Independent endometrial and ovarian carcinomas: two cases of synchronous and metachronous endometrioid carcinomas

Simultaneous carcinomas involving both the ovary and the endometrium may cause diagnostic difficulties, particularly if the tumors have a similar histology. We report two cases of independent endometrioid carcinomas of the endometrium and the ovary. Tumor development was synchronous in one case and metachronous in the other. These cases illustrate the morphological criteria helpful in distinguishing independent primaries from metastatic carcinomas which have a different therapeutic implication. Endometrial tumors were intra-mucosal without myometrial or vascular invasion, or tubal involvement and were associated with atypical complex hyperplasia (case 2). The ovarian tumors were uninodular, unilateral, without hilar invasion and were associated with endometriosis (case 2). The prognosis of endometrioid type carcinomas is better than for other histological types of carcinoma. Both our patients are well and disease free at 27 and 24 months.     

Relationship of different surgical margins with recurrence-free survival in patients with hepatocellular carcinoma

To investigate the impact of different surgical margin and recurrence-free survival in patients with hepatocellular carcinoma (HCC). The data of 601 patients who underwent curative hepatectomy for HCC between January 1997 and December 2009 were analyzed. Milan group and exceeding Milan group were divided according to the Milan Criteria. Each of them was divided into 3 groups: group A (surgical margin ≤ 1 mm), group B (1 mm < surgical margin ≤ 9 mm) and group C (surgical margin ≥ 10 mm). The relationship between surgical margin and recurrence-free survival in different groups was analyzed. In Milan group recurrence-free survival of group C was more than group B and group B more than group A (P < 0.05). And in the exceeding Milan group recurrence-free surgical of group B was more than group A. There were no statistic differences within groups of B and C. Enlarging surgical margin may increase recurrence-free survival in HCC under Milan criteria.1mm in cases of exceeding Milan criteria may be regarded as the suitable surgical margin for operation of HCC.     

The risk of metachronous neoplasia in patients with serrated adenoma

Serrated adenomas are the precursors of at least 5.8% of colorectal cancers; otherwise little is known of their clinical significance in comparison with conventional adenomas and hyperplastic polyps. We compared the risk of metachronous lesions in colorectal serrated adenomas, conventional adenomas, and hyperplastic polyps. A consecutive series of patients with colorectal polyps first diagnosed from January 1978 to December 1982 and follow-up specimens to the end of 2000 was reviewed, and 239 polyps fulfilling the selection criteria were chosen as index polyps. The type of polyp seen in follow-up correlated significantly with the type of the initial lesion. Serrated adenomas were estimated to grow faster than conventional adenomas, but the incidence of colorectal cancer did not differ significantly between serrated (2/38 [5%]) and conventional adenomas (2.2%). The results indicate that serrated adenomas are lesions with a significant risk of metachronous serrated adenomas and the development of cancer. We emphasize the need for the proper recognition and management of serrated adenomas.     

Cytogenomics and gene expression in a case of metachronous bilateral renal cell carcinomas with drop metastasis: Resolving a diagnostic dilemma with molecular technologies

Metachronous bilateral renal cell carcinomas (RCCs) are rare but well known. We present a case of metachronous bilateral RCCs with a ureter orifice metastasis, for which the pathological diagnosis was confirmed with single nucleotide polymorphism microarray (SNP‐M) and gene expression assay (GEA). A 53‐year‐old man presented with a right ureteral obstruction. A cystoscopy showed a large pedunculated tumor emanating from the right ureteral orifice, consistent with a drop metastasis, which was biopsied. He had a history of a clear cell RCC (ccRCC) 1.5 years prior and a right renal pelvic mass found 8 months later. Histologically, the biopsied right ureteral tumor demonstrated sheets of poorly differentiated cancer cells composed of a mixture of spindled and focal clear cell components. The main differential diagnosis was metastatic RCC versus urothelial carcinoma, but the immunohistochemical profile was not contributory. SNP‐M revealed a genomic profile consistent with a metastatic ccRCC with loss of chromosome 3p. GEA showed a gene expression pattern consistent with kidney origin. The cytogenomic array also identified chromosome copy number patterns that were shared between both kidney tumors. This finding suggests that both tumors had a common origin, and thus, the metachronous ccRCC in the contralateral kidney represents a metastasis.     

Independent genetic events associated with the development of multiple parathyroid tumors in patients with primary hyperparathyroidism

Multiple parathyroid tumors, as opposed to hyperplasia, have been reported in a subset of patients with sporadic primary hyperparathyroidism (PHPT). It is not clear whether these multiple tumors are representative of a neoplastic process or whether they merely represent hyperplasia that has affected the parathyroid glands differentially and resulted in asynchronous growth. The molecular genetic techniques of comparative genomic hybridization (CGH), loss of heterozygosity (LOH), and MEN1 mutation analysis were performed on a series of five patients with multiglandular PHPT, each of which had two parathyroid tumors removed. Analysis of these multiple parathyroid tumors from patients with PHPT revealed that independent genetic events were associated with the development of a subset of these tumors. The DNA sequence copy number changes, identified by CGH analyses, either involved different chromosomal regions in the paired glands of a patient (two patients), or those regions implicated in one gland were not changed in a second gland from the same patient (two patients). Each of the three patients exhibiting LOH demonstrated different changes between the paired glands. Where LOH was detected in one gland from a patient, the other gland from the same patient either exhibited no allelic loss or the loss detected was in another region. Each of the three tumors exhibiting LOH at 11q13 was found to contain a somatic MEN1 mutation in the remaining allele, however these mutations were not present in the germline or in the paired gland from the same patient. Although it is possible that a separate series of genetic changes has arisen randomly in two separate glands within the same individual, it seems more likely that the development of these multiple tumors has arisen because of the involvement of other unknown factors. These factors may be genetic [such as the involvement of one or more germline mutations in an unknown low-penetrance gene(s), germline mosaicism or alterations in calcium-sensing receptor gene(s)], epigenetic, physiological, or environmental.     

结直肠癌同时及异时性远处转移的临床病理特征

目的:回顾性分析结直肠癌同时性与异时性远处转移患者的临床病理特征及预后影响因素.方法:收集2010年1月至2015年12月间128例结直肠癌远处转移患者完整的临床病理资料,根据转移发生的时间分为两组:同时转移组(79例)、异时转移组(49例).比较两组临床病理特征,分析影响远处转移患者预后的因素.结果:同时性远处转移患者与肿瘤原发部位(P=0.025)、浸润深度(P=0.002)、分化程度(P=0.008)及脉管癌栓(P=0.012)有关;同时性远处转移患者中位生存期为19(12~28)个月,异时性远处转移患者中位生存期为20(13~28)个月,两组之间差异无统计学意义(P=0.866);多因素生存分析结果提示,肿瘤浸润深度(P<0.001)、肿瘤分化程度(P=0.002)、脉管癌栓(P=0.006)及转移器官数量(P=0.001)是影响远处转移预后的独立因素.结论:根据结直肠癌不同时期发生远处转移患者表现出的临床病理特点,可以有效估计可能发生远处转移的患者及预后情况.     

Neurophysiology of Hungarian subject–verb dependencies with varying intervening complexity

Non-adjacent dependencies are thought to be more costly to process than sentences wherein dependents immediately follow or precede what they depend on. In English locality effects have been revealed, while in languages with rich case marking (German and Hindi) sentence final structures show anti-locality-effects. The motivation of the current study is to test whether locality effects can be directly applied to a typologically different language than those investigated so far. Hungarian is a “topic prominent” language; it permits a variation of possible word sequencing for semantic reasons, including SVO word order. Hungarian also has a rich morphological system (e.g., rich case system) and postpositions to indicate grammatical functions. In the present ERP study, Hungarian subject–verb dependencies were compared by manipulating the mismatch of number agreement between the sentence's initial noun phrase and the sentence's final intransitive verb as well as the complexity of the intervening sentence material, interrupting the dependencies. Possible lexical class and frequency or cloze-probability effects for the first two words of the intervening sentence material were revealed when used separate baseline for each word, while at the third word of the intervening material as well as at the main verb ERPs were not modulated by complexity but at the verb ERPs were enhanced by grammaticality. Ungrammatical sentences enlarged the amplitude of both LAN and P600 components at the main verb. These results are in line with studies suggesting that the retrieval of the first element of a dependency is not influenced by distance from the second element, as the first element is directly accessible when needed for integration (e.g., McElree, 2000).     

Quantitative measurement of venous invasion of colorectal cancer with metachronous liver metastasis

Aims: Many studies have proven the importance of venous invasion in colorectal cancer with synchronous liver metastasis. The aim was to clarify the relationship between venous invasion and metachronous liver metastasis, which is not fully understood. Methods and results: A histological study of venous invasion in colorectal carcinoma was performed using a total of 156 patients, of whom 52 survived without recurrence for 5 years (Group A); 47 had metachronous liver metastasis (Group B), and 57 had synchronous liver metastasis (Group C). The number and the maximum area of venous invasion were estimated in each case per ×40 field of cancerous lesions, which were divided into intramural and extramural lesions. A high incidence and high average number of foci of venous invasion appeared in Groups B and C. The average maximum areas of extramural venous invasion were much larger in Groups B and C than in Group A. Conclusions: The average number of foci of venous invasion by colorectal cancer with metachronous liver metastasis did not differ significantly from that with synchronous ones. Furthermore, invasion into extramural large veins appeared to be associated with liver metastasis.     

The development of vision in cats after extended periods of dark-rearing

Summary The time course of development of visual acuity for square wave gratings was measured behaviourally in a number of cats that were reared in total darkness until they were either 4 (5 cats) or 6 (1 cat) months of age. Less extensive measurements were also made on animals reared in a similar manner until they were either 1 1/2 or 10 months old. Initially, all the animals appeared to be blind, but signs of vision became evident after periods of time in an illuminated environment that ranged from a few days, in the case of animals dark-reared for only 1 1/2 to 4 months, to 1 to 2 months for those animals that were deprived for 6 months or more. Thereafter, visual acuity as measured on a jumping stand progressively improved, reaching, in the case of animals deprived for 4 months, values that were comparable to those of normal animals (6.9 cycles/deg) after 4 months of exposure to light. The animal deprived for 6 months remained apparently blind for a month and eventually attained an acuity (5.7 cycles/deg) that was somewhat less than that of normal animals.The fact that such high acuities can be achieved after periods of binocular deprivation that extend throughout the classically defined critical period suggest that the effect of dark-rearing is somehow to impede the natural decline with age in the degree to which cortical neurones are susceptible to environmental modification.     

Synthesis and antithrombogenicity of heparinized polyurethanes with intervening spacer chains of various kinds

Heparin was immobilized to polyetherurethaneurea membrane by covalent or ionic bondings with intervening spacer chains having different lengths and different terminal functional groups. The amount of immobilization of heparin and the release rate of immobilized heparin were controlled by the nature and the mode of bonding of spacer chains. The heparinized polyetherurethaneurea membranes became more in vitro antithrombogenic and suppressed more strongly the adhesion and activation of platelets, as the amount of immobilization increased. It was also shown that the membrane to which the low-molecular-weight fraction of heparin was immobilized was less stimulating to platelets.     

An unusual coincidence of multiple synchronous kidney tumors with a metachronous rectal adenocarcinoma

In synchronous surgery specimens (right-sided nephrectomy and left-sided partial nephrectomy), a unique combination of a papillary (chromophil) renal cell carcinoma (4 x 3.7 x 3.5 cm) and a renal oncocytoma (11 x 10 x 9 mm) in the right kidney and a renal carcinoid (2.5 x 2.3 x 1.1 cm) in the resected part of the left kidney has been found. This multiplicity and bilaterality, based on the findings of three distinct histogenetic types of kidney tumors, was accompanied by a metachronous rectal adenocarcinoma discovered 14 months later. After surgery, no radiation or other oncologic therapy was given. At present, our patient is well without any evidence of neoplastic disease three years after primary diagnosis. To the best of our knowledge, this is the first case of a combination of three distinct histogenetic types of synchronous renal tumors associated with a metachronous rectal adenocarcinoma treated with simple surgery. In the absence of cytogenetic studies, the possibility of a the presence of a hereditary renal cancer syndrome must be considered.     

人类早期胚胎体外发育的分子基础

人类早期胚胎的发育过程是一个复杂的过程,不同的发育阶段的营养需求及代谢类型是在不断变化,并且基因表达也有所转变。胚胎在由母型调节向合子型调节转变的过渡期间细胞水平和分子水平上都发生了一系列复杂的变化,调节着胚胎的发育进程。     

分子影像技术在抗肿瘤药物开发中的应用进展

分子影像技术能够可视化活体生物分子水平上正常和异常的生物进程,是一种新的生物医学方法,在活体内的细胞和亚细胞水平的生物可视化、特征化和量化细胞进程.该技术具有非侵入性、实时、特异、灵敏度高和分辨率高的特性,能够帮助我们在药物开发的临床前和临床阶段对药物的活性进行分析研究,加快临床前研究进程,本文主要对肿瘤代谢成像、肿瘤细胞增殖成像、肿瘤细胞调亡成像和肿瘤血管生成像在肿瘤药物开发中的应用进行综述.     

Characterization and molecular epidemiology of extended spectrum beta-lactamase producing Enterobacter cloacae isolated from a Tunisian hospital

In 2009, out of the 66 nonrepetitive Enterobacter cloacae collected at Charles Nicolle hospital in Tunisia, 44 were extended spectrum β-lactamase (ESBL) producers. The aim of the current study was to detect and characterize the genes encoding the ESBLs including blaTEM, blaSHV, and blaCTX-M groups by polymerase chain reaction and sequencing. Pulsed-field gel electrophoresis (PFGE) analysis was used to determine the genetic relatedness between isolates. All strains were susceptible to carbapenems. They were resistant to fluoroquinolones, gentamicin, tobramycin, and trimethoprim+sulfamethoxazole but variably resistant to netilmicin, amikacin, and tetracyclines. Sequence analysis of the polymerase chain reaction products revealed the presence of blaCTX-M-15 (39 strains), blaSHV-12 (6 strains), and blaSHV-27 (1 strain). The coexistence of two ESBLs was observed in two isolates harboring, respectively, SHV-12+CTX-M-15 and SHV-27+CTX-M-15. PFGE revealed 36 unrelated profiles. Diffusion of E. cloacae producing CTX-M-15 ESBL in our hospital is the consequence of dissemination of identical or related plasmids harboring the CTX-M-15 gene.