Sample records for solitary cystic lymph

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

    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.

  2. Sentinel lymph node concept in gastric cancer with solitary lymph node metastasis

    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.

  3. Perpetual dilemma: Pleural or parenchymal/congenital or acquired solitary cystic lesion with fluid level.

    Talwar, Deepak; Jha, Onkar; Sharma, Rahul Kumar; Saxena, Rajat


    Congenital cystic adenomatoid malformations (CCAMs) are rare congenital, nonhereditary developmental anomalies of the lung with unknown etiology. CCAM is predominantly a disorder of infancy with the majority of the cases being diagnosed within the first 2 years of life. When CCAM presents in adults, it represents a diagnostic dilemma and requires careful evaluation. We here report a case of large solitary congenital pulmonary cystic adenomatoid malformation with infection and hemorrhage, which was diagnosed as encysted hydropneumothorax on computerized tomography scans but turned out to be infected pulmonary cystic adenomatoid malformation after surgical excision.

  4. Solitary mediastinal lymph node recurrence after curative resection of colon cancer

    Yasuhiro; Matsuda; Masahiko; Yano; Norikatsu; Miyoshi; Shingo; Noura; Masayuki; Ohue; Keijiro; Sugimura; Masaaki; Motoori; Kentaro; Kishi; Yoshiyuki; Fujiwara; Kunihito; Gotoh; Shigeru; Marubashi; Hirofumi; Akita; Hidenori; Takahashi; Masato; Sakon


    We report two cases of solitary mediastinal lymph node recurrence after colon cancer resection. Both cases had para-aortic lymph node metastasis at the time of initial surgery and received adjuvant chemotherapy for 4 years in case 1 and 18 mo in case 2. The time to recurrence was more than 8 years in both cases. After resection of the recurrent tumor, the patient is doing well with no recurrence for 6 years in case 1 and 4 mo in case 2. Patients should be followed up after colon cancer surgery considering the possibility of solitary mediastinal lymph node recurrence if they had para-aortic node metastasis at the time of initial surgery.

  5. Cystic solitary fibrous tumor arising from the left occipital meninges: a case report

    Oh, Bae Geun; Hwang, Yoon Joon; Cha, Soon Joo; Hur, Gham; Kim, Yong Hoon; Kim, Su Young; Seo, Jung Wook; Lee, Ji Young; Kim, Han Seung [Ilsan Paik Hospital, Inje University, School of Medicine, Goyang (Korea, Republic of)


    Solitary fibrous tumor (SFT) is a benign mesenchymal neoplasm of a spindle-cell origin, and it usually involves the pleura. It's occurrence in various organs of the body has recently been described. Meningeal SFT is very rare. Radiologically, it is a strongly enhancing solid mass and is undistinguishable from fibrous meningioma and hemangiopericytoma. Yet we report here on a case of SFT with massive cystic degeneration that arose from the meninges of the left occipital region.

  6. Seizure recurrence in patients with solitary cystic granuloma or single parenchymal cerebral calcification: a comparative evaluation.

    Sharma, Laxmi Narayan; Garg, Ravindra Kumar; Verma, Rajesh; Singh, Maneesh Kumar; Malhotra, Hardeep Singh


    Solitary cysticercus granuloma and single parenchymal calcified lesion are two common neuroimaging abnormalities in Indian patients with epilepsy. In this study, we evaluated the frequency and predictors of seizure recurrence in patients presenting with new onset epilepsy or single epileptic seizures and these two different imaging findings. We enrolled 115 patients with newly diagnosed epilepsy. All patients were clinically evaluated and were treated with oxcarbazepine. No anti-helminthic treatment was prescribed. The patients were followed up for 6 months. In the solitary cystic granuloma group, repeat computed tomography was done after 6 months. The study included 80 patients with solitary cysticercus granuloma and 35 patients with a single calcified lesion. Twenty (25%) patients with solitary cysticercus granuloma and 12 (34.3%) patients with parenchymal calcified lesion had a seizure recurrence during the study period (p = 0.307). After 6 months, 57 (71.3%) patients in the solitary cysticercus granuloma group demonstrated complete resolution of the granuloma and in 21 (26.2%) patients the granuloma transformed into a calcified lesion. In the solitary cysticercus granuloma group, a family history of seizure, serial seizures and calcification on follow-up neuroimaging (p seizures. In patients with a single parenchymal calcified lesions, electroencephalographic abnormalities and serial seizures (p = seizure recurrence rate was insignificantly higher in patients with calcified lesions than in patients with solitary cysticercosis granulomas. In conclusion, in patients with solitary cysticercus granuloma, a family history of seizures, serial seizures and calcification of the granuloma, and in patients with a calcified brain lesion, electroencephalographic abnormalities, family history of epilepsy and serial seizures were associated with an increased risk of seizure recurrence. Copyright © 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights

  7. Cystic fibrohistiocytic tumor of the lung presenting as a solitary lesion

    gGiorgio Sgarbi


    Full Text Available Cystic fibrohistiocytic tumor of the lung is a rare neoplasm. In many cases it represents a metastasis from a benign or low-grade fibrohistiocytic tumor of the skin, but occasionally it may be primary. Radiologically it usually occurs as a cystic change of multiple pulmonary nodules, and pneumothorax is the most frequent presenting symptom. We present here a 16-year-old man with recurrent right pneumothorax. The patient had no his-tory of cutaneous fibrohistiocytic lesions. He underwent videothoracoscopic right apical segmentectomy, right lower lobe nodulectomy, and pleuroabrasion. Microscopy of the apical segmentectomy showed a cystic fibrohistio-cytic tumor, whereas the nodule of the lower lobe was an intraparenchymal lymph node. The patient is alive with no tumor recurrence. The differential diagnosis includes Langerhans cell histiocytosis, lymphangioleiomyomatosis, pleuropulmonary blastoma, and metastatic endometrial stromal sarcoma. This disease usually occurs with multiple pulmonary cysts and cavitation. This case is the first reported presenting as a single lesion.

  8. Solitary extramedullary plasmacytomas of thyroid in Hashimoto's thyroiditis: Mimicking benign cystic nodule on ultrasonography

    Kwon, Yohan; Kim, Soo Jin; Hur, Joon Ho; Park, Sung Hee; Lee, Sun Jin; Lee, Tae Jin [Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul (Korea, Republic of)


    Solitary extramedullary plasmacytoma (SEP) of the thyroid is uncommon and mostly occur in patients with a Hashimoto's thyroiditis (82%). We present a case on SEP of thyroid in Hashimoto's thyroiditis, which mimics growing benign cystic masses on serial ultrasonography.

  9. Surgical resection of a solitary para-aortic lymph node metastasis from hepatocellular carcinoma

    Junji Ueda; Hiroshi Yoshida; Yasuhiro Mamada; Nobuhiko Taniai; Sho Mineta; Masato Yoshioka; Youichi Kawano


    Lymph node (LN) metastases from hepatocellular carcinoma (HCC) are considered uncommon.We describe the surgical resection of a solitary para-aortic LN metastasis from HCC.A 65-year-old Japanese man with B-type liver cirrhosis was admitted for the evaluation of a liver tumor.He had already undergone radiofrequency ablation,transcatheter arterial chemoemboliza tion,and percutaneous ethanol injection therapy for HCC.Despite treatment,viable regions remained in segments 4 and 8.We performed a right paramedian sectionectomy with partial resection of the left paramedian section of the liver.Six months later,serum concentrations of alpha-fetoprotein (189 ng/mL) and PIVKA-2 (507 mAU/mL) increased.Enhanced computed tomography of the abdomen revealed a tumor (20 mm in diameter) on the right side of the abdominal aorta.Fluorine-18 fluorodeoxyglucose positron emission tomography revealed an increased standard uptake value.There was no evidence of recurrence in other regions.Esophagogastroduodenoscopy and colonoscopy revealed no malignant tumor in the gastrointestinal tract.Para-aortic LN metastasis from HCC was thus diagnosed.We performed lymphadenectomy.Histopathological examination revealed that the tumor was largely necrotic,with poorly differentiated HCC on its surface,which confirmed the suspected diagnosis.After 6 mo tumor marker levels were normal,with no evidence of recurrence.Our experience suggests that a solitary para-aortic LN metastasis from HCC can be treated surgically.

  10. Renal malignant solitary fibrous tumor with single lymph node involvement: report of unusual metastasis and review of the literature

    Mearini E


    Full Text Available Ettore Mearini,1 Giovanni Cochetti,1 Francesco Barillaro,1 Sonia Fatigoni,2 Fausto Roila2 1Department of Medical-Surgical Specialties and Public Health, Division of Urological Andrological Surgery and Minimally Invasive Techniques, University of Perugia, Terni, Italy; 2Medical Oncology, S Maria Hospital, Terni, Italy Abstract: Solitary fibrous tumors are rare mesenchymal spindle cell neoplasms that are usually found in the pleura. The kidneys are an uncommon site and only few cases of renal solitary fibrous tumor exhibit malignant behavior metastasizing to the liver, lung, and bone through the hematogenous pathway. Purpose: To describe the first case of lymph node metastasis from renal solitary fibrous tumor in order to increase the knowledge about the malignant behavior of these tumors. Patients and methods: A 19-year-old female patient had intermittent hematuria for several months without flank pain or other symptoms. A chest and abdomen CT scan was performed and showed a multi-lobed bulky solid mass of 170 × 98 × 120 mm in the left kidney. One day before the surgery, the left renal artery was catheterized and the kidney embolization was performed using a Haemostatic Absorbable Gelatin Sponge and polyvinyl alcohol. We then performed a radical nephrectomy with hilar, para-aortic, and inter-aortocaval lymphadenectomy. Results: Estimated intraoperative blood loss was 200 mL and the operative time was 100 minutes. No postoperative complications occurred. The hospital stay was 7 days long. The histological examination was malignant solitary fibrous tumor of the kidney. Cancerous tissue showed cellular atypia, with an increased mitotic index (up to 7 × 10 hpf. Immunohistochemical analysis showed positive results for CD34, BCL2, partial expression of HBME1, and occasionally of synaptophysin. Histological evaluation confirmed the presence of metastasis in one hilar node. The patient did not receive any other therapy. At 30-month follow-up, the

  11. Risk factors for level V lymph node metastases in solitary papillary thyroid carcinoma with clinically lateral lymph node metastases.

    Yang, Jing; Gong, Yanping; Yan, Shuping; Zhu, Jingqiang; Li, Zhihui; Gong, Rixiang


    The extent of lateral neck dissection (LND) in surgical resection of papillary thyroid carcinoma (PTC) with clinically lateral LNM (LLNM) remains controversial. We aimed to explore the frequency of and risk factors for level V LNM in patients with solitary PTC and clinically LLNM. To analyze the frequency and risk factors for level V LNM, we retrospectively reviewed 220 solitary PTC patients who underwent total thyroidectomy, bilateral central neck dissection, and therapeutic LND. LLNM were present in 82.3% patients, and levels II-V LNM were present in 45.9%, 62.7%, 55.5%, and 12.3% patients, respectively. Ipsilateral level V LNM was significantly associated with tumor size >10 mm, extrathyroidal extension, ipsilateral central LNM ratio ≥50%, and contralateral central LNM (CLNM), bilateral CLNM, and simultaneous levels II-IV LNM. Contralateral CLNM was an independent risk factor for level V LNM. In patients with solitary PTC and clinically LLNM, level V LNM was relatively uncommon. Therefore, routine level V lymphadenectomy may be unnecessary in these patients unless level V LNM is suspected on preoperative examination or associated risk factors, especially contralateral CLNM, are present.

  12. Solitary AFP- and PIVKA-II-producing hepatoid gastric cancer with giant lymph node metastasis.

    Iso, Yukihiro; Sawada, Tokihiko; Shimoda, Mitsugi; Rokkaku, Kyu; Ohkura, Yasuo; Kubota, Keiichi


    A 61-year-old man was admitted to our hospital because of abdominal pain and an abdominal mass. The patient had anemia and elevated serum alpha-fetoprotein (AFP) (9630ng/mL) and PIVKA-II (91mAU/mL) levels. Roentgenographic examination revealed an extra-gastric tumor in the upper abdomen, and gastroscopy revealed Bormann type 2 gastric cancer in the lower portion of the stomach. The preoperative diagnosis was synchronous gastric cancer and hepatocellular carcinoma (HCC), and surgery was performed. The extra-gastric tumor appeared to be an extra-hepatically growing HCC because the tumor was fed by vessels ramifying from the umbilical portion of the liver. Distal gastrectomy with resection of the extra-gastric tumor was performed, and histological examination of the resected specimen revealed that the gastric cancer was an AFP-producing hepatoid gastric adenocarcinoma and that the extra-gastric tumor was a lymph node metastasis. AFP-producing hepatoid gastric adenocarcinoma tends to metastasize to the regional lymph nodes and form a giant tumor. A giant tumor in the upper abdomen associated with gastric cancer may therefore be a clinical manifestation of AFP-producing hepatoid gastric adenocarcinoma.

  13. Solitary axillary lymph node metastasis without breast involvement from ovarian Cancer: Case report and brief literature review

    Choi, Ji In; Kim, Soo Jin; Park, Sung Hee; Kim, Hee Sung [Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul (Korea, Republic of)


    Axillary lymph node metastasis without breast involvement from ovarian cancer is rare. We report a case of a 68-year-old woman proven as ovarian serous papillary carcinoma and metastatic papillary carcinoma of the omentum on surgical diagnostic laparoscopy. In addition, a hypermetabolic lymph node was detected in left axilla and was considered a reactive benign lesion. Mammography and ultrasonography showed no focal lesion in both breasts, but ultrasonography-guided core needle biopsy for the lymph node revealed metastatic serous papillary carcinoma from ovarian origin. Even with a low incidence of axillary lymph node metastasis without breast involvement from ovarian cancer and only marginally elevated standardized uptake value in positron emission tomography, the possibility of metastasis at axillary lymph node in patients with known primary ovarian cancer must be considered.

  14. Well-differentiated pancreatic neuroendocrine tumor with solitary hepatic metastasis presenting as a benign cystic mass: A case report

    Ahn, Su Joa; Choi, Seung Joon; Kim, Hyung Sik; Kim, Jeong Ho; Choi, Hye Young [Dept. of Radiology, Gachon University Gil Hospital, Incheon (Korea, Republic of)


    Pancreatic neuroendocrine tumors and their hepatic metastases have an inconsistent appearance with only a small percentage of lesions appearing as cystic masses in computed tomography (CT) and magnetic resonance imaging (MRI). Therefore, they can be mistaken as benign or infectious lesions, which can lead to a false diagnosis with delayed or inadequate treatment. We reported a patient with upper abdominal pain that lasted for several months, caused by a huge cystic neuroendocrine carcinoma of the liver. This was mistakenly interpreted as a complicated or hydatid cyst, and the findings in the CT and MRI was presented.

  15. Primary adenoid cystic carcinoma of the skin metastatic to the lymph nodes: immunohistochemical study of a new case and literature review.

    Rocas, Delphine; Asvesti, Catherine; Tsega, Artemis; Katafygiotis, Patroklos; Kanitakis, Jean


    Primary cutaneous adenoid cystic carcinoma (PCACC) is a rare adnexal skin tumor first described in 1975, of which merely 62 cases have so far been studied in detail and reported in the English literature. PCACC is usually regarded as apocrine in origin/differentiation, but its precise histogenesis is still not well known. PCACC has in most cases a rather indolent course but can produce local recurrences and, more rarely, regional (lymph node) and distant (pulmonary) metastases. We report herein a Greek woman with a long-standing PCACC that grew slowly over several years and produced metastasis in the regional lymph nodes, highlighting the potentially aggressive course of this tumor. The primary and metastatic tumors were studied immunohistochemically and proved to express several (sweat gland-related) antigens (such as keratin 7, epithelial membrane antigen, CD10, and CD117) but neither hormonal receptors nor p63 or Gross Cystic disease Fluid Protein 15. The salient clinicopathologic features of this rare cutaneous adnexal tumor are reviewed.

  16. Incidence of cervical lymph node metastasis and its association with outcomes in patients with adenoid cystic carcinoma

    Amit, Moran; Binenbaum, Yoav; Sharma, Kanika;


    BACKGROUND: The patterns of regional metastasis in adenoid cystic carcinoma (ACC) of the head and neck and its association with outcome is not established. METHODS: We conducted a retrospective multicentered multivariate analysis of 270 patients who underwent neck dissection. RESULTS: The incidence...

  17. Papillary thyroid microcarcinoma in Graves′ disease presenting as a cystic neck mass

    Milind Patil


    Full Text Available The presentation of papillary thyroid microcarcinoma (PTMC as a solitary cystic neck mass is uncommon. Additionally, its association with Graves′ disease is very rare. We report a case of occult PTMC, who presented with a cystic neck mass in the background of Graves′ disease without any goiter. Imaging like ultrasound of neck, single photon emission computed tomography-CT (SPECT-CT, and technetium scan failed to detect any lesion in the thyroid, which was picked up only by the contrast-enhanced computed tomography (CECT of neck. The patient underwent total thyroidectomy with right modified lymph node dissection. Our case highlights the presentation of metastatic PTMC as a differential diagnosis of a cystic neck mass even in a patient with Graves′ disease without any thyroid enlargement.

  18. Pyelo-cystic Reflux in F-18 FDG PET Scan Due to Ureteral Obstruction

    Reyhan, Mehmet [Baskent Univ., Adana (Turkmenistan)


    A 72-year-old woman with a history of cervical cancer was treated with brachytherapy and chemotherapy. Combined F-18 FDG PET/CT performed for restaging demonstrated increased FDG uptake in a hypodense cystic lesion at the posterior part of the right renal cortex and a hypermetabolic soft tissue mass at the right parailiac region suggestive of a metastatic lymph node causing ureteral obstruction. There had been no FDG uptake in the cystic lesion on the FDG PET/CT study performed 1 year before. These findings suggest that the increased FDG uptake in the cystic lesion was caused by pyelocystic reflux due to ureteral obstruction secondary to parailiac lymph node metastasis (Figs. 1 and 2). Several renal lesions may have increased metabolism, such as renal cell carcinoma, lymphoma, oncocytoma, adult Wilms' tumor, angiomyolipoma, metastatic lesions, xanthogranulo-matous pyelonephritis and infected cyst. Most of these lesions are solid. Some infected renal cysts may be FDG avid, but in this situation increased FDG uptake is observed on the wall of the cyst. In our case, FDG uptake was seen in the entire cystic lesion. The patient had no symptoms or laboratory findings related to infection. Cysts are the most common space-occupying lesions of the kidney. The vast majority of these are simple cysts that are usually unilateral and solitary. Simple cysts are asymptomatic, except when complications exist such as hemorrhage, infection or rupture. There have been a few reports on spontaneous communications between renal cysts and the pyelocaliceal system, in most cases involving ruptures of the cysts into the pyelocaliceal system due to increased intracystic pressure caused by bleeding or infection of the cyst. In the present case, the cause of the connection between the cystic cavity and the pyelocaliceal system is the increased pressure in the renal pelvic cavity due to the ureteral obstruction secondary to parailiac lymph node metastasis.

  19. Solitary myeloma with massive extracellular crystalline structures--a case report.

    Kim, Y. G.; Yang, K. H.; Gang, S. J.; Kim, B. K.; Kim, S. M.


    We describe a case of solitary myeloma showing cystic change filled with massive crystalline structures in a 54-year-old woman. A bone X-ray showed a solitary cystic osteolytic lesion in the right iliac bone. Serum and urine protein electrophoresis showed no demonstrable M-protein, and bone-marrow aspirates did not show any myeloma cells. Histologic examination of the tumor revealed aggregation of plasma cells with massive extracellular infiltration of the rhomboid-shaped crystalline structur...

  20. Lymph node metastases from an occult sclerosing carcinoma of the thyroid. A case report.

    Santini, L; Pezzullo, L; D'Arco, E; De Rosa, N; Guerriero, O; Salza, C


    Lymph node metastases from occult thyroid papillary carcinoma are not a rare event. An unusual case of cystic lymph node metastases from this type of carcinoma is reported, suggesting that fine needle aspiration biopsy or frozen section biopsies should always be performed in the presence of a cystic lesion of the neck.

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

    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.

  2. Bumblebees and solitary bees

    Henriksen, Casper Christian I

    Summary: The effects of farming system, flower resources and semi-natural habitats on bumblebees and solitary bees in intensively cultivated landscapes in Denmark were investigated in two sets of studies, in 2011 and 2012. The pan trap colour preferences of bumblebees and solitary bees were also...... assessed. In 2011, bumblebees and solitary bees were trapped in road verges bordering 14 organic (organic sites) and 14 conventional (conventional sites) winter wheat fields. The quantity and quality of local flower resources in the road verge and adjacent field headland were estimated as overall density...... use as a proxy at four different scales (250, 500, 750 and 1000 m). In 2012, the effect of a four-fold larger area of organic arable fields in simple, homogeneous landscapes on bumblebees and solitary bees was investigated in eight circular landscapes (radius 1000 m). Bumblebees and solitary bees were...

  3. Lymph system

    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 ...

  4. Male Breast Adenoid Cystic Carcinoma

    Seung Jin Yoo


    Full Text Available Introduction: Adenoid cystic carcinoma (ACC of the breast is a rare condition, and cases in male patients are even less common. Case: We describe a case of ACC of the breast with axillary lymph node metastasis, disseminated osteolytic bone metastasis and bone marrow involvement in a 41-year-old man. Conclusion: Male breast ACC is an extremely rare malignancy; there can be difficulty in obtaining a final diagnosis. We report this case because of its rarity.

  5. Beneficial effect of combined aspiration and interstitial laser therapy in patients with benign cystic thyroid nodules

    Døssing, H; Bennedbaek, F N; Hegedüs, L


    The aim of this study was to evaluate the effect of combined cyst aspiration and ultrasound-guided interstitial laser photocoagulation (ILP) on recurrence rate and the volume of benign cystic thyroid nodules. 10 euthyroid outpatients with a solitary and cytologically benign partially cystic thyroid...

  6. Brainstem cysticercose simulating cystic tumor lesion: a case report

    Walter O. Arruda


    Full Text Available The authors report the case of a 37 year-old man with a solitary cysticercus cyst in the brainstem (pons successfully removed through a suboccipital craniectomy. Surgery in neurocysticercosis has been indicated in patients with hydrocephalus and/or large cystic lesions. Cystic lesions in the brainstem and spinal cord may have indication for surgery for two reasons: (1 diagnosis; and (2 treatment. Aspects related to differential diagnosis and therapeutic alternatives are discussed.

  7. Adenocarcinoma and infection in a solitary hepatic cyst: A case report

    Ching-Chung Lin; Shee-Chan Lin; Wen-Ching Ko; Kuo-Ming Chang; Shou-Chuan Shih


    Solitary non-parasitic liver cysts are being increasingly diagnosed due to the increased use of abdominal sonography. The majority of solitary liver cysts are asymptomatic; however, there are some complications which include infection, perforation, spontaneous hemorrhage, obstructive jaundice and neoplastic degeneration. In some cases a cystic liver lesion may mimic a tumor and is difficult to differentiate with standard imaging studies or fine needle aspiration cytology. Here in, we report a case of adenocarcinoma arising in a solitary hepatic cyst complicated with Klebsiella pneumoniae infection. High levels of CEA in the cyst fluid levels suggested malignancy, which was confirmed by pathology of the resected specimen.

  8. Sentinel Lymph Node Biopsy

    ... 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 ...

  9. Lymph node biopsy

    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 ...

  10. Solitary Tibial Osteolytic Lesion

    Emilios E. Pakos


    Full Text Available We report an unusual case of solitary osteolytic tibial metastasis from a primary endometrial cancer in a 62-year-old woman. The primary cancer was treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy combined with postoperative external beam radiotherapy, while the tibial metastasis was treated with an above knee amputation. The rarity of the case lies on the fact that metastases distally to the elbow and knee are uncommon and endometrial cancer rarely gives distal bone metastases and particularly solitary to the extremities.

  11. Cystic Lung Diseases: Algorithmic Approach.

    Raoof, Suhail; Bondalapati, Praveen; Vydyula, Ravikanth; Ryu, Jay H; Gupta, Nishant; Raoof, Sabiha; Galvin, Jeff; Rosen, Mark J; Lynch, David; Travis, William; Mehta, Sanjeev; Lazzaro, Richard; Naidich, David


    Cysts are commonly seen on CT scans of the lungs, and diagnosis can be challenging. Clinical and radiographic features combined with a multidisciplinary approach may help differentiate among various disease entities, allowing correct diagnosis. It is important to distinguish cysts from cavities because they each have distinct etiologies and associated clinical disorders. Conditions such as emphysema, and cystic bronchiectasis may also mimic cystic disease. A simplified classification of cysts is proposed. Cysts can occur in greater profusion in the subpleural areas, when they typically represent paraseptal emphysema, bullae, or honeycombing. Cysts that are present in the lung parenchyma but away from subpleural areas may be present without any other abnormalities on high-resolution CT scans. These are further categorized into solitary or multifocal/diffuse cysts. Solitary cysts may be incidentally discovered and may be an age related phenomenon or may be a remnant of prior trauma or infection. Multifocal/diffuse cysts can occur with lymphoid interstitial pneumonia, Birt-Hogg-Dubé syndrome, tracheobronchial papillomatosis, or primary and metastatic cancers. Multifocal/diffuse cysts may be associated with nodules (lymphoid interstitial pneumonia, light-chain deposition disease, amyloidosis, and Langerhans cell histiocytosis) or with ground-glass opacities (Pneumocystis jirovecii pneumonia and desquamative interstitial pneumonia). Using the results of the high-resolution CT scans as a starting point, and incorporating the patient's clinical history, physical examination, and laboratory findings, is likely to narrow the differential diagnosis of cystic lesions considerably. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  12. What Causes Cystic Fibrosis?

    ... page from the NHLBI on Twitter. What Causes Cystic Fibrosis? A defect in the CFTR gene causes cystic ... in the severity of the disease. How Is Cystic Fibrosis Inherited? Every person inherits two CFTR genes—one ...

  13. Cystic Fibrosis Research

    ... please turn Javascript on. Feature: Steady Advances Against Cystic Fibrosis Cystic Fibrosis Research Past Issues / Fall 2012 Table of Contents "Remarkable strides in cystic fibrosis research over the past two decades have culminated ...

  14. Solitary midbrain metastasis.

    Ongerboer de Visser, B W; Moffie, D


    The available clinical and pathological data of 5 cases with solitary midbrain metastasis including 2 of the present study are reviewed. Progressive dementia occurred in one case and mild dementia in another who also developed ocular symptoms. Ocular symptoms with sensory and coordination disturbances were seen in one, and only ocular symptoms in another case. Right-sided hemiplegia of 5 years duration occurred in the remaining case. Survival in tegmentum lesions is short.

  15. Cystic changes associated with pulmonary tuberculosis: a case report

    CAI Hou-rong; CAO Min; MENG Fan-qing; LI Wei-chun


    @@ There are a wide range of computed tomography (CT) findings in patients with pulmonary tuberculosis, including diffuse or localized nodules,reticular opacities, ground glass attenuation, air trapping, consolidation, cavitation, fibrosis, lymph nodes enlargement, and septal thickening.1-3However, CT findings of pulmonary tuberculosis that appeared as multiple cystic lesions were very rare.3,4Herein, the CT findings appeared as multiple cystic lesions in a patient with pulmonary tuberculosis are reported.

  16. Solitary intraosseous neurofibroma of mandible.

    Vivek N


    Full Text Available Solitary intraosseous neurofibroma is a rare benign non-odontogenic tumor. Although neurofibromas occur predominantly as a feature of neurofibromatosis affecting the soft tissue, a few cases of solitary intraosseous neurofibromas of the jaw have been reported. We herewith report a case of solitary intraosseous neurofibroma of mandible in a middle-aged woman with a discussion on its clinical, radiological, and histopathological presentation along with review of cases.

  17. Schwannomatosis with Cystic Degeneration Arising from a Single Intercostal Nerve: A Case Report

    Kim, Kun Woo; Lee, Young Kyung [Dept. of Radiology, Kyung Hee University College of Medicine, Seoul (Korea, Republic of); Kim, Dae Hyun [Dept. of Thoracic and Cardiovascular, Kyung Hee Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul (Korea, Republic of); Sung, Dong Wook [Dept. of Radiology, Kyung Hee Medical Center, Kyung Hee University College of Medicine, Seoul (Korea, Republic of)


    An intrathoracic schwannoma is a benign neurogenic tumor that arises from the posterior mediastinum and is commonly found to be solitary. Schwannomatosis that manifests as multiple cysts is extremely rare. In this case study, we report a rare case of a 36-year-old man with no respiratory symptoms, with multiple cystic tumors in the posterior chest wall and pathologically confirmed schwannomatosis with cystic degeneration arising from a single intercostal nerve.

  18. [Treatment outcomes of patients with cervical lymph node recurrence after esophagectomy for esophageal cancer].

    Takemura, Masashi; Kaibe, Nobuaki; Takii, Mamiko; Yoshida, Kayo; Niwa, Hirotaka; Oshima, Tsutomu; Kikuchi, Shoujiro; Sasako, Mitsuru


    Herein, we report the treatment outcomes of patients with limited cervical lymph node recurrence after esophagectomy for esophageal cancer. Between April 2010 and December 2013, 8 patients with cervical lymph nodes recurrence were diagnosed and treated in our department. All patients were detected with recurrent disease by using positron emission tomography computed tomography(PET-CT), and among these, 5 patients had solitary node recurrence. Initial treatments were irradiation therapy in 5 patients and lymphadenectomy in 3 patients. Four of 5 patients underwent irradiation therapy and lymphadenectomy. Four of 5 patients with solitary node recurrence are still alive without relapse of disease. In conclusion, PET-CT can be useful for early detection of recurrent disease after esophagectomy. Appropriate therapy for patients with solitary cervical lymph node recurrence is associated with long-term survival after recurrence.

  19. [Primary Pelvic Cystic Echinococcosis].

    Yaman, İsmail; İnceboz, Ümit; İnceboz, Tonay; Keyik, Bahar; Uzgören, Engin


    Cystic echinococcosis caused by Echinococcus granulosus is still an important health problem in endemic areas. Cystic echinococcosis may involve different organs or areas with the most common sites being the liver and the lungs. Pelvic involvement has previously been reported and was mainly accepted as secondary to cystic echinococcosis in other organs, isolated pelvic involvement is very rare. In this case report, we aimed to present the case with pelvic cystic mass that was finally diagnosed with isolated pelvic cystic echinococcosis in and after the operation, and we would like to draw attention to include "cystic echinococcosis" in the differential diagnosis of pelvic masses.

  20. Solitary eyelid schwannoma

    Renu M Magdum


    Full Text Available Schwannomas are rare benign tumors arising from Schwann cells of peripheral nerves that form the neural sheath. While there have been reports of such tumors in the orbit, solitary schwannomas arising from the eyelids are very rare. There are reports of schwannomas being erroneously diagnosed as chalazion, inclusion cysts or even eyelid malignancy. We are reporting a case of a 20-year-old female who presented with a painless, non-tender, slow-growing mass in the upper eyelid of the right eye. The external appearance of the mass was suggestive of an implantation cyst of the eyelid and it could be completely excised as it had a well-defined capsule. Histopathological examination showed characteristic hypercellular and hypocellular areas with fusiform nuclei that tended to form palisades. The purpose of reporting this case of schwannoma in a young female is to recommend the inclusion of this entity as a differential diagnosis of well-defined lid tumors.

  1. Solitary Polypoid Laryngeal Xanthoma

    Francisco Vera-Sempere


    Full Text Available We report the case of a 51-year-old male smoker with diabetes mellitus and hyperlipidaemia and a long history of human immunodeficiency virus (HIV/hepatitis C virus (HCV infection treated with various antiretroviral regimes, who was referred to the otolaryngology department with progressive dysphonia. Fibre-optic laryngoscopy showed a solitary, yellowish-white pedunculated polyp on the anterior third of the left cord, with no other abnormality. Pathological analysis revealed a polypoid laryngeal xanthoma that was immunoreactive against CD68, perilipin, and adipophilin. This unusual laryngeal lesion in the clinical context of our patient suggests a possible role of antiretroviral treatment in the pathogenesis of these xanthomas.

  2. Solitary fibrous tumor

    Manlio Mencoboni


    Full Text Available Solitary fibrous tumor (SFT is a rare mesenchymal neoplasm which may be found everywhere in the body. It is now distinguished into two forms, pleural and extrapleural, which morphologically resemble each other. Abdomi­nal localizations are quite rare, with 10 cases only reported in bladder; rarely they can be source of paraneoplastic syndromes (i.e., hypoglycemia secondary to insulin-like growth factor. In April 2006 a 74-year-old white male presented with chills, diaphoresis and acute abdominal pain with hematuria. At admission in emergency he underwent an abdominal X-ray (no pathological findings and an ultrasound examination of the kidneys and urinary tract, which revealed a pelvic hyperechogenic neoformation measuring approximately 10¥8¥7 cm, compressing the bladder. Blood chemistry at admission revealed only a mild neutrophilic leucocytosis (WBC 16600, N 80%, L 11%, elevated fibrinogen and ESR, and hypoglycemia (38 mg/dL. Macro­scopic hematuria was evident, while urinocolture was negative. Contrast enhanced CT scan of the abdomen and pelvic region revealed a large round neoformation dislocating the bladder, with an evident contrast-enhanced periphery and a central necrotic area. Continuous infusion of glucose 5% solution was necessary in order to maintain blood glucose levels above 50 mg/dL. The patient underwent complete surgical resection of an ovoidal mass coated by adipose tissue, with well delimited margins; histological findings were consistent with solitary fibrous tumor (SFT. Hypoglycemia resolved completely with removal of the growth. In this case report we describe a SFT growing in the bladder, a quite rare localization, which presented a unique hypoglycemia. In contrast to the majority of cases reported in the literature, the behavior of this SFT was not aggressive, and, since the patient is still alive, surgical resection was considered conclusive.

  3. Solitary myeloma with massive extracellular crystalline structures--a case report.

    Kim, Y G; Yang, K H; Gang, S J; Kim, B K; Kim, S M


    We describe a case of solitary myeloma showing cystic change filled with massive crystalline structures in a 54-year-old woman. A bone X-ray showed a solitary cystic osteolytic lesion in the right iliac bone. Serum and urine protein electrophoresis showed no demonstrable M-protein, and bone-marrow aspirates did not show any myeloma cells. Histologic examination of the tumor revealed aggregation of plasma cells with massive extracellular infiltration of the rhomboid-shaped crystalline structures. In immunoperoxidase staining, both these crystalline structures and the cytoplasms of the myeloma cells demonstrated a positive reaction for lambda light chain. By electron microscope, the large extracellular crystalline structures were observed, and we found unique rhomboid or rectangular-shaped crystalline structures in the cytoplasms of the myeloma cells.

  4. Cystic fibrosis

    Radlović Nedeljko


    Full Text Available Cystic fibrosis (CF is a multisystemic autosomal recessive disease caused by a defect in the expression of CFTR protein, i.e. chloride channel present in the apical membrane of respiratory, digestive, reproductive and sweat glands epithelium. It primarily occurs in the Caucasians, while being considerably or exceptionally rare in persons of other races. Absence, deficit or structural and functional abnormalities of CFTR protein lead to mucosal hyperconcentration in the respiratory, digestive and reproductive systems and malabsorption of chloride and sodium in the sweat glands. Thus, the clinical features of patients’ with CF are predominated by respiratory, digestive and reproductive disorders, as well as the tendency to dehydration in the condition of increased sweating. Beside genotype variations, the degree of disease manifestation is also essentially influenced by various exogenous factors, such as the frequency and severity of respiratory infections, the level of aero-pollution, quality of immunoprophylaxis, patients’ nutritional condition and other. Chloride concentration of over 60 mmol/L in sweat, a high level of immunoreactive chymotrypsinogen in blood and the verification of homozygous mutation of CFTR gene are the basic methods in the diagnostics of the disease. CF belongs to the group of severe and complex chronic diseases, and therefore requires multidisciplinary therapeutic approach. Owing to the improvement of healthcare provision, most patients with CF now survive into adulthood. In addition, their quality of life is also considerably improved.

  5. Learning about Cystic Fibrosis

    ... Testing for Cystic Fibrosis Consensus Development Conference Statement Learning About Cystic Fibrosis What do we know about ... and treatment information. Hosted by the Dolan DNA Learning Center at Cold Spring Harbor Laboratory. What is ...

  6. Cystic fibrosis: case report

    Park, Si Hyun; Lee, Hyun Ju; Kim, Ji Hye; Park, Chol Heui [Gachon Medical School, Inchon (Korea, Republic of)


    Cystic fibrosis is an autosomal recessive genetic disease. Among Caucasians, it is the most common cause of pulmonary insufficiency during the first three decades of life. The prevalence of cystic fibrosis varies according to ethnic origin: it is common among Caucasians but rare among Asians. We report a case in which cystic fibrosis with bronchiectasis and hyperaeration was revealed by high-resolution CT, and mutation of the cystic fibrosis conductance transmembrane regulator gene (CFTR) by DNA analysis.

  7. [Sclerosing hemangioma presenting as a solitary lung nodule. Report of one case].

    Cardemil, Gonzalo; Fernández, Eduardo; Riffo, Paola; Reyes, Diego; Ledezma, Rodrigo; Mira, Magdalena; Morales, Claudia; Salguero, Jorge


    Lung sclerosing hemangioma is an uncommon tumor that presents as a solitary asymptomatic nodule and that affects middle age women. It derives from type II pneumocytes. We report a 52 years old female with a solitary lung nodule detected in a chest X ray requested for the diagnosis of an acute respiratory disease. The nodule was excised by video thoracoscopy and the frozen section biopsy was informed as a non small cell undifferentiated carcinoma. Therefore an inferior right lobectomy with lymph node resection was performed. The definitive biopsy was informed as a lung sclerosing hemangioma.

  8. Blood and Lymph Diseases

    ... 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 ...

  9. Keratocystic odontogenic tumor: A biopsy service’s experience with 104 solitary, multiple and recurrent lesions


    Background Keratocystic odontogenic tumor (KCOT) is a clinically significant cystic lesion of odontogenic origin. This study aimed to retrospectively review and describe the clinicopathologic features of KCOT and to objectively compare the clinical and histological features of solitary, multiple and recurrent KCOT in a Saudi Arabian population. Material and Methods Biopsy request forms, pathology records and archival materials (all histological slides) of 104 cases of KCOT from 75 patients were retrieved. Demographic and clinical details as well as histological evaluation were analyzed and compared between the 3 groups using chi-squared or Mann-Whitney tests of association as appropriate. Results Significant differences were noted in the age of presentation, location and association with impaction between multiple and solitary cases. Histologically, there was a difference in the mitotic count, presence of satellite cysts and proliferating odontogenic epithelium between solitary and multiple lesions. There was no difference between the KCOT that later recurred and solitary lesion which did not recur even when matched clinically for age, sex and location. There were differences when solitary KCOT that later recurred or recurrent KCOT were compared with multiple lesions. Multiple lesions still had more significant proliferative activity parameters than solitary recurrence-related KCOT. Conclusions KCOTs in Saudi Arabians are not different from those reported from other parts of the world. Clinical and histological analyses showed multiple KCOT is different from its solitary recurrent or non-recurrent counterparts and has a higher proliferative activity than both. Clinicohistologic features alone cannot wholly explain the behavior of KCOT. Key words:Descriptive study, keratocystic odontogenic tumor, odontogenic keratocyst, solitary, multiple, recurrent. PMID:27475695

  10. Cavitatory mesenteric lymph node syndrome: A rare entity



    Full Text Available Celiac disease is a gluten sensitive enteropathy that involves an abnormal immunological response to glutens in wheat, rye etc. It predominantly involves the small intestinal mucosa, though, extra luminal manifestations can also occur. One rare extraluminal manifestation is cavitatory mesenteric lymph node syndrome. It occurs in refractory celiac disease and is associated with poor prognosis due to various complications. The diagnosis is often made on imaging when cystic mesenteric lymph nodes with fat-fluid levels are seen and this can then be confirmed by histopathological examination. We recently had a typical case where we were able to make this diagnosis.

  11. How Is Cystic Fibrosis Treated?

    ... page from the NHLBI on Twitter. How Is Cystic Fibrosis Treated? Cystic fibrosis (CF) has no cure. However, ... help oral pancreatic enzymes work better. Treatments for Cystic Fibrosis Complications A common complication of CF is diabetes . ...

  12. Genetics Home Reference: cystic fibrosis

    ... Me Understand Genetics Home Health Conditions cystic fibrosis cystic fibrosis Enable Javascript to view the expand/collapse boxes. Download PDF Open All Close All Description Cystic fibrosis is an inherited disease characterized by the buildup ...

  13. Progression of solitary and multifocal papillary thyroid carcinoma— a retrospective study of 368 patients

    ZHENG Xiang-qian; WANG Chen; XU Meng; YU Yang; YUN Xin-wei; JIA Yong-sheng; WEI Song-feng; REN Xiu-bao; GAO Ming


    Background Papillary thyroid carcinoma (PTC) represents one of the most frequent endocrine malignancies.Several factors have been found to be involved in determining the outcome of treatment for patients with PTC.Large tumor size,diagnosis at an early age,extra-thyroidal invasion,aggressive histological variants,and distant metastases are the most important determinants of a poor outcome.BRAFv600E mutation has been found to be a major genetic alteration in PTC.This study aimed to evaluate progression in patients with multifocal and solitary PTC.Methods We performed a retrospective study to analyze 368 patients with PTC who underwent surgery,including 282 patients with solitary PTC and 86 patients with multifocal PTC.The status of BRAFv600E mutation in all tumor foci from multifocal PTC was detected.Results Our study suggested that multifocal PTC was more related to lymph node metastasis and vascular invasion than solitary PTC.However,the distant metastasis rate and 10-year survival rate showed no difference between these two groups.The number of tumor foci did not affect progression of disease in multifocal PTC patients.Lymph node metastasis in multifocal PTC patients was associated with larger tumors,diagnosis at early stage,and extra-thyroidal invasion.Conclusion The status of BRAFv600E mutation was more frequent in multifocal PTC patients with lymph node metastasis and diagnosis at later age.

  14. Neonatal cystic fibrosis screening test

    Cystic fibrosis screening - neonatal; Immunoreactive trypsinogen; IRT test; CF - screening ... Cystic fibrosis is a disease passed down through families. CF causes thick, sticky mucus to build up in ...

  15. Solitary mastocytoma in an adult

    Jain V


    Full Text Available A 24-year old female developed late onset solitary mastocytoma on the left forearm. She complained of intense pruritus off and on which was not associated with flushing of face and blister formation over the nodule. Darier′s sign was positive. Excisional biopsy was done and histopathology confirmed the diagnosis.

  16. Solitary waves and homoclinic orbits

    Balmforth, N.J.


    The notion that fluid motion often organizes itself into coherent structures has increasingly permeated modern fluid dynamics. Such localized objects appear in laminar flows and persist in turbulent states; from the water on windows on rainy days, to the circulations in planetary atmospheres. This review concerns solitary waves in fluids. More specifically, it centres around the mathematical description of solitary waves in a single spatial dimension. Moreover, it concentrates on strongly dissipative dynamics, rather than integrable systems like the KdV equation. One-dimensional solitary waves, or pulses and fronts as they are also called, are the simplest kinds of coherent structure (at least from a geometrical point of view). Nevertheless, their dynamics can be rich and complicated. In some circumstances this leads to the formation of spatio-temporal chaos in the systems giving birth to the solitary waves, and understanding that phenomenon is one of the major goals in the theory outlined in this review. Unfortunately, such a goal is far from achieved to date, and the author assess its current status and incompleteness.

  17. Morphological analysis of lymph nodes in Odontocetes from north and northeast coast of Brazil.

    De Oliveira e Silva, Fernanda Menezes; Guimarães, Juliana Plácido; Vergara-Parente, Jociery Einhardt; Carvalho, Vitor Luz; De Meirelles, Ana Carolina Oliveira; Marmontel, Miriam; Ferrão, Juliana Shimara Pires; Miglino, Maria Angelica


    The morphology and location of lymph nodes from seven species of Odontocetes, of both sexes and different age groups, were described. All animals were derived from stranding events along the North and Northeastern coasts of Brazil. After the identification of lymph nodes in situ, tissue samples were analyzed for light and electron microscopy. Vascular volume density (VVD) and vascular length density (VLD) were evaluated in the mesenteric lymph nodes. Lymph nodes occurred as solitary nodules or in groups, varying in shape and size. In addition to using the nomenclature recommended by Nomina Anatomica Veterinaria, new nomenclatures were suggested based on the lymph nodes topography. Lymph nodes were covered by a highly vascularized and innervated capsule of dense connective tissue, below which muscle fibers were observed, inconsistently, in all studied species. There was no difference in VLD among different age groups. However, VVD was higher in adults. Lymph nodes parenchyma was divided into an outer cortex, containing lymph nodules and germinal centers; a paracortical region, transition zone with dense lymphoid tissue; and an inner medulla, composed of small irregular cords of lymphatic tissue, blood vessels, and diffuse lymphoid tissue. Abundant collagen fibers were observed around arteries and arterioles. Germinal centers were more evident and developed in calves and young animals, being more discrete and sparse in adults. The morphology of lymph nodes in Odontocetes was typical of that observed in other terrestrial mammals. However, new groups of lymph nodes were described for seven species occurring in the Brazilian coast. Copyright © 2014 Wiley Periodicals, Inc.

  18. Intramammary lymph nodes.

    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.

  19. Cystic Granular Cell Ameloblastoma

    Thillaikarasi, Rathnavel; Balaji, Jayaram; Gupta, Bhawna; Ilayarja, Vadivel; Vani, Nandimandalam Venkata; Vidula, Balachander; Saravanan, Balasubramaniam; Ponniah, Irulandy


    Ameloblastoma is a locally aggressive benign epithelial odontogenic tumor, while unicystic ameloblastoma is a relatively less aggressive variant. Although rare in unicystic or cystic ameloblastoma, granular cell change in ameloblastoma is a recognized phenomenon. The purpose of the present article is to report a case of cystic granular cell ameloblastoma in 34-year old female.

  20. Cooccurrence of Metastatic Papillary Thyroid Carcinoma and Salmonella Induced Neck Abscess in a Cervical Lymph Node

    Kim, Jae-Myung; Jung, Eun Jung; Song, Eun Jin; Kim, Dong Chul; Jeong, Chi-Young; Ju, Young-Tae; Lee, Young-Joon; Hong, Soon-Chan; Choi, Sang-Kyung; Ha, Woo-Song


    Cervical lymph node metastasis is common in patients with papillary thyroid carcinoma (PTC). Salmonella species are rarely reported as causative agents in focal infections of the head and neck. The cooccurrence of lymph node metastasis from PTC and a bacterial infection is rare. This report describes a 76-year-old woman with a cervical lymph node metastasis from PTC and Salmonella infection of the same lymph node. The patient presented with painful swelling in her left lateral neck region for 15 days, and neck ultrasonography and computed tomography showed a cystic mass along left levels II–IV. The cystic mass was suspected of being a metastatic lymph node; modified radical neck dissection was performed. Histopathological examination confirmed the presence of PTC in the resected node and laboratory examination of the combined abscess cavity confirmed the presence of Salmonella Typhi. Following antibiotic sensitivity testing of the cultured Salmonella Typhi, she was treated with proper antibiotics. Cystic lesions in lymph nodes with metastatic cancer may indicate the presence of cooccurring bacterial infection. Thus, culturing of specimen can be option to make accurate diagnosis and to provide proper postoperative management. PMID:28261270

  1. Solitary angiokeratoma of the tongue.

    Sion-Vardy, Netta; Manor, Esther; Puterman, Max; Bodner, Lipa


    Angiokeratoma is a rare cutaneous lesion. It can be either a generalized systemic form, presenting as multiple asymptomatic papules on the skin, associated with metabolic diseases or a solitary cutaneous form. Oral cavity involvement is more common in the systemic form, as a part of a more generalized cutaneous disease, but very rare in the localized form of angiokeratoma. A 45-year-old female presented with a painless lesion on the tongue of one months duration, which bled occasionally. On clinical examination, a lesion of approximately 5 mm in diameter was observed on the left surface of the tongue. The lesion was purple in color with a granulomatous appearance. There were no other changes in the oral mucosa. On dermatologic examination, no angiokeratomas were found, anywhere on the skin. The lesion was excised under local anesthesia. The histologic diagnosis was angiokeratoma. A case of a solitary angiokeratoma of the tongue is reported. We report here the third intra-oral case and the second case in the tongue with solitary angiokeratoma.

  2. Swollen lymph nodes

    ... 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 ...

  3. Lymph node culture

    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 ...

  4. Multi-component optical solitary waves

    Kivshar, Y. S.; Sukhorukov, A. A.; Ostrovskaya, E. A.


    We discuss several novel types of multi-component (temporal and spatial) envelope solitary waves that appear in fiber and waveguide nonlinear optics. In particular, we describe multi-channel solitary waves in bit-parallel-wavelength fiber transmission systems for highperformance computer networks......, multi-color parametric spatial solitary waves due to cascaded nonlinearities of quadratic materials, and quasiperiodic envelope solitons due to quasi-phase-matching in Fibonacci optical superlattices. (C) 2000 Elsevier Science B.V. All rights reserved....

  5. Solitary gastric Peutz-Jeghers type stomach polyp mimicking a malignant gastric tumor

    Jong-Shiaw Jin; Ji-Kuen Yu; Tang-Yi Tsao; Lien-Fu Lin


    Most cases of Peutz-Jeghers type polyps of the stomach are associated with mucocutaneous pigmentation and multiple intestinal polyposis.A solitary PeutzJeghers type polyp of the stomach is rare.We here report a case of a 71-year-old woman with a solitary Peutz-Jeghers type polyp of the stomach who presented with intolerable epigastric pain and weight loss of 5 kg over the prior two months.During the hospital treatment course for this patient,endoscopic examination revealed a bulging lesion with a central hole,mucosal ulceration,an asymmetrical wall thickness and a narrowing of the gastric lumen.A gastric biopsy further revealed ulceration with moderate dysplasia.The patient received endoscopic ultrasonography which showed a second subepithelial lesion that measured 4 cm × 3 cm.Computed tomography of the abdomen subsequently showed a thickened gastric wall with three visibly enlarged lymph nodes,all greater than 1 cm.The suspected diagnosis was malignant gastric cancer with lymph node metastases.The other lesion,which measured 2 cm × 2 cm × 1 cm was noted in the submucosa of the jejunum during surgery.The patient was treated using a subtotal gastrectomy and partial resection of the jejunal tumor.The final pathological report indicated a gastric Peutz-Jeghers type polyp with proliferation of smooth muscle bundles in the submucosal layer,and hyperplastic glands in the mucosal layer and ectopic pancreas of the jejunum.This is the first reported clinical case of a solitary Peutz-Jeghers type polyp of the stomach accompanying a lymph node enlargement and ectopic pancreas in the jejunum that simulates stomach cancer with lymph node metastases.

  6. Cystic fibrosis - nutrition

    ... in recipes. Add marshmallows to fruit or hot chocolate. Add raisins, dates, or chopped nuts and brown ... AP, Quinton H. Evidence-based practice recommendations for nutrition-related management of children and adults with cystic ...

  7. Epidural Cystic Spinal Meningioma

    Zhang, Ji; Chen, Zheng-he; Wang, Zi-feng; Sun, Peng; Jin, Jie-tian; Zhang, Xiang-heng; Zhao, Yi-ying; Wang, Jian; Mou, Yong-gao; Chen, Zhong-ping


    Abstract Cystic spinal meningioma (CSM) is an uncommon meningioma variant. Extradural CSMs are particularly rare and difficult to distinguish from other intraaxial tumors. This study presents a case of a 36-year-old woman with intraspinal extradual CSM at the thoracolumbar spine. She experienced persistent weakness, progressive numbness, and sensory disturbance in the right lower limb. Magnetic resonance imaging (MRI) of the patient revealed an irregular cystic mass at the thoracic 11 to lumbar 3 levels dorsally. This case was misdiagnosed as other neoplasms prior to surgery because of the atypical radiographic features and location of the tumor. Extradural CSMs should be considered in the differential diagnosis of intraspinal extradural cystic neoplasms. Complete removal of cystic wall provides an optimal outcome, rendering the lesion curable. PMID:26986119

  8. Cystic tumors of the liver: A practical approach

    Paolo Del Poggio; Marco Buonocore


    Biliary cyst tumors (cystadenoma and cystadenocarcinoma) are an indication for liver resection. They account for only 5% of all solitary cystic lesions of the liver, but differential diagnosis with multiloculated or complicated biliary cysts, atypical hemangiomas, hamartomas and lymphangiomas may be difficult. The most frequent challenge is to differentiate biliary cyst tumors from hemorrhagic cysts. Computerized tomography (CT) and magnetic resonance imaging (MRI) are often not diagnostic and in these cases fine needle aspiration (FNA) is used to confirm the presence of atypical biliary cells. FNA, however, lacks adequate sensitivity and specificity and should always be used in conjunction with imaging. Pre-operative differentiation of cystadenoma from cystadenocarcinoma is impossible and surgery must be performed if a biliary cyst tumor is suspected. When multiple cystic lesions are observed throughout the liver parenchyma, it is important to exclude liver metastasis, of which colonic cancer is the most common primary site. Multiple biliary hamartomas (von Meyenburg complex) can appear as a mixture of solid and cystic lesions and can be confused with cystic metastasis. Strong and uniform T2 hyperintensity on MRI is usually diagnostic, but occasionally a percutaneous biopsy may be required.

  9. [Solitary plasmocytoma of the mandible].

    Laurent, F; Chausse, J M; Toccanier, M F; Kuffer, R


    The authors present a case of solitary bony plasmocytoma of the mandibule, with local amyloid deposition. Diagnosis was made at extemporaneous pathological examination, then confirmed by the examination of the fixed surgical sample. Immunoenzymologically the proliferation proved to be monoclonal, with secretion of kappa light chain. The patient was treated by surgical curettage and homologous cancelous bone filling, followed by 5,500 rads of electrontherapy. He was then regularly controlled during 8 years and remained free from local recurrence. All investigations in search of dissemination (Kahler disease) remained negative.

  10. Solitary Fibrous Tumor of the Stomach

    Hussain, Qulsoom; Shafique, Khurram; Hurairah, Abu; Grossman, Evan B.


    Solitary fibrous tumor is a rare mesenchymal neoplasm that usually originates from the pleura, but has been reported in other extrapleural locations. We report a rare case of a solitary fibrous tumor of the stomach, which was successfully treated with endoscopic mucosal resection. PMID:28286800

  11. Solitary intraosseous neurofibroma of the tibia

    Huang, Guo-Shu; Chang, Wei-Chou; Juan, Chun-Jung; Chen, Cheng-Yu. [National Defense Medical Center, Department of Radiology, Tri-Service General Hospital, Neihu 114, Taipei (Taiwan); Lee, Chian-Her [National Defense Medical Center, Department of Orthopedic Surgery, Tri-Service General Hospital, Neihu 114, Taipei (Taiwan); Lee, Herng-Sheng [National Defense Medical Center, Department of Pathology, Tri-Service General Hospital, Neihu 114, Taipei (Taiwan)


    A solitary intraosseous neurofibroma is rare and mostly occurs in the mandible. We report a case of a solitary intraosseous neurofibroma of the tibia. The radiographic findings were nonspecific and showed an eccentrically located, osteolytic lesion with a thin sclerotic border in the diaphysis of the left proximal tibia. The entity of intraosseous neurofibroma is briefly reviewed. (orig.)

  12. Solitary Waves in Relativistic Electromagnetic Plasma

    XIE Bai-Song; HUA Cun-Cai


    Solitary waves in relativistic electromagnetic plasmas are obtained numerically. The longitudinal momentum of electrons has been taken into account in the problem. It is found that in the moving frame with electromagnetic field propagating the solitary waves can exist in both cases, where the vector potential frequency is larger or smaller than the plasma characteristic frequency.

  13. Disorders of lymph flow.

    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

  14. Ultrasound Imaging of Cystic Nephroma

    Federico Greco


    Full Text Available Cystic nephroma is a rare, benign multicystic lesion of the kidney. This tumor occurs both in children and in adults. In children, it is highly prevalent in males; in adults, it is more frequent in women. The term “cystic nephroma” represents two apparently different entities: pediatric cystic nephroma, a benign form thought to originate from metanephric tissue, and adult cystic nephroma, considered as a lesion of mixed epithelial stromal tumor. The clinical presentation may be a palpable mass or nonspecific symptoms such as abdominal pain, hematuria, and urinary tract infections. In this review, we summarize the ultrasound imaging features of cystic nephroma and describe the characteristics of the most common renal cystic lesions and the differential diagnosis of cystic nephroma with other renal cystic lesions.

  15. Multiple cystic lung disease

    Flavia Angélica Ferreira Francisco


    Full Text Available Multiple cystic lung disease represents a diverse group of uncommon disorders that can present a diagnostic challenge due to the increasing number of diseases associated with this presentation. High-resolution computed tomography of the chest helps to define the morphological aspects and distribution of lung cysts, as well as associated findings. The combination of appearance upon imaging and clinical features, together with extrapulmonary manifestations, when present, permits confident and accurate diagnosis of the majority of these diseases without recourse to open-lung biopsy. The main diseases in this group that are discussed in this review are lymphangioleiomyomatosis, pulmonary Langerhans cell histiocytosis and folliculin gene-associated syndrome (Birt–Hogg–Dubé; other rare causes of cystic lung disease, including cystic metastasis of sarcoma, are also discussed. Disease progression is unpredictable, and understanding of the complications of cystic lung disease and their appearance during evolution of the disease are essential for management. Correlation of disease evolution and clinical context with chest imaging findings provides important clues for defining the underlying nature of cystic lung disease, and guides diagnostic evaluation and management.

  16. Retroperitoneal Cystic Lymphangioma

    Ş.Sevil Altunrende


    Full Text Available Abdominal cystic lymphangioma is a rare, benign, congenital tumor. It is an developmental abnormality of the lymphatic system. Males are relatively more affected and 90% of the cases are under 5 years of age. Multilocular cystic lesion with septations is seen on abdominal ultrasonography. As echogenicity can vary depending on the content of the cyst like cellular debris, hemorrhage or chylous, liquid-liquid or fat-liquid levels can be observed. Definitive treatment is total excision. Cyst aspiration is not an effective method and nearly always ends with recurrence. Computerized tomography and magnetic resonance imaging findings of sonographically detected retroperitoneal cystic lymphangioma in a newborn girl with abdominal distention are discussed in this paper. (The Medical Bulletin of Haseki 2010; 48: 47-9

  17. [Atypical intraperitoneal cystic masses].

    Domínguez-Pérez, S T; Baeza-Herrera, C; Villalobos-Castillejos, A; González-Mateos, T; Aguilar-Venegas, M


    Omental, mesenteric and retroperitoneal cystic masses are very rare in pediatric population. They usually present as asymptomatic abdominal tumors and only occasionally a preoperative diagnosis is made. We presented 4 cases presented to our hospital during a 2-year period. All patients were male with an age ranged from 5 months to 7 years. Three patients had previous diagnosis of cystic mass by abdominal ultrasound. Three patients presented with acute abdomen and one patient with bowel obstruction. All patients underwent successful resection of the mass with no perioperative mortality.

  18. A large tuberculous abscess mimicking a retroperitoneal cystic mass: A case report

    Kim, Kwang Suk; Cha, Seung Hwan; Ahn, Ji Hyun; Cho, Mi Yeon [Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju (Korea, Republic of)


    Large cystic masses originating from the retroperitoneal space are rare, and cystic tumors are often considered preferentially in the differential diagnosis. However, it is difficult to make a correct diagnosis. A 55-year-old man presented with a palpable abdominal mass. A computed tomography (CT) scan detected a mass mimicking a large cystic tumor in the retroperitoneal space anterior to the psoas muscle. The mass had an enhanced outer margin, an irregular inner margin, and several surrounding necrotic lymph nodes. However, histopathologic examination followed by an exploratory laparotomy confirmed that the mass was consistent with a tuberculous (TB) abscess. A retroperitoneal TB abscess without spinal or active pulmonary TB is very rare. To the best of our knowledge, there are no published reports of a retroperitoneal TB abscess confirmed by both CT scan and surgical pathology in the Korean literature. We report a rare case of a huge retroperitoneal TB abscess that can mimic a cystic tumor.

  19. Transversally periodic solitary gravity–capillary waves

    Milewski, Paul A.; Wang, Zhan


    When both gravity and surface tension effects are present, surface solitary water waves are known to exist in both two- and three-dimensional infinitely deep fluids. We describe here solutions bridging these two cases: travelling waves which are localized in the propagation direction and periodic in the transverse direction. These transversally periodic gravity–capillary solitary waves are found to be of either elevation or depression type, tend to plane waves below a critical transverse period and tend to solitary lumps as the transverse period tends to infinity. The waves are found numerically in a Hamiltonian system for water waves simplified by a cubic truncation of the Dirichlet-to-Neumann operator. This approximation has been proved to be very accurate for both two- and three-dimensional computations of fully localized gravity–capillary solitary waves. The stability properties of these waves are then investigated via the time evolution of perturbed wave profiles. PMID:24399922

  20. Solitary Fibrous Tumor of the Uterus

    Po-Wei Chu


    Conclusion: The behavior of solitary fibrous tumors arising from the uterus is difficult to evaluate; therefore, complete surgical excision featuring clear margins and comprehensive follow-up is recommended.

  1. Management of the Solitary Pulmonary Nodule.

    Chan, Edward Y; Gaur, Puja; Ge, Yimin; Kopas, Lisa; Santacruz, Jose F; Gupta, Nakul; Munden, Reginald F; Cagle, Philip T; Kim, Min P


    Context .- Optimal management of the patient with a solitary pulmonary nodule entails early diagnosis and appropriate treatment for patients with malignant tumors, and minimization of unnecessary interventions and procedures for those with ultimately benign nodules. With the growing number of high-resolution imaging modalities and studies available, incidentally found solitary pulmonary nodules are an increasingly common occurrence. Objective .- To provide guidance to clinicians involved in the management of patients with a solitary pulmonary nodule, including aspects of risk stratification, workup, diagnosis, and management. Data Sources .- Data for this review were gathered from an extensive literature review on the topic. Conclusions .- Logical evaluation and management pathways for a patient with a solitary pulmonary nodule will allow providers to diagnose and treat individuals with early stage lung cancer and minimize morbidity from invasive procedures for patients with benign lesions.

  2. Conservative numerical methods for solitary wave interactions

    Duran, A; Lopez-Marcos, M A [Departamento de Matematica Aplicada y Computacion, Facultad de Ciencias, Universidad de Valladolid, Paseo del Prado de la Magdalena s/n, 47005 Valladolid (Spain)


    The purpose of this paper is to show the advantages that represent the use of numerical methods that preserve invariant quantities in the study of solitary wave interactions for the regularized long wave equation. It is shown that the so-called conservative methods are more appropriate to study the phenomenon and provide a dynamic point of view that allows us to estimate the changes in the parameters of the solitary waves after the collision.

  3. Feline cystic thymoma: a clinicopathologic, immunohistologic, and electron microscopic study of 14 cases.

    Patnaik, A K; Lieberman, P H; Erlandson, R A; Antonescu, C


    Cystic thymoma was diagnosed in 14 cats in a period of 6 years. The most common clinical sign was laboured breathing. The tumours were characterized by various-sized cystic spaces with central vessels. The epithelial cells varied from oval to spindle to polygonal cells enclosing cystic spaces or in pure epithelial cell components. The nuclei of the neoplastic cells had scattered chromatin and small nucleoli. The cytoplasm was pale eosinophilic. The concentration of mature lymphocytes varied from area to area with rare germinal centres. Immunohistochemically, the epithelial cells stained only with AE(1)/AE(3). The central vessels were positive for vimentin, smooth muscle actin, and factor VIII antigen. Electron microscopy revealed that the cyst walls were lined by epithelial cells that were joined by desmosomes, and the walls were well separated from the cystic spaces by a well-defined basement membrane. The neoplastic epithelial cells contained scattered tonofilaments. Three of the cats had metastasis to the lymph nodes and lungs. Two novel cases of ectopic cystic thymoma have also been described. Results of this study reveal that cystic thymoma is uncommon in cats, and that the histomorphologic, immunohistochemical, and electron microscopic features are similar to those of cystic thymoma in humans.

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

    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.

  5. Cystic fibrosis. Diagnosis.

    Luis Ortigosa


    Full Text Available Cystic fibrosis (CF is one of the most frequent inherited mortal diseases in Caucasian population. Dysfunction in exocrine glands is described in CF patients, with severe pancreatic insufficiency and chronic lung disease. CF is inherited as an autosomal recessive disorder. More than 1000 disease-associated mutations in the cystic fibrosis transmembrane conductance regulator (CFTR gene have been described. DF508 mutation is the most common mutation in the CF gen. Diagnosis in CF is based on clinical and laboratory tests findings. Meconial ileus, CF in other relatives, chronic lung disease, congenital absence of the vas deferens with azoospermia are among other clinical findings, main criteria in CF patients. Two positive results in sweat chloride test , or demonstration in nasal epithelial ionic transport alteration (nasal potential difference and identification of two CF mutations in the patient are laboratory findings in CF.

  6. Abdominal cystic lymphangioma mimicking appendicitis.

    Wake, Sarah; Abhyankar, Aruna; Hutton, Kim


    A cystic lymphangioma arising within the abdomen is a rare entity in children. It may present with an abdominal mass and symptoms of abdominal pain, vomiting, and anorexia. These nonspecific clinical symptoms are often attributed to more common acute pediatric conditions. In this report, we describe two pediatric cases of intra-abdominal cystic lymphangioma that were initially diagnosed and treated as appendicitis. True diagnosis was only achieved on surgical excision and pathological investigation of cystic material.

  7. [News in cystic fibrosis].

    Delaisi, B


    The improvement over the last two decades in the treatment of cystic fibrosis led to an increase in life expectancy approaching 40 years at birth. Logically, the population of adult patients has been increasing and is currently 50% of patients followed in France. These therapeutic advances have justified the establishment in 2003 of a generalized neonatal screening for cystic fibrosis. The latest data of this screening show an incidence of CF of 1/5359 live births, far below the incidence of 1/2500 which was widely accepted twenty years ago. The performance of this screening is currently based on the dosage of trypsin immuno reactive, followed in case of exceeding the threshold of a search of the 30 most common mutations, can detect around 96% of 150 to 200 CF cases every year. Therefore, the possibility of a false negative of the screening cannot be excluded and evocative symptoms of cystic fibrosis, even for children born after 2003, will lead to prescribe a sweat test. While treatments available so far goal consequences of cystic fibrosis, a new therapeutic class to correct the functional defect of the mutated protein, called CFTR modulators, is emerging. Ivacaftor, leader of this new class, belonging to the category of "CFTR potentiator" got its access on the market in September 2012 for patients carrying the G551D mutation. New other molecules, named "CFTR correctors" which can have synergistic effect with ivacaftor and concern patients carrying the most common mutation--DF 508--are under development. Copyright © 2013. Published by Elsevier Masson SAS.

  8. Cystic adenoid carcinoma of the external auditory meatus with mastoid involvement

    Tinoco, Paulo


    Full Text Available Introduction: The cystic adenoid carcinoma (CAC in the external auditory meatus is rare and was originated in the ceruminous glands. It is manifested by otalgia in about 90% of the patients. Case Report: In this article we report the case of a patient with Cystic Adenoid Carcinoma of the external auditory meatus with mastoid involvement that presented peripheral facial paralysis. The treatment is essentially surgical, combined or not with postoperative radiotherapy. The factors of bad prognosis are the tumor expansion, facial nerve and middle ear invasion and lymph node affection, which diminish the survival in five years from 59% to 23%.

  9. Molecular Diagnosis of Cystic Fibrosis.

    Deignan, Joshua L; Grody, Wayne W


    This unit describes a recommended approach to identifying causal genetic variants in an individual suspected of having cystic fibrosis. An introduction to the genetics and clinical presentation of cystic fibrosis is initially presented, followed by a description of the two main strategies used in the molecular diagnosis of cystic fibrosis: (1) an initial targeted variant panel used to detect only the most common cystic fibrosis-causing variants in the CFTR gene, and (2) sequencing of the entire coding region of the CFTR gene to detect additional rare causal CFTR variants. Finally, the unit concludes with a discussion regarding the analytic and clinical validity of these approaches.

  10. Colloidal solitary waves with temperature dependent compressibility

    Azmi, A.; Marchant, T. R.


    Spatial solitary waves which form in colloidal suspensions of dielectric nanoparticles are considered. The interactions, or compressibility, of the colloidal particles, is modelled using a series in the particle density, or packing fraction, where the virial, or series, coefficients depend on the type of particle interaction model. Both the theoretical hard disk and sphere repulsive models, and a model with temperature dependent compressibility, are considered. Experimental results show that particle interactions can be temperature dependent and either repulsive or attractive in nature, so we model the second virial coefficient using a physically realistic temperature power law. One- and two-dimensional semi-analytical colloidal solitary wave solutions are found. Trial functions, based on the form of the nonlinear Schrödinger equation soliton, are used, together with averaging, to develop the semi-analytical solutions. When the background packing fraction is low, the one-dimensional solitary waves have three solutions branches (with a bistable regime) while the two-dimensional solitary waves have two solution branches, with a single stable branch. The temperature dependent second virial coefficient results in changes to the solitary wave properties and the parameter space, in which multiple solutions branches occur. An excellent comparison is found between the semi-analytical and numerical solutions.

  11. Adjustable solitary waves in electroactive rods

    Wang, Y. Z.; Zhang, C. L.; Dai, H.-H.; Chen, W. Q.


    This paper presents an asymptotic analysis of solitary waves propagating in an incompressible isotropic electroactive circular rod subjected to a biasing longitudinal electric displacement. Several asymptotic expansions are introduced to simplify the rod governing equations. The boundary conditions on the lateral surface of the rod are satisfied from the asymptotic point of view. In the limit of finite-small amplitude and long wavelength, a set of ten simplified one-dimensional nonlinear governing equations is established. To validate our approach and the derivation, we compare the linear dispersion relation with the one directly derived from the three-dimensional linear theory in the limit of long wavelength. Then, by the reductive perturbation method, we deduce the far-field equation (i.e. the KdV equation). Finally, the leading order of the electroelastic solitary wave solution is presented. Numerical examples are provided to show the influences of the biasing electric displacement and material constants on the solitary waves. It is found that the biasing electric displacement can modulate the velocity of solitary waves with a prescribed amplitude in the electroactive rod, a very interesting result which may promote the particular application of solitary waves in solids with multi-field coupling.

  12. Solitary Spinal Epidural Metastasis from Gastric Cancer

    Taisei Sako


    Full Text Available Solitary epidural space metastasis of a malignant tumor is rare. We encountered a 79-year-old male patient with solitary metastatic epidural tumor who developed paraplegia and dysuria. The patient had undergone total gastrectomy for gastric cancer followed by chemotherapy 8 months priorly. The whole body was examined for suspected metastatic spinal tumor, but no metastases of the spine or important organs were observed, and a solitary mass was present in the thoracic spinal epidural space. The mass was excised for diagnosis and treatment and was histopathologically diagnosed as metastasis from gastric cancer. No solitary metastatic epidural tumor from gastric cancer has been reported in English. Among the Japanese, 3 cases have been reported, in which the outcome was poor in all cases and no definite diagnosis could be made before surgery in any case. Our patient developed concomitant pneumonia after surgery and died shortly after the surgery. When a patient has a past medical history of malignant tumor, the possibility of a solitary metastatic tumor in the epidural space should be considered.

  13. Adenoid cystic carcinoma of the lacrimal gland metastasising to the liver: report of a case

    Pearce Neil W


    Full Text Available Abstract Background Adenoid Cystic Carcinoma of the lacrimal gland is a rare tumour. Their aggressive behaviour, with a high-risk of local recurrence, and late distant spread of the tumour even after aggressive management has been reported. Metastasis to the liver is rare and when it occurs, it is usually part of widespread metastasis, and therefore surgical treatment is seldom considered. Case presentation We report a rare case of an isolated liver metastasis from a lacrimal gland adenoid cystic carcinoma 20 years after resection of the primary tumour. The patient presented with right upper quadrant pain radiating to the back and shortness of breath of 3 months duration. No local recurrence was detected during a 15 year follow-up with computerized tomography (CT of the head. Abdominal CT scan demonstrated a solitary liver tumour with no other primary source, and the bone scan was normal. The patient was treated with an extended right hemihepatectomy. The histology revealed a predominantly cribriform tumour with focal areas of basaloid type metastatic lacrimal gland adenoid cystic carcinoma. Conclusion This case illustrates the unpredictable behaviour of adenoid cystic carcinoma and the need for a life long follow up for these patients after treatment. The possibility of surgical resection for liver metastasis from adenoid cystic carcinoma should always be considered.

  14. Intraoral solitary neurofibroma in an infant

    Narwal Anjali


    Full Text Available Neurofibroma is a non-circumscribed, thick and irregular benign tumor of the peripheral nerve sheath. On the skin, the diffuse and soft nature of neurofibroma often resembles "a bag of worms". It can develop at any point along a nerve and often form by late adolescence. Although neurofibromas occur predominantly as a feature of neurofibromatosis affecting the soft tissue, a few cases of solitary intraoral neurofibromas have also been reported. Solitary intraosseous neurofibroma in the oral cavity is a rare benign tumor with very few cases reported in literature. This case report presents a case of intraosseous solitary neurofibroma of maxilla in a 5-month-old male child due to the rarity of this tumor at this site in very early age, along with a discussion of its clinical, radiological, and histopathological presentation.

  15. Solitary Contralateral Adrenal Metastases after Nephrectomy for Renal Cell Carcinoma

    Nikolaos Antoniou


    Full Text Available Two cases are reported of patients with a single metastasis in the contralateral adrenal, one and nine years respectively after nephrectomy for localized cancer in the opposite kidney. These types of metastases are usually asymptomatic they do not appear with signs of adrenal insufficiency, they are detected incidentally and the diagnosis is confirmed mainly with CT scan, which comprises the method of choice for the detection of such types of metastases. Many adrenal metastases probably have been overlooked in the past when advanced imaging techniques were not available. Both patients underwent adrenalectomy and replacement therapy with corticosteroids. Approximately 50% of all patients with renal cell carcinoma either present with metastases at diagnosis or will have metastatic disease after nephrectomy11. In order of decreasing frequency, the most common metastatic sites are the lungs, lymph nodes, liver, bone, contralateral kidney and ipsilateral adrenal glands. Adrenal involvement has been reported in 7 to 19% of autopsystudies. 1,3 Solitary metachronous metastatic involvement of the contralateral adrenal from renal cell carcinoma is rarely diagnosed during life and only 4 cases have been reported. 4,5 Recent advances in imaging techniques have allowed the diagnosis of adrenal involvement by renal cancer. Two cases of contralateral adrenal metastasis are reported 1 and 9 years after radical nephrectomy for localized renal cell carcinoma. Both patients underwent adrenalectomy and steroid replacement therapy.

  16. Fine-needle aspiration biopsy of cervical lymph nodes: factors in predicting malignant diagnosis.

    Aribaş, B K; Arda, K; Ciledağ, N; Cetindağ, M F; Doğan, K; Sahin, G; Yoloğlu, Z; Aktaş, E


    The objective of the study was to determine the predicting factors in malignant diagnosis in ultrasonography guided fine-needle aspiration biopsy of cervical lymph nodes. Design is retrospective follow-up study. Ultrasonography guided fine-needle aspiration biopsies of cervical lymph nodes were performed in 290 patients. The mean age was 45.5 ± 14.4 years (range; 15-85). 207 (71.4%) and 83 (28.6%) were women and men, respectively. Cytopathologist was not present in any biopsy procedure. Factors in predicting malignancy were age, gender, presence of primary malignancy, localization (Level 1-6), hypoechogenicity with loss of echogenic hilum, microcalcification, cystic feature, minimum and maximum sizes, and index value (minimum size/maximum size). Factors were analyzed by univariate and multivariable tests. The mean minimum size and index value of the lymph nodes were 10.4 ± 5.5 mm and 0.58 ± 0.18, respectively. Age, gender, microcalcification, cystic feature, minimum size, and index value were poor predictors in malignancy. Predictors were presence of primary malignancy (p-hypoechogenicity (p-hypoechogenicity. Malignancy rate was relatively low in patients with thyroid malignancy than those with non thyroid malignancies in Level 5. Level 6 was the most difficult area for biopsy due to postoperative changes. Microcalcification was specific only in thyroid carcinoma, whereas cystic parts were more specific in the other malignancies

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

    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:

  18. A radiographic study of solitary bone cysts

    Kim, Kyung Rak; Hwang, Eui Hwan; Lee, Sang Rae [Dept. of Oral and Maxillofacial Radiology, Division of Dentistry, Kyung Hee University, Seoul (Korea, Republic of)


    The aim of this study was to evaluate the clinical, radiographic and histopathologic features of 23 cases of solitary bone cyst by means of the analysis of radiographs and biopsy specimens in 23 persons visited the Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University and Chunbuk National University. The obtained results were as follows; 1. The incidence of solitary bone cyst was almost equal in males (52.2%) and in females(42.8%) and the prevalent age of the solitary bone cyst were the second decade (47.8%) and the third decade (21.7%). 2. In the signs and symptoms of solitary bone cyst, pain or tenderness revealed in 17.4%, swelling revealed in 13.0%, pain and swelling revealed in 21.7%, paresthesia revealed in 4.4% and 43.5% were a symptom and the tooth vitality involved in the solitary bone cyst, 76.5% were posterior and 23.5% were either positive or negative. 3. In the location of the solitary bone cyst, 47.8% present posterior region, 21.7% present anterior region, 21.6% present anterior and posterior region, 4.4% present condylar process area. 4. In the hyperostotic border of the solitary bone cyst, 47.8% were seen entirely, 21.8% were seen partially, and 30.4% were not seen. 5. In the change of tooth, 59.1% were loss of the alveolar lamina dura, 13.6% were root resorption 4.55% were tooth displacement, 4.55% were root resorption and tooth displacement. 6. In the change of cortical bone of the solitary bone cyst, 39.1% were intact and 60.9% were thinning and expansion of cortical bone. 7. In the histopathologic findings of 9 cases, 33.3% were thin connective tissue wall, 11.1% were thickened myxo-fibromatous wall, 55.6% were thickened myxofibromatous wall with dysplastic bone formation.

  19. Uphill solitary waves in granular flows

    Martínez, E.; Pérez-Penichet, C.; Sotolongo-Costa, O.; Ramos, O.; Måløy, K. J.; Douady, S.; Altshuler, E.


    We have experimentally observed uphill solitary waves in the surface flow on a granular material. A heap is constructed by injecting sand between two vertical glass plates separated by a distance much larger than the average grain size, with an open boundary. As the heap reaches the open boundary, solitary fluctuations appear on the flowing layer and move “up the hill” (i.e., against the direction of the flow). We explain the phenomenon in the context of stop-and-go traffic models.

  20. Conventional papillary thyroid carcinoma: effects of cystic changes visible on ultrasonography on disease prognosis

    Kim, Ja Young; Kim, Eun Kyung; Kwak, Jin Young [Dept. of Radiology, Research Institute of Radiological Science, Seoul (Korea, Republic of); Lee, Hye Sun [Dept. of Biostatistics, Yonsei University College of Medicine, Seoul (Korea, Republic of)


    To investigate the characteristics of papillary thyroid carcinoma (PTC) with cystic changes visible on ultrasonography (US). This study included 553 PTCs in 553 patients between January 2003 and August 2004. One radiologist with 10 years of experience in thyroid imaging retrospectively reviewed the preoperative US images. Two different groups were formed according to two different reference points (group 1, 25%; group 2, 50%) of the cystic component. Patients between the groups were compared according to their clinicopathologic characteristics. Disease-free survival (DFS) was estimated. Cox's multivariate proportional hazards regression model was used to identify the effect of variable factors on the recurrence risk. Fifty-six patients (10.1%) were confirmed to have tumor recurrence within the follow-up period. Thirty-five patients had regional metastasis, one had distant metastasis, eight had multiple site metastases, and 12 had biochemical recurrence. PTC patients with a ≤ 50% or PTC patients with a ≤ 25% cystic component did not have a statistically significant longer DFS than those with a >50% (hazard ratio [HR], 1.118; 95% confidence interval [CI], 0.255 to 4.910; P=0.883) or those with a >25% cystic component (HR, 0.569; 95% CI, 0.164 to 1.976; P=0.375), respectively. Moreover, independent predictors of recurrence were pathologic size, male gender, and lymph node metastasis, not a >50% or >25% cystic component. The proportion of the cystic component in PTCs did not affect DFS.

  1. [Cystic fibrosis in 2008].

    Durieu, I; Josserand, R Nove


    To describe the epidemiological, physiopathological, clinical and therapeutic knowledge concerning cystic fibrosis (CF). Important modifications in the health organization of the care concerning this orphan disease have been implemented in France. The life expectancy has dramatically increased, as well as the knowledge concerning the pathological structure and function of the CFTR gene and protein. This will lead to the development of emerging drug treatments for this lethal disease. The life expectancy is predicted to exceed 40 years for children born in the 2000s. As a result, there has been a tremendous growth of the adult population that reached 40% of the overall approximately 5000 patients included in the CF French registry (Observatoire National de la Mucoviscidose). Lung disease remains the primary cause of morbidity and mortality. The characteristic phenotypic presentation associates bronchial and rhinosinusal symptoms, pancreatic insufficiency and liver disease. Bronchial damage leads to progressive chronic respiratory insufficiency. Diabetes mellitus and osteoporosis frequently appears in adulthood. Neonatal screening has been implemented in France since 2002. It will prevent delayed diagnosis and its deleterious consequences. Some atypical cases of CF presenting only with one or two organ system involvement can be diagnosed in adulthood. Isolated chronic rhinosinusitis, bronchiectasis, congenital bilateral absence of vas deferens, recurrent pancreatitis, allergic bronchopulmonary aspergillosis, and some case of cholangitis may so revealed late form of cystic fibrosis. The health care is organized in cystic fibrosis centres. Despite gene discovery, treatment still remains symptomatic, based on intensive pulmonary and nutritional treatments. Challenges for new treatments are to correct the basic defect, either by gene therapy or by pharmacological modulation of the abnormal physiological processes.

  2. Cystic fibrosis and sleep.

    Katz, Eliot S


    Sleep disturbances are frequently observed in cystic fibrosis (CF). The resultant sleep fragmentation, short sleep duration, and gas-exchange abnormalities are postulated to contribute to the neurocognitive, cardiovascular, and metabolic abnormalities associated with CF. There are no outcomes data to establish the optimal procedure for screening and treating CF patients for sleep-related respiratory abnormalities. Therapy with supplemental oxygen and bilevel ventilation are widely considered to be effective in the short term, but there are few evidence-based data to support long-term improvements in morbidity and mortality. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. [Cystic pyeloureteritis. Our approach].

    Castillo Jimeno, J M; González de Garibay, A S; Ruiz Rubio, J L; Sebastián Borruel, J L


    We report a case of massive cystic pyeloureteritis that had been diagnosed by ureterorenoscopy in a patient with recurrent urinary infection and episodes of nephritic colic. The reports published in the literature indicate there is no specific treatment for this disease whose etiology is unknown. Its pathogenesis has not been well-established and it is difficult to distinguish from other urothelial filling defects. Although it has also been reported that it may progress to malignancy, we believe that the therapeutic approach should be conservative.

  4. Childhood abdominal cystic lymphangioma

    Konen, Osnat; Rathaus, Valeria; Shapiro, Myra [Department of Diagnostic Imaging, Meir General Hospital, Sapir Medical Centre, Kfar Saba (Israel); Dlugy, Elena [Department of Paediatric Surgery, Schneider Medical Centre, Sackler School of Medicine, Tel-Aviv University (Israel); Freud, Enrique [Department of Paediatric Surgery, Sapir Medical Centre, Sackler School of Medicine, Tel-Aviv University (Israel); Kessler, Ada [Department of Diagnostic Imaging, Sourasky Medical Centre, Tel-Aviv (Israel); Horev, Gadi [Department of Diagnostic Imaging, Schneider Medical Centre, Tel-Aviv (Israel)


    Background: Abdominal lymphangioma is a rare benign congenital malformation of the mesenteric and/or retroperitoneal lymphatics. Clinical presentation is variable and may be misleading; therefore, complex imaging studies are necessary in the evaluation of this condition. US and CT have a major role in the correct preoperative diagnosis and provide important information regarding location, size, adjacent organ involvement, and expected complications. Objective: To evaluate the clinical and imaging findings of seven children with proven abdominal cystic lymphangioma. Materials and methods: Clinical and imaging files of seven children with pathologically proven abdominal lymphangioma, from three university hospitals, were retrospectively evaluated. Patient's ages ranged from 1 day to 6 years (mean, 2.2 years). Symptoms and signs included evidence of inflammation, abnormal prenatal US findings, chronic abdominal pain, haemorrhage following trauma, clinical signs of intestinal obstruction, and abdominal distension with lower extremities lymphoedema. Plain films of five patients, US of six patients and CT of five patients were reviewed. Sequential imaging examinations were available in two cases. Results: Abdominal plain films showed displacement of bowel loops by a soft tissue mass in five of six patients, two of them with dilatation of small bowel loops. US revealed an abdominal multiloculated septated cystic mass in five of six cases and a single pelvic cyst in one which changed in appearance over 2 months. Ascites was present in three cases. CT demonstrated a septated cystic mass of variable sizes in all available five cases. Sequential US and CT examinations in two patients showed progressive enlargement of the masses, increase of fluid echogenicity, and thickening of walls or septa in both cases, with multiplication of septa in one case. At surgery, mesenteric lymphangioma was found in five patients and retroperitoneal lymphangioma in the other two

  5. From bell-shaped solitary wave to W/M-shaped solitary wave solutions in an integrable nonlinear wave equation

    Aiyong Chen; Jibin Li; Chunhai Li; Yuanduo Zhang


    The bifurcation theory of dynamical systems is applied to an integrable non-linear wave equation. As a result, it is pointed out that the solitary waves of this equation evolve from bell-shaped solitary waves to W/M-shaped solitary waves when wave speed passes certain critical wave speed. Under different parameter conditions, all exact explicit parametric representations of solitary wave solutions are obtained.

  6. The solitary sellar plasmacytoma: a diagnostic challenge

    Soejbjerg, Anne; Dyve, Suzan; Baerentzen, Steen


    UNLABELLED: Solitary sellar plasmacytomas are exceedingly rare and difficult to distinguish from other pituitary tumors. We report a case of a 62-year-old woman presenting with blurred vision of the right eye and tenderness of the right temporal region, which was interpreted as temporal arteritis...

  7. Clinical implications of the solitary functioning kidney

    Westland, R.; Schreuder, M.F.; Goudoever, J.B. van; Sanna-Cherchi, S.; Wijk, J.A. van


    Congenital anomalies of the kidney and urinary tract are the major cause of ESRD in childhood. Children with a solitary functioning kidney form an important subgroup of congenital anomalies of the kidney and urinary tract patients, and a significant fraction of these children is at risk for progress

  8. Solitary waves on nonlinear elastic rods. I

    Sørensen, Mads Peter; Christiansen, Peter Leth; Lomdahl, P. S.


    Acoustic waves on elastic rods with circular cross section are governed by improved Boussinesq equations when transverse motion and nonlinearity in the elastic medium are taken into account. Solitary wave solutions to these equations have been found. The present paper treats the interaction between...

  9. Shallow Water Waves and Solitary Waves

    Hereman, Willy


    Encyclopedic article covering shallow water wave models used in oceanography and atmospheric science. Sections: Definition of the Subject; Introduction and Historical Perspective; Completely Integrable Shallow Water Wave Equations; Shallow Water Wave Equations of Geophysical Fluid Dynamics; Computation of Solitary Wave Solutions; Numerical Methods; Water Wave Experiments and Observations; Future Directions, and Bibliography.

  10. Solitary waves on nonlinear elastic rods. II

    Sørensen, Mads Peter; Christiansen, Peter Leth; Lomdahl, P. S.


    In continuation of an earlier study of propagation of solitary waves on nonlinear elastic rods, numerical investigations of blowup, reflection, and fission at continuous and discontinuous variation of the cross section for the rod and reflection at the end of the rod are presented. The results...

  11. Peptide Toxins in Solitary Wasp Venoms

    Konno, Katsuhiro; Kazuma, Kohei; Nihei, Ken-ichi


    Solitary wasps paralyze insects or spiders with stinging venom and feed the paralyzed preys to their larva. Accordingly, the venoms should contain a variety of constituents acting on nervous systems. However, only a few solitary wasp venoms have been chemically studied despite thousands of species inhabiting the planet. We have surveyed bioactive substances in solitary wasp venoms found in Japan and discovered a variety of novel bioactive peptides. Pompilidotoxins (PMTXs), in the venoms of the pompilid wasps Anoplius samariensis and Batozonellus maculifrons, are small peptides consisting of 13 amino acids without a disulfide bond. PMTXs slowed Na+ channel inactivation, in particular against neuronal type Na+ channels, and were rather selective to the Nav1.6 channel. Mastoparan-like cytolytic and antimicrobial peptides are the major components of eumenine wasp venoms. They are rich in hydrophobic and basic amino acids, adopting a α-helical secondary structure, and showing mast cell degranulating, antimicrobial and hemolytic activities. The venom of the spider wasp Cyphononyx fulvognathus contained four bradykinin-related peptides. They are hyperalgesic and, dependent on the structure, differently associated with B1 or B2 receptors. Further survey led to the isolation of leucomyosuppressin-like FMRFamide peptides from the venoms of the digger wasps Sphex argentatus and Isodontia harmandi. These results of peptide toxins in solitary wasp venoms from our studies are summarized. PMID:27096870

  12. Peptide Toxins in Solitary Wasp Venoms

    Katsuhiro Konno


    Full Text Available Solitary wasps paralyze insects or spiders with stinging venom and feed the paralyzed preys to their larva. Accordingly, the venoms should contain a variety of constituents acting on nervous systems. However, only a few solitary wasp venoms have been chemically studied despite thousands of species inhabiting the planet. We have surveyed bioactive substances in solitary wasp venoms found in Japan and discovered a variety of novel bioactive peptides. Pompilidotoxins (PMTXs, in the venoms of the pompilid wasps Anoplius samariensis and Batozonellus maculifrons, are small peptides consisting of 13 amino acids without a disulfide bond. PMTXs slowed Na+ channel inactivation, in particular against neuronal type Na+ channels, and were rather selective to the Nav1.6 channel. Mastoparan-like cytolytic and antimicrobial peptides are the major components of eumenine wasp venoms. They are rich in hydrophobic and basic amino acids, adopting a α-helical secondary structure, and showing mast cell degranulating, antimicrobial and hemolytic activities. The venom of the spider wasp Cyphononyx fulvognathus contained four bradykinin-related peptides. They are hyperalgesic and, dependent on the structure, differently associated with B1 or B2 receptors. Further survey led to the isolation of leucomyosuppressin-like FMRFamide peptides from the venoms of the digger wasps Sphex argentatus and Isodontia harmandi. These results of peptide toxins in solitary wasp venoms from our studies are summarized.

  13. Giant solitary fibrous tumour of the liver

    T. Terkivatan (Türkan); M. Kliffen (Mike); J.H.W. de Wilt (Johannes); A.N. van Geel (Albert); A.M.M. Eggermont (Alexander); C. Verhoef (Kees)


    textabstractBackground: Solitary fibrous tumour (SFT) is an uncommon mesenchymal neoplasm that most frequently affects the pleura, although it has been reported with increasing frequency in various other sites such as in the peritoneum, pericardium and in non-serosal sites such as lung parenchyma,

  14. Solitary Wave Solutions for Zoomeron Equation

    Amna IRSHAD


    Full Text Available Tanh-Coth Method is applied to find solitary wave solutions of the Zoomeron equation which is of extreme importance in mathematical physics. The proposed scheme is fully compatible with the complexity of the problem and is highly efficient. Moreover, suggested combination is capable to handle nonlinear problems of versatile physical nature.

  15. Solitary fibrous tumour of the vagus nerve.

    Scholsem, Martin; Scholtes, Felix


    We describe the complete removal of a foramen magnum solitary fibrous tumour in a 36-year-old woman. It originated on a caudal vagus nerve rootlet, classically described as the 'cranial' accessory nerve root. This ninth case of immunohistologically confirmed cranial or spinal nerve SFT is the first of the vagus nerve.

  16. Solitary Wave Propagation Influenced by Submerged Breakwater

    王锦; 左其华; 王登婷


    The form of Boussinesq equation derived by Nwogu (1993) using velocity at an arbitrary distance and surface elevation as variables is used to simulate wave surface elevation changes. In the numerical experiment, water depth was divided into five layers with six layer interfaces to simulate velocity at each layer interface. Besides, a physical experiment was carried out to validate numerical model and study solitary wave propagation.“Water column collapsing”method (WCCM) was used to generate solitary wave. A series of wave gauges around an impervious breakwater were set-up in the flume to measure the solitary wave shoaling, run-up, and breaking processes. The results show that the measured data and simulated data are in good agreement. Moreover, simulated and measured surface elevations were analyzed by the wavelet transform method. It shows that different wave frequencies stratified in the wavelet amplitude spectrum. Finally, horizontal and vertical velocities of each layer interface were analyzed in the process of solitary wave propagation through submerged breakwater.

  17. Solitary wave interactions of the GRLW equation

    Ramos, J.I. [Room I-320-D, E.T.S. Ingenieros Industriales, Universidad de Malaga, Plaza El Ejido, s/n 29013 Malaga (Spain)]. E-mail:


    An approximate quasilinearization method for the solution of the generalized regularized long-wave (GRLW) equation based on the separation of the temporal and spatial derivatives, three-point, fourth-order accurate, compact difference equations, is presented. The method results in a system of linear equations with tridiagonal matrices, and is applied to determine the effects of the parameters of the GRLW equation and initial conditions on the formation of undular bores and interactions/collisions between two solitary waves. It is shown that the method preserves very accurately the first two invariants of the GRLW equation, the formation of secondary waves is a strong function of the amplitude and width of the initial Gaussian conditions, and the collision between two solitary waves is a strong function of the parameters that appear in the GRLW equation and the amplitude and speed of the initial conditions. It is also shown that the steepening of the leading and trailing waves may result in the formation of multiple secondary waves and/or an undular bore; the former interacts with the trailing solitary wave which may move parallel to or converge onto the leading solitary wave.

  18. Squamous Cell Carcinoma Arising in a Mature Cystic Teratoma

    Suna Avcı


    Full Text Available Introduction. Malignant transformation in a mature cystic teratoma of the ovary is a rare complication. Squamous cell carcinoma is the most common transformation. We describe a new case of squamous cell carcinoma arising in a mature cystic teratoma. Case Report. A premenopausal 52-year-old female patient is diagnosed with vaginal bleeding. According to examination made on the women and the pelvic scanning, 7 cm mass is found on the right adnexa of the patient. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, pelvic lymph node dissection, and debulking were the treatments completed on the patient. According to histopathological diagnosis, squamous cell carcinoma arising in a mature cystic teratoma is diagnosed as a reason for the mass in the right adnexa of the patient. Conclusion. The prognosis of the malign transformation of MCT depends on surgery stage; however it is extremely poor. The patient should receive chemotherapy regardless of stage. We have decided to administer second cycle carboplatin and paclitaxel treatments on the patient.

  19. CT diagnosis of 52 patients with lymphoma in abdominal lymph nodes

    Ri-Sheng Yu; Wei-Min Zhang; Yi-Qing Liu


    AIM: To assess CT manifestations and its diagnostic value for lymphoma in the abdominal lymph nodes (LALN).METHODS: CT findings in 52 cases of LALN proved by surgery or biopsy, including Hodgkin's disease (HD) in 16 cases and non-Hodgkin's lymphoma (NHL) in 36 cases,were retrospectively analyzed.RESULTS: (1) CT manifestations based on distribution of the lesions of LALN: Solitary mass type was found in 10 cases, including solitary, round, uniform-density,enlarged lymph nodes in 3 cases; and multiple, enlarged lymph nodes fusing into singular lobular mass in 7cases. Thirty-four cases of multiple-nodular type showed multiple, round, enlarged lymph nodes with uniform density and clear margins. Vessels-embedded signs,including mesenteric vessels, renal vessels, abdominal aorta or inferior vena cava, were seen in 6 cases, and duodenum-embedded signs were seen in 2 cases. Eight cases of diffuse type showed characteristic "cobblestone signs". (2) CT manifestations correlated with pathological type: CT manifestations of 12 cases of HD were different from those of 40 cases of NHL in distribution, size,quantity and fused lesion of enlarged lymph nodes. (3)Twenty-eight cases of 52 patients were accompanied with extra-nodal lymphoma in the abdomen, especially gastrointestinal lymphoma, which had characteristic CT findings. (4) In follow-up examinations, CT images showed uniform, heterogeneous or rim enhancement in 15 cases, and occasional calcifications accompanied with reduction of the lesion size and quantity in 12 cases, whereas the lesions disappeared in 3 cases after treatment.CONCLUSION: CT images show many characteristic manifestations valuable for qualitative diagnosis of LALN,and it is also helpful for pathological classification of LALN and therapeutic evaluation in follow-up of patients.

  20. Nutritional Issues in Cystic Fibrosis.

    Solomon, Missale; Bozic, Molly; Mascarenhas, Maria R


    The importance of maintaining adequate nutrition in patients with cystic fibrosis has been well known for the past 3 decades. Achieving normal growth and maintaining optimal nutrition is associated with improved lung function. Comprehensive and consistent nutritional assessments at regular intervals can identify those at risk of nutritional failure and uncover micronutrient deficiencies contributing to malnutrition. Management of malnutrition in cystic fibrosis should follow a stepwise approach to determine the causes and comorbidities and to develop a nutritional plan. Nutritional management is crucial at every stage in a person's life with cystic fibrosis and remains a cornerstone of management.

  1. Intraosseous calcifying cystic odontogenic tumor

    Kler Shikha


    Full Text Available The calcifying odontogenic cyst was first reported by Gorlin et al . in 1962. It had been classified as a neoplasm related to the odontogenic apparatus because of its histological complexity and morphological diversity until it was renamed as a calcifying cystic odontogenic tumor by the WHO, in 2005. Here we describe a case of mandibular calcifying cystic odontogenic tumor in a 75-year-old male, which was present since five years, with a history of occurrence after the extraction of teeth in the involved region. The lesion was surgically removed and a histopathological examination revealed a cystic tumor with predominance of ghost cells and some amount of dentinoid tissue.

  2. Left inguinal lymphadenopathy as the solitary metastatic presentation of primitive neuroectodermal tumor of unknown origin

    Tamojit Chaudhuri


    Full Text Available Primitive neuroectodermal tumor (PNET/ewing′s sarcoma is a rare neural crest tumor of central nervous system, thoracopulmonary regions, pelvis, and lower extremities. Visceral involvement by PNET is a rare phenomenon, with kidney being the most commonly involved organ. We report a 35-year-old Asian female presenting with left inguinal swelling, with computed tomography scan evidence of conglomerate lymph nodal mass in the left external iliac and inguinal region. A clinico-radiological diagnosis of lymphoproliferative disorder was made. She subsequently underwent excision biopsy. Histopathology of the biopsy specimen revealed completely effaced lymph nodal architecture, which was replaced by a tumor composed of nests of small, round, blue cells. On immunohistochemistry, the tumor cells were positive for CD99 and negative for CD3, CD20, leucocyte common antigen, epithelial membrane antigen, cytokeratin, desmin, vimentin, synaptophysin, and chromogranin A. Extensive search regarding any possible different site of involvement by the tumor was negative. The clinical presentation and histological, cytological, and immunohistochemical pattern, lead to the diagnosis of metastatic PNET of the left external iliac and inguinal lymph node with unknown primary origin. To the best of our knowledge, it is the first ever reported case of inguinal lymphadenopathy as the solitary metastatic presentation of PNET of unknown origin.

  3. The Sentinel Lymph Node Concept


    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

  4. Mesenteric lymph node cavitation syndrome

    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...

  5. Profile of cystic fibrosis

    Mona M. El-Falaki


    Full Text Available It was generally believed that Cystic fibrosis (CF is rare among Arabs; however, the few studies available from Egypt and other Arabic countries suggested the presence of many undiagnosed patients. The aim of the present study was to determine the frequency of CF patients out of the referred cases in a single referral hospital in Egypt. A total of 100 patients clinically suspected of having CF were recruited from the CF clinic of the Allergy and Pulmonology Unit, Children’s Hospital, Cairo University, Egypt, throughout a 2 year period. Sweat chloride testing was done for all patients using the Wescor macroduct system for collection of sweat. Quantitative analysis for chloride was then done by the thiocyanate colorimetric method. Patients positive for sweat chloride (⩾60 mmol/L were tested for the ΔF508 mutation using primer specific PCR for cystic fibrosis transmembrane conductance regulator (CFTR gene. Thirty-six patients (36% had a positive sweat chloride test. The main clinical presentations in patients were chronic cough in 32 (88.9%, failure to thrive in 27 (75%, steatorrhea in 24 (66.7%, and hepatobiliary involvement in 5 (13.9%. Positive consanguinity was reported in 50% of CF patients. Thirty-two patients were screened for ΔF508 mutation. Positive ΔF508 mutation was detected in 22 (68.8% patients, 8 (25% were homozygous, 14 (43.8% were heterozygous, and 10 (31.3% tested were negative. CF was diagnosed in more than third of patients suspected of having the disease on clinical grounds. This high frequency of CF among referred patients indicates that a high index of suspicion and an increasing availability of diagnostic tests lead to the identification of a higher number of affected individuals.

  6. [Cystic lymphangioma of the scrotum].

    Oliver Llinares, F; Roques Serradilla, J L; Ruíz Jiménez, J I; Desus Ruíz, J; Segarra Llido, V


    The authors present a case of cystic lymphangioma of the scrotum. They stress the rarity of this location. They also comment upon the embriology, clinical picture and treatment of these benign tumours.

  7. [Lung physiotherapy in cystic fibrosis].

    Gursli, S; Haanaes, O C


    This article is intended as a brief practical guide for physicians and physiotherapists concerned with the treatment of cystic fibrosis. Physiotherapeutic techniques for the treatment of chest diseases have been developed and modified as advances have taken place in the medical management of cystic fibrosis. The article describes forced expiratory technique, positive expiratory pressure, postural drainage, autogenic drainage and other techniques. Patients with cystic fibrosis live longer and have a better quality of life than ever before, but progressive deterioration of lung function will always be their most serious problem. Physical activity and chest physiotherapy are essential parts of all treatment regimens for cystic fibrosis. It is important to realize that the physiotherapist is a very important member of the team which includes nurses, physicians-and the patient.

  8. Abdominal Cystic Lymphangioma Mimicking Appendicitis

    Wake, Sarah; Abhyankar, Aruna; Hutton, Kim


    A cystic lymphangioma arising within the abdomen is a rare entity in children. It may present with an abdominal mass and symptoms of abdominal pain, vomiting, and anorexia. These nonspecific clinical symptoms are often attributed to more common acute pediatric conditions. In this report, we describe two pediatric cases of intra-abdominal cystic lymphangioma that were initially diagnosed and treated as appendicitis. True diagnosis was only achieved on surgical excision and pathological investi...

  9. Alveolar inflammation in cystic fibrosis

    Ulrich, Martina; Worlitzsch, Dieter; Viglio, Simona


    BACKGROUND: In infected lungs of the cystic fibrosis (CF) patients, opportunistic pathogens and mutated cystic fibrosis transmembrane conductance regulator protein (CFTR) contribute to chronic airway inflammation that is characterized by neutrophil/macrophage infiltration, cytokine release...... accumulated in type II alveolar epithelial cells, lacking CFTR. P. aeruginosa organisms were rarely present in inflamed alveoli. CONCLUSIONS: Chronic inflammation and remodeling is present in alveolar tissues of the CF lung and needs to be addressed by anti-inflammatory therapies....

  10. What Are the Signs and Symptoms of Cystic Fibrosis?

    ... Twitter. What Are the Signs and Symptoms of Cystic Fibrosis? The signs and symptoms of cystic fibrosis (CF) ... respiratory, digestive, or reproductive systems of the body. Cystic Fibrosis Figure A shows the organs that cystic fibrosis ...

  11. On the solitary wave paradigm for tsunamis

    Madsen, Per A.; Fuhrman, David R.; Schäffer, Hemming Andreas


    Since the 1970s, solitary waves have commonly been used to model tsunamis especially in experimental and mathematical studies. Unfortunately, the link to geophysical scales is not well established, and in this work we question the geophysical relevance of this paradigm. In part 1, we simulate...... of finite amplitude solitary wave theory in laboratory studies of tsunamis. We conclude that order-of-magnitude errors in effective temporal and spatial duration occur when this theory is used as an approximation for long waves on a sloping bottom. In part 3, we investigate the phenomenon of disintegration...... of long waves into shorter waves, which has been observed e.g. in connection with the Indian Ocean tsunami in 2004. This happens if the front of the tsunami becomes sufficently steep, and as a result the front turns into an undular bore. We discuss the importance of these very short waves in connection...

  12. A Solitary Plasmocytoma Case Causing Horner Syndrome

    Mustafa Vayvada


    Full Text Available Solitary plasmacytoma is a rare plasma cell tumour, when seen in the chest wall, it is important to diagnose since the treatment scheme and prognosis will vary, compared to primary malignant tumours of the chest wall. A 60-year-old male presented to our clinic with left shoulder pain radiating to the left axilla. Horner%u2019s syndrome symptoms were present, in further examination a chest wall mass located in the left upper lung lobe region was detected. Histopathologic diagnosis was solitary plasmocytoma via video-assisted thoracoscopy. The primary tumor of the rib malignancy causing Horner%u2019s syndrome is discussed with reference to the relevant literature.

  13. Hypokalemia associated with a solitary pulmonary nodule

    Saeian, Samira; Ghayumi, Seiyed Mohammad Ali; Shams, Mesbah


    Abstract Background: Differential diagnosis of hypokalemia and adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome often presents challenging in endocrinology and requires careful clinical, biochemical, radiological, and pathological investigations. Hypokalemia is a common abnormality and systematic approach is required to avoid delays in diagnosis of important underlying causes. Case Summary: A 49-year-old woman presented with moderate hypokalemia. Further evaluation showed hypercortisolism due to ectopic ACTH secretion. Chest computed tomography (CT) revealed a peripheral solitary pulmonary nodule. Excision biopsy of the nodule showed carcinoid tumor. After excision biopsy, all of the patient's symptoms improved and electrolytes and ACTH levels also became normal. Conclusion: Carciniod tumors should be considered as a differential diagnosis in patients presenting with hypokalemia and ectopic ACTH syndrome. Carcinoid tumor often present as solitary pulmonary nodule and excision biopsy can be curative. PMID:27977570

  14. Asymptotic Linear Stability of Solitary Water Waves

    Pego, Robert L.; Sun, Shu-Ming


    We prove an asymptotic stability result for the water wave equations linearized around small solitary waves. The equations we consider govern irrotational flow of a fluid with constant density bounded below by a rigid horizontal bottom and above by a free surface under the influence of gravity neglecting surface tension. For sufficiently small amplitude waves, with waveform well-approximated by the well-known sech-squared shape of the KdV soliton, solutions of the linearized equations decay at an exponential rate in an energy norm with exponential weight translated with the wave profile. This holds for all solutions with no component in (that is, symplectically orthogonal to) the two-dimensional neutral-mode space arising from infinitesimal translational and wave-speed variation of solitary waves. We also obtain spectral stability in an unweighted energy norm.

  15. From solitary wave to traveling surge



    The solution of kinetic Alfven wave under action of anomalous resistance has two branches: the slow wave, VPVA cosθ will be in a wave-broken state. Such traveling surge structure is a typical self-organization phenomenon and its wave form is determined by parameter β which represents the magnitude of resistance. High β leads to shock-like structure and low β to the appearance of some solitary waves in front of the shock. According to the study on solitary wave, shock wave and traveling surge in conjunction with self-organization of nonlinear dynamics, a general definition of wave can be given.

  16. Partial Differential Equations and Solitary Waves Theory

    Wazwaz, Abdul-Majid


    "Partial Differential Equations and Solitary Waves Theory" is a self-contained book divided into two parts: Part I is a coherent survey bringing together newly developed methods for solving PDEs. While some traditional techniques are presented, this part does not require thorough understanding of abstract theories or compact concepts. Well-selected worked examples and exercises shall guide the reader through the text. Part II provides an extensive exposition of the solitary waves theory. This part handles nonlinear evolution equations by methods such as Hirota’s bilinear method or the tanh-coth method. A self-contained treatment is presented to discuss complete integrability of a wide class of nonlinear equations. This part presents in an accessible manner a systematic presentation of solitons, multi-soliton solutions, kinks, peakons, cuspons, and compactons. While the whole book can be used as a text for advanced undergraduate and graduate students in applied mathematics, physics and engineering, Part II w...

  17. [Solitary fibrous tumours of the kidney].

    Gres, Pascal; Avances, Christophe; Ben Naoum, Kamel; Chapuis, Héliette; Costa, Pierre


    Solitary fibrous tumours (SFT) are mesenchymal tumours that usually arise from the pleura. Renal SFT are exceptional (9 cases reported in the literature). The authors report a new case discovered during assessment of HT and treated by radical right nephrectomy. The histological appearance is characteristic: a tumour with a fibrous centre, composed of a monomorphic proliferation of spindle cells, with positive CD 34, CD 99, and bcl 2 labelling. The prognosis after complete resection is generally favourable.

  18. Solitary vascular malformation of the clitoris.

    Haritharan, T; Islah, M; Zulfiqar, A; Thambi Dorai, C R


    Isolated involvement of the clitoris by vascular malformation (VM) is very rare. Clinically, the lesion simulates female pseudohermaphroditism. A five-year-old girl presented with clitoromegaly and a clinical diagnosis of solitary VM of the clitoris was made. Magnetic resonance imaging showed characteristic features and confirmed the diagnosis and the extent of the VM. This is the first reported case of isolated involvement of the clitoris by VM to be diagnosed preoperatively.

  19. Two-color walking Peregrine solitary waves.

    Baronio, Fabio; Chen, Shihua; Mihalache, Dumitru


    We study the extreme localization of light, evolving upon a non-zero background, in two-color parametric wave interaction in nonlinear quadratic media. We report the existence of quadratic Peregrine solitary waves, in the presence of significant group-velocity mismatch between the waves (or Poynting vector beam walk-off), in the regime of cascading second-harmonic generation. This finding opens a novel path for the experimental demonstration of extreme rogue waves in ultrafast quadratic nonlinear optics.

  20. Thirteen-Year Disease-Free Survival after Surgery for Cystic Duct Carcinoma: A Case Report

    Zine Abedine Benchellal


    Full Text Available Cystic duct carcinoma is known to have a better prognosis compared to its location in other biliary ducts. Only one case with a survival over ten years has been previously published. The authors report a case of survival over 13 years without recurrence or metastasis. Preoperative diagnosis of cystic duct tumor was carried in a 66-year-old male. Under the diagnosis of carcinoma of the cystic duct, the patient underwent en bloc resection of the gallbladder, cystic duct, hepaticocholedochus and lymph node dissection. A Roux-en-Y hepaticojejunostomy was performed. Histological examination revealed a moderately differentiated adenocarcinoma of the cystic duct. Five months later the patient underwent second look surgery for benign obstruction of the hepaticojejunal anastomosis. The patient is still doing well 13 years later without any local recurrence or metastasis. To our knowledge, this is the longest disease-free survival ever published in the literature. This case sustains that better and longer survival is possible with a real chance of potential cure if radical surgery is performed.

  1. Thyroglobulin measurement in the fine-needle aspiration washout for diagnosing cervical lymph node metastasis in the patients with differentiated papillary thyroid cancer

    Kim, Byung Moon [Kangbuk Samsung Hospital, Seoul (Korea, Republic of); Kim, Eun Kyung; Kim, Min Jung [Yonsei University College of Medicine, Seoul (Korea, Republic of)


    We wanted to evaluate the utility of thyroglobulin measurement in the washout of the needle (FNA-Tg) used for fine needle biopsy for detecting lymph node metastasis in patients with differentiated papillary thyroid carcinoma (DPTC). We performed ultrasonography-guided fine-needle aspiration cytology (FNAC) and FNA-Tg for 50 ultrasonographically suspicious lymph nodes in 45 DPTC patients. Eighteen patients underwent thyroidectomy before FNA and the remaining 27 patients underwent fine-needle aspiration prior to surgery. The final diagnoses were determined based on the results of histological examination of the excised specimens (n = 21) or on the follow-up examination that was done least 12 months after surgery. Lymph node metastases were confirmed in 19 patients. FNAC detected 14 metastatic lymph nodes in 14 patients, and FNA-Tg detected 18 metastatic lymph nodes in 18 patients. While none of 3 cystic lymph nodes metastasis was detected via FNAC, they all revealed positive results via FNA-Tg. One patient with a negative result on both methods had one metastatic lymph node among 9 excised lymph nodes, and this one node had not been sampled via FNAC or Tg. The sensitivities and specificities of FNAC and FNA-Tg were 73.6% (14/19) and 100% (27/27), and 94.7% (18/19) and 96.2% (26/27), respectively. FNA-Tg is a useful technique for the early detection of lymph node metastasis, and especially for detecting cystic lymph node metastasis in patients with DPTC.

  2. Cystic thymic diseases: CT manifestations

    Song, Soon Young; Choi, Yo Won; Jeon, Eui Yong; Jeon, Seok Chol; Seo, Heung Suk; Hahm, Chang Kok [School of Medicine, Hanyang University, Seoul (Korea, Republic of)


    To describe CT findings and differential points of cystic thymic lesions. We evaluated retrospectively total 19 masses with well marginated cystic lesions at thymic area on CT scans. They were 10 teratomas, 3 congenital thymic cysts, 2 multilocular thymic cysts(associated with thymoma and myasthenia gravis in each), 2 cysts Assciated with thymic Hodgkin's lymphomas an ectopic parathyroid cyst, and an infected thymic cyst. The radiological abnormalities evaluated were thickness of the wall, presence or abscene of septa, mural nodule, solid component, calcification and fat component. All three cases of congenital thymic cysts and an ectopic parathyroid cyst appeared as thin-walled unilocular cyst with homogeneous internal density and without identifiable solid component. In multilocular thymic cyst, there were thick wall and solid components(n =2), thick internal septa and calcifications(n = 1). The cysts of teratomas manifested thick walls(n = 9), internal septa(n = 4), calcifications(n = 6), fat components(n = 4), and solid components(n = 4). Cysts in Hodgkin's diseases appeared as multilocular or unilocular and had thick wall and septa without calcification. Infected thymic cyst presented with multilocular cystic mass with identifiable wall and septa, calcification, and solid components. The thymic diseases with cystic lesion include teratomas, congenital thymic cysts, multilocular thymic cysts, parathyroid cyst, and Hodgkin's disease. Congenital thymic cyst and ectopic parathyroid cyst are thin-walled unilocular cystic lesions. Cystic lesions associated with teratoma, Hodgkin's disease, and multilocular thymic cyst are thick-walled cystic lesions with or without solid component.

  3. Stable complex solitary waves of Sasa Satsuma equation

    Sasanka Ghosh


    Existence of a new class of complex solitary waves is shown for Sasa Satsuma equation. These solitary waves are found to be stable in a certain domain of the parameter and become chaotic if the parameter exceeds the value 2.4. Significantly, the complex solitary waves propagate at higher bit rate over the most stable solitons under the same conditions of the input parameters.

  4. Numerical Study on Breaking Criteria for Solitary Waves

    Chung-ren CHOU; Ruey-syan SHIH; John Z. YIM


    Studies of the breaking criteria for solitary waves on a slope are presented in this paper. The boundary element method is used to model the processes of shoaling and breaking of solitary waves on various slopes. Empirical formulae that can be used to characterize the breaking of solitary waves are presented. These include the breaking index, the wave height, the water depth, and the maximum particle velocity at the point of breaking. Comparisons with the results of other researches are given.

  5. Surgical resection of a solitary liver metastasis from nasopharyngeal carcinoma:a case report

    Spiros Delis; Ioannis Biliatis; Antonia Bourli; Nikolaos Kapranos; Christos Dervenis


    BACKGROUND: Nasopharyngeal carcinoma (NPC) has a propensity to develop distant metastases at a high rate and with poor prognosis. Metastatic sites are usually multifocal and involve bones, lungs, liver and distant lymph nodes. Management of metastatic disease is essentially palliative and is based on chemotherapy. METHODS:A 50-year-old man with a solitary liver metastasis from a newly diagnosed NPC was treated by segmentectomy. Prior to surgery, neoadjuvant chemo-therapy followed by concurrent chemoradiotherapy was administered. RESULTS:Complete remission of the primary disease was achieved, although the size of the hepatic lesion was increased. After resection of the liver metastasis, no signs of local or distant recurrence was noted during the 6-month follow up. CONCLUSION:Although surgical treatment has a limited role in metastatic NPC, there are rare cases of localized disease with a reasonable outcome after resection.

  6. The cruel and unusual phenomenology of solitary confinement

    Shaun eGallagher


    Full Text Available What happens when subjects are deprived of intersubjective contact? This paper looks closely at the phenomenology and psychology of one example of that deprivation: solitary confinement. It also puts the phenomenology and psychology of solitary confinement to use in the legal context. Not only is there no consensus on whether solitary confinement is a cruel and unusual punishment, there is no consensus on the definition of the term ‘cruel’ in the use of that legal phrase. I argue that we can find a moral consensus on the meaning of ‘cruelty’ by looking specifically at the phenomenology and psychology of solitary confinement.

  7. The cruel and unusual phenomenology of solitary confinement.

    Gallagher, Shaun


    What happens when subjects are deprived of intersubjective contact? This paper looks closely at the phenomenology and psychology of one example of that deprivation: solitary confinement. It also puts the phenomenology and psychology of solitary confinement to use in the legal context. Not only is there no consensus on whether solitary confinement is a "cruel and unusual punishment," there is no consensus on the definition of the term "cruel" in the use of that legal phrase. I argue that we can find a moral consensus on the meaning of "cruelty" by looking specifically at the phenomenology and psychology of solitary confinement.


    Shivaji D


    Full Text Available Cylindroma is a rare tumour which originates from skin appendages. Cylindromas are of two types namely solitary and multiple. Malignant transformation of cylindroma is unusual and is extremely rare in solitary type. They show strong predilection for middle aged and elderly females. We report a case of a 70 year old male patient presented with nodular swelling along with surface ulceration in the right axillary region since six months, which on histopathological examination revealed a case of malignant transformation of benign solitary cylindroma. We report a rare case of malignant cylindroma arising in a patient with solitary cylindroma at an unusual site


    Santivanez, Saul; Garcia, Hector H.


    Pulmonary cystic echinococosis, a zoonosis caused by the larvae of the dog tapeworm Echinococcus granulosus, is considered as a major public health problem in those countries where dogs are used to care for large herds because of the incapacitating effects produced in affected population. The ratio lung:liver involvement is higher in children than in adults. A higher proportion of lung cases are discovered incidentally on a routine x-ray evaluation; the majority of infected people remain asymptomatic until the cyst enlarges sufficiently to cause symptoms. The majority of symptoms are caused by mass effect from the cyst volume; the presence of complications caused by cysts broke changes the clinical presentation; the principal complication is cyst rupture, producing cough, chest pain, hemoptysis, or vomica. Diagnosis is obtained by imaging evaluation (Chest X-ray or CT scan), supported by serology in the majority of cases. Surgery is the main therapeutic approach, having as principal objective, the removal of the parasite, preventing intraoperative dissemination; the use of pre surgical chemotherapy reduces the chances of seeding and recurrence; treatment using benzimidazoles is the preferred treatment when surgery is not available, or complete removal is not feasible PMID:20216420

  10. Lung adenocarcinoma presenting as a solitary gingival metastasis: a case report

    Federico Francesco


    Full Text Available Abstract Introduction Gingival metastases are very rare and generally occur in disseminated tumors. We report a case of solitary gingival metastasis of lung cancer. Case presentation We report the case of a 74-year-old asymptomatic Caucasian woman affected by a rapidly growing, painless gingival swelling. Histopathologic examination of the excisional biopsy showed metastasis of poorly differentiated thyroid transcription factor 1-positive adenocarcinoma. A total-body computed tomographic scan revealed a tumor of the right lung lower lobe with ipsilateral, mediastinal lymph node swelling. Moreover, bone scintigraphy revealed no bone metastases. No other metastases were found, so we planned a multi-modal therapeutic approach with a curative intent. However, the tumor proved to be intrinsically resistant and highly aggressive. Conclusion The presentation of solitary gingival metastasis is exceptional. In view of its rapid clinical evolution, our case confirms that gingival metastasis is an important prognostic factor. This behavior raises the question whether the poor prognosis for patients with tumors with oral metastases depends on its diffuse spread or on its highly malignant nature.

  11. Mucinous Cystic Neoplasms of Pancreas

    Naveed, Shah; Qari, Hasina; Banday, Tanveer; Altaf, Asma; Para, Mah


    The purpose of this study was to investigate the actual management of mucinous cystic neoplasm (MCN) of the pancreas. A systematic review was performed in December 2009 by consulting PubMed MEDLINE for publications and matching the key words “pancreatic mucinous cystic neoplasm”, “pancreatic mucinous cystic tumor”, “pancreatic mucinous cystic mass”, “pancreatic cyst” and “pancreatic cystic neoplasm” to identify English language articles describing the diagnosis and treatment of the MCN of the pancreas. In total, 16,322 references ranging from January 1969 to December 2009 were analyzed and 77 articles were identified. No articles published before 1996 were selected because MCNs were not previously considered to be a completely autonomous disease. Definition, epidemiology, anatomopathological findings, clinical presentation, preoperative evaluation, treatment and prognosis were reviewed. MCNs are pancreatic mucin-producing cysts with a distinctive ovarian-type stroma localized in the body-tail of the gland and occurring in middle-aged females. The majority of MCNs are slow growing and asymptomatic. The prevalence of invasive carcinoma varies between 6% and 55%. Preoperative diagnosis depends on a combination of clinical features, tumor markers, computed tomography (CT), magnetic resonance imaging, endoscopic ultrasound with cyst fluid analysis and positron emission tomography-CT. Surgery is indicated for all MCNs.

  12. Cystic Lesions in Autoimmune Pancreatitis

    Macarena Gompertz


    Full Text Available Autoimmune pancreatitis (AIP can be chronic or recurrent, but frequently completely reversible after steroid treatment. A cystic lesion in AIP is a rare finding, and it can mimic a pancreatic cystic neoplasm. Difficulties in an exact diagnosis interfere with treatment, and surgery cannot be avoided in some cases. We report the history of a 63-year-old male presenting with jaundice and pruritus. AIP was confirmed by imaging and elevated IgG4 blood levels, and the patient completely recovered after corticosteroid therapy. One year later, he presented with a recurrent episode of AIP with elevated IgG4 levels, accompanied by the appearance of multiple intrapancreatic cystic lesions. All but 1 of these cysts disappeared after steroid treatment, but the remaining cyst in the pancreatic head was even somewhat larger 1 year later. Pancreatoduodenectomy was finally performed. Histology showed the wall of the cystic lesion to be fibrotic; the surrounding pancreatic tissue presented fibrosis, atrophy and lymphoplasmacytic infiltration by IgG4-positive cells, without malignant elements. Our case illustrates the rare possibility that cystic lesions can be part of AIP. These pseudocysts appear in the pancreatic segments involved in the autoimmune disease and can be a consequence of the local inflammation or related to ductal strictures. Steroid treatment should be initiated, after which these cysts can completely disappear with recovery from AIP. Surgical intervention may be necessary in some exceptional cases.

  13. Intraoperative Sentinel Lymph Node Evaluation

    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...

  14. Using Cystic Fibrosis Therapies for Non-Cystic Fibrosis Bronchiectasis.

    ElMaraachli, Wael; Conrad, Douglas J; Wang, Angela C C


    Non-cystic fibrosis bronchiectasis (NCFB) is an increasingly prevalent disease that places a significant burden on patients and health systems globally. Although many of the therapies used to treat NCFB were originally developed as cystic fibrosis (CF) therapies, not all of them have been demonstrated to be efficacious in NCFB and some may even be harmful. This article explores the evidence for which therapeutic strategies used to treat CF have been translated into the care of NCFB. The conclusion is that therapies for adult NCFB cannot be simply extrapolated from CF clinical trials, and in some instances, doing so may actually result in harm.

  15. A Case of Bilateral Cystic Partially Differentiated Nephroblastoma vs Cystic Wilms' Tumor: Highlighting a Diagnostic Dilemma.

    Stout, Thomas E; Au, Jason K; Hicks, J M; Gargollo, Patricio C


    Cystic partially differentiated nephroblastoma (CPDN) is a rare multicystic renal tumor along the spectrum of cystic nephroma and cystic Wilms' tumor. There have only been two previously reported cases of bilateral CPDN in the literature. We present here a case of bilateral CPDN vs cystic Wilms' tumor treated with neoadjuvant and adjuvant chemotherapy in addition to a bilateral partial nephrectomy. We also review the relevant literature regarding CPDN in an effort to aid in diagnosis and management of these rare cystic renal tumors.

  16. Cystic Fibrosis (CF): Chloride Sweat Test

    ... Old Feeding Your 1- to 2-Year-Old Cystic Fibrosis (CF) Chloride Sweat Test KidsHealth > For Parents > Cystic Fibrosis (CF) Chloride Sweat Test Print A A A ... It Is A chloride sweat test helps diagnose cystic fibrosis (CF) , an inherited disorder that makes kids sick ...

  17. What's it Like to Have Cystic Fibrosis?

    ... Emergency Room? What Happens in the Operating Room? Cystic Fibrosis KidsHealth > For Kids > Cystic Fibrosis Print A A A What's in this article? ... with a condition she's known all her life — cystic fibrosis (say: SIS-tik fi-BRO-sus). Her parents ...

  18. Bulk solitary waves in elastic solids

    Samsonov, A. M.; Dreiden, G. V.; Semenova, I. V.; Shvartz, A. G.


    A short and object oriented conspectus of bulk solitary wave theory, numerical simulations and real experiments in condensed matter is given. Upon a brief description of the soliton history and development we focus on bulk solitary waves of strain, also known as waves of density and, sometimes, as elastic and/or acoustic solitons. We consider the problem of nonlinear bulk wave generation and detection in basic structural elements, rods, plates and shells, that are exhaustively studied and widely used in physics and engineering. However, it is mostly valid for linear elasticity, whereas dynamic nonlinear theory of these elements is still far from being completed. In order to show how the nonlinear waves can be used in various applications, we studied the solitary elastic wave propagation along lengthy wave guides, and remarkably small attenuation of elastic solitons was proven in physical experiments. Both theory and generation for strain soliton in a shell, however, remained unsolved problems until recently, and we consider in more details the nonlinear bulk wave propagation in a shell. We studied an axially symmetric deformation of an infinite nonlinearly elastic cylindrical shell without torsion. The problem for bulk longitudinal waves is shown to be reducible to the one equation, if a relation between transversal displacement and the longitudinal strain is found. It is found that both the 1+1D and even the 1+2D problems for long travelling waves in nonlinear solids can be reduced to the Weierstrass equation for elliptic functions, which provide the solitary wave solutions as appropriate limits. We show that the accuracy in the boundary conditions on free lateral surfaces is of crucial importance for solution, derive the only equation for longitudinal nonlinear strain wave and show, that the equation has, amongst others, a bidirectional solitary wave solution, which lead us to successful physical experiments. We observed first the compression solitary wave in the

  19. Localization and solitary waves in solid mechanics

    Champneys, A R; Thompson, J M T


    This book is a collection of recent reprints and new material on fundamentally nonlinear problems in structural systems which demonstrate localized responses to continuous inputs. It has two intended audiences. For mathematicians and physicists it should provide useful new insights into a classical yet rapidly developing area of application of the rich subject of dynamical systems theory. For workers in structural and solid mechanics it introduces a new methodology for dealing with structural localization and the related topic of the generation of solitary waves. Applications range from classi

  20. Microtubules: A network for solitary waves

    Zdravković Slobodan


    Full Text Available In the present paper we deal with nonlinear dynamics of microtubules. The structure and role of microtubules in cells are explained as well as one of models explaining their dynamics. Solutions of the crucial nonlinear differential equation depend on used mathematical methods. Two commonly used procedures, continuum and semi-discrete approximations, are explained. These solutions are solitary waves usually called as kink solitons, breathers and bell-type solitons. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. III45010

  1. Asymptotic Methods for Solitary Solutions and Compactons

    Ji-Huan He


    Full Text Available This paper is an elementary introduction to some new asymptotic methods for the search for the solitary solutions of nonlinear differential equations, nonlinear differential-difference equations, and nonlinear fractional differential equations. Particular attention is paid throughout the paper to giving an intuitive grasp for the variational approach, the Hamiltonian approach, the variational iteration method, the homotopy perturbation method, the parameter-expansion method, the Yang-Laplace transform, the Yang-Fourier transform, and ancient Chinese mathematics. Hamilton principle and variational principles are also emphasized. The reviewed asymptotic methods are easy to be followed for various applications. Some ideas on this paper are first appeared.

  2. Solitary lucent epiphyseal lesions in children

    Gardner, D.J.; Azouz, E.M.


    We evaluated retrospectively the varying radiographic appearances of 15 solitary lucent epiphyseal lesions occurring in children. Imaging modalities used included plain films, conventional tomography, nuclear scintigraphy, and computed tomography. 40% of the lesions (6) were due to osteomyelitis. The remaining lesions included tuberculosis (1), foreign body granuloma (1), chondroblastoma (2), chondromyoxid fibroma (1), enchondroma (1), osteoid osteoma (2), and eosinophilic granuloma (1). Although the radiographic appearances of such lesions may be particularly characteristic, pathologic correlation is frequently necessary. The high incidence of osteomyelitis in our cases emphasizes its importance as a cause for a lucent epiphyseal lesion.

  3. [Solitary naso-sinusal fibrous tumor].

    Martínez, V; Jiménez, M L; Cuatrecasas, M; Jürgens, A; de Amesti, C; Orus, C; Fabra, J M


    Here we present two clinical cases of solitary naso-sinusal fibrous tumour. This tumour has a mesenchymal origin and has an evident pleural location, with well defined immunohistochemical and ultrastructural characteristics. The clinical manifestation is an apparent benign tumour with an inclination to local aggressiveness. The most effective treatment seems to be surgical removal, but given the low number of cases mentioned (there are only eight cases reported in international literature), and the tendency to eventual recurrence, called for cobalt therapy after surgery. The evolution of clinical cases is irregular.

  4. Study on Solitary Waves of a General Boussinesq Model


    In this paper, we employ the bifurcation method of dynamical systems to study the solitary waves and periodic waves of a generalized Boussinesq equations. All possible phase portraits in the parameter plane for the travelling wave systems are obtained. The possible solitary wave solutions, periodic wave solutions and cusp waves for the general Boussinesq type fluid model are also investigated.

  5. Exact solitary wave solutions of nonlinear wave equations


    The hyperbolic function method for nonlinear wave equations ispresented. In support of a computer algebra system, many exact solitary wave solutions of a class of nonlinear wave equations are obtained via the method. The method is based on the fact that the solitary wave solutions are essentially of a localized nature. Writing the solitary wave solutions of a nonlinear wave equation as the polynomials of hyperbolic functions, the nonlinear wave equation can be changed into a nonlinear system of algebraic equations. The system can be solved via Wu Elimination or Grbner base method. The exact solitary wave solutions of the nonlinear wave equation are obtained including many new exact solitary wave solutions.

  6. The lifecycle of axisymmetric internal solitary waves

    J. M. McMillan


    Full Text Available The generation and evolution of solitary waves by intrusive gravity currents in an approximate two-layer fluid with equal upper- and lower-layer depths is examined in a cylindrical geometry by way of theory and numerical simulations. The study is limited to vertically symmetric cases in which the density of the intruding fluid is equal to the average density of the ambient. We show that even though the head height of the intrusion decreases, it propagates at a constant speed well beyond 3 lock radii. This is because the strong stratification at the interface supports the formation of a mode-2 solitary wave that surrounds the intrusion head and carries it outwards at a constant speed. The wave and intrusion propagate faster than a linear long wave; therefore, there is strong supporting evidence that the wave is indeed nonlinear. Rectilinear Korteweg-de Vries theory is extended to allow the wave amplitude to decay as r-p with p=½ and the theory is compared to the observed waves to demonstrate that the width of the wave scales with its amplitude. After propagating beyond 7 lock radii the intrusion runs out of fluid. Thereafter, the wave continues to spread radially at a constant speed, however, the amplitude decreases sufficiently so that linear dispersion dominates and the amplitude decays with distance as r-1.

  7. Radiation therapy for the solitary plasmacytoma

    Esengül Koçak


    Full Text Available Plasma-cell neoplasms are classically categorized into four groups as: multiple myeloma (MM, plasma-cell leukemias, solitary plasmacytomas (SP of the bone (SPB, and extramedullary plasmacytomas (EMP. These tumors may be described as localized or diffuse in presentation. Localized plasma-cell neoplasms are rare, and include SP of the skeletal system, accounting for 2-5% of all plasma-cell neoplasms, and EMP of soft tissue, accounting for approximately 3% of all such neoplasms. SP is defined as a solitary mass of neoplastic plasma cells either in the bone marrow or in various soft tissue sites. There appears to be a continuum in which SP often progresses to MM. The main treatment modality for SP is radiation therapy (RT. However, there are no conclusive data in the literature on the optimal RT dose for SP. This review describes the interrelationship of plasma-cell neoplasms, and attempts to determine the minimal RT dose required to obtain local control.

  8. Long solitary internal waves in stable stratifications

    W. B. Zimmerman


    Full Text Available Observations of internal solitary waves over an antarctic ice shelf (Rees and Rottman, 1994 demonstrate that even large amplitude disturbances have wavelengths that are bounded by simple heuristic arguments following from the Scorer parameter based on linear theory for wave trapping. Classical weak nonlinear theories that have been applied to stable stratifications all begin with perturbations of simple long waves, with corrections for weak nonlinearity and dispersion resulting in nonlinear wave equations (Korteweg-deVries (KdV or Benjamin-Davis-Ono that admit localized propagating solutions. It is shown that these theories are apparently inappropriate when the Scorer parameter, which gives the lowest wavenumber that does not radiate vertically, is positive. In this paper, a new nonlinear evolution equation is derived for an arbitrary wave packet thus including one bounded below by the Scorer parameter. The new theory shows that solitary internal waves excited in high Richardson number waveguides are predicted to have a halfwidth inversely proportional to the Scorer parameter, in agreement with atmospheric observations. A localized analytic solution for the new wave equation is demonstrated, and its soliton-like properties are demonstrated by numerical simulation.

  9. The solitary sellar plasmacytoma: a diagnostic challenge

    Anne Soejbjerg


    Full Text Available Solitary sellar plasmacytomas are exceedingly rare and difficult to distinguish from other pituitary tumors. We report a case of a 62-year-old woman presenting with blurred vision of the right eye and tenderness of the right temporal region, which was interpreted as temporal arteritis. MRI revealed a pituitary mass lesion (20mm×14mm×17mm without compression of the optic chiasm and her pituitary function was normal. Pituitary surgery was undertaken due to growth of the lesion, and histopathological examination showed a highly cellular neoplasm composed of mature monoclonal plasma cells. Subsequent examinations revealed no evidence of extrasellar myeloma. The patient received pituitary irradiation and has remained well and free of symptoms apart from iatrogenic central diabetes insipidus. Until now, only eight cases of solitary sellar plasmacytoma have been reported. Most frequent symptoms stem from compression of the cranial nerves in the cavernous sinus (III, IV, V, whereas the anterior pituitary function is mostly intact.

  10. Solitary fibrous tumor surrounding the carotid sheath.

    Gómez-Oliveira, Guillermo; Alvarez-Flores, Modesto; Arribas-García, Ignacio; Martínez-Gimeno, Carlos


    Solitary fibrous tumors (SFTs) are rare spindle cell neoplasms that are mostly found arising from the pleura. Although SFTs recently have been reported in other regions, they are rare in the head and neck and have often been misdiagnosed due to their rarity. SFTs are benign in most cases. Clinically, SFTs usually manifest as well-circumscribed, slow-growing, smooth and painless masses. Symptoms are often minimal, although they may include sore throat, difficulty in swallowing, change of voice or trismus. CT-Scan and MRI are the most sensitive imaging procedures used. The treatment of choice is complete surgical excision of the lesion. Because recurrences have been noted up to 30 years after surgery, long-term follow up is mandatory. In this article, we present a case of a Solitary Fibrous Tumor arising in the parapharyngeal space in a 20-year-old man, involving the carotid sheath, treated by surgical excision with no recurrence after 1 year. The clinical presentation, surgical management and pathological findings are described.

  11. Cystic echinococcosis of the liver

    Branci, Sonia; Ewertsen, Caroline; Thybo, Søren


    Cystic echinococcosis (CE) of the liver can be treated with ultrasound-guided puncture, aspiration, injection, and re-aspiration (PAIR), with surgery and with benzimidazole derivatives. The aim of this study was to review available data concerning treatment modality and outcome for patients treat...

  12. Lung transplantation for cystic fibrosis

    Adler, Frederick R; Aurora, Paul; Barker, David H; Barr, Mark L; Blackwell, Laura S; Bosma, Otto H; Brown, Samuel; Cox, D R; Jensen, Judy L; Kurland, Geoffrey; Nossent, George D; Quittner, Alexandra L; Robinson, Walter M; Romero, Sandy L; Spencer, Helen; Sweet, Stuart C; van der Bij, Wim; Vermeulen, J; Verschuuren, Erik A M; Vrijlandt, Elianne J L E; Walsh, William; Woo, Marlyn S; Liou, Theodore G


    Lung transplantation is a complex, high-risk, potentially life-saving therapy for the end-stage lung disease of cystic fibrosis (CF). The decision to pursue transplantation involves comparing the likelihood of survival with and without transplantation as well as assessing the effect of wait-listing

  13. Lactate in cystic fibrosis sputum

    Bensel, Tobias; Stotz, Martin; Borneff-Lipp, Marianne


    Antibiotic therapy is thought to improve lung function in patients with cystic fibrosis (CF) by decreasing neutrophil-derived inflammation. We investigated the origin and clinical significance of lactate in the chronically inflamed CF lung. Methods Lactate was measured in sputa of 18 exacerbated ...

  14. Cystic echinococcosis of the liver

    Branci, Sonia; Ewertsen, Caroline; Thybo, Søren;


    Cystic echinococcosis (CE) of the liver can be treated with ultrasound-guided puncture, aspiration, injection, and re-aspiration (PAIR), with surgery and with benzimidazole derivatives. The aim of this study was to review available data concerning treatment modality and outcome for patients treated...... for CE of the liver in a Danish tertiary reference center....

  15. Pseudomembranous colitis in cystic fibrosis.

    Nagakumar, Prasad


    Cystic fibrosis (CF) patients may require frequent courses of antibiotics and repeated hospital admissions. Although children with CF have high carriage rate for C.difficile, they rarely develop colitis. Pseudomembranous colitis is more common in adult post lung transplant CF patients. Although rare, paseudomembranous colitis should be considered in CF patients presenting with abdominal symptoms even in the absence of diarrhoea.

  16. Decellularized Lymph Nodes as Scaffolds for Tissue Engineered Lymph Nodes

    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

  17. [Therapeutic update in cystic fibrosis].

    Durupt, S; Nove Josserand, R; Durieu, I


    We present the recent therapeutic advances in the cystic fibrosis care. It concerns improvements in symptomatic treatment with the development of dry powder inhaled antibiotics that improved quality of life, and innovative treatments namely the modulators of the cystic fibrosis transmembrane protein conductance regulator (CFTR), molecules which act specifically at the level of the defective mechanisms implied in the disease. The life expectancy of cystic fibrosis patients born after 2000, is estimated now to be about 50 years. This improvement of survival was obtained with the organization of the care within the specialized centers for cystic fibrosis (Centre de ressource et de compétences de la mucoviscidose) and remains still based on heavy symptomatic treatments. Dry powder inhaled antibiotics constitute a significant time saving for patients to whom all the care can achieve two hours daily. Since 2012, the modulators of CFTR, molecules allowing a pharmacological approach targeted according to the type of the mutations, allows a more specific approach of the disease. Ivacaftor (Kalydeco(®)) which potentialises the function of the CFTR protein expressed on the cellular surface is now available for patients with the G551D mutation. Lumacaftor is going to be tested in association with ivacaftor in patients with the F508del mutation, that is present in at least 75% of the patients. The ataluren which allows the production of a functional protein CFTR in patients with a no sense mutation is the third representing of this new therapeutic class. We presently have numerous symptomatic treatments for the cystic fibrosis care. The development of CFTR modulators, today available to a restricted number of patients treated with ivacaftor represents a very promising therapeutic avenue. It will represent probably the first step to a personalized treatment according to CFTR genotype. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by

  18. Lymph node staging in prostate cancer.

    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.

  19. Utility of Thyroglobulin measurement in fine-needle aspiration biopsy specimens of lymph nodes in the diagnosis of recurrent thyroid carcinoma

    Baloch Zubair W


    Full Text Available Abstract Introduction The most common site for the metastasis of papillary carcinoma of the thyroid (PTC is regional lymph nodes. Ultrasound (US imaging may identify abnormal appearing lymph nodes, suspicious for PTC recurrence. Although fine needle aspiration biopsy (FNAB of abnormal lymph nodes is often diagnostic of recurrence, small or cystic lymph nodes may be non-diagnostic due to lack of tumor cells. The measurement of thyroglobulin (TG levels in FNAB specimens from lymph nodes suspicious for recurrent PTC can serve as an adjunct to the cytologic diagnosis. Materials and methods 115 abnormal appearing lymph nodes were aspirated under ultrasound guidance in 89 patients with history of thyroid carcinoma. In addition to obtaining material for cytologic interpretation, an additional aspirate was obtained by FNAB and rinsed in 1 ml of normal saline for TG level measurements. Results The cytologic diagnoses included: 35 (30% reactive lymph node, no tumor seen (NTS, 39 (34% PTC, 23 (20% inadequate for evaluation due to lack of lymphoid or epithelial cells (NDX 15 (13% atypical/suspicious for PTC, and 3 (3% other (e.g. paraganglioma, poorly differentiated carcinoma and carcinoma not otherwise specified. TG levels were markedly elevated (median 312 ng/ml; normal Conclusion The measurement of TG in FNAB specimens from lymph node in patients with history of PTC is useful in detecting recurrent disease, especially in cases when the specimen is known to be or likely to be inadequate for cytologic evaluation.

  20. Aggressive Trimodality Therapy for T1N2M1 Nonsmall Cell Lung Cancer with Synchronous Solitary Brain Metastasis: Case Report and Rationale

    Timothy N. Showalter


    Full Text Available Aggressive treatment, including resection of both metastasis and primary tumor, has been studied for non-small cell lung cancer patients with synchronous solitary brain metastasis. Involvement of mediastinal lymph nodes is considered a poor prognostic factor and a contraindication to surgical resection of the primary lung tumor after treatment for brain metastasis. Here we present the case of a patient who presented with a Stage IV T1N2M1 non-small cell lung cancer with synchronous solitary brain metastasis. He is alive and without evidence of disease two years after aggressive, multimodality treatment that included craniotomy, whole-brain radiation therapy, thoracic surgery, chemotherapy, and mediastinal radiation therapy.

  1. Desmoplastic fibroma of the rib with cystic change: a case report and literature review

    Okubo, Taketo [Juntendo University, Department of Orthopaedic Surgery, School of Medicine, Tokyo (Japan); Juntendo University, Department of Human Pathology, School of Medicine, Bunkyo-ku, Tokyo (Japan); Saito, Tsuyoshi [Juntendo University, Department of Human Pathology, School of Medicine, Bunkyo-ku, Tokyo (Japan); Takagi, Tatsuya; Suehara, Yoshiyuki; Kaneko, Kazuo [Juntendo University, Department of Orthopaedic Surgery, School of Medicine, Tokyo (Japan)


    Desmoplastic fibroma (DF) is a rare, locally aggressive, solitary tumor microscopically composed of well-differentiated myofibroblasts with abundant dense collagen deposition. The most common sites are the long tubular bones and mandible. To our knowledge, only five cases of DF in the ribs have been reported. Here, we report a case of DF in this rare location with unusual radiological findings. A 40-year-old man presented with a 4-year history of swelling of the right chest wall. Radiographs revealed a mass at the right 9th rib, and computed tomography demonstrated a mass of 14 x 12 x 8 cm at the right 9th rib with expanded cystic change and marked calcification that appeared to have arisen from the bone. Open biopsy suggested DF. Total excision was performed, and the chest wall was reconstructed. The surgical specimen was a yellowish tumor with multilocular cystic change containing a viscous liquid. The tumor was composed of a proliferation of less-atypical spindle-shaped cells in a collagenous background. The cystic change was observed in the extra-osseous lesion. No β-catenin cytoplasmic/nuclear accumulation was detected, and no β-catenin or GNAS genetic mutations were detected. A final diagnosis of DF was made on the basis of the pathological and radiological findings. The patient was successfully treated with total excision of the tumor with no evidence of recurrence 6 months after surgery. (orig.)

  2. Intraoperative Sentinel Lymph Node Evaluation

    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...


    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.

  4. Salivary Gland Like Breast Carcinoma/Adenoid Cystic Carcinoma: Case Report.

    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.

  5. Solitary plasmacytoma of spine with amyloidosis

    Cui-yun SUN


    Full Text Available Objective To report the diagnosis and treatment of one case of solitary plasmacytoma of spine with amyloidosis and investigate the clinicopathological features combined with literatures. Methods and Results The patient was a 46-year-old woman. She suffered from weakness of both lower limbs, unsteady gait and numbness of toes for 20 d. MRI examination revealed an irregular mass behind the spinal cord at T5-7 level and T6-7 vertebral body accessory. The enhanced MRI showed obvious heterogeneous enhancement. The border was clear and spinal dura mater was compressed to shift forward. During operation, T5-7 processus spinosus and vertebral laminae were eroded, and the cortex of bone showed "moth-eaten" erosion. The intraspinal and extradural lesion had rich blood supply, loose bone structure and intact spinal dura mater. Histologically, tumor cells were composed of intensive small cells, and focal plasmacytoid cells were seen. Flake pink staining substance was among them. Artificial cracks were common and multinuclear giant tumor cells were scatteredly distributed. Immunohistochemical analysis showed the cytoplasm of tumor cells were diffusely positive for CD138, CD38 and vimentin (Vim,scatteredly positive for leukocyte common antigen (LCA, and negative for immune globulin κ light chain(IgGκ and λ light chain (IgGλ, CD99, S-100 protein (S-100, pan cytokeratin (PCK, epithelial membrane antigen (EMA, HMB45 and CD34. The Ki-67 labeling index was 1.25%. Congo red staining showed the pink staining substance was brownish red. Hybridization in situ examination showed the DNA content of IgGκ was more than that of IgGλ. The final pathological diagnosis was solitary plasmacytoma of spine with amyloidosis. The patient was treated with postoperative chemotherapy, and there was no recurrence or metastasis during 18-month follow-up period. Conclusions Solitary plasmacytoma of spine with amyloidosis is a rare tumor. The imaging features can offer a few

  6. Weak bond detection in composites using highly nonlinear solitary waves

    Singhal, Taru; Kim, Eunho; Kim, Tae-Yeon; Yang, Jinkyu


    We experimentally investigate a diagnostic technique for identifying a weak bond in composites using highly nonlinear solitary waves (HNSWs). We set up a one-dimensional chain of granular crystals, consisting of spherical particles with nonlinear interactions, to generate HNSWs. These solitary wave packets are transmitted into an inspection area of composites by making a direct contact with the chain. We demonstrate that a strong type of solitary waves injected to the weak bond area can break the weak bond of laminates, thereby causing delamination. Then, to identify the creation of the delamination, we transmit a weak type of solitary waves by employing the same apparatus, and measure the solitary waves reflected from the specimens. By analyzing these reflected solitary waves, we differentiate the weak bond samples with the pristine bond ones in an efficient and fast manner. The diagnostic results based on the proposed method are compared with the strength and energy release rate at bond interfaces, which are measured via standard testing methods such as three point bending and end notched flexure tests. This study shows the potential of solitary wave-based detection of weak bonds for hot spot monitoring of composite-based structures.

  7. Adenoid cystic carcinoma of the breast; Carcinome adenoide kystique du sein

    Kallel, R.; Bahri Zouari, I.; Gouiaa, N.; Charfi, S.; Ayadi, L.; Makni, S.; Sellami Boudawara, T. [CHU Habib-Bourguiba, Lab. d' Anatomie et de Cytologie Pathologiques, Sfax (Tunisia); Daoud, E. [CHU Habib Bourguiba, Service de Radiologie, Sfax (Tunisia); Daoud, J. [CHU Habib Bourguiba, Service de Radiotherapie, Sfax (Tunisia)


    Adenoid cystic carcinoma of the breast is a rare neoplasm, accounting for only 0.1% of all malignant breast tumours. It is more common in women in the sixth decade of their lives and often in the sub areolar area. The clinical criteria is not specific and the radiographic examination showed a benign-appearing tumour. The preoperative diagnosis is possible with fine-needle aspiration cytology. The diagnosis is made by histological examination, presented a difficult differential diagnosis with cribriform carcinoma; so it is necessary to use histochemical or immunohistochemical techniques. The treatment is not well established. It consists of lumpectomy with radiation or mastectomy. Compared to other locations, adenoid cystic carcinoma of the breast has a favorable prognosis. Lymph node involvement or distant metastases seldom occur. The aim of our study is to describe the epidemiological, clinico pathological characteristics, the treatment and the prognosis of this rare type of breast tumour. (authors)

  8. A solitary fibrous tumor of the kidney

    Anuruddha M Abeygunasekera


    Full Text Available A solitary fibrous tumor (SFT is an uncommon spindle cell neoplasm that usually occurs in the pleura, but may occur in extrapleural sites. Its occurrence in the kidney is rare. We report a SFT, clinically thought to be a renal cell carcinoma arising in the kidney of a 68-year-old female. The tumor was well-circumscribed and composed of a mixture of spindle cells and dense collagenous bands. Immunohistochemical studies revealed reactivity for CD34, CD99, and Bcl-2 protein, with no staining for keratin or muscle markers, confirming the diagnosis. The immunohistochemical study was the key to diagnosis. Several younger members of her family had colorectal and lung cancers suggesting the possibility of a familial or genetic susceptibility.

  9. Solitary waves of the splitted RLW equation

    Zaki, S. I.


    A combination of the splitting method and the cubic B-spline finite elements is used to solve the non-linear regularized long wave (RLW) equation. This approach involves a Bubnov-Galerkin method with cubic B-spline finite elements so that there is continuity of the dependent variable and its first derivative throughout the solution region. Time integration of the resulting systems is effected using a Crank-Nicholson approximation. In simulations of the migration of a single solitary wave this algorithm is shown to have higher accuracy and better conservation than a recent splitting difference scheme based on cubic spline interpolation functions, for different amplitudes ranging from a very small ( ⩾0.03) to a considerably high amplitudes ( ⩽0.3). The development of an undular bore is modeled.

  10. Numerical Simulation of Solitary Kinetic Alfven Waves

    DING Jian; LI Yi; WANG Shui


    Using the two-fluid model in the case of α1 (α=β/2Q, β is the ratio of thermal pressure to magnetic pressure, and Q=m,e/m,I), we numerically investigate the interactions between two solitary kinetic Alfven waves (SKAWs) and between an SKAW and a density discontinuity. The results show that the two SKAWs would remain in their original shapes and propagate at their initiating speeds, which indicates that SKAWs behave just like standard solitons. The simulation also shows that SKAWs will reflect and refract when crossing a discontinuity and propagating into a higher density region. The transmission wave is an SKAW with increasing density, and the reverberation is a disturbance with lower amplitude.

  11. Benign solitary solid cold thyroid nodules

    Døssing, Helle; Bennedbaek, Finn Noe; Karstrup, Steen;


    PURPOSE: To evaluate the effects of ultrasonography (US)-guided interstitial laser photocoagulation (ILP) on the volume of benign solitary solid cold thyroid nodules and any nodule-related symptoms. MATERIALS AND METHODS: ILP was performed in 16 patients with normal thyroid function and a solid...... to evaluate the size of the untreated thyroid nodule. RESULTS: In the 16 patients treated with ILP, the mean thyroid nodule volume decreased from 10 to 5.4 mL (P .... Pressure symptoms were significantly reduced (P =.0002) after 6 months. The treatment was well-tolerated in all patients. No significant change in thyroid nodule volume was seen in the control group. CONCLUSION: US-guided ILP could become a useful nonsurgical alternative in the treatment of the benign...

  12. Solitary Plasmacytoma of the Chest Wall

    Servet Kayhan


    Full Text Available A previously healthy 55-year-old man with right sided lateral chest pain admitted to clinic. It was found a solid and painful mass at the right 4th rib in physical examination. Chest X-ray and thoracic computarized tomography showed an opacity measured 60x33 mm within the right chest wall destructing the 4th rib. Needle aspiration was performed from tumor and cytologic examination showed atypic plasma cell infiltration. The patient was scheduled for a chest wall resection and reconstructive surgery. Examination of a permanent section showed that the chest wall tumor was solitary plasmacytoma. There was no evidence of multiple myeloma recurrence after two years from the operation.

  13. Transparent lattices and their solitary waves.

    Sadurní, E


    We provide a family of transparent tight-binding models with nontrivial potentials and site-dependent hopping parameters. Their feasibility is discussed in electromagnetic resonators, dielectric slabs, and quantum-mechanical traps. In the second part of the paper, the arrays are obtained through a generalization of supersymmetric quantum mechanics in discrete variables. The formalism includes a finite-difference Darboux transformation applied to the scattering matrix of a periodic array. A procedure for constructing a hierarchy of discrete Hamiltonians is indicated and a particular biparametric family is given. The corresponding potentials and hopping functions are identified as solitary waves, pointing to a discrete spinorial generalization of the Korteweg-deVries family.

  14. Solitary vortex couples in viscoelastic Couette flow

    Groisman, A; Groisman, Alexander; Steinberg, Victor


    We report experimental observation of a localized structure, which is of a new type for dissipative systems. It appears as a solitary vortex couple ("diwhirl") in Couette flow with highly elastic polymer solutions. A unique property of the diwhirls is that they are stationary, in contrast to the usual localized wave structures in both Hamiltonian and dissipative systems which are stabilized by wave dispersion. It is also a new object in fluid dynamics - a couple of vortices that build a single entity somewhat similar to a magnetic dipole. The diwhirls arise as a result of a purely elastic instability through a hysteretic transition at negligible Reynolds numbers. It is suggested that the vortex flow is driven by the same forces that cause the Weissenberg effect. The diwhirls have a striking asymmetry between the inflow and outflow, which is also an essential feature of the suggested elastic instability mechanism.

  15. Recommendations for quality improvement in genetic testing for cystic fibrosis European Concerted Action on Cystic Fibrosis

    Dequeker, E; Cuppens, H; Dodge, J; Estivill, [No Value; Goossens, M; Pignatti, PF; Scheffer, H; Schwartz, M; Schwarz, M; Tummler, B; Cassiman, JJ

    These recommendations for quality improvement of cystic fibrosis genetic diagnostic testing provide general guidelines for the molecular genetic testing of cystic fibrosis in patients/individuals. General strategies for testing as well as guidelines for laboratory procedures, internal and external

  16. Solitary Fibrous Tumor of the Cerebello-Pontine Angle

    Biggs, Nigel D.; Fagan, Paul A.; Turner, Jennifer J.; Doust, Bruce


    A case is presented of solitary fibrous tumor occurring in the cerebello-pontine angle. There have been only two other reported cases of a solitary fibrous tumors in this region. Imaging studies showed the tumor to be characteristic in shape and position of an acoustic tumor. However, at surgery the tumor was found to have a “rock hard” consistency. Solitary fibrous tumor differs from acoustic schwannoma and meningioma in its histopathological features and in this case, regrowth, after incomplete excision, was extremely rapid. ImagesFigure 2Figure 3Figure 4Figure 5Figure 6 PMID:17171119

  17. Generation of Solitary Rossby Waves by Unstable Topography

    YANG Hong-Wei; YIN Bao-Shu; DONG Huan-He


    The effect of topography on generation of the solitary Rossby waves is researched. Here, the topography, as a forcing for waves generation, is taken as a function of longitude variable x and time variable t, which is called unstable topography. With the help of a perturbation expansion method, a forced mKdv equation governing the evolution of amplitude of the solitary Rossby waves is derived from quasi-geostrophic vortieity equation and is solved by the pseudo-spectral method. Basing on the waterfall plots, the generational features of the solitary Rossby waves under the influence of unstable topography and stable topography are compared and some conclusions are obtained.

  18. Cystic fibrosis from the gastroenterologist's perspective.

    Ooi, Chee Y; Durie, Peter R


    Cystic fibrosis is a life-limiting, recessive disease caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Increased survival outcomes and the multisystem nature of the disease, including the involvement of hepatobiliary and gastrointestinal tracts, now require the need for more extensive knowledge and expertise in cystic fibrosis among gastroenterologists. Manifestations are either a direct consequence of the primary defect in cystic fibrosis or a secondary complication of the disease or therapy. Adult patients with cystic fibrosis also have an increased risk of malignancy in the gastrointestinal and pancreatico-biliary tracts compared with the general population. Novel treatments that target the basic defects in the CFTR protein have emerged, but to date not much is known about their effects on the gastrointestinal and hepatobiliary systems. The introduction of such therapies has provided new opportunities for the application of intestinal endpoints in clinical trials and the understanding of underlying disease mechanisms that affect the gut in cystic fibrosis.

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

    Parodo Giuseppina


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

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

    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.

  1. Facial cystic lymphangioma in adults.

    Biasotto, Matteo; Clozza, Emanuele; Tirelli, Giancarlo


    Lymphangiomas are uncommon congenital malformations of the lymphatic system, generally diagnosed during childhood. These malformations are rarely seen in adults, and the literature provides poor guidelines for treatment options that must be carefully applied to the facial region. Diagnosis in adult subjects is difficult to achieve, and also management of these conditions is still challenging because they tend to infiltrate adjacent tissues, causing frequent relapses. Radical surgery is the main form of treatment, avoiding the sacrifice of function or aesthetics of the patient. Two cases of cystic lymphangioma of the facial region found in adults are described from a clinical and pathologic point of view. The aim of this article was to point out that an early recognition of cystic lymphangioma is a crucial goal to initiate a prompt treatment avoiding serious complication.

  2. [Historical compilation of cystic fibrosis].

    Navarro, Salvador


    Cystic fibrosis is the most common life-shortening recessively inherited disorder in the Caucasian population. The genetic mutation that most frequently provokes cystic fibrosis (ΔF508) appeared at least 53,000years ago. For many centuries, the disease was thought to be related to witchcraft and the "evil eye" and it was only in 1938 that Dorothy H. Andersen characterized this disorder and suspected its genetic origin. The present article reviews the pathological discoveries and diagnostic and therapeutic advances made in the last 75 years. The review ends with some considerations for the future. Copyright © 2015 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

  3. Posttraumatic Cranial Cystic Fibrous Dysplasia

    Arata Tomiyama


    Full Text Available A 14-year-old was girl admitted to our hospital with a subcutaneous mass of the occipital head. The mass had grown for 6 years, after she had sustained a head injury at the age of 6, and was located directly under a previous wound. Skull X-ray Photograph (xp, computed tomography (CT, and magnetic resonance imaging (MRI showed a bony defect and cystic changes in the skull corresponding to a subcutaneous mass. Bone scintigraphy revealed partial accumulation. The patient underwent total removal of the skull mass, and the diagnosis from the pathological findings of the cyst wall was fibrous dysplasia (FD. The radiographic findings for cystic cranial FD can be various. Progressive skull disease has been reported to be associated with head trauma, but the relationship between cranial FD and head trauma has not been previously reported. Previous studies have suggested that c-fos gene expression is a key mechanism in injury-induced FD.

  4. Head-on collision and overtaking collision between an envelope solitary wave and a KdV solitary wave in a dusty plasma.

    Zhang, Heng; Duan, Wen-Shan; Qi, Xin; Yang, Lei


    Head-on collision and overtaking collision between a KdV solitary wave and an envelope solitary wave are first studied in present paper by using Particle-in-cell (PIC) method in a dusty plasma. There are phase shifts of the KdV solitary wave in both head-on collision and the overtaking collision, while no phase shift is found for the envelop solitary wave in any cases. The remarkable difference between head-on collision and the overtaking collision is that the phase shift of KdV solitary wave increases as amplitude of KdV solitary wave increases in head-on collision, while it decreases as amplitude of the KdV solitary wave increases in the overtaking collision. It is found that the maximum amplitude during the collision process is less than sum of two amplitudes of both solitary waves, but is larger than either of the amplitude.

  5. A plethora of generalised solitary gravity-capillary water waves

    Clamond, Didier; Duran, Angel


    The present study describes, first, an efficient algorithm for computing gravity-capillary solitary waves solutions of the irrotational Euler equations and, second, provides numerical evidences of the existence of (likely) an infinite number of generalised solitary waves (i.e. solitary waves with undamped oscillatory wings). Using conformal mapping, the unknown fluid domain (which is to be determined) is mapped into a uniform strip of the complex plane. A Babenko-like equation is then derived from a Lagrangian expressed in the transformed domain. The Babenko equation is then solved numerically using a Levenberg-Marquardt algorithm. Various interesting solutions are computed, some of them being known, some seem to be new. The emergence of generalised solitary waves is shown when the Bond number is increased.

  6. Oblique solitary waves in a five component plasma

    Sijo, S.; Manesh, M.; Sreekala, G.; Venugopal, C., E-mail: [School of Pure and Applied Physics, Mahatma Gandhi University, Kottayam, 686 560 Kerala (India); Neethu, T. W. [Department of Physics, CMS College, Mahatma Gandhi University, Kottayam, 686 001 Kerala (India); Renuka, G. [Kerala State Council for Science, Technology and Environment, Thiruvananthapuram, 695 004 Kerala (India)


    We investigate the influence of a second electron component on oblique dust ion acoustic solitary waves in a five component plasma consisting of positively and negatively charged dust, hydrogen ions, and hotter and colder electrons. Of these, the heavier dust and colder photo-electrons are of cometary origin while the other two are of solar origin; electron components are described by kappa distributions. The K-dV equation is derived, and different attributes of the soliton such as amplitude and width are plotted for parameters relevant to comet Halley. We find that the second electron component has a profound influence on the solitary wave, decreasing both its amplitude and width. The normalized hydrogen density strongly influences the solitary wave by decreasing its width; the amplitude of the solitary wave, however, increases with increasing solar electron temperatures.

  7. Solitary pulmonary granuloma with marked enhancement on dynamic CT scanning

    Stark, P.; Wong, V.; Gold, P.


    A patient is described who presented with a vividly enhancing solitary pulmonary nodule during dynamic CT scanning. This mass proved to represent a granuloma due to coccidioidomycosis. The presumptive mechanism of enhancement as well as the differential diagnosis are discussed.

  8. The Sociology and Entrenchment. A Cystic Fibrosis Test for Everyone?

    Koch, Lene; Stemerding, Dirk


    Socialmedicine, genetic screening, cystic fibrosis, ethics, political regulation, sociology of technology......Socialmedicine, genetic screening, cystic fibrosis, ethics, political regulation, sociology of technology...

  9. Solitary plasmacytoma of the rib: A rare case

    Rikki Singal


    Full Text Available Localized solitary plasmacytoma of the bone is a rare disease and is characterized by only one or two isolated bone lesions with no evidence of disease dissemination. We report a case of solitary plasmacytoma of the rib in a 43-year-old female. The patient underwent complete en-bloc resection of the chest wall including rib, muscle, and parietal pleura. Patient is asymptomatic without any recurrence after two and half years of follow up.

  10. Solitary mesenteric vascular anomaly presenting as acute abdomen

    Thambidorai C


    Full Text Available A 4-year-old girl with a solitary vascular anomaly of the mesentery presented with acute lower abdominal pain. Despite the use of ultrasound, computed tomography scan and image-guided core biopsies, the lesion was initially mistaken for an inflammatory intra-abdominal mass. The correct diagnosis was made at laparotomy. Solitary vascular anomaly of the mesentery is rare and its presentation as an acute abdomen has not been reported before.

  11. Solitary osteochondroma arising from cervical spina bifida occulta.

    Ofluoglu, Ali Ender; Abdallah, Anas; Gokcedag, Akin


    Solitary osteochondromas are common benign long bone tumors originating from cartilage. They may produce a wide variety of symptoms and complications depending on their spinal location. These may include compressive myelopathy, nerve root compression, pathologic fracture and malignant degeneration, or in some cases only pain. Solitary cervical spine osteochondromas have been reported mostly in the neural arch or vertebral body. This report describes a patient presenting with neck pain, with a benign osteochondroma arising in the right bifid C5 lamina.

  12. [Adenocarcinoma of lung cancer with solitary metastasis to the stomach].

    Koh, Sung Ae; Lee, Kyung Hee


    Although hematogenous metastasis of cancer to the gastrointestinal track is rare, it sometime has been reported in patients with malignant melanoma and breast cancer. However, it is extremely rare for lung cancer to metastasize to the stomach, not to mention solitary gastric metastasis. Herein, the authors report a case of a 69-year-old man who was initially diagnosed with lung cancer with synchronous primary gastric cancer which proved to be lung cancer with solitary gastric metastasis after the operation.

  13. Solitary Wave in One-dimensional Buckyball System at Nanoscale

    Xu, Jun; Zheng, Bowen; Liu, Yilun


    We have studied the stress wave propagation in one-dimensional (1-D) nanoscopic buckyball (C60) system by molecular dynamics (MD) simulation and quantitative modeling. Simulation results have shown that solitary waves are generated and propagating in the buckyball system through impacting one buckyball at one end of the buckyball chain. We have found the solitary wave behaviors are closely dependent on the initial temperature and impacting speed of the buckyball chain. There are almost no dispersion and dissipation of the solitary waves (stationary solitary wave) for relatively low temperature and high impacting speed. While for relatively high temperature and low impacting speed the profile of the solitary waves is highly distorted and dissipated after propagating several tens of buckyballs. A phase diagram is proposed to describe the effect of the temperature and impacting speed on the solitary wave behaviors in buckyball system. In order to quantitatively describe the wave behavior in buckyball system, a simple nonlinear-spring model is established, which can describe the MD simulation results at low temperature very well. The results presented in this work may lay a solid step towards the further understanding and manipulation of stress wave propagation and impact energy mitigation at nanoscale. PMID:26891624

  14. On cusped solitary waves in finite water depth

    Liao, Shijun


    It is well-known that the Camassa-Holm (CH) equation admits both of the peaked and cusped solitary waves in shallow water. However, it was an open question whether or not the exact wave equations can admit them in finite water depth. Besides, it was traditionally believed that cusped solitary waves, whose 1st-derivative tends to infinity at crest, are essentially different from peaked solitary ones with finite 1st-derivative. Currently, based on the symmetry and the exact water wave equations, Liao [1] proposed a unified wave model (UWM) for progressive gravity waves in finite water depth. The UWM admits not only all traditional smooth progressive waves but also the peaked solitary waves in finite water depth: in other words, the peaked solitary progressive waves are consistent with the traditional smooth ones. In this paper, in the frame of the linearized UWM, we further give, for the first time, the cusped solitary waves in finite water depth, and besides reveal a close relationship between the cusped and p...

  15. Solitary mammals provide an animal model for autism spectrum disorders.

    Reser, Jared Edward


    Species of solitary mammals are known to exhibit specialized, neurological adaptations that prepare them to focus working memory on food procurement and survival rather than on social interaction. Solitary and nonmonogamous mammals, which do not form strong social bonds, have been documented to exhibit behaviors and biomarkers that are similar to endophenotypes in autism. Both individuals on the autism spectrum and certain solitary mammals have been reported to be low on measures of affiliative need, bodily expressiveness, bonding and attachment, direct and shared gazing, emotional engagement, conspecific recognition, partner preference, separation distress, and social approach behavior. Solitary mammals also exhibit certain biomarkers that are characteristic of autism, including diminished oxytocin and vasopressin signaling, dysregulation of the endogenous opioid system, increased Hypothalamic-pituitary-adrenal axis (HPA) activity to social encounters, and reduced HPA activity to separation and isolation. The extent of these similarities suggests that solitary mammals may offer a useful model of autism spectrum disorders and an opportunity for investigating genetic and epigenetic etiological factors. If the brain in autism can be shown to exhibit distinct homologous or homoplastic similarities to the brains of solitary animals, it will reveal that they may be central to the phenotype and should be targeted for further investigation. Research of the neurological, cellular, and molecular basis of these specializations in other mammals may provide insight for behavioral analysis, communication intervention, and psychopharmacology for autism.

  16. A solitary pulmonary ground-glass nodule in adult systemic langerhans’ cell histiocytosis

    Zhou, Ying; Li, Yunyuan; Fan, Li; Liu, Shiyuan


    During a thoracic computed tomography (CT) scan, a 36-year-old male was diagnosed with a solitary oval pulmonary mixed ground-glass nodule in the right upper lobe of the lung. The edge of the nodule was well-defined, and its largest axial size was approximately 1.1×0.9 cm2. This nodule was slightly lobulated, but not obviously speculated. Solid components, micro-cystic lucency shadow, small high-density rings and tiny vascular branches were all visible in the nodule. During hospitalization, a technetium 99 m methylene diphosphonate (Tc-99 m MDP) bone scan was performed, which showed a skeletal foci with abnormal uptake in the left iliac. A pulmonary lobectomy of the right upper lobe of the lung by video-assisted thoracoscopy was performed. In post-operative pathological photomicrographs, proliferative Langerhans’ cells, eosinophils and lymphocytes were found. Immunohistochemistry showed that the expression of S-100 protein, CD1a, and CD68 antigen all stained positive. Since Langerhans’ cell histiocytosis (LCH) that is also associated with isolated mixed ground-glass nodules is relatively rare, such a multi-systemic LCH case as identified herein, is reported. PMID:26722574

  17. Outcome in cystic fibrosis liver disease.

    Rowland, Marion


    Evidence suggests that cystic fibrosis liver disease (CFLD) does not affect mortality or morbidity in patients with cystic fibrosis (CF). The importance of gender and age in outcome in CF makes selection of an appropriate comparison group central to the interpretation of any differences in mortality and morbidity in patients with CFLD.

  18. European Cystic Fibrosis Society Standards of Care

    Stern, Martin; Bertrand, Dominique Pougheon; Bignamini, Elisabetta;


    Since the earliest days of cystic fibrosis (CF) treatment, patient data have been recorded and reviewed in order to identify the factors that lead to more favourable outcomes. Large data repositories, such as the US Cystic Fibrosis Registry, which was established in the 1960s, enabled successful...




    Intravenous antibiotics and enteral tube feeding at home for the treatment of pulmonary exacerbations and underweight condition in cystic fibrosis (CF) patients have become tools that are used in many cystic fibrosis centres, The experience with home care programmes from different countries is quite

  20. Self-management education for cystic fibrosis.

    Savage, Eileen


    Self-management education may help patients with cystic fibrosis and their families to choose, monitor and adjust treatment requirements for their illness, and also to manage the effects of illness on their lives. Although self-management education interventions have been developed for cystic fibrosis, no previous systematic review of the evidence of effectiveness of these interventions has been conducted.

  1. Laparoscopic cholecystectomy in adult cystic fibrosis.

    McGrath, D S


    Two female patients with Cystic Fibrosis, attending the Adult Regional Cystic Fibrosis centre at the Cork University Hospital, were investigated for upper abdominal pain and found to have gallstones at ultrasonography. Laparoscopic cholecystectomy was performed successfully and, without complication, in both patients.

  2. Solitary fibrous tumor of the pleura.

    Marak, Creticus P; Dorokhova, Olena; Guddati, Achuta K


    Solitary fibrous tumor of the pleura (SFTP) is a rare tumor of mesenchymal origin which can grow to a large size and present with symptoms of cough and pleuritic chest pain. No specific etiological factors for SFTPs are known and they may grow undetected for several years. These tumors are usually benign and may mimic a variety of malignancies. SFTPs are often detected as peripheral opacities on chest X-ray. Unfortunately, fine needle aspiration rarely provides adequate information for a definitive diagnosis. Imaging with computed tomography provides details about the size and extent of any invasion into adjacent tissues. Surgical resection is the mainstay of treatment, and immunohistochemistry of the resected tumor often provides confirmation of the diagnosis. Some SFTPs have been observed to be malignant, and surgical intervention is often lifesaving. There is no adequate data to support the usage of radiotherapy and chemotherapy in the treatment of SFTPs. This tumor exemplifies malignancies which require surgical resection to preempt worse outcomes. Awareness of their presentation and clinical course may help the clinician provide a prompt referral to the thoracic surgeon for resection.

  3. Food searching and superparasitism in solitary parasitoids

    Sirot, Etienne; Bernstein, Carlos

    Optimality theory predicts that, provided that a larva resulting from superparasitism has some chance of winning the competition with the other larvae present in the host, under certain conditions, solitatry parasitoids should resort to superparasitism. Both theoretical and experimental studies have shown that the life expectancy of the parasitoid has a strong influence on the decision to reject or to accept superparasitism. In many species, life expectancy on its turn depends on the feeding behaviour of the parasitoids, which have to forage for non-host food (mainly plant materials), for the maintenance of their energy reseves. As many solitary parasitoids do not find non-host food in their host patches, they have to choose at each instant whether to search for food or to search for hosts. In this paper, we develop a stochastic dynamic programming model to study the behavioural choice between host and food searching, and its consequences for the acceptance and rejection of superparasitism. We study the influence of habitat quality and parasitoid physiological state on the optimal choice. The model predicts that the crucial point determining the optimal strategy is the balance between egg-and time-limitation.

  4. Intracranial solitary fibrous tumor: Imaging findings

    Clarencon, Frederic, E-mail: [Department of Neuroradiology, Pitie-Salpetriere Hospital, APHP, 75013 Paris (France); Bonneville, Fabrice [Department of Neuroradiology, Hopital Rangueil, Toulouse University Hospital, 31000 Toulouse (France); Rousseau, Audrey [Department of Neuropathology, Pitie-Salpetriere Hospital (France); Galanaud, Damien [Department of Neuroradiology, Pitie-Salpetriere Hospital, APHP, 75013 Paris (France); Kujas, Michele [Department of Neuropathology, Pitie-Salpetriere Hospital (France); Naggara, Olivier [Department of Neuroradiology, St Anne Hospital, 75014 Paris (France); Cornu, Philippe [Department of Neurosurgery, Pitie-Salpetriere Hospital (France); Chiras, Jacques [Department of Neuroradiology, Pitie-Salpetriere Hospital, APHP, 75013 Paris (France)


    Objective: To study the neuroimaging features of intracranial solitary fibrous tumors (ISFTs). Materials and methods: Retrospective study of neuroimaging features of 9 consecutive histopathologically proven ISFT cases. Location, size, shape, density, signal intensity and gadolinium uptake were studied at CT and MRI. Data collected from diffusion-weighted imaging (DWI) (3 patients), perfusion imaging and MR spectroscopy (2 patients), and DSA (4 patients) were also analyzed. Results: The tumors most frequently arose from the intracranial meninges (7/9), while the other lesions were intraventricular. Tumor size ranged from 2.5 to 10 cm (mean = 6.6 cm). They presented multilobular shape in 6/9 patients. Most ISFTs were heterogeneous (7/9) with areas of low T2 signal intensity that strongly enhanced after gadolinium administration (6/8). Erosion of the skull was present in about half of the cases (4/9). Components with decreased apparent diffusion coefficient were seen in 2/3 ISFTs on DWI. Spectroscopy revealed elevated peaks of choline and myo-inositol. MR perfusion showed features of hyperperfusion. Conclusion: ISFT should be considered in cases of extra-axial, supratentorial, heterogeneous, hypervascular tumor. Areas of low T2 signal intensity that strongly enhance after gadolinium injection are suggestive of this diagnosis. Restricted diffusion and elevated peak of myo-inositol may be additional valuable features.

  5. Solitary magnetic perturbations at the ELM onset

    Wenninger, RP; Boom, JE; Burckhart, A; Dunne, MG; Dux, R; Eich, T; Fischer, R; Fuchs, C; Garcia-Munoz, M; Igochine, V; Hoelzl, M; Luhmann, NC; Lunt, T; Maraschek, M; Mueller, HW; Park, HK; Schneider, PA; Sommer, F; Suttrop, W; Viezzer, E


    Edge localised modes (ELMs) allow maintaining sufficient purity of tokamak H-mode plasmas and thus enable stationary H-mode. On the other hand in a future device ELMs may cause divertor power flux densities far in excess of tolerable material limits. The size of the energy loss per ELM is determined by saturation effects in the non-linear phase of the ELM, which at present is hardly understood. Solitary magnetic perturbations (SMPs) are identified as dominant features in the radial magnetic fluctuations below 100kHz. They are typically observed close (+-0.1ms) to the onset of pedestal erosion. SMPs are field aligned structures rotating in the electron diamagnetic drift direction with perpendicular velocities of about 10km/s. A comparison of perpendicular velocities suggests that the perturbation evoking SMPs is located at or inside the separatrix. Analysis of very pronounced examples showed that the number of peaks per toroidal turn is 1 or 2, which is clearly lower than corresponding numbers in linear stabil...

  6. Solitary caecum diverticulitis mimicking acute appendicitis.

    Hot, Semih; Eğin, Seracettin; Gökçek, Berk; Yeşiltaş, Metin; Alemdar, Ali; Akan, Arzu; Karahan, Servet Rüştü


    Solitary cecum diverticulum is a benign formation, but it can be complicated with inflammation, perforation and bleeding. Cecum diverticulitis (CD) is the most common complication of caecal diverticulum and it has the highest incidence among Asians, but it is a rare condition in the western world. The incidence of colonic diverticular disease can vary according to national origin, cultural structure and nutritional habits. CD is not common in our country, but it is an important situation because of its clinical similarity with the commonly seen acute right side abdominal diseases like acute appendicitis. Preoperative diagnosis is difficult, and hence, the actual frequency is not known. The treatment of CD can vary from medical therapy to right hemi colectomy. In this study, we presented ten CD cases on whom surgical resection was performed in our surgery unit during the last 8 years. Our purpose was to increase the awareness of surgeons about this situation, and so, make them pay attention for not having their first experience in the operating room.

  7. Muscular cystic hydatidosis: case report

    Naspetti Riccardo


    Full Text Available Abstract Background Hydatidosis is a zoonosis caused by Echinococcus granulosus, and ingesting eggs released through the faeces from infected dogs infects humans. The location of the hydatid cysts is mostly hepatic and/or pulmonary, whereas musculoskeletal hydatidosis is very rare. Case presentation We report an unusual case of primary muscular hydatidosis in proximity of the big adductor in a young Sicilian man. The patient, 34 years old, was admitted to the Department of Infectious and Tropical Diseases for ultrasonographic detection, with successive confirmation by magnetic resonance imaging, of an ovular mass (13 × 8 cm in the big adductor of the left thigh, cyst-like, and containing several small cystic formations. Serological tests for hydatidosis gave negative results. A second drawing of blood was done 10 days after the first one and showed an increase in the antibody titer for hydatidosis. The patient was submitted to surgical excision of the lesion with perioperatory prophylaxis with albendazole. The histopathological examination of the bioptic material was not diriment in the diagnosis, therefore further tests were performed: additional serological tests for hydatidosis for the evaluation of IgE and IgG serotype (Western Blot and REAST, and molecular analysis of the excised material. These more specific serological tests gave positive results for hydatidosis, and the sequencing of the polymerase chain reaction products from the cyst evidenced E. granulosus DNA, genotype G1. Any post-surgery complications was observed during 6 following months. Conclusion Cystic hydatidosis should always be considered in the differential diagnosis of any cystic mass, regardless of its location, also in epidemiological contests less suggestive of the disease. The diagnosis should be achieved by taking into consideration the clinical aspects, the epidemiology of the disease, the imaging and immunological tests but, as demonstrated in this case, without

  8. Contrast enhanced ultrasound of sentinel lymph nodes

    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

    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. Endocrine Disorders in Cystic Fibrosis.

    Blackman, Scott M; Tangpricha, Vin


    Cystic fibrosis is frequently complicated by endocrine disorders. Diabetes can be expected to affect most with CF and pancreatic insufficiency and varies widely in age of onset, but early identification and treatment improve morbidity and mortality. Short stature can be exacerbated by relative delay of puberty and by use of inhaled corticosteroids. Bone disease in CF causes fragility fractures and should be assessed by monitoring bone mineral density and optimizing vitamin D status. Detecting and managing endocrine complications in CF can reduce morbidity and mortality in CF. These complications can be expected to become more common as the CF population ages. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Five cases of cystic osteoechinococcosis

    JIANG Ci-peng


    @@ Osseous cystic echinococcosis (CE) is a rare disease caused by the larval stage of Echinococcus granulosus (E. granulosus) and CE is different from alveolar echinococcosis (AE) caused by the larva of E. multilocularis. During a period of 20 years (1983-2003), a total of 364 cases of echinococcosis, including 263 CE and 101 AE cases were diagnosed at Hydatidos Research Laboratory (HRL), Basic Medical College, Lanzhou University, China. Of them, 5 cases of osseous CE (1.37%) were encountered and now reported as follows.

  12. Cystic Lesions of the Mediastinum.

    Vargas, Daniel; Suby-Long, Thomas; Restrepo, Carlos S


    Cystic lesions are commonly seen in the mediastinum, and they may arise from virtually any organ. The vast majority of these lesions are benign and result in no symptoms. When large, cysts may produce symptoms related to compression of adjacent structures. The most common mediastinal cysts are pericardial and foregut duplication cysts. Both computed tomography and magnetic resonance are routinely used to evaluate these lesions. Although computed tomography offers superior spatial resolution, magnetic resonance is useful in differentiating cysts that contain proteinaceous material from solid lesions. Occasionally, cysts arise from solid lesions, such as thymoma or teratoma. Although cysts are alike in appearance, location helps narrowing the differential diagnoses.

  13. Extended lymph node dissection for prostate cancer.

    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.

  14. Cystic Fibrosis: Brazilian ENT Experience

    Tania Sih


    Full Text Available Most published studies about Cystic Fibrosis (CF are European or North American. There are still few publications about the characteristics of fibrocystic populations in developing countries. The incidence of cystic fibrosis (CF in Brazil varies among different regions (1 : 10,000 in Minas Gerais, 1 : 9,500 in Paraná, 1 : 8,700 in Santa Catarina, and 1 : 1600 in Rio Grande do Sul. The prevalence of the DF508 mutation also varies according to population: 33% in Sao Paulo, 49% in Rio Grande do Sul, 27% in Santa Catarina, and 52% in Minas Gerais. Cough and nasal obstruction are the most common symptoms. The variation in nasal polyposis prevalence may be explained by population genotypic characteristics in a country that spans a continent. Findings on nasal endoscopy and computed tomography (CT have better correlation than do this information compared with surgical and clinical history. Microbiologic studies suggest a high level of early contamination of the airways. Sensorineural hearing loss (SNHL occurs in these patients as a result of ototoxic antibiotics. The data compiled in this paper is useful, but also lead to the general agreement that more research would be welcome due to the unique characteristics of this country.

  15. Cystic lymphangioma of the pancreas

    Radoje B Colovic; Nikica M Grubor; Marjan T Micev; Henry Dushan E Atkinson; Vitomir I Rankovic; Mihajlo M Jagodic


    Lymphangioma of the pancreas is an extremely rare benign turnout of lymphatic origin, with fewer than 60 published cases. Histologically, it is polycystic, with the cysts separated by thin septa and lined with endothelial cells. Though congenital, it can affect all age groups, and occurs more frequently in females. Patients usually present with epigastric pain and an associated palpable mass. Complete excision is curative, even though, depending on the tumour location, surgery may be simple or involve extensive pancreatic resection and anastomoses. The authors present a 49-year-old woman in whom a polycystic septated mass, 35 mm × 35 mm in size, was discovered by ultrasonography (US) in the body of the pancreas during investigations for epigastric pain and nausea. At surgery, a well circumscribed polycystic tumor was completely excised, with preservation of the pancreatic duct. The postoperative recovery was uneventful. Histology confirmed a microcystic lymphangioma of the pancreas. Immunohistochemistry showed cystic endothelial cells reactivity to factor Ⅷ -RA (++), CD31 (+++) and CD34 (-). Postoperatively, abdominal pain disappeared and the patient remained symptomfree for 12 mo until now. Although extremely rare, lymphangioma of the pancreas should be taken into consideration as a differential diagnosis of a pancreatic cystic lesion, especially in women.

  16. [Cystic fibrosis and other channelopathies].

    Edelman, A; Saussereau, E


    Mutations in cystic fibrosis transmembrane conductance regulator gene, CFTR, are responsible for cystic fibrosis, CF, a channelopathie. CFTR protein is a multifunctional protein with a main function of Cl(-) channel. CFTR is expressed in epithelia (upper airways, intestine, pancreas etc.). In the first part of this revue, we describe the main properties of CFTR underlying that it is not only a Cl(-) channel protein but also a multifunctional protein. We present a hypothesis which postulates that CFTR is a hub protein interacting with more than 140 proteins, and through these interactions regulates a number of functions which are abnormal in CF (ion transport, inflammation etc.). In the second part of the revue we briefly present a selection of other epithelial channelopathies due to mutations in genes of other Cl(-) or cation channels. Of note, these channels either interacts with CFTR or are considered as alternative channels in CF, and, as such, are targets for pharmacotherapies. We want to leave the reader with a message that to investigate channalopathies, to dissect the molecular mechanisms underlying channels'activity, allow not only to better understand basic mechanisms of channel regulation but in fine, to propose new targets for pharmacotherapies. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  17. Solitary infantile myofibromatosis of the cranial vault: case report.

    Merciadri, Paolo; Pavanello, Marco; Nozza, Paolo; Consales, Alessandro; Ravegnani, Giuseppe Marcello; Piatelli, Gianluca; Gandolfo, Carlo; Cama, Armando


    Infantile myofibromatosis is a mesenchymal disorder of early childhood characterized by the formation of tumors in the skin, muscle, viscera, bone, and subcutaneous tissue. Although relatively rare overall, it represents the most common fibrous tumor of infancy. The etiology of this disorder is unknown. Infantile myofibromatosis can present as a solitary or multicentric form. With the multicentric form, bone is often involved, but solitary bone lesions account for only 10% of the cases. Imaging findings are not pathognomonic, and the differential diagnosis usually includes eosinophilic granuloma (Langerhans cell histiocytosis), osteomyelitis, metastasis, osteoblastoma, epidermoid cyst, hemangioma, fibrous dysplasia, fibrosarcoma, and meningioma. A histological pattern is typical, but there are no histopathological differences between the solitary and multicentric forms. Solitary lesions generally have a favorable prognosis if totally removed, with a 10% recurrence rate; incompletely resected lesions recur. We report the case of a 9-year-old boy who came to our attention with a solitary infantile myofibroma of the calvarium, appearing as a tight-elastic, lightly tender mass in the left frontal area, eroding both the inner and the outer tables. Histopathologically, the specimens showed a spindle-cell tumor with dense reticulin fiber network and expression of smooth muscle actin. Fifty-eight months MR follow-up after total removal showed no residual or relapse.


    蔡胜; 李建初; 姜玉新; 戴晴; 谭莉; 张缙熙


    Objective. To study the sonographic features and patterns of cystic renal carcinomas. Methods. Thirteen cases of cystic renal carcinoma confirmed by operation and pathology were examined by ultrasonography, and the cystic walls, septa and solid mural nodules were studied. Results. Solid mural nodules of some cases and irregular thickening of the cystic walls and septa were characteristic findings for the ultrasonic diagnosis of cystic renal carcinomas. According to their pathologic mechanisms and sonographic features, cystic renal carcinomas were classified into 3 patterns: unilocular cystic mass, multiloculated cystic mass and cystic-solid mass. Conclusions. Typical cystic renal carcinomas can be well diagnosed, while atypical cases may be misdiagnosed as benign renal cysts by ultrasonography. Color Doppler ultrasonography and needle aspiration guided by ultrasonography are helpful in the diagnosis of these atypical cases.


    蔡胜; 李建初; 等


    Objective:To study the sonographic features and patterns of cystic renal carcinomas.Methods:Thirteen cases of cystic renal carcinoma confirmed by operation and pathology were examined by ultrasonography,and the cystic walls,septa and solid mural nodules were studied.Results:Solid mural nodules of some cases and irregular thickening of the cystic walls and septa were characteristic findings for the ultrasonic diagnosis of cystic renal carcinomas.According to their pathologic mechanisms and sonographic features,cystic renal carcinomas were classified into 3 patterns:unilocular cystic mass,multiloculated cystic mass and cystic-solid mass.Conclusions:Typical cystic renal carcinomas can be well diagnosed,while atypical cases may be misdiagnosed as benign renal cysts by ultrasonography.Color Doppler ultrasonography and needle aspiration guided by ultrasonography are helpful in the diagnosis of these atypical cases.

  20. Laparoscopic Rectopexy in Solitary Rectal Ulcer

    Hassan Salmanroughani


    Full Text Available Patients with Solitary Rectal Ulcer Syndrome (SRUS come to a physician with passage of mucus and bloody liquid within defecation. The treatment for SRUS is depended to the severity of symptoms and the existance of rectal prolapse. This study is a report of the assessing of rectopexy as surgical modalities for 62 medical treatment resistant SRUS patients who were referred to the gastrointestinal department of Shahid Sadoughi Medical University and Mojibian hospital. The present non-randomized clinical trial was carried out in 62 SRUS patients from 1991 till 2005. In these patients SRUS was confirmed by histology. They were symptomatic after conservative therapy and referred for surgical intervention. All of them had been undergone abdominal rectopexy by two laparoscopic surgeons. In our study, rectal bleeding and history of digitalization had the highest and lowest frequency of symptoms and signs in our cases respectively. Abdominal rectopexy was done in 39 cases and complete recovery in our cases was 69.23%. Complete recovery rate in cases with dysplasia (63.8% was significantly higher than cases without that (P=0.04. Complete recovery rate in cases that had finger defecation (85% was significantly higher than cases without that (50% (P=0.03. Laparoscopic rectopexy is one of the main surgical techniques for treatment of SRUS. This technique can present complete recovery for SRUS patients. Some of them include topical medications, behavior modification supplemented by fiber and biofeedback and surgery were more available and studied. But it seems that education of SRUS patient conservative treatment remain cornerstone in the SRUS management.

  1. Solitary pancreas retransplant: Study of 22 cases

    Tércio Genzini


    Full Text Available Objective: To present our experience with pancreas retransplantin patients previously submitted to simultaneous pancreas-kidneytransplant, pancreas after kidney transplant and pancreastransplant alone. Methods: Between January/1996 and December/2005, 330 pancreas transplants were performed: 308 primarytransplants and 22 (6% retransplants of solitary pancreas. Thefollowing variables were analyzed: patient age; time elapsedbetween the first and the second transplant; causes of loss of thefirst graft; technical characteristics of the transplant andretransplant and the criteria for selecting donors for retransplant.These clinical data were submitted to statistical analysis. Results:The mean age of patients was 34.3 years and the mean elapsedtime between the first and second transplant was 19.3 months.The causes of the first graft loss were venous (8; 35% and arterial(5; 23% thrombosis, chronic rejection (4; 18%, ischemia/reperfusion injury (2, reflux pancreatitis (1, primary non-function(1 and sepsis (1. A second transplant was performed in thesame iliac fossa in 16 patients (72%. Venous drainage wasperformed in the iliac vein in 16 patients (72%, in the inferior venacava in 5 patients (22% and in the portal vein in one patient. 6 allbladder drainage was the technique used in 18 (82% cases andenteric drainage, in 4 patients (18%. Immunosuppressive regimenapplied to all cases was quadruple therapy with antilymphocyteinduction, tacrolimus, mycophenolate mofetil and steroids. Therewas one early death due to sepsis. One-year patient and pancreasgraft survival rates for retransplants were, respectively, 95% and85%. There was no additional risk for removing the pancreas graftat retransplant. Conclusion: Pancreas retransplant was technicallyfeasible in all cases and results similar to those described in theliterature were found for primary pancreas transplant.

  2. Clinicopathological analysis of solitary fibrous tumor

    Xiumei Zhang; Hai Wang; Shujing Wang; Jinfeng Miao; Zhengai Piao; Yingying Dong


    Objective: The aim of this study was to investigate the clinicopathologic characteristics, diagnosis and differential diagnosis, molecular genetics, treatment and prognosis of solitary fibrous tumor (SFT). Methods: The clinicopathological manifestations were analyzed retrospectively in 22 patients with surgically confirmed SFT. Results: There were 12 male patients and 10 female patients, with the age range 33–67 (mean 48.62) years. The SFTs originated from different from parts of the body, including 13 in the chest, 2 in the lungs, 3 in the abdomen, 1 in the lumbosacral area, 2 in the pelvis, and 1 in the left shoulder. There were 19 benign and 3 malignant tumors. Major clinical presentations were local masses and compression symptoms. Microscopy: the tumor was composed of areas of alternating hypercellularity and hypocellularity. The tumor cells were spindle to short-spindle shaped and arranged in fascicular or storiform pattern and hemangiopericytoma-like structure was presented. Immunohistochemically, Vimentin positive rate was 100% (22/22), Bcl-2 positive rate was 95.5% (21/22), CD99 positive rate was 86.4% (19/22), CD34 positive rate was 81.8 (18/22), focally positive for P53, as well as negative CK, S100 and Desmin. Ki67 labelling index was 2%–30%. Conclusion: SFT is a rare tumor which may be found in various parts of human body. SFT mostly is a benign tumor, but a few could be malignant. Its diagnosis mainly rely on its morphologic features and immunohistochemical profiles. The major treatment is to completely resect it by operation and long-term clinical follow-up is necessary.

  3. Gene expression profiling of solitary fibrous tumors.

    François Bertucci

    Full Text Available BACKGROUND: Solitary fibrous tumors (SFTs are rare spindle-cell tumors. Their cell-of-origin and molecular basis are poorly known. They raise several clinical problems. Differential diagnosis may be difficult, prognosis is poorly apprehended by histoclinical features, and no effective therapy exists for advanced stages. METHODS: We profiled 16 SFT samples using whole-genome DNA microarrays and analyzed their expression profiles with publicly available profiles of 36 additional SFTs and 212 soft tissue sarcomas (STSs. Immunohistochemistry was applied to validate the expression of some discriminating genes. RESULTS: SFTs displayed whole-genome expression profiles more homogeneous and different from STSs, but closer to genetically-simple than genetically-complex STSs. The SFTs/STSs comparison identified a high percentage (∼30% of genes as differentially expressed, most of them without any DNA copy number alteration. One of the genes most overexpressed in SFTs encoded the ALDH1 stem cell marker. Several upregulated genes and associated ontologies were also related to progenitor/stem cells. SFTs also overexpressed genes encoding therapeutic targets such as kinases (EGFR, ERBB2, FGFR1, JAK2, histone deacetylases, or retinoic acid receptors. Their overexpression was found in all SFTs, regardless the anatomical location. Finally, we identified a 31-gene signature associated with the mitotic count, containing many genes related to cell cycle/mitosis, including AURKA. CONCLUSION: We established a robust repertoire of genes differentially expressed in SFTs. Certain overexpressed genes could provide new diagnostic (ALDH1A1, prognostic (AURKA and/or therapeutic targets.

  4. Solitary median maxillary central incisor (SMMCI syndrome

    Hall Roger K


    Full Text Available Abstract Solitary median maxillary central incisor syndrome (SMMCI is a complex disorder consisting of multiple, mainly midline defects of development resulting from unknown factor(s operating in utero about the 35th–38th day(s from conception. It is estimated to occur in 1:50,000 live births. Aetiology is uncertain. Missense mutation in the SHH gene (I111F at 7q36 may be associated with SMMCI. The SMMCI tooth differs from the normal central incisor, in that the crown form is symmetric; it develops and erupts precisely in the midline of the maxillary dental arch in both primary and permanent dentitions. Congenital nasal malformation (choanal atresia, midnasal stenosis or congenital pyriform aperture stenosis is positively associated with SMMCI. The presence of an SMMCI tooth can predict associated anomalies and in particular the serious anomaly holoprosencephaly. Common congenital anomalies associated with SMMCI are: severe to mild intellectual disability, congenital heart disease, cleft lip and/or palate and less frequently, microcephaly, hypopituitarism, hypotelorism, convergent strabismus, oesophageal and duodenal atresia, cervical hemivertebrae, cervical dermoid, hypothyroidism, scoliosis, absent kidney, micropenis and ambiguous genitalia. Short stature is present in half the children. Diagnosis should be made by eight months of age, but can be made at birth and even prenatally at 18–22 weeks from the routine mid-trimester ultrasound scan. Management depends upon the individual anomalies present. Choanal stenosis requires emergency surgical treatment. Short stature may require growth hormone therapy. SMMCI tooth itself is mainly an aesthetic problem, which is ideally managed by combined orthodontic, prosthodontic and oral surgical treatment; alternatively, it can be left untreated.

  5. Penile Cancer: Contemporary Lymph Node Management.

    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

  6. Diagnostic Value of CT for the Detection of Cervical Lymph Node Metastases in Papillary Thyroid Carcinoma

    Son, Kyu Ri [Boramae Medical Center, Seoul (Korea, Republic of); Na, Dong Gyu; Chang, Kee Hyun [Seoul National University Hospital, Seoul (Korea, Republic of)


    To determine the diagnostic accuracy of CT for the detection of cervical lymph node metastases in patients with papillary thyroid carcinoma (PTC). Two hundred twelve consecutive patients with surgically proven PTC were included in this study. CT images were retrospectively evaluated to determine the presence of a node metastasis using morphologic CT criteria (at least one of the following: strong nodal enhancement without hilar vessel enhancement, heterogeneous enhancement, calcification, and cystic change). The diagnostic accuracy of CT for the diagnosis of a metastatic lymph node was assessed using a level-bylevel analysis. The accuracy of the CT finding for strong nodal enhancement was greater than the other morphologic CT criteria (81.6% and 74.5-78.5%, respectively). The sensitivity, specificity, and accuracy were 64.4%, 91.4%, and 84.3% by the morphologic CT criteria, and were 34.6%, 93.9%, and 78.2% by size criteria, respectively. The morphologic CT criteria are more accurate than the size criteria in the detection of cervical lymph node metastases in patients with papillary thyroid carcinoma; and, strong nodal enhancement on a CT scan is the most important factor for its diagnostic accuracy.

  7. Vitamin D deficiency as a risk factor for cystic fibrosis-related diabetes in the Scandinavian Cystic Fibrosis Nutritional Study

    Pincikova, T; Nilsson, Kristine Kahr; Moen, I E;


    Many cystic fibrosis patients are vitamin D-insufficient. Cystic fibrosis-related diabetes is a major complication of cystic fibrosis. The literature suggests that vitamin D might possess certain glucose-lowering properties. We aimed to assess the relationship between vitamin D and cystic fibrosis...

  8. Primary Adenoid Cystic Carcinoma of the Skin with Multiple Local Recurrences

    Ivan Dimitrov Tonev


    Full Text Available Primary adenoid cystic carcinoma (PACC of the skin is a rare tumor with fewer than 70 cases studied in detail in the English literature. This type of tumor shows a prolonged course and a growth pattern usually manifested by multiple local recurrences and has a low potential for distant metastases. The most important modality for primary treatment is surgical resection followed by radiotherapy. We report a woman aged 43 years at the time of diagnosis, who presented with a slow-growing nodule in the right axilla without lymph node enlargement. A wide local excision was performed, and the histology revealed an adenoid cystic carcinoma. During the next 24 years, another four local recurrences were excised (the last one in 2015 and confirmed histologically to be adenoid cystic carcinoma. The patient was given 44 Gy of radiotherapy after the second surgery in 1996. PACC of the skin is a rare tumor with insufficient data concerning the efficacy of the surgical technique and chemotherapy and radiotherapy treatment, even more so in the case of multiple recurrences. After the last recurrence, the patient was offered an active follow-up based on the long tumor-free intervals in the past and because the site of the primary tumor allowed further surgical excisions in future recurrences.

  9. Mediastinal Cystic Lymphangioma in a Patient with Situs Inversus Totalis

    Teruya Komatsu


    Full Text Available We present a case of cystic lymphangioma of the mediastinum complicated with situs inversus totalis. The 70-year-old man underwent thoracoscopic resection of a mediastinal cystic tumor, which was diagnosed as cystic lymphangioma. Cystic lymphangiomas are congenital cystic abnormalities of the lymphatic system. The head and neck area is often involved while the mediastinum is rarely affected. The rarity of this case is further attributed to the coexistence of situs inversus totalis.

  10. Rapidly Evoluting Congenital Cystic Neuroblastoma in a Neonate

    Yun, Tae Jun; Kim, Myung Jun; Han, Seok Joo; Lee, Mi Jung [Severance Children' s Hospital, Yonsei University, College of Medicine, Seoul(Korea, Republic of)


    Perinatal detection of neonatal suprarenal masses has increased. Here, we report an unusual case of an adrenal cystic neuroblastoma that presented as a purely cystic lesion upon initial postnatal ultrasonography (US) and showed rapid evolution to a mixed cystic and solid mass during follow-up US and MRI. We suggest a short-term (two weeks) follow-up US for neonatal adrenal cystic lesions, even if they appear as purely cystic.

  11. Artery to Cystic Duct: A Consistent Branch of Cystic Artery Seen in Laparoscopic Cholecystectomy

    Arshad Rashid


    Full Text Available Uncontrolled arterial bleeding during laparoscopic cholecystectomy is a serious problem and may increase the risk of bile duct damage. Therefore, accurate identification of the anatomy of the cystic artery is very important. Cystic artery is notoriously known to have a highly variable branching pattern. We reviewed the anatomy of the cystic artery and its branch to cystic duct as seen through the video laparoscope. A single artery to cystic duct with the classical “H-configuration” was demonstrated in 161 (91.47% patients. This branch may cause troublesome bleeding during laparoscopic dissection in the hepatobiliary triangle. Careful identification of artery to cystic duct is helpful in the proper dissection of Calot’s triangle as it reduces the chances of hemorrhage and thus may also be helpful in prevention of extrahepatic biliary radical injuries.

  12. The novel multi-solitary wave solution to the fifth-order KdV equation

    Zhang Yi; Chen Deng-Yuan


    By using Hirota's method, the novel multi-solitary wave solutions to the fifth-order KdV equation are obtained.Furthermore, various new solitary wave solutions are also derived by a reconstructed bilinear Backlund transformation.

  13. Giant cystic abdominal masses in children

    Wootton-Gorges, Sandra L.; Thomas, Kristen B.; Harned, Roger K.; Wu, Sarah R.; Stein-Wexler, Rebecca; Strain, John D. [University of California, Davis Health Center, Sacramento, CA (United States); Davis Children' s Hospital, Department of Radiology, Sacramento, CA (United States)


    In this pictorial essay the common and uncommon causes of large cystic and cyst-like abdominal masses in children are reviewed. We discuss and illustrate the following: mesenchymal hamartoma, choledochal cyst, hydrops of the gallbladder, congenital splenic cyst, pancreatic pseudocyst, pancreatic cystadenoma, hydronephrosis, multicystic dysplastic kidney, multilocular cystic nephroma, adrenal hemorrhage, mesenteric and omental cysts, gastrointestinal duplication cyst, meconium pseudocyst, ovarian cysts and cystic neoplasms, hematocolpos, urachal cysts, appendiceal abscess, abdominal and sacrococcygeal teratoma, and CSF pseudocyst. We also describe imaging features and clues to the diagnosis. (orig.)

  14. Cystic Pheochromocytoma Presenting as Adrenal Cyst

    Abdulsalam, Mohammed Shafi; Satish, Priyanka; Janakiraman, Raghunath Keddy; Singh, Shivshankar


    Pheochromocytomas are usually solid tumours. But it can present as cystic lesions in the adrenal gland. Cystic lesions in adrenal gland with hypertension needs attention to rule out pheochromocytoma. If ignored, it may lead to hypertensive emergency, multisystem crisis and death. Early diagnosis with biochemistry, Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) of abdomen, proper functional imaging like Meta Iodo Benzyl Guanidine (MIBG) scan is essential. Proper preoperative preparation is important to prevent hypertensive crisis during and after surgery. We are reporting a case of cystic pheochromocytoma in a young male. PMID:28050427

  15. Diffractons: Solitary Waves Created by Diffraction in Periodic Media

    Ketcheson, David I.


    A new class of solitary waves arises in the solution of nonlinear wave equations with constant impedance and no dispersive terms. These solitary waves depend on a balance between nonlinearity and a dispersion-like effect due to spatial variation in the sound speed of the medium. A high-order homogenized model confirms this effective dispersive behavior, and its solutions agree well with those obtained by direct simulation of the variable-coefficient system. These waves are observed to be long-time stable, globally attracting solutions that arise in general as solutions to nonlinear wave problems with periodically varying sound speed. They share some properties with known classes of solitary waves but possess important differences as well.

  16. Shoaling Large Amplitude Internal Solitary Waves in a Laboratory Tank

    Allshouse, Michael; Larue, Conner; Swinney, Harry


    The shoaling of internal solitary waves onto the continental shelf can change both the wave dynamics and the state of the environment. Previous observations have demonstrated that these waves can trap fluid and transport it over long distances. Through the use of a camshaft-based wavemaker, we produce large amplitude shoaling waves in a stratified fluid in a laboratory tank. Simulations of solitary waves are used to guide the tuning of the wave generator to approximate solitary waves; thus nonlinear waves can be produced within the 4m long tank. PIV and synthetic schlieren measurements are made to study the transport of fluid by the wave as it moves up a sloping boundary. The results are then compared to numerical simulations and analyzed using finite time Lyapunov exponent calculations. This Lagrangian analysis provides an objective measure of barriers surrounding trapped regions in the flow. Supported by ONR MURI Grant N000141110701 (WHOI).

  17. A rare gigantic solitary cysticercosis pseudotumour of the neck

    Seif J Uledi


    Full Text Available Cysticercosis is one of the ancient parasitic infections and endemic in many parts of the developing world. Humans acquire cysticercosis when they ingest pork tapeworm eggs either through faecal-oral route by eating faecally contaminated food or by auto infection.The clinical picture largely depends on the location of larval encystment. Neurocysticercosis is the most common form of presentation. Solitary extra neural lesions are quite rare and fairly small in size.We present a very unique case of 56 year old Malawian female with a very rare, long standing gigantic solitary cysticercosis pseudo tumour of the neck. By far, there is no documented report on incorrigible cysticercosis lesion with such a sheer size.Solitary extraneural cysticercosis lesions may mimic other soft tissue masses; therefore it is important for clinicians working in endemic regions to consider cysticercosis as a differential diagnosis when evaluating patients with soft tissue lesions.

  18. Giant solitary trichoepithelioma with desmoplasia on histopathology: An unusual finding

    Sundeep Chowdhry


    Full Text Available Trichoepithelioma is a well-recognized hamartoma of hair germ clinically presenting as solitary or multiple papules. Uncommonly, it may present as a large solitary lesion, termed as giant solitary trichoepithelioma (GST. A 50-year old man presented with a large, pedunculated mass over the root of nose obstructing visual field. It was excised and sent for histopathological examination. H&E staining revealed in addition to characteristic features of trichoepithelioma, a desmoplastic hypocellular stroma. After taking into account the clinical and histopathological features, a diagnosis of GST was made. This case is the first case to the best of authors’ knowledge describing desmoplastic stroma in a case of GST. It is also noteworthy because it reports the largest GST described so far over the nose.

  19. On solitary patterns in Lotka-Volterra chains

    Zilburg, Alon; Rosenau, Philip


    We present and study a class of Lotka-Volterra chains with symmetric 2N-neighbors interactions. To identify the types of solitary waves which may propagate along the chain, we study their quasi-continuum approximations which, depending on the coupling between neighbors, reduce into a large variety of partial differential equations. Notable among the emerging equations is a bi-cubic equation {u}t={[{{bu}}2+2κ {{uu}}{xx}+{({u}{xx})}2]}x which we study in some detail. It begets remarkably stable topological and non-topological solitary compactons that interact almost elastically. They are used to identify discretons, their solitary discrete antecedents on the lattice, which decay at a doubly exponential rate. Many of the discrete modes are robust while others either decompose or evolve into breathers.

  20. Solitary calvarial metastases : An unusual presentation of thoracic neuroblastoma

    Grover S


    Full Text Available A primary thoracic origin occurs only in 20% of neuroblastomas, and their classical presentation is mediastinal or cord compression. Skeletal metastases of neuroblastomas are characteristically multiple, and calvarial deposits usually show simultaneous involvement of orbit. Solitary metastases in neuroblastoma, is an unusual entity and its presentation as a large calvarial mass, especially from a thoracic primary, is rare. Furthermore, calvarial metastases are relatively uncommon in children compared to adults. We discuss the clinical, radiographic, CT features, and differential diagnosis of a large calvarial mass with sunray spiculation in a child, which was due to a solitary metastases from an occult thoracic neuroblastoma. The possibility of neuroblastoma presenting in this unique fashion and the importance of considering a chemosensitive tumor such as neuroblastoma in the differential diagnosis of a solitary calvarial mass in a child is highlighted by our report.

  1. Solitary and freak waves in superthermal plasma with ion jet

    Abdelsalam, U. M.; Abdelsalam


    The nonlinear solitary and freak waves in a plasma composed of positive and negative ions, superthermal electrons, ion beam, and stationary dust particles have been investigated. The reductive perturbation method is used to obtain the Korteweg-de Vries (KdV) equation describing the system. The latter admits solitary wave solution, while the dynamics of the modulationally unstable wavepackets described by the KdV equation gives rise to the formation of freak/rogue excitation described by the nonlinear Schrödinger equation. In order to show that the characteristics of solitary and freak waves are influenced by plasma parameters, relevant numerical analysis of appropriate nonlinear solutions are presented. The results from this work predict nonlinear excitations that may associate with ion jet and superthermal electrons in Herbig-Haro objects.

  2. Quantum ion-acoustic solitary waves in weak relativistic plasma

    Biswajit Sahu


    Small amplitude quantum ion-acoustic solitary waves are studied in an unmagnetized twospecies relativistic quantum plasma system, comprised of electrons and ions. The one-dimensional quantum hydrodynamic model (QHD) is used to obtain a deformed Korteweg–de Vries (dKdV) equation by reductive perturbation method. A linear dispersion relation is also obtained taking into account the relativistic effect. The properties of quantum ion-acoustic solitary waves, obtained from the deformed KdV equation, are studied taking into account the quantum mechanical effects in the weak relativistic limit. It is found that relativistic effects significantly modify the properties of quantum ion-acoustic waves. Also the effect of the quantum parameter on the nature of solitary wave solutions is studied in some detail.

  3. Numerical Simulation of Cylindrical Solitary Waves in Periodic Media

    Quezada de Luna, Manuel


    We study the behavior of nonlinear waves in a two-dimensional medium with density and stress relation that vary periodically in space. Efficient approximate Riemann solvers are developed for the corresponding variable-coefficient first-order hyperbolic system. We present direct numerical simulations of this multiscale problem, focused on the propagation of a single localized perturbation in media with strongly varying impedance. For the conditions studied, we find little evidence of shock formation. Instead, solutions consist primarily of solitary waves. These solitary waves are observed to be stable over long times and to interact in a manner approximately like solitons. The system considered has no dispersive terms; these solitary waves arise due to the material heterogeneity, which leads to strong reflections and effective dispersion.

  4. Lymph node involvement in multicystic peritoneal mesothelioma.

    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. Clinical analysis of bone scanning in solitary lesion


    A rational analysis procedure for solitary lesions on whole bone scan-ning was offered. This study was undertaken to analyze retrospectively solitary le-sions which obtained final diagnose through the following aspects: (1) diagnosis ofbone metastasis, (2) the incidence of bone metastasis in different tumor, (3) the mostpossible lesion sites indicating bone metastasis, (4) morphological analysis of solitarylesions. The results are: (1) The incidence of solitary lesions in 2465 cases on wholebone scanning is 15.3%. (2) The rate of bone metastasis is 24.8% in 282 patientswith primary malignancy. The rate of bone metastasis is 6.3% in 64 patients withoutprimary malignancy, and the total diagnostic rate of bone metastasis is 21.4% in 346patients. (3) In patients with primary malignancy, the incidence of bone metastasis ofsolitary lesions is as follows respectively: bronchi cancer 36.1%(22/61); breast cancer23.8%(20/84); prostate gland 17.2%(5/29); other urinary system cancer 22.2%(4/18):G.I. system cancer 16.9%(10/59); others 29.0%(9/31). There is no significant differ-ence in different cancer. (4) In patients without primary malignancy, 93.7%(60/64) ofsolitary lesions are benign. (5) From anatomical point of view, we found the diagnos-tic rate of bone metastasis is as follow: 30% in spine; 34.2% in pelvis; 36.4% in skull;10.8% in other bones. There are significant differences in four groups. It is concludedthat: (1) The diagnostic rate of bone metastasis in solitary lesions is 21.4%. (2) Themost possible solitary lesions indicating osseous tumor spread are at spine, pelvic andskull. (3) Special attention to "cold" and streak like lesions should be paid. (4) Aclinical analysis procedure for diagnosis of solitary lesions has been summarized outhere.``

  6. Serotonin enhances solitariness in phase transition of the migratory locust

    Xiaojiao eGuo


    Full Text Available The behavioral plasticity of locusts is a striking trait presented during the reversible phase transition between solitary and gregarious individuals. However, the results of serotonin as a neurotransmitter from the migratory locust Locusta migratoria in phase transition showed an alternative profile compared to the results from the desert locust Schistoserca gregaria. In this study, we investigated the roles of serotonin in the brain during the phase change of the migratory locust. During the isolation of gregarious nymphs, the concentration of serotonin in the brain increased significantly, whereas serotonin receptors (i.e. 5-HT1, 5-HT2 and 5-HT7 we identified here showed invariable expression patterns. Pharmacological intervention showed that serotonin injection in the brain of gregarious nymphs did not induced the behavior change toward solitariness, but injection of this chemical in isolated gregarious nymphs accelerated the behavioral change from gregarious to solitary phase. During the crowding of solitary nymphs, the concentration of serotonin in the brain remained unchanged, whereas 5-HT2 increased after 1 h of crowding and maintained stable expression level thereafter. Activation of serotonin-5-HT2 signaling with a pharmaceutical agonist inhibited the gregariousness of solitary nymphs in crowding treatment. These results indicate that the fluctuations of serotonin content and 5-HT2 expression are results of locust phase change. Overall, this study demonstrates that serotonin enhances the solitariness of the gregarious locusts. Serotonin may regulate the withdrawal-like behavioral pattern displayed during locust phase change and this mechanism is conserved in different locust species.

  7. Heart involvement in cystic fibrosis: A specific cystic fibrosis-related myocardial changes?

    Labombarda, Fabien; Saloux, Eric; Brouard, Jacques; Bergot, Emmanuel; Milliez, Paul


    Cystic fibrosis is a complex multi-systemic chronic disease characterized by progressive organ dysfunction with development of fibrosis, possibly affecting the heart. Over the last four decades pathological, experimental, and clinical evidence points towards the existence of a specific myocardial involvement in cystic fibrosis. Multi-modality cardiac imaging, especially recent echocardiographic techniques, evidenced diastolic and/or systolic ventricular dysfunction in cystic fibrosis leading to the concept of a cystic fibrosis-related cardiomyopathy. Hypoxemia and inflammation are among the most important factors for heart involvement in cystic fibrosis. Cystic Fibrosis Transmembrane Regulator was found to be involved in the regulation of cardiomyocyte contraction and may also account for cystic fibrosis-related myocardial dysfunction. This review, mainly focused on echocardiographic studies, seeks to synthesize the existing literature for and against the existence of heart involvement in cystic fibrosis, its mechanisms and prognostic implications. Careful investigation of the heart function may be helpful for risk stratification and therapeutic decisions in patients with cystic fibrosis.

  8. Solitary Eccrine Syringofibroadenoma and Successful Treatment with Cryotherapy.

    Ozkaya, Dilek Biyik; Su, Ozlem; Bahalı, Anıl Gülsel; Topukçu, Bugce; Dizman, Didem; Tosuner, Zeynep; Demirkesen, Cuyan; Onsun, Nahide


    First described in 1963, eccrine syringofibroadenoma (ESFA) is a rare benign tumor that proliferates with differentiation toward ductal eccrine structures. There are many clinical presentations, including plaques, papules, verrucous plaques, keratotic tumors, and solitary tumors. The age of onset varies, with presentation between 16 and 80 years; however, solitary lesions are seen most commonly in the seventh and eighth decades. Here, we present the case of a 72-year-old woman referred to our outpatient clinic with a nodule on her leg. The histopathology result was ESFA. The lesion regressed after six cryotherapy sessions. Physicians should consider the possibility of ESFA and must remember its malignant potential in elderly patients.

  9. A case of congenital solitary Langerhans cell histiocytoma.

    Ricciardo, Bernadette


    A newborn baby boy was referred to the Paediatric Dermatology Unit with a solitary asymptomatic nodule overlying his right nasolabial fold. Complete physical examination, full blood count, serum chemistry, liver function tests and baseline imaging were unremarkable. Histopathological examination showed an atypical dermal infiltrate of mononuclear cells that stained positive with CD1a and S100. A diagnosis of congenital solitary Langerhans cell histiocytoma was made. The lesion completely resolved by 4 months of age. The baby is now 15 months old and repeat systemic evaluation has remained normal.

  10. Measurement of velocity field in parametrically excited solitary waves

    Gordillo, Leonardo


    Paramerically excited solitary waves emerge as localized structures in high-aspect-ratio free surfaces subject to vertical vibrations. Herein, we provide the first experimental characterization of the hydrodynamics of thess waves using Particle Image Velocimetry. We show that the underlying velocity field of parametrically excited solitary waves is mainly composed by an oscillatory velocity field. Our results confirm the accuracy of Hamiltonian models with added dissipation in describing this field. Remarkably, our measurements also uncover the onset of a streaming velocity field which is shown to be as important as other crucial nonlinear terms in the current theory. The observed streaming pattern is particularly interesting due to the presence of oscillatory meniscii.

  11. Solitary structures with ion and electron thermal anisotropy

    Khusroo, Murchana


    Formation of electrostatic solitary structures are analysed for a magnetised plasma with ion and electron thermal anisotropies. The ion thermal anisotropy is modelled with the help of the Chew-Goldberger-Low (CGL) double adiabatic equations of state while the electrons are treated as inertia-less species with an anisotropic bi-Maxwellian velocity distribution function. A negative electron thermal anisotropy $(T_{e\\perp}/T_e{\\parallel}>1)$ is found to help form large amplitude solitary structures which are in agreement with observational data.

  12. Effect of nonthermal ion distribution and dust temperature on nonlinear dust-acoustic solitary waves

    K Annou; R Annou


    Dust-acoustic solitary waves in unmagnetized dusty plasma whose constituents are inertial charged dust grains, Boltzmannian electrons and nonthermal ions have been investigated by taking into account finite dust temperature. The pseudopotential has been used to study solitary solution. The existence of solitary waves having negative potential is reported.

  13. Single-peak solitary wave solutions for the variant Boussinesq equations

    Hong Li; Lilin Ma; Dahe Feng


    This paper presents all possible smooth, cusped solitary wave solutions for the variant Boussinesq equations under the inhomogeneous boundary condition. The parametric conditions for the existence of smooth, cusped solitary wave solutions are given using the phase portrait analytical technique. Asymptotic analysis and numerical simulations are provided for smooth, cusped solitary wave solutions of the variant Boussinesq equations.

  14. Existence,Orbital Stability and Instability of Solitary Waves for Coupled BBM Equations

    Li-wei Cui


    This paper is concerned with the orbital stability/instability of solitary waves for coupled BBM equations which have Hamiltonian form.The explicit solitary wave solutions will be worked out first.Then by detailed spectral analysis and decaying estimates of solutions for the initial value problem,we obtain the orbital stability/instability of solitary waves.

  15. Cystic fibrosis-related diabetes

    Andersen, Henrik U; Lanng, Susanne; Pressler, Tania


    OBJECTIVE: Cystic fibrosis (CF)-related diabetes has been regarded as a mild form of diabetes with a low risk of severe diabetes complications. The prevalence of CF-related diabetes increases with age, resulting in a 50% prevalence of diabetes at age 30 years. We sought to investigate whether...... microvascular complications in CF-related diabetes appear with a relevant frequency. RESEARCH DESIGN AND METHODS: Thirty-eight patients aged 30 (range 18-55) years with CF-related diabetes for 20 (0-31) years were screened for diabetes complications. Because of chronic pulmonary infections, the majority...... of diabetic retinopathy was found in patients with insulin-treated CF-related diabetes, stressing the need for a regular screening program as in type 1 diabetes. Severely impaired kidney function was common in lung transplant patients, probably secondary to cyclosporine treatment....

  16. Cystic mesothelioma of the peritoneum.

    Datta, R V; Paty, P B


    A 48-year-old man presented with a 3-month history of weight loss and progressive right lower quadrant abdominal pain. His medical history was notable for appendectomy at age 17. Ultrasonography and computed tomography of the abdomen revealed a 12 cm multicystic mass in the right paracolic space. At laparotomy a large serous cyst was found arising from the lateral wall of the cecum, and four additional small cysts were found on the small bowel mesentery, greater omentum, liver capsule, and right hemi-diaphragm. Complete removal of the tumor was accomplished by right colectomy with extraperitoneal dissection of the large cyst and simple excision of the four smaller cysts. Final pathology with immunohistochemical staining confirmed cystic mesothelioma of the peritoneum. In this report we discuss the diagnostic workup and treatment of this rare disease.

  17. Gastrointestinal manifestations in cystic fibrosis.

    Eggermont, E


    CFTR, or cystic fibrosis transmembrane conductance regulator, the gene product that is defective in cystic fibrosis, is present in the apical membrane of the epithelial cells from the stomach to the colon. In the foregut, the clinical manifestations are not directly related to the primary defect of the CFTR chloride channel. The most troublesome complaints and symptoms originate from the oesophagus as peptic oesophagitis or oesophageal varices. In the small intestinal wall, the clinical expression of CF depends largely on the decreased secretion of fluid and chloride ions, the increased permeability of the paracellular space between adjacent enterocytes and the sticky mucous cover over the enterocytes. As a rule, the brush border enzyme activities are normal and there is some enhanced active transport as shown for glucose and alanine. The results of continuous enteral feeding of CF patients clearly show that the small intestinal mucosa, in the daily situation, is not functioning at maximal capacity. Although CFTR expression in the colon is lower, the large intestine may be the site of several serious complications such as rectal prolapse, meconium ileus equivalent, intussusception, volvulus and silent appendicitis. In recent years colonic strictures, after the use of high-dose pancreatic enzymes, are being increasingly reported; the condition has recently been called CF fibrosing colonopathy. The CF gastrointestinal content itself differs mainly from the normal condition by the lower acidity in the foregut and the accretion of mucins and proteins, eventually resulting in intestinal obstruction, in the ileum and colon. Better understanding of the CF gastrointestinal phenotype may contribute to improvement of the overall wellbeing of these patients.

  18. Respiratory bacterial infections in cystic fibrosis

    Ciofu, Oana; Hansen, Christine R; Høiby, Niels


    Bacterial respiratory infections are the main cause of morbidity and mortality in patients with cystic fibrosis (CF). Pseudomonas aeruginosa remains the main pathogen in adults, but other Gram-negative bacteria such as Achromobacter xylosoxidans and Stenotrophomonas maltophilia as well...

  19. Pathohistological changes in fetuses with cystic fibrosis

    Đolai Matilda


    Full Text Available Introduction. Cystic fibrosis or mucoviscidosis is a genetically caused disease. The intensity of disease and histopathological changes grow throughout the life. According to the literature, pathological changes characteristic of cystic fibrosis become noticeable around the sixth month of life. Case Report. After amniocentesis of a 5-lunar month-old fetus had been done, which confirmed cystic fibrosis, the Ethics Commission approved the preterm labor. The autopsy and histopathological analysis demonstrated the existence of typical histopathological changes in the pancreas and intestines. Discussion. In the late fetal period or during the period around the delivery, cystic fibrosis is usually manifested as meconial cap with or without obstruction of the intestinal lumen. Morphological changes in the exocrine glands usually develop only after birth. In this case, the existence of meconial obstruction, as well as the typical acidofil content in the secretory ducts and acini of the pancreas was confirmed, which is unusual for the fetal age of five months.

  20. Epidural Cystic Spinal Meningioma: A Case Report.

    Zhang, Ji; Chen, Zheng-he; Wang, Zi-feng; Sun, Peng; Jin, Jie-tian; Zhang, Xiang-heng; Zhao, Yi-ying; Wang, Jian; Mou, Yong-gao; Chen, Zhong-ping


    Cystic spinal meningioma (CSM) is an uncommon meningioma variant. Extradural CSMs are particularly rare and difficult to distinguish from other intraaxial tumors. This study presents a case of a 36-year-old woman with intraspinal extradual CSM at the thoracolumbar spine. She experienced persistent weakness, progressive numbness, and sensory disturbance in the right lower limb. Magnetic resonance imaging (MRI) of the patient revealed an irregular cystic mass at the thoracic 11 to lumbar 3 levels dorsally. This case was misdiagnosed as other neoplasms prior to surgery because of the atypical radiographic features and location of the tumor. Extradural CSMs should be considered in the differential diagnosis of intraspinal extradural cystic neoplasms. Complete removal of cystic wall provides an optimal outcome, rendering the lesion curable.

  1. Preterm twin gestation and cystic periventricular leucomalacia

    Resch, B; Jammernegg, A; Vollaard, E; Maurer, U; Mueller, WD; Pertl, B


    Objective: To identify risk factors for the development of cystic periventricular leucomalacia (PVL) in twin gestation. Design: Retrospective case-control study. Setting: Tertiary care university hospital, Department of Paediatrics, Division of Neonatology, Graz, Austria. Patients: Preterm twin gest

  2. Nutrition in Cystic Fibrosis: Macro- and Micronutrients

    Oudshoorn, Johanna Hermiena


    Cystic fibrosis (CF) is the most common life-threatening autosomal recessive inherited disease in Caucasians, and is characterized by progressive lung disease, pancreatic insufficiency, malnutrition, hepatobiliary disease and elevated sweat electrolyte levels. The increased survival of CF patients d

  3. Radiological description of cystic pancreatic tumors.

    Rodríguez Torres, C; Larrosa López, R


    Although most cystic pancreatic lesions are pseudocysts, it is important to do a thorough differential diagnosis with true cystic tumors because cystic tumors are potentially malignant. Sometimes computed tomography and magnetic resonance imaging cannot establish the definitive diagnosis, making it necessary to perform other imaging tests such as endoscopic ultrasound, which in addition to morphological information, can also enable cytologic and biochemical analysis of the lesion through puncture and aspiration of its contents. Combining all these findings nearly always provides enough diagnostic information to allow the appropriate approach in each case. This article describes the specific morphological characteristics for each cystic pancreatic tumor on computed tomography, magnetic resonance imaging, and endoscopic ultrasound and reviews the guidelines for managing these types of lesions. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Subglottic adenoid cystic carcinoma mistaken for asthma

    Hua-lin WANG; Lin XU; Fu-jun LI


    of the tumor. The diagnosis of subglottic adenoid cystic carcinoma should be considered in patients who are characterized by dyspnea, cough, and stridor, but do not respond to regular anti-asthmatic therapy.

  5. Cystic cervical intramedullary schwannoma with syringomyelia

    Shenoy S


    Full Text Available We report a case of cervical intramedullary cystic schwannoma associated with segmental syrinx in a young adult without evidence of neurofibromatosis. The relevant literature is reviewed.

  6. The Cystic Fibrosis Transmembrane Conductance Regulator (CFTR)

    Rosenberg, Mark F.; O'Ryan, Liam P.; Hughes, Guy; Zhao, Zhefeng; Aleksandrov, Luba A.; Riordan, John R.; Ford, Robert C.


    Cystic fibrosis affects about 1 in 2500 live births and involves loss of transmembrane chloride flux due to a lack of a membrane protein channel termed the cystic fibrosis transmembrane conductance regulator (CFTR). We have studied CFTR structure by electron crystallography. The data were compared with existing structures of other ATP-binding cassette transporters. The protein was crystallized in the outward facing state and resembled the well characterized Sav1866 transporter. We identified ...

  7. Cystic adenomatoid tumor of the uterus

    Varsha Manucha


    Full Text Available We present a case of a cystic adenomatoid tumor in a 40-year-old woman. The tumor was an intramural multicystic mass, histologically similar to a multicystic mesothelioma. Cystic adenomatoid tumors of the uterus are extremely rare. They present with a wide differential diagnosis in radiology. The tumors are known to be benign and awareness of this rare entity is the key to its diagnosis for a pathologist.

  8. Adenoid cystic carcinoma of the lacrimal gland

    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....

  9. Clinical Experience of the Treatment of Solitary Pulmonary Nodules with Da Vinci Surgical System

    Xiangdong TONG


    Full Text Available Background and objective A solitary pulmonary nodule (SPN is defined as a round intraparenchimal lung lesion less than 3 cm in size, not associated with atelectasis or adenopathy. The aim of this study is to learn clinical experience of the treatment of SPN with Da Vinci Surgical System. Methods A total of 9 patients with solitary pulmonary nodules (SPN less than 3 cm in diameter was treated with Da Vinci Surgical System (Intuitive Surgical, California in thoracic surgery department from General Hospital of Shenyang Militrary Region from November 2011 to March 2014. This group of patients included 3 males and 6 females, and the mean age was 51±9.9 yr (range: 41-74 yr. Most of the patients were no obvious clinical symptoms (7 cases were found by physical examination, others were with cough and expectoration. Their median medical history was 12 mo (range: 4 d-3 yr. All the lesions of patients were peripheral pulmonary nodules and the mean diameter of those was (1.4±0.6 cm(range: 0.8-2.8 cm. Wedge-shaped resection or lobectomy was performed depending on the result of rapid pathology and systemic lymph node dissection was done for malignant leision. We used general anesthesis with double lumens trachea cannula. We set the patients in lateral decubitus position with jackknife. The patient cart enter from top of the patient. The position of trocars would be set according to the position of lesion. A 12 mm incision was positioned at the 8th intercostal space in the posterior axillary line as vision port, and two 8 mm incisions were positioned at the 5th intercostal space between the anterior axillary line and midclavicular line, and the 8th infrascapular line as robotic instrument ports about 10 cm apart from the vision port. One additional auxiliary small incision for instrument without retracting ribs was set at the 7th intercostal space in the middle axillary line. Results There were 4 benign leisions and 5 malignancies identified. Wedge


    ZhuYanjuan; ZhangChunhua


    The solitary wave solutions of the combined KdV-mKdV-Burgers equation and the Kolmogorov-Petrovskii-Piskunov equation are obtained by means of the direct algebra method, which can be generalized to deal with high dimensional nonlinear evolution equations.

  11. Reconstructive surgery in eight children with solitary kidneys

    Thorup, Jørgen Mogens


    Within a 10-year period reconstructive urinary tract surgery has been carried out in eight children with solitary kidneys. The children were 0-5 years old. Six had unilateral renal agenesis and two had unilateral multicystic kidney. In five children ureteroneocystostomy was performed, in two...

  12. Observations of Solitary Structures in a Magnetized, Plasma Loaded Waveguide

    Lynov, Jens-Peter; Michelsen, Poul; Pécseli, Hans;


    Two types of solitary structure were investigated experimentally and numerically in a magnetized, plasma-loaded waveguide. One was identified as an ordinary KdV soliton and its properties were investigated with particular attention to the damping by resonant particles. The other type of pulse...


    王涛; 高天赋


    Remote sensing and in situ observations of internal tides, solitary waves and bores in shallow water are briefly reviewed in this paper. The emphasis is laid on interpreting SAR images based on oceanographic measurements, and analyzing characteristics of internal waves in the China Seas. Direc-tions for future research are discussed.



    Remote sensing and in situ observations of internal tides, solitary waves and bores in shallow water are briefly reviewed in this paper. The emphasis is laid on interpreting SAR images based on oceanographic measurements, and analyzing characteristics of internal waves in the China Seas. Directions for future research are discussed.

  15. Sound exposure of professional orchestral musicians during solitary practice.

    O'Brien, Ian; Driscoll, Tim; Ackermann, Bronwen


    It is broadly acknowledged that professional orchestral musicians risk noise-induced hearing pathologies due to sound exposure in rehearsal and performance. While much has been published regarding orchestral sound levels, little is known of the sound exposure these musicians experience during solitary practice, despite the many hours they spend engaged in this activity. This study aimed to determine sound exposure during solitary practice of 35 professional orchestral musicians, representing players of most orchestral instruments. To allow cross-comparison, participants were assessed playing similar repertoire in a controlled environment, recording simultaneously at each ear to determine sound exposure levels. Sound levels were recorded between 60 and 107 dB L(Aeq), with peak levels between 101 and 130 dB L(C,peak). For average reported practice durations (2.1 h per day, five days a week) 53% would exceed accepted permissible daily noise exposure in solitary practice, in addition to sound exposure during orchestral rehearsals and performances. Significant inter-aural differences were noted in violin, viola, flute/piccolo, horn, trombone, and tuba. Only 40% used hearing protection at any time while practicing. These findings indicate orchestral musicians at risk of noise-induced hearing loss in ensemble face significant additional risks during solitary practice. Data presented will enable more effective and targeted management strategies for this population.

  16. Solitary waves in a nonintegrable Fermi-Pasta-Ulam chain

    Truskinovsky, Lev; Vainchtein, Anna


    We present a family of exact solutions describing discrete solitary waves in a nonintegrable Fermi-Pasta-Ulam chain. The family is sufficiently rich to cover the whole spectrum of known behaviors from delocalized quasicontinuum waves moving with near-sonic velocities to highly localized anticontinuum excitations with only one particle moving at a time.

  17. Transarterial Onyx Embolization of an Orbital Solitary Fibrous Tumor

    Hashemi, Nafiseh; Ling, Jeanie D.; Soparkar, Charles; Sami, Mirwat; Ellezam, Benjamin; Klucznik, Richard; Lee, Andrew G.; Chévez-Barrios, Patricia


    Solitary fibrous tumor (SFT) is an uncommon mesenchymal neoplasm sometimes found in the orbit. We report a case of an aggressive orbital SFT with enlarged feeding vessels that was successfully resected immediately after transarterial embolization with Onyx (ethylene vinyl alcohol copolymer). To our knowledge, this is the first report showing the histopathology of Onyx embolization material in an orbital SFT. PMID:27171911

  18. Solitary Wave in Linear ODE with Variable Coefficients

    LIU Shi-Da; FU Zun-Tao; LIU Shi-Kuo; XIN Guo-Jun; LIANG Fu-Ming; FENG Bei-Ye


    In this paper, the linear ordinary differential equations with variable coefficients are obtained from thecontrolling equations satisfied by wavelet transform or atmospheric internal gravity waves, and these linear equationscan be further transformed into Weber equations. From Weber equations, the homoclinic orbit solutions can be derived,so the solitary wave solutions to linear equations with variable coefficients are obtained.

  19. Solitary Wave and Wave Front as Viewed From Curvature

    LIU Shi-Kuo; FU Zun-Tao; LIU Shi-Da; LIANG Fu-Ming; XIN Guo-Jun


    The solitary wave and wave front are two important behaviors of nonlinear evolution equations. Geometri cally, solitary wave and wave front are all plane curve. In this paper, they can be represented in terms of curvature c(s), which varies with arc length s. For solitary wave when s →±∞, then its curvature c(s) approaches zero, and when s = 0, the curvature c(s) reaches its maximum. For wave front, when s →±∞, then its curvature c(s) approaches zero, and when s = 0, the curvature c(s) is still zero, but c'(s) ≠ 0. That is, s = 0 is a turning point. When c(s) is given, the variance at some point (x, y) in stream line with arc length s satisfies a 2-order linear variable-coefficient ordinary differential equation. From this equation, it can be determined qualitatively whether the given curvature is a solitary wave or wave front.

  20. Solitary plane waves in an isotropic hexagonal lattice

    Zolotaryuk, Yaroslav; Savin, A.V.; Christiansen, Peter Leth


    Solitary plane-wave solutions in a two-dimensional hexagonal lattice which can propagate in different directions on the plane are found by using the pseudospectral method. The main point of our studies is that the lattice model is isotropic and we show that the sound velocity is the same for diff...

  1. A Stylistic Appreciation of William Wordsworth's The Solitary Reaper



    This paper, based on the literary stylistic approach, is about the analysis of William Wordsworth's lyrics The Solitary Reaper. The features in its metrics, lexis and imagery explicitly reveal the poet's love for human, passion for nature and principle of simplicity.

  2. Exact Periodic Solitary Solutions to the Shallow Water Wave Equation

    LI Dong-Long; ZHAO Jun-Xiao


    Exact solutions to the shallow wave equation are studied based on the idea of the extended homoclinic test and bilinear method. Some explicit solutions, such as the one soliton solution, the doubly-periodic wave solution and the periodic solitary wave solutions, are obtained. In addition, the properties of the solutions are investigated.

  3. Internal solitary waves in the Red Sea: An unfolding mystery

    da Silva, J.C.B.; Magalhães, J.M.; Gerkema, T.; Maas, L.R.M.


    The off-shelf region between 16.0 degrees and 16.5 degrees N in the southern Red Sea is identified as a new hotspot for the occurrence of oceanic internal solitary waves. Satellite observations reveal trains of solitons that, surprisingly, appear to propagate from the center of the Red Sea, where it

  4. Solitary Wave and Wave Front as Viewed From Curvature

    LIUShi-Kuo; FUZun-Tao; LIUShi-Da; LIANGFu-Ming; XINGuo-Jun


    The solitary wave and wave front are two important behaviors of nonlinear evolution equations. Geometrically, solitary wave and wave front are all plane curve. In this paper, they can be represented in terms of curvature c(s),which varies with arc length s. For solitary wave when s→±∞, then its curvature c(s) approaches zero, and whens = 0, the curvature c(s) reaches its maximum. For wave front, when s→±∞, then its curvature c(s) approaches zero,and when s = 0, the curvature c(s) is still zero, but c'(s)≠0. That is, s = 0 is a turning point. When c(s) is given,the variance at some point (x, y) in stream line with arc length s satisfies a 2-order linear variable-coeffcient ordinary differential equation. From this equation, it can be determined qualitatively whether the given curvature is a solitary wave or wave front.

  5. Solitary fibrous tumor of the thyroid with capsular invasion.

    Bohórquez, Concepción Lara; González-Cámpora, Ricardo; Loscertales, Miguel Congregado; Escudero, Antonio García; Mezquita, Jesús Congregado


    This report describes the clinical and pathologic findings of a peculiar case of solitary fibrous tumor of the thyroid gland that showed capsular invasion. After four and a half years of follow-up, neither local recurrence nor metastasis has developed.

  6. Recommendations for quality improvement in genetic testing for cystic fibrosis European Concerted Action on Cystic Fibrosis

    Dequeker, E; Cuppens, H; Dodge, J; Estivill, [No Value; Goossens, M; Pignatti, PF; Scheffer, H; Schwartz, M; Schwarz, M; Tummler, B; Cassiman, JJ


    These recommendations for quality improvement of cystic fibrosis genetic diagnostic testing provide general guidelines for the molecular genetic testing of cystic fibrosis in patients/individuals. General strategies for testing as well as guidelines for laboratory procedures, internal and external q

  7. Recommendations for quality improvement in genetic testing for cystic fibrosis European Concerted Action on Cystic Fibrosis

    Dequeker, E; Cuppens, H; Dodge, J; Estivill, [No Value; Goossens, M; Pignatti, PF; Scheffer, H; Schwartz, M; Schwarz, M; Tummler, B; Cassiman, JJ


    These recommendations for quality improvement of cystic fibrosis genetic diagnostic testing provide general guidelines for the molecular genetic testing of cystic fibrosis in patients/individuals. General strategies for testing as well as guidelines for laboratory procedures, internal and external q

  8. Percutaneous nephrolithotomy in patients with a solitary kidney

    Tufan Süelözgen


    Full Text Available Material and method: The results of percutaneous nephrolithotomy applied to 716 patients in our clinic between January 2008 and January 2014 were retrospectively evaluated. Age, gender, urinary calculi size (mm2, urinary calculi localization, ESWL history, operation duration (min, fluoroscopy duration (sec, access type, reason of solitary kidney, hemoglobin drawdown (g/dl and operation success of the patients with a solitary kidney were recorded. The patients having no preoperative and postoperative non contrast abdominal tomography were excluded from the study. Results: Fifteen of nineteen patients (79% were men and 4 of them (21% were women. The average age of the patients was 42.52 ± 16.72 (14-72. Ten patients had anatomical solitary kidney and nine patients had physiological solitary kidney. In fact counter kidney was non functional in 9 patients (47% whereas there was agenesis in 2 (11% and outcome of nephrectomy in 8 (42% patients. In our study, presence of residual stone less than 4 mm at 1st month postoperative non contrast abdominal tomography was accepted as a successful result and accordingly our success rate was detected as 84%. Mean urinary calculi size was 405 ± 252.9 mm2; urinary calculi localization was pelvic, lower pole, upper-middle pole, middle-lower pole and staghorn in 11 (58%, 4 (21%, 1 (5%, 1 (5% and 1 (5% patients, respectively; previous ESWL history was 16%; operation duration was 55.47-± 28.1 min and fluoroscopy duration 131.10 ± 87.6 sec; access type was subcostal in 79%, supracostal in 10.5% and multiple in 10.5%; hemoglobin drawdown was 1.75 ± 0.97 mg/dl. Conclusions: PNL can be effectively and safely administered for the treatment of solitary kidney. In the treatment of large urinary calculi in patients with a solitary kidney, PNL has some advantages such as short surgery duration, less complication, acceptable hemoglobin drawdown and high success rates. According to our study, PNL operation in patients with a

  9. Solitary Large Hepatocellular Carcinoma: Staging and Treatment Strategy.

    Po-Hong Liu

    Full Text Available Controversies exist on staging and management of solitary large (>5 cm hepatocellular carcinoma (HCC. This study aims to evaluate the impact of tumor size on Barcelona Clinic Liver Cancer (BCLC staging and treatment strategy.BCLC stage A and B patients were included and re-classified as single tumor 2-5 cm or up to 3 tumors ≤3 cm (group A; n = 657, single tumor >5 cm (group SL; n = 224, and multiple tumors >3 cm (group B; n = 351. Alternatively, 240 and 229 patients with solitary large HCC regardless of tumor stage received surgical resection (SR and transarterial chemoembolization (TACE, respectively. The propensity score analysis identified 156 pairs of patients from each treatment arm for survival comparison.The survival was significantly higher for group A but was comparable between group SL and group B patients. Of patients with solitary large HCC, the 1-, 3- and 5-year survival rates were 88% versus 74%, 76% versus 44%, and 63% versus 35% between SR and TACE group, respectively (p<0.001. When baseline demographics were adjusted in the propensity model, the respective 1-, 3- and 5-year survival rates were 87% versus 79%, 76% versus 46%, and 61% versus 36% (p<0.001. The Cox proportional hazards model identified TACE with a 2.765-fold increased risk of mortality compared with SR (95% confidence interval: 1.853-4.127, p<0.001.Patients with solitary large HCC should be classified at least as intermediate stage HCC. SR provides significantly better survival than TACE for solitary large HCC regardless of tumor stage. Further amendment to the BCLC classification is mandatory.

  10. Solitary waves of the EW and RLW equations

    Ramos, J.I. [Room I-320-D, E.T.S. Ingenieros Industriales, Universidad de Malaga, Plaza El Ejido, s/n, 29013 Malaga (Spain)]. E-mail:


    Eight finite difference methods are employed to study the solitary waves of the equal-width (EW) and regularized long-wave (RLW) equations. The methods include second-order accurate (in space) implicit and linearly implicit techniques, a three-point, fourth-order accurate, compact operator algorithm, an exponential method based on the local integration of linear, second-order ordinary differential equations, and first- and second-order accurate temporal discretizations. It is shown that the compact operator method with a Crank-Nicolson discretization is more accurate than the other seven techniques as assessed for the three invariants of the EW and RLW equations and the L {sub 2}-norm errors when the exact solution is available. It is also shown that the use of Gaussian initial conditions may result in the formation of either positive or negative secondary solitary waves for the EW equation and the formation of positive solitary waves with or without oscillating tails for the RLW equation depending on the amplitude and width of the Gaussian initial conditions. In either case, it is shown that the creation of the secondary wave may be preceded by a steepening and an narrowing of the initial condition. The creation of a secondary wave is reported to also occur in the dissipative RLW equation, whereas the effects of dissipation in the EW equation are characterized by a decrease in amplitude, an increase of the width and a curving of the trajectory of the solitary wave. The collision and divergence of solitary waves of the EW and RLW equations are also considered in terms of the wave amplitude and the invariants of these equations.

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

    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

  12. Surgical outcome in cystic vestibular schwannomas

    Nair, Suresh; Baldawa, Sachin S.; Gopalakrishnan, Chittur Viswanathan; Menon, Girish; Vikas, Vazhayil; Sudhir, Jayanand B.


    Background: Cystic vestibular schwannomas (VS) form a rare subgroup that differs from the solid variant clinically, radiologically, and histopathologically. These tumors also vary in their surgical outcome and carry a different risk of post-operative complications. We analyzed our series of 64 patients with cystic VS and discuss the technical difficulties related to total excision of these tumors and focus on complication avoidance. Materials and Methods: A retrospective review of cystic VS surgically managed over a span of 11 years. The case records were evaluated to record the clinical symptoms and signs, imaging findings, surgical procedure, complications, and follow-up data. Post-operative facial nerve palsy was analyzed with respect to tumor size and tumor type. Results: Progressive hearing impairment was the most common initial symptom (76.6%). Atypical initial symptoms were present in 15 patients (23.4%). Preoperatively, 78% patients had good facial nerve function (HB grade 1, 2) and 22% had intermediate (HB grade 3, 4) to poor (HB grade 5 and 6) function. Mean tumor size was 4.1 cm. Complete tumor removal was achieved in 53 patients (83%). The facial nerve was anatomically intact but thinned out after tumor excision in 38 patients (59.4%). Ninety percent patients had either intermediate or poor facial nerve function at follow-up. Poor facial nerve outcome was associated with giant tumors and peripherally located, thin-walled cystic tumors. Conclusion: Resection of cystic VS is complicated by peritumoral adhesions of the capsule to the nerve. Extensive manipulation of the nerve in order to dissect the tumor–nerve barrier results in worse facial nerve outcome. The outcome is worse in peripherally located, thin-walled cystic VS as compared to centrally located, thick-walled cystic tumors. Subtotal excision may be justified, especially in tumors with dense adhesion of the cyst wall to the facial nerve in order to preserve nerve integrity. PMID:27366248

  13. Intracystic Therapies for Cystic Craniopharyngioma

    Ute Katharina Bartels


    Full Text Available AbstractIntroduction: Craniopharyngioma of childhood are commonly cystic in nature. An intracystic catheter insertion and subsequent instillation of substances inducing cyst shrinkage seems a beneficial strategy avoiding additional morbidity in a highly vulnerable brain location. Methods: A systematic review of the medical literature was performed to identify potentially relevant, all languages articles using Ovid MEDLINE and EMBASE from inception to July 2011 and Cochrane Central Register of Controlled Trials to 3rd quarter 2011. All references were examined for relevancy. Results: Of 142 unique references x referred to substances used for intracystic craniopharyngioma treatment. General aspects of intracystic catheter insertion as well as response rates, risks and outcomes of children treated with intracystic radio-isotopes, bleomycin and interferon are critically reviewed and an outline for potential future endeavours provided. Conclusions: Interferon seems currently the intracystic substance with the best benefit risk ratio. The authors advocate for consensus on prospective data collection and standardized intracystic treatment strategies to allow reliable comparisons and herewith optimize treatment and outcome.

  14. Cystic fibrosis: a clinical view.

    Castellani, Carlo; Assael, Baroukh M


    Cystic fibrosis (CF), a monogenic disease caused by mutations in the CFTR gene on chromosome 7, is complex and greatly variable in clinical expression. Airways, pancreas, male genital system, intestine, liver, bone, and kidney are involved. The lack of CFTR or its impaired function causes fat malabsorption and chronic pulmonary infections leading to bronchiectasis and progressive lung damage. Previously considered lethal in infancy and childhood, CF has now attained median survivals of 50 years of age, mainly thanks to the early diagnosis through neonatal screening, recognition of mild forms, and an aggressive therapeutic attitude. Classical treatment includes pancreatic enzyme replacement, respiratory physiotherapy, mucolitics, and aggressive antibiotic therapy. A significant proportion of patients with severe symptoms still requires lung or, less frequently, liver transplantation. The great number of mutations and their diverse effects on the CFTR protein account only partially for CF clinical variability, and modifier genes have a role in modulating the clinical expression of the disease. Despite the increasing understanding of CFTR functioning, several aspects of CF need still to be clarified, e.g., the worse outcome in females, the risk of malignancies, the pathophysiology, and best treatment of comorbidities, such as CF-related diabetes or CF-related bone disorder. Research is focusing on new drugs restoring CFTR function, some already available and with good clinical impact, others showing promising preliminary results that need to be confirmed in phase III clinical trials.

  15. Male fertility in cystic fibrosis.

    Chotirmall, S H


    Infertility rates among males with cystic fibrosis (CF) approximate 97%. No information is currently available within Ireland determining an understanding of fertility issues and the best methods of information provision to this specialized group. This study aimed to determine understanding and preferred approaches to information provision on fertility issues to Irish CF males. A Descriptive Study utilizing prospective coded questionnaires was mailed to a male CF cohort (n=50). Sections included demographics, fertility knowledge & investigation. Response rate was 16\\/50 (32%). All were aware that CF affected their fertility. More than two-thirds (n=11) were able to provide explanations whilst only one-third (n=5) provided the correct explanation. Significant numbers stated thoughts of marriage and a future family. Half have discussed fertility with a healthcare professional (HCP). Mean age of discussion was 21.9 years. One third preferred an earlier discussion. The commonest first source for information was written material which was also the preferred source. Three-quarters requested further information preferring again, written material. Significant gaps in sex education of Irish CF males exist. Discussion should be initiated by HCPs and centre-directed written material devised to address deficiencies.

  16. Metastases in small lymph nodes from colon cancer.

    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.

  17. Mature cystic teratoma of the pancreas in a child

    Yu, C.W.; Liu, K.L.; Li, Y.W. [Dept. of Medical Imaging, National Taiwan Univ. Hospital, Taipei (Taiwan); Lin, W.C. [Dept. of Pathology, National Taiwan Univ. Hospital, Taipei (Taiwan)


    A cystic pancreatic tumour is rare in a child and a mature cystic teratoma of the pancreas is even rarer. This is the first demonstration of the CT appearance of such a tumour in a child. We present a 2-year-old boy who presented with a palpable abdominal mass. Abdominal CT revealed a huge cystic mass in the upper abdomen. Pathology disclosed a mature cystic teratoma originating from the pancreas. (orig.)

  18. Calcified Cavitating Mesenteric Lymph Node Syndrome: Case Presentation and Literature Review

    Dipinder S Keer


    Full Text Available Cavitating mesenteric lymph node syndrome (CMLNS is a rare complication of celiac disease. Globally, only 36 cases of CMLNS have been reported to date. The present article reports an incidence of its unique pathology and possible complications of celiac disease, followed by a review of the syndrome. A case involving a 51-year-old man with celiac disease who was referred to hospital because of a non-tender abdominal mass is described. Plain film x-ray of the abdomen revealed fine curvilinear calcifications in the left lower quadrant. A complex, cystic-appearing, lobulated mass with somewhat echogenic walls most consistent with calcifications was revealed on subsequent ultrasound (US imaging. Colour Doppler imaging showed no evidence of vascularity within the lesion. Computed tomography (CT imaging showed a thin rim of calcification in the walls of multiple cystic components. Enhanced magnetic resonance (MR imaging revealed a mixed solid and cystic multiloculated mass, with fat-fluid layers originating from the root of the small bowel mesentery. A CT-guided biopsy was performed. The fine-needle aspirate revealed calcified matter with no associated cellular material. No malignant cells were seen; CMLNS was established as the diagnosis. To the authors’ knowledge, there are no previous reports in the literature describing the finding of rim calcification on US or MR imaging in the setting of CMLNS. CMLNS is an important diagnosis to consider, particularly in patients with a history of celiac disease. The finding of rim calcification on US in the setting of cavitating mesenteric adenopathy should prompt further diagnostic imaging studies such as CT or MR imaging. These may lead to additional pathology studies such as a CT-guided biopsy to further characterize the lesion at the cellular level, to investigate potential malignancy and to further guide follow-up and patient management.

  19. A mathematical model using computed tomography for the diagnosis of metastatic central compartment lymph nodes in papillary thyroid carcinoma

    Liu, Tianrun [The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou (China); Su, Xuan; Chen, Weichao; Zheng, Lie; Li, Li; Yang, AnKui [Sun Yat-sen University Cancer Center, Guangzhou (China)


    The purpose of this study was to establish a potential mathematical model for the diagnosis of the central compartment lymph node (LN) metastases of papillary thyroid carcinoma (PTC) using CT imaging. 303 patients with PTC were enrolled. We determined the optimal cut-off points of LN size and nodal grouping by calculating the diagnostic value of each cut-off point. Then, calcification, cystic or necrotic change, abnormal enhancement, size, and nodal grouping were analysed by univariate and multivariate statistical methods. The mathematical model was obtained using binary logistic regression analysis, and a scoring system was developed for convenient use in clinical practice. 30 mm{sup 2} for LNs area (size) and two LNs as the nodal grouping criterion had the best diagnostic value. The mathematical model was: p = e{sup y} /(1+ e {sup y}), y = -0.670-0.087 x size + 1.010 x cystic or necrotic change + 1.371 x abnormal enhancement + 0.828 x nodal grouping + 0.909 x area. We assigned the value for cystic or necrotic change, abnormal enhancement, size and nodal grouping value as 25, 33, 20, and 22, respectively, yielding a scoring system. This mathematical model has a high diagnostic value and is a convenient clinical tool. (orig.)

  20. Living with Cystic Fibrosis: A Guide for the Young Adult.

    Cystic Fibrosis Foundation, Atlanta, GA.

    Intended for the young adult with cystic fibrosis, the booklet provides information on dealing with problems and on advances in treatment and detection related to the disease. Addressed are the following topics: description of cystic fibrosis; inheritance of cystic fibrosis; early diagnosis; friends, careers, and other matters; treatment;…

  1. 78 FR 26681 - Medical Criteria for Evaluating Cystic Fibrosis


    ... ADMINISTRATION RIN 0960-AF58 Medical Criteria for Evaluating Cystic Fibrosis AGENCY: Social Security....04 to evaluate claims involving cystic fibrosis in adults and children under titles II and XVI of the... information on the disability program. 2. Information for individuals with cystic fibrosis who apply...

  2. A residual cystic lesion in acute disseminated encephalomyelitis

    Go, T. [Otsu Red Cross Hospital, Nagara (Japan). Dept. of Paediatrics; Imai, T. [Kyoto Univ. School of Medicine, Kyoto (Japan). Dept. of Paediatrics


    We report a case of acute disseminated encephalomyelitis (ADEM) with a residual cystic lesion on MRI. This seemed to be induced by Japanese encephalitis vaccination. Despite complete clinical improvement with high-dose steroid therapy, the cystic lesion has persisted for 3 years on MRI. There have been no previous reports of residual cystic lesions in ADEM. (orig.)

  3. Study of cystic artery by arteriography. Importance of previous cholecystography

    Machado, G.O.

    An oral cholecystography previously to celiac and mesenteric arteriography is performed, in order to identify the cystic artery, in 42 patients with pancreatitis, according Seldinger technique. The cystic artery was identified in all the cases, the pattern being the outlet of the cystic artery from the right hepatic artery. Infusion pump and seriography were not used.

  4. Congenital Cystic Adenomatoid Malformation of Lung-Rare Case Report

    N. S. Kamakeri


    Full Text Available Congenital cystic adenomatoid malformation of lung associated with Cystic dysplasia of kidney, cystic disease of liver with mixed gonadal dysgenesis is rare and is not reported in literature so far. Hence an attempt is made to present this rarest entity.

  5. Stereotactic intracavitary brachytherapy with P-32 for cystic craniopharyngiomas in children

    Maarouf, Mohammad; El Majdoub, Faycal [University Hospital of Cologne, Department of Stereotaxy and Functional Neurosurgery, Cologne (Germany); University of Witten/Herdecke, Department of Stereotaxy and Functional Neurosurgery, Center of Neurosurgery, Cologne-Merheim Medical Center (CMMC), Cologne (Germany); Fuetsch, Manuel [University Hospital of Munich, Department of Neurosurgery, Munich (Germany); Hoevels, Mauritius [University Hospital of Cologne, Department of Stereotaxy and Functional Neurosurgery, Cologne (Germany); Lehrke, Ralph [St. Barbara-Klinik Hamm-Heessen, Department of Stereotaxy and Functional Neurosurgery, Hamm (Germany); Berthold, Frank [University Hospital of Cologne, Department Pediatric Oncology, Cologne (Germany); Voges, Juergen [University Hospital of Magdeburg, Department of Stereotaxy and Functional Neurosurgery, Magdeburg (Germany); Sturm, Volker [University Hospital of Cologne, Department of Stereotaxy and Functional Neurosurgery, Cologne (Germany); University Hospital of Wurzburg, Department of Neurosurgery, Wuerzburg (Germany)


    Although microsurgery remains the first-line treatment, gross total resection of cystic craniopharyngeomas (CP) is associated with significant morbidity and mortality and the addition of external irradiation to subtotal resection proves to achieve similar tumor control. However, concern regarding long-term morbidity associated with external irradiation in children still remains. With this retrospective analysis, the authors emphasize intracavitary brachytherapy using phosphorus-32 (P-32) as a treatment option for children with cystic CP. Between 1992 and 2009, 17 children (median age 15.4 years; range 7-18 years) with cystic CP underwent intracavitary brachytherapy using P-32. Eleven patients were treated for recurrent tumor cysts; 6 patients were treated primarily. MR imaging revealed solitary cysts in 7 patients; 10 patients had mixed solid-cystic lesions (median tumor volume 11.1 ml; range 0.5-78.9 ml). The median follow-up time was 61.9 months (range 16.9-196.6 months). Local cyst control could be achieved in 14 patients (82 %). Three patients showed progression of the treated cystic formation (in-field progression) after a median time of 8.3 months (range 5.3-10.3 months), which led to subsequent interventions. The development of new, defined cysts and progression of solid tumor parts (out-of-field progression) occurred in 5 patients and led to additional interventions in 4 cases. There was neither surgery-related permanent morbidity nor mortality in this study. The overall progression-free survival was 75, 63, and 52 % after 1, 3, and 5 years, respectively. Intracavitary brachytherapy using P-32 represents a safe and effective treatment option for children harboring cystic CP, even as primary treatment. However, P-32 does not clearly affect growth of solid tumor parts or the development of new cystic formations. (orig.) [German] Obwohl die Mikrochirurgie die Methode der Wahl darstellt, ist die komplette Resektion zystischer Kraniopharyngeome haeufig mit einer

  6. Inguinal Lymph Node Anthracosis: A Case Report

    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

  7. Premalignant cystic neoplasms of the pancreas.

    Dudeja, Vikas; Allen, Peter J


    Due to increasing utilization of cross-sectional imaging, asymptomatic pancreatic cysts are frequently being diagnosed. Many of these cysts have premalignant potential and offer a unique opportunity for cancer prevention. Mucinous cystic neoplasm and intraductal papillary mucinous neoplasm are the major premalignant cystic neoplasms of pancreas. The prediction of the risk of malignancy (incidental and future risk of malignant transformation) and balancing the risks of watchful waiting with that of operative management with associated mortality and morbidity is the key to the management of these lesions. We review the literature that has contributed to the development of our approach to the management of these cystic neoplasms. We provide an overview of the key features used in diagnosis and in predicting malignancy. Particular attention is given to the natural history and management decision making.

  8. Cystic echinococcosis in Southern Israel.

    Ben-Shimol, Shalom; Sagi, Orli; Houri, Ohad; Bazarsky, Elina; Berkowitz, Anat; Bulkowstein, Shlomi; Barrett, Chiya; Greenberg, David


    The aim of this retrospective, population-based study was to characterize demographically and clinically cystic-echinococcosis (CE) in southern Israel, between 2005 and 2012. Newly-diagnosed (nd-CE) and past-diagnosed (pd-CE, diagnosed before the study) cases were defined. Two populations live in southern-Israel, receiving medical treatment at a single hospital: the Jewish and the Bedouin populations (resembling resource-rich and resource-poor populations, respectively). 126 CE cases were identified; 55 nd-CE and 71 pd-CE. Mean annual nd-CE incidence per 100,000 in the Bedouin and Jewish populations were 2.7 ± 1.2 and 0.4 ± 0.3, respectively (Pborn outside Israel. Liver and lung involvement were recorded in 85.7% and 15.1% of overall-CE, respectively. Abdominal pain, cough, fever, eosinophilia and asymptomatic disease were documented in 63.6%, 32.7%, 27.3%, 41.5% and 12.7% of nd-CE, respectively. Serology sensitivity for first test and any positive test were 67.3% and 83.3%, respectively. Computed tomography, ultrasonography and X-ray diagnosis were documented in 79.2%, 58.4% and 17.0% of overall-CE, respectively, with ultrasonography mainly used in liver-CE and X-ray in lung-CE. Treatment included surgery and albendazole in 50.0% and 55.3% of CE, respectively. We conclude that CE is endemic in southern-Israel among the Bedouin population, while disease is probably mainly imported in the Jewish population. Liver involvement and eosinophilia rates were high compared with those of other endemic regions, possibly due to differences in the timing of diagnosis. These findings may help developing treatment and prevention strategies.

  9. Reconstructive surgery in eight children with solitary kidneys

    Thorup, Jørgen Mogens


    Within a 10-year period reconstructive urinary tract surgery has been carried out in eight children with solitary kidneys. The children were 0-5 years old. Six had unilateral renal agenesis and two had unilateral multicystic kidney. In five children ureteroneocystostomy was performed, in two...... of them because of reflux. In two children pyeloureteroplasty was performed, and in one both ureteroneocystostomy and pyeloureteroplasty. The multicystic kidneys were removed. The renal function was poor preoperatively in five children; two of these also had urosepsis. These children were all under 15...... months of age. Postoperatively, the renal function was subnormal (although improved) in two children; in six it was normal. The most important prognostic factors in solitary kidneys with urinary tract obstruction are infection and developmental injury....

  10. Electron acoustic solitary waves with kappa-distributed electrons

    Devanandhan, S; Singh, S V; Lakhina, G S, E-mail: [Indian Institute of Geomagnetism, New Panvel (West), Navi Mumbai (India)


    Electron acoustic solitary waves are studied in a three-component, unmagnetized plasma composed of hot electrons, fluid cold electrons and ions having finite temperatures. Hot electrons are assumed to have kappa distribution. The Sagdeev pseudo-potential technique is used to study the arbitrary amplitude electron-acoustic solitary waves. It is found that inclusion of cold electron temperature shrinks the existence regime of the solitons, and soliton electric field amplitude decreases with an increase in cold electron temperature. A decrease in spectral index, {kappa}, i.e. an increase in the superthermal component of hot electrons, leads to a decrease in soliton electric field amplitude as well as the soliton velocity range. The soliton solutions do not exist beyond T{sub c}/T{sub h}>0.13 for {kappa}=3.0 and Mach number M=0.9 for the dayside auroral region parameters.


    LU Ji; YU Xi-ping


    Solitary wave fission over an underwater step is numerically investigated. The numerical model is based on the enhanced Boussinesq equations, which appropriately represent both the nonlinearity and dispersivity of surface water waves. The finite difference method defined on the staggered grid in space with an implicit scheme for time stepping is employed for the numerical solution of the governing equations. It is demonstrated that Boussinesq type equations, though they are vertically integrated, can describe the details of the solitary wave fission process with very good accuracy. Numerical results of the reflected and transmitting wave heights, the number of solitons emitted from the transmitting wave and their amplitudes all agree very well with the analytical solution derived from KdV equation by virtue of a linear long wave approximation in the vicinity of the underwater step.

  12. [Solitary fibrous tumor of endometrium--a case report].

    Dvořák, O; Dvořáková, E; Laco, J; Spaček, J


    Solitary fibrous tumor (SFT) is an uncommon mesenchymal tumor. We present a case of SFT occurring in endometrium. Case report. Department of Obstetrics and Gynecology, The Fingerland Department of Pathology, Medical Faculty of Charles University and Faculty Hospital Hradec Králové. We report a case of 57 years old woman with SFT arising from the endometrium, which was diagnosed and treated at our department. Histological finding was supported by typical immunohistochemical profile of the tumor. Aggressive nature of the tumor wasnt showed. The patient underwent abdominal hysterectomy with bilateral adnexectomy and is followed up in regular periods. Occurence of solitary fibrous tumor (SFT) in the female genital tract is extremely rare. To the best of our knowledge, we report the first case of SFT occurring in endometrium. Because of potencial aggressive behaviour of the tumor complete surgical excision and close follow-up is highly recommended.

  13. Primary Intrapulmonary Thymoma Presenting as a Solitary Pulmonary Nodule

    Jung, Woohyun; Kang, Chang Hyun; Kim, Young Tae; Park, In Kyu


    Primary intrapulmonary thymoma (PIT) is a very rare lesion of uncertain pathogenesis. PIT should be considered when the histopathological appearance of a lung tumor shows features that are uncommon but similar to those of a thymoma. In this case report, we discuss the case of a 59-year-old female with a solitary pulmonary nodule that was confirmed to be PIT on the basis of pathological tests. Treatment with complete resection showed good results. PMID:28180106

  14. The frustrated Brownian motion of nonlocal solitary waves

    Folli, Viola


    We investigate the evolution of solitary waves in a nonlocal medium in the presence of disorder. By using a perturbational approach, we show that an increasing degree of nonlocality may largely hamper the Brownian motion of self-trapped wave-packets. The result is valid for any kind of nonlocality and in the presence of non-paraxial effects. Analytical predictions are compared with numerical simulations based on stochastic partial differential equation

  15. Exact Solitary Wave Solution in the ZK-BBM Equation

    Juan Zhao


    Full Text Available The traveling wave solution for the ZK-BBM equation is considered, which is governed by a nonlinear ODE system. The bifurcation structure of fixed points and bifurcation phase portraits with respect to the wave speed c are analyzed by using the dynamical system theory. Furthermore, the exact solutions of the homoclinic orbits for the nonlinear ODE system are obtained which corresponds to the solitary wave solution curve of the ZK-BBM equation.

  16. Existence of solitary waves in dipolar quantum gases

    Antonelli, Paolo


    We study a nonlinear Schrdinger equation arising in the mean field description of dipolar quantum gases. Under the assumption of sufficiently strong dipolar interactions, the existence of standing waves, and hence solitons, is proved together with some of their properties. This gives a rigorous argument for the possible existence of solitary waves in BoseEinstein condensates, which originate solely due to the dipolar interaction between the particles. © 2010 Elsevier B.V. All rights reserved.

  17. Nonlinear dynamics of DNA - Riccati generalized solitary wave solutions

    Alka, W.; Goyal, Amit [Department of Physics, Panjab University, Chandigarh-160014 (India); Nagaraja Kumar, C., E-mail: [Department of Physics, Panjab University, Chandigarh-160014 (India)


    We study the nonlinear dynamics of DNA, for longitudinal and transverse motions, in the framework of the microscopic model of Peyrard and Bishop. The coupled nonlinear partial differential equations for dynamics of DNA model, which consists of two long elastic homogeneous strands connected with each other by an elastic membrane, have been solved for solitary wave solution which is further generalized using Riccati parameterized factorization method.

  18. Nonlinear dynamics of DNA - Riccati generalized solitary wave solutions

    Alka, W.; Goyal, Amit; Nagaraja Kumar, C.


    We study the nonlinear dynamics of DNA, for longitudinal and transverse motions, in the framework of the microscopic model of Peyrard and Bishop. The coupled nonlinear partial differential equations for dynamics of DNA model, which consists of two long elastic homogeneous strands connected with each other by an elastic membrane, have been solved for solitary wave solution which is further generalized using Riccati parameterized factorization method.

  19. Phase modulated solitary waves controlled by bottom boundary condition

    Mukherjee, Abhik


    A forced KdV equation is derived to describe weakly nonlinear, shallow water surface wave propagation over non trivial bottom boundary condition. We show that different functional forms of bottom boundary conditions self-consistently produce different forced kdV equations as the evolution equations for the free surface. Solitary wave solutions have been analytically obtained where phase gets modulated controlled by bottom boundary condition whereas amplitude remains constant.

  20. Conjugate flows and amplitude bounds for internal solitary waves

    N. I. Makarenko


    Full Text Available Amplitude bounds imposed by the conservation of mass, momentum and energy for strongly nonlinear waves in stratified fluid are considered. We discuss the theoretical scheme which allows to determine broadening limits for solitary waves in the terms of a given upstream density profile. Attention is focused on the continuously stratified flows having multiple broadening limits. The role of the mean density profile and the influence of fine-scale stratification are analyzed.

  1. Solitary rectal ulcer syndrome in children: A literature review

    Dehghani, Seyed Mohsen; Malekpour, Abdorrasoul; HAGHIGHAT, MAHMOOD


    Solitary rectal ulcer syndrome (SRUS) is a benign and chronic disorder well known in young adults and less in children. It is often related to prolonged excessive straining or abnormal defecation and clinically presents as rectal bleeding, copious mucus discharge, feeling of incomplete defecation, and rarely rectal prolapse. SRUS is diagnosed based on clinical symptoms and endoscopic and histological findings. The current treatments are suboptimal, and despite correct diagnosis, outcomes can ...

  2. Solitary Fibrous Tumors and So-Called Hemangiopericytoma

    Nicolas Penel


    Full Text Available We have reviewed the literature data regarding the spectrum of tumors including solitary fibrous tumor and hemangiopericytoma with special focus on definition of the disease, discussion of the criteria for malignancy, and the key elements of standard treatment of localized disease. We have discussed the emerging concepts on the tumor biology and the different systemic treatments (chemotherapy and molecular-targeted therapies.

  3. Turing patterns and solitary structures under global control

    Pismen, L M


    Striped Turing patterns and solitary band and disk structures are constructed using a three-variable multiscale model with cubic nonlinearity and global control. The existence and stability conditions of regular structures are analysed using the equation of motion of curved boundaries between alternative states of the short-range component. The combined picture of transitions between striped and spotted patterns with changing level of global control is in qualitative agreement with the results of the computer experiment by Middya and Luss

  4. Genetics of Cystic Fibrosis: Clinical Implications.

    Egan, Marie E


    Cystic fibrosis (CF) is a common life-shortening autosomal recessive genetic disorder caused by mutations in the gene that encodes for the cystic fibrosis transmembrane conductance regulator protein (CFTR). Almost 2000 variants in the CFTR gene have been identified. The mutational classes are based on the functional consequences on CFTR. New therapies are being developed to target mutant CFTR and restore CFTR function. Understanding specific CF genotypes is essential for providing state-of-the art care to patients. In addition to the variation in CFTR genotype, there are several modifier genes that contribute to the respiratory phenotype.

  5. Diagnosis of Adult Patients with Cystic Fibrosis.

    Nick, Jerry A; Nichols, David P


    The diagnosis of cystic fibrosis (CF) is being made with increasing frequency in adults. Patients with CF diagnosed in adulthood typically present with respiratory complaints, and often have recurrent or chronic airway infection. At the time of initial presentation individuals may appear to have clinical manifestation limited to a single organ, but with subclinical involvement of the respiratory tract. Adult-diagnosed patients have a good response to CF center care, and newly available cystic fibrosis transmembrane receptor-modulating therapies are promising for the treatment of residual function mutation, thus increasing the importance of the diagnosis in adults with unexplained bronchiectasis.

  6. The cystic fibrosis of exocrine pancreas

    Wilschanski, Michael; Novak, Ivana


    The cystic fibrosis transmembrane conductance regulator (CFTR) protein is highly expressed in the pancreatic duct epithelia and permits anions and water to enter the ductal lumen. This results in an increased volume of alkaline fluid allowing the highly concentrated proteins secreted by the acinar...... cells to remain in a soluble state. This work will expound on the pathophysiology and pathology caused by the malfunctioning CFTR protein with special reference to ion transport and acid-base abnormalities both in humans and animal models. We will also discuss the relationship between cystic fibrosis...

  7. [Lymph node staging in gastrointestinal cancer. Combination of methylene blue-assisted lymph node dissection and ex vivo sentinel lymph node mapping].

    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.


    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.

  9. Sonographic-pathologic correlation of complex cystic breast lesions

    Saravech Pongrattanaman


    Full Text Available Objective: To understand the pathologic basis for sonographic features of complex cystic lesions. Methods: From 2 646 female patients underwent breast sonography at King Chulalongkorn Memorial Hospital from January 2005 through December 2010, 103 cystic lesions were included. Pathologic confirmation was performed by fine-needle aspiration (n=42, core needle biopsy (n=6, excision (n=54 and mastectomy (n=1. Complex cystic breast masses were classified into 3 types as followings; thick outer wall and/or thick internal septa (type I; thick septation and thick wall were defined as equal or more than 0.5 cm, masses containing mixed cystic and solid components (at least 50% of cystic component (type II, predominantly solid with eccentric cystic foci (at least 50% of solid component (type III. Results: In 103 complex cystic masses, there are 27 lesions (26% classified as type I cystic breast masses, 37 lesions (36% as type II cystic breast masses and 39 lesions (38% type III cystic breast masses, 26 lesions (25.2% are proved to be malignant. All of type I cystic breast masses in our study are benign, and 14 (38% of type II cystic breast masses and 12 lesions (31% of type III cystic breast lesions are proved to be malignant. Conclusions: Type II and III lesions should suggest possibility of malignancy and biopsy should be performed in all lesions. All type I lesion in this study are benign. None of other parameters we included in this study (size or margin can effectively differentiate between benign or malignant cystic breast lesions. Also, grading of the malignant lesions by using type of cystic breast mass cannot be applied.

  10. Energetics of internal solitary waves in a background sheared current

    K. G. Lamb


    Full Text Available The energetics of internal waves in the presence of a background sheared current is explored via numerical simulations for four different situations based on oceanographic conditions: the nonlinear interaction of two internal solitary waves; an internal solitary wave shoaling through a turning point; internal solitary wave reflection from a sloping boundary and a deep-water internal seiche trapped in a deep basin. In the simulations with variable water depth using the Boussinesq approximation the combination of a background sheared current, bathymetry and a rigid lid results in a change in the total energy of the system due to the work done by a pressure change that is established across the domain. A final simulation of the deep-water internal seiche in which the Boussinesq approximation is not invoked and a diffuse air-water interface is added to the system results in the energy remaining constant because the generation of surface waves prevents the establishment of a net pressure increase across the domain. The difference in the perturbation energy in the Boussinesq and non-Boussinesq simulations is accounted for by the surface waves.

  11. Solitary wave shoaling and breaking in a regularized Boussinesq system

    Senthilkumar, Amutha


    A coupled BBM system of equations is studied in the situation of water waves propagating over decreasing fluid depth. A conservation equation for mass and a wave breaking criterion valid in the Boussinesq approximation is found. A Fourier collocation method coupled with a 4-stage Runge-Kutta time integration scheme is employed to approximate solutions of the BBM system. The mass conservation equation is used to quantify the role of reflection in the shoaling of solitary waves on a sloping bottom. Shoaling results based on an adiabatic approximation are analyzed. Wave shoaling and the criterion of breaking solitary waves on a sloping bottom is studied. To validate the numerical model the simulation results are compared with those obtained by Grilli et al.[16] and a good agreement between them is observed. Shoaling of solitary waves of two different types of mild slope model systems in [8] and [13] are compared, and it is found that each of these models works well in their respective regimes of applicability.

  12. Cystic Eccrine Spiradenoma of the Finger Mimicking a Ganglion

    Khalid F. Jaber, MBChB


    Full Text Available Summary: We report a rare case of cystic eccrine spiradenoma in the finger. A 46-year-old man presented with a cystic mass in his left index finger. Clinical assessment along with the investigation pointed toward a diagnosis of a ganglion. However, excisional biopsy of the mass revealed histopathological findings of cystic eccrine spiradenoma. Very few cases of eccrine spiradenoma have been reported in the hand and none of them were cystic in consistency. We believe that this case will draw the surgeon’s attention to the possibility of unusual differential diagnoses in the evaluation and treatment of cystic lumps in the hand.

  13. Solitary metastatic cancer to the thyroid: a report of five cases with fine-needle aspiration cytology

    Batoroev Yuri


    Full Text Available Abstract Three men and 2 women with ages ranging from 37 to 70 years, clinically and histologically confirmed solitary, palpable metastatic cancers to the thyroid (SMCT and preoperative cytologic investigation of their thyroid lesions by fine-needle aspiration (FNA, were reviewed. Four patients were known to have a solid cancer treated by radical surgery 1 to 4 years prior [1 bronchogenic squamous cell carcinoma, 1 parotid adenoid cystic carcinoma, 1 renal cell carcinoma (RCC and 1 cutaneous melanoma], and 1 patient had no past history of cancer. Direct smears prepared from the patients' thyroid FNAs were fixed in 95% ethanol and stained with the Papanicolaou method. In 3 cases, immunostaining of the aspirated tumor cells with thyroglobulin antibody was performed, and in 1 case an aspiration smear was stained with commercial HMB-45 antibody. A correct cytodiagnosis of metastatic cancer to the thyroid was made in all 5 cases. In 1 patient the thyroid FNA revealed a metastatic RCC that led to the discovery of a clinically occult RCC. All 5 patients died of metastatic disease 27 to 40 months after surgical resection of their SMCTs.

  14. Expressions of chemokine receptor CXCR4 and its ligand CXCL12 in salivary adenoid cystic carcinoma

    徐晓刚; 吕春堂; 周中华


    Objective: To examine expressions of chemokine receptor CXCR4 and its ligand CXCL12 in primary focus and lymphogenous metastasis of salivary adenoid cystic carcinoma (ACC) with lung metastasis. Methods: Using immunohistochemical hypersensitivity catalyzed signal amplification (CSA), expressions of chemokine receptor CXCR4 and ligand CXCL12 were detected in tissue specimens from 20 cases of primary cancer focus and lymphogenous metastasis of salivary adenoid cystic carcinoma, of which 7 cases were associated with lung metastasis and 3 with lympogenons metastasis. Twenty cases of tongue carcinoma (including 10 cases with lymphogenous metastasis) and 15 cases of mucoepidermoid carcinoma (including 5 cases with lymphogenous metastasis) were used as the malignant control group; and salivary mixed tumor ( n =10), tongue leukoceratosis ( n = 10) and cervical lymph node reactive hyperplasia ( n = 10) were used as the benign control group. Results: Expression of CXCR4 in the tissues and lymph metastases of oral and maxillofacial salivary ACC, mucoepidermoid carcinoma and tongue carcinoma was significantly higher than that of the benign control group ( P < 0.05); expression of CXCR4 in the primary focus of ACC was significantly higher than that of the malignant control group; and expression of CXCR4 in the ACC with lung metastasis was 87.1% (6/7), significantly higher than that without lung metastasis( P <0.01 ). There was evident positive expression of CXCL12 in endotheliocytes of microvessels within cancer and paracancer tissues and significantly high expression of CXCL12 in lymphogenous metastasis( P < 0.05). Conclusion: Chemokine receptor CXCR4 and its ligand CXCL12 may be associated with local invasion and lymphogenous metastasis of oral and maxillofacial cancer, especially with lung metastasis of salivary ACC.

  15. Inguinal lymph node metastasis of colon cancer

    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.

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

    [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 ...

  17. Groin surgery and the sentinel lymph node

    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

  18. Popliteal lymph node metastasis of tibial osteoblastic osteosarcoma

    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.

  19. Is Full Lymph Node Removal Always Needed for Melanoma?

    ... 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 ...

  20. Left ventricular diastolic function in patients with advanced cystic fibrosis.

    Koelling, Todd M; Dec, G William; Ginns, Leo C; Semigran, Marc J


    To assess left ventricular systolic and diastolic function in adult patients with cystic fibrosis using radionuclide ventriculography. Although myocardial fibrosis has been described in autopsy specimens of patients with cystic fibrosis, the possibility that myocardial dysfunction may occur during life in adult patients with cystic fibrosis has not been explored. To assess the possibility of cardiac dysfunction occurring in cystic fibrosis, we studied 40 patients with advanced cystic fibrosis with first-pass radionuclide ventriculography and compared them to 9 patients with advanced bronchiectasis and 18 normal control subjects. Indexes of right ventricular systolic function were similarly impaired in patients with cystic fibrosis and patients with bronchiectasis. Left ventricular ejection fraction of patients with cystic fibrosis, patients with bronchiectasis, and normal control subjects did not differ. Fractional left ventricular filling at 50% of diastole, an index of diastolic function, was significantly lower in patients with cystic fibrosis (54 +/- 13%, mean +/- SD) in comparison to patients with bronchiectasis (66 +/- 4%, p = 0.009) or normal control subjects (69 +/- 14, p = 0.0002). The contribution of atrial systole to total diastolic left ventricular filling was greater in patients with cystic fibrosis (38 +/- 18%) than in patients with bronchiectasis (21 +/- 4%, p = 0.01) or normal control subjects (25 +/- 12%, p = 0.01). Patients with advanced cystic fibrosis demonstrate impaired left ventricular distensibility when compared to normal control subjects and patients with bronchiectasis. Patients with cystic fibrosis may be at risk of heart failure due to right ventricular dysfunction or left ventricular diastolic dysfunction.

  1. Numerical Modelling of Solitary Wave Experiments on Rubble Mound Breakwaters

    Guler, H. G.; Arikawa, T.; Baykal, C.; Yalciner, A. C.


    Performance of a rubble mound breakwater protecting Haydarpasa Port, Turkey, has been tested under tsunami attack by physical model tests conducted at Port and Airport Research Institute (Guler et al, 2015). It is aimed to understand dynamic force of the tsunami by conducting solitary wave tests (Arikawa, 2015). In this study, the main objective is to perform numerical modelling of solitary wave tests in order to verify accuracy of the CFD model IHFOAM, developed in OpenFOAM environment (Higuera et al, 2013), by comparing results of the numerical computations with the experimental results. IHFOAM is the numerical modelling tool which is based on VARANS equations with a k-ω SST turbulence model including realistic wave generation, and active wave absorption. Experiments are performed using a Froude scale of 1/30, measuring surface elevation and flow velocity at several locations in the wave channel, and wave pressure around the crown wall of the breakwater. Solitary wave tests with wave heights of H=7.5 cm and H=10 cm are selected which represent the results of the experiments. The first test (H=7.5 cm) is the case that resulted in no damage whereas the second case (H=10 cm) resulted in total damage due to the sliding of the crown wall. After comparison of the preliminary results of numerical simulations with experimental data for both cases, it is observed that solitary wave experiments could be accurately modeled using IHFOAM focusing water surface elevations, flow velocities, and wave pressures on the crown wall of the breakwater (Figure, result of sim. at t=29.6 sec). ACKNOWLEDGEMENTSThe authors acknowledge developers of IHFOAM, further extend their acknowledgements for the partial supports from the research projects MarDiM, ASTARTE, RAPSODI, and TUBITAK 213M534. REFERENCESArikawa (2015) "Consideration of Characteristics of Pressure on Seawall by Solitary Waves Based on Hydraulic Experiments", Jour. of Japan. Soc. of Civ. Eng. Ser. B2 (Coast. Eng.), Vol 71, p I

  2. Bifurcation and Solitary-Like Solutions for Compound KdV-Burgers-Type Equation

    Yin Li


    Full Text Available Firstly, based on the improved sub-ODE method and the bifurcation method of dynamical systems, we investigate the bifurcation of solitary waves in the compound KdV-Burgers-type equation. Secondly, numbers of solitary patterns solutions are given for each parameter condition and numerical simulations are used to display the dynamical characteristics. Finally, we obtain twelve solitary patterns solutions under some parameter conditions, such as the trigonometric function solutions and the hyperbolic function solutions.

  3. 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.

  4. A case of lymphangioleiomyomatosis affecting the supraclavicular lymph nodes.

    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.

  5. Solid and Cystic Tumor (SCT of the Pancreas in an Adult Man

    K. Ohiwa


    Full Text Available Solid and cystic tumor (SCT of the pancreas predominantly Occurs in women, and the occurrence in men is extremely rare. We experienced a male case of SCT. A 38-year-old man was admitted with the complaint of upper abdominal pain. CT scan showed the presence of a mass in the head of the pancreas. The mass was composed of high density areas and low density areas. Ultrasonograms revealed the mass being composed of high echoic areas and low echoic areas. The mass .was hypovascular on angiography. SCT was suspected and pancreaticoduodenectomy was performed. The cut surface of the tumor showed mainly cystic degenerative areas containing dark red hemorrhagic materials. Microscopically, there were solid areas in the periphery and pseudopapillary areas in the center. No metastasis was found in the removed lymph nodes. The tumor cells were not stained by Grimelius' silver stain. The tumor cells were positive for alpha-l-antitrypsin (AAT and neuron-specific enolase (NSE. Pancreatic hormones such as insulin, glucagon, and somatostatin were all negative. Electron micrograph showed that tumor cells were rich in mitochondria. Zymogen granules and neurosecretory granules were not detected. Estrogen receptor (ER and progesterone receptor (PR were both negative.

  6. Spindle cell carcinoma of the breast as complex cystic lesion:a case report

    Masahiro Kitada; Satoshi Hayashi; Yoshinari Matsuda; Kei Ishibashi; Keisuke Oikawa; Naoyuki Miyokawa


    Spindle cell carcinoma of the breast is a rare tumor. hTis tumor can proliferate rapidly and cause cystic changes because of internal tissue necrosis. We evaluated a 54-year-old woman with right breast lump. Mammography showed a category four mass with a diameter of 2.5 cm. Ultrasonography (US) revealed a complex cystic lesion, and ifne-needle aspiration (FNA) cytology demonstrated bloody fluid and malignant cells. Partial breast resection and sentinel lymph node biopsy were performed. Immunohistology revealed spindle cells with positive results for cytokeratin (AE1/AE3) and vimentin, partially positive results for s-100, and negative results for desmin and α-actin. The pathological stage was IIA, and biochemical characterization showed that the tumor was triple negative. Six courses of FEC-100 chemotherapy (5-fluorouracil 500 mg/m2, epirubicin 100 mg/m2, and cyclophosphamide 500 mg/m2) were administered. Radiotherapy was performed. hTis case is discussed with reference to the literature.

  7. Cystic lesion around the hip joint

    Yukata, Kiminori; Nakai, Sho; Goto, Tomohiro; Ikeda, Yuichi; Shimaoka, Yasunori; Yamanaka, Issei; Sairyo, Koichi; Hamawaki, Jun-ichi


    This article presents a narrative review of cystic lesions around the hip and primarily consists of 5 sections: Radiological examination, prevalence, pathogenesis, symptoms, and treatment. Cystic lesions around the hip are usually asymptomatic but may be observed incidentally on imaging examinations, such as computed tomography and magnetic resonance imaging. Some cysts may enlarge because of various pathological factors, such as trauma, osteoarthritis, rheumatoid arthritis, or total hip arthroplasty (THA), and may become symptomatic because of compression of surrounding structures, including the femoral, obturator, or sciatic nerves, external iliac or common femoral artery, femoral or external iliac vein, sigmoid colon, cecum, small bowel, ureters, and bladder. Treatment for symptomatic cystic lesions around the hip joint includes rest, nonsteroidal anti-inflammatory drug administration, needle aspiration, and surgical excision. Furthermore, when these cysts are associated with osteoarthritis, rheumatoid arthritis, and THA, primary or revision THA surgery will be necessary concurrent with cyst excision. Knowledge of the characteristic clinical appearance of cystic masses around the hip will be useful for determining specific diagnoses and treatments. PMID:26495246

  8. Diagnosis and treatment of cystic lung disease

    Park, Sanghoon; Lee, Eun Joo


    Cystic lung disease (CLD) is a group of lung disorders characterized by the presence of multiple cysts, defined as air-filled lucencies or low-attenuating areas, bordered by a thin wall (usually Hogg-Dube syndrome, lymphocytic interstitial pneumonia/follicular bronchiolitis, and amyloidosis. PMID:28264540

  9. Barriers to adherence in cystic fibrosis

    Bregnballe, Vibeke; Schiøtz, Peter Oluf


    Danish patients with cystic fibrosis aged 14 to 25 years and their parents. Conclusions: The present study showed that the majority of adolescents with CF and their parents experienced barriers to treatment adherence. Patients and parents agreed that the three most common barriers encountered lack...

  10. Inhalation of antibiotics in cystic fibrosis

    Touw, D J; Brimicombe, R W; Hodson, M E; Heijerman, H G; Bakker, W

    Aerosol administration of antipseudomonal antibiotics is commonly used in cystic fibrosis. However, its contribution to the improvement of lung function, infection and quality of life is not well-established. All articles published from 1965 until the present time concerning the inhalation of

  11. Nutritional assessment in children with cystic fibrosis

    Optimal nutrition, including consuming 35–40% of calories (kcal) as fat, is a vital part of the management of cystic fibrosis (CF), and involves accurate assessment of dietary intake. We compared 3 methods of nutritional assessment in 8– to 14-year-old children (n=20) with CF: 1) a 24-h Dietary Reca...

  12. Zinc supplementation in children with cystic fibrosis

    Cystic fibrosis (CF) leads to malabsorption of macro- and micronutrients. Symptomatic zinc deficiency has been reported in CF but little is known about zinc homeostasis in children with CF. Zinc supplementation (Zn suppl) is increasingly common in children with CF but it is not without theoretcial r...

  13. Craniofacial morphology in children with cystic fibrosis.

    Hellsing, E; Brattström, V; Strandvik, B


    Cystic fibrosis (CF) is a hereditary metabolic disorder with clinical symptoms of abnormal mucus production. This blocks the airways, gives pancreatic insufficiency, and increases sweat electrolytes. The progressive respiratory disease often leads to respiratory insufficiency and cor pulmonale. The aim of the present investigation was to examine the facial morphology in children with cystic fibrosis. The sample comprised 11 children with cystic fibrosis, who were divided in two groups, one with gastrointestinal disorders and the other with predominantly respiratory insufficiency. Eleven healthy children with normal occlusions were selected as controls. Lateral skull radiographs obtained in natural head posture were digitized, and linear and angular variables for the different groups calculated and compared statistically. The cystic fibrosis group showed open bite, decreased posterior facial height, increased mandibular and craniocervical inclination. Additionally, within the CF-group, the children with respiratory insufficiency differed more from the controls than the children with gastrointestinal disorders. Despite the small number of subjects, the facial morphology of the CF children showed a similar pattern to that of children with nasal respiratory obstruction due to enlarged adenoids or tonsils.

  14. Inhalation of antibiotics in cystic fibrosis

    Touw, D J; Brimicombe, R W; Hodson, M E; Heijerman, H G; Bakker, W


    Aerosol administration of antipseudomonal antibiotics is commonly used in cystic fibrosis. However, its contribution to the improvement of lung function, infection and quality of life is not well-established. All articles published from 1965 until the present time concerning the inhalation of antibi

  15. Cystic fibrosis : terminology and diagnostic algorithms

    De Boeck, K; Wilschanski, M; Castellani, C; Taylor, C; Cuppens, H; Dodge, J; Sinaasappel, M


    There is great heterogeneity in the clinical manifestations of cystic fibrosis (CF). Some patients may have all the classical manifestations of CF from infancy and have a relatively poor prognosis, while others have much milder or even atypical disease manifestations and still carry mutations on eac

  16. [Intra-cystic renal calcium milk].

    Meunier, B; Médart, L; Massart, J P; Collignon, L


    Intra-cystic renal calcium milk is a rare entity. The authors report a clinical case, and describe the radiographic and tomodensitometric appearances. This 50 year old patient has been followed up for more than ten years for urinary lithiasis with recurrent pain.

  17. Psychosocial problems in children with cystic fibrosis

    Bregnballe, V; Thastum, M; Schiøtz, P O


    AIM: To compare the well-being of children (7-14 years) with cystic fibrosis (CF) (n = 43) with the well-being of healthy controls (n = 1121). METHODS: The self-report questionnaire Beck Youth Inventories (BYI) was used to study depression, anxiety, anger, disruptive behaviour and self...

  18. The mutational landscape of adenoid cystic carcinoma

    Ho, A.S.; Kannan, K.; Roy, D.M.; Morris, L.G.T.; Ganly, I.; Katabi, N.; Ramaswami, D.; Walsh, L.A.; Eng, S.; Huse, J.T.; Zhang, J.; Dolgalev, I.; Huberman, K.; Heguy, A.; Viale, A.; Drobnjak, M.; Leversha, M.A.; Rice, C.E.; Singh, B.; Iyer, N.G.; Leemans, C.R.; Bloemena, E.; Ferris, R.L.; Seethala, R.R.; Gross, B.E.; Liang, Y.; Sinha, R.; Peng, L.; Raphael, B.J.; Turcan, S.; Gong, Y.; Schultz, N.; Kim, S.; Chiosea, S.; Shah, J.P.; Sander, C.; Lee, W.; Chan, T.A.


    Adenoid cystic carcinomas (ACCs) are among the most enigmatic of human malignancies. These aggressive salivary gland cancers frequently recur and metastasize despite definitive treatment, with no known effective chemotherapy regimen. Here we determined the ACC mutational landscape and report the exo

  19. Intestinal organoids as model for cystic fibrosis

    Dekkers, J.F.


    Recent advances in adult stem cell culture technology have enabled long-term in vitro expansion of intestinal organoids or ‘mini-guts’. In this thesis, we used the organoid model to develop a novel assay to measure function of CFTR, the protein mutated in subjects with cystic fibrosis (CF). This met

  20. Transition from Solitons to Solitary Waves in the Fermi-Pasta-Ulam Lattice

    Wen, Zhenying; Wei, Nian


    In this paper, we study the smooth transition from solitons to solitary waves in localization, relation between energy and velocity, propagation and scattering property in the Fermi-Pasta-Ulam lattice analytically and numerically. A soliton is a very stable solitary wave that retains its permanent structure after interacting with other solitary waves. A soliton exists when the energy is small, and it becomes a solitary wave when the energy increases to the threshold. The transition could help to understand the distinctly different heat conduction behaviors of the Fermi-Pasta-Ulam lattice at low and high temperature.

  1. Experimental study of nonlinear dust acoustic solitary waves in a dusty plasma

    Bandyopadhyay, P; Sen, A; Kaw, P K


    The excitation and propagation of finite amplitude low frequency solitary waves are investigated in an Argon plasma impregnated with kaolin dust particles. A nonlinear longitudinal dust acoustic solitary wave is excited by pulse modulating the discharge voltage with a negative potential. It is found that the velocity of the solitary wave increases and the width decreases with the increase of the modulating voltage, but the product of the solitary wave amplitude and the square of the width remains nearly constant. The experimental findings are compared with analytic soliton solutions of a model Kortweg-de Vries equation.

  2. Solitary Plasmacytoma of the Cecum and the Ascending Colon: Surgical Resection as a Treatment Modality

    Dalgic, Tahsin; Bostanci, Erdal Birol; Cakir, Tebessum; Ozer, Ilter; Ulas, Murat; Aydog, Gulden; Akoglu, Musa


    Colonic solitary plasmacytoma is a rare disease, with few reports occurring in the literature. Solitary plasmacytoma is defined as a plasma cell tumour with no evidence of bone marrow infiltration. Plasmacytoma can present as a solitary tumour in bone or in other parts of the body. The gastrointestinal tract is rarely the site of the disease. We report on the case of a 51-year-old man presenting with a colonic symptomatic mass with unclear biopsy results. A resected specimen showed a solitary plasmacytoma. Surgical resection was an adequate treatment modality in this case. Endoscopic resection, radiotherapy, and chemotherapy are also preferred treatments in selected gastrointestinal plasmacytoma cases. PMID:25954564

  3. Solitary Plasmacytoma of the Cecum and the Ascending Colon: Surgical Resection as a Treatment Modality

    Tahsin Dalgic


    Full Text Available Colonic solitary plasmacytoma is a rare disease, with few reports occurring in the literature. Solitary plasmacytoma is defined as a plasma cell tumour with no evidence of bone marrow infiltration. Plasmacytoma can present as a solitary tumour in bone or in other parts of the body. The gastrointestinal tract is rarely the site of the disease. We report on the case of a 51-year-old man presenting with a colonic symptomatic mass with unclear biopsy results. A resected specimen showed a solitary plasmacytoma. Surgical resection was an adequate treatment modality in this case. Endoscopic resection, radiotherapy, and chemotherapy are also preferred treatments in selected gastrointestinal plasmacytoma cases.

  4. Calculation and analysis of solitary waves and kinks in elastic tubes


    The paper is devoted to analysis of different models that describe waves in fluid-filled and gas-filled elastic tubes and development of methods of calculation and numerical analysis of solutions with solitary waves and kinks for these models. Membrane model and plate model are used for tube. Two types of solitary waves are found. One-parametric families are stable and may be used as shock structures. Null-parametric solitary waves are unstable. The process of split of such solitary waves is ...

  5. Interaction of Submerged Breakwater by a Solitary Wave Using WC-SPH Method

    Afshin Mansouri


    Full Text Available Interaction of a solitary wave and submerged breakwater is studied in a meshless, Lagrangian approach. For this purpose, a two-dimensional smoothed particle hydrodynamics (SPH code is developed. Furthermore, an extensive set of simulations is conducted. In the first step, the generated solitary wave is validated. Subsequently, the interaction of solitary wave and submerged breakwater is investigated thoroughly. Results of the interaction of solitary wave and a submerged breakwater are also shown to be in good agreement with published experimental studies. Afterwards, the effects of the inclination and length of breakwater as well as distance between two breakwaters are evaluated on damping ratio of breakwater.

  6. 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

    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

  7. Molecular markers of lymph node metastases in oral cancer

    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

  8. Linfangioma cístico do mediastino Cystic lymphangioma of the mediastinum

    Filipa Maria Arruda Viveiros Correia


    Full Text Available O linfangioma cístico é um tumor congênito benigno e raro. Resulta da proliferação focal de tecido linfático bem diferenciado com origem num anormal desenvolvimento do sistema linfático. A maioria ocorre em crianças ou adultos jovens nos sacos linfáticos primordiais. Geralmente ocorrem no pescoço (75% e na região axilar (20%. Apenas 1% desses são localizados no mediastino. Os linfangiomas adquiridos, principalmente encontrados em adultos de meia-idade, são conseqüentes a um processo de obstrução linfática crônica secundária a cirurgia, infecção crônica ou radiação. Os autores apresentam um caso clínico de linfangioma cístico do mediastino num indivíduo do sexo masculino de 50 anos, detectado por achado em radiografia de tórax de rotina.Cystic lymphangioma is a rare congenital benign tumor. It results from focal proliferation of well-differentiated lymphatic tissue originating from abnormal development of the lymphatic system. Most cystic lymphangiomas occur in the primitive lymph sacs of children or young adults. They generally appear in the neck (75% and axillary region (20%. Only 1% are located in the mediastinum. Acquired lymphangiomas, which are principally seen in middle-aged adults, are caused by a process of chronic lymphatic obstruction secondary to surgery, chronic infection, or radiation. Here, we present the case of a 50-year-old male with cystic lymphangioma of the mediastinum, detected on a routine chest X-ray.

  9. Nutrient Status of Adults with Cystic Fibrosis



    Nutrition is thought to influence disease status in patients with cystic fibrosis (CF). This cross-sectional study sought to evaluate nutrient intake and anthropometric data from 64 adult outpatients with cystic fibrosis. Nutrient intake from food and supplements was compared with the Dietary Reference Intakes for 16 nutrients and outcomes influenced by nutritional status. Attention was given to vitamin D and calcium given potential skeletal implications due to cystic fibrosis. Measurements included weight, height, body composition, pulmonary function, and serum metabolic parameters. Participants were interviewed about dietary intake, supplement use, pulmonary function, sunlight exposure, and pain. The participants’ mean body mass index (±standard deviation) was 21.8±4.9 and pulmonary function tests were normal. Seventy-eight percent used pancreatic enzyme replacement for malabsorption. Vitamin D deficiency [25-hydroxyvitamin D (25OHD)<37.5 nmol/L] was common: 25 (39%) were deficient despite adequate vitamin D intake. Lipid profiles were normal in the majority, even though total and saturated fat consumption represented 33.0% and 16.8% of energy intake, respectively. Reported protein intake represented 16.9% of total energy intake (range 10%–25%). For several nutrients, including vitamin D and calcium, intake from food and supplements in many participants exceeded recommended Tolerable Upper Intake Levels. Among adults with cystic fibrosis, vitamin D deficiency was common despite reported adequate intake, and lipid profiles were normal despite a relatively high fat intake. Mean protein consumption was adequate, but the range of intake was concerning, as both inadequate or excessive intake may have deleterious skeletal effects. These findings call into question the applicability of established nutrient thresholds for patients with cystic fibrosis. PMID:18060897

  10. Lymph node content of supraclavicular and thoracodorsal-based axillary flaps for vascularized lymph node transfer.

    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.

  11. [Particular features of lymph dissection in operations for gastric cancer].

    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.

    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. Interaction between the solitary bee Chelostoma florisomne and its nest parasite Sapyga clavicornis-empty cells reduce the impact of parasites

    Munster-Swendsen, Mikael; Calabuig, Isabel


    Chelostoma, empty cells, interaction, mortality, nest architecture, nest parasite, protection, Sapyga, solitary bee......Chelostoma, empty cells, interaction, mortality, nest architecture, nest parasite, protection, Sapyga, solitary bee...

  14. Sentinel lymph node biopsy in oral cancer

    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...

  15. Imaging Classification of Cervical Lymph Nodes

    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.

  16. BGK electron solitary waves: 1D and 3D

    L.-J. Chen


    Full Text Available This paper presents new results for 1D BGK electron solitary wave (phase-space electron hole solutions and, based on the new results, extends the solutions to include the 3D electrical interaction (E ~ 1/r 2 of charged particles. Our approach for extending to 3D is to solve the nonlinear 3D Poisson and 1D Vlasov equations based on a key feature of 1D electron hole (EH solutions; the positive core of an EH is screened by electrons trapped inside the potential energy trough. This feature has not been considered in previous studies. We illustrate this key feature using an analytical model and argue that the feature is independent of any specific model. We then construct azimuthally symmetric EH solutions under conditions where electrons are highly field-aligned and ions form a uniform background along the magnetic field. Our results indicate that, for a single humped electric potential, the parallel cut of the perpendicular component of the electric field (E⊥ is unipolar and that of the parallel component (E|| bipolar, reproducing the multi-dimensional features of the solitary waves observed by the FAST satellite. Our analytical solutions presented in this article capture the 3D electric interaction and the observed features of (E|| and E⊥. The solutions predict a dependence of the parallel width-amplitude relation on the perpendicular size of EHs. This dependence can be used in conjunction with experimental data to yield an estimate of the typical perpendicular size of observed EHs; this provides important information on the perpendicular span of the source region as well as on how much electrostatic energy is transported by the solitary waves.

  17. Eady Solitary Waves: A Theory of Type B Cyclogenesis.

    Mitsudera, Humio


    Localized baroclinic instability in a weakly nonlinear, long-wave limit using an Eady model is studied. The resulting evolution equations have a form of the KdV type, including extra terms representing linear coupling. Baroclinic instability is triggered locally by the collision between two neutral solitary waves (one trapped at the upper boundary and the other at the lower boundary) if their incident amplitudes are sufficiently large. This characteristic is explained from the viewpoint of resonance when the relative phase speed, which depends on the amplitudes, is less than a critical value. The upper and lower disturbances grow in a coupled manner (resembling a normal-mode structure) initially, but they reverse direction slowly as the amplitudes increase, and eventually separate from each other.The motivation of this study is to investigate a type of extratropical cyclogenesis that involves a preexisting upper trough (termed as Type B development) from the viewpoint of resonant solitary waves. Two cases are of particular interest. First, the author examines a case where an upper disturbance preexists over an undisturbed low-level waveguide. The solitary waves exhibit behavior similar to that conceived by Hoskins et al. for Type B development; the lower disturbance is forced one sidedly by a preexisting upper disturbance initially, but in turn forces the latter once the former attains a sufficient amplitude, thus resulting in mutual reinforcement. Second, if a weak perturbation exists at the surface ahead of the preexisting strong upper disturbance, baroclinic instability is triggered when the two waves interact. Even though the amplitude of the lower disturbance is initially much weaker, it is intensified quickly and catches up with the amplitude of the upper disturbance, so that the coupled vertical structure resembles that of an unstable normal mode eventually. These results describe the observed behavior in Type B atmospheric cyclogenesis quite well.

  18. En Bloc Resection of Solitary Functional Secreting Spinal Metastasis.

    Goodwin, C Rory; Clarke, Michelle J; Gokaslan, Ziya L; Fisher, Charles; Laufer, Ilya; Weber, Michael H; Sciubba, Daniel M


    Study Design Literature review. Objective Functional secretory tumors metastatic to the spine can secrete hormones, growth factors, peptides, and/or molecules into the systemic circulation that cause distinct syndromes, clinically symptomatic effects, and/or additional morbidity and mortality. En bloc resection has a limited role in metastatic spine disease due to the current paradigm that systemic burden usually determines morbidity and mortality. Our objective is to review the literature for studies focused on en bloc resection of functionally active spinal metastasis as the primary indication. Methods A review of the PubMed literature was performed to identify studies focused on functional secreting metastatic tumors to the spinal column. We identified five cases of patients undergoing en bloc resection of spinal metastases from functional secreting tumors. Results The primary histologies of these spinal metastases were pheochromocytoma, carcinoid tumor, choriocarcinoma, and a fibroblast growth factor 23-secreting phosphaturic mesenchymal tumor. Although studies of en bloc resection for these rare tumor subtypes are confined to case reports, this surgical treatment option resulted in metabolic cures and decreased clinical symptoms postoperatively for patients diagnosed with solitary functional secretory spinal metastasis. Conclusion Although the ability to formulate comprehensive conclusions is limited, case reports demonstrate that en bloc resection may be considered as a potential surgical option for the treatment of patients diagnosed with solitary functional secretory spinal metastatic tumors. Future prospective investigations into clinical outcomes should be conducted comparing intralesional resection and en bloc resection for patients diagnosed with solitary functional secretory spinal metastasis.



    SOLITARY PARAGANGLIOMA OF THE HYPOGLOSSAL NERVE:: Case Report BACKGROUND AND IMPORTANCE:: We report the case history of solitary hypoglossal paraganglioma in a 64-year-old woman. The surgical difficulties encountered in the removal of this challenging tumour are discussed with literature review. CLINICAL PRESENTATION:: A 64-year-old woman presented with a short history of dysphonia, occasional dysphagia, tinnitus, altered taste, and unilateral left sided tongue wasting. On examination there was left lower motor hypoglossal paralysis. Imaging showed a discrete enhancing lobulated mass, measuring 2cm x 2cm, in the region of the hypoglossal nerve extending into the hypoglossal canal suggestive of hypoglossal paraganglioma. A left dorsolateral sub occipital craniotomy was carried out in the sitting position. The hypoglossal nerve appeared to be enlarged and the jugular foramen was normal. Complete surgical debulking of the tumour was not attempted due to its vascular nature. The nerve was decompressed and neuropathology confirmed a low grade paraganglioma arising from the hypoglossal nerve. The patient is scheduled to receive stereotactic radiation for further management. CONCLUSION:: When a case of solitary hypoglossal paraganglioma is encountered in clinical practice, the aim of management should be mainly focussed on achieving a diagnosis and preserving the hypoglossal nerve function. If there is evidence of vascularity in the lesion noted in the MRI scan, a pre-operative angiogram should be performed with a view for embolisation.We decompressed the hypoglossal canal and achieved a good improvement in the patient\\'s symptoms. We recommend stereotactic radiosurgery for remnant and small hypoglossal tumours and regular follow up with MRI scans.


    Raza, Kazim


    SOLITARY PARAGANGLIOMA OF THE HYPOGLOSSAL NERVE:: Case Report BACKGROUND AND IMPORTANCE:: We report the case history of solitary hypoglossal paraganglioma in a 64-year-old woman. The surgical difficulties encountered in the removal of this challenging tumour are discussed with literature review. CLINICAL PRESENTATION:: A 64-year-old woman presented with a short history of dysphonia, occasional dysphagia, tinnitus, altered taste, and unilateral left sided tongue wasting. On examination there was left lower motor hypoglossal paralysis. Imaging showed a discrete enhancing lobulated mass, measuring 2cm x 2cm, in the region of the hypoglossal nerve extending into the hypoglossal canal suggestive of hypoglossal paraganglioma. A left dorsolateral sub occipital craniotomy was carried out in the sitting position. The hypoglossal nerve appeared to be enlarged and the jugular foramen was normal. Complete surgical debulking of the tumour was not attempted due to its vascular nature. The nerve was decompressed and neuropathology confirmed a low grade paraganglioma arising from the hypoglossal nerve. The patient is scheduled to receive stereotactic radiation for further management. CONCLUSION:: When a case of solitary hypoglossal paraganglioma is encountered in clinical practice, the aim of management should be mainly focussed on achieving a diagnosis and preserving the hypoglossal nerve function. If there is evidence of vascularity in the lesion noted in the MRI scan, a pre-operative angiogram should be performed with a view for embolisation.We decompressed the hypoglossal canal and achieved a good improvement in the patient\\'s symptoms. We recommend stereotactic radiosurgery for remnant and small hypoglossal tumours and regular follow up with MRI scans.

  1. Research on consistency of identifying solitary pulmonary masses with CT

    Qiuping Wang; Gang Niu; Yun Zhang; Yongqian Qiang; Zicheng Li; Youmin Guo


    Objective:To research on consistency of identifying solitary pulmonary masses with CT.Methods:Three observers with different working backgrounds in imaging diagnosis individually interpreted the same group images of solitary pulmonary mass, by 12 indexes of objective signs.The differences in interpretation resulted in ante- and post-interpretations were assessed by the x2 test.The agreement of two interpretations from the same observer was confirmed with the kappa test.A double-blind method was adopted for analysis.Results:The agreement rates of ante- and post-interpreting from the three observers were respectively 82.65%(486/588) 80.27%(472/588) and 84.86% (499/588) while their interpreting results were generally accordant without significant difference(x2 = 4.975, df= 2,P = 0.083) however there was difference between the observer 2 and observer 3(x2 = 4.875, df= 1, P = 0.027).There were five indexes with k > 0.40 of ante- and post-interpreting results of the three observers, including clarity of nodule borderline, presence of sentus, uniformity of density, existence of cavity and calcification in pathological region, among them, the agreement rate of interpreting borderline and cavity was higher(k > 0.07); the blood vessel convergence poorer(0 < k ≤ 0.40); the other six CT signs of interpretation were slightly different.Conclusion:The ability to identify solitary pulmonary mass was inconsistent, and needs to be improved further.

  2. Breathing solitary-pulse pairs in a linearly coupled system

    Dana, Brenda; Bahabad, Alon


    It is shown that pairs of solitary pulses (SPs) in a linearly-coupled system with opposite group-velocity dispersions form robust breathing bound states. The system can be realized by temporal-modulation coupling of SPs with different carrier frequencies propagating in the same medium, or by coupling of SPs in a dual-core waveguide. Broad SP pairs are produced in a virtually exact form by means of the variational approximation. Strong nonlinearity tends to destroy the periodic evolution of the SP pairs.

  3. Blastomycosis presenting as solitary nodule: A rare presentation

    Ashish Dhamija


    Full Text Available Blastomycosis is a chronic granulomatous and suppurative mycosis, caused by Blastomyces dermatitidis, which in the great majority of cases presents as a primary pulmonary disease. Primary cutaneous blastomycosis is very rare. We present a 57-year-old female patient with a solitary, slowly progressive nodule over upper lip of 2½ months duration. Initially, differential diagnosis of cutaneous leishmaniasis, pyoderma and deep mycoses were entertained. Slit smear preparation was suspicious of deep mycotic infection which was subsequently confirmed by biopsy and culture.

  4. Solitary Fibrous Tumor in Bladder:A Case Report

    王涛; 陈瑞宝; 乔建坤; 胡涛; 刘继红; 杨为民; 叶章群


    Solitary fibrous tumor(SFT) in bladder is extremely rare.In this study,we reported one case of bladder SFT and reviewed the only ten cases of the disease that had been reported so far.The patient suffered from residual urine sensation and urethral pain.Cystoscopy revealed a 7-cm protruding mass at the dome of the bladder,and bladder mucosa biopsy showed normal differentiation of the bladder mucosa with a small amount of inflammatory cells.Radical resection of the tumor was performed in this patient.Patholog...

  5. Coherent structures in wave boundary layers. Part 2. Solitary motion

    Sumer, B. Mutlu; Jensen, Palle Martin; Sørensen, Lone B.;


    in an oscillating water tunnel. Two kinds of measurements were made: bed shear stress measurements and velocity measurements. The experiments show that the solitary-motion boundary layer experiences three kinds of flow regimes as the Reynolds number is increased: (i) laminar regime; (ii) laminar regime where...... the boundary-layer flow experiences a regular array of vortex tubes near the bed over a short period of time during the deceleration stage; and (iii) transitional regime characterized with turbulent spots, revealed by single/multiple, or, sometimes, quite dense spikes in the bed shear stress traces...

  6. A case report of reactive solitary eccrine syringofibroadenoma

    Tiwary, Anup K.; Firdous, J.; Mishra, Dharmendra K.; Chaudhary, Shyam S.


    Eccrine syringofibroadenoma is a very rare benign tumour of acrosyringium of eccrine sweat duct. Based on the evidences of known etiological factors, two forms have been proposed; reactive and nonreactive. Reactive forms are rarer, and on even rarer occasions, trauma complicated by secondary nonspecific infections may lead to the development of reactive eccrine syringofibroadenoma, as in our case. Here, we are documenting a case of reactive solitary eccrine syringofibroadenoma in a 65-year-old male presenting with coalescing, firm, pinkish, verrucous nodules and painful deep ulceration on the right sole preceded by trauma and secondary infection. Histopathologic revelation of distinctive microscopic findings confirmed the diagnosis in our case. PMID:28217470

  7. Metastatic melanoma mimicking solitary fibrous tumor: report of two cases.

    Bekers, Elise M; van Engen-van Grunsven, Adriana C H; Groenen, Patricia J T A; Westdorp, Harm; Koornstra, Rutger H T; Bonenkamp, Johannes J; Flucke, Uta; Blokx, Willeke A M


    Malignant melanomas are known for their remarkable morphological variation and aberrant immunophenotype with loss of lineage-specific markers, especially in recurrences and metastases. Hot spot mutations in BRAF, NRAS, GNAQ, and GNA11 and mutations in KIT are oncogenic events in melanomas. Therefore, genotyping can be a useful ancillary diagnostic tool. We present one case each of recurrent and metastatic melanoma, both showing histological and immunohistochemical features of solitary fibrous tumor (SFT). Mutational analysis detected BRAF and NRAS mutations in the primary and secondary lesions, respectively. This result confirmed the diagnosis of recurrent/metastastic melanoma.

  8. Experiments and computation of onshore breaking solitary waves

    Jensen, A.; Mayer, Stefan; Pedersen, G.K.


    This is a combined experimental and computational study of solitary waves that break on-shore. Velocities and accelerations are measured by a two-camera PIV technique and compared to theoretical values from an Euler model with a VOF method for the free surface. In particular, the dynamics of a so......-called collapsing breaker is scrutinized and the closure between the breaker and the beach is found to be akin to slamming. To the knowledge of the authors, no velocity measurements for this kind of breaker have been previously reported....

  9. [A solitary neurofibroma in the parotid gland from nervus vagus].

    Fagö-Olsen, Helena Anna; Hahn, Christoffer Holst


    A 37-year-old male, without stigmata of neurofibromatosis type 1, developed a firm mass below the right ear over several months without facial palsy. Clinical examination and ultra-sonography revealed a tumour in the parotid gland. Fine needle aspirationbiopsy was inconclusive. During complete resection, the tumour revealed an unusual anatomic location from the superficial lobe of the parotid to the deep and further into the parapharyngeal space. The pathological examination showed a solitary neurofibroma. In this case report, preoperative diagnosis, therapy and follow-up of this rare tumour in the parotid gland from n. vagus are discussed.


    LIU Zhi-fang; ZHANG Shan-yuan


    A new nonlinear wave equation of a finite deformation elastic circular rod simultaneously introducing transverse inertia and shearing strain was derived by means of Hamilton principle. The nonlinear equation includes two nonlinear terms caused by finite deformation and double geometric dispersion effects caused by transverse inertia and transverse shearing strain. Nonlinear wave equation and corresponding truncated nonlinear wave equation were solved by the hyperbolic secant function finite expansion method. The solitary wave solutions of these nonlinear equations were obtained. The necessary condition of these solutions existence was given also.

  11. Flow and sediment transport induced by a plunging solitary wave

    Sumer, B. Mutlu; Sen, M.Berke; Karagali, Ioanna


    , and for observation of the morphological changes. The two experimental conditions were maintained as similar as possible. The experiments showed that the complete sequence of the plunging solitary wave involves the following processes: Shoaling and wave breaking; Runup; Rundown and hydraulic jump; and Trailing wave...... affected, by as much as a factor of 2, in the runup and hydraulic jump stages. The pore-water pressure measurements showed that the sediment at (or near) the surface of the bed experiences upward-directed pressure gradient forces during the downrush phase. The magnitude of this force can reach values...

  12. Solitary fibrous tumor arising in an intrathoracic goiter

    Larsen, Stine Rosenkilde; Godballe, Christian; Krogdahl, Annelise


    . CONCLUSION: The histological appearance and immunohistochemical reaction pattern of SFT is characteristic. The entity should be considered when dealing with a spindle cell lesion in the thyroid gland. All cases of this site of origin reported have had a benign clinical course. As only a small number of cases......BACKGROUND: Solitary fibrous tumor (SFT) is a rare spindle cell tumor most often found in the mediastinal pleura. Nineteen cases of SFT arising in the thyroid gland have been reported. We report a case of SFT of the thyroid gland with immunohistochemical and cytogenetic investigation. SUMMARY: A 58...

  13. Solitary fibrous tumor of the orbit presenting in pregnancy

    Das Jayanta


    Full Text Available A 32-year-old woman, three months pregnant, reported with the complaint of protrusion of the right eye for six months. She gave history of rapid protrusion of eyeball for the last two months along with the history of double vision for the last one month. Computer tomography (CT scan revealed a well-defined mass lesion in the intraconal space of the right orbit which was excised through a lateral orbitotomy approach. Histological examination and immunohistochemistry revealed a solitary fibrous tumor, which showed a rapid progression in pregnancy.

  14. Sarcoidal Granuloma in Cervical Lymph Nodes

    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.

  15. Adenoid cystic carcinoma of head and neck: A single institutional analysis of 66 patients treated with multi-modality approach

    Ajeet Kumar Gandhi


    Full Text Available Background: Adenoid cystic carcinoma (ACC accounts for 1% of all head and neck (HN cancers. Materials and Methods: Demographic, clinical, treatment, and survival details of 66 patients were collected (1995-2011 and analyzed. Disease-free survival (DFS was estimated by Kaplan-Meier method. Results: Primary disease sites were sinonasal (n = 27, salivary gland (n = 30, and others (n = 9. Median follow-up was 23 months (range: 12-211 months. Estimated DFS at 2- and 5-year were 75% and 67.2%, respectively. On univariate analysis, intra-cranial extension (ICE (hazard ratio [HR]: 3.59, P = 0.0071, lymph node involvement (HR: 4.05, P = 0.0065, treatment modality (others vs. surgery plus adjuvant radiotherapy, HR: 2.39, P = 0.0286 and T stage (T3/4 vs. T1/2, HR: 3.27, P = 0.007 had significant impact on DFS. Lymph node involvement (P = 0.038 and ICE (P = 0.038 continued to have significant impact on DFS on multivariate analysis. Conclusion: Surgery followed by adjuvant radiotherapy remains the treatment of choice for HN ACC. Lymph node involvement and ICE confer poor prognosis.



    Using direct algebraic method,exact solitary wave solutions are performed for a class of third order nonlinear dispersive disipative partial differential equations. These solutions are obtained under certain conditions for the relationship between the coefficients of the equation. The exact solitary waves of this class are rational functions of real exponentials of kink-type solutions.

  17. Laboratory Generation of Solitary Waves:An Inversion Technique to Improve Available Methods

    A.Romano; M.Guerrini; G.Bellotti; 琚烈红


    Solitary waves are often used in laboratory experiments to study tsunamis propagation and interaction with coasts. However, the experimental shape of the waves may differ from the theoretical one. In this paper, a correction technique aiming at minimizing the discrepancies between the two profiles is presented. Laboratory experiments reveal their effectiveness in correcting the experimental shape of solitary waves, mainly for low nonlinearities.

  18. Solitary Solution of Discrete mKdV Equation by Homotopy Analysis Method

    XU Xi-Xiang; WANG Zhen; YANG Hong-Xiang; ZOU Li; LU Rong-Wu; ZHANG Hong-Qing


    In this paper, we apply homotopy analysis method to solve discrete mKdV equation and successfully obtain the bell-shaped solitary solution to mKdV equation. Comparison between our solution and the exact solution shows that homotopy analysis method is effective and validity in solving hybrid nonlinear problems, including solitary solution of difference-differential equation.

  19. Large Amplitude Solitary Waves in a Fluid-Filled Elastic Tube



    By usign the potential method to a fluid filled elastic tube, we obtained a solitary wave solution.Compared with recluetive perturbation method, this method can be used for larger amplitude solitary waves. The result is in agreement with that of small amplitude approximation from reduetive perturbation method when the amplitude is small enough.

  20. Large Amplitude Solitary Waves in a Fluid-Filled Elastic Tube

    DUAN Wen-Shan


    By using the potential method to a fluid filled elastic tube, we obtained a solitary wave solution. Comparedwith reductive perturbation method, this method can be used for larger amplitude solitary waves. The result is inagreement with that of small amplitude approximation from reductive perturbation method when the amplitude is smallenough.

  1. Solitary cysticercosis of the biceps brachii in a vegetarian: a rare and unusual pseudotumor

    Abdelwahab, Ibrahim Fikry [Department of Radiology, New York Methodist Hospital Affiliated with Weill Medical College of Cornell University, 506 Sixth Street, Brooklyn, NY 11215 (United States); Klein, Michael J. [Department of Pathology, Mount Sinai Medical Center, 1 Gustave Levy Place, New York, NY 10029 (United States); Hermann, George [Department of Radiology, Mount Sinai Medical Center, 1 Gustave Levy Place, New York, NY 10029 (United States); Abdul-Quader, Mohammed [Department of Radiology, Columbia Presbyterian Medical Center, 177 Fort Washington Avenue, New York, NY 10032 (United States)


    We report a 40-year-old man with cysticercosis presenting as a solitary tumor in the biceps brachii muscle. Physical examination revealed an intramuscular mass and magnetic resonance imaging suggested a cyst. The histologic diagnosis was a cysticercus. Such solitary presentation of muscular cysticercosis is extremely rare with only a handful of sporadic reports in the literature. (orig.)

  2. A double optical solitary wave in a nonlinear Schr(o)dinger-type equation

    Yin Jiu-Li; Ding Shan-Yu


    A qualitative analysis method to efficiently solve the shallow wave equations is improved,so that a more complicated nonlinear Schr(o)dinger equation can be considered.By using the detailed study,some quite strange optical solitary waves are obtained in which the bright and dark optical solitary waves are allowed to coexist.

  3. Solitary Wave Generation from Constant Continuous Wave in Asymmetric Oppositely Directed Waveguide Coupler

    Kazantseva E.V.


    Full Text Available In a model which describes asymmetric oppositely directed nonlinear coupler it was observed in numerical simulations a phenomenon of solitary wave generation from the input constant continuous wave set at the entrance of a waveguide with negative refraction. The period of solitary wave formation decreases with increase of the continuum wave amplitude.

  4. Vlasov Simulation of Electrostatic Solitary Structures in Multi-Component Plasmas

    Umeda, Takayuki; Ashour-Abdalla, Maha; Pickett, Jolene S.; Goldstein, Melvyn L.


    Electrostatic solitary structures have been observed in the Earth's magnetosheath by the Cluster spacecraft. Recent theoretical work has suggested that these solitary structures are modeled by electron acoustic solitary waves existing in a four-component plasma system consisting of core electrons, two counter-streaming electron beams, and one species of background ions. In this paper, the excitation of electron acoustic waves and the formation of solitary structures are studied by means of a one-dimensional electrostatic Vlasov simulation. The present result first shows that either electron acoustic solitary waves with negative potential or electron phase-space holes with positive potential are excited in four-component plasma systems. However, these electrostatic solitary structures have longer duration times and higher wave amplitudes than the solitary structures observed in the magnetosheath. The result indicates that a high-speed and small free energy source may be needed as a fifth component. An additional simulation of a five-component plasma consisting of a stable four-component plasma and a weak electron beam shows the generation of small and fast electron phase-space holes by the bump-on-tail instability. The physical properties of the small and fast electron phase-space holes are very similar to those obtained by the previous theoretical analysis. The amplitude and duration time of solitary structures in the simulation are also in agreement with the Cluster observation.

  5. Solitary extramedullary plasmacytoma in retroperitoneum: A case report and review of the literature

    Wei Hong; Xin-Min Yu; Ming-Qiang Jiang; Bo Chen; Xin-Bao Wang; Li-Tao Yang; Yi-Ping Zhang


    Extramedullary plasmacytoma (EPM) is a plasma cell tumor arising outside of the bone marrow. Solitary EMP is an uncommon neoplasm and rarely occurs in the retroperitoneum and lacks distinctive clinical manifestations. We report a 26-year-old man with a solitary EMP in the retroperitoneum and discuss its clinical features, diagnosis and treatment.

  6. Dispersal of solitary bees and bumblebees in a winter oilseed rape field

    Calabuig, Isabel


    Dispersal distributions of solitary bees and bumblebees were studied in a winter oilseed rape field. Window-traps were placed in the rape field along a line transect perpendicular to the field edge. 19 species of solitary bees were recorded and all but four species are polylectic, including...

  7. Differential Properties of Venom Peptides and Proteins in Solitary vs. Social Hunting Wasps

    Lee, Si Hyeock; Baek, Ji Hyeong; Yoon, Kyungjae Andrew


    The primary functions of venoms from solitary and social wasps are different. Whereas most solitary wasps sting their prey to paralyze and preserve it, without killing, as the provisions for their progeny, social wasps usually sting to defend their colonies from vertebrate predators. Such distinctive venom properties of solitary and social wasps suggest that the main venom components are likely to be different depending on the wasps’ sociality. The present paper reviews venom components and properties of the Aculeata hunting wasps, with a particular emphasis on the comparative aspects of venom compositions and properties between solitary and social wasps. Common components in both solitary and social wasp venoms include hyaluronidase, phospholipase A2, metalloendopeptidase, etc. Although it has been expected that more diverse bioactive components with the functions of prey inactivation and physiology manipulation are present in solitary wasps, available studies on venom compositions of solitary wasps are simply too scarce to generalize this notion. Nevertheless, some neurotoxic peptides (e.g., pompilidotoxin and dendrotoxin-like peptide) and proteins (e.g., insulin-like peptide binding protein) appear to be specific to solitary wasp venom. In contrast, several proteins, such as venom allergen 5 protein, venom acid phosphatase, and various phospholipases, appear to be relatively more specific to social wasp venom. Finally, putative functions of main venom components and their application are also discussed. PMID:26805885

  8. Stability of Solitary Waves for Three Coupled Long Wave - Short Wave Interaction Equations

    Borluk, H.; Erbay, S.


    In this paper we consider a three-component system of one dimensional long wave-short wave interaction equations. The system has two-parameter family of solitary wave solutions. We prove orbital stability of the solitary wave solutions using variational methods.

  9. Solitary central osteoma of mandible in a geriatric patient: Report and review

    Bhujbal, Ravi B.; Nayak, Ajay G.


    Solitary central osteomas of jaw are extremely rare lesions with only few previously documented cases. This paper reports a case of large solitary central osteoma involving mandible symphysis- parasymphysis region in an elderly female patient. A brief review of similar cases reported in the literature is also provided in this paper. Key words:Osteomas, osteogenic,bone, tumor, jaw, mandible. PMID:27034765

  10. [Lymph node preparation in colorectal cancer. Ex vivo methylene blue injection as a novel technique to improve lymph node visualization].

    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.

  11. Cystic fibrosis Delta F508 heterozygotes, smoking, and reproduction

    Dahl, Morten; Tybjaerg-Hansen, A; Wittrup, H H


    Cystic fibrosis is the most common fatal autosomal recessive disease affecting Caucasian populations. It remains a puzzle how this disease is maintained at such a remarkably high incidence, however, it could be due to a reproductive advantage in cystic fibrosis heterozygotes. We tested this hypot......Cystic fibrosis is the most common fatal autosomal recessive disease affecting Caucasian populations. It remains a puzzle how this disease is maintained at such a remarkably high incidence, however, it could be due to a reproductive advantage in cystic fibrosis heterozygotes. We tested.......001). In conclusion, overall these results do not support a reproductive advantage for cystic fibrosis DeltaF508 heterozygotes. However, the data cannot totally exclude the possibility that nonsmoking DeltaF508 heterozygotes experience a reproductive advantage while smoking DeltaF508 heterozygotes experience...... the opposite, a reproductive disadvantage. Accordingly, the data suggest a previously undocumented role of smoking on fecundity among cystic fibrosis heterozygotes....

  12. Inflammation and its genesis in cystic fibrosis.

    Nichols, David P; Chmiel, James F


    The host inflammatory response in cystic fibrosis (CF) lung disease has long been recognized as a central pathological feature and an important therapeutic target. Indeed, many believe that bronchiectasis results largely from the oxidative and proteolytic damage comprised within an exuberant airway inflammatory response that is dominated by neutrophils. In this review, we address the longstanding argument of whether or not the inflammatory response is directly attributable to impairment of the cystic fibrosis transmembrane conductance regulator or only secondary to airway obstruction and chronic bacterial infection and challenge the importance of this distinction in the context of therapy. We also review the centrality of neutrophils in CF lung pathophysiology and highlight more recent data that suggest the importance of other cell types and signaling beyond NF-κB activation. We discuss how protease and redox imbalance are critical factors in CF airway inflammation and end by reviewing some of the more promising therapeutic approaches now under development.

  13. Cystic fibrosis lung disease in adult patients.

    Vender, Robert L


    As the longevity of all patients with cystic fibrosis (CF) continues to increase (median 2005 survival=36.8 years), more adult patients will be receiving their medical care from nonpediatric adult-care providers. Cystic fibrosis remains a fatal disease, with more than 80% of patients dying after the age of 18 years, and most deaths resulting from pulmonary disease. The changing epidemiology requires adult-care providers to become knowledgeable and competent in the clinical management of adults with CF. Physicians must understand the influence of specific genotype on phenotypic disease presentation and severity, the pathogenic factors determining lung disease onset and progression, the impact of comorbid disease factors such as CF-related diabetes and malnutrition upon lung disease severity, and the currently approved or standard accepted therapies used for chronic management of CF lung disease. This knowledge is critical to help alleviate morbidity and improve mortality for the rapidly expanding population of adults with CF.

  14. Oceanic pycnocline depth retrieval from SAR imagery in the existence of solitary internal waves


    Oceanic pycnocline depth is usually inferred from in situ measurements. It is attempted to estimate the depth remotely. As solitary internal waves occur on oceanic pycnocline and propagate along it, it is possible to retrieve the depth indirectly in virtue of the solitary internal waves. A numerical model is presented for retrieving the pycnocline depth from synthetic aperture radar (SAR) images where the solitary internal waves are visible and when ocean waters are fully stratified. This numerical model is constructed by combining the solitary internal wave model and a two-layer ocean model. It is also assumed that the observed groups of solitary internal wave packets on the SAR imagery are generated by local semidiurnal tides. A case study in the East China Sea shows a good agreement with in situ CTD (conductivity-temperature-depth) data.

  15. Electrostatic Korteweg-deVries solitary waves in a plasma with Kappa-distributed electrons

    Choi, C.-R.; Min, K.-W. [Department of Physics, Korea Advanced Institute of Science and Technology, Taejon 305-701 (Korea, Republic of); Rhee, T.-N. [National Fusion Research Institute, Daejeon 305-333 (Korea, Republic of)


    The Korteweg-deVries (KdV) equation that describes the evolution of nonlinear ion-acoustic solitary waves in plasmas with Kappa-distributed electrons is derived by using a reductive perturbation method in the small amplitude limit. We identified a dip-type (negative) electrostatic KdV solitary wave, in addition to the hump-type solution reported previously. The two types of solitary waves occupy different domains on the {kappa} (Kappa index)-V (propagation velocity) plane, separated by a curve corresponding to singular solutions with infinite amplitudes. For a given Kappa value, the dip-type solitary wave propagates faster than the hump-type. It was also found that the hump-type solitary waves cannot propagate faster than V = 1.32.

  16. Generation of internal solitary waves by frontally forced intrusions in geophysical flows.

    Bourgault, Daniel; Galbraith, Peter S; Chavanne, Cédric


    Internal solitary waves are hump-shaped, large-amplitude waves that are physically analogous to surface waves except that they propagate within the fluid, along density steps that typically characterize the layered vertical structure of lakes, oceans and the atmosphere. As do surface waves, internal solitary waves may overturn and break, and the process is thought to provide a globally significant source of turbulent mixing and energy dissipation. Although commonly observed in geophysical fluids, the origins of internal solitary waves remain unclear. Here we report a rarely observed natural case of the birth of internal solitary waves from a frontally forced interfacial gravity current intruding into a two-layer and vertically sheared background environment. The results of the analysis carried out suggest that fronts may represent additional and unexpected sources of internal solitary waves in regions of lakes, oceans and atmospheres that are dynamically similar to the situation examined here in the Saguenay Fjord, Canada.

  17. Fluorine-18 fluorodeoxyglucose positron emission tomography in the management of solitary pulmonary nodule: a review.

    Divisi, Duilio; Barone, Mirko; Zaccagna, Gino; Crisci, Roberto


    Solitary pulmonary nodules are common radiologic findings and their detection has increased due to the introduction and improvement of diagnostics. Since a nodule can be an expression of early lung cancers, a proper classification and management are required because its treatment might lead to decreased morbidity and mortality. In this regard, prominent guidelines are available although they are characterized sometimes by discordant and misleading evidences. Furthermore, the same results of studies in the literature appear conflicting. Aim of this work is to evaluate the role of imaging through an extensive literature review but focusing on 18-fluorine fluorodeoxyglucose positron emission tomography combined with computed tomography ((18)F-FDG-PET/CT) in order to assess the limits and future perspectives of solitary pulmonary nodule characterization in early detection of lung cancer. Key messages Detection of solitary pulmonary nodules has increased. Management of solitary pulmonary nodules is still debated. Future perspectives of early solitary pulmonary nodule characterization.

  18. Generation of internal solitary waves by frontally forced intrusions in geophysical flows

    Bourgault, Daniel; Galbraith, Peter S.; Chavanne, Cédric


    Internal solitary waves are hump-shaped, large-amplitude waves that are physically analogous to surface waves except that they propagate within the fluid, along density steps that typically characterize the layered vertical structure of lakes, oceans and the atmosphere. As do surface waves, internal solitary waves may overturn and break, and the process is thought to provide a globally significant source of turbulent mixing and energy dissipation. Although commonly observed in geophysical fluids, the origins of internal solitary waves remain unclear. Here we report a rarely observed natural case of the birth of internal solitary waves from a frontally forced interfacial gravity current intruding into a two-layer and vertically sheared background environment. The results of the analysis carried out suggest that fronts may represent additional and unexpected sources of internal solitary waves in regions of lakes, oceans and atmospheres that are dynamically similar to the situation examined here in the Saguenay Fjord, Canada.

  19. Impending Airway Compromise due to Cystic Hygroma

    Itai Shavit


    Full Text Available We report on a 3-month-old infant, who arrived in the pediatric emergency department (ED with a cervical cystic hygroma causing an impending compromise of the airway. We recognize that such a lesion can rapidly progress, and the judicious use of imaging in the ED may help to avoid airway compromise and possibly fatal complications. [West J Emerg Med. 2011;12(4:368–369.

  20. Adenoid Cystic Carcinoma of the Larynx

    Roopesh Sankaran


    Full Text Available This is case where a middle aged gentleman presented with history of progressively worseninghoarseness for 1 year. On further history taking and examination including imaging noted patient had supraglottic mass arising from left ventricle, measuring 2x2cm with smooth surface mimicking a benign lesion. Histopatological examination revealed as adenoid cystic carcinoma of left ventricle with perineural invasion . [Cukurova Med J 2014; 39(3.000: 611-615

  1. Posterior midline cervical fetal cystic hygroma.

    Oak S


    Full Text Available Posterior midline cervical cystic hygromas (PMC are frequently found associated with chromosomal aberrations and usually do not survive. The present report illustrates diagnosis of this condition by sonography in an 18 weeks old fetus and an amniocentesis revealed 45 x0 karyotype and increased concentration of alpha-fetoproteins. Pregnancy was terminated in view of Turner′s syndrome. The etiology and natural history of the condition is reviewed.

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

    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....

  3. Dust Acoustic Solitary Waves in Saturn F-ring's Region

    E.K. El-Shewy; M.I. Abo el Maaty; H.G. Abdelwahed; M.A.Elmessary


    Effect of hot and cold dust charge on the propagation of dust-acoustic waves (DAWs) in unmagnetized plasma having electrons, singly charged ions, hot and cold dust grains has been investigated.The reductive perturbation method is employed to reduce the basic set of fluid equations to the Kortewege-de Vries (KdV) equation.At the critical hot dusty plasma density NhO, the KdV equation is not appropriate for describing the system.Hence, a set of stretched coordinates is considered to derive the modified KdV equation.It is found that the presence of hot and cold dust charge grains not only significantly modifies the basic properties of solitary structure, but also changes the polarity of the solitary profiles.In the vicinity of the critical hot dusty plasma density NhO, neither KdV nor mKdV equation is appropriate for describing the DAWs.Therefore, a further modified KdV (fmKdV) equation is derived, which admits both soliton and double layer solutions.

  4. Measurement of Ultra-Short Solitary Electromagnetic Pulses

    Eva Gescheidtova


    Full Text Available In connection with the events of the last few years and with the increased number of terrorist activities, the problem of identification and measurement of electromagnetic weapons or other systems impact occurred. Among these are also microwave sources, which can reach extensive peak power of up to Pmax = 100 MW. Solitary, in some cases several times repeated, impulses lasting from tp E <1, 60>ns, cause the destruction of semiconductor junctions. These days we can find scarcely no human activity, where semiconductor structures are not used. The problem of security support of the air traffic, transportation, computer nets, banks, national strategic data canter’s, and other applications crops up. Several types of system protection from the ultra-short electromagnetic pulses present itself, passive and active protection. The analysis of the possible measuring methods, convenient for the identification and measurement of the ultra-short solitary electromagnetic pulses in presented in this paper; some of the methods were chosen and used for practical measurement. This work is part of Research object MSM262200022 "Research of microelectronic systems".

  5. Mycobacterium abscessus and Children with Cystic Fibrosis

    Sermet-Gaudelus, Isabelle; Le Bourgeois, Muriel; Pierre-Audigier, Catherine; Offredo, Catherine; Guillemot, Didier; Halley, Sophie; Akoua-Koffi, Chantal; Vincent, Véronique; Sivadon-Tardy, Valérie; Ferroni, Agnès; Berche, Patrick; Scheinmann, Pierre; Lenoir, Gérard


    We prospectively studied 298 patients with cystic fibrosis (mean age 11.3 years; range 2 months to 32 years; sex ratio, 0.47) for nontuberculous mycobacteria in respiratory samples from January 1, 1996, to December 31, 1999. Mycobacterium abscessus was by far the most prevalent nontuberculous mycobacterium: 15 patients (6 male, 9 female; mean age 11.9 years; range 2.5–22 years) had at least one positive sample for this microorganism (versus 6 patients positive for M. avium complex), including 10 with >3 positive samples (versus 3 patients for M. avium complex). The M. abscessus isolates from 14 patients were typed by pulsed-field gel electrophoresis: each of the 14 patients harbored a unique strain, ruling out a common environmental reservoir or person-to-person transmission. Water samples collected in the cystic fibrosis center were negative for M. abscessus. This major mycobacterial pathogen in children and teenagers with cystic fibrosis does not appear to be acquired nosocomially. PMID:14720400

  6. A case of cystic hemangioma in mesentery

    Makoto Komura


    Full Text Available A nine-year-old, otherwise healthy girl presented with abdominal pain. On exam, there was a palpable cystic tumor in the left abdomen. According to imaging examinations, we tentatively diagnosed the tumor as lymphangioma of mesentery with bleeding. We planned to perform laparoscopic surgery to remove the tumor. On laparoscopy, cyst aspiration was performed to reduce the volume of the cysts, and the aspirated fluid was found to contain red blood cells. Due to technical difficulties, laparoscopic surgery was converted to open surgery. RBCs were detected in the cyst fluid at the sigmoid colon and intestinal mesentery. Resection of the cystic tumor and sigmoidectomy were performed. On pathologic examination of the tumor, there were multiple cysts but there was no cavernous part. The largest cyst was 6 × 5 × 3 cm. Simple squamous epithelium cells were found along parts of the inner lining of enlarged luminal cysts. On immunohistochemical staining, the tumor was positive for CD31 and CD34, and negative on D2-40 antibody staining. Therefore, we diagnosed this specimen as hemangioma with giant cysts at the mesentery. We conclude that bleeding into cysts of a hemangioma of mesentery might lead to the development of giant cysts and, in turn, a cystic tumor in the abdomen.

  7. Congenital cystic lung malformations; Konnatale zystische Lungenfehlbildungen

    Stoever, B.; Scheer, I.; Bassir, C. [Klinik fuer Strahlenheilkunde, Berlin (Germany). Abt. Paediatrische Radiologie, Charite; Mau, H. [Campus Virchow-Klinikum, Klinik fuer Kinderchirurgie, Berlin (Germany); Chaoui, R. [Campus Mitte, Klinik fuer Geburtsmedizin, Berlin (Germany); Henrich, W. [Campus Virchow-Klinikum, Klinik fuer Geburtsmedizin, Berlin (Germany); Schwabe, M. [Campus Mitte, Inst. fuer Pathologie, Berlin (Germany); Wauer, R. [Campus Mitte, Klinik fuer Neonatologie, Berlin (Germany)


    Purpose: The aim of the study concerning congenital cystic lung malformations was to evaluate prenatal diagnoses postnatally to determine prognostic factors as well as to define optimized perinatal management. Materials and Methods: The study is based on 45 prenatal ultrasound examinations depicting fetal cystic lung lesions. 32 of the mothers had follow-up examinations. 5 pregnancies were terminated due to CCAM and additional malformations. Complete regression of the lesions was seen prenatally in 8 cases and postnatally in 5 children. Results: Surgical intervention due to respiratory insufficiency was necessary in 4 neonates. According to the imaging results, CCAM was present in 4 cases and sequestration in 7 patients. No correlation between the imaging findings and the surgical results was found in 3 children: One child suffered from rhadomyoid dysplasia, and in the case of the second child, a left-sided hernia of the diaphragm and additional sequestration were detected. The third child showed AV malformation. The cystic lesions of the 14 children operated upon were proven histologically. The degree of accuracy in the present study was high. Conclusion: Precise perinatal management is warranted in order to determine according to the clinical relevance surgical intervention and to prevent complications after the first year of life. This is performed during the neonatal period for respiratory insufficient neonates and within the first year of life for clinically stable children. (orig.)

  8. [Treatment of Cystic Fibrosis with CFTR Modulators].

    Tümmler, B


    Personalized medicine promises that medical decisions, practices and products are tailored to the individual patient. Cystic fibrosis, an inherited disorder of chloride and bicarbonate transport in exocrine glands, is the first successful example of customized drug development for mutation-specific therapy. There are two classes of CFTR modulators: potentiators that increase the activity of CFTR at the cell surface, and correctors that either promote the read-through of nonsense mutations or facilitate the translation, folding, maturation and trafficking of mutant CFTR to the cell surface. The potentiator ivacaftor and the corrector lumacaftor are approved in Germany for the treatment of people with cystic fibrosis who carry a gating mutation such as p.Gly551Asp or who are homozygous for the most common mutation p.Phe508del, respectively. This report provides an overview of the basic defect in cystic fibrosis, the population genetics of CFTR mutations in Germany and the bioassays to assess CFTR function in humans together with the major achievements of preclinical research and clinical trials to bring CFTR modulators to the clinic. Some practical information on the use of ivacaftor and lumacaftor in daily practice and an update on pitfalls, challenges and novel strategies of bench-to-bedside development of CFTR modulators are also provided.

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

    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)

  10. Minimally invasive surgery colloidal cystic thyroid nodules

    V G Petrov


    Full Text Available An analysis of the use of minimally invasive interventions - laser-induced thermotherapy (LITT, ethanol destruction (ED under ultrasound guidance, a combination of these methods in the treatment of сystic-col- loidal nodes (CCN of thyroid nodules in 120 patients. ED carried out in 31 patients with cystic destruction of a site of more than 70%. Marked decrease in the average volume with 4.68 ± 2.25 cm3 to 1.15 ± 0.9 cm3. In 4 patients remained cystic cavity of small size, which required a combination of LITT (CombiLITT. Nine patients underwent LITT solid residue of more than 1 cm3. The average size of nodules within 6 months after the primary surgery was 0.9 ± 0.3 cm3. СombiLITT performed in 42 patients with cystic cavity from 20 to 70%. The volume of units decreased from 7.98 ± 4.56 to 1.87 ± 0.9 cm3. After 3 months, 11 patients with the size of a solid residue of more than 1 cm3 held LITT. All of them when viewed after 3 months observed decrease of more than 50%. LITT performed 23 patients with major nodes and cystic cavities less than 20% of the node. Marked decrease in the amount of nodes with 2.89 ± 1.25 cm3 to 1.42 ± 0.8 cm3. Retesting LITT took 2 patients. After 6 months, the average amount of units was 0.7 ± 0.2 cm3 LITT conducted in 24 patients with small cystic nodes to 1 cm3. Marked decrease in size from 0.69 ± 0.23 cm3 to 0.29 ± 0.12 cm3. Varied selection of minimally inva- sive treatment of CCN is effective and in most cases, to achieve reduction of the size of nodes.

  11. Lack of correlation between pulmonary disease and cystic fibrosis transmembrane conductance regulator dysfunction in cystic fibrosis: a case report

    Cleveland Robert H


    Full Text Available Abstract Introduction Mutations in both alleles of the cystic fibrosis transmembrane conductance regulator gene result in the disease cystic fibrosis, which usually manifests as chronic sinopulmonary disease, pancreatic insufficiency, elevated sodium chloride loss in sweat, infertility among men due to agenesis of the vas deferens and other symptoms including liver disease. Case presentation We describe a pair of African-American brothers, aged 21 and 27, with cystic fibrosis. They were homozygous for a rare frameshift mutation in the cystic fibrosis transmembrane conductance regulator 3791delC, which would be expected to cause significant morbidity. Although 80% of cystic fibrosis patients are colonized with Pseudomonas aeruginosa by eight years of age, the older brother had no serum opsonic antibody titer to P. aeruginosa by age 13 and therefore would have failed to mount an effective antibody response to the alginate (mucoid polysaccharide capsule of P. aeruginosa. He was not colonized with P. aeruginosa until 24 years of age. Similarly, the younger brother was not colonized with P. aeruginosa until age 20 and had no significant lung disease. Conclusion Despite a prevailing idea in cystic fibrosis research that the amount of functional cystic fibrosis transmembrane conductance regulator predicts clinical status, our results indicated that respiratory disease severity in cystic fibrosis exhibits phenotypic heterogeneity. If this heterogeneity is, in part, genetic, it is most likely derived from genes outside the cystic fibrosis transmembrane conductance regulator locus.

  12. Oral calorie supplements for cystic fibrosis.

    Smyth, Rosalind L; Rayner, Oli


    Poor nutrition occurs frequently in people with cystic fibrosis and is associated with other adverse outcomes. Oral calorie supplements are used to increase total daily calorie intake and improve weight gain. However, they are expensive and there are concerns they may reduce the amount of food eaten and not improve overall energy intake. This is an update of a previously published review. To establish whether in people with cystic fibrosis, oral calorie supplements: increase daily calorie intake; and improve overall nutritional intake, nutritional indices, lung function, survival and quality of life. To assess adverse effects associated with using these supplements. We searched the Cochrane Cystic Fibrosis Trials Register comprising references from comprehensive electronic database searches, handsearches of relevant journals and abstract books of conference proceedings. We contacted companies marketing oral calorie supplements.Last search: 18 October 2016. Randomised or quasi-randomised controlled trials comparing use of oral calorie supplements for at least one month to increase calorie intake with no specific intervention or additional nutritional advice in people with cystic fibrosis. We independently selected the included trials, assessed risk of bias and extracted data. We contacted the authors of included trials and obtained additional information for two trials. We identified 21 trials and included three, reporting results from 131 participants lasting between three months and one year. Two trials compared supplements to additional nutritional advice and one to no intervention. Two of the included trials recruited only children. In one trial the risk of bias was low across all domains, in a second trial the risk of bias was largely unclear and in the third mainly low. Blinding of participants was unclear in two of the trials. Also, in one trial the clinical condition of groups appeared to be unevenly balanced at baseline and in another trial there were

  13. Sentinel lymph node biopsy and melanoma: 2010 update Part II.

    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.

  14. Sentinel lymph nodes in cancer of the oral cavity

    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...

  15. Sentinel lymph nodes in cancer of the oral cavity

    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...

  16. Numerical study of interfacial solitary waves propagating under an elastic sheet

    Wang, Zhan; Părău, Emilian I.; Milewski, Paul A.; Vanden-Broeck, Jean-Marc


    Steady solitary and generalized solitary waves of a two-fluid problem where the upper layer is under a flexible elastic sheet are considered as a model for internal waves under an ice-covered ocean. The fluid consists of two layers of constant densities, separated by an interface. The elastic sheet resists bending forces and is mathematically described by a fully nonlinear thin shell model. Fully localized solitary waves are computed via a boundary integral method. Progression along the various branches of solutions shows that barotropic (i.e. surface modes) wave-packet solitary wave branches end with the free surface approaching the interface. On the other hand, the limiting configurations of long baroclinic (i.e. internal) solitary waves are characterized by an infinite broadening in the horizontal direction. Baroclinic wave-packet modes also exist for a large range of amplitudes and generalized solitary waves are computed in a case of a long internal mode in resonance with surface modes. In contrast to the pure gravity case (i.e without an elastic cover), these generalized solitary waves exhibit new Wilton-ripple-like periodic trains in the far field. PMID:25104909

  17. Clinical and radiographic features of solitary and cemento-osseous dysplasia-associated simple bone cysts.

    Chadwick, J W; Alsufyani, N A; Lam, E W N


    The simple bone cyst (SBC) is a pseudocyst that can occur as a solitary entity in the jaws or may occur in association with cemento-osseous dysplasia (COD). The purpose of this study was to review the clinical and radiographic features of solitary and COD-associated SBCs. Archived imaging reports from the Special Procedures Clinic in Oral and Maxillofacial Radiology at the Faculty of Dentistry at the University of Toronto between 1 January 1989 and 31 December 2009 revealed 23 COD-associated SBCs and 68 solitary SBCs. Almost all solitary and COD-associated SBCs were found in the mandible. Furthermore, 87.0% of COD-associated SBCs were found in females in their fifth decade of life (P < 0.001) while solitary SBCs were found in equal numbers in both sexes in their second decade of life (P < 0.005). COD-associated SBCs were also more likely to cause thinning of the endosteal cortex, bone expansion and scalloping of the superior border between teeth (all P < 0.001) than solitary SBCs that are classically described as having these characteristics. Finally, COD-associated SBC demonstrated a loss of lamina dura more often (P < 0.05) than solitary SBCs. Knowledge of the sporadic association between COD and SBC and their potential radiographic appearances should prevent inappropriate treatment and management of these patients.

  18. An experimental study on runup of two solitary waves on plane beaches

    XUAN Rui-tao; WU Wei; LIU Hua


    Experiments of the runup of two solitary waves on a plane beach are carried out in a wave flume.The two solitary waves with the same amplitude and the crest separating distances are generated by using an improved wave generation method.It is found that,with regard to the two solitary waves with same wave amplitude,the runup amplification of the second wave is less than that of the first wave if the relative crest separating distance is reduced to a certain threshold value.The rundown of the first solitary wave depresses the maximum runup of the second wave.If the leading solitary wave is of relatively smaller amplitude for the two solitary waves,the runup amplification is affected by the overtaking process of two solitary waves.It turns out that the runup amplification of the second wave is larger than that of the first wave if the similarity factor is approximately larger than 15,which means the larger wave overtakes the smaller one before the waves runup on a beach.

  19. Co-morbidity of cystic fibrosis and celiac disease in Scandinavian cystic fibrosis patients

    Fluge, Gjermund; Olesen, Hanne Vebert; Giljam, Marita


    Background: The co-morbidity of cystic fibrosis (CF) and celiac disease (CD) has been reported sporadically since the 1960s. To our knowledge, this is the first time a systematic screening is performed in a large cohort of CF patients. Methods: Transglutaminase-IgA (TGA), endomysium-IgA (EMA...

  20. 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...

  1. Radiological Evaluation of Cystic Lesions Presenting as Painful Knee

    Rajpal Yadav


    Conclusion:Painful knee can be a presenting symptom of many cystic lesions of knee. Ultrasound can show the cystic abnormality, but it is only the Magnetic Resonance Imaging which can demonstrate the complete entity. [Cukurova Med J 2014; 39(3.000: 550-558




    Worldwide more than 600 heart-lung or lung transplantations have been performed in patients with cystic fibrosis and end-stage respiratory disease. At the University Hospital in Groningen 10 patients with cystic fibrosis underwent bilateral sequential lung transplantation until April 1994. The 1-yea

  3. Model of mucociliary clearance in cystic fibrosis lungs

    P. Kurbatova (Polina); N. Bessonov; V. Volpert; H.A.W.M. Tiddens (Harm); C. Cornu (Catherine); P. Nony; D. Caudri (Daan)


    textabstractMucus clearance is a primary innate defense mechanism in the human airways. Cystic fibrosis (CF) is a genetic disease caused by mutations in the gene encoding the cystic fibrosis transmembrane conductance regulator (CFTR) protein. CF is characterized by dehydration of airway surface

  4. Chest physiotherapy compared to no chest physiotherapy for cystic fibrosis.

    A. Gates; L. Warnock; Dr. C.P. van der Schans


    BACKGROUND: Chest physiotherapy is widely used in people with cystic fibrosis in order to clear mucus from the airways. OBJECTIVES: To determine the effectiveness and acceptability of chest physiotherapy compared to no treatment or spontaneous cough alone to improve mucus clearance in cystic

  5. First Isolations of Segniliparus rugosus from Patients with Cystic Fibrosis▿

    Butler, W. Ray; Sheils, Catherine A.; Brown-Elliott, Barbara A.; Charles, Nadege; Colin, Andrew A.; Gant, Mary J.; Goodill, John; Hindman, Diane; Toney, Sean R.; Wallace, Richard J.; Yakrus, Mitchell A.


    We report three cases of the new genus Segniliparus isolated from patients with cystic fibrosis. All isolates were unambiguously identified by 16S rRNA gene sequencing as Segniliparus rugosus (GenBank accession no. AY 60892). Drug susceptibility results that may enhance treatment for cystic fibrosis patients with this opportunistic pathogen are presented. PMID:17670929

  6. Cystic duct closure by sealing with bipolar electrocoagulation

    Schulze, S; Damgaard, B; Jørgensen, Lars Nannestad;


    BACKGROUND: Cystic duct leakage after cholecystectomy is not uncommon and is a potentially serious complication. The aim of this study was to assess a bipolar sealing system (LigaSure) for closure of the cystic duct. METHODS: The records from consecutive laparoscopic cholecystectomies performed i...

  7. Differential points of mediastinal cystic lesion in chest computed tomography

    Lee, Seung Jin; Baek, Jang Mi; Song, Jang Hyeon; Seon, Hyun Ju [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of); Kim, Yun Hyeon [Dept. of Radiology, Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of)


    To find differential diagnostic imaging findings of mediastinal cystic lesions in chest computed tomography. We retrospectively reviewed imaging findings of 70 patients with histopathologically proven mediastinal cystic lesions. They were 33 male and 37 female patients. Among 70 cases, 49 cases were in the anterior mediastinum, 12 cases were in the middle mediastinum, and 9 cases were in the posterior mediastinum. 19 patients had symptoms. Chest discomfort was the most common symptom. When the cystic lesion was located in the anterior mediastinum, and unilocular, the possibility of thymic cyst was the most likely (p < 0.0027). When the cystic lesion was located in the anterior mediastinum and was multilocular with a relatively thick wall, the possibility of a mature cystic teratoma was the most likely (p < 0.001). When the lesion was a high attenuation cystic lesion located around the air-way, the possibility of a bronchogenic cyst was the most likely (p < 0.001). Chest CT gives information about the location, loculation, wall thickness and internal attenuation of mediastinal cystic lesions. And certain details seen on CT imaging can help with the correct diagnosis, especially in the cases of thymic cyst, mature cystic teratoma and bronchogenic cyst.

  8. Rotating solitary wave at the wall of a cylindrical container

    Amaouche, Mustapha


    This paper deals with the theoretical modeling of a rotating solitary surface wave that was observed during water drainage from a cylindrical reservoir, when shallow water conditions were reached. It represents an improvement of our previous study, where the radial flow perturbation was neglected. This assumption led to the classical planar Korteweg–de Vries equation for the wall wave profile, which did not account for the rotational character of the base flow. The present formulation is based on a less restricting condition and consequently corrects the last shortcoming. Now the influence of the background flow appears in the wave characteristics. The theory provides a better physical depiction of the unique experiment by predicting fairly well the wave profile at least in the first half of its lifetime and estimating the speed of the observed wave with good accuracy.

  9. Solitary fibrous tumor of the pleura: 3 case reports

    Elias Amorim


    Full Text Available Summary Introduction: solitary fibrous tumor of the pleura (SFTP is a rare tumor arising from mesenchymatous cells in submesothelial pleural tissue which, unlike mesothelioma, is not related to asbestos or smoking. Methods: report of four patients who underwent surgical treatment for giant SFTP and review of the pertinent literature. Results: of the four patients operated, two presented symptoms including cough, chest pain and feeling of compression, whereas the other two subjects were asymptomatic. All patients underwent complete surgical resection by wide posterolateral thoracotomy, and surgical specimens removed with minimum bleeding. None of the cases required complementary lobectomy or segmentectomy. All tumors were histologically benign. Conclusion: complete resection of the lesion is the treatment of choice in all SFTP cases. Prognosis of the benign lesion is excellent, although close follow-up is necessary. In the rarer, more aggressive forms, treatment may be complemented by adjunctive chemotherapy or radiotherapy, the benefits of which have yet to be confirmed.

  10. Solitary-like waves in a liquid foam microchannel

    Bouret, Yann; Cohen, Alexandre; Fraysse, Nathalie; Argentina, Médéric; Raufaste, Christophe


    Plateau borders (PBs) are liquid microchannels located at the contact between three bubbles in liquid foams. They are stable, deformable, and can be thought of as quasi-one-dimensional model systems to study surface waves in fluid dynamics. We show that the burst of a bubble trapped in a PB produces local constrictions which travel along the liquid channel at constant velocity, without significant change in shape. These patterns are reminiscent of the depression solitary waves encountered in nonlinear systems. By coupling flow inertia to capillary stresses, we derive a simple model that admits solitonic solutions, which we characterized numerically and analytically in the limit of small deformation. These solutions capture most of the features observed experimentally.

  11. Solitary Large Intestinal Diverticulitis in Leatherback Turtles (Dermochelys coriacea).

    Stacy, B A; Innis, C J; Daoust, P-Y; Wyneken, J; Miller, M; Harris, H; James, M C; Christiansen, E F; Foley, A


    Leatherback sea turtles are globally distributed and endangered throughout their range. There are limited data available on disease in this species. Initial observations of solitary large intestinal diverticulitis in multiple leatherbacks led to a multi-institutional review of cases. Of 31 subadult and adult turtles for which complete records were available, all had a single exudate-filled diverticulum, as large as 9.0 cm in diameter, arising from the large intestine immediately distal to the ileocecal junction. All lesions were chronic and characterized by ongoing inflammation, numerous intralesional bacteria, marked attenuation of the muscularis, ulceration, and secondary mucosal changes. In three cases, Morganella morganii was isolated from lesions. Diverticulitis was unrelated to the cause of death in all cases, although risk of perforation and other complications are possible.

  12. Squamous cell carcinoma of esophagus masquerading as solitary thyroid nodule

    Basu S


    Full Text Available Secondary neoplasm of the thyroid mimicking a primary thyroid lesion is a rare finding, especially in an individual without a past history of malignancy. A case of squamous cell carcinoma metastatic to the thyroid (presenting as a solitary thyroid nodule, who had an unsuspected primary in the esophagus is described. Usually, multiple areas of the gland are involved in the secondary involvement of the thyroid. The clinical presentation of an apparently asymptomatic mass with neck lymphadenopathy, normal thyroid functions, and a cold nodule on 99mTcO4- thyroid scan can often lead to a misdiagnosis as primary thyroid neoplasm. The present case underscores the fact that due importance to the subtle signs and symptoms and a high degree of suspicion, whenever the histology is unusual for a thyroid primary, is needed and the workup should include ruling out other primary malignancies.

  13. [Solitary fibrous tumor of the pelvis: a rare extrathoracic manifestation].

    Gessmann, J; Seybold, D; Helwing, M; Muhr, G; Schildhauer, T A


    Solitary fibrous tumors (SFT) are rare spindle cell neoplasms. To date only very few cases of pelvic SFT have been reported in the literature. SFT are characterized by unique microscopic and immunohistochemical findings. Complete local resection is the treatment of choice. Recurrence and metastasis may be related to infrequent malignant histological features, but histology is not always a reliable predictor for prognosis. Therefore long-term follow-up is necessary.We report about a male patient with a malignant pelvic SFT. After complete resection the tumor recurred after a short period of 6 months posterior to the original location in the pelvis. The differential diagnoses and the therapy options are discussed with a review of the present literature.

  14. Solitary spinal metastasis of Hürthle cell thyroid carcinoma.

    Sciubba, Daniel M; Petteys, Rory J; Kang, Steven; Than, Khoi D; Gokaslan, Ziya L; Gallia, Gary L; Wolinsky, Jean-Paul


    Hürthle cell carcinoma is a rare variant of differentiated thyroid cancer that occasionally forms distant metastases. However, even in the presence of metastases, patients with Hürthle cell carcinoma have a relatively good prognosis. There are few reports of Hürthle cell carcinoma metastases to the vertebral column, and none describing aggressive resection of spinal metastases. Here, we report a 68-year-old woman with a solitary metastasis of Hürthle cell carcinoma to the T1 vertebral body causing severe kyphotic deformity, myelopathy, and pain. The patient was treated with aggressive excisional decompression of the spinal cord and T1 vertebral body resection from an entirely posterior approach. Reconstruction and stabilization of the anterior spine was accomplished with a transforaminal lumbar interbody fusion allograft spacer and posterior instrumentation. We discuss aspects of the diagnosis, management, patient selection, and surgical treatment of metastatic Hürthle cell carcinoma in reference to the literature.

  15. Solitary osteosclerotic plasmacytoma: association with demyelinating polyneuropathy and amyloid deposition

    Voss, S.D.; Hall, F.M. [Dept. of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (United States); Harvard Medical School, Boston, MA (United States); Murphey, M.D. [Dept. of Radiologic Pathology, Armed Forces Institute of Pathology, Washington, DC (United States); Dept. of Radiology and Nuclear Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD (United States); Department of Radiology, University of Maryland School of Medicine, Baltimore, Maryland (United States)


    A 51-year-old man presented with a 1-year history of polyneuropathy necessitating the use of a wheelchair. Initial diagnosis was idiopathic chronic inflammatory demyelinating polyneuropathy (CIDP) and associated monoclonal gammopathy. Investigations for multiple myeloma, including bone marrow aspiration and biopsy, were negative. What was initially felt to be an incidental osteosclerotic focus noted on the radiographic bone survey was eventually shown to be a solitary osteosclereotic plasmacytoma with associated amyloid. This dramatically altered treatment. This case emphasizes the importance of including osteosclerotic plasmacytoma in the differential diagnosis of a focal sclerotic bone lesion in the clinical setting of polyneuropathy. These lesions are less likely to progress to multiple myeloma than lytic plasma cell neoplasms, and the presence of polyneuropathy often results in earlier diagnosis and treatment with enhanced prospect of cure. The finding of amyloid deposition within the osteosclerotic lesion may be of prognostic importance. (orig.)

  16. Solitary plexiform neurofibroma determining pyloric obstruction: a case report

    Eduardo Cambruzzi


    Full Text Available Solitary gastric plexiform neurofibroma (PN is a very rare tumor that originates from the peripheral nerves. PN is a rare cause of pyloric obstruction. A 58 year-old man, reported epigastric discomfort, nausea, and vomiting for two months. Upper digestive endoscopy showed a moderate/accentuated pyloric stenosis. Computed tomography (CT and echoendoscopy revealed a pyloric nodule. The patient underwent to distal gastrectomy. Macroscopically, a gray nodule measuring 1.1 × 1.0 × 1.0 cm was identified. Using microscopy, a benign tumor composed of enlarged tortuous nerve fascicles showing a neurofibromatous proliferation with mild atypia and myxoid matrix was found. The lesion showed positive immunoexpression for S100, Leu7, and epithelial membrane antigen (EMA, and was negative for CD117, DOG-1, desmin, and smooth muscle actin. The diagnosis of PN was then determined.

  17. Solitary wave generation from continuum in asymmetric oppositely directed nonlinear waveguide coupler

    Kazantseva, E. V.; Maimistov, A. I.


    In a model which describes asymmetric oppositely directed nonlinear waveguide coupler it was observed in the numerical simulation a phenomenon of solitary wave formation from the input constant continuous wave set at the entrance of a waveguide with negative index of refraction. Threshold value of the amplitude of the constant continuous wave, which defines the condition of appearance of the first solitary wave, decreases with increasing of the parameter of nonlinearity. The period of solitary wave formation decreases with increasing of the continuum wave amplitude.

  18. Effect of adiabatic variation of dust charges on dust acoustic solitary waves in magnetized dusty plasmas

    Duan Wen-Shan


    The effect of dust charging and the influence of its adiabatic variation on dust acoustic waves is investigated. By employing the reductive perturbation technique we derived a Zakharov-Kuznetsov (ZK) equation for small amplitude dust acoustic waves. We have analytically verified that there are only rarefactive solitary waves for this system. The instability region for one-dimensional solitary wave under transverse perturbations has also been obtained. The obliquely propagating solitary waves to the z-direction for the ZK equation are given in this paper as well.

  19. Developing Serpent-Type Wave Generators to Create Solitary Wave Simulations with BEM

    Wen-Kai WENG; Ruey-Syan SHIH; Chung-Ren CHOU


    Developing serpent-type wave generators to generate solitary waves in a 3D-basin was investigated in this study. Based on the Lagrangian description with time-marching procedures and finite differences of the time derivative, a 3D multiple directional wave basin with multidirectional piston wave generators was developed to simulate ocean waves by using BEM with quadrilateral elements, and to simulate wave-caused problems with fully nonlinear water surface conditions. The simulations of perpendicular solitary waves were conducted in the first instance to verify this scheme. Furthermore, the comparison of the waveform variations confirms that the estimation of 3D solitary waves is a feasible scheme.

  20. Periodic Semifolded Solitary Waves for (2+1)-Dimensional Variable Coefficient Broer-Kaup System

    JI Jie; HUANG Wen-Hua


    Applying the extended mapping method via Riccati equation, many exact variable separation solutions for the (2+1)-dimensional variable coefficient Broer-Kaup equation are obtained. Introducing multiple valued function and Jacobi elliptic function in the seed solution, special types of periodic semifolded solitary waves are derived. In the long wave limit these periodic semifolded solitary wave excitations may degenerate into single semifolded localized soliton structures. The interactions of the periodic semifolded solitary waves and their degenerated single semifolded soliton structures are investigated graphically and found to be completely elastic.

  1. The Solitary Variant of Mandibular Intraosseous Neurofibroma: Report of a Rare Entity

    Pavan Kumar Gujjar


    Full Text Available Neurofibroma (NF is a benign neoplasm derived from peripheral nerve cells. NF may extend either as a solitary lesion or as part of a generalized syndrome of neurofibromatosis. Intraorally, the intraosseous variant of neurofibroma is a very rare tumor. The literature provides only few cases of solitary intraosseous neurofibroma of the mandible. We report a case of 28-year-old female who was diagnosed with a solitary intraosseous neurofibroma involving the lower left quadrant of the mandible. The present case is rare in regard to its dimensions and its location.

  2. Scabies presenting as solitary mastocytoma-like eruption in an infant.

    Salces, Inés García; Alfaro, Jorge; Sáenz DE Santamaría, Maria Carmen; Sanchez, Milagros


    We report a case in which the initial clinical finding was a solitary cutaneous nodule on the wrist of a young infant which urticated when rubbed, and was diagnosed as a solitary mastocytoma. Two months later, she had the onset of a new vesiculo-pustular eruption on the palms and soles, consistent with scabies infestation and treatment with topical permethrin 5% cream resulted in resolution of the entire eruption, including the primary nodule. While scabies has been reported to mimick a variety of conditions including urticaria pigmentosa, to our knowledge no previous cases masquerading as solitary mastocytoma have been reported.

  3. Bifurcation and Solitary Waves of the Combined KdV and KdV Equation

    HUA Cun-Cai; LIU Yan-Zhu


    Bifurcation, bistability and solitary waves of the combined KdV and mKdV equation are investigatedsystematically. At first, bifurcation and bistability are analyzed by selecting an integral constant as the bifurcationparameter. Then, different conditions expressed in terms of the bifurcation parameter are obtained for the existence ofbreather-like, algebraic, pulse-like solitary waves, and shock waves. All types of the solitary wave and shock wave solutionsare given by direct integration. Finally, an approximate analytic method by employing the interpolation polynomials iscomplete and the theoretical methods are the simplest hitherto.

  4. Bifurcation and solitary waves of the nonlinear wave equation with quartic polynomial potential

    化存才; 刘延柱


    For the nonlinear wave equation with quartic polynomial potential, bifurcation and solitary waves are investigated. Based on the bifurcation and the energy integral of the two-dimensional dynamical system satisfied by the travelling waves, it is very interesting to find different sufficient and necessary conditions in terms of the bifurcation parameter for the existence and coexistence of bright, dark solitary waves and shock waves. The method of direct integration is developed to give all types of solitary wave solutions. Our method is simpler than other newly developed ones. Some results are similar to those obtained recently for the combined KdV-mKdV equation.

  5. An ancillary CT finding of intrapulmonary solitary fibrous tumor: A case report

    Lee, Dong Jun; Rho, Ji Young; Kwon, Ah Young [CHA Bundang Medical Center, CHA University, Seongnam (Korea, Republic of)


    Intrapulmonary solitary fibrous tumor is extremely rare. A few reports have presented typical CT findings such as well-defined, variable—sized, heterogeneously or homogenously well-enhanced intrapulmonary nodules. We report herein a rare case of intrapulmonary solitary fibrous tumor that showed typical clinical and CT features, and we also provide an ancillary CT finding that shows a distinguishable tubular vascular structure within the nodule. The tubular vascular structure was conjoined to the proximal pulmonary vein. In this study, we highlight an ancillary CT finding reported for the first time for the diagnosis of a patient with intrapulmonary solitary fibrous tumor.

  6. Solitary SH waves in two-layered traction-free plates

    Djeran-Maigre, Irini; Kuznetsov, Sergey


    A solitary wave, resembling a soliton wave, is observed when analyzing the linear problem of polarized shear (SH) surface acoustic waves propagating in elastic orthotropic two-layered traction-free plates. The analysis is performed by applying a special complex formalism and the Modified Transfer Matrix (MTM) method. Conditions for the existence of solitary SH waves are obtained. Analytical expressions for the phase speed of the solitary wave are derived. To cite this article: I. Djeran-Maigre, S. Kuznetsov, C. R. Mecanique 336 (2008).

  7. Solitary paraganglioma of the hypoglossal nerve: case report.

    Raza, Kazim


    BACKGROUND AND IMPORTANCE: We report the case history of solitary hypoglossal paraganglioma in a 64-year-old woman. The surgical difficulties encountered in the removal of this challenging tumor are discussed and as a literature review provided. CLINICAL PRESENTATION: A 64-year-old woman presented with a short history of dysphonia, occasional dysphagia, tinnitus, altered taste, and unilateral left-sided tongue wasting. On examination, there was left lower motor hypoglossal paralysis. Imaging showed a discrete enhancing lobulated mass, measuring 2 × 2 cm, in the region of the hypoglossal nerve extending into the hypoglossal canal suggestive of hypoglossal paraganglioma. A left dorsolateral suboccipital craniotomy was performed with the patient in the sitting position. The hypoglossal nerve appeared to be enlarged, and the jugular foramen was normal. Complete surgical debulking of the tumor was not attempted because of its vascular nature. The nerve was decompressed, and neuropathology confirmed a low-grade paraganglioma arising from the hypoglossal nerve. The patient was scheduled to receive stereotactic radiation for further management. CONCLUSION: When a case of solitary hypoglossal paraganglioma is encountered in clinical practice, the aim of management should be mainly focused on achieving a diagnosis and preserving the hypoglossal nerve function. If there is evidence of vascularity in the lesion noted on magnetic resonance imaging, a preoperative angiogram should be obtained with a view for embolization. We decompressed the hypoglossal canal and achieved good improvement in the patient\\'s symptoms. We recommend stereotactic radiosurgery for remnant and small hypoglossal tumors and regular follow-up with magnetic resonance imaging scans.

  8. Numerical simulations of shoaling internal solitary waves of elevation

    Xu, Chengzhu; Subich, Christopher; Stastna, Marek


    We present high-resolution, two- and three-dimensional direct numerical simulations of large amplitude internal solitary waves of elevation on the laboratory scale, shoaling onto and over a small-amplitude shelf. The three-dimensional, mapped coordinate, spectral collocation method used for the simulations allows for accurate modelling of both the shoaling waves and the bottom boundary layer. The shoaling of the waves is characterized by the formation of a quasi-trapped core which undergoes a spatially growing stratified shear instability at its edge and a lobe-cleft instability in its nose. Both of these instabilities develop and three-dimensionalize concurrently, leading to strong bottom shear stress. We explore significant regions of Schmidt and Reynolds number space and demonstrate that the formation of shear instabilities during shoaling is robust and should be readily observable in a number of standard laboratory setups. In the experiments with a corrugated bottom boundary, boundary layer separation is found inside each of the corrugations during shoaling. This more complex boundary layer phenomenology precludes the formation of the lobe-cleft instability almost completely and hence provides a different mechanism for fluid and material exchange across the bottom boundary layer. Our analyses suggest that all of these wave-induced instabilities can lead to enhanced turbulence in the water column and increased shear stress on the bottom boundary. Through the generation and evolution of these instabilities, the shoaling of internal solitary waves of elevation is likely to provide systematic mechanisms for material mixing, cross-boundary layer transport, and sediment resuspension.

  9. Solitary paraganglioma of the hypoglossal nerve: case report.

    Raza, Kazim


    BACKGROUND AND IMPORTANCE: We report the case history of solitary hypoglossal paraganglioma in a 64-year-old woman. The surgical difficulties encountered in the removal of this challenging tumor are discussed and as a literature review provided. CLINICAL PRESENTATION: A 64-year-old woman presented with a short history of dysphonia, occasional dysphagia, tinnitus, altered taste, and unilateral left-sided tongue wasting. On examination, there was left lower motor hypoglossal paralysis. Imaging showed a discrete enhancing lobulated mass, measuring 2 x 2 cm, in the region of the hypoglossal nerve extending into the hypoglossal canal suggestive of hypoglossal paraganglioma. A left dorsolateral suboccipital craniotomy was performed with the patient in the sitting position. The hypoglossal nerve appeared to be enlarged, and the jugular foramen was normal. Complete surgical debulking of the tumor was not attempted because of its vascular nature. The nerve was decompressed, and neuropathology confirmed a low-grade paraganglioma arising from the hypoglossal nerve. The patient was scheduled to receive stereotactic radiation for further management. CONCLUSION: When a case of solitary hypoglossal paraganglioma is encountered in clinical practice, the aim of management should be mainly focused on achieving a diagnosis and preserving the hypoglossal nerve function. If there is evidence of vascularity in the lesion noted on magnetic resonance imaging, a preoperative angiogram should be obtained with a view for embolization. We decompressed the hypoglossal canal and achieved good improvement in the patient\\'s symptoms. We recommend stereotactic radiosurgery for remnant and small hypoglossal tumors and regular follow-up with magnetic resonance imaging scans.

  10. VATS intraoperative tattooing to facilitate solitary pulmonary nodule resection

    Boutros Cherif


    Full Text Available Abstract Introduction Video-assisted thoracic surgery (VATS has become routine and widely accepted for the removal of solitary pulmonary nodules of unknown etiology. Thoracosopic techniques continue to evolve with better instruments, robotic applications, and increased patient acceptance and awareness. Several techniques have been described to localize peripheral pulmonary nodules, including pre-operative CT-guided tattooing with methylene blue, CT scan guided spiral/hook wire placement, and transthoracic ultrasound. As pulmonary surgeons well know, the lung and visceral pleura may appear featureless on top of a pulmonary nodule. Case description This paper presents a rapid, direct and inexpensive approach to peripheral lung lesion resection by marking the lung parenchyma on top of the nodule using direct methylene blue injection. Methods In two patients with peripherally located lung nodules (n = 3 scheduled for VATS, we used direct methylene blue injection for intraoperative localization of the pulmonary nodule. Our technique was the following: After finger palpation of the lung, a spinal 25 gauge needle was inserted through an existing port and 0.1 ml of methylene blue was used to tattoo the pleura perpendicular to the localized nodule. The methylene blue tattoo immediately marks the lung surface over the nodule. The surgeon avoids repeated finger palpation, while lining up stapler, graspers and camera, because of the visible tattoo. Our technique eliminates regrasping and repalpating the lung once again to identify a non marked lesion. Results Three lung nodules were resected in two patients. Once each lesion was palpated it was marked, and the area was resected with security of accurate localization. All lung nodules were resected in totality with normal lung parenchymal margins. Our technique added about one minute to the operative time. The two patients were discharged home on the second postoperative day, with no morbidity. Conclusion

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

    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.

  12. Vaccines for preventing infection with Pseudomonas aeruginosa in cystic fibrosis

    Johansen, H.K.; Gøtzsche, Peter C.; Johansen, Helle Krogh


    BACKGROUND: Chronic pulmonary infection in cystic fibrosis results in progressive lung damage. Once colonisation of the lungs with Pseudomonas aeruginosa occurs, it is almost impossible to eradicate. Vaccines, aimed at reducing infection with Pseudomonas aeruginosa, have been developed. OBJECTIVES......: To assess the effectiveness of vaccination against Pseudomonas aeruginosa in cystic fibrosis. SEARCH STRATEGY: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register using the terms vaccines AND pseudomonas (last search May 2008) and PubMed using the terms vaccin* AND cystic...... fibrosis (last search May 2008). SELECTION CRITERIA: Randomised trials (published or unpublished) comparing Pseudomonas aeruginosa vaccines (oral, parenteral or intranasal) with control vaccines or no intervention in cystic fibrosis. DATA COLLECTION AND ANALYSIS: The authors independently selected trials...

  13. New insights into cystic fibrosis-related diabetes in children.

    Ode, Katie L; Moran, Antoinette


    Cystic fibrosis-related diabetes (CFRD) is the most common complication of cystic fibrosis. It is associated with significantly increased morbidity and mortality in adults and children. Adolescents with cystic fibrosis have a much higher prevalence of diabetes than any other similar age population. Glucose abnormalities that precede diabetes are even more common, especially in children younger than 10 years. The pathophysiology of glucose metabolic abnormalities is poorly understood, but insulin insufficiency is clearly the main component. Findings from animal studies have provided insight into the pathophysiology of CFRD, and imply that carbohydrate metabolic abnormalities might begin at much younger ages than was previously thought in patients with cystic fibrosis, and might be related to the basic cystic fibrosis chloride channel defect. In this Review we explore present knowledge of CFRD in children and adolescents, and new data that indicate that the pathophysiology of CFRD begins in very young patients.

  14. Microbiological surveillance in patients with cystic fibrosis

    Paola Gualdi


    Full Text Available Pulmonary infections in patients with cystic fibrosis (CF, are a major cause of morbidity and mortality. Prevention, diagnosis and therapy in cystic fibrosis, lead to the necessary collaboration between clinical and laboratory to identify effective strategies and appropriate solutions to address the problems inherent isolation micro-organisms, antibiotic strategies, overcoming of bacterial resistance and other problems management of these patients. The task of the microbiology laboratory and research in quickly and accurately, the agents responsible for these infectious processes, in order to isolate them from material, identify and determine their sensitivity antibiotics. A microbiological surveillance on 34 patients (13 males and 21 females with CF and related to the “Support Services Provincial Trento for the treatment of cystic fibrosis “in the period July 2005 - August 2008, was carried out. 180 Gram positive and 278 of Gram negative bacteria as well as 235 fungi wre collected. Staphylococcus aureus was the most frequently organism found in patients with CF with an incidence of 23% on 156 strains isolated, Pseudomonas aeruginosa was collected 19% of all microorganisms isolated corresponding to 131 strains, Candida albicans is the yeast often isolated with a frequency 22% equal to 149 isolates, Aspergillus fumigatus was isolated at a rate of 8%. From the data we collected and processed has been noted that the local epidemiology of CF patients reflects as reported in the scientific literature and national international consulting, both as a type microorganisms that frequency also isolated compared to age groups. Considering the score of Bartlett as discriminating respiratory fitness of the material, it has been observed that only 32 samples over 327 total (10% would materials insignificant. It follows therefore that the time of sample collection, followed by personnel (physiotherapists dedicated to CF patients, represents a crucial step

  15. Mediastinal Cystic Lesions; Experience of 77 Patients

    Koray Aydogdu


    Full Text Available Aim: Cystic lesions of the mediastinum are rare. Most of them are congenital lesions and account for 20% to 30 % of all primary masses of the mediastinum. A retrospective study of primary mediastinal cystic lesions (PMCL was conducted to review their clinical, radiological, and pathological features, as well as the early and long-term results of surgical management.Material and Method: From January 1998 through July 2008, 77 patients—47 females and 30 males, aged 4–81 years—with PMCL were treated in our department. All of the patients were analysed acording to the age, gender, symptoms, types of cysts and type of surgery. Results: There were thirty male patients (40 %, aged 4–81 years with a mean age of 39.2, and forty-seven female (60 % patients, aged 16–65 with a mean age of 35.8. Some of the patients’ pathology slides who were diagnosed as benign cysts before are re-examined then reclassified with the new diagnosis. There were thirty-one bronchogenic cysts (44 %; 19 female, 12 males, eighteen  pericardial coelomic cysts (24 %; 7 female, 11 male, five mediastinal hydatid cysts (6 %; 4 female, 1 male, five enterogenous cysts (6 %; 3 female, 2 male,  eight thymic cysts (10 %; 7 female, 1 male, two cystic lymphangiomatosis (4 %; 1 female, 1 male, five teratogenous cysts (6 %;  4 female, 1 male, and three pleural cysts (2 female, 1 male. The main symptoms were pain, fever, dyspnea, and coughing. Twenty-three patients (30 % were asymptomatic. All of the patients underwent surgery. Mean stay in the hospital was 8 days. We did not have any deaths. Discussion: Most of the patients with PMCL were female. Most of the PMCL were foregut lesions. Despite varied location and histology, the clinical presentation of mediastinal cysts was similar. Surgery provides the best chance for cure in all cases of PMCL.

  16. Airway clearance therapy in cystic fibrosis patients.

    Pisi, Giovanna; Chetta, Alfredo


    Cystic fibrosis (CF) is the most common life-shortening inherited disease affecting Caucasian people. In CF, the major feature of lung disease is the retention of mucus due to impaired clearance of abnormally viscous airway secretions. Airway clearance techniques (ACTs) may significantly improve mucociliary clearance and gas exchange, thereby being of clinical benefit in reducing pulmonary complications in CF patients. ACTs include conventional chest physiotherapy, active cycle of breathing techniques, autogenic drainage, positive expiratory pressure and high-frequency chest compression. In order to suit the needs of patients, families and care-givers, ACTs need to be individually and continuously adapted.

  17. [Cystic fibrosis: centers and care networks organization].

    Bellon, G


    More than 20 years after the gene discovery, without specific treatment, the observed improvement of the cystic fibrosis prognosis appears due to management's organization as well as early diagnosis (neonatal screening) or progress in symptomatic treatment. The CF Centers (CRCM) official recognition was a necessary step before generalization of routine neonatal screening (October, 2002). Actually French CF management relies on three levels of organization: CF centers, regional care networks and French CF Society, in close relationship with patients association (Vaincre la Mucoviscidose). Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  18. [Measurement of pulmonary inflammation in cystic fibrosis].

    Fayon, M; Chiron, R; Abely, M


    Lung inflammation is a pivotal phenomenon in the pathogenesis of cystic fibrosis. Inflammation can be measured and quantified within a research perspective, as well as in daily clinical practice. In this review paper, the "Inflammation Task Force" of the "Société Française de Mucoviscidose" has reviewed the literature regarding the various techniques currently available (bronchoalveolar lavage, sputum analysis, nasal wash and brushing, exhaled breath condensates, carbon monoxide and nitric oxide, and systemic measurements (plasma and urine)). The interpretation of all these determinations in children and adults is also discussed.

  19. Mycobacterium abscessus and Children with Cystic Fibrosis

    Sermet-Gaudelus, Isabelle; Le Bourgeois, Muriel; Pierre-Audigier, Catherine; Offredo, Catherine; Guillemot, Didier; Halley, Sophie; Akoua-Koffi, Chantal; Vincent, Véronique; Sivadon-Tardy, Valérie; Ferroni, Agnès; Berche, Patrick; Scheinmann, Pierre; Lenoir, Gérard; Gaillard, Jean-Louis


    We prospectively studied 298 patients with cystic fibrosis (mean age 11.3 years; range 2 months to 32 years; sex ratio, 0.47) for nontuberculous mycobacteria in respiratory samples from January 1, 1996, to December 31, 1999. Mycobacterium abscessus was by far the most prevalent nontuberculous mycobacterium: 15 patients (6 male, 9 female; mean age 11.9 years; range 2.5–22 years) had at least one positive sample for this microorganism (versus 6 patients positive for M. avium complex), including...

  20. Normal bone mineral density in cystic fibrosis

    Hardin, D.; R. Arumugam; Seilheimer, D.; Leblanc, A.; Ellis, K.


    BACKGROUND—Osteoporosis has been reported as a complication of cystic fibrosis (CF).
AIMS—To measure bone mineral density (BMD) in non-acutely ill adults and bone mineral content (BMC) in children with CF.
METHODS—We analysed data from 28 adults and 13 children with CF. Corticosteroid use was minimal for the year prior to study in both groups. Dual x ray absorptiometry was used to measure total body and regional bone mineral density in adults. In children, whole body BMC was...