2 x 106 somatic cells in one mililiter of milk. Macrophages account for most of these (58%, as well as lymphocytes (28%, while a smaller number of somatic cells (12% are polymorphonuclears (PMN. The paper considers the characteristics and main functions of these cell types.

  17. Inguinal Lymph Node Anthracosis: A Case Report (United States)

    Soto, Carlos Alberto


    Summary: Anthracosis is defined as black, dense pigments in tissues, usually carbon deposits. We, as surgeons, have to make decisions during surgery to the best of our knowledge and based on what the literature provides us. We present the case of a 30-year-old female patient who underwent abdominoplasty. During surgery, bilateral inguinal pigmented and enlarged lymph nodes were seen. Biopsy of the nodes was done to rule out any malignancy. The results showed tattoo pigments on all lymph nodes. We present this case as tattoo pigment migration, which has been rarely described. PMID:27536493

  18. Outcome analysis of 215 patients with parotid gland tumors: a retrospective cohort analysis. (United States)

    Erovic, Boban M; Shah, Manish D; Bruch, Guillem; Johnston, Meredith; Johnston, U; Kim, John; O'Sullivan, Brian; Perez-Ordonez, Bayardo; Weinreb, Ilan; Atenafu, Eshetu G; de Almeida, John R; Gullane, Patrick J; Brown, Dale; Gilbert, Ralph W; Irish, Jonathan C; Goldstein, David P


    To identify prognostic factors in patients with parotid gland carcinomas who were treated at the Princess Margaret Hospital. Clinical outcome of two hundred fifteen patients with malignancies of the parotid gland was evaluated over a 16-year period. Two-hundred-fifteen patients with adenoid cystic carcinoma (n = 20), adenocarcinoma (n = 19), acinic cell carcinoma (n = 62), basal cell adenocarcinoma (n = 7), carcinoma-ex-pleomorphic adenoma (n = 18), mucoepidermoid carcinoma (n = 70) and salivary duct carcinoma (n = 19) have been included. The 5- and 10-year overall and disease-free survivals were 80.62%/69.48% and 74.37%/62.42%, respectively. Multivariable analysis showed that age greater than 60 years, advanced pN classification, histopathological grade and the presence of lymphovascular invasion significantly worsened overall and disease-free survival. Univariable analysis revealed periparotid lymph node involvement was associated with decreased overall (p < 0.0001) and disease-free survival (p < 0.0001). In addition to age, pN classification, histopathological grade, perineural invasion, and lymphovascular involvement, periparotid lymph node metastasis appears to be an important prognosticator in parotid gland malignancy.

  19. In situ preservation of the inferior parathyroid gland during central neck dissection for papillary thyroid carcinoma. (United States)

    Wang, J B; Wu, K; Shi, L H; Sun, Y Y; Li, F B; Xie, L


    Postoperative hypocalcaemia due to dysfunction of the parathyroid glands is the most common complication after total thyroidectomy plus central neck dissection (CND). There is a lack of surgical techniques described to help preserve the inferior parathyroid gland in situ during CND. The objective of this study was to introduce the 'TBP layer' (layer of thymus-blood vessel-inferior parathyroid gland) concept for preserving the inferior parathyroid gland in situ during CND, and to evaluate its effectiveness. The study group included patients with primary papillary thyroid cancer who underwent total thyroidectomy with CND using the new surgical concept between January and December 2014. The control group included sex- and age-matched patients who underwent conventional total thyroidectomy with CND between January 2012 and December 2013. The proportion of inferior parathyroid glands preserved in situ and postoperative hypoparathyroidism rates in the two groups were compared. There were 181 patients in the study group and 306 in the control group. There were no significant differences between the groups in tumour size, multifocality, extrathyroidal extension, and number of harvested and metastatic central lymph nodes. The rate of inferior parathyroid gland preservation in situ was significantly improved from 37·9 to 76·3 per cent on the left side (P < 0·001), and from 52·0 to 77·9 per cent on the right side (P < 0·001), in the study group compared with the control group. The incidence of transient hypoparathyroidism decreased significantly from 35·0 to 7·2 per cent (P < 0·001). Applying the proposed surgical concept improved the rate of inferior parathyroid gland preservation in situ and decreased the incidence of transient postoperative hypoparathyroidism. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  20. [Lymph node staging in gastrointestinal cancer. Combination of methylene blue-assisted lymph node dissection and ex vivo sentinel lymph node mapping]. (United States)

    Märkl, B; Arnholdt, H


    The histopathological lymph node staging is of crucial importance for the prognosis estimation and therapy stratification in gastrointestinal cancer. However, the recommended numbers of lymph nodes that should be evaluated are often not reached in routine practice. Methylene blue assisted lymph node dissection was introduced as a new, simple and efficient technique to improve lymph node harvest in gastrointestinal cancer. This method is inexpensive, causes no delay and needs no toxic substances. All studies performed revealed a highly significantly improved lymph node harvest in comparison to the conventional technique. Moreover, this technique can be combined with a new ex vivo sentinel lymph node mapping that for the first time is based on histological sentinel lymph node detection. The success rate of this method is similar to conventional techniques and it enables an efficient application of extended investigation methods, such as immunohistochemistry or the polymerase chain reaction.


    Institute of Scientific and Technical Information of China (English)

    YIN Tong; JI Xiao-long


    This study is to find out the histopathological characteristics of lymph node sinus containing blood. Routine autopsy was carried out in the randomly selected 102 patients(among them,100 patients died of various diseases, and 2 of non-diseased causes),their superficial lymph nodes locating in the bilateral neck, axilla, inguina, thorax and abdomen were sampled. Haematoxylin-eosin staining was performed on 10% formalin-fixed and paraffin-embedded lymph node tissue sections(5μm).The histological characteristics of the lymph node sinuses containing blood were observed under light microscope. Among the 1362 lymph nodes sampled from the 100 autopsies, lymph sinuses containing blood were found in 809 lymph nodes sampled from 91 cases, but couldn't be seen in the lymph nodes sampled from the non-diseased cases. According to histology, five kinds of lymph sinuses containing blood were found:vascular-opening sinus, blood-deficient sinus, erythrophago-sinus, blood-abundant sinus, and vascular-formative sinus. It is concluded that in the state of disease, the phenomenon of blood in the lymph sinus is not uncommon. Blood could possibly enter into lymph sinus through lymphatic-venous communications between the veins and sinuses in the node. Lymph circulation and blood circulation could communicate with each other in the lymph sinus.

  2. [Phosphate sensing and parathyroid gland]. (United States)

    Mizobuchi, Masahide; Suzuki, Taihei


    In the latter 1990s, phosphate, as well as calcium, has been shown to have a direct action on parathyroid function. Since then although many researchers have tried to detect the phosphate sensor in parathyroid gland, none has found it yet. In 2000s, the importance of FGF23 was revealed in patients with autosomal dominant hypophosphatemic rickets and then investigating the role of FGF23 in mineral metabolism has spread. FGF23 target organs comprise those that express coreceptor Klotho, such as kidney and parathyroid glands. While associations of calcium sensing receptor or vitamin D receptor with parathyroid function have been mainly investigated for parathyroid dysfunction, many efforts recently have made to study the effects of FGF23 on parathyroid glands.

  3. Effect of leachate recycle and inoculation on microbial characteristics of municipal refuse in landfill bioreactors

    Institute of Scientific and Technical Information of China (English)


    Population development of key groups of anaerobic and aerobic bacteria involved in municipal refuse decomposition under laboratory landfill bioreactors with and without leachate recycle adinoculation was measured since modeling municipal refuse was landfilled in bioreactors for about 210 days. Hydrolytic fermentative bacteria (HFB), hydrogen-producing acetogenic bacteria (HPAB), methane-producing bacteria (MPB), sulfate-reducing bacteria (SRB), anaerobic and aerobic cellulolytic bacteria and denitrabacteria were enumerated by the most probable number technique. The results showed that the dominant microorganismgroups were the methanogenic bacteria including hydrolytic fermentative, hydrogen-producing acetogenic and methane-producing bacteria. They were present in fresh refuse but at low values and positively affected by leachate recycle and refuse inoculation. The amounts of HFB or HPAB in digesters D4 and D5 operated with noculation and leachate recycle reached their maximum values of1010-1012 cells/g dry refuse for HFB or 105-106 cells/g dry refuse for HPAB on day 60, in digester D3 operated with leachate recycle on day 120 for HFB (109 cells/g dry refuse) or on day 90 for HPAB (105 cells/g dry refuse), and in digesters D1 and D2 on day 210 for HFB (109 cells/g dry refuse) or on day 90 for HPAB (104-106 cells/g dry refuse). The population of methane-producing bacteria in digesters D4 and D5 sharply increased on days 60 and 90 respectively, however in igesters D1, D2 and D3 on day 120. Leachate recycle and inoculation changed the cellulolytic microorganisms composition of refuse ecosystem, the higher amounts of anaerobic cellulolytic bacteria were measured in digesters D4 and D5 (107 cells/g dry refuse), followed by digesters D3 (106 cells/g dry refuse), D2 or D1(104 cells/g dry refuse). However, the amounts of aerobic cellulolytic bacteria were much lower than that of anaerobic cellulolytic bacteria. And it was higher in digester D3 than those in digesters D1, D2

  4. Video-assisted breast surgery and sentinel lymph node biopsy guided by three-dimensional computed tomographic lymphography. (United States)

    Yamashita, K; Shimizu, K


    Video-assisted breast surgery (VABS) is a less invasive and aesthetically better option for benign and malignant breast diseases and for sentinel lymph node biopsy (SLNB). The authors have performed 150 VABS procedures since December 2001. They have examined the usefulness of three-dimensional computed tomographic (3D-CT) lymphography for detecting sentinel lymph nodes (SLNs) precisely, as well as the cosmetic and treatment results of VABS. In this study, VABS was performed with a 2.5-cm skin incision in the axilla or periareola (1 cm in the axilla for SLNB), using a retraction method, for mammary gland resection, SLNB, axillary lymph node dissection, and breast reconstruction under video assistance. On the day before the surgery, 3D-CT lymphography was performed to mark SLN on the skin. Above the tumor and near the areola, 2 ml of Iopamiron 300 was injected subcutaneously. A 16-channnel multidetector-row helical CT scan image was taken after 1 min and reconstructed to produce a 3D image. Sentinel lymph node biopsy was performed by the VABS technique using the Visiport. The VABS procedure was performed for 19 benign and 131 malignant diseases, and 115 SLNBs (74 with 3D-CT) were performed. The SLNs were shown precisely by 3D-CT lymphography, as proved by a case of lymph node metastasis, in which accurate relationships between lymph ducts and SLNs were shown. These were classified into four patterns: a single duct to single node (40 cases), multiple ducts to a single node (13 cases), a single duct to multiple nodes (1 case), and multiple ducts to multiple nodes (12 cases). The SLNB procedure can be performed safely by 3D-CT lymphography and less invasively by VABS. The findings show that 3D-CT lymphography is useful for performing precise SLNB using VABS.

  5. Inguinal lymph node metastasis of colon cancer

    Directory of Open Access Journals (Sweden)

    Sloane McGraw


    Full Text Available We present a case of adenocarcinoma of colon with unusual metastasis to inguinal lymph nodes. Our patient is a young male with bilateral inguinal lymphadenopathy, bone pains, and jaundice who presented as carcinoma of unknown primary. He was diagnosed as widely metastatic adenocarcinoma of colon for which he received chemotherapy and has had a good response to the treatment.

  6. Histological and immunohistochemical evaluation of sentinel lymph ...

    African Journals Online (AJOL)

    [6,7] The technique is sensitive and specific to ... of sentinel lymph nodes in breast cancer at a tertiary hospital in ... tumour excision or simple mastectomy as well as SLN biopsies. All the ... [6,7] Significant resource implications of the increasing ...

  7. Groin surgery and the sentinel lymph node

    NARCIS (Netherlands)

    de Hullu, JA; van der Zee, AGJ


    Vulvar cancer is a rare disease. Squamous-cell carcinomas account for 90% of vulvar cancers. The main mode of spread is lymphogenic to the inguinofemoral lymph nodes. Therefore, elective unior bilateral inguinofemoral lymphadenectomy is part of the standard treatment in combination with radical (wid

  8. 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.

  9. Is Full Lymph Node Removal Always Needed for Melanoma? (United States)

    ... Is Full Lymph Node Removal Always Needed for Melanoma? Survival was just as long for those who ... all lymph nodes in the vicinity of a melanoma skin cancer may not increase a patient's overall ...

  10. Characterization of human pineal gland proteome. (United States)

    Yelamanchi, Soujanya D; Kumar, Manish; Madugundu, Anil K; Gopalakrishnan, Lathika; Dey, Gourav; Chavan, Sandip; Sathe, Gajanan; Mathur, Premendu P; Gowda, Harsha; Mahadevan, Anita; Shankar, Susarla K; Prasad, T S Keshava


    The pineal gland is a neuroendocrine gland located at the center of the brain. It is known to regulate various physiological functions in the body through secretion of the neurohormone melatonin. Comprehensive characterization of the human pineal gland proteome has not been undertaken to date. We employed a high-resolution mass spectrometry-based approach to characterize the proteome of the human pineal gland. A total of 5874 proteins were identified from the human pineal gland in this study. Of these, 5820 proteins were identified from the human pineal gland for the first time. Interestingly, 1136 proteins from the human pineal gland were found to contain a signal peptide domain, which indicates the secretory nature of these proteins. An unbiased global proteomic profile of this biomedically important organ should benefit molecular research to unravel the role of the pineal gland in neuropsychiatric and neurodegenerative diseases.

  11. Unusual presentation of Warthin variant of Papillary thyroid carcinoma with lymph nodal metastases in a patient of Graves' disease. (United States)

    Padma, Subramanyam; Sundaram, Palaniswamy Shanmuga; Arun, B R


    Warthin-like Papillary thyroid carcinoma (WPTC) is a rare variant of papillary carcinoma of thyroid, PTC which derives its name by closely resembling Warthin's tumor of salivary gland. Hallmark histological feature of this variant is papillary folding lined by oncocytic neoplastic cells with clear nuclei and nuclear pseudoinclusions, accompanied by prominent lymphocytic infiltrate in the papillary stalks. It is thought to be one of those differentiated thyroid cancers with favorable prognosis. We report a case of Graves' disease with a cold nodule harboring WPTC with initial presentation of lymph nodal metastases. It is important to identify this peculiar variant of PTC as 5 to 10% of them undergo dedifferentiation and 30% have the lymph nodal metastases and extra thyroidal extension.

  12. Thermochemoradiation Therapy Using Superselective Intra-arterial Infusion via Superficial Temporal and Occipital Arteries for Oral Cancer With N3 Cervical Lymph Node Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Mitsudo, Kenji, E-mail: [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan); Koizumi, Toshiyuki; Iida, Masaki; Iwai, Toshinori; Oguri, Senri [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan); Yamamoto, Noriyuki [Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine, Nagoya (Japan); Itoh, Yoshiyuki [Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Kioi, Mitomu; Hirota, Makoto; Tohnai, Iwai [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan)


    Purpose: To evaluate the therapeutic results and histopathological effects of treatment with thermochemoradiation therapy using superselective intra-arterial infusion via the superficial temporal and occipital arteries for N3 cervical lymph node metastases of advanced oral cancer. Methods and Materials: Between April 2005 and September 2010, 9 patients with N3 cervical lymph node metastases of oral squamous cell carcinoma underwent thermochemoradiation therapy using superselective intra-arterial infusion with docetaxel (DOC) and cisplatin (CDDP). Treatment consisted of hyperthermia (2-8 sessions), superselective intra-arterial infusions (DOC, total 40-60 mg/m{sup 2}; CDDP, total 100-150 mg/m{sup 2}) and daily concurrent radiation therapy (total, 40-60 Gy) for 4-6 weeks. Results: Six of 9 patients underwent neck dissection 5-8 weeks after treatment. In four of these 6 patients, all metastatic lymph nodes, including those at N3, were grade 3 (non-viable tumor cells present) or grade 4 (no tumor cells present) tumors, as classified by the system by Shimosato et al (Shimosato et al Jpn J Clin Oncol 1971;1:19-35). In 2 of these 6 patients, the metastatic lymph nodes were grade 2b (destruction of tumor structures with a small amount of residual viable tumor cells). The other 3 patients did not undergo neck dissection due to distant metastasis after completion of thermochemoradiation therapy (n=2) and refusal (n=1). The patient who refused neck dissection underwent biopsy of the N3 lymph node and primary sites and showed grade 3 cancer. During follow-up, 5 patients were alive without disease, and 4 patients died due to pulmonary metastasis (n=3) and noncancer-related causes (n=1). Five-year survival and locoregional control rates were 51% and 88%, respectively. Conclusions: Thermochemoradiation therapy using intra-arterial infusion provided good histopathologic effects and locoregional control rates in patients with N3 metastatic lymph nodes. However, patients with N3

  13. HEPACAM1 and 2 are differentially regulated in canine mammary adenomas and carcinomas and its lymph node metastases

    Directory of Open Access Journals (Sweden)

    Brunnberg Leo


    Full Text Available Abstract Background Cell adhesion is an important regulator of cell growth and motility. Recently the hepatocyte cell adhesion molecules 1 and 2 (HEPACAM1 and 2, members of the immunoglobulin family of adhesion genes, have been identified. HEPACAM1 is involved in negative cell cycle regulation via p53, p21 and p27 signalling but also mediates increased human breast cancer cell spread. The role and expression pattern of HEPACAM2 has not been analyzed so far. In the present study we quantified gene expression levels of HEPACAM1 and 2 to evaluate their possible role during the carcinogenesis of canine mammary tumours. Results Adenomas displayed increased HEPACAM1 and 2 mRNA expression levels and decreased HEPACAM1 protein expression levels when compared to normal gland, carcinomas and lymph node metastases. In contrast, metastatic carcinomas, intravascular tumour cells and lymph node metastases had HEPACAM 1 protein and mRNA expression levels similar to normal gland but decreased HEPACAM2 mRNA expression when compared to normal gland of the same dog. Conclusions HEPACAM1 and 2 seem to be important for cell-cell adhesion of normal and neoplastic canine mammary cells. The loss of HEPACAM1 protein expression in adenomas but not in carcinomas questions its role as a tumour suppressor at late stages of malignant transformation and indicates that it might rather be involved in physiologic mammary cell adhesion and canine mammary tumour metastasis. Furthermore, it can be speculated, whether HEPACAM2 plays a different role in malignancy and metastasis of canine mammary tumours since its transcriptional levels are different in carcinomas and their lymph node metastases when compared to HEPACAM1.

  14. Small renal tumor with lymph nodal enlargement: A histopathological surprise


    Mujeeburahiman Thottathil; Ashish Verma; Nischith D′souza; Altaf Khan


    Renal cancer with lymph nodal mass on the investigation is clinically suggestive of an advanced tumor. Small renal cancers are not commonly associated with lymph nodal metastasis. Association of renal cell carcinoma with renal tuberculosis (TB) in the same kidney is also rare. We report here a case of small renal cancer with multiple hilar and paraaortic lymph nodes who underwent radical nephrectomy, and histopathology report showed renal and lymph nodal TB too.

  15. A case of lymphangioleiomyomatosis affecting the supraclavicular lymph nodes. (United States)

    Kamitani, Takeshi; Yabuuchi, Hidetake; Soeda, Hiroyasu; Matsuo, Yoshio; Okafuji, Takashi; Sakai, Shuji; Hatakenaka, Masamitsu; Minami, Takahiro; Inoue, Hiromasa; Tanaka, Atsuo; Kohno, Hiroyuki; Tanaka, Michiko; Nakashima, Yutaka; Honda, Hiroshi


    The case of a 46-year-old woman with lymphangioleiomyomatosis (LAM) involving the supraclavicular, mediastinal, and pelvic lymph nodes in addition to the lungs is reported. Computed tomography incidentally revealed multiple thin-walled pulmonary cysts and low-attenuating masses in the supraclavicular, mediastinal, and retroperitoneal lymph nodes. A biopsy of the supraclavicular mass was performed and diagnosed as LAM histopathologically. The common sites of extrapulmonary LAM include retroperitoneal and mediastinal lymph nodes; however, supraclavicular lymph node involvement is extremely rare.

  16. 49 CFR 199.103 - Use of persons who fail or refuse a drug test. (United States)


    ... SAFETY DRUG AND ALCOHOL TESTING Drug Testing § 199.103 Use of persons who fail or refuse a drug test. (a) An operator may not knowingly use as an employee any person who— (1) Fails a drug test required by... 49 Transportation 3 2010-10-01 2010-10-01 false Use of persons who fail or refuse a drug test. 199...

  17. Dispreferred Responses in Interlanguage Pragmatics Refusal Sequences in Learner-NS Interactions (United States)

    Felix-Brasdefer, J. Cesar


    This study examines the pragmatic strategies that learners utilize to negotiate a resolution when refusing a native speaker of higher status in three asymmetric situations (+Power, +Distance). Following Pomerantz's (1984) analysis of dispreferred responses, this study focuses on refusals to an invitation, a request, and a suggestion. Refusal…

  18. Refusing artificial nutrition and hydration: does statutory law send the wrong message? (United States)

    Sieger, Carol E; Arnold, Jason F; Ahronheim, Judith C


    Ethical consensus and appellate court decisions view artificial nutrition and hydration (ANH) as medical treatment that can be refused like other treatments. However, advance directive statutes may produce obstacles for refusal of ANH, as distinct from other life-sustaining treatments, in patients who lack capacity. This paper reviews state statutes and appellate case law regarding medical decision making for patients who lack decisional capacity. Twenty states (39%) have one or more explicit statutory provisions delineating a separate and more stringent standard for ANH refusal. These standards include higher evidentiary standard; requirement for specific preauthorization, qualifying medical conditions, second medical opinion, or judicial review; refusal not permitted; refusal not permitted if death would result from "starvation" or "dehydration"; and previous law with higher standard applies to old documents. In 11 of these states and in eight others, statutory law contains language that could be misinterpreted, implying, but not rising to, an explicitly higher standard. Four appellate decisions departed from the judicial consensus that ANH can be refused like other treatments, but subsequent court decisions or legislative enactments reduced or eliminated their impact. Legislators and the courts should ask whether higher standards for ANH refusal are appropriate in light of case law authority that ANH should not be treated differently and in light of statutory language that preserves those common law rights. These higher standards may make it more difficult in certain states to refuse ANH for patients who lack capacity or place a burden on good practice by making providers fearful of the law.

  19. 20 CFR 410.666 - Effect of Appeals Council's decision or refusal to review. (United States)


    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Effect of Appeals Council's decision or refusal to review. 410.666 Section 410.666 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL....666 Effect of Appeals Council's decision or refusal to review. The Appeals Council may deny a...

  20. Acquisition of cup drinking using previously refused foods as positive and negative reinforcement.


    Kelley, Michael E; Piazza, Cathleen C; Fisher, Wayne W; Oberdorff, Amanda J


    We used previously refused foods as positive and negative reinforcement in the acquisition of cup drinking. Cup drinking increased with positive and negative reinforcement, both alone and in combination (without escape extinction), indicating that treatment of food refusal can establish some foods as appetitive stimuli whereas others remain aversive.

  1. 29 CFR 102.88 - Refusal to conduct referendum; appeal to Board. (United States)


    ... 29 Labor 2 2010-07-01 2010-07-01 false Refusal to conduct referendum; appeal to Board. 102.88..., SERIES 8 Procedure for Referendum Under Section 9(e) of the Act § 102.88 Refusal to conduct referendum... appear to the regional director that no referendum should be conducted, he shall dismiss the petition by...

  2. Strategie di rifuto in Italiano: uno studio etnografico (Refusal Strategies in Italian: An Ethnographic Study). (United States)

    Frescura, Marina


    After reviewing previous research on speech acts, this article describes a study that analyzed the behavior of speakers of standard Italian in refusing an offer of food. The importance of "face" is explained, and the refusal strategies are classified into four categories: explicit, tactical, decisive, and conclusive. (CFM)

  3. Family Influences on Treatment Refusal in School-Linked Mental Health Services (United States)

    Keeley, Mary L.; Wiens, Brenda A.


    This study analyzed family influences on treatment refusal in school-linked mental health services (SLMHS). Specifically, it assessed whether levels of family cohesion, conflict, and organization were related to whether a family refused to initiate recommended treatment. Children (N = 133) referred for emotional and behavioral problems and their…

  4. Realization of Speech Acts of Refusals and Pragmatic Competence by Turkish EFL Learners (United States)

    Han, Turgay; Burgucu-Tazegül, Assiye


    The purpose of the present study is to examine a) how lower-intermediate and upper-intermediate level Turkish learners of English-as-a-foreign language (EFL) realize refusals in English, b) the differences between native and non-native speakers of English in the use of refusals, and c) if L2 proficiency affects possible pragmatic transfer or not.…

  5. 21 CFR 314.127 - Refusal to approve an abbreviated new drug application. (United States)


    ... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Refusal to approve an abbreviated new drug... HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE APPLICATIONS FOR FDA APPROVAL TO MARKET A NEW DRUG FDA Action on Applications and Abbreviated Applications § 314.127 Refusal to approve an abbreviated new...

  6. Refusing HIV testing in an urgent care setting: results from the "Think HIV" program. (United States)

    Liddicoat, Rebecca V; Losina, Elena; Kang, Minhee; Freedberg, Kenneth A; Walensky, Rochelle P


    Efforts to increase HIV case identification through routine, voluntary HIV testing are hindered by high refusal rates. Our objective was to identify patients most likely to refuse routine HIV testing. We developed a new HIV testing program at four Massachusetts urgent care centers. Patients were asked if they were interested in routine HIV testing. We performed analyses to assess differences in characteristics between those who refused testing and those who accepted it. Data were available for 9129/10,354 (88%) patients offered routine HIV testing from January to December 2002. Of these 9129 patients, 67% refused testing. In the crude analysis, HIV test refusal was associated with female gender, white race, older age, and higher educational level. In multivariate analysis, non-English-speaking patients who were Hispanic, Haitian, and other race were more likely to refuse testing than their English-speaking counterparts. Among all patients, "not at risk" and "already tested" were the most common reasons for test refusal. Two thirds of patients refused routine HIV testing when it was offered in a statewide urgent care-based program. If routine HIV testing programs are to be successful, strategies must be developed to increase HIV test acceptance among patients most likely to refrain from testing.

  7. Learned Helplessness and Learning Goals: Role played in School Refusal. A Study on Italian Students.

    Directory of Open Access Journals (Sweden)

    Luana Sorrenti


    Full Text Available Literature on school refusal has shown a link between school refusal and poor school performance. However, there has been little investigation into the individual underlying factors, and specifically factors directly related to the learning process, such as the learning goals of students and their expectations of success and/or failure. The main purpose of the present study is to investigate the influence of Learned Helplessness (LH and learning goals on school refusal. We hypothesized that LH and learning goals exert a unique role in predicting school refusal above and beyond the roles of academic achievement, age, and gender. The sample consisted of 201 Italian students with an average age of 11.93, with both low (57.2 % of students and high (42.8 % academic achievement. School refusal, LH, and learning goals were measured by means of questionnaires. The results confirm the hypothesis of this study; in fact, we found that learning goals and, above all, LH play a more predictive role of school refusal than academic achievement. These results extend previous studies on school refusal and, for the first time, they provide additional knowledge about this problem, analyzing the relationship between school refusal, learning goals, and LH, still neglected in the literature. Implications on the psychological well-being of students are discussed.

  8. Prostate Cancer Patients’ Refusal of Cancer-Directed Surgery: A Statewide Analysis

    Directory of Open Access Journals (Sweden)

    K. M. Islam


    Full Text Available Introduction. Prostate cancer is the most common cancer among men in USA. The surgical outcomes of prostate cancer remain inconsistent. Barriers such as socioeconomic factors may play a role in patients’ decision of refusing recommended cancer-directed surgery. Methods. The Nebraska Cancer Registry data was used to calculate the proportion of prostate cancer patients recommended the cancer-directed surgery and the surgery refusal rate. Multivariate logistic regression was applied to analyze the socioeconomic indicators that were related to the refusal of surgery. Results. From 1995 to 2012, 14,876 prostate cancer patients were recommended to undergo the cancer-directed surgery in Nebraska, and 576 of them refused the surgery. The overall refusal rate of surgery was 3.9% over the 18 years. Patients with early-stage prostate cancer were more likely to refuse the surgery. Patients who were Black, single, or covered by Medicaid/Medicare had increased odds of refusing the surgery. Conclusion. Socioeconomic factors were related to the refusal of recommended surgical treatment for prostate cancer. Such barriers should be addressed to improve the utilization of surgical treatment and patients’ well-being.

  9. Strategie di rifuto in Italiano: uno studio etnografico (Refusal Strategies in Italian: An Ethnographic Study). (United States)

    Frescura, Marina


    After reviewing previous research on speech acts, this article describes a study that analyzed the behavior of speakers of standard Italian in refusing an offer of food. The importance of "face" is explained, and the refusal strategies are classified into four categories: explicit, tactical, decisive, and conclusive. (CFM)

  10. Thinking through Moments of Sexual Refusal in "Looking for Alibrandi" and "The Rage in Placid Lake" (United States)

    Clarke, Kyra


    This paper explores two scenarios in which young women refuse the sexual advances of young men in the films "Looking for Alibrandi" and "The Rage in Placid Lake." The paper highlights the heteronormative nature of education around refusing sex, which reinstates gendered stereotypes of masculine as active and feminine as…

  11. Predictors of refusal to participate: a longitudinal health survey of the elderly in Australia

    Directory of Open Access Journals (Sweden)

    Christensen Helen


    Full Text Available Abstract Background The loss of participants in longitudinal studies due to non-contact, refusal or death can introduce bias into the results of such studies. The study described here examines reasons for refusal over three waves of a survey of persons aged ≥ 70 years. Methods In a longitudinal study involving three waves, participants were compared to those who refused to participate but allowed an informant to be interviewed and to those who refused any participation. Results At Wave 1 both groups of Wave 2 non-participants had reported lower occupational status and fewer years of education, had achieved lower verbal IQ scores and cognitive performance scores and experienced some distress from the interview. Those with an informant interview only were in poorer physical health than those who participated and those who refused. Depression and anxiety symptoms were not associated with non-participation. Multivariate analyses found that verbal IQ and cognitive impairment predicted refusal. Results were very similar for refusers at both Waves 2 and 3. Conclusions Longitudinal studies of the elderly may over estimate cognitive performance because of the greater refusal rate of those with poorer performance. However, there is no evidence of bias with respect to anxiety or depression.

  12. 37 CFR 1.47 - Filing when an inventor refuses to sign or cannot be reached. (United States)


    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Filing when an inventor... Processing Provisions Who May Apply for A Patent § 1.47 Filing when an inventor refuses to sign or cannot be reached. (a) If a joint inventor refuses to join in an application for patent or cannot be found...

  13. 21 CFR 515.21 - Refusal to approve a medicated feed mill license application. (United States)


    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Refusal to approve a medicated feed mill license... SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS MEDICATED FEED MILL LICENSE Administrative Actions on Licenses § 515.21 Refusal to approve a medicated feed mill license application. (a)...

  14. Thinking through Moments of Sexual Refusal in "Looking for Alibrandi" and "The Rage in Placid Lake" (United States)

    Clarke, Kyra


    This paper explores two scenarios in which young women refuse the sexual advances of young men in the films "Looking for Alibrandi" and "The Rage in Placid Lake." The paper highlights the heteronormative nature of education around refusing sex, which reinstates gendered stereotypes of masculine as active and feminine as…

  15. Application of carbon nanoparticles in lymph node dissection and parathyroid protection during thyroid cancer surgeries: a systematic review and meta-analysis (United States)

    Wang, Lun; Yang, Dong; Lv, Jun-Yuan; Yu, Dan; Xin, Shi-Jie


    Purpose To investigate whether carbon nanoparticles (CNs) are helpful in identifying lymph nodes and metastatic lymph nodes and in parathyroid protection during thyroid cancer surgery. Methods English and Chinese literature in PubMed, Cochrane Database of Systematic Reviews, EMBASE,, China Biology Medicine Database, China National Knowledge Infrastructure, China Master’s and Doctoral Theses Full-Text Database, Wanfang database, and Cqvip database were searched (till March 22, 2016). Randomized controlled trials (RCTs) that compared the use of CNs with a blank control in patients undergoing thyroid cancer surgery were included. Quality assessment and data extraction were performed, and a meta-analysis was conducted using RevMan 5.1 software. The primary outcomes were the number of retrieved central lymph nodes and metastatic lymph nodes, and the rate of accidental parathyroid removal. Results We obtained 149 relevant studies, and only 47 RCTs with 4,605 patients (CN group: n=2,197; blank control group: n=2,408) met the inclusion criteria. Compared with the control group, the CN group was associated with more retrieved lymph nodes/patient (weighted mean difference [WMD]: 3.39, 95% confidence interval [CI]: 2.73–4.05), more retrieved metastatic lymph nodes (WMD: 0.98, 95% CI: 0.61–1.35), lower rate of accidental parathyroid removal, and lower rates of hypoparathyroidism and hypocalcemia. However, the total metastatic rate of the retrieved lymph nodes did not differ between the groups (odds ratio: 1.13, 95% CI: 0.87–1.47, P=0.35). Conclusion CNs can improve the extent of neck dissection and protect the parathyroid glands during thyroid cancer surgery. And the number of identified metastatic lymph nodes can be simultaneously increased. PMID:28280359

  16. Salivary gland diseases : infections, sialolithiasis and mucoceles

    NARCIS (Netherlands)

    Delli, K; Spijkervet, FK; Vissink, A.


    The three most frequently diagnosed salivary gland diseases are salivary gland infections, sialolithiasis and mucoceles. Salivary gland infections are usually of bacterial or viral etiology and can be divided into acute and chronic types. Occasionally they can result from obstruction of the salivary

  17. [Brunners gland hiperplasia. Report of two cases]. (United States)

    Padilla Ruiz, Maykel


    Brunner's gland hyperplasia is an infrequent benign injury located on the first or second portion of the duodenum. The disease spectrum includes diffuse nodular hyperplasia, circumscribed nodular hyperplasia, and Brunner's gland adenoma. We report two cases, one with an adenoma of Brunner's glands as a duodenal polyp and the other as a diffuse nodular hyperplasia of the duodenal bulb.

  18. Salivary gland diseases : infections, sialolithiasis and mucoceles

    NARCIS (Netherlands)

    Delli, K; Spijkervet, FK; Vissink, A.


    The three most frequently diagnosed salivary gland diseases are salivary gland infections, sialolithiasis and mucoceles. Salivary gland infections are usually of bacterial or viral etiology and can be divided into acute and chronic types. Occasionally they can result from obstruction of the salivary

  19. A longitudinal comparison of arm morbidity in stage I-II breast cancer patients treated with sentinel lymph node biopsy, sentinel lymph node biopsy followed by completion lymph node dissection, or axillary lymph node dissection

    NARCIS (Netherlands)

    Kootstra, Jan J.; Hoekstra-Weebers, Josette E.; Rietman, Johan S.; Vries, de Jakob; Baas, Peter C.; Geertzen, Jan H.B.; Hoekstra, Harald J.


    Background: Long-term shoulder and arm function following sentinel lymph node biopsy (SLNB) may surpass that following complete axillary lymph node dissection (CLND) or axillary lymph node dissection (ALND). We objectively examined the morbidity and compared outcomes after SLNB, SLNB + CLND, and ALN

  20. Molecular markers of lymph node metastases in oral cancer

    NARCIS (Netherlands)

    Leusink, FKJ


    Cervical lymph node metastasis occurs frequently in patients with oral squamous-cell carcinoma (OSCC) and is a major determinant of prognosis and treatment planning. Accurate lymph node staging is therefore crucial. Current preoperative clinical assessment of the lymph nodes by physical examination

  1. Cardiac metastasis of squamous cell carcinoma of the thyroid gland with severe disseminated intravascular coagulation: A case report. (United States)

    Yoshihiro, Tomoyasu; Tsuchihashi, Kenji; Kusaba, Hitoshi; Nakashima, Torahiko; Obara, Teppei; Nio, Kenta; Takayoshi, Kotoe; Kodama, Hiroyuki; Tsuruta, Nobuhiro; Kiyohara, Hideyuki; Asai, Kaori; Harada, Eiji; Kamezaki, Kenjiro; Arita, Takeshi; Sato, Masanobu; Yamamoto, Hidetaka; Arita, Shuji; Ariyama, Hiroshi; Odashiro, Keita; Oda, Yoshinao; Akashi, Koichi; Baba, Eishi


    Distant metastasis of primary squamous cell carcinoma (SCC) of the thyroid gland is rare and, to the best of our knowledge, cardiac metastasis has not been reported to date. A 57-year-old man underwent surgery and adjuvant chemoradiotherapy for stage IVA SCC of the thyroid gland. After 3 months, the patient was admitted to the Kyushu University Hospital (Fukuoka, Japan) with subcutaneous hematomas of the left thigh and lower leg, and he was diagnosed with cardiac and mediastinal lymph node metastases of SCC of the thyroid gland with severe disseminated intravascular coagulation (DIC). Echocardiography revealed a mass, 52 mm in greatest diameter, protruding from the interventricular septum towards the right ventricle. Weekly administration of paclitaxel and concurrent irradiation of the cardiac and lymph node metastases were performed. Eighteen days after the initiation of chemoradiotherapy, the DIC and hematomas had significantly improved, and the cardiac metastasis was stable. However, 2 months after admission, the patient developed dyspnea and multiple nodular shadows appeared to be spreading in the subpleura of the lungs bilaterally, which were initially suspected to be pulmonary tumor embolisms. Prednisolone and subsequent administration of lenvatinib were not effective and the patient succumbed to respiratory failure. Severe DIC caused by extremely rare cardiac metastasis of SCC of the thyroid gland was effectively controlled by chemoradiotherapy. However, intensive local control appears to be required for this condition.

  2. Utilisation of Coloured Paper Refuse in Eco-products

    Directory of Open Access Journals (Sweden)

    TAKÁTS, Alexandra


    Full Text Available In the course of our research we have found a solution for recycling coloured advertisingpaper in a cellulose fibre based composite. This paper quality is produced in huge quantities and canbe recycled with difficulties even in paper industry. Our aim was to produce a kind of organiccomposite that does not contain any adhesives fixing the matrix part of the composite. An eco-productgenerated this way has similar physical and mechanical attributes to medium density fibreboard(MDF. Fibre made of coloured newspaper can easily be adapted to board production while, at thesame time, this supports also the development of an environment oriented product policy. Boardbasedcomposites produced by utilizing recycled refuse paper can be used for designing and creatingenvironmentally friendly products following the eco-design trend.

  3. A case of pervasive refusal syndrome: a diagnostic conundrum.

    LENUS (Irish Health Repository)

    McNicholas, Fiona


    A case is presented of an 11-year-old girl with pervasive refusal syndrome (PRS) who ultimately recovered acutely and completely after an 18-month paediatric hospitalisation. There was an apparent absence of previously proposed important aetiological factors in PRS, such as family pathology and markedly traumatic or abusive experiences, and her recovery was sudden and complete. The authors consider the differential diagnoses of PRS paying particular attention to the possibility of a conversion disorder or catatonia, given the absence of PRS in the North American literature. Consideration of catatonia is important as it has a diagnostic test and responds rapidly to appropriate treatment, in contrast to conventional treatment for PRS and conversion disorder.

  4. Assessment of latest technology in coal refuse fire extinguishment

    Energy Technology Data Exchange (ETDEWEB)

    Maneval, D.R.


    It is easier, cheaper, and less hazardous to prevent fires in coal refuse banks than to extinguish them. This can be done by compacting in thin layers (to reduce air and air flow), sealing edges with various materials (crushed linestone is good, it gives off CO/sub 2/ when heated), etc. In particular the tippler form of pile construction should be avoided. Once these piles do ignite (by spontaneous combustion or other means), it is often difficult and hazardous (gases, explosions, unsafe regions, etc) to work at extinguishing them. Various methods are given. Once the fire is put out, the pile should be reworked, compacting and sealing it, so the process does not start again. (LTN)

  5. Low Temperature Dechlorination of Densified Refuse Derived Fuel in Pyrolysis

    Institute of Scientific and Technical Information of China (English)

    LI Wei; XIE Qiang


    Study on behavior of chlorine contained in oval-shaped densified refuse derived fuel (d-RDF) prepared from unicipal solid waste in pyrolysis was carried out by means of temperature-programmed electrical furnace, and the gasevolving from pyrolysis was investigated by FTIR. De-HCl rate was calculated by determining the emission fraction of HCl in the flue gas and the fraction of Cl left in the pyrolysis residue. The results show that Cl in the d-RDF releases primarily in the form of HCl during the pyrolysis, and the initial releasing temperature of HCl enhances with the increase of heating rate. Meanwhile, the higher the end temperature of pyrolysis, the more the Cl released. De-HCl rate is about 70% when the end temperature of pyrolysis is around 600℃. Besides, mechanism of Cl release is discussed.

  6. Adsorption of phenolic compound by aged-refuse

    Energy Technology Data Exchange (ETDEWEB)

    Chai Xiaoli [State Key Laboratory of Pollution Control and Resource Reuse, School of Enviromental Science and Engineering, Tongji University, Siping Road 1239, Shanghai 200092 (China)]. E-mail:; Zhao Youcai [State Key Laboratory of Pollution Control and Resource Reuse, School of Enviromental Science and Engineering, Tongji University, Siping Road 1239, Shanghai 200092 (China)


    The adsorption of phenol, 2-chlorophenol, 4-chlorophenol and 2,4-dichlorophenol by aged-refuse has been studied. Adsorption isotherms have been determined for phenol, 2-chlorophenol, 4-chlorophenol and 2,4-dichlorophenol and the data fits well to the Freundlich equation. The chlorinated phenols are absorbed more strongly than the phenol and the adsorption capacity has an oblivious relationship with the numbers and the position of chlorine subsistent. The experiment data suggests that both the partition function and the chemical adsorption involve in the adsorption process. Pseudo-first-order and pseudo-second-order model were applied to investigate the kinetics of the adsorption and the results show that it fit the pseudo-second-order model. More than one step involves in the adsorption process and the overall rate of the adsorption process appears to be controlled by the chemical reaction. The thermodynamic analysis indicates that the adsorption is spontaneous and endothermic.

  7. Wrongness, Responsibility, and Conscientious Refusals in Health Care. (United States)

    Liberman, Alida


    In this article, I address what kinds of claims are of the right kind to ground conscientious refusals. Specifically, I investigate what conceptions of moral responsibility and moral wrongness can be permissibly presumed by conscientious objectors. I argue that we must permit HCPs to come to their own subjective conclusions about what they take to be morally wrong and what they take themselves to be morally responsible for. However, these subjective assessments of wrongness and responsibility must be constrained in several important ways: they cannot involve empirical falsehoods, objectionably discriminatory attitudes, or unreasonable normative beliefs. I argue that the sources of these constraints are the basic epistemic, relational, and normative competencies needed to function as a minimally decent health-care professional. Finally, I consider practical implications for my framework, and argue that it shows us that the objection raised by the plaintiffs in Zubik v. Burwell is of the wrong sort. © 2017 John Wiley & Sons Ltd.

  8. Arti fi cial Salivary Glands

    Directory of Open Access Journals (Sweden)

    Rezwana Begum Mohammed


    Full Text Available Head and neck cancer is the fi fth most common malignancy and accounts for 3% of all new cancer cases each year. Treat- ment for most patients with head and neck cancers includes ionizing radiation. A consequence of this treatment is irreversible damage to salivary glands which is accompanied by a loss of fl uid-secreting acinar-cells and a considerable decrease of saliva output. Despite recent improvements in treating xerostomia (e.g. saliva stimulants, saliva substitutes, and gene therapy, there is a need of more scienti fi c advancements that can be clinically applied toward restoration of compromised salivary gland func- tion. Here we provide a summary of the current salivary cell models that have been used to advance restorative treatments via development of an arti fi cial salivary gland. Although these models are not fully characterized, their improvement may lead to the construction of an arti fi cial salivary gland that is in high demand for improving the quality of life of many patients suffe- ring from salivary secretory dysfunction

  9. Lymph node content of supraclavicular and thoracodorsal-based axillary flaps for vascularized lymph node transfer. (United States)

    Gerety, Patrick A; Pannucci, Christopher J; Basta, Marten N; Wang, Amber R; Zhang, Paul; Mies, Carolyn; Kanchwala, Suhail K


    Microvascular transfer of lymph node flaps has recently gained popularity as a treatment for secondary lymphedema often occurring after axillary, groin, or pelvic lymph node dissections. This study aimed to delineate the lymph node contents and pedicle characteristics of the supraclavicular (SC) and thoracodorsal (TD)-based axillary flaps as well as to compare lymph node quantification of surgeon vs pathologist. SC and TD flaps were dissected from fresh female cadavers. The surgeon assessed pedicle characteristics, lymph node content, and anatomy. A pathologist assessed all flaps for gross and microscopic lymph node contents. The κ statistic was used to compare surgeon and pathologist. Ten SC flaps and 10 TD flaps were harvested and quantified. In comparing the SC and TD flaps, there were no statistical differences between artery diameter (3.1 vs 3.2 mm; P = .75) and vein diameter (2.8 vs 3.5 mm; P = .24). The TD flap did have a significantly longer pedicle than the SC flap (4.2 vs 3.2 cm; P = .03). The TD flap was found to be significantly heavier than the SC flap (17.0 ± 4.8 vs 12.9 ± 3.3 g; P = .04). Gross lymph node quantity was similar in the SC and TD flaps (2.5 ± 1.7 vs 1.8 ± 1.2; P = .33). There was good agreement between the surgeon and pathologist in detecting gross lymph nodes in the flaps (SC κ = 0.87, TD κ = 0.61). The SC and TD flaps have similar lymph node quantity, but the SC flap has higher lymphatic density. A surgeon's estimation of lymph node quantity is reliable and has been verified in this study by comparison to a pathologist's examination. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  10. Cytologic diagnosis of acinic cell carcinoma of minor salivary gland: a distinct rarely described entity

    Directory of Open Access Journals (Sweden)

    Rana Sherwani


    Full Text Available A rare case of acinic cell carcinoma of minor salivary gland with cervical lymph node metastasis in a 50-year-old man is reported and the literature regarding this type of tumor is reviewed. These tumors arise from either an intercalated duct stem cell or the reserve cell of the salivary gland terminal tubule but not from both simultaneously. Rarely these neoplasms arise from more mature acinar cells. It is clear that these tumors behave ominously. The 25 year determinate survival rate is 50%, with a 20% incidence of metastasis. Surgical excision is the treatment of choice. Radiotherapy, especially neutron therapy, has a place in the treatment of this tumor but the role of chemotherapy is not exactly known at this time.

  11. [Particular features of lymph dissection in operations for gastric cancer]. (United States)

    Iaitskiĭ, A N; Danilov, I N


    In order to optimize the technique of lymph dissection, a method of intraoperative mapping of lymph outflow tracts was used with a lymphotropic dye Blue patente V. It allowed better orientation during lymphodissection in operations for gastric cancer. The detection and investigation of the "signal" lymph node as the most probable object of lymphogenic metastazing can improve the accuracy of postoperative staging of gastric cancer. Visualization of the lymph nodes in the preparation made it possible to increase the number of lymph nodes sent for histological investigation.

  12. Hsp70 vaccination-induced primary immune responses in efferent lymph of the draining lymph node. (United States)

    Vrieling, Manouk; Santema, Wiebren; Vordermeier, Martin; Rutten, Victor; Koets, Ad


    Bovine paratuberculosis is a highly prevalent chronic infection of the small intestine in cattle, caused by Mycobacterium avium subspecies paratuberculosis (MAP). In earlier studies we showed the protective effect of Hsp70/DDA subunit vaccination against paratuberculosis. In the current study we set out to measure primary immune responses generated at the site of Hsp70 vaccination. Lymph vessel cannulation was performed to obtain efferent lymph from the prescapular lymph node draining the neck area where the vaccine was applied. Hsp70 vaccination induced a significant increase of CD21(+) B cells in efferent lymph, accounting for up to 40% of efferent cells post-vaccination. Proliferation (Ki67(+)) within the CD21(+) B cell and CD4(+) T cell populations peaked between day 3 and day 5 post-vaccination. From day 7, Hsp70-specific antibody secreting cells (ASCs) could be detected in efferent lymph. Hsp70-specific antibodies, mainly of the IgG1 isotype, were also detected from this time point onwards. However, post-vaccination IFN-γ production in efferent lymph was non-sustained. In conclusion, Hsp70-vaccination induces only limited Th1 type immune responsiveness as reflected in efferent lymph draining the vaccination site. This is in line with our previous observations in peripheral blood. The main primary immunological outcome of the Hsp70/DDA subunit vaccination is B cell activation and abundant Hsp70-specific IgG1 production. This warrants the question whether Hsp70-specific antibodies contribute to the observed protective effect of Hsp70 vaccination in calves.

  13. 48 CFR 252.222-7001 - Right of first refusal of employment-Closure of military installations. (United States)


    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Right of first refusal of... SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions And Clauses 252.222-7001 Right of first refusal...: Right of First Refusal of Employment—Closure of Military Installations (APR 1992) (a) The...

  14. Mammary analogue secretory carcinoma (MASC) of salivary gland in four Mexican patients. (United States)

    Serrano-Arévalo, Mónica L; Mosqueda-Taylor, Adalberto; Domínguez-Malagón, Hugo; Michal, Michal


    The Clinco-pathological, immunohistochemical and molecular findings of four cases of Mammary Analogue Secretory Carcinoma (MASC) of salivary glands found in Mexico are described. The cases were extracted from 253 salivary gland tumors from a single institution in Mexico City. The 85 Candidates for initial selection were: low grade mucoepidermoid carcinoma (MEC) (N=70 ), Acinic cell cancinoma (AciCC) (N=14), papillary cystadenocarcinoma (N=1), and adenocarcinoma NOS (N=0). Tumors with some histological features consistent with MASC (N= 17, 6.7%) were studied by immunohistochemistry for mammaglobin, STAT5, and S-100 protein and four cases were positive (1.5%), thus the diagnosis of MASC was established, and these were submitted for molecular studies for ETV6-NTRK3. Fusion gene was demonstrated in three cases, two had been erroneously diagnosed as poorly granulated AciCC, and one as low grade MEC with microcystic pattern. Female gender predominated (3:1); one occurred in the parotid, two in minor salivary glands and one in the submaxillary gland; infiltrating borders, atypical mitosis and lymph node metastases were seen in the parotideal tumor. Two patients with major salivary gland tumors are alive and well at 10 and 20 months respectively, the two patients with minor salivary gland tumors are lost. It can be concluded that is important to think in MASC in poorly granulated AciCC and low grade MEC with microcystic pattern. Immunohistochemisty studies confirm the diagnosis, preferentially supported by molecular studies. MASC may follow aggressive behavior or transform into a high grade neoplasm.

  15. Sentinel lymph node biopsy in oral cancer

    DEFF Research Database (Denmark)

    Thomsen, Jørn Bo; Sørensen, Jens Ahm; Grupe, Peter;


    PURPOSE: To validate lymphatic mapping combined with sentinel lymph node biopsy as a staging procedure, and to evaluate the possible clinical implications of added oblique lymphoscintigraphy and/or tomography and test the intra- and interobserver reproducibility of lymphoscintigraphy. MATERIAL...... AND METHODS: Forty patients (17 F and 23 M, aged 32-90) with 24 T1 and 16 T2 squamous cell carcinoma of the oral cavity. Planar lymphoscintigraphy, emission and transmission tomography were performed. Detection and excision of the sentinel nodes were guided by a gamma probe. The sentinel nodes were step......-sectioning and stained with hematoxylin and eosin and cytokeratin (CK 1). Histology and follow-up were used as "gold standard". Tumor location, number of sentinel lymph nodes, metastasis, and recurrences were registered. Two observers evaluated the lymphoscintigraphic images to assess the inter-rater agreement. RESULTS...

  16. Imaging Classification of Cervical Lymph Nodes

    Directory of Open Access Journals (Sweden)

    Gh. Bakhshandepour


    Full Text Available Nearly four decades, Rouviere classification, which is a clinically based system, was the only system for cervical adenopathy classification. The best possible classification of cervical nodal disease may be accomplished by using both clinical palpation and also informations provided by imaging, because imaging can reveal clinically silent lymph nodes. most head and neck tumors spread to the neck nodes as a part of their natural history ,depending on the primary site. Up to 80% of patients with upper aerodigestive mucosal malignancies will have cervical nodal metastasis"nat presentation.The occurrence of nodal metastasis has a profound effect on the management and prognosis of the patients .nodal metastasis is the most important prognostic factor in squamous cell carcinoma of the head and neck. In general it decreases the overall survival by half, and extracapsular spread worsens the prognosis by another half. Our purpose in this presentation is to review imaging classification of cervical lymph nodes.

  17. Sarcoidal Granuloma in Cervical Lymph Nodes

    Directory of Open Access Journals (Sweden)

    Hsin-Chien Chen


    Full Text Available Sarcoidosis is a multiorgan granulomatous disease, the most common head and neck manifestation of which is cervical lymphadenopathy. Only the presentation of sarcoidal granuloma in cervical lymph nodes without typical manifestations of systemic sarcoidosis poses a diagnostic difficulty. We describe the case of a 39-year-old male who had a 2-month history of a progressively increasing mass with soreness in his right neck. The biopsy from the neck mass demonstrated non-caseating epithelioid cell granuloma of the lymph nodes. The differential diagnoses of mycobacterial or fungal infections were excluded. Thoracic evaluations, including chest X-ray and high-resolution computed tomography, revealed no abnormal findings. Treatment with systemic corticosteroids resulted in improved clinical symptoms. No recurrence of the neck mass or other signs of systemic sarcoidosis were noted during 1.5 years of follow-up. Although our patient's definitive diagnosis could not be determined, the case highlights 2 important issues: sarcoidal granuloma in lymph nodes may be a precursor of sarcoidosis, even in the absence of pulmonary or other systemic involvement; and regular follow-up is recommended in such cases.

  18. The effect of the transplanted pineal gland on the sympathetic innervation of the rat sublingual gland. (United States)

    Chanthaphavong, R S; Murphy, S M; Anderson, C R


    We investigated the effect of the pineal on sympathetic neurons that normally innervate the sublingual gland of the rat. When the pineal gland was transplanted into the sublingual gland, it remained as a distinct mass that was innervated by sympathetic axons. Injection of the retrograde tracer, Fast Blue, into the sublingual gland labelled sympathetic neurons in the ipsilateral superior cervical ganglion (SCG). Thirty per cent of all neurons labelled retrogradely by Fast Blue injection into transplanted pineal glands were immunoreactive for both neuropeptide Y (NPY) and calbindin. This combination is characteristic of sympathetic neurons innervating the pineal gland in its normal location, but not the sympathetic vasoconstrictor neurons normally innervating the sublingual gland. This, and our previous study in which the pineal gland was shown to similarly influence the phenotype of salivary secretomotor neurons, suggests that a range of different functional classes of sympathetic neuron are able to change their phenotype in response to signals released by the pineal gland.

  19. Characteristics and prognosis of patients with early-stage endometrial cancer who refuse adjuvant radiotherapy. (United States)

    Koskas, Martin; Huchon, Cyrille; Amant, Frederic


    To investigate the risk factors for refusing adjuvant radiotherapy in patients who have undergone surgery for early-stage endometrial cancer, and to compare their survival rates with patients who have undergone adjuvant radiotherapy. Data from the Surveillance, Epidemiology, and End Results database for patients operated on for histologically-proven early-stage endometrioid endometrial cancer, between 1988 and 2012, were screened. Univariate and multivariate logistic regression analyses tested the associations between refusal of adjuvant radiotherapy and demographic, tumoral, and management characteristics. Overall and cancer-related survival rates were compared between 376 patients who refused adjuvant radiotherapy and 752 patients who received adjuvant radiotherapy, matched for demographics (age, race, year of diagnosis, marital status, region), tumoral (grade, FIGO stage, size), and management (lymphadenectomy performed) criteria. 434 of the 16,014 patients (2.7%) who were proposed adjuvant radiotherapy refused this treatment. Older, widowed, divorced, or separated patients, who were recently diagnosed and managed in the Northern plains or Pacific coast (USA), with limited tumoral extension, were more likely to refuse adjuvant radiotherapy. Five-year cancer-related survival was significantly lower in patients who refused adjuvant radiotherapy (88.9% vs. 95.7%, pradiotherapy. Refusing adjuvant radiotherapy increased cancer-related death but probably does not reduce overall survival. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Parents who refuse or delay HPV vaccine: Differences in vaccination behavior, beliefs, and clinical communication preferences. (United States)

    Gilkey, Melissa B; Calo, William A; Marciniak, Macary W; Brewer, Noel T


    We sought to estimate the national prevalence of HPV vaccine refusal and delay in a nationally-representative sample of parents of adolescents. We also compared parents who refused versus delayed HPV vaccine in terms of their vaccination beliefs and clinical communication preferences. In 2014 to 2015, we conducted an online survey of 1,484 US parents who reported on an 11- to 17-year-old child in their household. We used weighted multinomial logistic regression to assess correlates of HPV vaccine refusal and delay. Overall, 28% of parents reported that they had ever "refused or decided not to get" HPV vaccine for their child, and an additional 8% of parents reported that they had "delayed or put off getting" HPV vaccine. Compared to no refusal/delay, refusal was associated with lower confidence in adolescent vaccination (relative risk ratio [RRR] = 0.66, 95% confidence interval [CI], 0.48-0.91), lower perceived HPV vaccine effectiveness (RRR = 0.68, 95% CI, 0.50-0.91), and higher perceived harms (RRR = 3.49, 95% CI, 2.65-4.60). In contrast, delay was associated with needing more information (RRR = 1.76, 95% CI, 1.08-2.85). Most parents rated physicians and information sheets as helpful for making decisions about HPV vaccination, although parents who reported refusal endorsed these resources less often. Our findings suggest that HPV vaccine refusal is common among parents of adolescents and may have increased relative to previous estimates. Because the vaccination beliefs and communication preferences of parents who refuse appear to differ from those who delay, targeted communication strategies may be needed to effectively address HPV vaccine hesitancy.

  1. Development of the thyroid gland. (United States)

    Nilsson, Mikael; Fagman, Henrik


    Thyroid hormones are crucial for organismal development and homeostasis. In humans, untreated congenital hypothyroidism due to thyroid agenesis inevitably leads to cretinism, which comprises irreversible brain dysfunction and dwarfism. Elucidating how the thyroid gland - the only source of thyroid hormones in the body - develops is thus key for understanding and treating thyroid dysgenesis, and for generating thyroid cells in vitro that might be used for cell-based therapies. Here, we review the principal mechanisms involved in thyroid organogenesis and functional differentiation, highlighting how the thyroid forerunner evolved from the endostyle in protochordates to the endocrine gland found in vertebrates. New findings on the specification and fate decisions of thyroid progenitors, and the morphogenesis of precursor cells into hormone-producing follicular units, are also discussed. © 2017. Published by The Company of Biologists Ltd.

  2. [Lymph node preparation in colorectal cancer. Ex vivo methylene blue injection as a novel technique to improve lymph node visualization]. (United States)

    Märkl, B; Kerwel, T; Jähnig, H; Anthuber, M; Arnholdt, H


    The UICC requires investigation of a minimum of 12 lymph nodes for adequate lymph node staging in colorectal cancer. Despite that, many authors recommend investigation of a larger number, and different techniques, such as fat clearance, have therefore been developed. In this study we introduce a novel technique involving ex vivo lymph node staining with intraarterial methylene blue injection in colon cancer. We compared 14 cases in which methylene injection was used with 14 cases from our records in which conventional investigation techniques were applied. The lymph node harvest differed highly significantly (pmethylene blue group and the unstained group, respectively. The largest difference occurred in the size group 2-4 mm (191 vs 70 lymph nodes). In 6 cases in the unstained group additional embedding of fatty tissue was necessary to reach an adequate number of investigated lymph nodes. Methylene blue injection is a novel and highly effective method that will improve lymph node preparation in colorectal cancer.

  3. Microwave thermolysis of sweat glands. (United States)

    Johnson, Jessi E; O'Shaughnessy, Kathryn F; Kim, Steve


    Hyperhidrosis is a condition that affects a large percentage of the population and has a significant impact on peoples' lives. This report presents a technical overview of a new noninvasive, microwave-based device for creating thermolysis of sweat glands. The fundamental principles of operation of the device are presented, as well as the design and optimization of the device to target the region where the sweat glands reside. An applicator was designed that consists of an array of four waveguide antennas, a cooling system, and a vacuum acquisition system. Initially, the performance of the antenna array was optimized via computer simulation such that microwave absorption was maximized near the dermal/hypodermal interface. Subsequently, hardware was implemented and utilized in pre-clinical testing on a porcine model to optimize the thermal performance and analyze the ability of the system to create thermally affected zones of varying size yet centered on the target region. Computer simulation results demonstrated absorption profiles at a frequency of 5.8 GHz that had low amounts of absorption at the epidermis and maximal absorption at the dermal/hypodermal interface. The targeted zone was shown to be largely independent of skin thickness. Gross pathological and histological response from pre-clinical testing demonstrated the ability to generate thermally affected zones in the desired target region while providing protection to the upper skin layers. The results demonstrate that microwave technology is well suited for targeting sweat glands while allowing for protection of both the upper skin layers and the structures beneath the subcutaneous fat. Promising initial results from simulation and pre-clinical testing demonstrate the potential of the device as a noninvasive solution for sweat gland thermolysis. Copyright © 2011 Wiley Periodicals, Inc.

  4. Local administration of liposomal adriamycin inhibited proliferation of metastatic cells in axillary lymph nodes in rabbit breast cancer model

    Institute of Scientific and Technical Information of China (English)

    Li Xiaojun; Qin Hong; Yao Jia; Wang Jiansheng; Xian Yinsheng; Zhang Yunfeng; Ren Hong


    Objective: To assess the inhibitory effects of liposomal adriamycin (LADR) locally injected into mammary glands of VX2 tumor-bearing rabbits on proliferation of lymph nodal metastatic cells. Methods: Twenty-one VX2 tumor-bearing rabbits were randomly and equally divided into 3 groups. Rabbits were randomized to receive sham treatment (Group I), subcutaneous LADR around tumor (Group II) and intravenous free adriamycin (Group III), respectively. Breast tumor and axillary lymph nodes were harvested after 3 repeated treatment. Nodal sizes of both pre- and post-treatment were measured. Proliferating cell nuclear antigen (PCNA) mRNA in both tumor and lymph nodes were determined by RT-PCR. Results: The mean size of axillary lymph nodes in Group I, II and III increased by 3.70%, 1.55% and 2.89%, respectively, with significant difference between Group III and I (P=0.004) and between Group II and III (P=0.002). Relative expression values of PCNA mRNA in breast tumors of Group I, II and III were 0.486, 0.513 and 0.396, respectively. For Group III, PCNA mRNA was significantly less expressed than that in Group I (P=0.023) and II (P=0.005). Relative expression values of PCNA mRNA in axillary lymph nodes of Group I, II and III were 0.541, 0.329 and 0.450, respectively. Compared with Group I, Group III showed a markedly decreased expression of PCNA (P=0.021). The least level of PCNA mRNA was found in Group II, with a significant difference from that in Group HI (P=0.004). Conclusion: Local injection of LADR was an effective therapeutic regimen for lymphatic metastases from breast cancer, regardless of its little effect on primary tumor.

  5. Microbial ecology studies at two coal mine refuse sites in Illinois

    Energy Technology Data Exchange (ETDEWEB)

    Miller, R. M.; Cameron, R. E.


    An investigation was made of the microflora associated with coal refuse at two abandoned mines in the midwestern United States. Information was gathered for both the edaphic and the biotic composition of the refuse material. Emphasis was placed on heterotrophic and autotrophic components as to numbers, kinds, and physiological groups. The presence of chemolithotrophs was also investigated. The relationship between abiotic and biotic components in regard to distribution of bacteria, fungi, and algae is discussed. Information presented in this report will be utilized in assessing trends and changes in microbial numbers and composition related to manipulations of the edaphic and biotic ecosystem components associated with reclamation of the refuse piles.

  6. Pattern of Colon Cancer Lymph Node Metastases in Patients Undergoing Central Mesocolic Lymph Node Excision

    DEFF Research Database (Denmark)

    Bertelsen, Claus A; Kirkegaard-Klitbo, Anders; Nielsen, Mingyuan


    not considered appropriate. The risk of central mesocolic lymph node metastases for right-sided cancers varies between 1% and 22%. In sigmoid cancer, the risk is reported in ≤12% of the patients and is associated with advanced T stage. LIMITATIONS: The retrospective design and heterogeneity, in terms...... of definitions of lymph node location, tumor sites, stage, morphology, pathology assessment, and inclusion criteria (selection bias), of the included studies were limitations. Also, anatomic definitions were not uniform. CONCLUSIONS: The present literature cannot give a theoretical explanation of a better...... oncological outcome after extended lymph node dissection. Consensus for a standardization of anatomical definitions and surgical and pathological assessments is warranted for future mapping studies....

  7. Preoperative diagnosis of lymph node metastasis in thoracic esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Eguchi, Reiki; Yamada, Akiyoshi; Ueno, Keiko; Murata, Yoko [Tokyo Women`s Medical Coll. (Japan)


    From 1994 to 1995, to evaluate the utility of preoperative CT, EUS (endoscopic ultrasonography) and US in the diagnosis of lymph node metastasis in thoracic esophageal cancer, 94 patients with thoracic esophageal cancer who underwent esophagectomy were studied clinicopathologically. The sensitivity of EUS diagnosis of upper mediastinal lymph node metastasis (85%), left-sided paragastrin lymph node metastasis (73-77%), and especially lower paraesophageal lymph node metastasis (100%) were good. But due to their low-grade specificity in EUS diagnosis, their overall accuracy was not very good. On the other hand, the overall accuracy of the CT diagnosis of lymph node metastasis was fine. However, sensitivity, the most important clinical factor in the CT diagnosis of lymph node metastasis was considerably inferior to EUS. The assessment of the diagnosis of lymph node metastasis around the tracheal bifurcation and the pulmonary hilum and the left para-cardial lesion by CT or EUS was poor. It was concluded that lymph node metastasis of these area must be the pitfall in preoperative diagnosis. The average diameter of the lymph nodes and the proportion of cancerous tissue in the lymph nodes diagnosed as metastatic lymph nodes by CT was larger than that of the false negative lymph nodes. However, the lymph nodes diagnosed as true positives by EUS showed no such tendency. This must be the reason the sensitivity of the EUS diagnosis and specificity of the CT diagnosis were favorable, but the specificity of the EUS diagnosis and especially the sensitivity of the CT diagnosis were not as good. (author)

  8. Histological and immunohistochemical study of the thyroid gland of the broad-snouted caiman (Caiman latirostris - doi: 10.4025/actascibiolsci.v35i4.18444

    Directory of Open Access Journals (Sweden)

    Clarice Machado-Santos


    Full Text Available The broad-snouted caiman, Caiman latirostris, is widely distributed in countries of South America. In Brazil it is considered an endangered species because of natural habitat destruction and illegal hunting.  In reptiles, the thyroid gland plays an integral part in ecdysis, reproduction, tail regeneration, growth, endocrine function and metabolism rate. The aim of the present study was to characterize the thyroid gland morphology of C. latirostris, based on histochemical and immunohistochemical techniques. The thyroid glands were fixed in Bouin's fluid and serial cross sections were stained with hematoxylin-eosin, Mallory’s trichrome, periodic acid-Schiff (PAS and Alcian blue (AB pH 1.5 and 2.5. The immunohistochemical technique for 5-HT-IR cells was used. The thyroid gland has a dense irregular connective tissue forms a capsule enveloping the gland. There are several follicular acini of varying size lined by simple cuboidal or columnar epithelium in the thyroid gland. The follicles are connected by interfollicular connective tissue which contains blood vessels. We observed the presence of lymph nodes around the entire gland. There was a positive PAS reaction and negative AB reaction in the colloid. 5-HT-IR cells were detected around the follicle cells. No striking morphological differences were observed between C. latirostris and other domesticated mammals.

  9. Turning refuse plastic into multi-walled carbon nanotube forest

    Directory of Open Access Journals (Sweden)

    Eugene Oh, Jaegeun Lee, Seung-Ho Jung, Seungho Cho, Hye-Jin Kim, Sung-Hyun Lee, Kun-Hong Lee, Kyong-Hwa Song, Chi-Hoon Choi and Do Suck Han


    Full Text Available A novel and effective method was devised for synthesizing a vertically aligned carbon nanotube (CNT forest on a substrate using waste plastic obtained from commercially available water bottles. The advantages of the proposed method are the speed of processing and the use of waste as a raw material. A mechanism for the CNT growth was also proposed. The growth rate of the CNT forest was ~2.5 μm min−1. Transmission electron microscopy images indicated that the outer diameters of the CNTs were 20–30 nm on average. The intensity ratio of the G and D Raman bands was 1.27 for the vertically aligned CNT forest. The Raman spectrum showed that the wall graphitization of the CNTs, synthesized via the proposed method was slightly higher than that of commercially available multi-walled carbon nanotubes (MWCNTs. We expect that the proposed method can be easily adapted to the disposal of other refuse materials and applied to MWCNT production industries.

  10. Gasification process of refuse derived fuel in circulating fluidized bed

    Energy Technology Data Exchange (ETDEWEB)

    Ichikawa, S.; Kinoshita, Y.; Lee, C.W.; Itaya, Y.; Mori, S. [Nagoya Univ., Nagoya (Japan). Dept. of Chemical Engineering


    This paper presents a fuel gas production system involving gasification of refuse-derived fuel (RDF) in a circulating fluidized bed (CFB). Although RDF is considered to be a viable source of energy, combustion of RDF has not spread widely because of a lack of conventional incinerators, erosion due to hydrogen chloride, and emissions of dioxin. This paper presents the results of an experimental study of the pyrolysis behaviour of 3 kinds of RDF and the particle motion in a cold model CFB. The objective was to clarify operating parameters for optimum control. It was shown that an increase in combustion temperature improves the yield of the combustible gas components and the energy recycling efficiency from the RDF. The highest heating value of pyrolysis gas was obtained at 873 to 973 degrees K. The gas flow rate in the pneumatic valve of the CFB was an important control factor for the circulation flux and solids holdup in the riser. High holdups were observed when minute silica sand particles were used in the CFB. 15 refs., 1 tab., 8 figs.

  11. Hygiene tests in the anaerobic digestion of household refuse

    Energy Technology Data Exchange (ETDEWEB)

    Maier, H.; Philipp, W.; Wekerle, J.; Strauch, D.

    In a pilot plant the disinfecting effect of composting the effluent of an anaerobic mesophilic digestion process of the organic fraction of household refuse was investigated. The dewatered effluent was mixed with straw as bulking material, put in not aerated windrows and aerobically composted. It was further investigated whether the influent of the digester could be disinfected with lime milk prior to the anaerobic mesophilic digestion process. For the evaluation of the disinfection salmonellas, enterococci, klebsiellas, parvo-, polio- and rotavirus were used as test agents. Temperature, total aerobic germ count, enterobacteriaceae and coliforms were also considered. The effect of lime milk in the influent on the digestion process, survival of the test bacteria and gas production was also studied. Both treatments can result in a hygienically safe product. But composting under the conditions given should not be operated during the winter period. Lime treatment of the influent results in a disinfection of the effluent which immediately can be utilized as liquid sludge in agriculture. (orig.)

  12. Production, quality and quality assurance of Refuse Derived Fuels (RDFs). (United States)

    Sarc, R; Lorber, K E


    This contribution describes characterization, classification, production, application and quality assurance of Refuse Derived Fuels (RDFs) that are increasingly used in a wide range of co-incineration plants. It is shown in this paper, that the fuel-parameter, i.e. net calorific value [MJ/kg(OS)], particle size d(90) or d(95) [mm], impurities [w%], chlorine content [w%], sulfur content [w%], fluorine content [w%], ash content [w%], moisture [w%] and heavy metals content [mg/kg(DM)], can be preferentially used for the classification of different types of RDF applied for co-incineration and substitution of fossil-fuel in different industial sectors. Describing the external production of RDF by processing and confectioning of wastes as well as internal processing of waste at the incineration plant, a case study is reported on the application of RDF made out of different household waste fractions in a 120,000t/yr Waste to Energy (WtE) circulating fluidized bed (CFB) incinerator. For that purpose, delivered wastes, as well as incinerator feedstock material (i.e. after internal waste processing) are extensively investigated. Starting with elaboration of sampling plan in accordance with the relevant guidelines and standards, waste from different suppliers was sampled. Moreover, manual sorting analyses and chemical analyses were carried out. Finally, results of investigations are presented and discussed in the paper.

  13. Carcinoma in a mediastinal fifth parathyroid gland

    Energy Technology Data Exchange (ETDEWEB)

    Kastan, D.J.; Kottamasu, S.R.; Frame, B.; Greenwald, K.A.


    Commonly four parathyroid glands are located in the neck. The incidence of a fifth supernumery parathyroid gland has been reported to be between 2% and 6%. Most reports of a hyperfunctioning supernumery parathyroid gland have been adenomas. There have been only a few reports of parathyroid gland carcinoma occurring outside of the cervical region, none of which were in a supernumery parathyroid gland. The authors believe this is the first report of a carcinoma occurring in a supernumery parathyroid gland. Following surgery, four views of the chest during a barium swallow examination showed an anterior mediastinal mass. Computed tomographic (CT) scans of the mediastinum confirmed a contrast-enhancing soft-tissue mass anterior to and separate from the aorta.

  14. Site of iodination in rat mammary gland

    Energy Technology Data Exchange (ETDEWEB)

    Strum, J.M.


    The ability of the mammary gland to take up and organically bind radioiodide was studied in non-pregnant, pregnant, and lactating rats. Autoradiography was used to determine whether duct cells or alveolar cells are responsible for iodination in the rat mammary gland. Iodination was not detected in mammary glands from non-pregnant rats, but occurred late in the twelfth day of gestation and continued throughout pregnancy and lactation. Protein-containing vacuoles in alveolar cells and casein-like proteins in milk were the major sites where iodination occurred within the gland. Milk proteins in the lumens of ductules adjacent to alveoli were also iodinated. In contrast, ducts, myoepithelial cells, fat cells, blood vessels and other histological components of the gland did not show iodinating capability. Cytochemistry was also used to identify endogenous mammary peroxidase activity in the same glands, and it was found that the presence and location of this enzyme were correlated with the ability to iodinate.

  15. 29 CFR 102.19 - Appeal to the general counsel from refusal to issue or reissue. (United States)


    ... Unfair Labor Practices 1 Complaint § 102.19 Appeal to the general counsel from refusal to issue or.... Consideration of an appeal untimely filed is within the discretion of the General Counsel upon good cause...

  16. Effects from different types of construction refuse in the soil on electrodialytic remediation

    DEFF Research Database (Denmark)

    Ottosen, Lisbeth M.; Eriksson, Thomas; Hansen, Henrik K.


    of different sorts of construction refuse on electrodialytic soil remediation was investigated in laboratory cells. An insulator, a stone, resulted in an uneven Cu removal in the close vicinity of the stone itself. An electric conductive screw disturbed the Cu removal due to the redox reactions occurring...... at the surface of the screw causing pH changes in the soil. Two types of refuse with ionic conducting properties were placed within the test cell, a piece of brick and concrete. The brick did not influence the Cu removal from the soil to a high extent, but it was seen that during the remediation the Cu...... poor. It is very important to be aware of the presence of construction refuse at such sites when planning an electrochemical remediation action. All the refuse types investigated here influenced the Cu removal negatively compared to the reference experiment. $CPY 2002 Elsevier Science B.V. All rights...

  17. Development of new high-rate composting process of municipal refuse

    Energy Technology Data Exchange (ETDEWEB)

    Kajimoto, H.; Tamura, T.; Kumagaya, T.; Shimada, T.; Yoneda, M.; Hamamoto, I.


    In Japan, the composting technique is being re-evaluated as one of the alternative techniques for solid waste disposal. A review is made of the municipal refuse high-rate composting technique from the viewpoints of the changed properties of munficipal refuses and environmental protection. As the result of an operation of a pilot plant having a composting capacity of one ton of refuse per day, a new process suited to the properties of today's municipal refuses in Japan was developed. The feature of the new process is to control the moisture content of fresh compost (obtained from the primary digester) by a mechanical press and produce fully ripened compost without non-compostable materials such as plastics and glass.

  18. The parathyroid gland in health and disease.


    Ghandur-Mnaymneh, L.; Cassady, J.; Hajianpour, M. A.; Paz, J; Reiss, E


    The authors studied the parathyroid glands from 100 previously healthy subjects who died suddenly and were admitted to the Dade County Medical Examiner's (ME) morgue and from 66 inpatients who died at Jackson Memorial Hospital (JMH). Parathyroid glands in patients with diseases (JMH series) were heavier than those in healthy persons (ME series), and both groups of glands were significantly heavier than those previously reported. Mean glandular weight in white subjects was 42.6 +/- 20.3 mg, wi...

  19. The parathyroid gland in health and disease. (United States)

    Ghandur-Mnaymneh, L.; Cassady, J.; Hajianpour, M. A.; Paz, J.; Reiss, E.


    The authors studied the parathyroid glands from 100 previously healthy subjects who died suddenly and were admitted to the Dade County Medical Examiner's (ME) morgue and from 66 inpatients who died at Jackson Memorial Hospital (JMH). Parathyroid glands in patients with diseases (JMH series) were heavier than those in healthy persons (ME series), and both groups of glands were significantly heavier than those previously reported. Mean glandular weight in white subjects was 42.6 +/- 20.3 mg, with a range of 22-103 mg. The 95% upper limit of gland weight for healthy white subjects was 73.1 mg and for black subjects, 91.6 mg. The size and weight exhibited a skewed distribution. Gland weight varied with age, increasing to a maximum in the 41-60 year old age group in all subsets except white women, in whom it continued to increase till after age 70. There was slight correlation (r2 = 0.15) of gland weight with body weight within series and race groups; parenchymal content of the glands was not constant but correlated positively with glandular weight. Glands from both series had a comparable fat content. Fat was unevenly distributed throughout the gland, and its amount was highly variable, ranging between 0 and 90%, with a mean of 26% for white subjects and 24% for black subjects in both series. Therefore, percentage fat may not be used as an index of hyperplasia. Healthy back subjects had heavier glands than healthy white subjects, unaccounted for by differences in body weights; this difference was not statistically significant in subjects with disease. Within the black race, glands were not significantly heavier in disease than in health, and in the few cases with serum calcium determinations, the gland weight did not vary inversely with serum calcium levels as in white subjects, suggesting a basic difference in parathyroid calcium metabolism between the two races. PMID:3789088

  20. Lacrimal gland fistula after upper eyelid blepharoplasty

    Directory of Open Access Journals (Sweden)

    Mohsen Bahmani Kashkouli


    Full Text Available To report the first case of lacrimal gland fistula after upper eyelid blepharoplasty for blepharochalasis. Standard upper blepharoplasty and the hooding excision were performed in a female with blepharochalasis. The patient developed a fistulous tract with tearing from the incision few days after hooding excision. Fistula excision and lacrimal gland repositioning were performed. There were no complications after the repositioning procedure (6 months follow up. Prolapsed lacrimal gland and fistula formation can occur after upper blepharoplasty hooding excision.

  1. Sentinel lymph node biopsy and melanoma: 2010 update Part II. (United States)

    Stebbins, William G; Garibyan, Lilit; Sober, Arthur J


    This article will discuss the evidence for and against the therapeutic efficacy of early removal of potentially affected lymph nodes, morbidity associated with sentinel lymph node biopsy and completion lymphadenectomy, current guidelines regarding patient selection for sentinel lymph node biopsy, and the remaining questions that ongoing clinical trials are attempting to answer. The Sunbelt Melanoma Trial and the Multicenter Selective Lymphadenectomy Trials I and II will be discussed in detail. At the completion of this learning activity, participants should be able to discuss the data regarding early surgical removal of lymph nodes and its effect on the overall survival of melanoma patients, be able to discuss the potential benefits and morbidity associated with complete lymph node dissection, and to summarize the ongoing trials aimed at addressing the question of therapeutic value of early surgical treatment of regional lymph nodes that may contain micrometastases. Copyright 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  2. Sentinel lymph nodes in cancer of the oral cavity

    DEFF Research Database (Denmark)

    Thomsen, Jørn Bo; Christensen, Rikke Kølby; Sørensen, Jens Ahm;


    BACKGROUND: Extended histopathologic work-up has increased the detection of micrometastasis in sentinel lymph nodes in malignant melanoma and breast cancer. The aim of this study was to examine if (A) step-sectioning of the central 1000 microM at 250 microM levels with immunostaining were accurate...... when compared with (B) step-sectioning and immunostaining of the entire sentinel lymph node at 250 microM levels. METHODS: Forty patients with T1/T2 cN0 oral cancer were enrolled. Three patients were excluded. In one patient no sentinel lymph node was identified. The remaining two had unidentified...... sentinel lymph nodes due to lymphoscintigraphic and surgical sampling error. The central 1000 microM of 147 sentinel lymph nodes were step-sectioned in 250-microm intervals and stained with hematoxylin and eosin and CK-KL1. All lymph nodes were recorded as negative or positive for macrometastases...

  3. Process Effects of Refusal on Psychological Stress Response for Elementary School Students


    井邑, 智哉


    The process in which refusal affects psychological stress response was examined. A total of 300 participants (157 men, 143 women) completed the questionnaire survey. A model was constructed based on the assumption that the seven types of refusal facilitate the attainment of social support from friends. Thus, we proposed social support affects psychological stress response. A covariance structural analysis was conducted, indicating that modesty decreased depression-anxiety and displeasure-ange...

  4. Parotitis and Sialendoscopy of the Parotid Gland. (United States)

    Hernandez, Stephen; Busso, Carlos; Walvekar, Rohan R


    Nonneoplastic disorders of the salivary glands involve inflammatory processes. These disorders have been managed conservatively with antibiotics, warm compresses, massage, sialogogues, and adequate hydration. Up to 40% of patients may have an inadequate response or persistent symptoms. When conservative techniques fail, the next step is operative intervention. Sialendoscopy offers a minimally invasive option for the diagnosis and management of chronic inflammatory disorders of the salivary glands and offers the option of gland and function preservation. In this article, we review some of the more common nonneoplastic disorders of the parotid gland, indications for diagnostic and interventional sialendoscopy, and operative techniques.

  5. Parental refusal of vaccination and transplantation listing decisions: a nationwide survey. (United States)

    Ladd, Jennifer M; Karkazis, Katrina; Magnus, David


    Many professional societies and research studies recommend complete vaccination before pediatric solid organ transplantation. Nevertheless, incompletely vaccinated children often receive transplants. As the number of parents refusing to vaccinate children for nonmedical reasons increases, pediatric transplantation programs face difficult listing decisions. Given the importance of psychosocial criteria in listing decisions, this study explores how parental refusal of vaccination affects those listing decisions. Surveys were emailed to individuals at 195 pediatric solid organ transplantation programs in the United States, with a 71% response rate. Forty-four respondents (39%) reported that their programs have had cases involving parental refusal of vaccination. In response to hypothetical scenarios, 93 respondents (82%) would list a child not vaccinated for medical reasons, whereas only 54 respondents (47%) would list a child whose parents refused vaccination. Only five respondents (4%) reported that their programs had written policies regarding parental refusal of vaccination. These data reveal inconsistencies across pediatric transplantation programs regarding how parental refusal of vaccination affects listing decisions and raise the issue of whether and how the reason for incomplete vaccination should be factored into listing decisions. We recommend further discussion and the development of written guidelines to unify programs' assessments of incompletely vaccinated pediatric transplantation candidates.

  6. Mammary Analog Secretory Carcinoma (MASC) Involving the Thyroid Gland: A Report of the First 3 Cases. (United States)

    Dettloff, Jennifer; Seethala, Raja R; Stevens, Todd M; Brandwein-Gensler, Margaret; Centeno, Barbara A; Otto, Kristen; Bridge, Julia A; Bishop, Justin A; Leon, Marino E


    Salivary gland-type tumors have been rarely described in the thyroid gland. Mammary Analog Secretory Carcinoma (MASC) is a recently defined type of salivary gland carcinoma characterized by a t(12;15)(p13;q25) resulting in an ETV6-NTRK3 fusion gene. We report 3 cases of MASC involving the thyroid gland without clinical evidence of a salivary gland or breast primary; the clinico-pathologic characteristics are reviewed. Assessment for rearrangement of the ETV6 (12p13) locus was conducted by fluorescence in situ hybridization (FISH) on representative FFPE sections using an ETV6 break apart probe (Abbott Molecular, Des Plaines, IL, USA). The patients were two females (52 and 55 years-old) and 1 male (74 years-old). The tumors were poorly circumscribed solid white tan nodules involving the thyroid. Histologically, they were invasive and showed solid, microcystic, cribriform, and tubular growth patterns composed of variably bland polygonal eosinophilic cells with vesicular nuclear chromatin and conspicuous nucleoli. All three cases showed metastasis to lymph nodes; one case showed lateral neck involvement. The tumor cells were positive for S100 and mammaglobin. GATA-3 and PAX-8 were positive in 2 cases, one of which only focally so. All three cases were negative for TTF-1 and thyroglobulin. Rearrangement of the ETV6 locus was confirmed in all cases and a diagnosis of MASC rendered for each case. A site of origin distinct from the thyroid gland was not identified, with a median follow up of 24 months. MASC may rarely involve the thyroid gland. The origin of these lesions is unknown; while an origin from ectopic salivary gland-type cells is entertained, a metastatic origin from an occult primary cannot be definitively excluded at this time. Given the histologic (follicular-like microcystic pattern with colloid-like secretions and papillary pattern), immunophenotypic (PAX-8), and even molecular overlap, MASC can be mistaken for papillary thyroid carcinoma and should be

  7. Salivary gland choristoma (heterotopic salivary gland tissue) on the anterior chest wall of a newborn. (United States)

    Aby, Janelle L; Patel, Mayha; Sundram, Uma; Benjamin, Latanya T


    Salivary gland choristoma (heterotopic salivary gland tissue) is a rare condition typically seen in the newborn period. This developmental heterotopia is generally nonprogressive, with little risk of malignant transformation. We present the second known reported case of a salivary gland choristoma located on the anterior chest wall. Knowledge of this rare entity will allow for accurate diagnosis and management of this benign anatomic variant.

  8. Para-aortic lymph node metastases in pancreatic cancer should not be considered a watershed for curative resection. (United States)

    Hempel, Sebastian; Plodeck, Verena; Mierke, Franz; Distler, Marius; Aust, Daniela E; Saeger, Hans-Detlev; Weitz, Jürgen; Welsch, Thilo


    No international consensus regarding the resection of the para-aortic lymph node (PALN) station Ln16b1 during pancreatoduodenectomy for pancreatic ductal adenocarcinoma (PDAC) has been reached. The present retrospectively investigated 264 patients with PDAC who underwent curative pancreatoduodenectomy or total pancreatectomy between 2005-2015. In 95 cases, the PALN were separately labelled and histopathologically analysed. Metastatic PALN (PALN+) were found in 14.7% (14/95). PALN+ stage was associated with increased regional lymph node metastasis. The median overall survival (OS) of patients with metastatic PALN and with non-metastatic PALN (PALN-) was 14.1 and 20.2 months, respectively. Five of the PALN+ patients (36%) survived >19 months. The OS of PALN+ and those staged pN1 PALN- was not significantly different (P = 0.743). Patients who underwent surgical exploration or palliative surgery (n = 194) had a lower median survival of 8.8 (95% confidence interval: 7.3-10.1) months. PALN status could not be reliably predicted by preoperative computed tomography. We concluded that the survival data of PALN+ cases is comparable with advanced pN+ stages; one-third of the patients may expect longer survival after radical resection. Therefore, routine refusal of curative resection in the case of PALN metastasis is not indicated.

  9. Sentinel lymph nodes in cancer of the oral cavity

    DEFF Research Database (Denmark)

    Thomsen, Jørn Bo; Sørensen, Jens Ahm; Krogdahl, Annelise


    BACKGROUND: Sentinel lymph node biopsy, step sectioning and immunohistochemistry have changed detection of tumour deposits. Isolated tumour cells (ITC) are detected more frequently than earlier because of a changed level of detection. METHODS: A total of 108 sentinel lymph nodes from 30 patients...... with T1/T2 cN0 oral cancer were re-classified histologically to find possible ITC and to describe technical pitfalls. RESULTS: Primarily we found metastatic spread in 12 of 108 sentinel lymph nodes: five macrometastasis and seven micrometastasis. After re-classification, we found seven lymph nodes...

  10. Aged refuse enhances anaerobic digestion of waste activated sludge. (United States)

    Zhao, Jianwei; Gui, Lin; Wang, Qilin; Liu, Yiwen; Wang, Dongbo; Ni, Bing-Jie; Li, Xiaoming; Xu, Rui; Zeng, Guangming; Yang, Qi


    In this work, a low-cost alternative approach (i.e., adding aged refuse (AR) into waste activated sludge) to significantly enhance anaerobic digestion of sludge was reported. Experimental results showed that with the addition dosage of AR increasing from 0 to 400 mg/g dry sludge soluble chemical oxygen demand (COD) increased from 1150 to 5240 mg/L at the digestion time of 5 d, while the maximal production of volatile fatty acids (VFA) increased from 82.6 to 183.9 mg COD/g volatile suspended solids. Although further increase of AR addition decreased the concentrations of both soluble COD and VFA, their contents in these systems with AR addition at any concentration investigated were still higher than those in the blank, which resulted in higher methane yields in these systems. Mechanism studies revealed that pertinent addition of AR promoted solubilization, hydrolysis, and acidogenesis processes and did not affect methanogenesis significantly. It was found that varieties of enzymes and anaerobes in AR were primary reason for the enhancement of anaerobic digestion. Humic substances in AR benefited hydrolysis and acidogenesis but inhibited methanogenesis. The effect of heavy metals in AR on sludge anaerobic digestion was dosage dependent. Sludge anaerobic digestion was enhanced by appropriate amounts of heavy metals but inhibited by excessive amounts of heavy metals. The relative abundances of microorganisms responsible for sludge hydrolysis and acidogenesis were also observed to be improved in the system with AR addition, which was consistent with the performance of anaerobic digestion. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Lymph-migrating, tissue-derived dendritic cells are minor constituents within steady-state lymph nodes


    Jakubzick, Claudia; Bogunovic, Milena; Bonito, Anthony J.; Kuan, Emma L.; Merad, Miriam; Randolph, Gwendalyn J.


    Observations that dendritic cells (DCs) constitutively enter afferent lymphatic vessels in many organs and that DCs in some tissues, such as the lung, turnover rapidly in the steady state have led to the concept that a major fraction of lymph node DCs are derived from migratory DCs that enter the lymph node through upstream afferent lymphatic vessels. We used the lysozyme M–Cre reporter mouse strain to assess the relationship of lymph node and nonlymphoid organ DCs. Our findings challenge the...

  12. Risk factors for non-sentionel lymph node metastases in brdeast cancer patients with positive sentionel lymph ondes

    Institute of Scientific and Technical Information of China (English)

    ZHANG Tao; WANG Hong; CHEN Bao-ping; ZHANG Hai-song; WEI Xi-liang; FU Ying; LI Zhong; HU Geng-kun


    @@ The presence or absence of metastases in the axillary lymph nodes has remained the most powerful prognostic factor in breast carcinoma. Axillary lymph node dissection (ALND) is the standard procedure for obtaining this information. However, postoperative complications are common. Sentinel lymph node (SLN) biopsy has been proposed as a potential alternative to ALND for staging breast carcinoma. This technique has been shown to be sensitive and specific for predicting the status of the axillary lymph nodes.1 Furthermore, it has the potential advantage of decreasing the morbidity associated with ALND.

  13. Schwannoma of the adrenal gland

    Directory of Open Access Journals (Sweden)

    Anunayi Jeshtadi


    Full Text Available Visceral schwannomas are extremely rare and are usually discov-ered incidentally on USG/CT-Scan. Primary schwannomas of the adrenal gland are extremely uncommon. It has been theorized that they originate from Schwann cells that insulate the nerve fi-bers innervating the adrenal medulla. Histopathological examina-tion coupled with immunohistochemistry provides the definitive diagnosis. A 55 year old normotensive female presented with pain in the right loin since 5 months. Her renal parameters were normal. Contrast enhanced computed tomography of abdomen showed a well delineated 6.5 x 5cms mass at upper pole of her right kidney. 24-hour urinary metanephrine was slightly elevated (3.07mg/24hrs. A decline in Serum cortisol levels was observed following a dexamethasone suppression test (18.89nmol/l. Histopathological examination revealed a spindle cell tumor. Immunohistochemistry showed strong and diffuse positive staining for S-100 with negative expression for CD-117, desmin, CD-34, HMB-45, synaptophysin, chromogranin, cytokeratin, and SMA. Ki-67 index was 2%.A diagnosis of cellular schwannoma of adrenal gland was confirmed.

  14. Management of a mucocoele of the submandibular gland without removal of the gland: a case report. (United States)

    Andrade, Neelam N; Aggarwal, Neha; Thomas, Roy; Sahu, Vyankatesh V


    A mucocoele or extravasation of mucus is common in minor salivary glands, but unusual in major ones. Those from the submandibular gland are a diagnostic challenge and conventional management includes excision of the associated gland. We describe a 27-year-old man with a mucocoele of the submandibular gland that presented as a lateral cervical swelling and looked like a plunging ranula. The cystic lesion was completely excised and, to our knowledge, this is the first published case in which the submandibular gland was saved with no recurrence up to two years postoperatively. Copyright © 2016. Published by Elsevier Ltd.

  15. Pathology of the parathyroid glands in hyperparathyroidism. (United States)

    Baloch, Zubair W; LiVolsi, Virginia A


    This paper reviews the embryology, histology and pathology of the human parathyroid glands. It emphasizes those pathologic lesions which are found in the setting of clinical hyperparathyroidism. Also discussed are certain molecular features of hyperfunctioning parathyroid glands. The difficulties encountered in parathyroid FNA are reviewed and illustrated.

  16. Flagelliform or coronata glands of Nephila clavipes. (United States)

    Rodríguez, R; Candelas, G C


    The flagelliform or coronata glands of the orb-web spider, Nephila clavipes, have been studied and compared to other silk-producing glands from the organism. The glands, which produce silk for the double filament of the core thread in the sticky spiral, exhibit three distinct morphological areas: tail, sac, and duct. Electrophoretic separation of the solubilized contents of the glands yields an uppermost diffuse band of high molecular size, preceded by a stepladder of well-defined peptides, which have been shown to be products of discontinuous translation in three other sets of glands. The luminal contents do not migrate as a discrete and well-defined band as those of the other glands, but rather as a diffuse area, typical of glycosylated proteins. Fibroin synthesis is stimulated by the mechanical depletion of the organism's stored silks, as in other Nephila glands, judged by the increased intensity of the bands and also by the structural alterations seen in cross sections of the glands' tails.

  17. Isolation of Mouse salivary gland stem cells

    NARCIS (Netherlands)

    Pringle, Sarah; Nanduri, Lalitha; van der Zwaag, Marianne; van Os, Ronald; Coppes, Rob


    Mature salivary glands of both human and mouse origin comprise a minimum of five cell types, each of which facilitates the production and excretion of saliva into the oral cavity. Serous and mucous acinar cells are the protein and mucous producing factories of the gland respectively, and represent

  18. Salivary gland hypofunction in elderly patients. (United States)

    Navazesh, M


    Elderly dental patients often complain of mouth dryness. This complaint is most often caused by xerogenic medications or, less often, by systemic diseases. Aging per se has no significant clinical impact on salivary gland output. Salivary gland hypofunction, whether caused by medications or systemic disorders, have a strong negative impact on intraoral tissues, with a significant reduction in the quality of life.

  19. The role of pineal gland and exogenous melatonin on the irradiation stress response of suprarenal gland. (United States)

    Alicelebić, Selma; Mornjaković, Zakira; Susko, Irfan; Cosović, Esad; Beganović-Petrović, Amira


    Pineal gland has and antistressogenic role. Its main hormone, melatonin, has radio protective effect on endocrine and other dynamic tissues. In our previous study, we have shown that pinealectomy changes the behavior of suprarenal gland in totally irradiated rats. The aim of this study is to evaluate the effect of exogenous melatonin on suprarenal gland of rats with or without pineal gland. Four months after pinealectomy (experimental group) or shampinealectomy (control group), adult Wistar male rats were daily treated with 0,2 mg of melatonin intraperitoneally, during two weeks. Thereafter, all animals were totally irradiated with 8 Gy of Gamma rays produced from Cobalt 60. Animals who survived were sacrificed on the 17(th) post irradiation day. Qualitative and quantitative characteristics of the suprarenal gland were studied using histological methods. The results show that exogenous melatonin had protective role on suprarenal gland in totally irradiated rats and that those effects were more pronounced in the presence of pineal gland.

  20. Clinical Research of Sentinel Lymph Node in Cervical Cancer%宫颈癌前哨淋巴结的临床研究

    Institute of Scientific and Technical Information of China (English)

    陈丽珍; 林莉萍


    Objective:To explore the feasibility and clinical effect of methylene blue used in the detection of sentinel lymph node which used to forecast pelvic lymphonode metastasis of cervical cancer.Method:40 patients with cervical cancer of stage Ⅰb to Ⅱb in our hospital from January 2010 and January 2014 were selected as the research objects. The injection of methylene blue were given to the 40 patients before operation,after waiting 90 to 180 minutes,they were given pelvic lymphadenectomy and radical hysterectomy.During the operation,the blue dyed lymph gland was regarded as the sentinel lymph node,then the blue dyed and un-blue dyed lymph glands which were removed from the operation were tested respectively.Then the pathology result was analyzed.Result:Among the 40 cervical cancer patients,37 patients were successfully detected with sentinel lymph nodes by methylene blue.The detection rate was 92.5%.According to the pathology result,all patients were with pelvic lymphonode metastasis and 11 patients with sentinel lymph node positive. The prediction rate of blue dyed sentinel lymph node to the pelvic lymphonode metastasis was 92.5%.The discovery rate of false negative was 0.Conclusion:It's feasible to apply methylene blue as tracer to test the sentinel lymph node.The use of methylene blue can identify and locate the position of sentinel lymph node quite accurately.Besides,the use of it can also estimate whether lymph gland shift or not,which is of great clinical value.%目的:探讨亚甲蓝用于检测前哨淋巴结预测宫颈癌盆腔淋巴结转移的可行性和临床意义。方法:选择本院2010年1月-2014年1月收治的40例Ⅰb~Ⅱb期宫颈癌患者作为研究对象,对40例患者术前注射亚甲蓝示踪剂,注射后等待90~180 min后行盆腔淋巴结清扫术以及广泛子宫切除术,在术中把蓝染的淋巴结认定为前哨淋巴结,把所有蓝染的以及未蓝染的切除后的淋巴结分开送检,并

  1. Dialysis patients refusing kidney transplantation: data from the Slovenian Renal Replacement Therapy Registry. (United States)

    Buturović-Ponikvar, Jadranka; Gubenšek, Jakob; Arnol, Miha; Bren, Andrej; Kandus, Aljoša; Ponikvar, Rafael


    Kidney transplantation is considered the best renal replacement therapy (RRT) for patients with end-stage renal disease; nevertheless, some dialysis patients refuse to be transplanted. The aim of our registry-based, cross-sectional study was to compare kidney transplant candidates to dialysis patients refusing transplantation. Data were collected from the Slovenian Renal Replacement Therapy Registry database, as of 31 December 2008. Demographic and some RRT data were compared between the groups. There were 1448 dialysis patients, of whom 1343 were treated by hemodialysis and 105 by peritoneal dialysis (PD); 132 (9%) were on the waiting list for transplantation, 208 (14%) were preparing for enrollment (altogether 340 [23%] dialysis patients were kidney transplant candidates); 200 (13.7%) patients were reported to refuse transplantation, all ≤ 65 years of age; 345 (24%) were not enrolled due to medical contraindications, 482 (33%) due to age, and 82 (6%) due to other or unknown reasons. No significant difference was found in age, gender, or presence of diabetes between kidney transplant candidates vs. patients refusing transplantation (mean age 50.5 ± 13.9 vs. 51.3 ± 9.6 years, males 61% vs. 63%, diabetics 18% vs. 17%). The proportion of patients ≤ 65 years old who were refusing transplantation was 28% (187/661) for hemodialysis and 17% (13/79) for PD patients (P = 0.03). There is a considerable group of dialysis patients in Slovenia refusing kidney transplantation. Compared to the kidney transplant candidates, they are similar in age, gender and prevalence of diabetes. Patients treated by peritoneal dialysis refuse kidney transplantation less often than hemodialysis patients.

  2. [Accumulation of respiratory diseases among employees at a recently established refuse sorting plant]. (United States)

    Sigsgaard, T I; Bach, B; Taudorf, E; Malmros, P; Gravesen, S


    An increasing number of plants for re-use of refuse have been constructed in Denmark in recent years. The Kaastrup Plant near Skive was opened in spring 1986. The plant accepts household rubbish and industrial refuse separately. The refuse is sorted by machine (industrial refuse is sorted partially manually) and in a large partially open machine plant, refuse is converted into fuel pellets. During a period of eight months, eight out of 15 employees developed respiratory symptoms. In seven, bronchial asthma was diagnosed and chronic bronchitis in one person. Four had initial symptoms of the organic dust toxic syndrome. After further six months, another case of occupationally-conditioned asthma occurred in the plant. Only two out of nine had previously had asthma or atopic disease. The investigation did not reveal any evidence of type-I allergy. Six out of nine had specific precipitating antibodies to refuse while all had negative RAST tests to this. In spring 1989, from six to eighteen months after the onset of the symptoms, six had still dyspnoea on exertion and three had positive histamine-provocation tests and seven out of nine had left the plant. Occupational medical measurements revealed dust concentrations of 8.1 mg/cubic millimeter in September 1986 and total germs of up to 3 x 10(9) cfu/cubic meter. Construction of the plant involved considerable contact with the refuse on account of the cleansing processes and open systems and it was reconstructed in the course of 1987/1988 so that the hygienic conditions are now acceptable.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. An audit of consent refusals in clinical research at a tertiary care center in India

    Directory of Open Access Journals (Sweden)

    S J Thaker


    Full Text Available Background and Rationale: Ensuring research participants′ autonomy is one of the core ethical obligations of researchers. This fundamental principle confers on every participant the right to refuse to take part in clinical research, and the measure of the number of consent refusals could be an important metric to evaluate the quality of the informed consent process. This audit examined consent refusals among Indian participants in clinical studies done at our center. Materials and Methods: The number of consent refusals and their reasons in 10 studies done at our center over a 5-year period were assessed. The studies were classified by the authors according to the type of participant (healthy vs patients, type of sponsor (investigator-initiated vs pharmaceutical industry, type of study (observational vs interventional, level of risk [based on the Indian Council of Medical Research (ICMR "Ethical Guidelines for Biomedical Research on Human Participants"], available knowledge of the intervention being studied, and each patient′s disease condition. Results: The overall consent refusal rate was 21%. This rate was higher among patient participants [23.8% vs. healthy people (14.9%; P = 0.002], in interventional studies [33.6% vs observational studies (7.5%; P < 0.0001], in pharmaceutical industry-sponsored studies [34.7% vs investigator-initiated studies (7.2%; P < 0.0001], and in studies with greater risk (P < 0.0001. The most common reasons for consent refusals were multiple blood collections (28%, inability to comply with the study protocol (20%, and the risks involved (20%. Conclusion: Our audit suggests the adequacy and reasonable quality of the informed consent process using consent refusals as a metric.

  4. Effect of leachate recycling and inoculation on the biochemical characteristics of municipal refuse in landfill bioreactors

    Institute of Scientific and Technical Information of China (English)


    Activity development of key groups of enzymes involved in municipal refuse decomposition was measured in laboratory landfill hioreactors with and without leachate recycling and inoculation for about 210 days.The results showed that the enzymes (amylase,protease,cellulase,lipase and pectinase ) were present in fresh refuse but at low values and positively affected hy leachate recycling and refuse inoculation.The total average of cellulase activity in digesters D3 operated with leachate recycling but no inoculation,D4 and D5 operated with leachate recycling and inoculation was much higher than that in digesters D1 and D2 without leachate recycling and inoculation by 88%-127%,117%-162% and 64%-98%.The total average of protease activity was higher in digester D4 than that in digesters D1,D2,D3and D5 by 63%,39%,24% and 24%,respectively,and the positive effect of leachate and inoculation on protease activity of landfilled refuse mainly was at the first two months.The total average of amylase activity was higher in digesters D3,D4 and D5 than that in digesters D1 and D2 by 83%-132%,96%-148% and 81%-129%.During the early phase of incubation,the stimulatory effect of inoculation on lipase activity was measured,but refuse moisture was the main factor affecting lipase activity of landfilled refuse.The inoculation,initial and continuous inoculation of microorganisms existing in leachate,was the mainly stimulatory factor affecting pectinase activity of landfilled refuse.

  5. Primary malignant lymphoma of the parotid gland

    Directory of Open Access Journals (Sweden)

    Sudha H Metikurke


    Full Text Available Lymphoma of the salivary gland accounts for 5% of cases of extranodal lymphoma and 10% of malignant salivary gland tumors. Most primary salivary gland lymphomas are B marginal zone lymphomas arising on a background of sialadenitis associated with an autoimmune disorder such as Sjorgen′s syndrome. This report describes a case of primary B-cell lymphoma arising in the parotid gland in a middle-aged female, which was not associated with an autoimmune disorder. Immunohistochemistry studies confirmed the clonal B-cell nature of the tumor. This case highlights the fact that B-cell lymphoma in the salivary gland can go unrecognized due to its non-specific symptoms and requires immunohistochemistry studies for confirmation. We present this case for its rarity.

  6. Orbital Lymphoma Mimicking Lacrimal Gland Pleomorphic Adenoma

    Directory of Open Access Journals (Sweden)

    Diego Strianese


    Full Text Available Purpose: To describe the case of a patient affected by orbital lymphoma mimicking pleomorphic adenoma of the lacrimal gland. Methods: This was a retrospective case report. Results: We present the case of a patient with 15-year history of slowly progressive left proptosis and inferomedial bulbar dislocation who had the presumptive diagnosis of lacrimal gland pleomorphic adenoma based on clinical and radiological features. The patient underwent lateral orbitotomy and lacrimal gland excision. Postoperative histological features were consistent with low-grade B-cell non-Hodgkin lymphoma. Conclusion: The accepted clinico-radiological criteria used for the diagnosis of lacrimal gland fossa lesions might have a certain false-positive rate, even in recent years. The initial surgical approach with the appropriate choice between fine-needle aspiration biopsies, intraoperative biopsies and lacrimal gland excisions might be a challenge.

  7. Submaxillary gland mucocele: presentation of a case. (United States)

    Boneu-Bonet, Fernando; Vidal-Homs, Enric; Maizcurrana-Tornil, Aránzazu; González-Lagunas, Javier


    The term mucocele is referred to two concepts: the extravasation cysts resulting from salivary glandular duct rupture, with mucin leakage into the surrounding peri-glandular soft tissue, and the retention cysts, caused by a glandular duct obstruction and resulting in a decrease or even an absence of glandular secretion. Mucocele can not be considered as a true cyst because its wall lacks an epithelial lining. These lesions are very common in the minor salivary glands (particularly in the labial glands), but are very infrequent in the major salivary glands--including the submaxillary glands. The present study describes a clinical case of a right submaxillary gland mucocele resolved by surgical treatment and reviews the differential diagnosis with other clinical entities.

  8. Homeobox Genes in the Rodent Pineal Gland

    DEFF Research Database (Denmark)

    Rath, Martin Fredensborg; Rohde, Kristian; Klein, David C


    The pineal gland is a neuroendocrine gland responsible for nocturnal synthesis of melatonin. During early development of the rodent pineal gland from the roof of the diencephalon, homeobox genes of the orthodenticle homeobox (Otx)- and paired box (Pax)-families are expressed and are essential...... for normal pineal development consistent with the well-established role that homeobox genes play in developmental processes. However, the pineal gland appears to be unusual because strong homeobox gene expression persists in the pineal gland of the adult brain. Accordingly, in addition to developmental...... functions, homeobox genes appear to be key regulators in postnatal phenotype maintenance in this tissue. In this paper, we review ontogenetic and phylogenetic aspects of pineal development and recent progress in understanding the involvement of homebox genes in rodent pineal development and adult function...

  9. Do adenocarcinomas of the prostate with Gleason score (GS) ≤6 have the potential to metastasize to lymph nodes? (United States)

    Ross, Hillary M; Kryvenko, Oleksandr N; Cowan, Janet E; Simko, Jeffry P; Wheeler, Thomas M; Epstein, Jonathan I


    Although rare, there are cases within reported series of men with Gleason score (GS) ≤6 on radical prostatectomies that show pelvic lymph node (LN) metastases. However, there are no studies on whether pelvic LN metastases occur in tumors with GS ≤6 using the International Society of Urological Pathology (ISUP) updated GS system. We performed a search of the radical prostatectomy databases at 4 large academic centers for cases of GS ≤6. Only prostatectomies submitted and embedded in entirety with pelvic LN dissections were included. A combined total of 14,123 cases were identified, of which 22 cases had a positive LN. Histopathologic review of 19 cases (3 cases unavailable for review) showed higher grade than originally reported by the pathologists in all cases. Of the 17 pre-ISUP reviewed cases, 2 were upgraded to 4+3=7 with both cribriform and poorly formed glands. One case was upgraded to 4+3=7 with tertiary pattern 5 displaying cribriform glands, poorly formed glands, and cords of single cells. Eleven cases were upgraded to 3+4=7 with glomeruloid structures and small to large cribriform glands (1 of these also had features of ductal adenocarcinoma). Two cases had tertiary pattern 4 with small cribriform glands. One case had a prominent colloid component that would currently be graded as 4+5=9 because of large cribriform glands and solid sheets of cells within the mucin. Of the 2 post-ISUP cases, 1 demonstrated tertiary pattern 4, and the other showed GS 3+4=7 with irregular cribriform glands. Undergrading is the primary reason for LN positivity with GS ≤6, which has decreased significantly since the adoption of the ISUP grading system in 2005. Of over 14,000 totally embedded radical prostatectomies from multiple institutions, there was not a single case of a GS ≤6 tumor with LN metastases. In contrast to prevailing assumptions, GS ≤6 tumors do not appear to metastasize to LNs. Rather, Gleason pattern 4 or 5, as better defined by the current ISUP

  10. Clinical Research on the Identification and Protection Effects of Nano Carbon Particles on Parathyroid Gland in Thyroid Carcinoma Surgery%纳米碳在甲状腺癌手术中对甲状旁腺辨认保护的临床研究

    Institute of Scientific and Technical Information of China (English)

    陈治龙; 陈光裕; 范洪亮


    目的 探讨纳米碳在甲状腺癌手术时对甲状旁腺的保护作用.方法 将173例甲状腺乳头状癌患者随机分为实验组与对照组,实验组于甲状腺内注射纳米碳混悬液,10 min后待中央区黑染后再行清扫术,对照组按传统手术方式行甲状腺切除术.统计两组清扫组织中淋巴结数量、转移淋巴结数量及甲状旁腺数量.结果 实验组与对照组在清扫淋巴结数目、清扫转移淋巴结数目及甲状旁腺误切数目上差异具有统计学意义.纳米碳使中央区淋巴结黑染,而甲状旁腺不黑染,且在黑染组织中均未发现甲状旁腺.结论 纳米碳示踪效果确切,而且甲状旁腺不黑染,可达到既彻底清扫淋巴结同时又使甲状旁腺易于识别和保护的目的.%Objective To explore the protection effect of nano carbon particle on parathyroid gland in thyroid carcinoma surgery. Method A total of 173 patients with papillary thyroid carcinoma were randomly divided into two groups. In the control group,conventional surgery and central lymph node dissection were executed. In the experimental group,the nano carbon particle suspension was injected into thyroid gland 10 minutes before the excision. The control group was operated with traditional thyroid carcinoma surgery. The number of lymph nodes, metastatic lymph nodes and parathyroid glands in the specimen of the two groups were calculated. Results The comparisons of the number of lymph nodes, metastatic lymph nodes and parathyroid glands showed statistical significance. The central lymph nodes were stained black by nano carbon particles, but the parathyroid glands were not affected. There was no parathyroid gland in the stained tissue. Conclusion The tracer effect of nano carbon particle is exact, with no influence on parathyroid gland. The utilization of it could excise lymph node thoroughly and protect parathyroid gland at the same time.

  11. [Sentinel lymph node biopsy in endometrial cancer - methods]. (United States)

    Yordanov, G; Gorchev, S; Tomov, N; Hinkova


    Endometrial canceris the most common gynaecological malignancy after brest cancer. The lymph node status is with great prognostic value and it is important for postoperative treatment and survival. That is why it is looking for methods giving information for the lymph node status and not increasing postoperative complications.

  12. Internal mammary sentinel lymph node biopsy: abandon or persist?

    Directory of Open Access Journals (Sweden)

    Qiu PF


    Full Text Available Peng-Fei Qiu, Yan-Bing Liu, Yong-Sheng Wang Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, Shandong, People’s Republic of China Abstract: Although the 2009 American Joint Committee on Cancer incorporated the internal mammary sentinel lymph node biopsy (IM-SLNB concept, there has been little change in surgical practice patterns due to the low visualization rate of internal mammary sentinel lymph nodes with the traditional injection technique. Meanwhile, as internal mammary lymph nodes (IMLN metastases are mostly found concomitantly with axillary lymph nodes (ALN metastases, previous IM-SLNB clinical trials fail to evaluate the status of IMLN in patients who are really in need (only in clinically ALN negative patients. Our modified injection technique (periareolar intraparenchymal, high volume, and ultrasonographic guidance significantly improved the visualization rate of internal mammary sentinel lymph nodes, making the routine IM-SLNB possible in daily practice. IM-SLNB could provide individual minimally invasive staging, prognosis, and decision-making for breast cancer patients, especially for patients with clinically positive ALN. Moreover, IMLN radiotherapy should be tailored and balanced between the potential benefit and toxicity, and IM-SLNB-guided IMLN radiotherapy could achieve this goal. In the era of effective adjuvant therapy, within the changing treatment approach – more systemic therapy, less loco-regional therapy – clinicians should deliberate the application of regional IMLN therapy. Keywords: breast cancer, internal mammary lymph node, axillary lymph node, sentinel lymph node biopsy 

  13. Most frequent location of the sentinel lymph nodes

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    Chiao Lo


    Conclusion: The area between these four landmarks is the most frequent location of the sentinel lymph node identified using the radioisotope method. We suggest that this area should be carefully evaluated preoperatively by ultrasound for appropriate surgical planning. A skin incision in this area is also recommended when sentinel lymph node dissection is guided by blue dye.

  14. Lymph node mapping with carbon nanoparticles and the risk factors of lymph node metastasis in gastric cancer. (United States)

    Wang, Hui; Chen, Man-Man; Zhu, Guang-Sheng; Ma, Mao-Guang; Du, Han-Song; Long, Yue-Ping


    The study aimed to examine the applicability of carbon nanoparticles as a tracer for lymph node mapping and the related factors of lymph node and No.8p subgroup metastasis in patients with gastric cancer. Clinical data of 50 patients with gastric cancer, who had not received treatment preoperatively and underwent gastrectomy in Department of Gastrointestinal Surgery, Wuhan Union Hospital, between October 2014 and August 2015, were retrospectively analyzed. These patients were found to have no distant metastasis preoperatively. Thirty-five out of 50 patients were subjected to lymphatic mapping technique using carbon nanoparticles as the tracer, and the rest 15 cases did not experience the lymphatic mapping and served as controls. The sensitivity, specificity, false positive rate and false negative rate were calculated according to the number of lymph nodes, and the staining and metastasis condition of lymph nodes. The diagnostic value of carbon nanoparticles on metastatic lymph nodes was evaluated. The relationship between the metastasis of lymph nodes or subgroup No.8p lymph nodes and clinicopathologic features was analyzed by χ(2)-test or Fisher's exact test. All patients underwent D2 surgery (lymph node dissection including all the group 1 and group 2 nodes) plus the dissection of the subgroup No.8p lymph nodes. It was found that the average number of harvested lymph nodes in lymphatic mapping technique group (45.7±14.5) was greater than that in control group (39.2±11.7), but the difference was not significantly different (P=0.138>0.05). The success rate, the accuracy, sensitivity, specificity and false negative rate was 97%, 57%, 28%, 62% and 72% respectively. The metastasis of lymph nodes was correlated to the depth of cancer invasion (T stage) (P=0.004nanoparticles failed to show good selectivity for metastatic lymph nodes; the result of lymphatic mapping does not achieve a satisfactory performance; the incidence of lymph node metastasis may increase

  15. Raman spectra of normal and cancerous mouse mammary gland tissue using near infrared excitation energy (United States)

    Naik, Vaman; Serhatkulu, G. K.; Dai, H.; Shukla, N.; Weber, R.; Thakur, J. S.; Freeman, D. C.; Pandya, A. K.; Auner, G. W.; Naik, R.; Miller, R. F.; Cao, A.; Klein, M. D.; Rabah, R.


    Raman spectra of normal mammary gland tissues, malignant mammary gland tumors, and lymph nodes have been recorded using fresh tissue from mice. Tumors were induced in mice by subcutaneously injecting 4T1 BALB/c mammary tumor (a highly malignant) cell line. The Raman spectra were collected using the same tissues that were examined by histopathology for determining the cancerous/normal state of the tissue. Differences in various peak intensities, peak shifts and peak ratios were analyzed to determine the Raman spectral features that differentiate mammary gland tumors from non-tumorous tissue. Tissues that were confirmed by pathology as cancerous (tumors) show several distinctive features in the Raman spectra compared to the spectra of the normal tissues. For example, the cancerous tissues show Raman peaks at 621, 642, 1004, 1032, 1175 and 1208 cm-1 that are assignable to amino acids containing aromatic side-chains such as phenylalanine, tryptophan and tyrosine. Further, the cancerous tissues show a greatly reduced level of phospholipids compared to the normal tissues. The Raman spectral regions that are sensitive to pathologic alteration in the tissue will be discussed.

  16. Application of carbon nanoparticles in lymph node dissection and parathyroid protection during thyroid cancer surgeries: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Wang L


    Full Text Available Lun Wang, Dong Yang, Jun-Yuan Lv, Dan Yu, Shi-Jie Xin Department of Vascular and Thyroid Surgery, The First Affiliated Hospital, China Medical University, Shenyang, People’s Republic of China Purpose: To investigate whether carbon nanoparticles (CNs are helpful in identifying lymph nodes and metastatic lymph nodes and in parathyroid protection during thyroid cancer surgery. Methods: English and Chinese literature in PubMed, Cochrane Database of Systematic Reviews, EMBASE,, China Biology Medicine Database, China National Knowledge Infrastructure, China Master’s and Doctoral Theses Full-Text Database, Wanfang database, and Cqvip database were searched (till March 22, 2016. Randomized controlled trials (RCTs that compared the use of CNs with a blank control in patients undergoing thyroid cancer surgery were included. Quality assessment and data extraction were performed, and a meta-analysis was conducted using RevMan 5.1 software. The primary outcomes were the number of retrieved central lymph nodes and metastatic lymph nodes, and the rate of accidental parathyroid removal. Results: We obtained 149 relevant studies, and only 47 RCTs with 4,605 patients (CN group: n=2,197; blank control group: n=2,408 met the inclusion criteria. Compared with the control group, the CN group was associated with more retrieved lymph nodes/patient (weighted mean difference [WMD]: 3.39, 95% confidence interval [CI]: 2.73–4.05, more retrieved metastatic lymph nodes (WMD: 0.98, 95% CI: 0.61–1.35, lower rate of accidental parathyroid removal, and lower rates of hypoparathyroidism and hypocalcemia. However, the total metastatic rate of the retrieved lymph nodes did not differ between the groups (odds ratio: 1.13, 95% CI: 0.87–1.47, P=0.35. Conclusion: CNs can improve the extent of neck dissection and protect the parathyroid glands during thyroid cancer surgery. And the number of identified metastatic lymph nodes can be simultaneously increased

  17. [Accumulation of tattoo pigment in sentinel lymph nodes]. (United States)

    Kürle, S; Schulte, K W; Homey, B


    A 22-year-old woman presented with a superficial spreading melanoma on her right thigh (tumor thickness 1.0 mm, Clark-Level III). She also had decorative tattoos on her right ankle, right groin and coccyx. The staging results gave no indication for metastases. Intra-operatively, we observed a black pigmented lymph node highly suspicious for metastatic disease, but histological examination excluded metastatic spread and detected the accumulation of black pigment within the lymph node. Clinical differentiation between tattoo pigments and metastatic disease within lymph nodes is not possible. Histological confirmation of an enlarged pigmented lymph node is therefore essential before radical surgery is performed. Hence, accumulation of tattoo pigment within enlarged and pigmented lymph nodes needs to be included into the differential diagnosis and the documentation of decorative tattoos is important during skin cancer screening as well as during the follow-up of melanoma patients.

  18. Regenerating a kidney in a lymph node. (United States)

    Francipane, Maria Giovanna; Lagasse, Eric


    The ultimate treatment for end-stage renal disease (ESRD) is orthotopic transplantation. However, the demand for kidney transplantation far exceeds the number of available donor organs. While more than 100,000 Americans need a kidney, only 17,000 people receive a kidney transplant each year (National Kidney Foundation's estimations). In recent years, several regenerative medicine/tissue engineering approaches have been exploited to alleviate the kidney shortage crisis. Although these approaches have yielded promising results in experimental animal models, the kidney is a complex organ and translation into the clinical realm has been challenging to date. In this review, we will discuss cell therapy-based approaches for kidney regeneration and whole-kidney tissue engineering strategies, including our innovative approach to regenerate a functional kidney using the lymph node as an in vivo bioreactor.

  19. The metapleural gland of ants

    DEFF Research Database (Denmark)

    Yek, Sze Huei; Mueller, Ulrich G


    The metapleural gland (MG) is a complex glandular structure unique to ants, suggesting a critical role in their origin and ecological success. We synthesize the current understanding of the adaptive function, morphology, evolutionary history, and chemical properties of the MG. Two functions...... of the MG, sanitation and chemical defence, have received the strongest empirical support; two additional possible functions, recognition odour and territorial marking, are less well supported. The design of the MG is unusual for insects; glandular secretions are stored in a rigid, non...... morphology, phylogenetic transitions and chemical ecology of the MGs of both the derived and the unstudied early-branching (basal) ant lineages is needed to elucidate the evolutionary origin and diversification of the MG of ants....

  20. Investigating cross-linguistic differences in refusal speech act among native Persian and English speakers

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    Ghazanfari, Mohammad


    Full Text Available The aim of this study was to investigate the speech act of refusal performed by native Persian and English speakers with respect to linguistic devices. The study was conducted in two phases. In the first phase, refusal utterances were analyzed with respect to semantic formulas - that is words, phrases, or sentences meeting a particular semantic criterion to perform an act of eliciting. In the second phase, gender differences were examined, as well. One hundred movies (50 in Persian, 50 in English were used as instruments for gathering the data. The movies were watched closely, and the utterances native speakers employed in their refusals were transcribed and analyzed. Persian speakers used excuse more than English speakers; however, they applied strategies such as regret, non-performative statements, and lack of enthusiasm less frequently than English speakers. The Chi-square (χ² formula was then conducted to find out whether there were any significant differences in performing refusal speech act among the speakers of the two languages. The results showed that there were some differences between the two languages with regard to refusal utterances and gender. Finally, pedagogical implications of study for language learning and teaching have been enumerated.

  1. Are they really refusing to travel? A qualitative study of prehospital records

    Directory of Open Access Journals (Sweden)

    Christopher Sarah


    Full Text Available Abstract Background Refusal by the patient to travel after calling an emergency ambulance may lead to a preventable waste of scarce resources if it can be shown that an alternative more appropriate response could be employed. A greater understanding is required of the reasons behind 'refusal to travel' (RTT in order to find appropriate solutions to address this issue. We sought to investigate the reasons why patients refuse to travel following emergency call-out in a rural county. Methods Written records made by ambulance crews for patients (n = 397 who were not transported to hospital following an emergency call-out during October 2004 were retrospectively analysed. Results Twelve main themes emerged for RTT which included non injury or minor injury, falls and recovery after treatment on scene; other themes included alternative supervision, follow-up and treatment arrangements or patients arranging their own transport. Importantly, only 8% of the sample was recorded by ambulance crews as truly refusing to travel against advice. Conclusion A system that facilitates standardised recording of RTT information including social reasons for non-transportation needs to be designed. 'Refused to travel' disclaimers need to reflect instances when crew and patient are satisfied that not going to hospital is the right outcome. These recommendations should be considered within the context of the plans for widening the role of ambulance services.

  2. Lymph-migrating, tissue-derived dendritic cells are minor constituents within steady-state lymph nodes (United States)

    Jakubzick, Claudia; Bogunovic, Milena; Bonito, Anthony J.; Kuan, Emma L.; Merad, Miriam; Randolph, Gwendalyn J.


    Observations that dendritic cells (DCs) constitutively enter afferent lymphatic vessels in many organs and that DCs in some tissues, such as the lung, turnover rapidly in the steady state have led to the concept that a major fraction of lymph node DCs are derived from migratory DCs that enter the lymph node through upstream afferent lymphatic vessels. We used the lysozyme M–Cre reporter mouse strain to assess the relationship of lymph node and nonlymphoid organ DCs. Our findings challenge the idea that a substantial proportion of lymph node DCs derive from the upstream tissue during homeostasis. Instead, our analysis suggests that nonlymphoid organ DCs comprise a major population of DCs within lymph nodes only after introduction of an inflammatory stimulus. PMID:18981237

  3. Accumulation of FDG in axillary sweat glands in hyperhidrosis: a pitfall in whole-body PET examination

    Energy Technology Data Exchange (ETDEWEB)

    Jacobsson, H. [Department of Radiology, Karolinska Hospital, Stockholm (Sweden); Celsing, F. [Department of Haematology and Infectious Diseases, Karolinska Hospital, Stockholm (Sweden); Ingvar, M. [Department of Cognitive Neurophysiology, Karolinska Hospital, Stockholm (Sweden); Stone-Elander, S. [Department of Cognitive Neurophysiology, Karolinska Hospital, Stockholm (Sweden)]|[Karolinska Pharmacy, Stockholm (Sweden); Larsson, S.A. [Department of Hospital Physics, Karolinska Hospital, Stockholm (Sweden)


    A diabetic male with severe autonomic neuropathy and recently discovered Hodgkin`s disease demonstrated bilateral uptake of [2-{sup 18}F]-2-fluoro-2-deoxy-d-glucose (FDG) in the axillary sweat glands during profuse sweating caused by hypoglycaemia at positron emission tomography examination. It is not yet clear whether the sweating interfered with the distribution of the radiopharmaceutical. Regardless of the cause or mechanism for the uptake, the finding is clinically relevant. A bilateral symmetrical accumulation of FDG in the axillae of a tumour patient does not necessarily indicate malignant involvement of the lymph nodes. (orig.) With 1 fig., 9 refs.

  4. Small ampullate glands of Nephila clavipes. (United States)

    Ortíz, R; Céspedes, W; Nieves, L; Robles, I V; Plazaola, A; File, S; Candelas, G C


    The small ampullate glands of the orb-web spider, Nephila clavipes, have been studied and compared to other of the silk producing glands from this organism. They exhibit the same gross morphological features of the other glands. Electrophoretic analyses show that the gland's luminal contents migrate as a single band, while the contents of the secretory epithelium reveal a step-ladder array of peptides in addition to the full size product. Previous studies from our laboratory identified these peptides as products generated by translational pauses. This alternate mode of translation is typical of fibroin synthesis in all the spider glands thus far studied as well as in those of the silkworm. The correlation of the peptides to the process of fibroin synthesis is shown through experimental evidence in this paper. The gradual ultrastructural changes in Golgi vesicles elicited by the fibroin synthesis stimulus can be seen in this paper. The response to stimulation is of a higher magnitude in these glands than in any of those previously analyzed. These studies show the small ampullate glands are a promising and certainly exploitable model system for studies on the synthesis of tissue-specific protein product and its control. J. Exp. Zool. 286:114-119, 2000.

  5. Primary parotid gland lymphoma: a case report

    Directory of Open Access Journals (Sweden)

    Paraskevas Katsaronis


    Full Text Available Abstract Introduction Mucosa associated lymphoid tissue lymphomas are the most common lymphomas of the salivary glands. The benign lymphoepithelial lesion is also a lymphoproliferative disease that develops in the parotid gland. In the present case report, we describe one case of benign lymphoepithelial lesion with a subsequent low transformation to grade mucosa associated lymphoid tissue lymphoma appearing as a cystic mass in the parotid gland. Case presentation A 78-year-old Caucasian female smoker was referred to our clinic with a non-tender left facial swelling that had been present for approximately three years. The patient underwent resection of the left parotid gland with preservation of the left facial nerve through a preauricular incision. The pathology report was consistent with a low-grade marginal-zone B-cell non-Hodgkin lymphoma (mucosa associated lymphoid tissue lymphoma following benign lymphoepithelial lesion of the gland. Conclusions Salivary gland mucosa associated lymphoid tissue lymphoma should be considered in the differential diagnosis of cystic or bilateral salivary gland lesions. Parotidectomy is recommended in order to treat the tumor and to ensure histological diagnosis for further follow-up planning. Radiotherapy and chemotherapy should be considered in association with surgery in disseminated forms or after removal.

  6. The influence of site of antigen deposition on the local immune response in the mammary gland of the ewe. (United States)

    Watson, D L


    Experiments were carried out to compare the local antibody responses in mammary glands of ewes immunized by infusion of antigen (killed Brucella abortus) into the lactiferous sinuses (trans-epithelial presentation of antigen) or injection into the mammary tissue near the supramammary lymph node (interstitial presentation of antigen). Although both methods of antigen presentation resulted in similar antibody levels in blood, infusion of antigen into the lactiferous sinus resulted in significantly higher levels of agglutinating antibody in milk whey than did injection of antigen. When within-animal comparisons were made, infusion of antigen was also significantly superior to injection of antigen in terms of levels of non-agglutinating antibody in milk as determined by Coomb's antiglobulin assays. Evidence from immunoglobulin estimations in milk whey suggested that any elevation in concentrations of immunoglobulins (including IgA) in milk from ewes, which had received injections of antigen into mammary tissue, was associated with chronic inflammatory damage to these glands.

  7. Thyroid Gland in Patients with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    B T Turumhambetova


    Full Text Available The purpose of our study was to investigate the main parameters of thyroid status in patients with rheumatoid arthritis (RA, as well as particularities of course of this disease depending on of thyroid gland function disorder. Materials and methods. 52 women with RA were examined. The first group consisted of 11 women with subclinical and manifestive hypothyroidism the second one 41 women without thyroid gland function disorder. The group comparison was conducted on main indexes of thyroid gland condition the hormon level, AT-TPO, ultrasonic data, as well as clinical and laboratory RA data. Results. In women with hypothyroidism the systemic manifestations of RA were more often truely diagnosed; DAS28 indexes, ESR, the number ot swollen joints were higher. The high level ot AT-TPO was diagnosed in 54,55% – I group and in 31,7% – II group TTG level was really less in patients receiving synthetic glycocorticoids. Small thyroid gland volume was diagnosed in 23,07% of examined patients. The thyroid gland status indexes in them did not differ from patients with normal thyroid gland volume. Reliable increasing of the peripheral resistance index was revealed in lower thyroid artery according to the ultrasonic study data under the reduced thyroid gland size. Conclusions. High incidence of hypothyroidism and AT-TPO carriage in RA was revealed. Hypothyroidism development is accompanied by high clinic-laboratory RA activity. The reduction of the thyroid gland volumes in RA is possibly stipulated not only by autoimmunal pathology, but also chronic ischemia of the organ in the conditions of immune-complex vasculitis and early atherosclerosis. The TTG level in patients with RA is defined not only by pathology of the thyroid gland, but glycocorticoid therapy as well.

  8. Salivary gland carcinomas of the larynx

    DEFF Research Database (Denmark)

    Nielsen, Troels Krogh; Bjørndal, Kristine; Krogdahl, Annelise


    OBJECTIVE: Salivary gland carcinomas of the larynx are rare. The purpose of this study is to present a national series of laryngeal salivary gland carcinoma patients and to bring a review of recent literature. METHODS: By merging The Danish Cancer Registry, The National Pathology Registry...... a review of literature from 1991 to 2010 was performed. RESULTS: Six Danish patients with a malignant salivary gland tumor in the larynx were identified resulting in an incidence of 0.001/100,000 inhabitants/year. Four had adenoid cystic carcinoma and two a mucoepidermoid carcinoma. All patients were male...

  9. Imaging of the major salivary glands

    DEFF Research Database (Denmark)

    Afzelius, Pia; Nielsen, Ming-Yuan; Ewertsen, Caroline;


    dental caries or swelling. Imaging plays an important role in visualization of morphology and function, to establish a diagnosis, for treatment, and for surgical planning. There are several options for diagnostic imaging: plain radiography, sialography, ultrasound (US), magnetic resonance imaging (MRI......The major salivary glands, submandibular, parotid and sublingual glands play an important role in preserving the oral cavity and dental health. Patients with problems of the major salivary glands may present with symptoms such as dry mouth, dysphagia and obstruction of duct, inflammation, severe...

  10. Adenoma of anogenital mammary-like glands. (United States)

    Ahmed, Sartaj; Campbell, Ross M; Li, Jin Hong; Wang, Li Juan; Robinson-Bostom, Leslie


    Adenomas in the anogenital region are uncommon. There has been debate about the origin, including ectopic breast tissue, cutaneous apocrine gland, and most recently anogenital mammary-like gland. An anogenital mass in a 36-year-old woman was excised, and histopathologic examination and immunostaining were performed. Microscopic tissue sections showed a morphologic pattern similar to that of a mammary fibroadenoma, and immunostaining demonstrated the presence of estrogen receptors and progesterone receptors. The possibility of adenomas of anogenital mammary-like glands should be considered when evaluating patients with a mass in this area with confirmation by tissue biopsy or aspiration cytology.

  11. NUT Carcinoma of the Sublingual Gland

    DEFF Research Database (Denmark)

    Andreasen, Simon; French, C A; Josiassen, Michael


    p13, resulting in the t(15;19)(q14;p13) karyotype. NC is poorly differentiated and is likely to be overlooked and misdiagnosed as poorly differentiated squamous cell carcinoma (SCC) when immunohistochemical evaluation of NUT protein expression is omitted. Previously, NC has been found in the parotid...... and submandibular glands and we present the first case in the sublingual gland arising in a 40-year-old woman. We discuss the diagnostic considerations for poorly differentiated carcinomas of the salivary glands and advocate the inclusion of NUT immunohistochemistry in this setting. Not only does the NC diagnosis...

  12. Interlanguage Pragmatics: A Study of the Refusal Strategies of Indonesian Speakers Speaking English

    Directory of Open Access Journals (Sweden)

    Novy Amarien


    Full Text Available Abstract. This is a pilot study investigating the interlanguage pragmatics of the refusal strategies (RSs of Indonesian Speakers Speaking English (ISSE. The aims of the study are to investigate strategies ISSE use in their refusals of, specifically, offering and requesting initiation acts (IAs. Data were taken from 30 Discourse Completion Tasks undertaken by five males and females in the following groups: Indonesian speakers Speaking Indonesian (ISSI, ISSE and Australian Speakers Speaking English (ASSE. The study revealed that ISSE strategies in refusing offers were `intercultural', that is apparently uninfluenced by L1 patterns and yet not characteristic of L2 patterns. Pragmatic transfer was not in evidence. The data in this study could be the basis for further research in Indonesian interlanguage pragmatics.

  13. [Are we legally allowed to administer blood for lifesaving to a patient who refuses it?]. (United States)

    Shimasaki, H; Yamamoto, H; Magaribuchi, T; Urabe, N; Shimasaki, A


    We surveyed the literatures and discussed the legal issues whether we should administer blood for lifesaving to a patient who refuses it. The valid refusal of the transfusion requires the distinct intention of a competent patient. Minors below fifteen years of age are incompetent and their parents make a substituted judgement. Anyone must not give priority to the parents' belief and blood ought to be transfused if necessary for the children's benefits. We could evade liability for withholding blood only when we manage an operation arranged to succeed without blood transfusion, undergoing the sufficient treatments to avoid the risks, as well as on the basis of the valid refusal of a patient. The release deed and the intervention of hospital directors, ethics committees and courts are invalid for the immunity from liability. Anesthesiologists have to take the responsibility on themselves of administering blood or not. A statute law should be established to define what is a patient's valid intention and who is responsible.

  14. The issue of refuse derived fuel - quantities, characterisation and use; Das Ersatzbrennstoffproblem - Aufkommen, Charakterisierung und Einsatz

    Energy Technology Data Exchange (ETDEWEB)

    Beckmann, M. [Bauhaus-Univ. Weimar (Germany). Lehrstuhl fuer Verfahren und Umwelt; Thome-Kozmiensky, K.J. [Thome-Kozmiensky Ingenieure, Nietwerder (Germany)


    Due to the many mechanical-biological waste treatment plants in operation and under construction as well as the ongoing implementation of the Household Waste Technical Code the use of refuse derived fuels in processes of the primary, cement, steel, power and other industries is becoming increasingly important. Ultimately all the detail questions being raised boil down to the one question of whether the mechanical-biological treatment of household waste and industrial waste similar to household waste offers economic or ecological advantages over thermal waste treatment, which in the meantime is acknowledged as environmentally benign and technically reliable. The present paper gives a classification of solid refuse derived fuels. It then goes on to explain the various types of mechanical-biological waste treatment plants and depict the quantities of refuse derived fuel required and residue fractions produced by each.

  15. Computed Tomographic Evaluation of Presumptively Normal Canine Sternal Lymph Nodes. (United States)

    Iwasaki, Ryota; Mori, Takashi; Ito, Yusuke; Kawabe, Mifumi; Murakmi, Mami; Maruo, Kohji

    The sternal lymph nodes receive drainage from a wide variety of structures in the thoraco-abdominal region. Evaluation of these lymph nodes is essential, especially in cancer patients. Computed tomography (CT) can detect sternal lymph nodes more accurately than radiography or ultrasonography, and the criteria of the sternal lymphadenopathy are unknown. The purpose of this retrospective study was to describe the CT characteristics of the sternal lymph nodes in dogs considered unlikely to have lymphadenopathy. The ratio of the short axis dimension of the sternal lymph nodes to the thickness of the second sternebra was also investigated. At least one sternal lymph node was identified in each of the 152 dogs included in the study. The mean long axis and short axis dimensions were 0.700 cm and 0.368 cm, respectively. The mean ratio of the sternal lymph nodes to the second sternebrae was 0.457, and the 95% prediction interval ranged from 0.317 to 0.596 (almost a fixed value independent of body weight). These findings will be useful when evaluating sternal lymphadenopathy using CT.

  16. Extended lymph node dissection in robotic radical prostatectomy: Current status

    Directory of Open Access Journals (Sweden)

    Sameer Chopra


    Full Text Available Introduction: The role and extent of extended pelvic lymph node dissection (ePLND during radical prostatectomy (RP for prostate cancer patients remains unclear. Materials and Methods: A PubMed literature search was performed for studies reporting on treatment regimens and outcomes in patients with prostate cancer treated by RP and extended lymph node dissection between 1999 and 2013. Results: Studies have shown that RP can improve progression-free and overall survival in patients with lymph node-positive prostate cancer. While this finding requires further validation, it does allow urologists to question the former treatment paradigm of aborting surgery when lymph node invasion from prostate cancer occurred, especially in patients with limited lymph node tumor infiltration. Studies show that intermediate- and high-risk patients should undergo ePLND up to the common iliac arteries in order to improve nodal staging. Conclusions: Evidence from the literature suggests that RP with ePLND improves survival in lymph node-positive prostate cancer. While studies have shown promising results, further improvements and understanding of the surgical technique and post-operative treatment are required to improve treatment for prostate cancer patients with lymph node involvement.

  17. Sentinel Lymph Node Mapping In Gastric Cancer Surgery: Current Status

    Directory of Open Access Journals (Sweden)

    Bara Tivadar


    Full Text Available Lymphonodular metastases remain an important predictive and prognostic factor in gastric cancer development. The precise determination of the lymphonodular invasion stage can be made only by extended intraoperative lymphadenectomy and histopathological examination. But the main controversy is the usefulness of extended lymph dissection in early gastric cancer. This increases the duration of the surgery and the complications rate, and it is unnecessary without lymphonodular invasion. The identification of the sentinel lymph nodes has been successfully applied for some time in the precise detection of lymph nodes status in breast cancer, malignant melanoma and the use for gastric cancer patients has been a controversial issue. The good prognosis in early gastric cancer had been a surgery challenge, which led to the establishment of minimally invasive individualized treatment and acceptance of sentinel lymph node mapping. The dual-tracer method, submucosally administered endoscopically is also recommended in sentinel lymph node biopsy by laparoscopic approach. There are new sophisticated technologies for detecting sentinel lymph node such as: infrared ray endoscopy, florescence imaging and near-infrared technology, carbon nanoparticles, which will open new perspectives in sentinel lymph nodes mapping.

  18. The Impact of Age and Sex on the Refusal Strategies Used by Iranian EFL Learners

    Directory of Open Access Journals (Sweden)

    Shohreh Shahpouri Arani


    Full Text Available One major problem for non-native speakers is using refusals and because of this, second language teachers and others who communicate in that language should have the cultural differences in mind. When the interlocutors say “no” to a request or invitation, either directly or indirectly, they use speech act of refusalRefusal is considered a face threatening act, as there exists a kind of contradiction in it and is always realized indirectly. Thus, a high level of pragmatic competence is needed to realize it. The aim of this study is to find out whether the age and sex of Iranian learners have any effect on their used refusal strategies and if the existence of such an effect was demonstrated which group is more native like in terms of content and form of used strategies. To achieve this end, graduated students (male/female of different age, sex and different fields of study were selected. Three groups of participants participated in this study. The first group includes 30 American English Speakers (A.E.S. The second group consists of participants whose ages were between 22-29 and the third group was a group of 30 participants of both sexes who speak English as a second language (sex is the only variable under study in this group. Using a Discourse Completion Test (DCT, a number of refusal situations were collected, responded by participants and analyzed. The results revealed that the age and sex of EFL learners does not have any significant effect on using refusal strategies.

  19. A novel silica alumina-based backfill material composed of coal refuse and fly ash. (United States)

    Yao, Yuan; Sun, Henghu


    In this paper, a systematic study was conducted to investigate a novel silica alumina-based backfill material composed of coal refuse and fly ash. The coal refuse and fly ash had different properties under various thermal activation temperatures (20 °C, 150 °C, 350 °C, 550 °C, 750 °C and 950 °C). It is known that a thermal activation temperature ranging from 20 °C to 950 °C significantly increases the flowability and pozzolanic properties of the coal refuse; however, the flowability of fly ash decreases when the activation temperature is higher than 550 °C because of a severe agglomeration phenomenon on its surface. An optimal design for this backfill material was determined to include an activated portion composed of 5% coal refuse at 750 °C and 15% fly ash at 20 °C. This combination yields the best performance with excellent flowability, a high compressive strength and a low bleeding rate. The microanalysis results corresponded well with the performance tests at different activation conditions. In the coal refuse, kaolinite peaks began to decrease because of their transformation into metakaolin at 550 °C. Chlorite peaks disappeared at 750 °C. Muscovite peaks decreased at 750 °C and disappeared at 950 °C. During this process, muscovite 2M(1) gradually dehydroxylated to muscovite HT. Furthermore, this paper examined the environmental acceptance and economic feasibility of this technology and found that this silica alumina-based backfill material composed of coal refuse and fly ash not only meets EPA requirements but also has several advantages in industry feasibility when compared with hydraulic backfill, rock backfill and paste backfill.

  20. New exocrine glands in ants: the hypostomal gland and basitarsal gland in the genus Melissotarsus (Hymenoptera: Formicidae) (United States)

    Hölldobler, Bert; Obermayer, Malu; Plowes, Nicola J. R.; Fisher, Brian L.


    Fisher and Robertson (Insect Soc 46: 78-83, 1999) discovered the production of silk-like secretions emerging from slit-shaped openings along the anterior margin of the ventral hypostoma of Melissotarsus ant workers. The current histological study describes a hitherto unknown hypostomal gland from which this silk-like substance originates. In addition, this study describes a new basitarsal gland in the three pairs of legs of Melissotarsus workers.

  1. Dysgenetic polycystic disease of the minor and submandibular salivary glands

    NARCIS (Netherlands)

    Koudounarakis, Eleftherios; Willems, Stefan; Karakullukcu, Baris


    Background Dysgenetic polycystic salivary gland disease is a rare pathology. No case of minor salivary gland involvement has been reported in the literature. Methods A female patient presented with bilateral tumors of the parotid glands, bilateral submandibular gland enlargement, and multiple cystic

  2. A comparison of food refusal related to characteristics of food in children with autism spectrum disorder and typically developing children. (United States)

    Hubbard, Kristie L; Anderson, Sarah E; Curtin, Carol; Must, Aviva; Bandini, Linda G


    Parents of children with autism spectrum disorder (ASD) frequently report child food refusal based on characteristics of food. Our study sought to determine whether parent report of food refusal based on the characteristics of food was greater in children with ASD than in typically developing children, associated with a greater percentage of foods refused of those offered, and associated with fruit and vegetable intake. A modified food frequency questionnaire was used to determine overall food refusal as well as fruit and vegetable intake. Parent-reported food refusal related to characteristics of food (eg, texture/consistency, temperature, brand, color, shape, taste/smell, foods mixed together, or foods touching other foods) was compared between 53 children with ASD and 58 typically developing children aged 3 to 11 years in the Children's Activity and Meal Patterns Study (2007-2008). Children with ASD were significantly more likely to refuse foods based on texture/consistency (77.4% vs 36.2%), taste/smell (49.1% vs 5.2%), mixtures (45.3% vs 25.9%), brand (15.1% vs 1.7%), and shape (11.3% vs 1.7%). No differences between groups were found for food refusal based on temperature, foods touching other foods, or color. Irrespective of ASD status, the percentage of foods refused of those offered was associated with parent reports of food refusal based on all characteristics examined, except temperature. Food refusal based on color was inversely associated with vegetable consumption in both groups. Routine screening for food refusal among children with ASD is warranted to prevent dietary inadequacies that may be associated with selective eating habits. Future research is needed to develop effective and practical feeding approaches for children with ASD.

  3. Land reclamation in the refuse dump of open coal mines and its following ecology principle

    Institute of Scientific and Technical Information of China (English)

    FAN Jun-fu; WANG Xiu-lan


    Through the research on the model of the land reclamation in the refuse dump of Heidaigou open coal mines, it was concerned that ecology was the theoretical basic for the land reclamation of open coal mines. According to the principle of ecological substituting, the land reclamation can be divided into three stages: water and soil conservation,ecological performance and economic performance. Taking the land reclamation in the refuse dump of Heidaigou open coal mines as the practical example, explained the application of the ecological substituting principle on the land reclamation in the open coal mines.

  4. Methodology for regional economic analysis of urban refuse as an energy source for the Northeast

    Energy Technology Data Exchange (ETDEWEB)

    Meier, P.M.; Le, T.


    The potential contribution of municipal refuse as an energy source depends on the spatial distribution and characteristics of population and the cost of alternative fuels. A methodology for regional economic analysis of urban refuse as an energy source requires a methodology that integrates population, interregional fuel price variations, and other engineering variables into a single model that can be subjected to sensitivity analysis helpful to the policy maker. Such a framework in the context of the Northeast States is developed. The area includes New England, New York, New Jersey, Pennsylvania, Maryland, Delaware, and the District of Columbia.

  5. Sentinel Lymph Node Identification in Endometrial Cancer

    Institute of Scientific and Technical Information of China (English)

    Bin Li; Lingying Wu; Xiaoguang Li; Haizhen Lu; Ping Bai; Shumin Li; Wenhua Zhang; Juzhen Gao


    OBJECTIVE To evaluate the feasibility of intra-operative detection of sentinel lymph nodes (SLN) in the patient with endometrial cancer (EC).METHODS Thirty-one patients with Stage Ⅰ and Ⅱ endometrial cancer, who underwent a hysterectomy and a lymphadenectomy,were enrolled in the study. At laparotomy, methylene blue dye tracer was injected into the subserosal myometrium of corpus uteri at multiple sites, and dye uptake into the lymphatic channels was observed. The blue nodes which were identified as SLNs were traced and excised. The other nodes were then removed. All of the excised nodes were submitted for pathological hematoxylin and eosin (H&E) staining examination.RESULTS Failure of dye uptake occurred in 4 of the 31 cases (12.9%) because of spillage, and no lymphatic coloration was observed there. Lymphatic staining was clearly observable as blue dye diffused to the lymphatic channels of the uterine surface and the infundibulopelvic ligaments in 27 (87.1%) cases. Concurrent coloration in the pelvic lymphatic vessels was also observed in 22of the 27 patients. The SLNs were identified in 23 of the 27 (85.2%)cases with a lymphatic staining, with a total number of 90 SLNs,and a mean of 3.9 in each case (range, 1-10). Besides one SLN (1.1%)in the para-aortic area, the other 89 (98.9%) were in the nodes of the pelvis. The most dense locations of SLNs included obturator in 38 (42.2%) and interiliac in 19 (21.1%) cases. In our group, pelvic lymphadenectomy was conducted in 27 (87.1%) patients and pelvic nodal sampling in 4 (12.9%). Of the 31 cases, a concurrent abdominal para-aortic lymph node sampling was conducted in 7. A total of 926 nodes were harvested, with an average of 39.8 in each case (range, 14-55). Nodal metastases occurred in 3 patients (9.7%), 2 of them with SLN involvement and the other without SLN involvement. Adverse reactions or injury related to the study was not found.CONCLUSION Application of methylene blue dye is feasible in an intra

  6. [Pheochromocytomas as adrenal gland incidentalomas]. (United States)

    Cerović, Snezana; Cizmić, Milica; Milović, Novak; Ajdinović, Boris; Brajusković, Goran


    Adrenal incidentalomas are a heterogeneous group of pathological entities, including benign or malignant adrenocortical or medullary tumors, hormonally active or inactive lesions, which are identified incidentally during the examination of nonadrenal-related abdominal complaints. About 1.5% to 23% of adrenal incidentalomas are pheochromocytomas. Composite pheochromocytoma is a rare tumour of adrenal medulla with divergente clinical course. This type of pheochromocytoma is designated "composite" or "mixed," depending on whether pheochromocytoma and nonpheochromocytoma components show the same embryologic origin. Nonpheochromocytoma components found in the composite pheochromocytoma include ganglioneuroma, ganglioneuroblastoma, neuroblastoma, and malignant schwannoma. The biologic behavior of composite pheochromocytomas may be as difficult to predict as more traditional pheochromocytomas; based on the number of cases reported to date the presence of areas resembling ganglioneuroblastoma or neuroblastoma does not necessary indicate a poor prognosis. Some may behave in a malignant fashion with metastasis by a component of the tumour which has neural features. Pheochromocytomas and paragangliomas are well-defined entities. Some of their nonsporadic associations and unusual morphological appearances are not universally appreciated. We report on a rare association of left adrenal CP, with typical right adrenal phochromocytoma and retroperitoneal paraganglioma, and a review of literature. We analyzed the clinical and immunohistochemical features in a 24-year-old woman with composite pheochromocytoma localized in the left adrenal gland and associated with blood pressure of 200/140 mmHg. Abdominal computed tomography and 131-J MIBG revealed a 65 x 60 mm mass in the right adrenal gland, but no revealed 45 x 40 mm retroperitoneal mass and 20 x 20 mm mass in the left adrenal region. Serum and urinary adrenaline levels were high, and catecholamine levels in the blood sample of

  7. Structure and context in prostatic gland segmentation and classification. (United States)

    Nguyen, Kien; Sarkar, Anindya; Jain, Anil K


    A novel gland segmentation and classification scheme applied to an H&E histology image of the prostate tissue is proposed. For gland segmentation, we associate appropriate nuclei objects with each lumen object to create a gland segment. We further extract 22 features to describe the structural information and contextual information for each segment. These features are used to classify a gland segment into one of the three classes: artifact, normal gland and cancer gland. On a dataset of 48 images at 5x magnification (which includes 525 artifacts, 931 normal glands and 1,375 cancer glands), we achieved the following classification accuracies: 93% for artifacts v. true glands; 79% for normal v. cancer glands, and 77% for discriminating all three classes. The proposed method outperforms state of the art methods in terms of segmentation and classification accuracies and computational efficiency.

  8. Ascending colon cancer with synchronous external iliac and inguinal lymph node metastases but without regional lymph node metastasis: a case report and brief literature review. (United States)

    Kitano, Yuki; Kuramoto, Masafumi; Masuda, Toshiro; Kuroda, Daisuke; Yamamoto, Kenichiro; Ikeshima, Satoshi; Iyama, Ken-Ichi; Shimada, Shinya; Baba, Hideo


    Lymph node metastasis to the iliac or inguinal region of colon cancer is extremely rare. We experienced a case of ascending colon cancer with synchronous isolated right external iliac and inguinal lymph node metastases but without any regional lymph node metastasis. An 83-year-old woman was admitted to our hospital due to anemia. Colonoscopy and computed tomography revealed an ascending colon cancer and also right external iliac and inguinal lymph node swelling. Further examination by F-deoxyglucose positron emission tomography strongly suggested that these lymph nodes were metastatic. Right hemicolectomy with lymph node dissection along the superior mesenteric artery, and right external iliac and inguinal lymph node dissection were performed. Histological examination revealed that both lymph nodes were metastasized from colon cancer, and there was no evidence of regional lymph node metastasis. The patient has shown no sign of recurrence at 27 months after surgery.

  9. The Origin of the Parathyroid Gland

    National Research Council Canada - National Science Library

    Masataka Okabe; Anthony Graham; John C. Gerhart


    It has long been held that the parathyroid glands and parathyroid hormone evolved with the emergence of the tetrapods, reflecting a need for new controls on calcium homeostasis in terrestrial, rather...

  10. Treatment Option Overview (Salivary Gland Cancer) (United States)

    ... following stages are used for major salivary gland cancers: Enlarge Tumor sizes. The size of a tumor may be compared to the size of a pea (1 cm), peanut (2 cm), grape (3 cm), walnut (4 cm), lime (5 cm), ...

  11. Role of sebaceous glands in inflammatory dermatoses. (United States)

    Shi, Vivian Y; Leo, Michael; Hassoun, Lauren; Chahal, Dev S; Maibach, Howard I; Sivamani, Raja K


    Skin is an important interface between the host and its environment. Inflammatory dermatoses often have disrupted skin barrier function, rendering patients more susceptible to allergenic triggers leading to an exaggerated immune response. The skin surface lipid film, an important component of the skin barrier, comprises a mixture of keratinocyte and sebaceous gland-derived lipids. Recent evidence demonstrated that defective keratinocyte lipid synthesis predisposes for the development of atopic dermatitis. However, the important role of sebaceous gland-derived lipids in skin inflammatory diseases may be underrecognized. This overview focuses on the importance of the contribution of sebaceous glands to barrier function. Sebaceous gland alteration may play a role in the pathogenesis of common skin diseases including acne vulgaris, atopic dermatitis, psoriasis, rosacea, and seborrheic dermatitis.

  12. Plexiform Neurofibroma Involving the Lacrimal Gland (United States)

    Hofsli, Mikael; Gampenrieder, Nico; Heegaard, Steffen


    Background To present a rare case of a 2-year-old girl with neurofibromatosis type 1 (NF1) who presented with ptosis of the right upper eyelid along with a tumor in the eyelid. Methods A magnetic resonance imaging scan of the orbit revealed a solid tumor located extraconally at the site of the right lacrimal gland. A transcranial orbitotomy was performed. Results Histopathological examination demonstrated expanded nerve branches/fascicles cut in various planes in between normal lacrimal gland acini. These findings were consistent with a plexiform neurofibroma presumably deriving from the lacrimal nerve and/or a supraorbital nerve branch. Conclusion This is the first case of a plexiform neurofibroma involving the lacrimal gland ever described and the tumor shows similarities with neurofibroma in other salivary glands with a high recurrence rate. Plexiform neurofibromas are frequently seen in patients with NF1 and rarely undergo malignant transformation. PMID:28203199

  13. Salivary Gland Biopsy for Sjogren's Syndrome

    NARCIS (Netherlands)

    Delli, Konstantina; Vissink, Arjan; Spijkervet, Fred K. L.


    Salivary gland biopsy is a technique broadly applied for the diagnosis of Sjogren's syndrome (SS), lymphoma accompanying SS, sarcoidosis, amyloidosis, and other connective tissue disorders. SS has characteristic microscopic findings involving lymphocytic infiltration surrounding the excretory ducts

  14. Salivary Gland Biopsy for Sjogren's Syndrome

    NARCIS (Netherlands)

    Delli, Konstantina; Vissink, Arjan; Spijkervet, Fred K. L.


    Salivary gland biopsy is a technique broadly applied for the diagnosis of Sjogren's syndrome (SS), lymphoma accompanying SS, sarcoidosis, amyloidosis, and other connective tissue disorders. SS has characteristic microscopic findings involving lymphocytic infiltration surrounding the excretory ducts

  15. Ectopic mineral formation in the prostate gland

    Directory of Open Access Journals (Sweden)



    Full Text Available This work analyzes the data of cont emporary scientific literature regarding the ectopic mineralization in the prostate gland, its pathogenetic features are considered. The scientific literature of recent decades gives grounds to assert that the processes of concrement formation in the prostate gland are influenced by many factors, pathological mineralization can be realized by different mechanisms. They include chronic inflammation, stagnation fract ions in gland, reflux of urine from the urethra at intravesicle obstruction, malformation of prostate and seminal vesicles, specific inflammation, polymorphism of gene protein inhibitors of calcification. These mechanisms are interconnected, each of them may participate in the overall development of concrement fo rmation in the prostate. In recent years, due to improved instrumental diagnosis we observe a significant increase of the number of patients, who were found with pathogenic prostate gland biol iths, which requires more detailed and in-depth study of the mechanisms of mineral formation in the prostate.

  16. Lymphoepithelial cyst of the submandibular gland

    Directory of Open Access Journals (Sweden)

    A Saneem Ahamed


    Full Text Available Lymphoepithelial cysts are benign, slowly growing unilocular or multilocular lesions that appear in the head and neck. They are also called Branchial cyst. The head and neck sites are the salivary glands(more commonly parotid and rarely submandibular gland and the oral cavity (usually the floor of the mouth. there are various methods of investigation available today, of which Fine needle aspiration cytology (FNAC can be used to provide an immediate diagnosis of a lymphoepithelial cyst. The other investigations include, Ultrasonogram,and Computed tomography.It usually occurs due to the process of lymphocyte-induced cystic ductular dilatation and the confirmatory diagnosis is always made postoperatively by histopathological examination. The mainstay in the treatment of a lymphoepithelial cyst remains the surgical approach, which includes complete enucleation of the cyst along with total excision of the involved salivary gland. This is a report of a lymphoepithelial cyst involving the submandibular salivary gland and its management.

  17. Transfer of immunoglobulins through the mammary endothelium and epithelium and in the local lymph node of cows during the initial response after intramammary challenge with E. coli endotoxin

    Directory of Open Access Journals (Sweden)

    Lun Shichun


    local sources, respectively. Our observations indicate a selective mechanism in the transfer of IgG1 through the epithelium also in lactating glands, not previously shown; a local synthesis of IgA and possibly of IgM, released primarily into milk, not into tissue fluid; that IgG2 transfer through both barriers is a result of passive diffusion only and that the content of efferent lymph is strongly influenced by IgG1, IgM and IgA in the mammary tissue, brought to the lymph node by afferent lymph.

  18. Effect of P2X(7) receptor knockout on exocrine secretion of pancreas, salivary glands and lacrimal glands

    DEFF Research Database (Denmark)

    Novak, Ivana; Jans, Ida M; Wohlfahrt, Louise


    the P2X(7) receptors affect fluid secretion in pancreas, salivary glands and tear glands. We monitored gland secretions in in vivo preparations of wild-type and P2X(7)(-/-) (Pfizer) mice stimulated with pilocarpine. In cell preparations from pancreas, parotid and lacrimal glands we measured ATP release...

  19. The origin of the parathyroid gland


    Okabe, Masataka; Graham, Anthony


    It has long been held that the parathyroid glands and parathyroid hormone evolved with the emergence of the tetrapods, reflecting a need for new controls on calcium homeostasis in terrestrial, rather than aquatic, environments. Developmentally, the parathyroid gland is derived from the pharyngeal pouch endoderm, and studies in mice have shown that its formation is under the control of a key regulatory gene, Gcm-2. We have used a phylogenetic analysis of Gcm-2 to probe the evolutionary origins...

  20. Pheromones and exocrine glands in Isoptera. (United States)

    Costa-Leonardo, Ana Maria; Haifig, Ives


    Termites are eusocial insects that have a peculiar and intriguing system of communication using pheromones. The termite pheromones are composed of a blend of chemical substances and they coordinate different social interactions or activities, including foraging, building, mating, defense, and nestmate recognition. Some of these sociochemicals are volatile, spreading in the air, and others are contact pheromones, which are transmitted by trophallaxis and grooming. Among the termite semiochemicals, the most known are alarm, trail, sex pheromones, and hydrocarbons responsible for the recognition of nestmates. The sources of the pheromones are exocrine glands located all over the termite body. The principal exocrine structures considered pheromone-producing glands in Isoptera are the frontal, mandibular, salivary or labial, sternal, and tergal glands. The frontal gland is the source of alarm pheromone and defensive chemicals, but the mandibular secretions have been little studied and their function is not well established in Isoptera. The secretion of salivary glands involves numerous chemical compounds, some of them without pheromonal function. The worker saliva contains a phagostimulating pheromone and probably a building pheromone, while the salivary reservoir of some soldiers contains defensive chemicals. The sternal gland is the only source of trail-following pheromone, whereas sex pheromones are secreted by two glandular sources, the sternal and tergal glands. To date, the termite semiochemicals have indicated that few molecules are involved in their chemical communication, that is, the same compound may be secreted by different glands, different castes and species, and for different functions, depending on the concentration. In addition to the pheromonal parsimony, recent studies also indicate the occurrence of a synergic effect among the compounds involved in the chemical communication of Isoptera. Copyright © 2010 Elsevier Inc. All rights reserved.

  1. Histiocytosis mimicking a pineal gland tumour

    Energy Technology Data Exchange (ETDEWEB)

    Gizewski, E.R.; Forsting, M. [Dept. of Neuroradiology, Univ. of Essen (Germany)


    We report an unusual case of isolated Langerhans cell histiocytosis of the central nervous system. A 19-year-old man presented with an incomplete ocular palsy. MRI revealed a solitary mass in the pineal gland with marked contrast enhancement. Complete microsurgical excision was followed by local radiotherapy. Histological examination revealed histiocytosis. Unifocal brain involvement by histiocytosis X is rare with few cases in the literature; the most commonly involved areas are the hypothalamus and the pituitary gland. (orig.)

  2. Adenoid cystic carcinoma of the lacrimal gland

    DEFF Research Database (Denmark)

    von Holstein, Sarah L; Fehr, André; Persson, Marta;


    To investigate genetic alterations in lacrimal gland adenoid cystic carcinomas (ACCs) with emphasis on the MYB-NFIB fusion oncogene and its downstream targets, MYB rearrangements, and copy number alterations in relation to clinical data and survival.......To investigate genetic alterations in lacrimal gland adenoid cystic carcinomas (ACCs) with emphasis on the MYB-NFIB fusion oncogene and its downstream targets, MYB rearrangements, and copy number alterations in relation to clinical data and survival....

  3. Sclerosing polycystic adenosis of the parotid gland

    Directory of Open Access Journals (Sweden)

    Hugo Lara-Sánchez


    Conclusion: The SPA is similar to the fibrocystic changes, sclerosing adenosis and adenoid tumors of the mammary gland. The main location of the SPA is the parotid gland and it is considered a disease due to a pseudotumoral inflammatory reaction with a possible association with the Epstein–Barr virus. There is evidence that monoclonal cell populations exist. The treatment consists in excision of the tumor with a superficial parotidectomy, which has demonstrated high cure rates.

  4. [Adenomatoid tumour of the adrenal gland]. (United States)

    Bandier, Philippe Claus; Hansen, Alastair; Thorelius, Lars


    An adenomatoid tumour in the right suprarenal gland was discovered during clinical cancer staging of a 73-year-old woman. Adenomatoid tumours in the suprarenal glands are rare and are most often found incidentally. A definitive diagnosis is made on the basis of histology since imaging methods are non-specific. Differential diagnoses comprise malignant vascular neoplasm or adenocarcinoma. Immunohistochemistry or electron microscopy allows uncomplicated distinction between these tumours. In general, it is recommended to obtain biopsies from suprarenal processes.

  5. Management of xerostomia and salivary gland hypofunction. (United States)

    Ram, Saravanan; Kumar, Satish; Navazesh, Mahvash


    Xerostomia and salivary gland hypofunction are conditions that have been associated with increased prevalence of caries, periodontitis, and candidiasis. Oral health care providers must be aware of the etiologies and clinical manifestations of salivary gland hypofunction in order to identify patients with this condition and to prevent its potential complications. The various modalities available to manage this condition range from frequent sips of water to the intake of systemic medications like pilocarpine or cevimeline.

  6. Papillary Thyroid Carcinoma: Analysis of the Central Compartmentʼs Lymph Nodes Metastases

    Directory of Open Access Journals (Sweden)

    Ján Sojak


    Full Text Available Background: Papillary thyroid carcinoma is typical by regional lymph nodes metastases. Therefore we decided to analyse associated risk factors. Objective: In this retrospective study we focused on the incidence of metastatic involvement of the central compartment’s lymph nodes correlated with age, size of the primary tumour, infiltration of thyroid gland capsule, positive lymphangioinvasion in order to assess risk factors. Method: We analysed group of 156 patients with papillary carcinoma, who have undergone total thyroidectomy and bilateral elective central compartment neck dissection. We evaluated the occurrence of metastases, size, infiltration and lymphangioinvasion based on definitive histology of the whole group and separately for subgroups of patients under and over 45 years. Result: We found metastatic involvement in 88 (56.4% patients. When comparing the subgroups of patients under (73 patients and over 45 years (83 patients, we found metastases in 56 vs. 32 (76.7% vs. 38.6% patients. In the subgroup of younger patients we found significant higher incidence of metastases compared with the group of over 45 years, P < 0.001 (P = 0.000027. We found significant higher incidence of metastases in patients with positive capsule infiltration in the whole group, P < 0.001 (P = 0.00049; in the subgroup of under 45 years, P < 0.001 (P = 0.00091 and in patients with positive lymphangioinvasion in the whole group, P < 0.01 (P = 0.00177; in the subgroup of over 45 years, P < 0.001 (P = 0.0002. In patients with metastases we found tumour size ≥1cm more frequently in all groups. Conclusion: We recorded higher incidence of regional metastases in patients under 45 years, positive capsule infiltration, lymphangioinvasion. Age under 45 years itself does not correlate with less aggressive disease, to the contrary some of other analysed risk factors correlate with more aggressive disease.

  7. Lymphocyte migration into syngeneic implanted lymph nodes

    Energy Technology Data Exchange (ETDEWEB)

    Gordeeva, M.S.


    To judge the functional activity of lymphocytes of an implanted lymph node (LN), the proliferative response of lymphocytes of the implanted organ in the blast-transformation reaction in vitro and their ability to induce a local graft versus host reaction (GVHR) were determined. The lymphocyte suspension for labeling with /sup 51/Cr was obtained from peripheral LN in different situations from syngeneic mice. The resulting lymphocyte suspension was labeled with a solution of sodium chromate-/sup 51/Cr in a concentration of 20-40 microCi/100.10/sup 6/ cells in 1 ml for 40 min at 37/sup 0/C. The proliferative activity of a suspension of lymphocytes was estimated as incorporation of /sup 3/H-thymidine into DNA during incubation of the cell suspension for 3 days. Data on migration of /sup 51/Cr-labeled cells and the results of the morphological observations revealed marked ability of lymphocytes of the peripheral pool to colonize the regenerating stroma.

  8. LIGHT regulates inflamed draining lymph node hypertrophy (United States)

    Zhu, Mingzhao; Yang, Yajun; Wang, Yugang; Wang, Zhongnan; Fu, Yang-Xin


    Lymph node (LN) hypertrophy, the increased cellularity of LNs, is the major indication of the initiation and expansion of the immune response against infection, vaccination, cancer or autoimmunity. The mechanisms underlying LN hypertrophy remain poorly defined. Here, we demonstrate that LIGHT (TNFSF14) is a novel factor essential for LN hypertrophy after CFA immunization. Mechanistically, LIGHT is required for the influx of lymphocytes into but not egress out of LNs. In addition, LIGHT is required for DC migration from the skin to draining LNs. Compared with WT mice, LIGHT−/− mice express lower levels of chemokines in skin and addressins in LN vascular endothelial cells after CFA immunization. We unexpectedly observed that LIGHT from radioresistant rather than radiosensitive cells, likely Langerhans cells, is required for LN hypertrophy. Importantly, antigen-specific T cell responses were impaired in DLN of LIGHT−/− mice, suggesting the importance of LIGHT regulation of LN hypertrophy in the generation of an adaptive immune response. Collectively, our data reveal a novel cellular and molecular mechanism for the regulation of LN hypertrophy and its potential impact on the generation of an optimal adaptive immune response. PMID:21572030

  9. Epithelial myoepithelial carcinoma of the parotid gland

    Directory of Open Access Journals (Sweden)

    Sachin A Badge


    Full Text Available Epithelial-myoepithelial carcinoma (EMC is a low-grade malignant tumor of the salivary glands. It is extremely rare neoplasm accounting for <1% of all salivary gland neoplasms. It is most commonly seen in parotid gland, but has also been described in the submandibular gland, minor salivary glands and extra oral sites. It is most commonly seen in females; with a peak occurrence in the seventh decade. We present a case of EMC of parotid gland in a 55-year-old male patient presented with painless swelling of 8 cm × 8 cm in preauricular region since 1-year. There was no history of fever and no palpable cervical lymphadenopathy. Facial nerve function was intact. All other findings in general examination were within normal limit. As EMC is a very rare tumor having high rate of recurrence we must aware of this entity while giving diagnosis on histopathological examination. Surgeons and oncologist must focus on the best treatment approach to prevent the recurrence of this tumor. Wide local excision, followed by radiotherapy remains the treatment of choice.

  10. Iatrogenic causes of salivary gland dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Schubert, M.M.; Izutsu, K.T.


    Saliva is important for maintaining oral health and function. There are instances when medical therapy is intended to decrease salivary flow, such as during general anesthesia, but most instances of iatrogenic salivary gland dysfunction represent untoward or unavoidable side-effects. The clinical expression of the salivary dysfunction can range from very minor transient alteration in saliva flow to a total loss of salivary function. The most common forms of therapy that interfere with salivation are drug therapies, cancer therapies (radiation or chemotherapy), and surgical therapy. These therapies can affect salivation by a number of different mechanisms that include: disruption of autonomic nerve function related to salivation, interference with acinar or ductal cell functions related to salivation, cytotoxicity, indirect effects (vasoconstriction/dilation, fluid and electrolyte balance, etc.), and physical trauma to salivary glands and nerves. A wide variety of drugs is capable of increasing or decreasing salivary flow by mimicking autonomic nervous system actions or by directly acting on cellular processes necessary for salivation: drugs can also indirectly affect salivation by altering fluid and electrolyte balance or by affecting blood flow to the glands. Ionizing radiation can cause permanent damage to salivary glands, damage that is manifest as acinar cell destruction with subsequent atrophy and fibrosis of the glands. Cancer chemotherapy can cause changes in salivation, but the changes are usually much less severe and only transient. Finally, surgical and traumatic injuries interfere with salivation because of either disruption of gland innervation or gross physical damage (or removal) of glandular tissue (including ducts).

  11. The neurobiology of the meibomian glands. (United States)

    Cox, Stephanie M; Nichols, Jason J


    This article compiles research regarding the neuroanatomy of the meibomian glands and their associated blood vessels. After a review of meibomian gland morphology and regulation via hormones, a case for innervation is made based on anatomical findings whereby the nerves lack a myelin sheath and Schwann cells. The localization and co-localization of dopamine beta-hydroxylase, tyrosine hydroxylase, neuropeptide Y, vasoactive intestinal polypeptide, calcitonin gene-related peptide, and substance P are explored with emphasis on differences that exist between species. The presence of the various neuropeptides/neurotransmitters adjacent to the meibomian gland versus the vasculature associated with the meibomian gland is documented so that conclusions can be made with regard to direct and indirect effects. Research regarding the presence of receptors and receptor proteins for these neuropeptides is documented. Evidence supporting the influence of certain neurotransmitters and/or neuropeptides on the meibomian gland is given based on research that correlates changes in meibomian gland morphology and/or tear film with changes in neurotransmitter and/or neuropeptide presence. Conclusions are drawn related to direct and indirect regulation and differences between the various nervous systems.

  12. The pineal gland from development to function. (United States)

    Sapède, Dora; Cau, Elise


    The pineal gland is a small neuroendocrine organ whose main and most conserved function is the nighttime secretion of melatonin. In lower vertebrates, the pineal gland is directly photosensitive. In contrast, in higher vertebrates, the direct photosensitivity of the pineal gland had been lost. Rather, the action of this gland as a relay between environmental light conditions and body functions involves reception of light information by the retina. In parallel to this sensory regression, the pineal gland (and its accessory organs) appears to have lost several functions in relation to light and temperature, which are important in lower vertebrate species. In humans, the functions of the pineal gland overlap with the functions of melatonin. They are extremely widespread and include general effects both on cell protection and on more precise functions, such as sleep and immunity. Recently, the role of melatonin has received a considerable amount of attention due to increased cancer risk in shift workers and the discovery that patients suffering from neurodegenerative diseases, autism, or depression exhibit abnormal melatonin rhythms.

  13. Cell therapy for salivary gland regeneration. (United States)

    Lin, C-Y; Chang, F-H; Chen, C-Y; Huang, C-Y; Hu, F-C; Huang, W-K; Ju, S-S; Chen, M-H


    There are still no effective therapies for hyposalivation caused by irradiation. In our previous study, bone marrow stem cells can be transdifferentiated into acinar-like cells in vitro. Therefore, we hypothesized that transplantation with bone marrow stem cells or acinar-like cells may help functional regeneration of salivary glands. Bone marrow stem cells were labeled with nanoparticles and directly co-cultured with acinar cells to obtain labeled acinar-like cells. In total, 140 severely combined immune-deficiency mice were divided into 4 groups for cell therapy experiments: (1) normal mice, (2) mice receiving irradiation around their head-and-neck areas; (3) mice receiving irradiation and intra-gland transplantation with labeled stem cells; and (4) mice receiving irradiation and intra-gland transplantation with labeled acinar-like cells. Our results showed that salivary glands damaged due to irradiation can be rescued by cell therapy with either bone marrow stem cells or acinar-like cells for recovery of saliva production, body weight, and gland weight. Transdifferentiation of bone marrow stem cells into acinar-like cells in vivo was also noted. This study demonstrated that cell therapy with bone marrow stem cells or acinar-like cells can help functional regeneration of salivary glands, and that acinar-like cells showed better therapeutic potentials than those of bone marrow stem cells.

  14. The metapleural gland of ants. (United States)

    Yek, Sze Huei; Mueller, Ulrich G


    The metapleural gland (MG) is a complex glandular structure unique to ants, suggesting a critical role in their origin and ecological success. We synthesize the current understanding of the adaptive function, morphology, evolutionary history, and chemical properties of the MG. Two functions of the MG, sanitation and chemical defence, have received the strongest empirical support; two additional possible functions, recognition odour and territorial marking, are less well supported. The design of the MG is unusual for insects; glandular secretions are stored in a rigid, non-compressible invagination of the integument and the secretion is thought to ooze out passively through the non-closable opening of the MG or is groomed off by the legs and applied to target surfaces. MG loss has occurred repeatedly among the ants, particularly in the subfamilies Formicinae and Myrmicinae, and the MG is more commonly absent in males than in workers. MG chemistry has been characterized mostly in derived ant lineages with unique biologies (e.g. leafcutter ants, fire ants), currently precluding any inferences about MG chemistry at the origin of the ants. A synthetic approach integrating functional morphology, phylogenetic transitions and chemical ecology of the MGs of both the derived and the unstudied early-branching (basal) ant lineages is needed to elucidate the evolutionary origin and diversification of the MG of ants.

  15. Specifications for refuse-derived fuels utilisation in industrial power plants; Bedingungen fuer die Ersatzbrennstoffverwertung in Industriekraftwerken

    Energy Technology Data Exchange (ETDEWEB)

    Seiler, U.; Hoelter, G. [Fichtner GmbH und Co. KG, Stuttgart (Germany)


    Concepts and definitions in the refuse-derived fuels sector are presented, as well as forecasts of the volumes to be expected. Utilisation options are presented, and specifications for a refuse-derived fuel are laid down. The necessary treatment stages are described, and the cost of the various processes is compared. (orig.)

  16. Sentinel lymph node concept in gastric cancer with solitary lymph node metastasis

    Institute of Scientific and Technical Information of China (English)

    Li-Yang Cheng; Shi-Zhen Zhong; Zong-Hai Huang


    AIM: To study the localization of the solitary metastases in relation to the primary gastric cancers and the feasibility of sentinel lymph node (SLN) concept in gastric cancer.METHODS: Eighty-six patients with gastric cancer, who had only one lymph node involved, were regarded retrospectively as patients with a possible sentinel node metastasis, and the distribution of these nodes were assessed. Thirteen cases with jumping metastases were further studied and followed up.RESULTS: The single nodal metastasis was found in the nearest perigastric nodal area in 65.1% (56/86) of the cases and in 19.8% (17/86) of the cases in a fairly remote perigastric area. Out of 19 middle-third gastric cancers,3 tumors at the lesser or greater curvatures had transverse metastases. There were also 15.1% (13/86) of patients with a jumping metastasis to N2-N3 nodes without N1 involved. Among them, the depth of invasion was mucosal (M) in 1 patient, submucosal (SM) in 2, proper-muscular (MP) in 4, subserosal (SS) in 5, and serosa-exposed (SE)in 1. Five of these patients died of gastric cancer recurrence at the time of this report within 3 years after surgery.CONCLUSION: These results suggest that nodal metastases occur in a random and multidirectional process in gastric cancer and that not every first metastatic node is located in the perigastric region near the primary tumor.The rate of "jumping metastasis" in gastric cancer is much higher than expected, which suggests that the blind examination of the nodal area close to the primary tumor can not be a reliable method to detect the SLN and that a extended lymph node dissection (ELND) should be performed if the preoperative examination indicates submucosal invasion.

  17. Lymph node density predicts recurrence and death after inguinal lymph node dissection for penile cancer (United States)

    Schwen, Zeyad R.; Ko, Joan S.; Meyer, Alexa; Netto, George J.; Burnett, Arthur L.; Bivalacqua, Trinity J.


    Purpose To determine the impact of lymph node density (LND) on survival after inguinal lymph node dissection (ILND) for penile cancer. Materials and Methods Our institutional penile cancer database was queried for patients who underwent ILND. Clinicopathologic characteristics including LND and total number of positive lymph nodes (LNs) were analyzed to determine impact on recurrence-free survival (RFS) and overall survival (OS). LND, or the percent of positive LN out of total LN, was calculated as a categorical variable at varying thresholds. Results Twenty-eight patients with complete follow-up were identified. Indications for ILND were stage >T2 in 20 patients (71.4%), palpable adenopathy in 7 (25%), high grade T1 in 1 (3.6%). Median node yield was 17.5 (interquartile range, 12−22), and positive LNs were found in 14 patients (50%). RFS and OS were significantly lower for patients with >15% LN density (median RFS: 62 months vs. 6.3 months, p=0.0120; median OS: 73.6 months vs. 6.3 months, p15% was independently associated with worse RFS (hazard ratio [HR], 3.6; p=0.04) and OS (HR, 73.6; p=0.002). The c-index for LND was higher than total positive LNs for RFS (0.64 vs. 0.54) and OS (0.79 vs. 0.61). Conclusions In this small, retrospective penile cancer cohort, the presence of nodal involvement >15% was associated with decreased RFS and OS, and outperformed total number of positive LN as a prognostic indicator.

  18. Clear cell myoepithelial carcinoma of salivary glands showing EWSR1 rearrangement: molecular analysis of 94 salivary gland carcinomas with prominent clear cell component. (United States)

    Skálová, Alena; Weinreb, Ilan; Hyrcza, Martin; Simpson, Roderick H W; Laco, Jan; Agaimy, Abbas; Vazmitel, Marina; Majewska, Hanna; Vanecek, Tomas; Talarčik, Peter; Manajlovic, Spomenka; Losito, Simona N; Šteiner, Petr; Klimkova, Adela; Michal, Michal


    This study examines the presence of the EWSR1 rearrangement in a variety of clear cell salivary gland carcinomas with myoepithelial differentiation. A total of 94 salivary gland carcinomas with a prominent clear cell component included 51 cases of clear cell myoepithelial carcinomas de novo (CCMC), 21 cases of CCMCs ex pleomorphic adenoma (CCMCexPA), 11 cases of epithelial-myoepithelial carcinoma (EMC), 6 cases of EMC with solid clear cell overgrowth, and 5 cases of hyalinizing clear cell carcinoma of minor salivary glands. In addition, 10 cases of myoepithelial carcinomas devoid of clear cell change and 12 cases of benign myoepithelioma were included as well. All the tumors in this spectrum were reviewed, reclassified, and tested by fluorescence in situ hybridization (FISH) for the EWSR1 rearrangement using the Probe Vysis EWSR1 Break Apart FISH Probe Kit. The EWSR1 rearrangement was detected in 20 of 51 (39%) cases of CCMC, in 5 of 21 (24%) cases of CCMCexPA, in 1 of 11 (9%) cases of EMC, and in 4 of 5 (80%) cases of hyalinizing clear cell carcinoma. The 25 EWSR1-rearranged CCMCs and CCMCexPAs shared similar histomorphology. They were arranged in nodules composed of compact nests of large polyhedral cells with abundant clear cytoplasm. Necrosis, areas of squamous metaplasia, and hyalinization were frequent features. Immunohistochemically, the tumors expressed p63 (96%), cytokeratin CK14 (96%), and S100 protein (88%). MIB1 index varied from 10% to 100%, with most cases in the 20% to 40% range. Clinical follow-up information was available in 21 cases (84%) and ranged from 3 months to 15 years (mean 5.2 y); 4 patients were lost to follow-up. Ten patients are alive with no evidence of recurrent or metastatic disease in the follow-up period from 3 months to 15 years (mean 5 y), 3 patients are alive with recurrent and metastatic disease, and 8 died of disseminated cancer 9 months to 16 years after diagnosis (mean 6 y). Lymph node metastasis appeared in 5 patients

  19. Clinical Implication of Cyclooxygenase-2 Expression for Rectal Cancer Patients with Lymph Node Involvement

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyung Sik; Choi, Young Min; Hur, Won Joo; Kim, Su Jin; Kim, Dae Cheol; Roh, Mee Sook; Hong, Young Seoub; Park, Ki Jae [Dona-A University School of Medicine, Busan (Korea, Republic of)


    To assess the influence of cyclooxygenase-2 (COX-2) expression on the survival of patients with a combination of rectal cancer and lymph node metastasis. The study included rectal cancer patients treated by radical surgery and postoperative radiotherapy at the Dong-A university hospital from 1998 to 2004. A retrospective analysis was performed on a subset of patients that also had lymph node metastasis. After excluding eight of 86 patients, due to missing tissue samples in three, malignant melanoma in one, treatment of gastric cancer around one year before diagnosis in one, detection of lung cancer after one year of diagnosis in one, liver metastasis in one, and refusal of radiotherapy after 720 cGy in one, 78 patients were analyzed. The immunohistochemistry for COX-2 was conducted with an autostainer (BenchMark; Ventana, Tucson, AZ, USA). An image analyzer (TissueMine; Bioimagene, Cupertino, CA, USA) was used for analysis after scanning (ScanScope; Aperio, Vista, CA, USA). A survival analysis was performed using the Kaplan Meier method and significance was evaluated using the log rank test. COX-2 was stained positively in 62 patients (79.5%) and negatively in 16 (20.5%). A total of 6 (7.7%), 15 (19.2%), and 41 (52.6%) patients were of grades 1, 2, and 3, respectively for COX-2 expression. No correlation was found between being positive of COX-2 patient characteristics, which include age (<60-year old vs. {>=}60), sex, operation methods (abdominoperineal resection vs. lower anterior resection), degrees of differentiation, tumor size (<5 cm vs. {>=}5 cm), T stages, N stages, and stages (IIIa, IIIb, IIIc). The 5-year overall and 5-year disease free survival rates for the entire patient population were 57.0% and 51.6%, respectively. The 5-year overall survival rates for the COX-2 positive and negative patients were 53.0% and 72.9%, respectively (p=0.146). Further, the 5-year disease free survival rates for the COX-2 positive and negative patients were 46.3% and 72

  20. Ultrasound elastography for evaluation of cervical lymph nodes

    Directory of Open Access Journals (Sweden)

    Young Jun Choi


    Full Text Available Ultrasound (US elastography has been introduced as a noninvasive imaging technique for evaluating cervical lymph nodes. US elastography techniques include strain elastography and shear wave-based elastography. The application of this technique is based on the fact that stiff tissues tend to deform less and show less strain than compliant tissues when the same force is applied. In general, metastatic lymph nodes demonstrate higher stiffness than benign lymph nodes. Overall, preliminary studies suggest that US elastography may be useful in differentiating benign and malignant cervical lymph nodes, thereby informing decisions to perform a biopsy and facilitating follow-up. For US elastography to be accepted into clinical practice, however, its techniques, associated diagnostic criteria, and reliability need to be further refined.

  1. Fine-needle aspiration biopsy of lymph nodes

    African Journals Online (AJOL)


    Feb 2, 2012 ... Lymph nodes in the posterior cervical triangle and supraclavicular nodes are more suspicious for malignancy. ... exclusively primary or recurrent breast carcinoma in aspirates ... Lung carcinoma – small cell and non- small cell.

  2. Mapping refuse profile in Singapore old dumping ground through electrical resistivity, S-wave velocity and geotechnical monitoring. (United States)

    Yin, Ke; Tong, Huan Huan; Noh, Omar; Wang, Jing-Yuan; Giannis, Apostolos


    The purpose of this study was to track the refuse profile in Lorong Halus Dumping Ground, the largest landfill in Singapore, by electrical resistivity and surface wave velocity after 25 years of closure. Data were analyzed using an orthogonal set of plots by spreading 24 lines in two perpendicular geophone-orientation directions. Both geophysical techniques determined that refuse boundary depth was 13 ± 2 m. The refuse boundary revealed a certain degree of variance, mainly ascribed to the different principle of measurements, as well as the high heterogeneity of the subsurface. Discrepancy was higher in spots with greater heterogeneity. 3D analysis was further conducted detecting refuse pockets, leachate mounding and gas channels. Geotechnical monitoring (borehole) confirmed geophysical outcomes tracing different layers such as soil capping, decomposed refuse materials and inorganic wastes. Combining the geophysical methods with borehole monitoring, a comprehensive layout of the dumping site was presented showing the hot spots of interests.

  3. Tissue heterogeneity in the anterior chest wall and its influence on radiation therapy of the internal mammary lymph nodes. (United States)

    Lindskoug, B; Hultborn, A


    The density (g cm-3) and electron density (cm-3) of material from the anterior chest wall was determined. On the average, the difference in density between rib bone and intercostal soft tissue amounted to 17 per cent, while the difference in electron density was 7 per cent. The attenuation of high-energy electrons in specimens of rib bone, costal cartilage and sternum was determined by an experimental technique, using dosimeters of TLD material. The results of determinations of attenuation of 10 and 13 MeV electrons in fresh specimens are presented. It is concluded that electron radiation in the energy range of 10 to 13 MeV can be utilized for irradiation of lymph glands along the internal thoracic vessels without risk of underdosage.

  4. Fine needle aspiration cytology of palpable supraclavicular lymph nodes

    Directory of Open Access Journals (Sweden)

    RC Adhikari


    Full Text Available Background: Fine needle aspiration cytology as a first line of investigation has assumed importance in diagnosing a variety of disease process. The aim of this study was to assess the diagnostic value of fine needle aspiration cytology in the evaluation of palpable supraclavicular lymph nodes. Materials and methods: This was a retrospective study of fine needle aspiration cytology of palpable supraclavicular lymph node done between January 1, 2007 and December 31, 2009. Fine needle aspiration cytology was performed on 149 patients (49 cases at Om Hospital & Research Centre and 100 cases at Tribhuvan University Teaching Hospital. Results: The right supraclavicular lymph node was enlarged in 55% cases, while the left supraclavicular lymph node alone was palpable in 40.3% cases and in 7 of 149 (4.7% cases, bilateral supraclavicular lymph nodes were palpable. Cytological diagnoses were categorized as reactive (8.7%, tuberculosis (41.6%, lymphoma (4.8% and metastasis (44.9%. Of a total of 74 cases of malignancy, 90.5% were non-lymphoid and 9.5% were lymphoid (5 Non-Hodgkin lymphoma and 2 Hodgkin lymphoma. Of the 67 cases of metastatic disease, three major types of malignancy found in supraclavicular lymph nodes were Squamous cell carcinoma (28 cases, adenocarcinoma (21 cases and others (small cell carcinoma, papillary thyroid carcinoma etc. Adenocarcinoma tended to metastasize to the left supraclavicular lymph node. Lung was the most common primary site (43.3%, followed by stomach, ovary, breast and larynx. However, in 28.4% cases, no primary site was found. Conclusion: The fine needle aspiration cytology can be used as a first line investigation in the evaluation of supraclavicular lymphadenopathy due to its low cost, simplicity and minimal invasiveness. Keywords: Supraclavicular lymph node; Fine needle aspiration cytology; Metastasis DOI: 10.3126/jpn.v1i1.4441 Journal of Pathology of Nepal (2011 Vol.1, 8-12  

  5. Mesenteric Lymph: The Bridge to Future Management of Critical Illness



    Toxic factors released from the intestine have been implicated in the pathophysiology of severe acute illness, including acute pancreatitis, trauma and hemorrhagic shock, and burns. Toxic factors in mesenteric lymph may induce an inflammatory systemic response while bypassing the portal circulation and liver. This paper reviews current knowledge of the anatomy, physiology and pathophysiology of mesenteric lymph and focuses on factors influencing its composition and flow, and potential therape...

  6. Isolated Axillary Lymph Node Metastasis from Serous Ovarian Cancer

    Directory of Open Access Journals (Sweden)

    Hemant Goyal


    Full Text Available A 68-year-old female with past medical history of stage IIIc serous ovarian cancer after cytoreductive surgery and adjuvant chemotherapy came to clinic for regular follow-up visit. Physical examination was completely normal except for an isolated left axillary lymph node enlargement. Patient's abdominal sonogram and CT scan of abdomen and pelvis did not show any other new metastasis. Surgical excisional biopsy of the lymph node was performed and pathology revealed features of metastatic serous ovarian carcinoma.

  7. Lymph node hemangioma in one-humped camel


    Aljameel, M.A.; M.O. Halima


    Hemangioma is a benign tumor of blood and lymphatic vessels. It is common in skin, mucosa and soft tissues, and its occurrence in lymph nodes is extremely rare. A 10 year-old she-camel was slaughtered at Nyala slaughterhouse, South Darfur State, Sudan. Grossly, the carcass was emaciated. The left ventral superficial cervical lymph node was enlarged, hard on palpation and protruded outside the body. Its cut surface was dark red in color and measured (18 cm) in diameter. Histopathologically, th...

  8. Can children aged 12 years or more refuse life-saving treatment ...

    African Journals Online (AJOL)

    arises whether a child may refuse to consent to life-saving medical treatment ... things, that the following be taken into account: (i) the child's age, maturity and stage ... other relevant characteristics; (ii) the child's physical and emotional security ...

  9. Behavioural treatment of a food refusal conversion disorder in a mentally retarded adult. (United States)

    Weinman, B; Haydon, S; Sapan, J


    A 31-year-old woman with mental retardation who demonstrated total food refusal as the symptom of a conversion disorder was successfully treated with behavioural management techniques. The treatment utilized a shaping paradigm combined with relaxation procedures. The results supported the hypothesis that conversion disorder symptoms are maintained through their consequences, and the efficacy of behavioural treatments for those disorders.

  10. 45 CFR 5b.8 - Appeals of refusals to correct or amend records. (United States)


    ... Services Administration; Alcohol, Drug Abuse, and Mental Health Administration; Center for Disease Control... circumstances of the delay. The subject individual's request to amend or correct the record, the responsible... 45 Public Welfare 1 2010-10-01 2010-10-01 false Appeals of refusals to correct or amend...

  11. 76 FR 46820 - Proposal To Refuse To Approve a Supplemental New Drug Application for Bromday (Bromfenac... (United States)


    ... HUMAN SERVICES Food and Drug Administration Proposal To Refuse To Approve a Supplemental New Drug Application for Bromday (Bromfenac Ophthalmic Solution), 0.09%; Opportunity for a Hearing AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA), the...

  12. 30 CFR 780.25 - Reclamation plan: Siltation structures, impoundments, and refuse piles. (United States)


    ... for each proposed siltation structure, impoundment, and refuse pile within the proposed permit area....C. 552(a) and 1 CFR part 51. You may review and download the incorporated document from the Natural... copy of this document at the National Archives and Records Administration (NARA). For information...

  13. Influence of Refuse Sites on the Prevalence of Campylobacter spp. and Salmonella Serovars in Seagulls▿


    Ramos, Raül; Cerdà-Cuéllar, Marta; Ramírez, Francisco; Jover, Lluís; Ruiz, Xavier


    Wild animals are well-known reservoirs of Campylobacter and Salmonella. We investigated the influence of insalubrious diets on the prevalence of both enterobacteria in seagulls. Campylobacter occurrence in gull chicks sampled along the northeastern Iberian coast was directly related to the degree of refuse consumption. High Salmonella values from the sampling sites did not reflect any dietary relationship.

  14. High-context and Low-context communication:A Case Study of A Chinese Refusal

    Institute of Scientific and Technical Information of China (English)

    吴建晓; 钱敏


    Edward Hall offers us an effective means of examining cultural similarities and differences, that is the classification of high-context and low-context culture. The paper attempts to analyze a case of a Chinese refusal from the perspective of high-context and low-context communication and explores the differences between the two types of communication.

  15. Interim storage of wastes and refuse derived fuels; Zwischenlagerung von Abfaellen und Ersatzbrennstoffen

    Energy Technology Data Exchange (ETDEWEB)

    Thome-Kozmiensky, K.J.; Versteyl, A.; Beckmann, M. (eds.)


    Authors comment on interim storage of municipal wastes and refuse derived fuels. Topics of the 16 contributions are: Logistics and engineering, planning, estimation of storage time, cost and commitment, amend ment of the regulations, penal risks of interim storage, material flow management at waste incinerators, fire prevention, environmental risk, insurances. (uke)

  16. Determinants for refusal of HIV testing among women attending for antenatal care in Gambella Region, Ethiopia

    Directory of Open Access Journals (Sweden)

    Fanta Wondimagegn


    Full Text Available Abstract Background In Gambella region, inhabitants owe socio-cultural factors that might favor refusal for HIV testing service utilization among Antenatal Care attendees. Objective To assess determinants for refusal of HIV testing service utilization among ANC attendees in Gambella Region. Methods A comparative cross sectional study was conducted among ANC attendees from March 2008 to May 2008 in four selected health facilities of Gambella region. Sample size of 332 participants (83 who refused HIV testing and 249 who accepted HIV testing were taken for the study. The study was supplemented with four focus group discussions. Multivariate binary logistic regression was employed to control for confounding factors. Results When adjusted with other factors pregnant women with 2–3 live births in the past; who claimed divorce as a perceived response of their husband following HIV positive test result; who had not sought agreement from their husband for testing; disclosure of test for husband and being from certain ethnic group (E.g. Mejenger were independent predictors for refusal of HIV testing among ANC attendees. Conclusion and recommendation Based on the findings, the following recommendations were forwarded: Provision of innovative information and education on the pre-test session for those pregnant women having two or more children; community involvement to tackle stigma; women empowerment; designing couple friendly counseling service; and fighting harmful traditional practices related with decision of HIV testing.

  17. Additive, Multi-Component Treatment of Emerging Refusal Topographies in a Pediatric Feeding Disorder (United States)

    Sharp, William G.; Jaquess, David L.; Bogard, Jennifer D.; Morton, Jane F.


    This case study describes inter-disciplinary treatment of chronic food refusal and tube dependency in a 2-year-old female with a pediatric feeding disorder. Evidence-based behavioral components--including escape extinction (EE), differential reinforcement of alterative mealtime behavior (DRA), and stimulus fading--were introduced sequentially as…

  18. Behavioral Assessment and Treatment of Chronic Food Refusal in Handicapped Children. (United States)

    Riordan, Mary M.; And Others


    Chronic food refusal of four handicapped children (one-three years old) was modified by a procedure involving the delivery of reinforcement (social praise, access to preferred foods, brief toy play periods) contingent upon consumption of a targeted food item. (CL)

  19. Resisting Colonial Education: Zitkala-Sa and Native Feminist Archival Refusal (United States)

    Terrance, Laura L.


    This paper examines resistance through a Native Feminist lens, employing the boarding school memoirs of Zitkala-Sa. Within a "story" of appropriation in methodology, it considers protest and parody, and presents archival refusal as modes of resistance to colonial education. (Contains 1 figure.)

  20. [Tuberculosis and refusal of treatment: resorting to legislation on serious health threats]. (United States)

    Bouvet, R; Le Gueut, M


    Clinicians are regularly confronted with the question of refusal of treatment from patients with tuberculosis. For several years, the French public health authorities have been studying the possibility of compelling treatment or isolation, but no plan has been implemented even though European and American experiences have shown the effectiveness of restrictive measures. Neither the statutory exceptions to the principle of consent to medical treatment nor the conditions of implementation of "required care" allow legally binding measures against patients refusing care or isolation. The legislation on serious health threats has recently been applied to the situation of a refusal of treatment in the context of tuberculosis. It allowed the patient to be ordered to observe prescribed care and the possibility of forced isolation in the event of breach of this order. The legislation on serious health threats is a response to the question of refusal of treatment from patients with tuberculosis. However the opinion of the legal authority as to its necessity and proportionality to the risk remains unknown. Copyright © 2013 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  1. Refuse derived soluble bio-organics enhancing tomato plant growth and productivity

    Energy Technology Data Exchange (ETDEWEB)

    Sortino, Orazio [Dipartimento di Scienze Agronomiche Agrochimiche e delle Produzioni Animali, Universita degli Studi di Catania, Via Valdisavoia 5, 95123 Catania (Italy); Dipasquale, Mauro [Dipartimento di Chimica, Universita di Torino, Via P. Giuria 7, 10125 Torino (Italy); Montoneri, Enzo, E-mail: [Dipartimento di Chimica, Universita di Torino, Via P. Giuria 7, 10125 Torino (Italy); Tomasso, Lorenzo; Perrone, Daniele G. [Dipartimento di Chimica, Universita di Torino, Via P. Giuria 7, 10125 Torino (Italy); Vindrola, Daniela; Negre, Michele; Piccone, Giuseppe [Dipartimento di Valorizzazione e Protezione delle Risorse Agroforestali, Universita di Torino, Via L. da Vinci 44, 10095 Grugliasco (Italy)


    Highlights: Black-Right-Pointing-Pointer Municipal bio-wastes are a sustainable source of bio-based products. Black-Right-Pointing-Pointer Refuse derived soluble bio-organics promote chlorophyll synthesis. Black-Right-Pointing-Pointer Refuse derived soluble bio-organics enhance plant growth and fruit ripening rate. Black-Right-Pointing-Pointer Sustainable chemistry exploiting urban refuse allows sustainable development. Black-Right-Pointing-Pointer Chemistry, agriculture and the environment benefit from biowaste technology. - Abstract: Municipal bio-refuse (CVD), containing kitchen wastes, home gardening residues and public park trimmings, was treated with alkali to yield a soluble bio-organic fraction (SBO) and an insoluble residue. These materials were characterized using elemental analysis, potentiometric titration, and 13C NMR spectroscopy, and then applied as organic fertilizers to soil for tomato greenhouse cultivation. Their performance was compared with a commercial product obtained from animal residues. Plant growth, fruit yield and quality, and soil and leaf chemical composition were the selected performance indicators. The SBO exhibited the best performance by enhancing leaf chlorophyll content, improving plant growth and fruit ripening rate and yield. No product performance-chemical composition relationship could be assessed. Solubility could be one reason for the superior performance of SBO as a tomato growth promoter. The enhancement of leaf chlorophyll content is discussed to identify a possible link with the SBO photosensitizing properties that have been demonstrated in other work, and thus with photosynthetic performance.

  2. An Alternating Treatments Comparison of Two Intensive Interventions for Food Refusal. (United States)

    Ahearn, William H.; And Others


    The effects of two methods of negative reinforcement on three young children (ages two and three) with developmental delays and chronic food refusal were examined. Physically guiding the child to accept food contingent on noncompliance and nonremoval of the spoon until the child ate were tested. Both treatments were effective; however, parents…

  3. Missed opportunities: refusal to confirm reactive rapid HIV tests in the emergency department.

    Directory of Open Access Journals (Sweden)

    Ishani Ganguli

    Full Text Available BACKGROUND: HIV infection remains a major US public health concern. While HIV-infected individuals now benefit from earlier diagnosis and improved treatment options, progress is tempered by large numbers of newly diagnosed patients who are lost to follow-up prior to disease confirmation and linkage to care. METHODOLOGY: In the randomized, controlled USHER trial, we offered rapid HIV tests to patients presenting to a Boston, MA emergency department. Separate written informed consent was required for confirmatory testing. In a secondary analysis, we compared participants with reactive results who did and did not complete confirmatory testing to identify factors associated with refusal to complete the confirmation protocol. PRINCIPAL FINDINGS: Thirteen of 62 (21.0%, 95% CI (11.7%, 33.2% participants with reactive rapid HIV tests refused confirmation; women, younger participants, African Americans, and those with fewer HIV risks, with lower income, and without primary care doctors were more likely to refuse. We projected that up to four true HIV cases were lost at the confirmation stage. CONCLUSIONS: These findings underscore the need to better understand the factors associated with refusal to confirm reactive HIV testing and to identify interventions that will facilitate confirmatory testing and linkage to care among these populations. TRIAL REGISTRATION: NCT00502944; NCT01258582.

  4. Choosing none of the above: Persistence of negativity after group discussion and group decision refusal

    NARCIS (Netherlands)

    Nijstad, B.A.


    Within psychology and other disciplines, group decision making is a much-studied topic. However, the conditions in which groups do not decide but rather refuse to choose among available options have not been studied systematically. This research begins to fill this void, studying the effects of the

  5. Choosing none of the above : Persistence of negativity after group discussion and group decision refusal

    NARCIS (Netherlands)

    Nijstad, Bernard A.


    Within psychology and other disciplines, group decision making is a much-studied topic. However, the conditions in which groups do not decide but rather refuse to choose among available options have not been studied systematically. This research begins to fill this void, studying the effects of the

  6. Psychological Factors behind Truancy, School Phobia, and School Refusal: A Literature Study (United States)

    Ek, Hans; Eriksson, Rikard


    Truancy is a problem that normally leads to treatment interventions within different organizations. Within these organizations different perspectives on the causes and consequences of the above problem can be found. The purpose of this literature study is to map out and describe the current state of research within the fields of school refusal,…

  7. High quality coal extraction and environmental remediation of fine coal refuse ponds using advanced cleaning technologies

    Energy Technology Data Exchange (ETDEWEB)

    Honaker, R.Q.; Mohanty, M.K.; Patwardhan, A. [Department of Mining Engineering, Southern Illinois University-Carbondale, Carbondale, Illinois (United States)


    A vast number of coal refuse ponds represent a significant economical resource base that are also considered to be environmentally harmful. Significant amounts of cleanable fine coal generally exist in the refuse ponds due to the inability of conventional technologies to effectively separate the fine coal from the associated gangue particles. In addition, acid generation, generally a result of pyrite oxidation, has potential to adversely affect the surrounding environment. An integrated processing strategy of simultaneously recovering high quality coal and pyrite-rich products from the treatment of a coal refuse pond slurry has been successfully evaluated using an advanced physical cleaning circuit. A clean coal product having ash and pyritic sulfur contents of 10.1% and 0.41% was recovered with a mass yield of nearly 49%. In addition, a pyrite-rich product containing nearly 83% of the coal pyrite particles present in the refuse pond material was generated for neutralization purposes for the environmental remediation of the slurry pond. 4 refs.

  8. A Study on the Perception of Jordanian EFL Learners’ Pragmatic Transfer of Refusals

    Directory of Open Access Journals (Sweden)

    Ibrahim Fathi Huwari


    Full Text Available This study investigates the perception of Jordanian EFL learners’ (JEFL pragmatic transfer of refusal strategies in terms of contextual and cultural factors. Data were collected using a discourse completion test (DCT and a scaled-response questionnaire (SRQ to elicit perception data from the participants. Data from the SRQ were analyzed based on the speaker’s right to refuse the initiating act. Findings revealed that the right the speaker has to refuse the initiating act was assigned high ratings by the three groups (i.e., M > 3.00 in all social categories. Individually, however, the groups displayed the rating value differently where the AEL1 group’s perception of the speaker’s right was relatively higher than that of the JEFL and JAL1 groups in all the social categories. The JEFL participants’ negative pragmatic transfer criteria were met in the first and third social categories. The study concludes with a discussion of important directions for future research. Keywords: Perception, Refusal, Pragmatic transfer, Pragmalinguistic transfer, Sociopragmatic transfer

  9. War Memories and the Refusal of Male Dominance in Shakir's "Oh, Lebanon" (United States)

    Al-Momani, Hassan Ali Abdullah


    This study investigates the role of the war memories in the construction of the female gender identity in Evelyin Shakir's "Oh, Lebanon," in which the female protagonist refuses to belong to her Arab identity when she lives in the United States because of the brutal war memories she witnesses in Lebanon. Such memories make the…

  10. Using Food Redistribution to Reduce Packing in Children with Severe Food Refusal (United States)

    Gulotta, Charles S.; Piazza, Cathleen C.; Patel, Meeta R.; Layer, Stacy A.


    Positive- and negative-reinforcement-based procedures typically have targeted acceptance for children with severe food refusal; however, these procedures do not always result in successful swallowing. Once acceptance is achieved, some children expel the food repeatedly or pack (hold or pocket) it in their mouths for extended periods of time. This…

  11. An Alternating Treatments Comparison of Two Intensive Interventions for Food Refusal. (United States)

    Ahearn, William H.; And Others


    The effects of two methods of negative reinforcement on three young children (ages two and three) with developmental delays and chronic food refusal were examined. Physically guiding the child to accept food contingent on noncompliance and nonremoval of the spoon until the child ate were tested. Both treatments were effective; however, parents…

  12. Insulin refusal in Iranian patients with poorly controlled type 2 diabetes mellitus. (United States)

    Ghadiri-Anari, Akram; Fazaelipoor, Zahra; Mohammadi, Seyed Mohammad


    To achieve tight glycemic control in diabetic patients, it may be necessary to introduce insulin therapy much earlier in the disease course. Poor glycemic control is a risk factor for the development of diabetic complications. Many patients require insulin therapy after several years of disease in order to maintain good glycemic control and prevent complications. But many patients do not receive insulin therapy in a timely manner because of a negative appraisal of this treatment. Understanding the cause of this negative attitudes is necessary for better evaluation to overcome for this problem. The purpose of this study was to evaluate the reasons for insulin refusal among patients with type 2 diabetes. This is a descriptive cross-sectional study from Yazd Diabetes Research Center. 400 patients with type 2 diabetes who had an HbA1c ≥8.0% despite optimal oral therapy were identified that participated in this study. Data were obtained by patient interview using validated questionnaires. This study showed that Insulin refusal was common. 77% of participant reported being unwilling to take insulin if prescribed. Fear of injection is an important cause for insulin refusal among patients. Insulin refusal is an important problem among our patients with type 2 diabetes mellitus. Findings of this study suggest that interventions aimed at increasing insulin use should focus on injection-related concerns, education and correction of misconceptions.

  13. Insulin refusal in Iranian patients with poorly controlled type 2 diabetes mellitus.

    Directory of Open Access Journals (Sweden)

    Akram Ghadiri-Anari


    Full Text Available To achieve tight glycemic control in diabetic patients, it may be necessary to introduce insulin therapy much earlier in the disease course. Poor glycemic control is a risk factor for the development of diabetic complications. Many patients require insulin therapy after several years of disease in order to maintain good glycemic control and prevent complications. But many patients do not receive insulin therapy in a timely manner because of a negative appraisal of this treatment. Understanding the cause of this negative attitudes is necessary for better evaluation to overcome for this problem. The purpose of this study was to evaluate the reasons for insulin refusal among patients with type 2 diabetes. This is a descriptive cross-sectional study from Yazd Diabetes Research Center. 400 patients with type 2 diabetes who had an HbA1c ≥8.0% despite optimal oral therapy were identified that participated in this study. Data were obtained by patient interview using validated questionnaires. This study showed that Insulin refusal was common. 77% of participant reported being unwilling to take insulin if prescribed. Fear of injection is an important cause for insulin refusal among patients. Insulin refusal is an important problem among our patients with type 2 diabetes mellitus. Findings of this study suggest that interventions aimed at increasing insulin use should focus on injection-related concerns, education and correction of misconceptions.

  14. [A patient who refused treatment after self-poisoning with paracetamol

    NARCIS (Netherlands)

    Kramers, C.; Jansman, F.G.A.; Droogleever Fortuyn, H.A.


    Two patients, a 20-year-old man and a 33-year-old woman, were admitted with paracetamol poisoning. Both patients refused treatment initially but eventually complied. The man had a paracetamol concentration of 47.5 mg/l 2.5-5.0 h after ingestion, so antidote treatment was not considered necessary. Th

  15. Modern on-line control system for refuse-fueled power plants. Moderne Leittechnik fuer Muellverbrennungsanlage

    Energy Technology Data Exchange (ETDEWEB)

    Grasmueck, L. (Asea Brown Boveri AG, Mannheim (Germany, F.R.)); Klitzke, H.J. (Goepfert und Reimer und Partner, Beratende Ingenieure, Hamburg (Germany, F.R.)); Schumacher, E. (Technische Werke Ludwigshafen am Rhein AG (Germany, F.R.))


    30 years after commissioning a refuse-fueled power plant in Ludwigshafen was retrofitted and extended. A process control system provides an optimal waste combustion and flue gas cleanup. An on-line central strategy, special requirements on waste combustion and solutions are presented in this report. (orig.).

  16. 21 CFR 516.131 - Refuse to file a request for determination of eligibility for indexing. (United States)


    ... eligibility for indexing. 516.131 Section 516.131 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... § 516.131 Refuse to file a request for determination of eligibility for indexing. (a) If a request for determination of eligibility for indexing contains all of the information required by § 516.129, FDA shall...

  17. Reasons Given by High School Students for Refusing Sexually Transmitted Disease Screening (United States)

    Sanders, Ladatra S.; Nsuami, Malanda; Cropley, Lorelei D.; Taylor, Stephanie N.


    Objective: To determine reasons given by high school students for refusing to participate in a school-based noninvasive chlamydia and gonorrhea screening that was offered at no cost to students, using the health belief model as theoretical framework. Design: Cross-sectional survey. Setting: Public high schools in a southern urban United States…

  18. Correlates of Inconsistent Refusal of Unprotected Sex among Armenian Female Sex Workers

    Directory of Open Access Journals (Sweden)

    Karine Markosyan


    Full Text Available This cross-sectional study assessed the prevalence and correlates of inconsistent refusal of unprotected sex among female sex workers (FSWs in Armenia. One hundred and eighteen street-based FSWs between the ages of 20 and 52 completed a questionnaire assessing FSWs’ demographic, psychosocial, and behavioral characteristics. A total of 52.5% (n=62 of FSWs reported inconsistent refusal of unprotected sex with clients in the past 3 months. Logistic regression analysis controlling for participants’ age and education revealed that perceiving more barriers toward condom use (AOR = 1.1; P<0.01, reporting more types of abuse (AOR = 2.1; P<0.01, and setting lower fees for service (AOR = 0.9; P=0.02 significantly predicted inconsistent refusal of unprotected sex. HIV-risk-reduction behavioral interventions tailored to FSWs working in Yerevan Armenia should address the factors identified in this study toward the goal of enhancing refusal of unprotected sex and ultimately preventing acquisition of sexually transmitted infections (STIs including HIV.

  19. The Right of Psychiatric Patients to Refuse Medication: Where Should Social Workers Stand? (United States)

    Bentley, Kia J.


    Addresses differences among competence, commitment, and mental illness; the right to privacy; and the prohibition against cruel and unusual punishment. Reviews professional motivations in relation to both sides of controversy over rights of psychiatric patients to refuse medication. Presents position for social work profession that stands for…

  20. School Factors Associated with School Refusal- and Truancy-Related Reasons for School Non-Attendance (United States)

    Havik, Trude; Bru, Edvin; Ertesvåg, Sigrun K.


    The primary aim of this study was to investigate how students' perceptions of relationships with peers at school and teachers' classroom management are associated with school refusal-related reasons and truancy-related reasons for school non-attendance. The study included controls for emotional stability and relevant parental variables. A student…

  1. Characteristics of H2S emission from aged refuse after excavation exposure. (United States)

    Shen, Dong-Sheng; Du, Yao; Fang, Yuan; Hu, Li-Fang; Fang, Cheng-Ran; Long, Yu-Yang


    Hydrogen sulfide (H2S(g)) emission from landfills is a widespread problem, especially when aged refuse is excavated. H2S(g) emission from aged refuse exposed to air was investigated and the results showed that large amounts of H2S(g) can be released, especially in the first few hours after excavation, when H2S(g) concentrations in air near refuse could reach 2.00 mg m(-3). Initial exposure to air did not inhibit the emission of H2S(g), as is generally assumed, but actually promoted it. The amounts of H2S(g) emitted in the first 2 d after excavation can be very dangerous, and the risks associated with the emission of H2S(g) could decrease significantly with time. Unlike a large number of sulfide existed under anaerobic conditions, the sulfide in aged municipal solid waste can be oxidized chemically to elemental sulfur (but not sulfate) under aerobic conditions, and its conversion rate was higher than 80%. Only microorganisms can oxidize the reduced sulfur species to sulfate, and the conversion rate could reach about 50%. Using appropriate techniques to enhance these chemical and biological transformations could allow the potential health risks caused by H2S(g) after refuse excavation to be largely avoided. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Detection of Sentinel Lymph Nodes in Patients with Papillary Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    Hiroshi Takami


    Conclusions: Sentinel lymph node biopsy may allow discrimination between patients with true lymph-node-negative papillary thyroid carcinoma and those with non-palpable metastatic lymph nodes. It may also be helpful in diagnosing metastases and avoiding unnecessary lymph node dissection in thyroid cancer.

  3. Molecular and functional imaging for detection of lymph node metastases in prostate cancer

    NARCIS (Netherlands)

    Fortuin, A.S.; Rooij, M. de; Zamecnik, P.; Haberkorn, U.; Barentsz, J.


    Knowledge on lymph node metastases is crucial for the prognosis and treatment of prostate cancer patients. Conventional anatomic imaging often fails to differentiate benign from metastatic lymph nodes. Pelvic lymph node dissection is an invasive technique and underestimates the extent of lymph node

  4. Sentinel lymph node biopsy and melanoma: 2010 update Part I. (United States)

    Stebbins, William G; Garibyan, Lilit; Sober, Arthur J


    Sentinel lymph node biopsy for melanoma was introduced in the early 1990s as a minimally invasive method of identifying and pathologically staging regional lymph node basins in patients with clinical stage I/II melanoma. Numerous large trials have demonstrated that sentinel lymph node evaluation has utility in improving accuracy of prognostication and for risk stratifying patients into appropriate groups for clinical trials. However, there remains a great deal of controversy regarding the therapeutic role of removal of the remainder of locoregional lymph nodes should metastatic cells be identified in the sentinel node. This CME article will outline a brief history of the sentinel node concept before reviewing updates in surgical technique, histopathologic evaluation of nodal tissue, and cost effectiveness of sentinel node biopsy. After completing this learning activity, participants should be able to describe the concept of sentinel lymph node biopsy, to discuss the risks and benefits associated with this procedure, and to summarize the role of sentinel lymph node biopsy in management of patients with melanoma. Copyright 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  5. Sentinel lymph node biopsy indications and controversies in breast cancer. (United States)

    Wiatrek, Rebecca; Kruper, Laura


    Sentinel lymph node biopsy (SLNB) has become the standard of care for early breast cancer. Its use in breast cancer has been evaluated in several randomized controlled trials and validated in multiple prospective studies. Additionally, it has been verified that SLNB has decreased morbidity when compared to axillary lymph node dissection (ALND). The technique used to perform sentinel lymph node mapping was also evaluated in multiple studies and the accuracy rate increases when radiocolloid and blue dye are used in combination. As SLNB became more accepted, contraindications were delineated and are still debated. Patients who have clinically positive lymph nodes or core biopsy-proven positive lymph nodes should not have SLNB, but should have an ALND as their staging procedure. The safety of SLNB in pregnant patients is not fully established. However, patients with multifocal or multicentric breast cancer and patients having neoadjuvant chemotherapy are considered candidates for SLNB. However, the details of which specific neoadjuvant patients should have SLNB are currently being evaluated in a randomized controlled trial. Patients with ductal carcinoma in situ (DCIS) benefit from SLNB when mastectomy is planned and when there is a high clinical suspicion of invasion. With the advent of SLNB, pathologic review of breast cancer lymph nodes has evolved. The significance of occult metastasis in SLNB patients is currently being debated. Additionally, the most controversial subject with regards to SLNB is determining which patients with positive SLNs benefit from further axillary dissection.

  6. Fluorescence imaging to study cancer burden on lymph nodes (United States)

    D'Souza, Alisha V.; Elliott, Jonathan T.; Gunn, Jason R.; Samkoe, Kimberley S.; Tichauer, Kenneth M.; Pogue, Brian W.


    Morbidity and complexity involved in lymph node staging via surgical resection and biopsy calls for staging techniques that are less invasive. While visible blue dyes are commonly used in locating sentinel lymph nodes, since they follow tumor-draining lymphatic vessels, they do not provide a metric to evaluate presence of cancer. An area of active research is to use fluorescent dyes to assess tumor burden of sentinel and secondary lymph nodes. The goal of this work was to successfully deploy and test an intra-nodal cancer-cell injection model to enable planar fluorescence imaging of a clinically relevant blue dye, specifically methylene blue along with a cancer targeting tracer, Affibody labeled with IRDYE800CW and subsequently segregate tumor-bearing from normal lymph nodes. This direct-injection based tumor model was employed in athymic rats (6 normal, 4 controls, 6 cancer-bearing), where luciferase-expressing breast cancer cells were injected into axillary lymph nodes. Tumor presence in nodes was confirmed by bioluminescence imaging before and after fluorescence imaging. Lymphatic uptake from the injection site (intradermal on forepaw) to lymph node was imaged at approximately 2 frames/minute. Large variability was observed within each cohort.

  7. Predictors of condom use and refusal among the population of Free State province in South Africa

    Directory of Open Access Journals (Sweden)

    Chandran Thoovakkunon


    Full Text Available Abstract Background This study investigated the extent and predictors of condom use and condom refusal in the Free State province in South Africa. Methods Through a household survey conducted in the Free Sate province of South Africa, 5,837 adults were interviewed. Univariate and multivariate survey logistic regressions and classification trees (CT were used for analysing two response variables ‘ever used condom’ and ‘ever refused condom’. Results Eighty-three per cent of the respondents had ever used condoms, of which 38% always used them; 61% used them during the last sexual intercourse and 9% had ever refused to use them. The univariate logistic regression models and CT analysis indicated that a strong predictor of condom use was its perceived need. In the CT analysis, this variable was followed in importance by ‘knowledge of correct use of condom’, condom availability, young age, being single and higher education. ‘Perceived need’ for condoms did not remain significant in the multivariate analysis after controlling for other variables. The strongest predictor of condom refusal, as shown by the CT, was shame associated with condoms followed by the presence of sexual risk behaviour, knowing one’s HIV status, older age and lacking knowledge of condoms (i.e., ability to prevent sexually transmitted diseases and pregnancy, availability, correct and consistent use and existence of female condoms. In the multivariate logistic regression, age was not significant for condom refusal while affordability and perceived need were additional significant variables. Conclusions The use of complementary modelling techniques such as CT in addition to logistic regressions adds to a better understanding of condom use and refusal. Further improvement in correct and consistent use of condoms will require targeted interventions. In addition to existing social marketing campaigns, tailored approaches should focus on establishing the perceived need

  8. Recurrent ovarian cancer presenting in the right supraclavicular lymph node with isolated metastasis: a case report. (United States)

    Tanaka, Tomohito; Ohmichi, Masahide


    The majority of ovarian cancer recurrences are in the abdomen. However, some cases relapse as isolated lymph node metastases, mostly in pelvic or para-aortic nodes. Peripheral isolated lymph node metastasis is rare. A 69-year-old Japanese woman had recurrent ovarian cancer presenting with isolated right supraclavicular lymph node metastasis. After surgical resection and combination chemotherapy with carboplatin and paclitaxel, her right supraclavicular lymph node completely regressed. Peripheral isolated lymph nodes, including right supraclavicular lymph node, can recur without a macroscopic abdominal lesion. Clinicians should carefully examine peripheral lymph nodes for recurrence.

  9. Recurrent ovarian cancer presenting in the right supraclavicular lymph node with isolated metastasis: a case report

    Directory of Open Access Journals (Sweden)

    Tanaka Tomohito


    Full Text Available Abstract Introduction The majority of ovarian cancer recurrences are in the abdomen. However, some cases relapse as isolated lymph node metastases, mostly in pelvic or para-aortic nodes. Peripheral isolated lymph node metastasis is rare. Case presentation A 69-year-old Japanese woman had recurrent ovarian cancer presenting with isolated right supraclavicular lymph node metastasis. After surgical resection and combination chemotherapy with carboplatin and paclitaxel, her right supraclavicular lymph node completely regressed. Conclusions Peripheral isolated lymph nodes, including right supraclavicular lymph node, can recur without a macroscopic abdominal lesion. Clinicians should carefully examine peripheral lymph nodes for recurrence.

  10. Radiation induced cell loss in rat submandibular gland and its relation to gland function

    NARCIS (Netherlands)

    Zeilstra, LJW; Vissink, A; Konings, AWT; Coppes, RP

    Purpose: To understand early and late radiation-induced loss of function of the submandibular gland, changes in cell number were documented and correlated with data on gland function. Modulation of the radiation effect by sialogogues was used to investigate possible mechanisms of action. Materials

  11. Rescue of salivary gland function after stem cell transplantation in irradiated glands.

    Directory of Open Access Journals (Sweden)

    Isabelle M A Lombaert

    Full Text Available Head and neck cancer is the fifth most common malignancy and accounts for 3% of all new cancer cases each year. Despite relatively high survival rates, the quality of life of these patients is severely compromised because of radiation-induced impairment of salivary gland function and consequential xerostomia (dry mouth syndrome. In this study, a clinically applicable method for the restoration of radiation-impaired salivary gland function using salivary gland stem cell transplantation was developed. Salivary gland cells were isolated from murine submandibular glands and cultured in vitro as salispheres, which contained cells expressing the stem cell markers Sca-1, c-Kit and Musashi-1. In vitro, the cells differentiated into salivary gland duct cells and mucin and amylase producing acinar cells. Stem cell enrichment was performed by flow cytrometric selection using c-Kit as a marker. In vitro, the cells differentiated into amylase producing acinar cells. In vivo, intra-glandular transplantation of a small number of c-Kit(+ cells resulted in long-term restoration of salivary gland morphology and function. Moreover, donor-derived stem cells could be isolated from primary recipients, cultured as secondary spheres and after re-transplantation ameliorate radiation damage. Our approach is the first proof for the potential use of stem cell transplantation to functionally rescue salivary gland deficiency.

  12. Radiation induced cell loss in rat submandibular gland and its relation to gland function

    NARCIS (Netherlands)

    Zeilstra, LJW; Vissink, A; Konings, AWT; Coppes, RP


    Purpose: To understand early and late radiation-induced loss of function of the submandibular gland, changes in cell number were documented and correlated with data on gland function. Modulation of the radiation effect by sialogogues was used to investigate possible mechanisms of action. Materials a

  13. Procedure guidelines for sentinel lymph node diagnosis; Verfahrensanweisung fuer die nuklearmedizinische Waechter-Lymphknoten-Diagnostik

    Energy Technology Data Exchange (ETDEWEB)

    Vogt, H. [Klinikum Augsburg (Germany). Klinik fuer Nuklearmedizin; Schmidt, Matthias [Universitaeten zu Koeln (Germany). Klinik fuer Nuklearmedizin; Bares, R. [Klinik fuer Nuklearmedizin, Tuebingen (DE)] (and others)


    The authors present a procedure guideline for scintigraphic detection of sentinel lymph nodes in malignant melanoma and other skin tumours, in breast cancer, in head and neck cancer, and in prostate and penile carcinoma. Important goals of sentinel lymph node scintigraphy comprise reduction of the extent of surgery, lower postoperative morbidity and optimization of histopathological examination focussing on relevant lymph nodes. Sentinel lymph node scintigraphy itself does not diagnose tumorous lymph node involvement and is not indicated when lymph node metastases have been definitely diagnosed before sentinel lymph node scintigraphy. Procedures are compiled with the aim to reliably localise sentinel lymph nodes with a high detection rate typically in early tumour stages. Radiation exposure is low so that pregnancy is not a contraindication for sentinel lymph node scintigraphy. Even with high volumes of scintigraphic sentinel lymph node procedures surgeons, theatre staff and pathologists receive a radiation exposure <1 mSv/year so that they do not require occupational radiation surveillance. (orig.)

  14. Feasibility of landfill gas as a liquefied natural gas fuel source for refuse trucks. (United States)

    Zietsman, Josias; Bari, Muhammad Ehsanul; Rand, Aaron J; Gokhale, Bhushan; Lord, Dominique; Kumar, Sunil


    The purpose of this paper is to develop a methodology to evaluate the feasibility of using landfill gas (LFG) as a liquefied natural gas (LNG) fuel source for heavy-duty refuse trucks operating on landfills. Using LFG as a vehicle fuel can make the landfills more self-sustaining, reduce their dependence on fossil fuels, and reduce emissions and greenhouse gases. Acrion Technologies Inc. in association with Mack Trucks Inc. developed a technology to generate LNG from LFG using the CO2 WASH process. A successful application of this process was performed at the Eco Complex in Burlington County, PA. During this application two LNG refuse trucks were operated for 600 hr each using LNG produced from gases from the landfill. The methodology developed in this paper can evaluate the feasibility of three LFG options: doing nothing, electricity generation, and producing LNG to fuel refuse trucks. The methodology involved the modeling of several components: LFG generation, energy recovery processes, fleet operations, economic feasibility, and decision-making. The economic feasibility considers factors such as capital, maintenance, operational, and fuel costs, emissions and tax benefits, and the sale of products such as surplus LNG and food-grade carbon dioxide (CO2). Texas was used as a case study. The 96 landfills in Texas were prioritized and 17 landfills were identified that showed potential for converting LFG to LNG for use as a refuse truck fuel. The methodology was applied to a pilot landfill in El Paso, TX. The analysis showed that converting LFG to LNG to fuel refuse trucks proved to be the most feasible option and that the methodology can be applied for any landfill that considers this option.

  15. A kinetic compartment model for evaluating salivary gland scintigraphies

    DEFF Research Database (Denmark)

    Afzelius, Pia; Fuglsang, Stefan


    through a syringe. Time activity curves were generated for each of the four major salivary glands (i.e. the right and left submandibular and right and left parotid glands). Excretion fractions (the fraction of mobilizable radioactivity after administering lemon juice) and the gland activity......-to-thyroid activity ratio were calculated. The data were fitted to both a one- and two-phase uptake model. RESULTS: The median uptake slope and maximal activity were significantly higher in the parotid glands than the submandibular glands (Pparotid glands than...... the submandibular glands (Pparotid glands (Pparotid and submandibular glands. CONCLUSIONS: Tracer accumulation can be represented by a one-phase simple uptake model. The background regions...

  16. Identification of parathyroid glands: anatomical study and surgical implications. (United States)

    Melo, Catarina; Pinheiro, Susana; Carvalho, Lina; Bernardes, António


    While performing thyroid surgery, the unintentional lesion of parathyroid glands and laryngeal nerves results in a profound alteration in patient's quality of life. To minimize thyroid surgery morbidity, the surgeon must have an in-depth knowledge of the thyroid gland morphology and its anatomical relations in the anterior compartment of the neck. This work intended to simulate total thyroidectomies using cadaver parts and isolate fragments that may correspond to parathyroid glands. The thyroid glands and "eventual" parathyroid glands were then submitted to histological study. Ninety-two cadaver parts were used for macroscopic dissection. A total of 242 fragments were isolated, 154 of which were confirmed through histological study to be parathyroid glands. In 36 cases, all "eventual" parathyroid glands isolated during dissection were confirmed through histological verification. In 40 cases, some glands were confirmed. In 16 cases, none of the "eventual" parathyroid glands was confirmed. The 92 thyroid glands isolated during dissection were also submitted to histological study. In 21 thyroid glands, 16 parathyroid glands were identified in the histological cuts: 8 sub-capsular, 8 extra-capsular, 6 intra-thyroidal. There was no statistical difference between the dimensions of the parathyroid glands. Parathyroid gland identification and preservation are sometimes a challenge during thyroid surgery, difficulty that has been demonstrated during dissection of cadaver parts.

  17. Langerhans Cell Histiocytosis of the Thyroid with Multiple Cervical Lymph Node Involvement Accompanying Metastatic Thyroid Papillary Carcinoma (United States)

    Ceyran, A. Bahar; Şenol, Serkan; Bayraktar, Barış; Özkanlı, Şeyma; Cinel, Z. Leyla; Aydın, Abdullah


    A 37-year-old male case was admitted with goiter. Ultrasonography of thyroid showed a 5 cm cystic nodule in the left lobe with a 1.5 cm solid component. Fine needle aspiration biopsy revealed atypia of undetermined significance or follicular lesion. The patient was operated on. The pathological diagnosis was reported as papillary thyroid carcinoma. The immunohistochemical examination showed multiple foci of Langerhans cell histiocytosis involving both lobes. The patient died due to cardiac arrest with respiratory causes in the early postoperative period. Langerhans cell histiocytosis is a rare primary condition which involves abnormal clonal proliferation of Langerhans cells in various tissues and organs. Thyroid involvement is infrequently seen. Although the etiology is unknown, genetic components may be linked to the disease. It is also associated with a family history of thyroid disease. Papillary thyroid carcinoma is the most common malignant epithelial tumor of the thyroid gland. Langerhans cell histiocytosis presenting with papillary thyroid carcinoma is rare. The privilege of our case is langerhans cell histiocytosis of the thyroid with multiple cervical lymph node involvement accompanying cervical lymph node metastatic thyroid papillary carcinoma. PMID:25349760

  18. Primary Mucosa-Associated Lymphoid Tissue Lymphoma of the Salivary Glands: A Multicenter Rare Cancer Network Study

    Energy Technology Data Exchange (ETDEWEB)

    Anacak, Yavuz, E-mail: [Department of Radiation Oncology, Ege University Medical School, Izmir (Turkey); Miller, Robert C. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Constantinou, Nikos [Department of Hematology, Theagenion Cancer Center, Thessaloniki (Greece); Mamusa, Angela M. [Division of Hematology, Armando Businco Cancer Center, Cagliari (Italy); Epelbaum, Ron [Department of Oncology, Rambam Medical Center, Haifa (Israel); Li Yexiong [Department of Radiation Oncology, Cancer Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China); Calduch, Anna Lucas [Servicio de Oncologia Radioterapica, Institut Catala d' Oncologia, Barcelona (Spain); Kowalczyk, Anna [Department of Oncology and Radiotherapy, Medical University of Gdansk (Poland); Weber, Damien C. [Department of Radiation Oncology, Geneva University Hospital (Switzerland); Kadish, Sidney P. [Department of Radiation Oncology, University of Massachusetts Medical School/Center, North Worcester, MA (United States); Bese, Nuran [Department of Radiation Oncology, Istanbul University Cerrahpasa Medical School, Istanbul (Turkey); Poortmans, Philip [Institute Verbeeten, Tilburg (Netherlands); Kamer, Serra [Department of Radiation Oncology, Ege University Medical School, Izmir (Turkey); Ozsahin, Mahmut [Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne (Switzerland)


    Purpose: Involvement of salivary glands with mucosa-associated lymphoid tissue (MALT) lymphoma is rare. This retrospective study was performed to assess the clinical profile, treatment outcome, and prognostic factors of MALT lymphoma of the salivary glands. Methods and Materials: Thirteen member centers of the Rare Cancer Network from 10 countries participated, providing data on 63 patients. The median age was 58 years; 47 patients were female and 16 were male. The parotid glands were involved in 49 cases, submandibular in 15, and minor glands in 3. Multiple glands were involved in 9 patients. Staging was as follows: IE in 34, IIE in 12, IIIE in 2, and IV in 15 patients. Results: Surgery (S) alone was performed in 9, radiotherapy (RT) alone in 8, and chemotherapy (CT) alone in 4 patients. Forty-one patients received combined modality treatment (S + RT in 23, S + CT in 8, RT + CT in 4, and all three modalities in 6 patients). No active treatment was given in one case. After initial treatment there was no tumor in 57 patients and residual tumor in 5. Tumor progression was observed in 23 (36.5%) (local in 1, other salivary glands in 10, lymph nodes in 11, and elsewhere in 6). Five patients died of disease progression and the other 5 of other causes. The 5-year disease-free survival, disease-specific survival, and overall survival were 54.4%, 93.2%, and 81.7%, respectively. Factors influencing disease-free survival were use of RT, stage, and residual tumor (p < 0.01). Factors influencing disease-specific survival were stage, recurrence, and residual tumor (p < 0.01). Conclusions: To our knowledge, this report represents the largest series of MALT lymphomas of the salivary glands published to date. This disease may involve all salivary glands either initially or subsequently in 30% of patients. Recurrences may occur in up to 35% of patients at 5 years; however, survival is not affected. Radiotherapy is the only treatment modality that improves disease-free survival.

  19. Mismatch repair protein deficient endometrioid adenocarcinomas, metastasizing to adrenal gland and lymph nodes: Unusual cases with diagnostic implications

    Directory of Open Access Journals (Sweden)

    Bharat Rekhi


    Full Text Available Recently, certain endometrial carcinomas have been found to be associated with mismatch repair (MMR protein defects/deficiency. A 39-year-old female presented with cough, decreased appetite and significant weight loss since 2 months. Earlier, she had undergone total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH-BSO for endometrioid adenocarcinoma. Imaging disclosed an 8 cm-sized adrenal mass that was surgically excised. Histopathology of the adrenal tumor, endocervical tumor, and endometrial biopsy revealed Federation of Gynecology and Obstetrics (FIGO Grade II to III endometrioid adenocarcinoma. By immunohistochemistry, tumor cells were positive for cytokeratin 7, epithelial membrane antigen, PAX8, MLH1 and PMS2 while negative for estrogen receptor (ER, progesterone receptor (PR, MSH2 and MSH6. She underwent adjuvant radiotherapy and chemotherapy. A 34-year-old lady presented with vaginal bleeding since 9 months. She underwent TAH-BSO, reported as FIGO Grade III endometrioid adenocarcinoma. By immunohistochemistry, tumor cells were negative for ER, PR, MLH1, and PMS2 while positive for MSH2 and MSH6. She underwent adjuvant radiotherapy and chemotherapy. However, she developed multiple nodal and pericardial metastases and succumbed to the disease within a year post-diagnosis. Certain high-grade endometrioid adenocarcinomas occurring in younger women are MMR protein deficient and display an aggressive clinical course. Adrenal metastasis in endometrial carcinomas is rare.

  20. Canine Trichomonas tenax mandibular gland infestation. (United States)

    Szczepaniak, Klaudiusz; Łojszczyk-Szczepaniak, Anna; Tomczuk, Krzysztof; Skrzypek, Tomasz; Lisiak, Barbara; Abd-Al-Hammza Abbass, Zahrai


    Several species of trichomonads are intestinal or urogenital parasites of humans and animals, with only a few species typically being located in the oral cavity. The prevalence of oral trichomoniasis in dogs is approximately 15-25 %, although the prevalence varies among different populations and depends on age, sex and the health of the oral cavity. A case of mandibular gland infestation by trichomonads in a 13-year-old female Dachshund with advanced periodontal disease and oral trichomoniasis is reported. The dog was referred due to a history of a painless swelling over the left submandibular region that increased in size over time. Based on physical and ultrasound examinations, a final diagnosis of mandibular gland cyst was established and transcutaneous needle aspiration was carried out. Numerous mobile trophozoites of trichomonads were found by microscopy and culturing for trichomonas was performed. The species was finally characterized as Trichomonas tenax by polymerase chain reaction and sequencing. Studies have shown that T. tenax can be found in humans in atypical locations such as the salivary glands and upper and lower respiratory tracts. According to our knowledge this is the first report of T. tenax being present in the salivary glands of a dog. Because of the relatively high prevalence of trichomoniasis in dogs with periodontal diseases, these parasites should be considered together with bacterial and viral agents in salivary gland infections, especially in individuals with compromised oral health.

  1. Management of the thyroid gland during laryngectomy. (United States)

    Li, S X; Polacco, M A; Gosselin, B J; Harrington, L X; Titus, A J; Paydarfar, J A


    This study aimed to: describe the incidence of thyroid gland involvement in advanced laryngeal cancer, analyse patterns of spread to the thyroid and elucidate predictors of thyroid involvement. A retrospective review was performed on patients who underwent laryngectomy from 1991 to 2015 as a primary or salvage treatment for squamous cell carcinoma of the larynx, hypopharynx or base of tongue. The incidence of thyroidectomy during total laryngectomy, type of thyroidectomy, incidence of gland involvement, route of spread, and positive predictors of spread were analysed and reported. A total of 188 patients fit the inclusion criteria. Of these, 125 (66 per cent) underwent thyroidectomy. The thyroid was involved in 10 of the 125 patients (8 per cent), 9 by direct extension and 1 by metastasis. Cartilage invasion was a predictor of thyroid gland involvement, with a positive predictive value of 26 per cent. There is a low incidence of thyroid gland involvement in laryngeal carcinoma. Most cases of gland involvement occurred by direct extension. Thyroidectomy during laryngectomy should be considered for advanced stage tumours with cartilage invasion.

  2. Occurrence of antennal glands in ants. (United States)

    Renthal, Robert; Velasquez, Daniel; Olmos, David; Vinson, S Bradleigh


    A previous report of the discovery of exocrine glands in the antennal club of queens and workers of Solenopsis invicta Buren, 1972 left open the question of the extent to which similar glands occur in the Formicidae family. We wanted to know if these antennal glands are unique to Solenopsis, or they are found in a wider taxonomic group. Using scanning electron microscopy, we examined the antennae of 41 ant species. Presence of the antennal glands was indicated by a characteristic circumferential ring of pores in a distal antennal segment of workers. Pores were found in the 9th antennal segment of all 26 species of Solenopsis examined. Pores were absent in the following: Monomorium minimum, M. pharaonis, Pheidole sp., Crematogaster sp., Linepithema humile, Forelius sp., Dorymyrmex sp., Paratrechina sp., Oecophylla smaragdina, Campanotus sp., Ectatomma ruidum, E. tuberlatum, and Pseudomyrmex ferruginea. However, pores were found in the antennal club of Tetramorium bicarinatum workers and queens. After KOH digestion of T. bicarinatum antennae, internal canals were observed in both workers and queens, and the canals are connected to spherical reservoirs in queens. T. bicarinatum was the only non-Solenopsis species examined, which showed evidence for antennal glands in the distal funiculus.

  3. Occurrence of Antennal Glands in Ants (United States)

    Renthal, Robert; Velasquez, Daniel; Olmos, David; Vinson, S. Bradleigh


    A previous report of the discovery of exocrine glands in the antennal club of queens and workers of Solenopsis invicta Buren, 1972 (Isidoro et al., Insectes Sociaux 47: 236-240, 2000) left open the question of the extent to which similar glands occur in the Formicidae family. We wanted to know if these antennal glands are unique to Solenopsis, or if they are found in a wider taxonomic group. Using scanning electron microscopy, we examined the antennae of 41 ant species. Presence of the antennal glands was indicated by a characteristic circumferential ring of pores in a distal antennal segment of workers. Pores were found in the 9th antennal segment of all 26 species of Solenopsis examined. Pores were absent in the following: Monomorium minimum, M. pharaonis, Pheidole sp., Crematogaster sp., Linepithema humile, Forelius sp., Dorymyrmex sp., Paratrechina sp., Oecophylla smaragdina, Campanotus sp., Ectatomma ruidum, E. tuberlatum, and Pseudomyrmex ferruginea. However, pores were found in the antennal club of Tetramorium bicarinatum workers and queens. After KOH digestion of T. bicarinatum antennae, internal canals were observed in both workers and queens, and the canals connected to spherical reservoirs in queens. T. bicarinatum was only non-Solenopsis species examined which showed evidence for antennal glands in the distal funiculus. PMID:18655135

  4. [Morphofunctional and molecular bases of pineal gland aging]. (United States)

    Khavinson, V Kh; Lin'kova, N S


    The review analyzed morphology, molecular and functional aspects of pineal gland aging and methods of it correction. The pineal gland is central organ, which regulates activity of neuroimmunoendocrine, antioxidant and other organisms systems. Functional activity of pineal gland is discreased at aging, which is the reason of melatonin level changing. The molecular and morphology research demonstrated, that pineal gland hadn't strongly pronounced atrophy at aging. Long-term experience showed, that peptides extract of pineal gland epithalamin and synthetic tetrapeptide on it base epithalon restored melatonin secretion in pineal gland and had strong regulatory activity at neuroimmunoendocrine and antioxidant organism systems.

  5. Aplasia of the parotid glands with accessory parotid tissue

    Energy Technology Data Exchange (ETDEWEB)

    Higley, Meghan J.; Walkiewicz, Thomas W.; Miller, Jeffrey H.; Curran, John G.; Towbin, Richard B. [Phoenix Children' s Hospital, Department of Radiology, Phoenix, AZ (United States)


    Congenital absence of the parotid gland is a rare entity. Absence is most commonly unilateral, and is not associated with accessory glandular tissue. In the majority of reported cases, parotid gland aplasia is seen with craniofacial abnormalities or hypoplasia of other ectodermal structures, particularly the lacrimal glands. We present a 14-year-old male with bilateral parotid gland aplasia detected incidentally on MRI of the brain and then confirmed on neck CT. The studies also revealed accessory parotid tissue superficial to the left masseter muscle. There were no associated craniofacial abnormalities. The lacrimal glands and submandibular glands were normal. (orig.)

  6. Popliteal lymph node metastasis of tibial osteoblastic osteosarcoma. (United States)

    Dirik, Yalın; Çınar, Arda; Yumrukçal, Feridun; Eralp, Levent


    We report a case with lymph node metastasis of osteosarcoma, which is a rare entity in comparison to hematogeneous lung or bone metastasis. Twenty-seven years old male patient referred to our clinic complaining of ongoing left knee pain and swelling since one month without a history of prior trauma. Magnetic resonance imaging (MRI) revealed a mass of malignant nature which causes more prominent expansion and destruction of the bone distally with periosteal reaction. A lymphadenomegaly 16mm×13mm in diameter was also present in the popliteal fossa having the same signal pattern with the primary lesion. Thirteen weeks following the first referral of the patient, wide resection and reconstruction with modular tumor prosthesis was performed. Popliteal lymph node was excised through the same incision. Pathologic examination of the resected speciman reported osteoblastic osteosarcoma. The lymph node extirpated from the popliteal fossa was reported to be a metastasis of the primary tumor. Osteosarcoma of the long bones is the most common primary malignant bone neoplasm of both childhood and adulthood. Osteosarcomas commonly metastasize hematogeneously to the lungs and bones. Lymph node metastasis is a rare entity. Similar studies report rates between 2.3% and 4%. It is not clearly explained, how lymph node metastasis in osteosarcoma occurs despite lack of lymphatic drainage in normal cortical and spongious bone. 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. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. Number of Lymph Nodes Harvested From a Mediastinal Lymphadenectomy (United States)

    Allen, Mark S.; Decker, Paul A.; Ballman, Karla; Malthaner, Richard A.; Inculet, Richard I.; Jones, David R.; McKenna, Robert J.; Landreneau, Rodney J.; Putnam, Joe B.


    Background: Lymph node status is a major determinant of stage and survival in patients with lung cancer; however, little information is available about the expected yield of a mediastinal lymphadenectomy. Methods: The American College of Surgeons Oncology Group Z0030 prospective, randomized trial of mediastinal lymph node sampling vs complete mediastinal lymphadenectomy during pulmonary resection enrolled 1,111 patients from July 1999 to February 2004. Data from 524 patients who underwent complete mediastinal lymph node dissection were analyzed to determine the number of lymph nodes obtained. Results: The median number of additional lymph nodes harvested from a mediastinal lymphadenectomy following systematic sampling was 18 with a range of one to 72 for right-sided tumors, and 18 with a range of four to 69 for left-sided tumors. The median number of N2 nodes harvested was 11 on the right and 12 on the left. A median of at least six nodes was harvested from at least three stations in 99% of patients, and 90% of patients had at least 10 nodes harvested from three stations. Overall, 21 patients (4%) were found to have occult N2 disease. Conclusions: Although high variability exists in the actual number of lymph nodes obtained from various nodal stations, complete mediastinal lymphadenectomy removes one or more lymph nodes from all mediastinal stations. Adequate mediastinal lymphadenectomy should include stations 2R, 4R, 7, 8, and 9 for right-sided cancers and stations 4L, 5, 6, 7, 8, and 9 for left-sided cancers. Six or more nodes were resected in 99% of patients in this study. Trial registry:; No.: NCT00003831; URL: PMID:20829340

  8. Aedes aegypti salivary gland extract ameliorates experimental inflammatory bowel disease. (United States)

    Sales-Campos, Helioswilton; de Souza, Patricia Reis; Basso, Paulo José; Ramos, Anderson Daniel; Nardini, Viviani; Chica, Javier Emílio Lazo; Capurro, Margareth Lara; Sá-Nunes, Anderson; de Barros Cardoso, Cristina Ribeiro


    Current therapies for inflammatory bowel disease (IBD) are not totally effective, resulting in persistent and recurrent disease for many patients. Mosquito saliva contains immunomodulatory molecules and therein could represent a novel therapy for IBD. Here, we demonstrated the therapeutic activity of salivary gland extract (SGE) of Aedes aegypti on dextran sulfate sodium (DSS)-induced colitis. For this purpose, C57BL/6 male mice were exposed to 3% DSS in drinking water and treated with SGE at early (days 3-5) or late (days 5-8) time points, followed by euthanasia on days 6 and 9, respectively, for sample collection. The results showed an improvement in clinical disease outcome and postmortem scores after SGE treatment, accompanied by the systemic reduction in peripheral blood lymphocytes, with no impact on bone marrow and mesenteric lymph nodes cellularity or macrophages toxicity. Moreover, a local diminishment of IFN-γ, TNF-α, IL-1β and IL-5 cytokines together with a reduction in the inflammatory area were observed in the colon of SGE-treated mice. Strikingly, early treatment with SGE led to mice protection from a late DSS re-challenging, as observed by decreased clinical and postmortem scores, besides reduced circulating lymphocytes, indicating that the mosquito saliva may present components able to prevent disease relapse. Indeed, high performance liquid chromatography (HPLC) experiments pointed to a major SGE pool fraction (F3) able to ameliorate disease signs. In conclusion, SGE and its components might represent a source of important immunomodulatory molecules with promising therapeutic activity for IBD.

  9. Refuse-derived fuels and fuel preparation plants of proven quality from REMONDIS; Guetegesicherte Sekundaerbrennstoffe und Brennstoffanlagen von REMONDIS

    Energy Technology Data Exchange (ETDEWEB)

    Fendel, A. [Remondis AG und Co. KG, Luenen (Germany); Glorius, T. [Remondis Trade and Sales, Essen (Germany)


    Efforts to conserve resources have been reinvigorated by a number of factors, including the interest of various waste-producing industries in reutilisation and, initially on the part of the cement and lime industry but later also power plant operators, the search for a quantitatively and qualitatively reliable source of less expensive refuse-derived fuels of the greatest possible homogeneity. Other factors that have stimulated the demand for partially biogenic refuse-derived fuels have been the requirements imposed for the purpose of reducing climatically harmful emissions in accordance with the Kyoto Treaty and the now established market for CO{sub 2} emission trading. Rising primary energy prices are a powerful incentive for operators of power plants and industrial firing installations to lower their energy costs through the use of refuse-derived fuels. The refuse-derived fuel must be brought to a quality level where it can substitute fossil fuels without operational or technical constraints. This applies in particular to power plants and cement and lime works, since these depend on cocombustion. Refuse-derived fuels are therefore subject to very stringent quality requirements. In the ideal case this will result in a refuse-derived fuel whose properties come very close to those of the fuel being substituted. Novel preparation technologies have facilitated the breakthrough of two new generations of refuse-derived fuels, namely BPG registered and SBS registered. The quality requirements agreed upon with the purchasers of these fuels necessitate very extensive and involved preparation processes.

  10. Understanding the reasons for the refusal of cholecystectomy in patients with cholelithiasis: how to help them in their decision? (United States)

    Peron, Adilson; Schliemann, Ana Laura; Almeida, Fernando Antonio de


    Cholelithiasis is prevalent surgical disease, with approximately 60,000 admissions per year in the Unified Health System in Brazil. Is often asymptomatic or oligosymptomatic and major complications arise from the migration of calculi to low biliary tract. Despite these complications are severe and life threatening, some patients refuse surgical treatment. To understand why individuals with cholelithiasis refuse cholecystectomy before complications inherent to the presence of gallstones in the bile duct and pancreatitis occur. To investigate the universe of the justifications for refusing to submit to surgery it was performed individual interviews according to a predetermined script. In these interviews, was evaluate the knowledge of individuals about cholelithiasis and its complications and the reasons for the refusal of surgical treatment. Were interviewed 20 individuals with cholelithiasis who refused or postponed surgical treatment without a plausible reason. To these interviews, was applied the technique of thematic analysis (Minayo, 2006). The majority of respondents had good knowledge of their disease and its possible complications, were well oriented and had surgical indications by their physicians. The refusal for surgery was justified primarily on negative experiences of themselves or family members with surgery, including anesthesia; fear of pain or losing their autonomy during surgery and postoperative period, preferring to take the risk and wait for complications to then solve them compulsorily. The reasons for the refusal to surgical resolution of cholelithiasis were diverse, but closely related to personal (or related persons) negative surgical experiences or complex psychological problems that must be adequately addressed by the surgeon and other qualified professionals.

  11. Predictive Factors for Nonsentinel Lymph Node Metastasis in Patients With Positive Sentinel Lymph Nodes After Neoadjuvant Chemotherapy: Nomogram for Predicting Nonsentinel Lymph Node Metastasis. (United States)

    Ryu, Jai Min; Lee, Se Kyung; Kim, Ji Young; Yu, Jonghan; Kim, Seok Won; Lee, Jeong Eon; Han, Se Hwan; Jung, Yong Sik; Nam, Seok Jin


    Axillary lymph node (ALN) status is an important prognostic factor for breast cancer patients. With increasing numbers of patients undergoing neoadjuvant chemotherapy (NAC), issues concerning sentinel lymph node biopsy (SLNB) after NAC have emerged. We analyzed the clinicopathologic features and developed a nomogram to predict the possibility of nonsentinel lymph node (NSLN) metastases in patients with positive SLNs after NAC. A retrospective medical record review was performed of 140 patients who had had clinically positive ALNs at presentation, had a positive SLN after NAC on subsequent SLNB, and undergone axillary lymph node dissection (ALND) from 2008 to 2014. On multivariate stepwise logistic regression analysis, pathologic T stage, lymphovascular invasion, SLN metastasis size, and number of positive SLN metastases were independent predictors for NSLN metastases (P Samsung Medical Center NAC nomogram was developed to predict the likelihood of additional positive NSLNs. The Samsung Medical Center NAC nomogram could provide information to surgeons regarding whether to perform additional ALND when the permanent biopsy revealed positive findings, although the intraoperative SLNB findings were negative. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Frozen section analysis of sentinel lymph nodes in patients with breast cancer does not impair the probability to detect lymph node metastases

    NARCIS (Netherlands)

    E.V.E. Madsen (Eva V. E.); J. van Dalen (Jan); P.J. van Gorp (Patrick); P.M.P. Van Oort (Poultje M. P.)


    textabstractIntra-operative frozen section analysis (FS analysis) of sentinel lymph nodes (SLNs) in patients with breast cancer can prevent a second operation for axillary lymph node dissection. In contrast, loss of tissue during FS analysis may impair the probability to detect lymph node metastases

  13. Pathophysiology of myoepithelial cells in salivary glands

    Directory of Open Access Journals (Sweden)

    Amisha Ashok Kumar Shah


    Full Text Available Myoepithelial cells (MECs are considered to be a key participant in most salivary gland diseases, particularly tumors. MECs structurally resemble both epithelial cells and smooth muscles. Diagnostic dilemmas caused are due to inadequacy of characterizing the wide spectrum of morphologic and immunologic features which are different for both normal and neoplastic MECs. This article discusses the development, functions and structure of both normal and neoplastic MECs, their staining properties and differences in the morphologic and immunophenotypic properties of the MEC in detail. It also describes the role of MEC in pathogenesis and morphogenesis of various nonneoplastic and neoplastic salivary gland lesions and thereby are responsible for the myriad histopathology of salivary gland tumors.

  14. Cadmium effects on the thyroid gland. (United States)

    Jancic, Snezana A; Stosic, Bojan Z


    Cadmium has been listed as one of the 126 priority pollutants and a category I carcinogen. Carcinogenic effects of cadmium on the lungs, testicles, and prostate are widely recognized, but there has been insufficient research on the effect of cadmium on the thyroid gland. Cadmium has the affinity to accumulate not only in the liver, kidneys, and pancreas but also in the thyroid gland. It has been established that cadmium blood concentration correlates positively with its accumulation in the thyroid gland. Women of fertile age have higher cadmium blood and urine concentrations than men. In spite of its redox inertia, cadmium brings about oxidative stress and damage to the tissue by indirect mechanisms. Mitochondria are considered to be the main intracellular targets for cadmium. Colloid cystic goiter, adenomatoid follicular hyperplasia with low-grade dysplasia and thyroglobulin hypo- and asecretion, and parafollicular cell diffuse and nodular hyperplasia and hypertrophy are often found in chronic cadmium toxicity. © 2014 Elsevier Inc. All rights reserved.

  15. Thyroid gland in chronic obstructive pulmonary disease. (United States)

    Miłkowska-Dymanowska, Joanna; Białas, Adam J; Laskowska, Paulina; Górski, Paweł; Piotrowski, Wojciech J


    The risk of chronic obstructive pulmonary disease (COPD), as well as thyroid diseases increases with age. COPD is a common systemic disease associated with chronic inflammation. Many endocrinological disorders, including thyroid gland diseases are related to systemic inflammation. Epidemiological studies suggest that patients with COPD are at higher risk of thyroid disorders. These associations are not well-studied and thyroid gland diseases are not included on the broadly acknowledged list of COPD comorbidities. They may seriously handicap quality of life of COPD patients. Unfortunately, the diagnosis may be difficult, as many signs are masked by the symptoms of the index disease. The comprehension of the correlation between thyroid gland disorders and COPD may contribute to better care of patients. In this review, we attempt to revise available literature describing existing links between COPD and thyroid diseases.

  16. Osteopontin expression in salivary gland carcinomas

    DEFF Research Database (Denmark)

    Bjørndal, Kristine; Larsen, Stine R; Godballe, Christian;


    J Oral Pathol Med (2010) Background:  In several cancer types, osteopontin (OPN) expression has been correlated with tumor progression and prognosis. Two earlier studies have examined OPN expression in salivary gland carcinomas with contradictory results. Methods:  One hundred and seventy......-five patients with a primary salivary gland carcinoma diagnosed from January 1, 1990 to December 31, 2005 were identified in the local pathology register, Odense University Hospital. Criteria as documented by Allred et al. were used to assess OPN immunostaining that was performed on surgical specimens. Results......:  Osteopontin was expressed in all salivary gland carcinomas. Adenoid cystic carcinomas had the highest mean sum score (7.3) and a significantly higher proportion of carcinomas with high OPN sum score than both mucoepidermoid carcinoma and acinic cell carcinoma. Correlation of OPN expression with known...

  17. The activity of selected glycosidases in salivary gland tumors. (United States)

    Bierc, Marcin; Minarowski, Lukasz; Woźniak, Lukasz; Chojnowska, Sylwia; Knas, Malgorzata; Szajda, Slawomir; Zwierz, Krzysztof


    The monitoring of the patients after salivary gland tumors surgery is an important clinical issue. Still imperfect diagnostic procedures also remain a challenge for searching new sensitive and specific biomarkers of neoplastic processes in salivary glands. The aim of the presented study was an the assessment of the activity of HEX, with its isoforms HEX-A and HEX-B, GLU, GAL, MAN and FUC in salivary gland tumor tissues in comparison to a healthy salivary gland tissues taken during autopsy. A group of 42 patients with benign and malignant salivary gland tumors, aged 25-65 were examined. Fragments of salivary gland tumor tissue, fragments of healthy tissue removed during autopsy, blood serum and saliva were collected from patients with salivary gland tumors and healthy volunteers. In salivary gland tumor tissue the activity of HEX, HEX-A, HEX-B, GAL, FUC was considerably higher than in comparison to healthy salivary gland tissue and ascending trend of activity of GLU, MAN was also noticed. The activity of all lysosomal exoglycosidases in blood serum in patients with salivary gland tumors was considerably higher in comparison to healthy volunteers blood serum. The considerably higher activity of HEX, HEX-A, GLU, GAL, MAN, FUC and descending trend of activity of HEX-B were noticed in saliva of patients with salivary gland tumors in comparison to healthy volunteers. The assessment of HEX in blood serum and saliva of patients with salivary gland tumor can be possibly used in diagnostics and monitoring of salivary glands tumors.

  18. Histological step sectioning of pelvic lymph nodes increases the number of identified lymph node metastases

    DEFF Research Database (Denmark)

    Engvad, Birte; Poulsen, Mads H; Staun, Pia W;


    Pathological examinations of lymph nodes (LN) in prostate cancer patients are handled differently at various institutions. The objective of this study is to provide means to improve the guidelines by examining the impact of step sectioning on LN status in patients with intermediate and high......-risk prostate cancer. Two hundred ten patients who awaited curative indented therapy were included. We first performed a standard pathological examination of the LN, followed by an extended pathological examination of the patients who were LN negative in the standard examination. The extended pathological...... indicate that an extended pathological examination of LN will improve the staging of intermediate- and high-risk prostate cancer patients; however, we acknowledge that it is both costly and time consuming. We do not recommend the use of cytokeratin staining in routine staining because...

  19. Virtual lymph node analysis to evaluate axillary lymph node coverage provided by tangential breast irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Park, Shin Hyung; Kim, Jae Chul; Lee, Jeong Eun; Park, In Kyu [Dept.of Radiation Oncology, Kyungpook National University Hospital, Daegu(Korea, Republic of)


    To investigate the coverage of axillary lymph node with tangential breast irradiation fields by using virtual lymph node (LN) analysis. Forty-eight women who were treated with whole breast irradiation after breast-conserving surgery were analyzed. The axillary and breast volumes were delineated according to the Radiation Therapy Oncology Group (RTOG) contouring atlas. To generate virtual LN contours, preoperative fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) scans with identifiable LN were fused with the CT scans, and the virtual LN contour were delineated on the CT. The median level I and II axillary volume coverage percentages at the VD95% line were 33.5% (range, 5.3% to 90.4%) and 0.6% (range, 0.0% to 14.6%), respectively. Thirty-one LNs in 18 patients were delineated (26 in level I and 5 in level II). In the level I axilla, 84.6% of virtual LNs were encompassed by the 95% isodose line. In the level II axilla, by contrast, none of the virtual LNs were encompassed by the 95% isodose volumes. There was a substantial discrepancy between the RTOG contouring atlas-based axillary volume analysis and the virtual LN analysis, especially for the level I axillary coverage. The axillary volume coverage was associated with the body mass index (BMI) and breast volume. The tangential breast irradiation did not deliver adequate therapeutic doses to the axillary region, particularly those in the level II axilla. Patients with small breast volumes or lower BMI showed reduced axillary coverage from the tangential breast fields. For axillary LN irradiation, individualized anatomy-based radiation fields for patients would be necessary.

  20. Automatic detection and segmentation of lymph nodes from CT data. (United States)

    Barbu, Adrian; Suehling, Michael; Xu, Xun; Liu, David; Zhou, S Kevin; Comaniciu, Dorin


    Lymph nodes are assessed routinely in clinical practice and their size is followed throughout radiation or chemotherapy to monitor the effectiveness of cancer treatment. This paper presents a robust learning-based method for automatic detection and segmentation of solid lymph nodes from CT data, with the following contributions. First, it presents a learning based approach to solid lymph node detection that relies on marginal space learning to achieve great speedup with virtually no loss in accuracy. Second, it presents a computationally efficient segmentation method for solid lymph nodes (LN). Third, it introduces two new sets of features that are effective for LN detection, one that self-aligns to high gradients and another set obtained from the segmentation result. The method is evaluated for axillary LN detection on 131 volumes containing 371 LN, yielding a 83.0% detection rate with 1.0 false positive per volume. It is further evaluated for pelvic and abdominal LN detection on 54 volumes containing 569 LN, yielding a 80.0% detection rate with 3.2 false positives per volume. The running time is 5-20 s per volume for axillary areas and 15-40 s for pelvic. An added benefit of the method is the capability to detect and segment conglomerated lymph nodes.

  1. Mesenteric lymph: the bridge to future management of critical illness. (United States)

    Fanous, Medhat Y Z; Phillips, Anthony J; Windsor, John A


    Toxic factors released from the intestine have been implicated in the pathophysiology of severe acute illness, including acute pancreatitis, trauma and hemorrhagic shock, and burns. Toxic factors in mesenteric lymph may induce an inflammatory systemic response while bypassing the portal circulation and liver. This paper reviews current knowledge of the anatomy, physiology and pathophysiology of mesenteric lymph and focuses on factors influencing its composition and flow, and potential therapeutic interventions. A search of the Ovid MEDLINE database up until the end of January 2006 yielded 1,761 relevant publications, the references of which were then searched manually to identify further related publications. A wide range of factors potentially affecting mesenteric lymph flow and composition were identified. Targeted interventions have been similarly broad, including medical therapy, nutritional support and surgery. Of the available surgical interventions, thoracic duct external drainage has been the most widely studied. This systematic review highlights significant gaps in our present understanding of the role of mesenteric lymph in health and disease. Further research is needed to identify factors responsible for the generation of biologically active mesenteric lymph, the role of agents modulating its flow and composition, the importance of intrinsic pump activity, the potential therapeutic role of lipophilic antioxidant agents, the comparative effects of low-fat enteral nutrition and standard enteral nutrition, and the therapeutic outcomes of thoracic duct ligation versus thoracic duct external drainage.

  2. Mesenteric Lymph: The Bridge to Future Management of Critical Illness

    Directory of Open Access Journals (Sweden)

    Medhat YZ Fanous


    Full Text Available Toxic factors released from the intestine have been implicated in the pathophysiology of severe acute illness, including acute pancreatitis, trauma and hemorrhagic shock, and burns. Toxic factors in mesenteric lymph may induce an inflammatory systemic response while bypassing the portal circulation and liver. This paper reviews current knowledge of the anatomy, physiology and pathophysiology of mesenteric lymph and focuses on factors influencing its composition and flow, and potential therapeutic interventions. A search of the Ovid MEDLINE database up until the end of January 2006 yielded 1,761 relevant publications, the references of which were then searched manually to identify further related publications. A wide range of factors potentially affecting mesenteric lymph flow and composition were identified. Targeted interventions have been similarly broad, including medical therapy, nutritional support and surgery. Of the available surgical interventions, thoracic duct external drainage has been the most widely studied. This systematic review highlights significant gaps in our present understanding of the role of mesenteric lymph in health and disease. Further research is needed to identify factors responsible for the generation of biologically active mesenteric lymph, the role of agents modulating its flow and composition, the importance of intrinsic pump activity, the potential therapeutic role of lipophilic antioxidant agents, the comparative effects of low-fat enteral nutrition and standard enteral nutrition, and the therapeutic outcomes of thoracic duct ligation versus thoracic duct external drainage.

  3. Modeling lymphocyte homing and encounters in lymph nodes

    Directory of Open Access Journals (Sweden)

    Bernaschi Massimo


    Full Text Available Abstract Background The efficiency of lymph nodes depends on tissue structure and organization, which allow the coordination of lymphocyte traffic. Despite their essential role, our understanding of lymph node specific mechanisms is still incomplete and currently a topic of intense research. Results In this paper, we present a hybrid discrete/continuous model of the lymph node, accounting for differences in cell velocity and chemotactic response, influenced by the spatial compartmentalization of the lymph node and the regulation of cells migration, encounter, and antigen presentation during the inflammation process. Conclusion Our model reproduces the correct timing of an immune response, including the observed time delay between duplication of T helper cells and duplication of B cells in response to antigen exposure. Furthermore, we investigate the consequences of the absence of dendritic cells at different times during infection, and the dependence of system dynamics on the regulation of lymphocyte exit from lymph nodes. In both cases, the model predicts the emergence of an impaired immune response, i.e., the response is significantly reduced in magnitude. Dendritic cell removal is also shown to delay the response time with respect to normal conditions.

  4. The Parathyroid Gland and Heart Disease. (United States)

    Brown, Spandana J; Ruppe, Mary D; Tabatabai, Laila S


    The parathyroid glands are critical to maintaining calcium homeostasis through actions of parathyroid hormone (PTH). Recent clinical and molecular research has shown that direct and indirect actions of PTH also affect the heart and vasculature through downstream actions of G protein-coupled receptors in the myocardium and endothelial cells. Patients with disorders of the parathyroid gland have higher incidences of hypertension, arrhythmias, left ventricular hypertrophy, heart failure, and calcific disease which translate into increased cardiac morbidity and mortality. Importantly, clinical research also suggests that early treatment of parathyroid disorders through medical or surgical management may reverse cardiovascular remodeling and mitigate cardiac risk factors.

  5. [Clinical importance of thyroid gland cytology]. (United States)

    Ting, S; Synoracki, S; Bockisch, A; Führer, D; Schmid, K W


    The cytological evaluation of fine needle biopsies (FNB) of the thyroid gland crucially depends on a close cooperation between clinicians and cytopathologists. Scintigraphy, sonography as well as clinical data and patient history are necessary for a correct interpretation of the indications for FNB; moreover, these data are of outstanding importance for cytopathologists for the correct interpretation of the cytomorphological findings. This overview describes the present standards in the acquisition, technical workup and cytopathological interpretation of thyroid gland tissue obtained by FNB, particularly focusing on the rapidly growing relevance of additional molecular pathological investigations to increase the diagnostic accuracy of thyroid FNB.

  6. Pediatric robot-assisted laparoscopic radical adrenalectomy and lymph-node dissection for neuroblastoma in a 15-month-old. (United States)

    Uwaydah, Nabeel I; Jones, Alex; Elkaissi, Mahmoud; Yu, Zhongxin; Palmer, Blake W


    Neuroblastoma (NB) is the most common extra-cranial solid tumor in children and the most common malignancy in infants, with complete resection being curative in low-stage disease. The previous standard of treatment for many abdominal NBs involving the adrenal gland had been open surgery; however, there have been numerous descriptions of the safety and feasibility of a laparoscopic approach to resect adrenal masses in the pediatric population in benign and malignant disease, including improved cosmetic results, decreased length of stay, decreased surgical morbidity, and comparable oncological outcomes to open surgery. Despite these reported advantages over open surgery, the newer robot-assisted laparoscopy (RAL) offers benefits over the conventional laparoscopic approach that could further improve outcomes and expand the use of minimally invasive surgical approaches for pediatric adrenal masses. RAL offers many additional advantages over conventional laparoscopy, such as 3D visualization, increased range of motion of surgical instruments, tremor control, and a shorter learning curve compared with traditional laparoscopic surgery, while still maintaining the advantages of minimally invasive surgery. The body of literature concerning robot-assisted oncological surgery involving the adrenal gland in children is quite small, and to our knowledge no case reports have been published describing robot-assisted removal of an adrenal NB in a pediatric patient. We present our experience and technique of an RAL approach for lymph-node dissection and radical resection of a low-stage NB involving the adrenal gland with no image-defined risk factors in a 15-month-old infant.

  7. Salivary Gland Like Breast Carcinoma/Adenoid Cystic Carcinoma: Case Report. (United States)

    Acar, Turan; Atahan, Murat Kemal; Çelik, Salih Can; Yemez, Kürşat; Ülker, Gülden Ballı; Yiğit, Seyran; Tarcan, Ercüment


    Adenoid cystic carcinoma of the breast constitutes approximately 0.1% of all breast tumors. They can be located in the trachea, bronchus, cervix, lacrimal gland, and skin as well as the breast. Tumors in the breast have better prognoses compared to those in other locations. The diagnosis and treatment planning of this tumor is challenging due to its rare incidence. In this article, we presented a case that was diagnosed with adenoid cystic carcinoma of the breast upon pathology evaluation. A 59-year-old female patient was admitted to our clinic due to a mass in her right breast. Her mammography revealed a 1 cm in diameter mass in the upper outer quadrant of the right breast, which was classified as BIRADS 4C (Breast Imaging Reporting and Data System). On magnetic resonance imaging (MRI) the lesion was also reported as BIRADS 4C. The patient underwent breast conserving surgery (BCS), and the pathology result was reported as adenoid cystic carcinoma of the breast. The patient received chemo-radiotherapy in the postoperative period. Adenoid cystic carcinoma of the breast has been first described in the salivary glands. They can be confused with benign lesions both on physical and radiological examinations. Sentinel lymph node biopsy (SLNB) can be used since axillary metastases are rare. Local recurrence and distant metastases are also very rare. Usually, BCS followed by radiotherapy is adequate to obtain local control. In selected patients with a poor prognosis, chemotherapy and hormonal therapy should be added to the treatment.

  8. Tetrodotoxin secreting glands in the skin of puffer fishes. (United States)

    Kodama, M; Sato, S; Ogata, T; Suzuki, Y; Kaneko, T; Aida, K


    Unique exocrine glands or gland-like structures were found in the skin of several species of puffer fishes of the genus Takifugu. The glands of T. pardalis and T. vermiculare porphyreum consisted only of secretory cells with a large vacuole. These cells were completely enclosed by epithelial cells with developed microfilaments, except at their opening to the lumen. The contents of the large vacuole in the peculiar secretory cell were forced out when the puffer was stimulated. Exocrine glands or gland-like structures with peculiar secretory cells were also found in the skin of T. poecilonotus, T. niphobles and T. vermiculare radiatum. A high concentration of TTX was detected in the gland contents collected directly from live specimens of T. pardalis. We therefore conclude that these glands are TTX secreting glands.

  9. Bilateral choroidal metastasis from carcinoma of the submandibular gland

    Directory of Open Access Journals (Sweden)

    John Sheeja


    Full Text Available Metastatic tumor is the most common uveal malignancy. However, choroidal metastasis from a salivary gland neoplasm is extremely rare. We report a case of bilateral, multifocal choroidal metastasis from carcinoma of the submandibular gland.

  10. Trans*+ing Classrooms: The Pedagogy of Refusal as Mediator for Learning

    Directory of Open Access Journals (Sweden)

    sj Miller


    Full Text Available Gender and sexuality norms, conscribed under cis/heteropatriarchy, have established violent and unstable social and educational climates for the millennial generation of lesbian, gay, bisexual, transgender, intersex, agender/asexual, gender creative, and questioning youth. While strides have been made to make schools more supportive and queer inclusive, schools still struggle to include lesbian, gay, bisexual, transgender*+, intersex, agender/asexual, gender creative, queer and questioning (LGBT*+IAGCQQ-positive curricula. While extensive studies must be done on behalf of all queer youth, this work specifically focuses on how to support classroom teachers to uptake and apply a pedagogy of refusal that attends to the most vulnerabilized population of queer youth to date, those that are trans*+. A pedagogy of refusal will be explored through an evolving theory of trans*+ness, then demonstrated through a framework for classroom application, followed by recommendations for change.

  11. Caesarean Section Refusal in the Irish Courts: Health Service Executive v B. (United States)

    Wade, Katherine


    In the Irish High Court case of Health Service Executive v B, it was held that a competent woman could not be forced to have a caesarean section against her will notwithstanding the fact that her refusal increased the risk of injury and death to both her and her unborn child.1 This case is of particular interest since it is the first reported case on caesarean section refusal in Ireland. This commentary provides a critical analysis of the judgment, focusing on aspects of the law on informed consent and the way in which the judge reached the conclusion that an order for an enforced caesarean section should not be made. It is argued that, while the outcome can be justified, the reasoning appears at times to be unpersuasive. © The Author 2017. Published by Oxford University Press; all rights reserved. For Permissions, please email:

  12. Alcohol expectancy and drinking refusal self-efficacy: a test of specificity theory. (United States)

    Oei, T P; Burrow, T


    Although alcohol expectancy (expectations about the effects of drinking alcohol on one's behavior and mood) and drinking refusal self-efficacy (one's perceived ability to resist drinking in high-risk situations) have consistently been demonstrated to be useful to our understanding of alcohol use and abuse, the specificity of these constructs to alcohol consumption has not been previously demonstrated. Using 161 first-year psychology students and multiple regression analyses this study indicated that alcohol expectancies and drinking refusal self-efficacy were specifically related to quantity of alcohol consumption, but not to caffeine or nicotine intake. These results provide empirical evidence to confirm the theoretical and practical utility of these two cognitive constructs to alcohol research and serve to strengthen the theoretical foundations of alcohol expectancy theory.


    Directory of Open Access Journals (Sweden)



    Full Text Available Power generation from biomass is an attractive technology which utilizes municipal solid waste-based refused derived fuel. In order to explain the behavior of biomass-fired fluidized bed incinerator, biomass sources from refuse derived fuel was co-fired with coal in a 0.15 m diameter and 2.3 m high fluidized bed combustor. The combustion efficiency and carbon monoxide emissions were studied and compared with those from pure coal combustion. This study proved that the blending effect had increased the carbon combustion efficiency up to 12% as compared to single MSW-based RDF. Carbon monoxide levels fluctuated between 200-1600 ppm were observed when coal is added. It is evident from this research that efficient co-firing of biomass with coal can be achieved with minimum modification of existing coal-fired boilers.

  14. Depressive Symptoms and Gambling Behavior: Mediating Role of Coping Motivation and Gambling Refusal Self-Efficacy. (United States)

    Takamatsu, Stephanie K; Martens, Matthew P; Arterberry, Brooke J


    Understanding the variables that contribute to the comorbidity of depression and gambling behaviors is important in developing effective intervention strategies for those who experience gambling-related problems. The purpose of this study was to implement core concepts from Jacob's general theory of addiction and the social cognitive theory in a multiple mediation model. Specifically, we tested two models to examine whether coping motivation and refusal self-efficacy mediated the relationship between depressive symptoms, gambling related problems, and days gambled. Data was collected from 333 undergraduate students at a large public Midwest university, participating in a larger clinical trial. Analyses indicated a direct effect between depressive symptoms and gambling related problems. Depressive symptoms were found to have a significant indirect effect through coping motivation and gambling refusal self-efficacy on gambling related problems and days gambled. These results provide further support regarding the mechanisms through which depressive symptoms may increase risk for problematic gambling behavior.

  15. Performance characteristics of turbo blower in a refuse collecting system according to operation conditions

    Energy Technology Data Exchange (ETDEWEB)

    Jang, C. M.; Kim, D. W. [Korea Institute of Construction Technology, Goyang (Korea, Republic of); Lee, S. Y. [ANST, Seoul (Korea, Republic of)


    A simulator for a refuse collecting system is designed to investigate the performance characteristics of a turbo blower operating at different rotational frequencies. The simulator consists of an air intake, a waste chute, circular duct, waste collector and turbo blower. Experimental measurements and numerical simulation with three-dimensional Navier- Stokes equations have been performed to analyze the performance of the turbo blower. Throughout numerical simulation of the simulator, it is found that the input energy of the blower can be reduced by controlling the rotational frequency of impeller while the efficiency of the blower keeps constant. The required outlet pressure and flow rate of the blower can be also adjusted along the system resistance of the refuse collecting system. Detailed flow characteristics inside the blower are analyzed for different rotational frequencies

  16. Submandibular gland mucocele associated with a mixed ranula. (United States)

    Hze-Khoong, Eugene Poh; Xu, Liqun; Shen, Shukun; Yin, Xuelai; Wang, Lizhen; Zhang, Chenping


    Mucoceles of the submandibular gland are extremely rare pathologic occurrences that present an investigative and management dilemma owing to their clinical indistinguishability from plunging ranulas. Of the few that have been documented, these mucous extravasation cysts involved the submandibular gland alone. We describe perhaps the first case of an extensive submandibular gland mucocele occurring in conjunction with a mixed ranula from the ipsilateral sublingual gland, and discuss the various considerations in the management of such lesions.

  17. Relapse of leprosy presenting as nodular lymph node swelling

    Directory of Open Access Journals (Sweden)

    Kiran K


    Full Text Available Lymphadenopathy is known to be associated with lepromatous leprosy and has also been observed as a feature of type-2 lepra reaction. However, nodular lymph node enlargement is not commonly reported in leprosy patients or as a feature of relapse. We herewith are presenting a case of bacteriological relapse in a patient of lepromatous leprosy treated 22 years before till smear negativity with WHO multidrug therapy (MDT multibacillary type (MB. She presented with prominent nodular swelling of the cervical group of lymph nodes along with generalized lymphadenopathy, which was mistakenly treated as tubercular lymphadenopathy. A diagnosis of late bacteriological relapse of lepromatous leprosy presenting with prominent lymphadenopathy and ENL was made after relevant investigations. The patient was started on treatment with WHO MDT MB (daily dapsone and clofazimine and monthly rifampicin and thalidomide (200 mg/day. Nerve pain regressed within 2 weeks of therapy. The lymph nodal swelling regressed within 3 months of starting treatment.


    Institute of Scientific and Technical Information of China (English)

    刘琳; 李斌; 章文华


    Objective: To assess the value of sentinel lymph node (SLN) localization by lymphoscintigraphy and gamma probe detection in early cervical cancer. Methods: A total of 27 patients with operable invasive early cervical cancer and clinically proved negative pelvic lymph nodes were included in this study. The 99Tcm-dextran of 74 MBq (2 mCi) was injected around the cervix at 2( and 10(. Lymphoscintigraphy and gamma probe detection were used to find the SLN. Results: The SLN was identified in 27 patients. The sensitivity and specificity of the SLN detection to predict the metastasis of the pelvic lymph node were 100% and 100% respectively. Conclusion: Identification of the SLN using radionuclide is feasible and possible in women with early cervical cancer.

  19. Lymph node hemangioma in one-humped camel

    Directory of Open Access Journals (Sweden)

    M.A. Aljameel


    Full Text Available Hemangioma is a benign tumor of blood and lymphatic vessels. It is common in skin, mucosa and soft tissues, and its occurrence in lymph nodes is extremely rare. A 10 year-old she-camel was slaughtered at Nyala slaughterhouse, South Darfur State, Sudan. Grossly, the carcass was emaciated. The left ventral superficial cervical lymph node was enlarged, hard on palpation and protruded outside the body. Its cut surface was dark red in color and measured (18 cm in diameter. Histopathologically, the sections revealed vascular masses were composed of non-encapsulated clusters of small and medium sized with thick and thin-walled, filled with blood, separated by courageous stroma and surrounded by closely packed proliferating capillaries. To the best of our knowledge, this is the first record of the left ventral superficial cervical lymph node hemangioma in a camel in the Sudan.

  20. [The case of carcinoma adenoides cysticum of the tongue, the trachea and the thyroid gland]. (United States)

    Wojdas, Andrzej; Jurkiewicz, Dariusz; Kenig, Dagmara; Rapiejko, Piotr


    We present a case of a 65-year-old female patient who was for the first time admitted to the clinic in 1997 due to a tuber of the tongue root. The removed tuber turned out to be histopatologically a polymorphic adenoma. The patient was re-admitted to the Clinic in 2001 due to a tuber of the tongue and of the oral cavity bottom. The tuber was removed entirely through a central incision, and an apart hypertrophic change has been found on the posterior pharynx wall and in the scar after the tracheostomy carried out during the previous surgery. In all cases carcinoma adenoides cysticum has been found, as well as metastasis into the thyroid gland and the lungs. The patient was qualified for chemotherapy in the Institute of Oncology, which she has been going through periodically every two weeks until now. In 2002 the patient was operated on a small tuber located hypodermically in the scar after the tracheotomy, which was removed. Carcinoma adenoides cysticum was found. In November 2002, during the surgery a tumorous infiltration of the thyroid gland was found comprehending trachea and reaching the mediastenum. In February 2003 the patient was re-admitted to the Clinic due to dyspnoea caused by a significant contraction of the trachea which occurred as a result of a focus of carcinoma adenoides cysticum and significantly enlarged lymph glands near the trachea. The patient was qualified for stent placement in the Institute of Pulmonary Disease and Tuberculosis (Instytut Chorób Płuc i Gruźlicy). The presented case describes an exceptionally aggressive and polyfocal regrowth and transformation of a polymorphic adenoma into cancer.