Cellular neurothekoma in an 11-year-old child

INTRODUCTION: Neurothekoma is a rare benign tumor which must be distinguished from certain malignant tumors such as fibrohistiocyte tumors or plexiform cell tumors, neurotropic melanomas and clear-cell sarcoma. CASE REPORT: An 11-year-old girl consulted for a recurrent subcutaneous tumor of the chin which had been operated 4 months earlier. The resection was incomplete. A wider revision resection successfully stopped recurrence. The histology study established the diagnosis of neurothekoma due to the presence of mitosis atypia, cellular nodules, and extension to the hypodermis. Immunohistochemistry confirmed the diagnosis. DISCUSSION: Neurothekoma is a benign tumor observed in young women, mainly on the face. It occurs as a dermal cohesive mass without infiltration of the epidermis. The typical immunohistochemical pattern enables differential diagnosis with myxoid neurothekoma, melanocytic and nervous system tumors. Surgical resection is indicated.     

Perfusion CT in patients with advanced bronchial carcinomas: a novel chance for characterization and treatment monitoring?

Advanced bronchial carcinomas by means of perfusion and peak enhancement using dynamic contrast-enhanced multislice CT are characterized. Twenty-four patients with advanced bronchial carcinoma were examined. During breathhold, after injection of a contrast-medium (CM), 25 scans were performed (1 scan/s) at a fixed table position. Density-time curves were evaluated from regions of interest of the whole tumor and high- and low-enhancing tumor areas. Perfusion and peak enhancement were calculated using the maximum-slope method of Miles and compared with size, localization (central or peripheral) and histology. Perfusion of large tumors (>50 cm³) averaged over both the whole tumor (P=0.001) and the highest enhancing area (P=0.003) was significantly lower than that of smaller ones. Independent of size, central carcinomas had a significantly (P=0.04) lower perfusion (mean 27.9 ml/min/100 g) than peripheral ones (mean 66.5 ml/min/100 g). In contrast, peak enhancement of central and peripheral carcinomas was not significantly different. Between non-small-cell lung cancers and small-cell lung cancers, no significant differences were observed in both parameters. In seven tumors, density increase after CM administration started earlier than in the aorta, indicating considerable blood supply from pulmonary vessels. Tumor perfusion was dependent on tumor size and localization, but not on histology. Furthermore, perfusion CT disclosed blood supply from both pulmonary and/or bronchial vessels in some tumors.Abbreviations AIF arterial input function - CT computed tomography - CM contrast media - ROI region of interest - SCLC small-cell lung cancer - NSCLC non-small-cell lung cancer - SD standard deviation     

Cardiac computed tomography-verified right ventricular lead position and outcomes in cardiac resynchronization therapy

Journal of Interventional Cardiac Electrophysiology - To evaluate the association between different right ventricular (RV) lead positions as assessed by cardiac computed tomography (CT) and...     

Zur Frage der idiopathischen Pulmonalektasie

Zusammenfassung Einleitend wird der Begriff der idiopathischen Pulmonalektasie erläutert und gegen die übrigen mit einer Erweiterung der Arteria pulmonalis verbundenen Anomalien und Krankheiten abgegrenzt, wobei darauf hingewiesen wird, daß die Sicherung der Diagnose intra vitam nur mit Hilfe des Herzkatheterismus möglich ist. Es folgt eine Übersicht über die bisher in der Literatur beschriebenen Fälle.Bei der Besprechung der Ätiologie des Krankheitsbildes werden als Hauptursachen eine anlagebedingte Schwäche der elastischen Elemente der Arterienwand und die fehlerhafte Anlage des Septum trunci arteriosi während der Embryonalentwicklung genannt.Sodann wird das klinische Bild beschrieben. Dabei werden die relativ geringen subjektiven Beschwerden, der auskultatorische und röntgenologische Befund und schließlich die wesentlichen durch den Herzkatheterismus gewonnenen hämodynamischen und blutchemischen Werte hervorgehoben.Es folgt die Schilderung von 8 Fällen, die in der I. Medizinischen Klinik der Medizinischen Akademie Düsseldorf untersucht wurden. Hierbei konnte siebenmal die Diagnose einer idiopathischen Pulmonalektasie gestellt werden, während sich bei dem letzten — klinisch sehr ähnlichen — Fall indirekt eine Lungenvenentransposition mit Einmündung in die Vena cava cranialis nachweisen ließ.Da die Bedeutung der Anomalie im wesentlichen in der Differentialdiagnose liegt, wird diese in der Diskussion eingehend erörtert. Abschließend werden die typischen, bei den eigenen Fällen erhobenen Befunde zusammengefaßt und die Prognose sowie die Therapie kurz besprochen.Mit 2 Abbildungen und 1 Tabelle     

Acute and chronic toxicity of nickel to rainbow trout (Oncorhynchus mykiss)

Of the fish species tested in chronic Ni exposures, rainbow trout (Oncorhynchus mykiss) is the most sensitive. To develop additional Ni toxicity data and to investigate the toxic mode of action for Ni, we conducted acute (96-h) and chronic (85-d early life-stage) flow-through studies using rainbow trout. In addition to standard toxicological endpoints, we investigated the effects of Ni on ionoregulatory physiology (Na, Ca, and Mg). The acute median lethal concentration for Ni was 20.8 mg/L, and the 24-h gill median lethal accumulation was 666 nmol/g wet weight. No effects on plasma Ca, Mg, or Na were observed during acute exposure. In the chronic study, no significant effects on embryo survival, swim-up, hatching, or fingerling survival or growth were observed at dissolved Ni concentrations up to 466 microg/L, the highest concentration tested. This concentration is considerably higher than the only other reported chronic no-observed-effect concentration (<33 microg/L) for rainbow trout. Accumulation of Ni in trout eggs indicates the chorion is only a partial barrier with 36%, 63%, and 1% of total accumulated Ni associated with the chorion, yolk, and embryo, respectively. Whole-egg ion concentrations were reduced by Ni exposure. However, most of this reduction occurred in the chorion rather than in the embryos, and no effects on hatching success or larval survival were observed as a result. Plasma ion concentrations measured in swim-up fingerlings at the end of the chronic-exposure period were not significantly reduced by exposure to Ni. Nickel accumulated on the gill in an exponential manner but plateaued in trout plasma at waterborne Ni concentrations of 118 microg/L or greater. Consistent with previous studies, Ni did not appear to disrupt ionoregulation in acute exposures of rainbow trout. Our results also suggest that Ni is not an ionoregulatory toxicant in long-term exposures, but the lack of effects in the highest Ni treatment precludes a definitive conclusion.     

Die Objektivierung akustischer und optischer Vorstellungen im Elektroenzephalogramm

Zusammenfassung In dieser Arbeit werden zwei neue Gleichspannungspotentiale beschrieben, die während akustischen bzw. optischen Vorstellungen auftreten. Das akustische Imaginationspotential (AIP) ist eine am Vertex ableitbare negative Gleichspannungsschwankung, die während der gesamten Dauer einer akustischen Vorstellung anhält. Während einer optischen Vorstellung entsteht eine ähnliche negative Gleichspannungsschwankung nur in der Occipitalregion. Diese Vorstellungspotentiale können infolge einer speziellen Versuchstechnik schon im Roh-EEG erkannt werden. Die Amplitudengröße korreliert mit dem Konzentrationsgrad der Versuchsperson. Bei intensiven Vorstellungen sind Potentiale mit Amplituden bis zu 20 V und einer Dauer von einigen Sekunden registrierbar. Der Vergleich zwischen der Vertex- und der Occipitalableitung erlaubt die Beobachtung des abwechselnden Auftretens von akustischen und optischen Bewußtseinsprozessen. Die Vorstellungspotentiale (AIP und OIP) sind reiz- und reaktionsunabhängig und stellen modalitätsspezifische EEG-Korrelate kognitiver, bewußter Erlebensprozesse (Erinnerung bzw. Vorstellung) dar. Ihre Bedeutung für die objektive Audiometrie wird diskutiert.     

Clinically-oriented hints for the technic of integrated dosage modification in a partial irradiation field

The authors present a method allowing the application of doses differing from the reference dose in partial zones of an irradiation volume. The compensator-integrated modification is performed by a simultaneous dose harmonization in the reference plane. Three methods are described by which a topographic and anatomic assignment of field and partial field is possible on the basis of the irradiation features. The optimum application of each method in the individual irradiation schemes is discussed.     

Field-integrated dose modification. 1: Clinical significance of the procedure

A method is derived from a previously published compensator-integrated modification proceeding which maintains the principle of a field-integrated dose modification without needing CT input data. Three typical clinical examples are presented in order to describe this considerably simplified technique thus suited for everyday practice. The authors discuss the interesting radiobiological aspects involved.