Science.gov

Sample records for duct adenoma peribiliary

  1. Tubulopapillary adenoma of the common bile duct presenting with jaundice

    PubMed Central

    Yusif-zade, Kenan; Musayev, Jamal; Yeler, Maryam

    2016-01-01

    In this report, an adult patient with tubulopapillary adenoma of the common bile duct that manifested with jaundice is presented. Diagnostic challenges were analyzed. Although adenomas of the common bile duct are rare, they should be kept in mind in the differentiation of lesions of this region. It should be remembered that these lesions radiologically could mimic carcinoma and choledocholithiasis. Endoscopic resection should be considered as the primary method for treatment. Histopathology is the gold standard in diagnosis. PMID:27528819

  2. Cystic micropapillary neoplasm of peribiliary glands with concomitant perihilar cholangiocarcinoma.

    PubMed

    Uchida, Tsuneyuki; Yamamoto, Yusuke; Ito, Takaaki; Okamura, Yukiyasu; Sugiura, Teiichi; Uesaka, Katsuhiko; Nakanuma, Yasuni

    2016-02-21

    We report a case of a 75-year-old man with cystic micropapillary neoplasm of peribiliary glands detected preoperatively by radiologic examination. Enhanced computed tomography showed a low-density mass 2.2 cm in diameter in the right hepatic hilum and a cystic lesion around the common hepatic duct. Under a diagnosis of perihilar cholangiocarcinoma, right hepatectomy with caudate lobectomy and bile duct resection were performed. Pathological examination revealed perihilar cholangiocarcinoma mainly involving the right hepatic duct. The cystic lesion was multilocular and covered by columnar lining epithelia exhibiting increased proliferative activity and p53 nuclear expression; it also contained foci of micropapillary and glandular proliferation. Therefore, the lesion was diagnosed as a cystic micropapillary neoplasm of peribiliary glands and resembled flat branch-type intraductal papillary mucinous neoplasm of the pancreas. Histological examination showed the lesion was discontinuous with the perihilar cholangiocarcinoma. Immunohistochemistry showed the cystic neoplasm was strongly positive for MUC6 and that the cholangiocarcinoma was strongly positive for MUC5AC and S100P. These results suggest these two lesions have different origins. This case warrants further study on whether this type of neoplasm is associated with concomitant cholangiocarcinoma as observed in pancreatic intraductal papillary mucinous neoplasm with concomitant pancreatic duct adenocarcinoma. PMID:26900302

  3. Cystic micropapillary neoplasm of peribiliary glands with concomitant perihilar cholangiocarcinoma

    PubMed Central

    Uchida, Tsuneyuki; Yamamoto, Yusuke; Ito, Takaaki; Okamura, Yukiyasu; Sugiura, Teiichi; Uesaka, Katsuhiko; Nakanuma, Yasuni

    2016-01-01

    We report a case of a 75-year-old man with cystic micropapillary neoplasm of peribiliary glands detected preoperatively by radiologic examination. Enhanced computed tomography showed a low-density mass 2.2 cm in diameter in the right hepatic hilum and a cystic lesion around the common hepatic duct. Under a diagnosis of perihilar cholangiocarcinoma, right hepatectomy with caudate lobectomy and bile duct resection were performed. Pathological examination revealed perihilar cholangiocarcinoma mainly involving the right hepatic duct. The cystic lesion was multilocular and covered by columnar lining epithelia exhibiting increased proliferative activity and p53 nuclear expression; it also contained foci of micropapillary and glandular proliferation. Therefore, the lesion was diagnosed as a cystic micropapillary neoplasm of peribiliary glands and resembled flat branch-type intraductal papillary mucinous neoplasm of the pancreas. Histological examination showed the lesion was discontinuous with the perihilar cholangiocarcinoma. Immunohistochemistry showed the cystic neoplasm was strongly positive for MUC6 and that the cholangiocarcinoma was strongly positive for MUC5AC and S100P. These results suggest these two lesions have different origins. This case warrants further study on whether this type of neoplasm is associated with concomitant cholangiocarcinoma as observed in pancreatic intraductal papillary mucinous neoplasm with concomitant pancreatic duct adenocarcinoma. PMID:26900302

  4. Combined salivary duct carcinoma and squamous cell carcinoma suspected of carcinoma ex pleomorphic adenoma.

    PubMed

    Enokida, Tomohiro; Fujii, Satoshi; Kuno, Hirofumi; Mukaigawa, Takashi; Tahara, Makoto; Sakuraba, Minoru; Hayashi, Ryuichi

    2016-08-01

    A 76-year-old Japanese woman had noticed an asymptomatic and palpable mass in her left parotid gland region for 20 years. The tumor had showed rapid growth during the last two months. Therefore, the tumor was clinically suspected of being a malignant tumor and was surgically resected. A histopathological examination revealed that the tumor consisted of two different histopathological neoplastic components accompanied by hyalinized fibrosis at the center of the tumor. The two-neoplastic components were squamous cell carcinoma and salivary duct carcinoma. The tumor was suspected to be a carcinoma ex pleomorphic adenoma after considering the clinical course and the histopathological findings, such as hyalinized fibrosis at the center of the tumor. There was no evidence of recurrence at 30 months after the surgical resection. PMID:27435055

  5. Peribiliary hepatic cysts presenting as hilar cholangiocarcinoma in a patient with end-stage liver disease

    PubMed Central

    Lim, Jane; Nissen, Nicholas N.; McPhaul, Christopher; Annamalai, Alagappan; Klein, Andrew S.; Sundaram, Vinay

    2016-01-01

    Peribiliary cysts are cystic dilatations of peribiliary glands in the liver. They are present in ~50% of cirrhotic patients, but are underrecognized because they are usually asymptomatic and rarely present as obstructive jaundice. A 63-year-old male with hepatitis C cirrhosis, awaiting liver transplantation, had a new finding of intrahepatic dilatation on magnetic resonance imaging. This was initially concerning for cholangiocarcinoma, but was ultimately diagnosed as peribiliary cysts. Peribiliary cysts can imitate cholangiocarcinoma on imaging. Therefore, awareness of this condition is essential because misdiagnosis may lead to inappropriate delay or denial for liver transplantation. The ideal imaging modalities to identify peribiliary cysts are magnetic resonance cholangiography and drip infusion cholangiographic computed tomography, though hepatic dysfunction may limit the usefulness of the latter. Peribiliary cysts should be considered in cirrhotic patients with cholestasis, biliary dilatations and negative biopsy of the biliary system for malignancy. PMID:27511912

  6. Tubular Pyloric Gland Adenoma of the Left and Right Hepatic Ducts: Report of a Unique Case With Immunohistochemical and Molecular Studies.

    PubMed

    Hatzibougias, Dimitris I; Fouzas, Ioannis; Bobos, Mattheos; Papanikolaou, Vasileios; Daoudaki, Maria; Kotoula, Vasiliki; Hytiroglou, Prodromos; Albores-Saavedra, Jorge

    2016-06-01

    Pyloric gland adenomas (PGAs) of the extrahepatic biliary system are rare lesions. We report a case of a tubular PGA that led to biliary obstruction. The tumor was located at the confluence of the right and left hepatic ducts, extending to the left hepatic duct. The tumor cells expressed MUC6 and MUC5AC. MUC1 and CD10 were focally positive. MUC2, p53, and CDX2 were not expressed. The Ki67 positivity was estimated at <15%. None of the KRAS, NRAS, BRAF, EGFR coding regions resulted in clinically relevant amino acid substitutions. SNP rs1050171 (EGFR p.Q787Q, silent mutation) corresponding to c.2361G>A transition in exon 20 was noticed. Awareness of this rare lesion is important for pathologists and clinicians alike, because it may cause significant morphologic and clinical difficulties, especially when presenting as an obstructive mass. Because of the possible risk of evolving malignancy, surgical resection is recommended whenever possible. PMID:26762143

  7. Adenoma

    Cancer.gov

    Well circumscribed areas consisting of cuboidal to columnar cells lining alveoli. The size is usually less than 5 mm in diameter. These lesions retain preexisting alveolar structure and tend to be multiple in existing mouse models. Absence of pronounced fibrovascular stroma, as well as more "plump" shape of epithelial cells, may be the reason for different appearance of mouse adenomas, as compared to their human counterparts. Differentiation between a small adenoma and focal hyperplasia can be very difficult. At the same time, no absolute criteria exist for distinguishing a large adenoma from a well-differentiated adenocarcinoma. Among features indicating benign character are a small size, and absence of vascular invasion. Well delineated demarcation and absence of lepidic growth are considered by some as indicators of a benign character. Bland character of nuclei is a main feature of human adenomas. By this criterion many mouse adenomas could be assigned to adenocarcinomas. However, unlike in humans, mouse tumors rarely metastasize during the time of their observation.

  8. Lensing duct

    DOEpatents

    Beach, R.J.; Benett, W.J.

    1994-04-26

    A lensing duct to condense (intensify) light using a combination of front surface lensing and reflective waveguiding is described. The duct tapers down from a wide input side to a narrow output side, with the input side being lens-shaped and coated with an antireflective coating for more efficient transmission into the duct. The four side surfaces are uncoated, preventing light from escaping by total internal reflection as it travels along the duct (reflective waveguiding). The duct has various applications for intensifying light, such as in the coupling of diode array pump light to solid state lasing materials, and can be fabricated from inexpensive glass and plastic. 3 figures.

  9. Lensing duct

    DOEpatents

    Beach, Raymond J. , Benett

    1994-01-01

    A lensing duct to condense (intensify) light using a combination of front surface lensing and reflective waveguiding. The duct tapers down from a wide input side to a narrow output side, with the input side being lens-shaped and coated with an antireflective coating for more efficient transmission into the duct. The four side surfaces are uncoated, preventing light from escaping by total internal reflection as it travels along the duct (reflective waveguiding). The duct has various applications for intensifying light, such as in the coupling of diode array pump light to solid state lasing materials, and can be fabricated from inexpensive glass and plastic.

  10. Nipple adenoma in infancy.

    PubMed

    Clune, James E; Kozakewich, Harry P; VanBeek, Christine A; Labow, Brian I; Greene, Arin K

    2009-11-01

    We report the first patient with a nipple adenoma presenting in infancy. Nipple adenoma is a benign lesion typically affecting women between 45 and 55 years of age. This lesion can occur in the pediatric population and should be included in the differential diagnosis of an infantile breast lesion. Management of children with nipple adenoma requires consideration for breast development; excision before maturity may cause nipple-areola deformity or injury to the breast bud. PMID:19944237

  11. Adenomas involving the extrahepatic biliary tree are rare but have an aggressive clinical course.

    PubMed

    Loh, Kah Poh; Nautsch, Deborah; Mueller, James; Desilets, David; Mehendiratta, Vaibhav

    2016-02-01

    Biliary adenomas that are usually found in surgically removed gallbladders are rare, but can also occur in the extrahepatic biliary tree. We present a case series of extrahepatic bile duct adenomas at our institution, along with a review of the literature. All three patients with extrahepatic biliary adenomas (two in the common bile ducts, one in the hepatic duct) were female with a mean age of 74 years. On initial presentation, none of the patients had obstructive jaundice but two of the three patients had symptoms of biliary origin. Case 1 is an 85-year-old woman with an incidental biliary dilation seen on chest imaging; endoscopic ultrasound revealed a sessile adenomatous polyp in the distal bile duct. The patient refused surgery and presented with occlusive biliary stricture and jaundice 5 months after initial presentation, with cytology confirming malignant progression. Case 2 is a 78-year-old woman with a history of primary sclerosing cholangitis and who presented with cholangitis, and Gram-negative sepsis. A polypoid lesion was seen on imaging in the common hepatic duct and direct cholangioscopy with biopsies confirmed the presence of adenoma with high grade dysplasia. The patient underwent successful total bile duct resection and hepaticojejunostomy but represented 1 year later with diffuse metastatic disease to the bone, liver, and peritoneum. Case 3 is a 61-year-old woman who presented with symptoms suggestive of gallbladder pathology and was found to have a polypoid bile duct lesion on intraoperative cholangiogram. Endoscopic retrograde cholangioscopy showed an adenomatous polyp with high grade dysplasia involving the distal common bile duct. The patient underwent distal bile duct resection with choledochojejunostomy but presented with jaundice 4 years after surgery. She was found to have adenocarcinoma involving the small bowel in the Roux limb of jejunum and transverse colon. All three patients in our series presented with interval gastrointestinal

  12. Duct closure

    DOEpatents

    Vowell, Kennison L.

    1987-01-01

    A closure for an inclined duct having an open upper end and defining downwardly extending passageway. The closure includes a cap for sealing engagement with the open upper end of the duct. Associated with the cap are an array of vertically aligned plug members, each of which has a cross-sectional area substantially conforming to the cross-sectional area of the passageway at least adjacent the upper end of the passageway. The plug members are interconnected in a manner to provide for free movement only in the plane in which the duct is inclined. The uppermost plug member is attached to the cap means and the cap means is in turn connected to a hoist means which is located directly over the open end of the duct.

  13. [Thyroid Adenomas in Children].

    PubMed

    Morozov, D A; Pimenova, E S; Mirokova, E D

    2015-01-01

    According to the papers thyroid nodules are quite rare in the first two decades of life. However, there are some exceptions, relating to areas with an iodine deficiency or affected by radioactive fallout, where the risk of nodules and carcinomas is increased. Therefore, it is a great challenge for the physician to distinguish between benign and malignant lesions preoperatively, and not only in these areas of greater risk. The authors analyzed current works, which are devoted to diagnostics and treatment of adenomas of thyroid gland in children. This literature review is based on works dedicated to epidemiology, histotypes study, and methods of diagnostics, surgical treatment, prognosis and complications of this pathology. The current tendencies in surgical approaches, intraoperative monitoring of recurrent laryngeal nerve are also discussed. The actuality of this problem is connected with last decade increase of adenomas in structure of thyroid gland nodules, increase of number of patients with multiple adenomas and with polypathias: adenomas with nodular goiter, autoimmune thyroiditis and cancer in children. The difficulties of diagnostic of adenomas are related to the similar clinical symptoms, cytogenetic characteristics of growth of benign and malignant lesions of thyroid gland. Additionally there is no systematic review about thyroid adenomas in children recent years. PMID:26846075

  14. Large hepatic adenoma in a 21-year-old male

    PubMed Central

    Martinez-Mier, Gustavo; Enriquez De los Santos, Horacio; Grube-Pagola, Peter

    2013-01-01

    Hepatic adenoma is an uncommon benign lesion of the liver that occurs more frequently in women in their third and fourth decades. The female/male ratio is up to 11:1. Hepatic adenomas may be single or multiple occasionally reaching sizes up to 20 cm. They are non-cancerous lesions, however they can become malignant. We present a 21-year-old male patient with no medical history who presented with abdominal pain, a palpable abdominal mass, abnormal liver function tests and a 14 kg weight loss in a 2-year period. A CT scan was performed with a 17 cm tumour compressing intrahepatic bile ducts. The patient underwent a right hepatectomy with no complications. Histopathological analysis of the tumour revealed a hepatic adenoma with central necrosis. The patient is asymptomatic at 1-year follow-up. PMID:24306431

  15. Peribiliary Glands as a Niche of Extrapancreatic Precursors Yielding Insulin-Producing Cells in Experimental and Human Diabetes.

    PubMed

    Carpino, Guido; Puca, Rosa; Cardinale, Vincenzo; Renzi, Anastasia; Scafetta, Gaia; Nevi, Lorenzo; Rossi, Massimo; Berloco, Pasquale B; Ginanni Corradini, Stefano; Reid, Lola M; Maroder, Marella; Gaudio, Eugenio; Alvaro, Domenico

    2016-05-01

    Peribiliary glands (PBGs) are niches in the biliary tree and containing heterogeneous endodermal stem/progenitors cells that can differentiate, in vitro and in vivo, toward pancreatic islets. The aim of this study was to evaluate, in experimental and human diabetes, proliferation of cells in PBGs and differentiation of the biliary tree stem/progenitor cells (BTSCs) toward insulin-producing cells. Diabetes was generated in mice by intraperitoneal injection of a single dose of 200 mg/kg (N = 12) or 120 mg/kg (N = 12) of streptozotocin. Liver, pancreas, and extrahepatic biliary trees were en bloc dissected and examined. Cells in PBGs proliferated in experimental diabetes, and their proliferation was greatest in the PBGs of the hepatopancreatic ampulla, and inversely correlated with the pancreatic islet area. In rodents, the cell proliferation in PBGs was characterized by the expansion of Sox9-positive stem/progenitor cells that gave rise to insulin-producing cells. Insulin-producing cells were located mostly in PBGs in the portion of the biliary tree closest to the duodenum, and their appearance was associated with upregulation of MafA and Gli1 gene expression. In patients with type 2 diabetes, PBGs at the level of the hepatopancreatic ampulla contained cells showing signs of proliferation and pancreatic fate commitment. In vitro, high glucose concentrations induced the differentiation of human BTSCs cultures toward pancreatic beta cell fates. The cells in PBGs respond to diabetes with proliferation and differentiation towards insulin-producing cells indicating that PBG niches may rescue pancreatic islet impairment in diabetes. These findings offer important implications for the pathophysiology and complications of this disease. Stem Cells 2016;34:1332-1342. PMID:26850087

  16. Characterization and identification of differentially expressed microRNAs during the process of the peribiliary fibrosis induced by Clonorchis sinensis.

    PubMed

    Yan, Chao; Shen, Li-Ping; Ma, Rui; Li, Bo; Li, Xiang-Yang; Hua, Hui; Zhang, Bo; Yu, Qian; Wang, Yu-Gang; Tang, Ren-Xian; Zheng, Kui-Yang

    2016-09-01

    Clonorchis sinensis (C. sinensis) infection can lead to biliary fibrosis. MicroRNAs (miRNAs) play important roles in regulation of genes expression in the liver diseases. However, the differential expression of miRNAs that probably regulates the portal fibrogenesis caused by C. sinensis has not yet been investigated. Hepatic miRNAs expression profiles from C. sinensis-infected mice at different time-points were analyzed by miRNA microarray and validated by quantitative real-time PCR (qRT-PCR). 349 miRNAs were differentially expressed in the liver of the C. sinensis-infected mice at 2, 8 or 16weeks post infection (p.i.), compared with those at 0week p.i., and there were 143 down-regulated and 206 up-regulated miRNAs among them. These all dysregulated miRNAs were potentially involved in the pathological processes of clonorchiasis by regulation of cancer-related signaling pathway, TGF-β signaling pathway, MAPK signaling pathway, Toll-like receptor signaling pathway, PI3K /AKT signaling pathway, etc. 169 of these dysregulated miRNAs were predicted to be involved in the TGF/Smads signaling pathway which plays an important role in the biliary fibrosis caused by C. sinensis. Additionally, miRNA-32, miRNA-34a, miRNA-125b and miRNA-497 were negatively correlated with Smad7 expression, indicating these miRNAs may specifically down-regulate Smad7 expression and participate in regulation of biliary fibrosis caused by C. sinensis. The results of the present study for the first time demonstrated that miRNAs were differentially expressed in the liver of mice infected by C. sinensis, and these miRNAs may play important roles in regulation of peribiliary fibrosis caused by C. sinensis, which may provide possible therapeutic targets for clonorchiasis. PMID:27267304

  17. Adenoma-Like Adenocarcinoma

    PubMed Central

    Gonzalez, Raul S.; Cates, Justin M.M.; Washington, M. Kay; Beauchamp, R. Daniel; Coffey, Robert J.; Shi, Chanjuan

    2015-01-01

    Aims A subset of colorectal carcinomas (CRCs) architecturally and cytologically resembles adenomatous change, making them difficult to diagnose on biopsy. This subset has not been well-characterized to date. Methods and results For 35 carcinomas with adenomatous-like areas (cytologic and surface architectural appearance that would be insufficient to warrant a diagnosis of adenocarcinoma if evaluated on biopsy), we recorded staging information, molecular data, clinical outcome, whether precursor adenoma was present, and whether prior biopsy had been diagnosed as malignant. Despite advanced T-category in 23 (66%) tumors, only 7 (20%) had nodal metastases, and only 5 patients (15%) developed distant metastases. Fifteen cases (43%) had been diagnosed as adenoma on biopsy. Twenty-one resections (60%) showed no residual associated adenoma, including 9 called adenoma on biopsy. Median follow-up was 44 months. Four patients (12%) died of disease; 22 were alive at last follow-up. KRAS mutation was seen in 14/24 (58%), and 4/17 (24%) were microsatellite-unstable. Patients had significantly improved survival compared to a cohort of patients with conventional well-differentiated CRC after controlling for age and stage (p=0.011). Conclusions Adenoma-like adenocarcinoma is an uncommon variant of CRC with a low rate of metastasis and good prognosis. Biopsy diagnosis of this lesion may be challenging. PMID:25913616

  18. Double pituitary adenomas.

    PubMed

    Iacovazzo, D; Bianchi, A; Lugli, F; Milardi, D; Giampietro, A; Lucci-Cordisco, E; Doglietto, F; Lauriola, L; De Marinis, L

    2013-04-01

    Double pituitary adenomas represent up to 2.6 % of pituitary adenomas in large surgical series and up to 3.3 % of patients with Cushing's disease have been found to have double or multiple pituitary adenomas. We report the case of a 60-year-old male patient whose medical history began in 2002 with erectile dysfunction; hyperprolactinemia was found and MRI showed a 6-mm area of delayed enhancement in the lateral portion of the right pituitary lobe. Treatment with cabergoline was started with normalization of prolactin levels; the following MRI, performed in 2005 and 2008, showed shrinkage of the pituitary lesion. In 2005, the patient began to manifest weight gain, hypertension, and facial plethora, but no further evaluations were done. In January 2010, the patient came to our attention and underwent multiple tests that suggested Cushing's disease. A new MRI was negative. Bilateral inferior petrosal sinus sampling showed significant pituitary-to-peripheral ratio and, in May 2010, the patient underwent exploratory pituitary surgery with evidence of a 1-2-mm white-coloured midline area compatible with pituitary adenoma that was surgically removed. Post-operatively, the patient's clinical conditions improved with onset of secondary hypoadrenalism. The histologic examination confirmed a pituitary adenoma (immunostaining was found to be positive for ACTH and negative for prolactin). We report the case of an ACTH-producing microadenoma metachronous to a prolactin secreting microadenoma although not confirmed histologically, shrunk by medical treatment. A review of data in the literature regarding double or multiple pituitary adenomas has also been done. PMID:23325364

  19. Pregnancy and pituitary adenomas.

    PubMed

    Glezer, Andrea; Jallad, Raquel S; Machado, Marcio C; Fragoso, Maria C; Bronstein, Marcello D

    2016-09-01

    Infertility is frequent in patients harboring pituitary adenomas. The mechanisms involved include hypogonadism secondary to hormonal hypersecretion (prolactin, growth hormone and cortisol), stalk disconnection and pituitary damage. With the improvement of clinical and surgical treatment, pregnancy in women harboring pituitary adenomas turned into a reality. Pituitary hormonal hyper- and hyposecretion influences pregnancy outcomes, as well as pregnancy can interfere on pituitary tumors, especially in prolactinomas. We review literature about specific follow-up and management in pregnant women harboring prolactinomas, acromegaly, or Cushings disease and the impact of clinical and surgical treatment on each condition. PMID:26977888

  20. Progenitor cell niches in the human pancreatic duct system and associated pancreatic duct glands: an anatomical and immunophenotyping study.

    PubMed

    Carpino, Guido; Renzi, Anastasia; Cardinale, Vincenzo; Franchitto, Antonio; Onori, Paolo; Overi, Diletta; Rossi, Massimo; Berloco, Pasquale Bartolomeo; Alvaro, Domenico; Reid, Lola M; Gaudio, Eugenio

    2016-03-01

    Pancreatic duct glands (PDGs) are tubule-alveolar glands associated with the pancreatic duct system and can be considered the anatomical counterpart of peribiliary glands (PBGs) found within the biliary tree. Recently, we demonstrated that endodermal precursor niches exist fetally and postnatally and are composed functionally of stem cells and progenitors within PBGs and of committed progenitors within PDGs. Here we have characterized more extensively the anatomy of human PDGs as novel niches containing cells with multiple phenotypes of committed progenitors. Human pancreata (n = 15) were obtained from cadaveric adult donors. Specimens were processed for histology, immunohistochemistry and immunofluorescence. PDGs were found in the walls of larger pancreatic ducts (diameters > 300 μm) and constituted nearly 4% of the duct wall area. All of the cells identified were negative for nuclear expression of Oct4, a pluripotency gene, and so are presumably committed progenitors and not stem cells. In the main pancreatic duct and in large interlobular ducts, Sox9(+) cells represented 5-30% of the cells within PDGs and were located primarily at the bottom of PDGs, whereas rare and scattered Sox9(+) cells were present within the surface epithelium. The expression of PCNA, a marker of cell proliferation, paralleled the distribution of Sox9 expression. Sox9(+) PDG cells proved to be Pdx1(+) /Ngn3(+/-) /Oct4A(-) . Nearly 10% of PDG cells were positive for insulin or glucagon. Intercalated ducts contained Sox9(+) /Pdx1(+) /Ngn3(+) cells, a phenotype that is presumptive of committed endocrine progenitors. Some intercalated ducts appeared in continuity with clusters of insulin-positive cells organized in small pancreatic islet-like structures. In summary, PDGs represent niches of a population of Sox9(+) cells exhibiting a pattern of phenotypic traits implicating a radial axis of maturation from the bottoms of the PDGs to the surface of pancreatic ducts. Our results complete the

  1. Familial pituitary adenomas.

    PubMed

    Vandeva, S; Vasilev, V; Vroonen, L; Naves, L; Jaffrain-Rea, M-L; Daly, A F; Zacharieva, S; Beckers, A

    2010-12-01

    Pituitary adenomas are benign intracranial neoplasms that present a major clinical concern because of hormonal overproduction or compression symptoms of adjacent structures. Most arise in a sporadic setting with a small percentage developing as a part of familial syndromes such as multiple endocrine neoplasia type 1 (MEN1), Carney complex (CNC), and the recently described familial isolated pituitary adenomas (FIPA) and MEN-4. While the genetic alterations responsible for the formation of sporadic adenomas remain largely unknown, considerable advances have been made in defining culprit genes in these familial syndromes. Mutations in MEN1 and PRKAR1A genes are found in the majority of MEN1 and CNC patients, respectively. About 15% of FIPA kindreds present with mutations of the aryl hydrocarbon receptor-interacting protein (AIP) gene. Mutations in the CDKN1B gene, encoding p27(Kip)¹ were identified in MEN4 cases. Familial tumours appear to differ from their sporadic counterparts not only in genetic basis but also in clinical characteristics. Evidence suggests that, especially in MEN1 and FIPA, they are more aggressive and affect patients at younger age, therefore justifying the importance of early diagnosis. In this review, we summarize the genetic and clinical characteristics of these familial pituitary adenomas. PMID:20961530

  2. Undescended parathyroid adenoma.

    PubMed

    Kanack, Melissa D; Maawy, Ali A; Oh, Deborah K; Bouvet, Michael

    2015-01-01

    Undescended parathyroid adenomas are rare, representing 0.08% of all parathyroid adenomas; however, they make up 7% of the underlying cause of failed cervical exploration in patients with persistent primary hyperparathyroidism. A 43-year-old woman with no significant medical or family history presented with fatigue and was diagnosed with primary hyperparathyroidism; however, preoperative imaging including sestamibi scan and ultrasound was unable to identify the hyperfunctioning gland. She underwent a neck exploration and hemithyroidectomy and partial parathyroidectomy with failure of resolution of her disease. Subsequent work up including a CT of the neck demonstrated a 1.9 cm mass adjacent to the left submandibular gland. This was removed with postoperative normalisation of the patient's serum calcium and parathyroid hormone levels. PMID:25737222

  3. Ampullary neuroendocrine tumor diagnosed by endoscopic papillectomy in previously confirmed ampullary adenoma.

    PubMed

    Lee, Seoung Ho; Lee, Tae Hoon; Jang, Si-Hyong; Choi, Chi Young; Lee, Won Myung; Min, Ji Hey; Cho, Hyun Deuk; Park, Sang-Heum

    2016-04-01

    Ampullary adenoma is a common indication for endoscopic papillectomy. Ampullary neuroendocrine tumor (NET) is a rare disease for which complete surgical resection is the treatment of choice. However, because of the morbidity and mortality associated with surgical resection, endoscopic papillectomy is increasingly used in selected cases of low grade, with no metastasis and no invasion of the pancreatic or bile duct. Also, confirmed and complete endoscopic resection of ampullary NET accompanied by adenoma has not been reported to date. We report herein a rare case of an ampullary NET accompanied with adenoma, which was successfully and completely resected via endoscopic papillectomy. Prior to papillectomy, this case was diagnosed as an ampullary adenoma. PMID:27053861

  4. [Treatment of pituitary adenomas].

    PubMed

    Mezosi, Emese; Nemes, Orsolya

    2009-09-27

    According to epidemiological studies, the prevalence of pituitary adenomas is 16.5% and the majority of them are "incidentalomas". The symptoms of pituitary disorders are often non-specific; disturbances of pituitary function, compression symptoms, hypophysis apoplexy or accidental findings may help the diagnosis. The hormonal evaluation of pituitary adenomas is different from the algorithm used in the disorders of peripheral endocrine organs. The first-line therapy of prolactinomas are the dopamine agonists, and the aims of the treatment are to normalize the prolactin level, restore fertility in child-bearing age, decrease tumor mass, save or improve the residual pituitary function and inhibit the relapse of the disease. The available dopamine agonists in Hungary are bromocriptine and quinagolide. In case of tumors with good therapeutic response, medical therapy can be withdrawn after 3-5 years; hyperprolactinemia will not recur in 2/3 of these patients. Neurosurgery is the primary therapy of GH-, ACTH-, TSH-producing and inactive adenomas. In the last decades, significant improvement has been reached in surgical procedures, resulting in low mortality rates. Acromegalic patients with unresectable tumors have a great benefit from somatostatin analog treatment. The growth hormone receptor antagonist pegvisomant is the newest modality for the treatment of acromegaly. The medical therapy of Cushing's disease is still based on the inhibition of steroid production. A new, promising somatostatin analog, pasireotide is evaluated in clinical trials. The rare TSH-producing tumor can respond to both dopamine agonist and somatostatin analog therapy. The application of conventional radiotherapy has decreased; radiotherapy is mainly used in the treatment of invasive, incurable or malignant tumors. Further studies are needed to elucidate the exact role of radiosurgery and fractionated stereotaxic irradiation in the treatment of pituitary tumors. PMID:19758960

  5. Flue gas duct assembly

    SciTech Connect

    Montana, F.J.

    1984-08-28

    A length of longitudinally extending duct assembly for heated corrosive gases includes an outer support duct and a substantially gas-tight liner. The liner is spaced from the outer support duct by a relatively yielding spacer material that accommodates expansion of the liner in directions parallel to the inner surface of the outer support duct and in directions normal to the inner surface of the outer support duct without imposing any substantial resistance to such thermal expansion.

  6. Ectopic parathyroid adenoma in child.

    PubMed

    Libánský, P; Astl, J; Adámek, S; Nanka, O; Pafko, P; Spacková, J; Foltán, R; Sedý, J

    2008-01-01

    A 10-year old girl presented with fatigue, hypercalcemia, and subperiosteal phalangeal osteolytic lesions. Ultrasonography and MIBI scintigraphy showed a structure near the lower pole of thyroid gland. The structure macroscopically appeared as adenoma, histologically it was thymic tissue. Bilateral neck exploration together with exploration of cervical thymic extensions was performed; adenoma was not found. During next two years, the level of calcium and parathormone raised, bone mineral density decreased. Ultrasonography, MRI, CT and PET/CT were negative. Adenoma was located by MIBI-SPECT/CT near the left border of jugulum. It was found dorsolateral to left common carotid artery and removed. PMID:19548602

  7. Duct joining system

    DOEpatents

    Proctor, John P.; deKieffer, Robert C.

    2001-01-01

    A duct joining system for providing an air-tight seal and mechanical connection for ducts and fittings is disclosed. The duct joining system includes a flexible gasket affixed to a male end of a duct or fitting. The flexible gasket is affixed at an angle relative to normal of the male end of the duct. The female end of the other duct includes a raised bead in which the flexible gasket is seated when the ducts are properly joined. The angled flexible gasket seated in the raised bead forms an air-tight seal as well as fastens or locks the male end to the female end. Alternatively, when a flexible duct is used, a band clamp with a raised bead is clamped over the female end of the flexible duct and over the male end of a fitting to provide an air tight seal and fastened connection.

  8. Duct Joining System

    DOEpatents

    Proctor, John P.

    2001-02-27

    A duct joining system for providing an air-tight seal and mechanical connection for ducts and fittings is disclosed. The duct joining system includes a flexible gasket affixed to a male end of a duct or fitting. The flexible gasket is affixed at an angle relative to normal of the male end of the duct. The female end of the other duct includes a raised bead in which the flexible gasket is seated when the ducts are properly joined. The angled flexible gasket seated in the raised bead forms an air-tight seal as well as fastens or locks the male end to the female end. Alternatively, when a flexible duct is used, a band clamp with a raised bead is clamped over the female end of the flexible duct and over the male end of a fitting to provide an air tight seal and fastened connection.

  9. Hepatocellular adenoma: An update

    PubMed Central

    Vijay, Adarsh; Elaffandi, Ahmed; Khalaf, Hatem

    2015-01-01

    Hepatocellular adenomas (HCA) are rare benign liver tumors. Recent technological advancements have helped in the early identification of such lesions. However, precise diagnosis of hepatocellular incidentalomas remains challenging. Studies at the molecular level have provided new insights into the genetics and pathophysiology of these lesions. These in turn have raised questions over their existing management modalities. However, the rarity of the tumor still restricts the quality of evidence available for current recommendations and guidelines. This article provides a comprehensive review on the etiology, molecular biology, patho-physiology, clinical manifestations, and complications associated with HCA. It also elaborates on the genetic advancements, existing diagnostic tools and current guidelines for management for such lesions. PMID:26557953

  10. Synchronous pituitary adenoma and pituicytoma.

    PubMed

    Neidert, Marian C; Leske, Henning; Burkhardt, Jan-Karl; Kollias, Spyros S; Capper, David; Schrimpf, Daniel; Regli, Luca; Rushing, Elisabeth J

    2016-01-01

    Pituicytoma is a rare benign neoplasm arising in the sellar region, usually found in the posterior lobe and/or pituitary stalk. Here, we report the case of a 67-year-old woman who presented with bitemporal hemianopsia and visual impairment accompanied by mildly elevated prolactin. Pathologic and molecular examination of the tissue removed transsphenoidally revealed 2 distinct tumors: pituitary adenoma and pituicytoma. To the best of our knowledge, histologically proven pituicytoma and pituitary adenoma have never been reported together. PMID:26476569

  11. Gut Microbiome and Colorectal Adenomas

    PubMed Central

    Dulal, Santosh; Keku, Temitope O.

    2015-01-01

    The trillions of bacteria that naturally reside in the human gut collectively constitute the complex system known the gut microbiome, a vital player for the host’s homeostasis and health. However, there is mounting evidence that dysbiosis, a state of pathological imbalance in the gut microbiome is present in many disease states. In this review, we present recent insights concerning the gut microbiome’s contribution to the development of colorectal adenomas and the subsequent progression to colorectal cancer (CRC). In the United States alone, CRC is the second leading cause of cancer deaths. As a result, there is a high interest in identifying risk factors for adenomas, which are intermediate precursors to CRC. Recent research on CRC and the microbiome suggest that modulation of the gut bacterial composition and structure may be useful in preventing adenomas and CRC. We highlight the known risk factors for colorectal adenomas and the potential mechanisms by which microbial dysbiosis may contribute to the etiology of CRC. We also underscore novel findings from recent studies on the gut microbiota and colorectal adenomas along with current knowledge gaps. Understanding the microbiome may provide promising new directions towards novel diagnostic tools, biomarkers, and therapeutic interventions for CRC. PMID:24855012

  12. A rare cause of dilated bile duct incidentally detected on imaging

    PubMed Central

    Loh, Kah Poh; Nautsch, Deborah; Desilets, David; Mehendiratta, Vaibhav

    2014-01-01

    Adenomas involving the extrahepatic bile ducts are rare benign tumours of the biliary tract. Given the asymptomatic nature of these tumours and the natural progression of biliary adenoma to carcinoma including cholangiocarcinoma, early detection is challenging. We present a case of an octogenarian woman with a remote history of gallstones who initially presented to the gastroenterology office for an incidental finding of biliary dilation, and whose subsequent imagings and biopsy suggested common bile adenoma. However, the patient was deemed a poor surgical candidate for pancreaticoduodenectomy, and unfortunately represented 5 months later with findings suggesting cholangiocarcinoma. This case provides a unique opportunity to study the natural progression of biliary adenoma to cholangiocarcinoma. PMID:24859557

  13. Lightweight Valve Closes Duct Quickly

    NASA Technical Reports Server (NTRS)

    Fournier, Walter L.; Burgy, N. Frank

    1991-01-01

    Expanding balloon serves as lightweight emergency valve to close wide duct. Uninflated balloon stored in housing of duct. Pad resting on burst diaphragm protects balloon from hot gases in duct. Once control system triggers valve, balloon inflates rapidly to block duct. Weighs much less than does conventional butterfly, hot-gas, or poppet valve capable of closing duct of equal diameter.

  14. Lactating Adenoma of the Breast.

    PubMed

    Barco Nebreda, Israel; Vidal, M Carmen; Fraile, Manel; Canales, Lydia; González, Clarisa; Giménez, Nuria; García-Fernández, Antonio

    2016-08-01

    Lactating adenoma is an uncommon breast palpable lesion occurring in pregnancy or lactation. Although it is a benign condition, it often requires core biopsy or even surgery to exclude malignancy. As with other solid lesions in pregnancy and lactation, lactating adenoma needs an accurate evaluation in order to ensure its benign nature. Work-up must include both imaging and histologic findings. Ultrasound evaluation remains the first step in assessing the features of the lesion. Some authors consider magnetic resonance imaging as a useful tool in cases of inconclusive evaluation after ultrasound and histologic exam in an attempt to avoid surgery. Most lactating adenomas resolve spontaneously, whereas others persist or even increase in size and must be removed. The authors present a case of a 35-year-old woman at 6 months postpartum with a lactating adenoma in her right breast. After surgical removal, breastfeeding was perfectly continued within the next 24 hours, which highlights the fact that breast surgery is most often compatible with breastfeeding. PMID:27197575

  15. Nephrogenic adenoma of the bladder.

    PubMed

    Vorreuther, R; Nayal, W; Hake, R; Engelmann, U

    1994-01-01

    A nephrogenic adenoma of the bladder in a 4-year-old girl with a past history of urologic surgery for vesicorenal reflux is described. The multifocal tumor was treated by transurethral resection. Relapse occurred 15 months later and was again treated by transurethral resection. Pathological aspects, clinical features and therapeutic considerations of this proliferative lesion are reviewed and discussed. PMID:7855943

  16. The genetics of pituitary adenomas.

    PubMed

    Vandeva, Silvia; Jaffrain-Rea, Marie-Lise; Daly, Adrian F; Tichomirowa, Maria; Zacharieva, Sabina; Beckers, Albert

    2010-06-01

    Pituitary adenomas are one of the most frequent intracranial tumors with a prevalence of clinically-apparent tumors close to 1:1000 of the general population. They are clinically significant because of hormone overproduction and/or tumor mass effects in addition to the need for neurosurgery, medical therapies and radiotherapy. The majority of pituitary adenomas have a sporadic origin with recognized genetic mutations seldom being found; somatotropinomas are an exception, presenting frequent somatic GNAS mutations. In this and other phenotypes, tumorigenesis could possibly be explained by altered function of genes implicated in cell cycle regulation, growth factors or their receptors, cell-signaling pathways, specific hormonal factors or other molecules with still unclear mechanisms of action. Genetic changes, such as allelic loss or gene amplification, and epigenetic changes, usually by promoter methylation, have been implicated in abnormal gene expression, but alternative mechanisms may be present. Familial cases of pituitary adenomas represent 5% of all pituitary tumors. MEN1 mutations cause multiple endocrine neoplasia type 1 (MEN1), while the Carney complex (CNC) is characterized by mutations in the protein kinase A regulatory subunit-1alpha (PRKAR1A) gene or changes in a locus at 2p16. Recently, a MEN1-like condition, MEN4, was found to be related to mutations in the CDKN1B gene. The clinical entity of familial isolated pituitary adenomas (FIPA) is characterized by genetic defects in the aryl hydrocarbon receptor interacting protein (AIP) gene in about 15% of all kindreds and 50% of homogenous somatotropinoma families. Identification of familial cases of pituitary adenomas is important as these tumors may be more aggressive than their sporadic counterparts. PMID:20833337

  17. Advanced Duct Sealing Testing

    SciTech Connect

    Sherman, Max H.; Walker, Iain S.

    2003-08-01

    Duct leakage has been identified as a major source of energy loss in residential buildings. Most duct leakage occurs at the connections to registers, plenums or branches in the duct system. At each of these connections a method of sealing the duct system is required. Typical sealing methods include tapes or mastics applied around the joints in the system. Field examinations of duct systems have typically shown that these seals tend to fail over extended periods of time. The Lawrence Berkeley National Laboratory has been testing sealant durability for several years. Typical duct tape (i.e. fabric backed tapes with natural rubber adhesives) was found to fail more rapidly than all other duct sealants. This report summarizes the results of duct sealant durability testing of five UL 181B-FX listed duct tapes (three cloth tapes, a foil tape and an Oriented Polypropylene (OPP) tape). One of the cloth tapes was specifically developed in collaboration with a tape manufacturer to perform better in our durability testing. The first test involved the aging of common ''core-to-collar joints'' of flexible duct to sheet metal collars, and sheet metal ''collar-to-plenum joints'' pressurized with 200 F (93 C) air. The second test consisted of baking duct tape specimens in a constant 212 F (100 C) oven following the UL 181B-FX ''Temperature Test'' requirements. Additional tests were also performed on only two tapes using sheet metal collar-to-plenum joints. Since an unsealed flexible duct joint can have a variable leakage depending on the positioning of the flexible duct core, the durability of the flexible duct joints could not be based on the 10% of unsealed leakage criteria. Nevertheless, the leakage of the sealed specimens prior to testing could be considered as a basis for a failure criteria. Visual inspection was also documented throughout the tests. The flexible duct core-to-collar joints were inspected monthly, while the sheet metal collar-to-plenum joints were inspected

  18. Ducted auroral kilometric radiation

    NASA Technical Reports Server (NTRS)

    Calvert, W.

    1982-01-01

    Certain discrete, intense wave signals attributed to auroral kilometric radiation (AKR) were observed with ISEE-l while it was within the plasmaspheric shadow zone for direct propagation. It is believed that wave ducting by thin depletions of the plasma density aligned with the magnetic field accounts for such signals, and that their discrete nature is caused by the satellite intercepting individual ducts. These ducts, which were also observed as coincident decreases of the upper hybrid resonance frequency, appeared to be twenty-percent depletions roughly one hundred kilometers across. The AKR, which is emitted approximately perpendicular to the magnetic field, apparently entered these ducts equatorward of the source after the waves had been refracted parallel to the duct axis. A diffuse background was also observed which is consistent with the leakage from similar ducts at lower L-values. These observations establish the existence of ducted AKR, its signature on the satellite wave spectrograms, and new evidence for depletion ducts within the plasmasphere.

  19. Loft duct project report

    SciTech Connect

    Reed, J.R.

    1993-06-01

    On October 16, 1992, during a routine examination of the loft of Building 332, the Building Coordinator observed cracks in the welds of the duct work that services the fume hoods for Rooms 1313, 1321, and 1329. Further examination revealed cracks in the weld of the duct work that services the gloveboxes in Rooms 1321 and 1329. Upon discovery of the cracked welds, facility management immediately took the following two actions: Because one crack in the fume hood exhaust extended 70% around the duct circumference, a 1-ton chain fall was used to secure the duct to the roof support structure to prevent the duct from falling if the duct completely fractured. The Facility Manager suspended plutonium handling operations in the gloveboxes and work in the fume hoods in the affected rooms until the situation could be thoroughly investigated. Building 332 is ventilated by drawing conditioned air from the building hallways into the laboratories, hoods, and gloveboxes. This air is filtered through two sets of high-efficiency particulate air (HEPA) filters before being exhausted from the facility. Figure 1 is a schematic of the typical air flow pattern for the facility. All affected duct work is located in the loft of the facility or pressure zone 4. This ducting is fabricated from 12-, 14- and 16-gauge, 304 stainless-steel sheet stock and joined by the Gas Tungsten Arc Welding (GTAW) process.

  20. Sellar gangliocytoma with adrenocorticotropic and prolactin adenoma.

    PubMed

    Kissiedu, Juliana O; Prayson, Richard A

    2016-02-01

    We report a case of a 60-year-old man who presented with weight gain, headaches, dizziness, erectile dysfunction and decreased libido. He was found to have elevated adrenocorticotropic hormone (ACTH) and prolactin serum levels. The imaging studies revealed a 1.4 cm sella/suprasellar mass which was compressing the optic chiasm. Histologic slides of the lesion showed a pituitary adenoma, marked by a proliferation of biphenotypic appearing cells, associated with a gangliocytoma, and marked by a proliferation of atypical appearing neuronal cells arranged against a glial-appearing background. Pituitary adenoma-gangliocytomas are benign combination tumors that rarely occur in the sellar region. Adenomas in this setting are sometimes functional, and rare patients with mixed adenomas (adenomas secreting more than one hormone) have been reported. To our knowledge, there has been only one other report of a combined ACTH and prolactin-producing adenoma with gangliocytoma, reported in a patient who also had acromegaly. In our patient, the immunohistochemical stains demonstrated that the bulk of the adenoma cells stained with prolactin antibody, and scattered clusters of cells within the adenoma stained positively for ACTH. The adenoma did not stain with antibodies to any of the other anterior pituitary hormones. Postoperatively, the elevated prolactin and ACTH levels returned to normal levels and there was no evidence of residual tumor. Adequate sampling and immunohistochemistry are important in rendering a correct diagnosis and in identifying the hormone status of mixed adenoma-gangliocytomas. PMID:26314658

  1. Laparoscopic Anatomical Left Hepatectomy for Intrahepatic Bile Duct Papillary Mucinous Cystadenoma With Intraoperative Vascular Repair: A Case Report.

    PubMed

    Li, Hongyu; Peng, Bing

    2016-02-01

    Laparoscopic hepatectomy has been widely performed for patients with benign liver tumors such as hepatic hemangioma, focal nodular hyperplasia, and hepatic adenoma.We here present a case of a 78-year-old female patient who was initially admitted to our department due to fever and jaundice for 2 days. Abdominal enhanced computed tomography scan showed intrahepatic and extrahepatic bile duct dilatation with liver atrophy of left lobe. Unenhanced nodules were seen within the left intrahepatic bile duct. Ultrasonography revealed intrahepatic and extrahepatic bile duct dilatation with viscous fluid, tubular adenoma? Tumor markers including alpha fetoprotein, carcinoembryonic antigen, and CA19-9 were normal. Preoperative total bilirubin was 64.4 mmol/L.Laparoscopic anatomical left hepatectomy and common bile duct exploration were performed. In this procedure, a lot of mucus was seen within the common bile duct and left intrahepatic bile duct. No bile duct stones were found after the exploration. During parenchymal transection, intraoperative hemorrhage from middle hepatic vein was met, and we repaired middle hepatic vein by laparoscopic suture (5-0 Prolene). No air embolism and hypotension were met. This operation took 232 minutes and estimated blood loss was 300 mL. Postoperative ultrasonography indicated a normal outflow of middle hepatic vein and there was no stricture. The patient's postoperative course was uneventful and was discharged on the 6th day after surgery. Postoperative pathological diagnosis was intrahepatic bile duct papillary mucinous cystadenoma. PMID:26871845

  2. Genomic Landscape of Colorectal Mucosa and Adenomas.

    PubMed

    Borras, Ester; San Lucas, F Anthony; Chang, Kyle; Zhou, Ruoji; Masand, Gita; Fowler, Jerry; Mork, Maureen E; You, Y Nancy; Taggart, Melissa W; McAllister, Florencia; Jones, David A; Davies, Gareth E; Edelmann, Winfried; Ehli, Erik A; Lynch, Patrick M; Hawk, Ernest T; Capella, Gabriel; Scheet, Paul; Vilar, Eduardo

    2016-06-01

    The molecular basis of the adenoma-to-carcinoma transition has been deduced using comparative analysis of genetic alterations observed through the sequential steps of intestinal carcinogenesis. However, comprehensive genomic analyses of adenomas and at-risk mucosa are still lacking. Therefore, our aim was to characterize the genomic landscape of colonic at-risk mucosa and adenomas. We analyzed the mutation profile and copy number changes of 25 adenomas and adjacent mucosa from 12 familial adenomatous polyposis patients using whole-exome sequencing and validated allelic imbalances (AI) in 37 adenomas using SNP arrays. We assessed for evidence of clonality and performed estimations on the proportions of driver and passenger mutations using a systems biology approach. Adenomas had lower mutational rates than did colorectal cancers and showed recurrent alterations in known cancer driver genes (APC, KRAS, FBXW7, TCF7L2) and AIs in chromosomes 5, 7, and 13. Moreover, 80% of adenomas had somatic alterations in WNT pathway genes. Adenomas displayed evidence of multiclonality similar to stage I carcinomas. Strong correlations between mutational rate and patient age were observed in at-risk mucosa and adenomas. Our data indicate that at least 23% of somatic mutations are present in at-risk mucosa prior to adenoma initiation. The genomic profiles of at-risk mucosa and adenomas illustrate the evolution from normal tissue to carcinoma via greater resolution of molecular changes at the inflection point of premalignant lesions. Furthermore, substantial genomic variation exists in at-risk mucosa before adenoma formation, and deregulation of the WNT pathway is required to foster carcinogenesis. Cancer Prev Res; 9(6); 417-27. ©2016 AACR. PMID:27221540

  3. Ectopic suprasellar pituitary adenoma. A case report.

    PubMed

    Caranci, F; Cirillo, L; Bartiromo, F; Ferraioli, M; Del Basso De Caro, M L; Esposito, F; Cappabianca, P; Brunetti, A; Elefante, R

    2007-01-31

    The occurrence of a pituitary adenoma located entirely outside the sella turcica, so-called ectopic adenoma, is extremely rare. We report a case of a non secreting-pituitary adenoma located above the diaphragma sellae, with no invasion into the sella turcica, confirmed at surgery. The tumor was initially treated unsuccessfully by operations via the transphenoidal route. After initial negative exploration by the transphenoidal route, the patient was successfully treated by an endoscopic endonasal transphenoidal approach extended to the tuberculum sellae and the posterior planum sphenoidale to access the suprasellar supraglandular region. A brief review of ectopic adenomas and a discussion of the preoperative diagnosis are presented. PMID:24351300

  4. Sessile serrated adenoma: from identification to resection.

    PubMed

    Bordaçahar, Benoît; Barret, Maximilien; Terris, Benoît; Dhooge, Marion; Dreanic, Johann; Prat, Frédéric; Coriat, Romain; Chaussade, Stanislas

    2015-02-01

    Until the past two decades, almost all colorectal polyps were divided into two main groups: hyperplastic polyps and adenomas. Sessile serrated adenomas presented endoscopic, pathological and molecular profiles distinct from others polyps. Previously under-diagnosed, physicians now identified sessile serrated adenomas. The serrated neoplastic pathway is accounting for up to one-third of all sporadic colorectal cancers and sessile serrated adenomas have been identified as the main precursor lesions in serrated carcinogenesis. By analogy with the adenoma-adenocarcinoma sequence, the sessile serrated adenomas-adenocarcinoma sequence, has been identified. The development of endoscopic resection techniques permits the consideration of a non-surgical approach as the first option regardless of the size of the lesion. Sessile serrated adenoma warrants the watchfulness of physicians and requires an optimal quality of the colonoscopy procedure, a thorough evaluation of the lesion, an adequate endoscopic resection and follow-up colonoscopies in accordance with sessile serrated adenomas guidelines. We herein present a review on sessile serrated adenomas focusing on their pathological specificities, epidemiology, treatment modalities and follow-up. PMID:25445408

  5. Piecemeal Versus En Bloc Resection of Large Rectal Adenomas

    ClinicalTrials.gov

    2016-05-10

    Colorectal Adenoma With Mild Dysplasia; Colorectal Adenoma With Severe Dysplasia; Colorectal Adenomatous Polyp; Colorectal Low Grade Intraepithelial Neoplasia; Colorectal High Grade Intraepithelial Neoplasia

  6. Salivary duct stones

    MedlinePlus

    ... glands. Salivary duct stones are a type of salivary gland disorder. ... 83. Jackson NM, Mitchell JL, Walvekar RR. Inflammatory disorders of the salivary glands. In: Flint PW, Haughey BH, Lund LJ, et ...

  7. Patent arterial duct

    PubMed Central

    Forsey, Jonathan T; Elmasry, Ola A; Martin, Robin P

    2009-01-01

    Patent arterial duct (PAD) is a congenital heart abnormality defined as persistent patency in term infants older than three months. Isolated PAD is found in around 1 in 2000 full term infants. A higher prevalence is found in preterm infants, especially those with low birth weight. The female to male ratio is 2:1. Most patients are asymptomatic when the duct is small. With a moderate-to-large duct, a characteristic continuous heart murmur (loudest in the left upper chest or infraclavicular area) is typical. The precordium may be hyperactive and peripheral pulses are bounding with a wide pulse pressure. Tachycardia, exertional dyspnoea, laboured breathing, fatigue or poor growth are common. Large shunts may lead to failure to thrive, recurrent infection of the upper respiratory tract and congestive heart failure. In the majority of cases of PAD there is no identifiable cause. Persistence of the duct is associated with chromosomal aberrations, asphyxia at birth, birth at high altitude and congenital rubella. Occasional cases are associated with specific genetic defects (trisomy 21 and 18, and the Rubinstein-Taybi and CHARGE syndromes). Familial occurrence of PAD is uncommon and the usual mechanism of inheritance is considered to be polygenic with a recurrence risk of 3%. Rare families with isolated PAD have been described in which the mode of inheritance appears to be dominant or recessive. Familial incidence of PAD has also been linked to Char syndrome, familial thoracic aortic aneurysm/dissection associated with patent arterial duct, and familial patent arterial duct and bicuspid aortic valve associated with hand abnormalities. Diagnosis is based on clinical examination and confirmed with transthoracic echocardiography. Assessment of ductal blood flow can be made using colour flow mapping and pulsed wave Doppler. Antenatal diagnosis is not possible, as PAD is a normal structure during antenatal life. Conditions with signs and symptoms of pulmonary overcirculation

  8. Patent arterial duct.

    PubMed

    Forsey, Jonathan T; Elmasry, Ola A; Martin, Robin P

    2009-01-01

    Patent arterial duct (PAD) is a congenital heart abnormality defined as persistent patency in term infants older than three months. Isolated PAD is found in around 1 in 2000 full term infants. A higher prevalence is found in preterm infants, especially those with low birth weight. The female to male ratio is 2:1. Most patients are asymptomatic when the duct is small. With a moderate-to-large duct, a characteristic continuous heart murmur (loudest in the left upper chest or infraclavicular area) is typical. The precordium may be hyperactive and peripheral pulses are bounding with a wide pulse pressure. Tachycardia, exertional dyspnoea, laboured breathing, fatigue or poor growth are common. Large shunts may lead to failure to thrive, recurrent infection of the upper respiratory tract and congestive heart failure. In the majority of cases of PAD there is no identifiable cause. Persistence of the duct is associated with chromosomal aberrations, asphyxia at birth, birth at high altitude and congenital rubella. Occasional cases are associated with specific genetic defects (trisomy 21 and 18, and the Rubinstein-Taybi and CHARGE syndromes). Familial occurrence of PAD is uncommon and the usual mechanism of inheritance is considered to be polygenic with a recurrence risk of 3%. Rare families with isolated PAD have been described in which the mode of inheritance appears to be dominant or recessive. Familial incidence of PAD has also been linked to Char syndrome, familial thoracic aortic aneurysm/dissection associated with patent arterial duct, and familial patent arterial duct and bicuspid aortic valve associated with hand abnormalities. Diagnosis is based on clinical examination and confirmed with transthoracic echocardiography. Assessment of ductal blood flow can be made using colour flow mapping and pulsed wave Doppler. Antenatal diagnosis is not possible, as PAD is a normal structure during antenatal life. Conditions with signs and symptoms of pulmonary overcirculation

  9. Expression of PI3Kp110α and PI3Kp110β in the colorectal conventional adenoma, serrated lesions and adenoma with canceration and their significance

    PubMed Central

    Wu, Shuhua; Li, Tangyue; Mu, Qinghai; Li, Yangyang; Gao, Xiangqian; He, Shuang; Sun, Chenbo

    2015-01-01

    Aims: To evaluate the expression and clinical significance of PI3Kp110α and PI3Kp110β in colorectal conventional adenoma, serrated lesions and adenoma with canceration. Methods and results: Immunohistochemistry and Western blot analysis were conducted to detect the expression of p110α and p110β in normal colorectal tissues, conventional adenoma, serrated lesions and adenoma canceration. Results revealed that the expression of P110α and P110β in the adenoma canceration was significantly higher than that in normal tissues, tubular adenoma (low grade) and tubular-villous adenoma (low grade) of conventional adenoma, hyperplastic polyps of serrated lesions (P<0.05). But there was no significant difference between the adenoma canceration and the high grade adenoma of conventional adenoma, all grade of villous adenoma and serrated adenoma (P>0.05). The expression of p110α and p110β was correlated with different clinicopathologic factors in conventional adenoma, serrated adenoma and adenoma canceration (P<0.05). Conclusions: p110α and p110β were highly expressed in villous adenoma, serrated adenoma and adenoma with canceration. Its high expression may be the risk factor of the progress of adenoma to adenocarcinoma, and may be an important cause of what canceration rate of villous adenoma and serrated adenoma was higher than that of other adenomas. Combined detection of p110α and p110β is helpful to determine the canceration potential of colorectal villous adenoma and serrated adenoma. PMID:26884879

  10. Particle deposition in ventilation ducts

    SciTech Connect

    Sippola, Mark R.

    2002-09-01

    Exposure to airborne particles is detrimental to human health and indoor exposures dominate total exposures for most people. The accidental or intentional release of aerosolized chemical and biological agents within or near a building can lead to exposures of building occupants to hazardous agents and costly building remediation. Particle deposition in heating, ventilation and air-conditioning (HVAC) systems may significantly influence exposures to particles indoors, diminish HVAC performance and lead to secondary pollutant release within buildings. This dissertation advances the understanding of particle behavior in HVAC systems and the fates of indoor particles by means of experiments and modeling. Laboratory experiments were conducted to quantify particle deposition rates in horizontal ventilation ducts using real HVAC materials. Particle deposition experiments were conducted in steel and internally insulated ducts at air speeds typically found in ventilation ducts, 2-9 m/s. Behaviors of monodisperse particles with diameters in the size range 1-16 {micro}m were investigated. Deposition rates were measured in straight ducts with a fully developed turbulent flow profile, straight ducts with a developing turbulent flow profile, in duct bends and at S-connector pieces located at duct junctions. In straight ducts with fully developed turbulence, experiments showed deposition rates to be highest at duct floors, intermediate at duct walls, and lowest at duct ceilings. Deposition rates to a given surface increased with an increase in particle size or air speed. Deposition was much higher in internally insulated ducts than in uninsulated steel ducts. In most cases, deposition in straight ducts with developing turbulence, in duct bends and at S-connectors at duct junctions was higher than in straight ducts with fully developed turbulence. Measured deposition rates were generally higher than predicted by published models. A model incorporating empirical equations based on

  11. Turbofan Duct Propagation Model

    NASA Technical Reports Server (NTRS)

    Lan, Justin H.; Posey, Joe W. (Technical Monitor)

    2001-01-01

    The CDUCT code utilizes a parabolic approximation to the convected Helmholtz equation in order to efficiently model acoustic propagation in acoustically treated, complex shaped ducts. The parabolic approximation solves one-way wave propagation with a marching method which neglects backwards reflected waves. The derivation of the parabolic approximation is presented. Several code validation cases are given. An acoustic lining design process for an example aft fan duct is discussed. It is noted that the method can efficiently model realistic three-dimension effects, acoustic lining, and flow within the computational capabilities of a typical computer workstation.

  12. Vitamin E deficiency ataxia associated with adenoma.

    PubMed

    Benomar, A; Yahyaoui, M; Marzouki, N; Birouk, N; Bouslam, N; Belaidi, H; Amarti, A; Ouazzani, R; Chkili, T

    1999-01-01

    Vitamin E is one of the most important lipid-soluble antioxidant nutrient. Severe vitamin E deficiency (VED) can have a profound effect on the central nervous system. VED causes ataxia and peripheral neuropathy that resembles Friedreich's ataxia. We report here a patient presenting this syndrome, but also a prolactin and FSH adenoma. Both the neurological syndromes and the adenoma regressed after treatment with alpha-tocopherol. Although, the presence of the prolactinoma in this patient may not be related to his vitamin E deficiency, alpha-tocopherol treatment seems to be beneficial and might usefully be tested in patients with hypophyseal secreting other forms of adenoma. PMID:10064178

  13. Association between atypical parathyroid adenoma and neurofibromatosis.

    PubMed

    Favere, Aline Mesquita Ferreira de; Tsukumo, Daniela Miti; Matos, Patrícia Sabino de; Santos, Sérgio Luiz Marques dos; Lalli, Cristina Alba

    2015-10-01

    Primary hyperparathyroidism is a disease characterized by excessive production of parathyroid hormone (PTH), which is due to a parathyroid adenoma in 85% of cases. An atypical parathyroid adenoma, with some histopathological features of parathyroid carcinoma, may be found in some of the cases, although it may not fulfill all the criteria for this diagnosis. Neurofibromatosis type 1 (NF1) is an autosomal dominant systemic disease that may be associated with hyperparathyroidism. We report here the rare combination of a patient with NF1 and clinical manifestations of hyperparathyroidism due to an atypical parathyroid adenoma. PMID:26421674

  14. What Is Bile Duct Cancer?

    MedlinePlus

    ... of bile duct cancer. The rest of this document refers only to cholangiocarcinomas. Benign bile duct tumors ... tumors, which aren’t discussed further in this document. Other cancers in the liver The most common ...

  15. Dynamic instability of ducts conveying fluid

    NASA Technical Reports Server (NTRS)

    Yu, Y. Y.

    1975-01-01

    A finite element analysis was used to study dynamic instability in ducts conveying high speed fluids. Ducts examined include cantilevered curved, flexibly supported, arbitrarily shaped, and composite duct systems. Partial differential equations were used to study the duct systems.

  16. Duct Leakage Repeatability Testing

    SciTech Connect

    Walker, Iain; Sherman, Max

    2014-08-01

    The purpose of this report is to evaluate the repeatability of the three most significant measurement techniques for duct leakage using data from the literature and recently obtained field data. We will also briefly discuss the first two factors. The main question to be answered by this study is to determine if differences in the repeatability of these tests methods is sufficient to indicate that any of these methods is so poor that it should be excluded from consideration as an allowed procedure in codes and standards. The three duct leak measurement methods assessed in this report are the two duct pressurization methods that are commonly used by many practitioners and the DeltaQ technique. These are methods B, C and A, respectively of the ASTM E1554 standard. Although it would be useful to evaluate other duct leak test methods, this study focused on those test methods that are commonly used and are required in various test standards, such as BPI (2010), RESNET (2014), ASHRAE 62.2 (2013), California Title 24 (CEC 2012), DOE Weatherization and many other energy efficiency programs.

  17. Cornice Duct System

    SciTech Connect

    Wayne Place; Chuck Ladd

    2004-10-29

    SYNERGETICS, INC., has designed, developed, and tested an air handling duct system that integrates the air duct with the cornice trim of interior spaces. The device has the advantage that the normal thermal losses from ducts into unconditioned attics and crawl spaces can be totally eliminated by bringing the ducts internal to the conditioned space. The following report details work conducted in the second budget period to develop the Cornice Duct System into a viable product for use in a variety of residential or small commercial building settings. A full-scale prototype has been fabricated and tested in a laboratory test building at the Daylighting Facility at North Carolina State University., Based on the results of that testing, the prototype design as been refined, fabricated, installed, and extensively tested in a residential laboratory house. The testing indicates that the device gives substantially superior performance to a standard air distribution system in terms of energy performance and thermal comfort. Patent Number US 6,511,373 B2 has been granted on the version of the device installed and tested in the laboratory house. (A copy of that patent is attached.) Refinements to the device have been carried through two additional design iterations, with a particular focus on reducing installation time and cost and refining the air control system. These new designs have been fabricated and tested and show substantial promise. Based on these design and testing iterations, a final design is proposed as part of this document. That final design is the basis for a continuation in part currently being filed with the U.5, Patent office.

  18. Genetics Home Reference: familial isolated pituitary adenoma

    MedlinePlus

    ... 1,000 people. FIPA, though, is quite rare, accounting for approximately 2 percent of pituitary adenomas. More ... be inherited? More about Inheriting Genetic Conditions Diagnosis & Management These resources address the diagnosis or management of ...

  19. Gamma knife radiosurgery for pituitary adenomas.

    PubMed

    Ježková, Jana; Marek, Josef

    2016-09-01

    Pituitary adenomas are frequently occurring intracranial neoplasms. The aim of the treatment of pituitary adenomas is to normalize hormonal hypersecretion, to preserve the normal pituitary function, to reserve or treat impaired pituitary function and to control tumor growth and its mechanical effects on the surrounding structures. Treatment modalities include surgical, medical and radiation therapy. Radiosurgery is mainly used as a secondary line treatment after surgery for residual or recurrent tumors. The antiproliferative effect is achieved by LKG irradiation in more than 90% of patients. Regarding the functioning pituitary adenomas, the manifestation of the treatment effect is slow and depends mainly on the type of adenoma. Gamma knife irradiation is safe when the maximal doses to pituitary and infundibulum are respected. PMID:26899535

  20. Tubulovillous Adenoma in a Urethral Neobladder Anastomosis

    PubMed Central

    Morganstern, Bradley A.; Greenblatt, Logan B.; Yaskiv, Oksana; Steckel, Joph

    2015-01-01

    We present a case of a tubulovillous adenoma arising in a neobladder that was managed by cystoscopic resection. A 64 year-old male underwent a cystectomy with creation of an ileocolic neobladder urinary diversion for T2 urothelial carcinoma of the bladder. Nine years following his surgery, the patient noted several episodes of gross hematuria. Cystoscopic evaluation revealed the rare occurrence of a 3 cm tubulovillous adenoma with high-grade dysplasia at the neck of the neobladder. PMID:26793555

  1. Genetic Variants Associated with Colorectal Adenoma Susceptibility

    PubMed Central

    Abulí, Anna; Castells, Antoni; Bujanda, Luis; Lozano, Juan José; Bessa, Xavier; Hernández, Cristina; Álvarez-Urturi, Cristina; Pellisé, Maria; Esteban-Jurado, Clara; Hijona, Elizabeth; Burón, Andrea; Macià, Francesc; Grau, Jaume; Guayta, Rafael

    2016-01-01

    Background Common low-penetrance genetic variants have been consistently associated with colorectal cancer risk. Aim To determine if these genetic variants are associated also with adenoma susceptibility and may improve selection of patients with increased risk for advanced adenomas and/or multiplicity (≥ 3 adenomas). Methods We selected 1,326 patients with increased risk for advanced adenomas and/or multiplicity and 1,252 controls with normal colonoscopy from population-based colorectal cancer screening programs. We conducted a case-control association study analyzing 30 colorectal cancer susceptibility variants in order to investigate the contribution of these variants to the development of subsequent advanced neoplasia and/or multiplicity. Results We found that 14 of the analyzed genetic variants showed a statistically significant association with advanced adenomas and/or multiplicity: the probability of developing these lesions increased with the number of risk alleles reaching a 2.3-fold risk increment in individuals with ≥ 17 risk alleles. Conclusions Nearly half of the genetic variants associated with colorectal cancer risk are also related to advanced adenoma and/or multiplicity predisposition. Assessing the number of risk alleles in individuals within colorectal cancer screening programs may help to identify better a subgroup with increased risk for advanced neoplasia and/or multiplicity in the general population. PMID:27078840

  2. The role of postoperative radiation therapy in carcinoma ex pleomorphic adenoma of the parotid gland

    SciTech Connect

    Chen, Allen M. . E-mail: allenmchen@yahoo.com; Garcia, Joaquin; Bucci, M. Kara; Quivey, Jeanne M.; Eisele, David W.

    2007-01-01

    Purpose: To evaluate the impact of postoperative radiation therapy on the clinical course of patients with carcinoma ex pleomorphic adenoma of the parotid gland. Methods and Materials: Between 1960 and 2004, 63 patients were treated with definitive surgery for carcinoma ex pleomorphic adenoma of the parotid gland. Forty patients (63%) received postoperative radiation therapy to a median dose of 60 Gy (range, 45-71 Gy). Adenocarcinoma (29 patients), salivary duct carcinoma (16 patients), and adenoid cystic carcinoma (9 patients) were the most common malignant subtypes. Pathologic T -stage was: 16% T1, 33% T2, 32% T3, and 19% T4. Twenty-one patients (33%) had microscopically positive margins and 39 (62%) had perineural invasion. Median follow-up was 50 months (range, 2-96 months). Results: The use of postoperative therapy significantly improved 5-year local control from 49% to 75% (p = 0.005) and was associated with an improvement in survival among patients without evidence of cervical lymph node metastasis (p = 0.01). A Cox proportional hazard model identified pathologic involvement of cervical lymph nodes as an independent predictor of overall survival. Overall survival was 16% for patients with pathologic N-positive disease compared with 67% for those whose lymph node status was negative or unknown (p = 0.001). Conclusion: Surgery followed by postoperative radiation should be considered the standard of care for patients with carcinoma ex pleomorphic adenoma.

  3. Complicated bile duct stones.

    PubMed

    Roy, Ashwin; Martin, Derrick

    2013-01-01

    Common bile duct stones (CBDSs) are solid deposits that can either form within the gallbladder or migrate to the common bile duct (CBD), or form de novo in the biliary tree. In the USA around 15% of the population have gallstones and of these, 3% present with symptoms annually. Because of this, there have been major advancements in the management of gallstones and related conditions. Management is based on the patient's risk profile; young and healthy patients are likely to be recommended for surgery and elderly patients with comorbidities are usually recommended for endoscopic procedures. Imaging of gallstones has advanced in the last 30 years with endoscopic retrograde cholangiopancreatography evolving from a diagnostic to a therapeutic procedure in removing CBDSs. We present a complicated case of a patient with a CBDS and periampullary diverticulum and discuss the techniques used to diagnose and remove the stone from the biliary system. PMID:23946532

  4. Complicated bile duct stones

    PubMed Central

    Roy, Ashwin; Martin, Derrick

    2013-01-01

    Common bile duct stones (CBDSs) are solid deposits that can either form within the gallbladder or migrate to the common bile duct (CBD), or form de novo in the biliary tree. In the USA around 15% of the population have gallstones and of these, 3% present with symptoms annually. Because of this, there have been major advancements in the management of gallstones and related conditions. Management is based on the patient's risk profile; young and healthy patients are likely to be recommended for surgery and elderly patients with comorbidities are usually recommended for endoscopic procedures. Imaging of gallstones has advanced in the last 30 years with endoscopic retrograde cholangiopancreatography evolving from a diagnostic to a therapeutic procedure in removing CBDSs. We present a complicated case of a patient with a CBDS and periampullary diverticulum and discuss the techniques used to diagnose and remove the stone from the biliary system. PMID:23946532

  5. Lacrimal duct cyst abscess.

    PubMed

    Dharmasena, Aruna; Sobajo, Cassandra; Irion, Luciane; Ataullah, Sajid

    2014-12-01

    Cystic dilatation within the lacrimal gland is thought to be related to chronic inflammation and scarring of the lacrimal gland ductules. We review the literature and discuss a case and of lacrimal duct cyst suppuration presenting with visual loss, external ophthalmoplegia, proptosis and ptosis. To our knowledge, only one other report of a lacrimal ductal cyst abscess has been reported in the literature so far. PMID:25208223

  6. Meta-Analysis of the Effect of Bowel Preparation on Adenoma Detection: Early Adenomas Affected Stronger than Advanced Adenomas

    PubMed Central

    Prakash, Meher; Manser, Christine N.; Heinrich, Henriette; Misselwitz, Benjamin

    2016-01-01

    Background and Aims Low-quality bowel preparation reduces efficacy of colonoscopy. We aimed to summarize effects of bowel preparation on detection of adenomas, advanced adenomas and colorectal cancer. Methods A systematic literature search was performed regarding detection of colonic lesions after normal and low-quality bowel preparation. Reported bowel preparation quality was transformed to the Aronchick scale with its qualities “excellent”, “good”, “fair”, “poor”, and “insufficient” or “optimal” (good/excellent), “suboptimal” (fair/poor/insufficient), “adequate” (good/excellent/fair) and “inadequate” (poor/insufficient). We identified two types of studies: i) Comparative studies, directly comparing lesion detection according to bowel preparation quality, and ii) repeat colonoscopy studies, reporting results of a second colonoscopy after previous low-quality preparation. Results The detection of early adenomas was reduced with inadequate vs. adequate bowel preparation (Odds Ratio (OR) 0.53, CI: 0.46–0.62, p<0.001). The advanced adenomas were affected less in comparison (0.74, CI: 0.62–0.87, p<0.001). The large number of subjects considered in the present meta-analysis resulted in smaller confidence intervals compared to earlier studies. Classifying the bowel-preparation quality as suboptimal vs. optimal led to the same qualitative conclusion (OR: 0.81, CI: 0.74–0.89, p<0.001 for early adenomas, OR: 0.94, CI: 0.87–1.01, n.s. for advanced adenomas). Bowel preparation was equally important for right-sided/ flat/ serrated vs. other lesions in most observational studies but more relevant in some repeat colonoscopy studies; data regarding carcinoma detection were insufficient. Conclusion Inadequate bowel preparation affects detection of early colonic lesions stronger than advanced lesions. PMID:27257916

  7. Bile duct malignancies.

    PubMed

    Tucek, S; Tomasek, J; Halámkova, J; Kiss, I; Andrasina, T; Hemmelová, B; Adámková-Krákorová, D; Vyzula, R

    2010-01-01

    Bile duct malignancies include intrahepatic cholangiocarcinoma (ICC), extrahepatic cholangiocarcinoma (ECC), gall bladder carcinoma (GC) and carcinoma of Vater's ampulla (ampulloma). Bile duct neoplasms are rare tumours with overall poor prognosis. The overall incidence affects up to 12.5 per 100,000 persons in the Czech Republic. The mortality rate has risen recently to 9.5 per 100,000 persons. The incidence and mortality have been remarkably stable over the past 3 decades. The survival rate of patients with these tumours is poor, usually not exceeding 12 months. The diagnostic process is complex, uneasy and usually late. Most cases are diagnosed when unresectable, and palliative treatment is the main approach of medical care for these tumours. The treatment remains very challenging. New approaches have not brought much improvement in this field. Standards of palliative care are lacking and quality of life assessments are surprisingly not common. From the scarce data it seems, however, that multimodal individually tailored treatment can prolong patients'survival and improve the health-related quality of life. The care in specialized centres offers methods of surgery, interventional radiology, clinical oncology and high quality supportive care. These methods are discussed in the article in greater detail. Improvements in this field can be sought in new diagnostic methods and new procedures in surgery and interventional radiology. Understanding the tumour biology on the molecular level could shift the strategy to a more successful one, resulting in more cured patients. Further improvements in palliative care can be sought by defining new targets and new drug development. The lack of patients with bile duct neoplasms has been the limiting factor for any improvements. A new design of larger randomized international multicentric clinical trials with prompt data sharing could help to overcome this major problem. Defining standards of palliative care is a necessity

  8. Percutaneous Irreversible Electroporation of a Large Centrally Located Hepatocellular Adenoma in a Woman with a Pregnancy Wish

    SciTech Connect

    Scheffer, Hester J. Melenhorst, Marleen C. A. M. Tilborg, Aukje A. J. M. van; Nielsen, Karin; Nieuwkerk, Karin M. van Vries, Richard A. de; Tol, Petrousjka van den; Meijerink, Martijn R.

    2015-08-15

    Irreversible electroporation (IRE) is a novel image-guided ablation technique that is rapidly gaining popularity in the treatment of malignant liver tumors located near large vessels or bile ducts. We describe a 28-year-old female patient with a 5 cm large, centrally located hepatocellular adenoma who wished to get pregnant. Regarding the risk of growth and rupture of the adenoma caused by hormonal changes during pregnancy, treatment of the tumor was advised prior to pregnancy. However, due to its central location, the tumor was considered unsuitable for resection and thermal ablation. Percutaneous CT-guided IRE was performed without complications and led to rapid and impressive tumor shrinkage. Subsequent pregnancy and delivery went uncomplicated. This case report suggests that the indication for IRE may extend to the treatment of benign liver tumors that cannot be treated safely otherwise.

  9. Percutaneous Irreversible Electroporation of a Large Centrally Located Hepatocellular Adenoma in a Woman with a Pregnancy Wish.

    PubMed

    Scheffer, Hester J; Melenhorst, Marleen C A M; van Tilborg, Aukje A J M; Nielsen, Karin; van Nieuwkerk, Karin M; de Vries, Richard A; van den Tol, Petrousjka M P; Meijerink, Martijn R

    2015-08-01

    Irreversible electroporation (IRE) is a novel image-guided ablation technique that is rapidly gaining popularity in the treatment of malignant liver tumors located near large vessels or bile ducts. We describe a 28-year-old female patient with a 5 cm large, centrally located hepatocellular adenoma who wished to get pregnant. Regarding the risk of growth and rupture of the adenoma caused by hormonal changes during pregnancy, treatment of the tumor was advised prior to pregnancy. However, due to its central location, the tumor was considered unsuitable for resection and thermal ablation. Percutaneous CT-guided IRE was performed without complications and led to rapid and impressive tumor shrinkage. Subsequent pregnancy and delivery went uncomplicated. This case report suggests that the indication for IRE may extend to the treatment of benign liver tumors that cannot be treated safely otherwise. PMID:25537309

  10. GIANT PITUITARY ADENOMA WITH NORMAL VISION AND MISLEADING RADIOLOGICAL FINDINGS.

    PubMed

    Khalid, Muhammad; Raina, Umer Farooq; uz Zaman, Khaleeq; Tahir, Muhammad

    2015-01-01

    Giant pituitary adenomas are rare and present with visual loss. Giant pituitary adenoma has rarely been reported presenting with normal vision. We report Giant pituitary adenoma with Normal vision in a 35 years old patient presenting with adult onset epilepsy and headache. PMID:26721053

  11. Advanced endoscopic imaging to improve adenoma detection

    PubMed Central

    Neumann, Helmut; Nägel, Andreas; Buda, Andrea

    2015-01-01

    Advanced endoscopic imaging is revolutionizing our way on how to diagnose and treat colorectal lesions. Within recent years a variety of modern endoscopic imaging techniques was introduced to improve adenoma detection rates. Those include high-definition imaging, dye-less chromoendoscopy techniques and novel, highly flexible endoscopes, some of them equipped with balloons or multiple lenses in order to improve adenoma detection rates. In this review we will focus on the newest developments in the field of colonoscopic imaging to improve adenoma detection rates. Described techniques include high-definition imaging, optical chromoendoscopy techniques, virtual chromoendoscopy techniques, the Third Eye Retroscope and other retroviewing devices, the G-EYE endoscope and the Full Spectrum Endoscopy-system. PMID:25789092

  12. Preoperative volume determination for pituitary adenoma

    NASA Astrophysics Data System (ADS)

    Zukic, Dženan; Egger, Jan; Bauer, Miriam H. A.; Kuhnt, Daniela; Carl, Barbara; Freisleben, Bernd; Kolb, Andreas; Nimsky, Christopher

    2011-03-01

    The most common sellar lesion is the pituitary adenoma, and sellar tumors are approximately 10-15% of all intracranial neoplasms. Manual slice-by-slice segmentation takes quite some time that can be reduced by using the appropriate algorithms. In this contribution, we present a segmentation method for pituitary adenoma. The method is based on an algorithm that we have applied recently to segmenting glioblastoma multiforme. A modification of this scheme is used for adenoma segmentation that is much harder to perform, due to lack of contrast-enhanced boundaries. In our experimental evaluation, neurosurgeons performed manual slice-by-slice segmentation of ten magnetic resonance imaging (MRI) cases. The segmentations were compared to the segmentation results of the proposed method using the Dice Similarity Coefficient (DSC). The average DSC for all datasets was 75.92%+/-7.24%. A manual segmentation took about four minutes and our algorithm required about one second.

  13. Intrahepatic Transposition of Bile Ducts

    PubMed Central

    Delić, Jasmin; Savković, Admedina; Isaković, Eldar; Marković, Sergije; Bajtarevic, Alma; Denjalić, Amir

    2012-01-01

    Objective. To describe the intrahepatic bile duct transposition (anatomical variation occurring in intrahepatic ducts) and to determine the frequency of this variation. Material and Methods. The researches were performed randomly on 100 livers of adults, both sexes. Main research methods were anatomical macrodissection. As a criterion for determination of variations in some parts of bile tree, we used the classification of Segmentatio hepatis according to Couinaud (1957) according to Terminologia Anatomica, Thieme Stuugart: Federative Committee on Anatomical Terminology, 1988. Results. Intrahepatic transposition of bile ducts was found in two cases (2%), out of total examined cases (100): right-left transposition (right segmental bile duct, originating from the segment VIII, joins the left liver duct-ductus hepaticus sinister) and left-right intrahepatic transposition (left segmental bile duct originating from the segment IV ends in right liver duct-ductus hepaticus dexter). Conclusion. Safety and success in liver transplantation to great extent depends on knowledge of anatomy and some common embryological anomalies in bile tree. Variations in bile tree were found in 24–43% of cases, out of which 1–22% are the variations of intrahepatic bile ducts. Therefore, good knowledge on ductal anatomy enables good planning, safe performance of therapeutic and operative procedures, and decreases the risk of intraoperative and postoperative complications. PMID:22550601

  14. Ascariasis of the pancreatic duct.

    PubMed

    Klimovskij, Michail; Dulskas, Audrius; Kraulyte, Zita; Mikalauskas, Saulius

    2015-01-01

    Ascariasis is a common helminthic disease worldwide, although Lithuania and other European countries are not considered endemic areas. The presence of the Ascaris worm in the biliary tree causes choledocholithiasis-like symptoms. We report a case of pancreatic duct ascariasis causing such symptoms. A 73-year-old Lithuanian woman underwent endoscopic retrograde cholangiopancreatography (ERCP) suspecting choledocholithiasis. Contrast injection into the common bile duct demonstrated a slightly dilated biliary tree without any filling defects, and the tail of an Ascaris worm protruding from the opening of the papilla Vater. The worm was captured by a snare but escaped deep into the duct. After a small wirsungotomy the worm was retrieved from the pancreatic duct. The patient received a 150 mg dose of levamisole orally repeated 7 days later and was discharged after complete resolution of symptoms. This first reported sporadic case of pancreatic duct ascariasis in Lithuania was successfully treated with ERCP and Levamisole. PMID:26374772

  15. Germline Variants and Advanced Colorectal Adenomas: Adenoma Prevention with Celecoxib Trial Genomewide Association Study

    PubMed Central

    Wang, Jiping; Carvajal-Carmona, Luis G.; Chu, Jen-Hwa; Zauber, Ann G.; Kubo, Michikai; Matsuda, Koichi; Dunlop, Malcolm; Houlston, Richard S.; Sieber, Oliver; Lipton, Lara; Gibbs, Peter; Martin, Nicholas G.; Montgomery, Grant W.; Young, Joanne; Baird, Paul N.; Ratain, Mark J.; Nakamura, Yusuke; Weiss, Scott T.; Tomlinson, Ian; Bertagnolli, Monica M.

    2014-01-01

    Purpose Identification of single nucleotide polymorphisms (SNPs) associated with development of advanced colorectal adenomas. Experimental Design Discovery Phase: 1,406 Caucasian patients (139 advanced adenoma cases and 1,267 controls) from the Adenoma Prevention with Celecoxib (APC) trial were included in a genome-wide association study (GWAS) to identify variants associated with post-polypectomy disease recurrence. Genome-wide significance was defined as false discovery rate < 0.05, unadjusted p=7.4×10−7. Validation Phase: Results were further evaluated using 4,175 familial colorectal adenoma or CRC cases and 5,036 controls from patients of European ancestry (COloRectal Gene Identification consortium, Scotland, Australia and VQ58). Results Our study identified eight SNPs associated with advanced adenoma risk in the APC trial (rs2837156, rs7278863, rs2837237, rs2837241, rs2837254, rs741864 at 21q22.2, and rs1381392 and rs17651822 at 3p24.1, at p<10–7 level with odds ratio – OR>2). Five variants in strong pairwise linkage disequilbrium (rs7278863, rs2837237, rs741864, rs741864 and rs2837241, r2=0.8–1) are in or near the coding region for the tight junction adhesion protein, IGSF5. An additional variant associated with advanced adenomas, rs1535989 (minor allele frequency 0.11; OR 2.09; 95% confidence interval 1.50–2.91), also predicted CRC development in a validation analysis (p=0.019) using a series of adenoma cases or CRC (CORGI study) and 3 sets of CRC cases and controls (Scotland, VQ58 and Australia, N=9,211). Conclusions Our results suggest that common polymorphisms contribute to the risk of developing advanced adenomas and might also contribute to the risk of developing CRC. The variant at rs1535989 may identify patients whose risk for neoplasia warrants increased colonoscopic surveillance. PMID:24084763

  16. Bilateral Adrenal Adenoma Presented As Multiple Metatarsal And Phalangeal Fractures

    PubMed Central

    LiYeung, L L; Lui, T H

    2015-01-01

    Introduction: Symptomatic adrenal adenoma usually presents with systemic symptoms. Depending on the function of the adenoma, the patient can present with pheochromocytoma-like symptoms; primary hyperaldosteronism and Cushing syndrome (weight gain, weakness, depression, and bruising). Case report: A 41 year-old lady presented with multiple metatarsal and phalangeal fractures of the both feet without significant injury. DEXA scan showed evidence of osteoporosis. Investigations showed that the picture was compatible with adrenal Cushing syndrome. Computed tomogram showed bilateral adrenal adenoma. Adrenal cortex scintigraphy with NP-59 scan showed hyperfunctioning right adrenal adenoma. Laproscopic R adrenalectomy was performed and histological study confirmed adrenal cortical adenoma with adjacent cortical atrophy suggestive of a functioning adenoma. Post-operatively, she was put on hydrocortisone replacement and recovered well. Conclusion: Adrenal adenoma can present with insufficiency fractures of the feet. PMID:27299107

  17. URINARY MUTAGENICITY AND COLORECTAL ADENOMA RISK

    EPA Science Inventory

    Abstract

    We investigated urinary mutagenicity and colorectal adenoma risk in a clinic-based, case-control study of currently nonsmoking cases (n = 143) and controls (n = 156). Urinary organics were extracted by C18/methanol from 12-h overnight urine samples, and mutagenici...

  18. Parathyroid adenoma upstaging the lung cancer.

    PubMed

    Okuyucu, Kursat; Kavakli, Kuthan; Ozaydın, Sukru; Karahatay, Serdar; Karatas, Okan; Doğan, Deniz

    2015-05-01

    Mediastinal staging of NSCLC with noninvasive methods such as PET/CT can be misleading when a mediastinal disease accompany. Histopathologic confirmation should be made before any treatment plan. Herein, we presented a case of parathyroid adenoma upstaging the lung cancer. PMID:25618011

  19. Paediatric pituitary adenomas: a decade of change.

    PubMed

    Guaraldi, Federica; Storr, Helen L; Ghizzoni, Lucia; Ghigo, Ezio; Savage, Martin O

    2014-01-01

    Pituitary adenomas, although rare in the paediatric age range and mostly benign, represent very challenging disorders for diagnosis and management. The recent identification of genetic alterations in young individuals with pituitary adenomas has broadened the scope of molecular investigations and contributed to the understanding of mechanisms of tumorigenesis. Recent identification of causative mutations of genes such as GNAS, PRKAR1A, MEN1 and AIP has introduced the concept of molecular screening of young apparently healthy family members. Population-based studies have reported a significantly higher number of affected subjects and genetic variations than expected. Radiological techniques have advanced, yet many microadenomas remain undetectable on scanning. However, experience with transsphenoidal and endoscopic pituitary surgery has led to higher rates of cure. Prolactinomas, corticotroph and somatotroph adenomas remain the most prevalent, with each diagnosis presenting its own challenges. As paediatric pituitary adenomas occur very infrequently within the paediatric age range, paediatric endocrine units cannot provide expert management in isolation. Consequently, close co-operation with adult endocrinology colleagues with experience of pituitary disease is strongly recommended. PMID:24525527

  20. The impact of duct-to-duct interaction on the hex duct dilation

    SciTech Connect

    Lee, M.J.; Chang, L.K.; Lahm, C.E.; Porter, D.L.

    1992-07-01

    Dilation of the hex duct is an important factor in the operational lifetime of fuel subassemblies in liquid metal fast reactors. It is caused primarily by the irradiation-enhanced creep and void swelling of the hex duct material. Excessive dilation may jeopardize subassembly removal from the core or cause a subassembly storage problem where the grid size of the storage basket is limited. Dilation of the hex duct in Experimental Breeder Reactor II (EBR-II) limits useful lifetime because of these storage basket limitations. It is, therefore, important to understand the hex duct dilation behavior to guide the design and in-core management of fuel subassemblies in a way that excessive duct deformation can be avoided. To investigate the dilation phenomena, finite-element models of the hex duct have been developed. The inelastic analyses were performed using the structural analysis code, ANSYS. Both Type 316 and D9 austenitic stainless steel ducts are considered. The calculated dilations are in good agreement with profilometry measurements made after irradiation. The analysis indicates that subassembly interaction is an important parameter in addition to neutron fluence and temperature in determining hex duct dilation. 5 refs.

  1. Thyroid Adenomas After Solid Cancer in Childhood

    SciTech Connect

    Haddy, Nadia; El-Fayech, Chiraz; Guibout, Catherine; Adjadj, Elisabeth; Thomas-Teinturier, Cecile; Oberlin, Odile; Veres, Cristina; Pacquement, Helene; Jackson, Angela; Munzer, Martine; N'Guyen, Tan Dat; Bondiau, Pierre-Yves; Berchery, Delphine; Laprie, Anne; Bridier, Andre; Lefkopoulos, Dimitri; Schlumberger, Martin; Rubino, Carole; Diallo, Ibrahima; Vathaire, Florent de

    2012-10-01

    Purpose: Very few childhood cancer survivor studies have been devoted to thyroid adenomas. We assessed the role of chemotherapy and the radiation dose to the thyroid in the risk of thyroid adenoma after childhood cancer. Methods and Materials: A cohort of 3254 2-year survivors of a solid childhood cancer treated in 5 French centers before 1986 was established. The dose received by the isthmus and the 2 lobes of the thyroid gland during each course of radiation therapy was estimated after reconstruction of the actual radiation therapy conditions in which each child was treated as well as the dose received at other anatomical sites of interest. Results: After a median follow-up of 25 years, 71 patients had developed a thyroid adenoma. The risk strongly increased with the radiation dose to the thyroid up to a few Gray, plateaued, and declined for high doses. Chemotherapy slightly increased the risk when administered alone but also lowered the slope of the dose-response curve for the radiation dose to the thyroid. Overall, for doses up to a few Gray, the excess relative risk of thyroid adenoma per Gray was 2.8 (90% CI: 1.2-6.9), but it was 5.5 (90% CI: 1.9-25.9) in patients who had not received chemotherapy or who had received only 1 drug, and 1.1 (90% CI: 0.4-3.4) in the children who had received more than 1 drug (P=.06, for the difference). The excess relative risk per Gray was also higher for younger children at the time of radiation therapy than for their older counterparts and was higher before attaining 40 years of age than subsequently. Conclusions: The overall pattern of thyroid adenoma after radiation therapy for a childhood cancer appears to be similar to that observed for thyroid carcinoma.

  2. PMR Graphite Engine Duct Development

    NASA Technical Reports Server (NTRS)

    Stotler, C. L.; Yokel, S. A.

    1989-01-01

    The objective was to demonstrate the cost and weight advantages that could be obtained by utilizing the graphite/PMR15 material system to replace titanium in selected turbofan engine applications. The first component to be selected as a basis for evaluation was the outer bypass duct of the General Electric F404 engine. The operating environment of this duct was defined and then an extensive mechanical and physical property test program was conducted using material made by processing techniques which were also established by this program. Based on these properties, design concepts to fabricate a composite version of the duct were established and two complete ducts fabricated. One of these ducts was proof pressure tested and then run successfully on a factory test engine for over 1900 hours. The second duct was static tested to 210 percent design limit load without failure. An improved design was then developed which utilized integral composite end flanges. A complete duct was fabricated and successfully proof pressure tested. The net results of this effort showed that a composite version of the outer duct would be 14 percent lighter and 30 percent less expensive that the titanium duct. The other type of structure chosen for investigation was the F404 fan stator assembly, including the fan stator vanes. It was concluded that it was feasible to utilize composite materials for this type structure but that the requirements imposed by replacing an existing metal design resulted in an inefficient composite design. It was concluded that if composites were to be effectively used in this type structure, the design must be tailored for composite application from the outset.

  3. Statin Use and Colorectal Adenoma Risk: Results from the Adenoma Prevention with Celecoxib (APC) Trial

    PubMed Central

    Bertagnolli, Monica M.; Hsu, Meier; Hawk, Ernest T.; Eagle, Craig J.; Zauber, Ann G.

    2010-01-01

    Background Statins are widely prescribed for cardiovascular disease prevention, and also commonly used in patients at high risk for colorectal cancer (CRC). We report the results of a planned secondary analysis of the relationship between statin use and colorectal adenoma risk in a large chemoprevention trial. Methods The Adenoma Prevention with Celecoxib (APC) trial randomized 2035 adenoma patients to receive placebo (679 patients), 200 mg celecoxib twice daily (685 patients), or 400 mg celecoxib twice daily (671 patients). The study collected complete medical history and medication use data, and performed colonoscopic surveillance to 5 years after study enrollment. Effects of statin use on newly detected adenomas and cardiovascular adverse events were analyzed as time-dependent variables by multivariable Cox regression. Results Statins were used by 36% (N=730) of APC trial participants. When adjusted for covariates including cardioprotective aspirin use, age, and sex, participants on the placebo arm who used statins at any time had no benefit over 5 years compared to never users (Risk Ratio (RR) 1.24; 95% confidence interval (CI) (0.99-1.56); p=0.065). Statin use for >3 years increased adenoma risk over 5 years (RR 1.39; 95%CI 1.04-1.86; p=0.024). For all comparisons of patients treated with celecoxib, adenoma detection rates for statin users and non-users were equivalent. Consistent with their use in patients at high risk, cardiovascular serious adverse events were more common among statin users. Conclusions For patients at high risk of CRC, statins do not protect against colorectal neoplasms and may even increase the risk of developing colorectal adenomas. PMID:20403998

  4. Thyroglossal Duct Remnant with Follicular Hyperplasia Presenting After Total Thyroidectomy

    PubMed Central

    Nelson, Ryan E.; Ahmad, Hassan; Hildrew, Douglas M.; Lawlor, Claire M.; Aslam, Rizwan; Sholl, Andrew; Kandil, Emad

    2016-01-01

    Background: The thyroglossal duct fails to involute in up to 7% of adults, creating a thyroglossal duct remnant (TGDR) attached to the hyoid bone. Thyroid malignancies have been reported in approximately 1% of TGDRs. In previous reports of TGDR carcinoma, patients had radiographic evidence of a TGDR at initial clinical presentation. Alternatively, hypertrophy of a TGDR is well described in patients with hypothyroidism because of the growth of functional ectopic thyroid tissue. We present the case of a patient who had no radiographic evidence of a TGDR prior to thyroidectomy but presented 14 months after surgery with a recurrent cervical mass. Case Report: A 58-year-old female underwent total thyroidectomy for micropapillary thyroid cancer. Fourteen months later, she presented with an enlarging cervical mass. She underwent a Sistrunk procedure, and surgical pathology revealed a TGDR with compensatory glandular hypertrophy. Conclusion: To our knowledge, this is the first report of a TGDR follicular adenoma initially appearing as a result of compensatory thyroid glandular hypertrophy following total thyroidectomy for a micropapillary thyroid carcinoma. Our case presented a novel clinical dilemma regarding the best management for a patient with a new TGDR along with a recent history of micropapillary thyroid cancer. PMID:27303226

  5. 14 CFR 29.1103 - Induction systems ducts and air duct systems.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Induction systems ducts and air duct... TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Induction System § 29.1103 Induction systems ducts and air duct systems. (a) Each induction system duct upstream of the...

  6. Articulated transition duct in turbomachine

    DOEpatents

    Flanagan, James Scott; McMahan, Kevin Weston; LeBegue, Jeffrey Scott; Pentecost, Ronnie Ray

    2014-04-29

    Turbine systems are provided. A turbine system includes a transition duct comprising an inlet, an outlet, and a duct passage extending between the inlet and the outlet and defining a longitudinal axis, a radial axis, and a tangential axis. The outlet of the transition duct is offset from the inlet along the longitudinal axis and the tangential axis. The duct passage includes an upstream portion and a downstream portion. The upstream portion extends from the inlet between an inlet end and an aft end. The downstream portion extends from the outlet between an outlet end and a head end. The turbine system further includes a joint coupling the aft end of the upstream portion and the head end of the downstream portion together. The joint is configured to allow movement of the upstream portion and the downstream portion relative to each other about or along at least one axis.

  7. Wave reflections from duct terminations.

    PubMed

    Selamet, A; Ji, Z L; Kach, R A

    2001-04-01

    The reflection coefficients and inertial end corrections of several duct terminations, including finite length duct extensions perpendicular to an infinite wall, as well as at a number of angles, curved interface surfaces, and annular cavities, are determined and analyzed in the absence of flow by employing the boundary element method. Predictions for the classical unflanged and flanged circular ducts show good agreement with analytical and computational results available in the literature. The predictions for curved interface surfaces (bellmouth or horn) are also consistent with the available experimental data. In view of its high reflection coefficient, the duct termination with an annular cavity may be suggested for the suppression of noise radiation in a specific frequency band or for an effective wave reflection from the termination. PMID:11325101

  8. Sound propagation in choked ducts

    NASA Technical Reports Server (NTRS)

    Hersh, A. S.; Liu, C. Y.

    1976-01-01

    The linearized equations describing the propagation of sound in variable area ducts containing flow are shown to be singular when the duct mean flow is sonic. The singularity is removed when previously ignored nonlinear terms are retained. The results of a numerical study, for the case of plane waves propagating in a one-dimensional converging-diverging duct, show that the sound field is adequately described by the linearized equations only when the axial mean flow Mach number at the duct throat M sub th 0.6. For M sub th 0.6, the numerical results showed that acoustic energy flux was not conserved. An attempt was made to extend the study to include the nonlinear behavior of the sound field. Meaningful results were not obtained due, primarily, to numerical difficulties.

  9. Characteristics and outcomes of endoscopically resected colorectal cancers that arose from sessile serrated adenomas and traditional serrated adenomas

    PubMed Central

    Seo, Ji Yeon; Choi, Seung Ho; Chun, Jaeyoung; Choi, Ji Min; Jin, Eun Hyo; Hwang, Sung Wook; Im, Jong Pil; Kim, Sang Gyun; Kim, Joo Sung

    2016-01-01

    Background/Aims The efficacy and safety of endoscopic resection of colorectal cancer derived from sessile serrated adenomas or traditional serrated adenomas are still unknown. The aims of this study were to verify the characteristics and outcomes of endoscopically resected early colorectal cancers developed from serrated polyps. Methods Among patients who received endoscopic resection of early colorectal cancers from 2008 to 2011, cancers with documented pre-existing lesions were included. They were classified as adenoma, sessile serrated adenoma, or traditional serrated adenoma according to the baseline lesions. Clinical characteristics, pathologic diagnosis, and outcomes were reviewed. Results Overall, 208 colorectal cancers detected from 198 patients were included: 198 with adenoma, five with sessile serrated adenoma, and five with traditional serrated adenoma. The sessile serrated adenoma group had a higher prevalence of high-grade dysplasia (40.0% vs. 25.8%, P<0.001) than the adenoma group. During follow-up, local recurrence did not occur after endoscopic resection of early colorectal cancers developed from serrated polyps. In contrast, two cases of metachronous recurrence were detected within a short follow-up period. Conclusions Cautious observation and early endoscopic resection are recommended when colorectal cancer from serrated polyp is suspected. Colorectal cancers from serrated polyp can be treated successfully with endoscopy. PMID:27433150

  10. Flow duct for nuclear reactors

    DOEpatents

    Straalsund, Jerry L.

    1978-01-01

    Improved liquid sodium flow ducts for nuclear reactors are described wherein the improvement comprises varying the wall thickness of each of the walls of a polygonal tubular duct structure so that each of the walls is of reduced cross-section along the longitudinal center line and of a greater cross-section along wall junctions with the other walls to form the polygonal tubular configuration.

  11. TWO NEW DUCT LEAKAGE TESTS

    SciTech Connect

    ANDREWS,J.W.

    1998-12-01

    Two variations on the tests for duct leakage currently embodied in ASHRAE Standard 152P (Method of Test for Determining the Design and Seasonal Efficiencies of Residential Thermal Distribution Systems) are presented. Procedures are derived for calculating supply and return duct leakage to/from outside using these new variations. Results of these tests are compared with the original ones in Standard 152P on the basis of data collected in three New York State homes.

  12. Two New Duct Leakage Tests

    SciTech Connect

    Andrews, J.W.

    1998-12-01

    Two variations on the tests for duct leakage currently embodied in ASHRAE Standard 152P (Method of Test for Determining the Design and Seasonal Efficiencies of Residential Thermal Distribution Systems) are presented. Procedures are derived for calculating supply and return duct leakage to/from outside using these new variations. Results of these tests are compared with the original ones in Standard 152P on the basis of data collected in three New York State homes.

  13. Duct Leakage Repeatability Testing

    SciTech Connect

    Walker, Iain; Sherman, Max

    2014-01-01

    Duct leakage often needs to be measured to demonstrate compliance with requirements or to determine energy or Indoor Air Quality (IAQ) impacts. Testing is often done using standards such as ASTM E1554 (ASTM 2013) or California Title 24 (California Energy Commission 2013 & 2013b), but there are several choices of methods available within the accepted standards. Determining which method to use or not use requires an evaluation of those methods in the context of the particular needs. Three factors that are important considerations are the cost of the measurement, the accuracy of the measurement and the repeatability of the measurement. The purpose of this report is to evaluate the repeatability of the three most significant measurement techniques using data from the literature and recently obtained field data. We will also briefly discuss the first two factors. The main question to be answered by this study is to determine if differences in the repeatability of these tests methods is sufficient to indicate that any of these methods is so poor that it should be excluded from consideration as an allowed procedure in codes and standards.

  14. Turbofan aft duct suppressor study

    NASA Technical Reports Server (NTRS)

    Syed, A. A.; Motsinger, R. E.; Fiske, G. H.; Joshi, M. C.; Kraft, R. E.

    1983-01-01

    Suppressions due to acoustic treatment in the annular exhaust duct of a model fan were theoretically predicted and compared with measured suppressions. The predictions are based on the modal analysis of sound propagation in a straight annular flow duct with segmented treatment. Modal distributions of the fan noise source (fan-stator interaction only) were measured using in-duct modal probes. The flow profiles were also measured in the vicinity of the modal probes. The acoustic impedance of the single degree of freedom treatment was measured in the presence of grazing flow. The measured values of mode distribution of the fan noise source, the flow velocity profile and the acoustic impedance of the treatment in the duct were used as input to the prediction program. The predicted suppressions, under the assumption of uniform flow in the duct, compared well with the suppressions measured in the duct for all test conditions. The interaction modes generated by the rotor-stator interaction spanned a cut-off ratio range from nearly 1 to 7.

  15. Myxoid adrenal adenoma with focal pseudoglandular pattern.

    PubMed

    De Padua, Michelle; Rajagopal, V

    2008-05-01

    Adrenal cortical tumors with myxoid change are rare tumors. To our knowledge, only 22 cases have been described so far in literature, which include 13 carcinomas and 9 adenomas. A pseudoglandular pattern has been described in 9 of these tumors. We report a case of a myxoid adenoma of the left adrenal gland in a 67-year-old woman, with a focal pseudoglandular pattern involving about 20% of the studied tumor. Rest of the tumor was composed of anastomosing cords of tumor cells. Abundant myxoid stroma was present, which stained positively with alcian blue and was weakly focally positive with periodic acid Schiff. Immunophenotype was consistent with an adrenal tumor, i.e., positive for vimentin, inhibin, and melan A. Cytokeratin AE1/AE3 and chromogranin were negative. MIB-1 index was < 0.1%. PMID:18579979

  16. Giant pleomorphic adenoma of the parotid gland.

    PubMed

    Takahama, Ademar; da Cruz Perez, Danyel Elias; Magrin, José; de Almeida, Oslei Paes; Kowalski, Luiz Paulo

    2008-01-01

    Pleomorphic adenoma is the most common type of all benign and malignant salivary gland tumors, involving more frequently the parotid gland. It is a benign tumor with a slow and continuous growth that without treatment can reach an enormous size. We present a case of a giant pleomorphic adenoma in a 78-year-old man with a history of more than 30 years of a growing lesion in the parotid gland. Clinical examination revealed a giant mass on the right side of the face, however without any sign of facial nerve damage. The tumor was completely resected by total parotidectomy and preservation of the facial nerve. Macroscopically, the tumor measured 28 cm and weighed 4.0 Kg. On the histological examination there was a predominance of epithelial and myoepithelial cells in a hyaline and myxoid stroma. It was not found any area of malignant transformation. In the post-operatory the aesthetic and functional results were excellent. PMID:18167483

  17. [One case of laryngeal pleomorphic adenoma].

    PubMed

    An, Huiqin; Bu, Guiqing; Guo, Mingli

    2013-05-01

    A male patient, 55 years old, suffered from intermittent sound,voice depression and shortness of breath for one year,and from dysphagia for 3-4 months. Through fiber laryngoscopy,we could see tumor in the left posterior aryepiglottic fold. The tumor's surface was smooth. A portion of the tumor protruded to the laryngeal cavity and the aryepiglottic fold external,it also covered most of the glottis. Bilateral vocal cord were smooth and had good mobility. Throat CT demonstrated an irregular soft tissue mass on the left side of the aryepiglottic fold in supraglottic area with obscure normal boundary from adjacent structure. The left side of pyriform sinus became shallow without obvious bone destruction. The pathological report showed pleomorphic adenoma. The diagnosis was laryngeal pleomorphic adenoma. PMID:23898619

  18. Bronchial pleomorphic adenoma coexisting with lung cancer.

    PubMed

    Goto, Taichiro; Maeshima, Arafumi; Akanabe, Kumi; Hamaguchi, Reo; Wakaki, Misa; Oyamada, Yoshitaka; Kato, Ryoichi

    2011-01-01

    Pleomorphic adenoma usually occurs in the salivary glands but rarely in the trachea or bronchi. A 71-year-old man had abnormal shadows on a chest X-ray. Chest CT revealed one tumor in the right basal segment of the lung and another, in the left main bronchus. Bronchoscopic biopsy of the right tumor revealed well-differentiated squamous cell carcinoma. Right lower lobectomy and lymph node dissection were performed (pT2N0M0, stage IB). At the orifice of the left main bronchus, bronchoscopy identified a polypoid lesion nearly obstructing the airway. The lesion was resected with hot snare ablation. The histological examination revealed a mixture of epithelial and myxoid mesenchymal elements, characterized by ductal structures, squamous metaplasia, and cartilage tissue. The diagnosis was bronchial pleomorphic adenoma coexisting with squamous cell carcinoma of the lung. PMID:21597416

  19. Genetic characterization of large parathyroid adenomas

    PubMed Central

    Sulaiman, Luqman; Nilsson, Inga-Lena; Juhlin, C Christofer; Haglund, Felix; Höög, Anders; Larsson, Catharina; Hashemi, Jamileh

    2012-01-01

    In this study, we genetically characterized parathyroid adenomas with large glandular weights, for which independent observations suggest pronounced clinical manifestations. Large parathyroid adenomas (LPTAs) were defined as the 5% largest sporadic parathyroid adenomas identified among the 590 cases operated in our institution during 2005–2009. The LPTA group showed a higher relative number of male cases and significantly higher levels of total plasma and ionized serum calcium (P<0.001). Further analysis of 21 LPTAs revealed low MIB1 proliferation index (0.1–1.5%), MEN1 mutations in five cases, and one HRPT2 (CDC73) mutation. Total or partial loss of parafibromin expression was observed in ten tumors, two of which also showed loss of APC expression. Using array CGH, we demonstrated recurrent copy number alterations most frequently involving loss in 1p (29%), gain in 5 (38%), and loss in 11q (33%). Totally, 21 minimal overlapping regions were defined for losses in 1p, 7q, 9p, 11, and 15q and gains in 3q, 5, 7p, 8p, 16q, 17p, and 19q. In addition, 12 tumors showed gross alterations of entire or almost entire chromosomes most frequently gain of 5 and loss of chromosome 11. While gain of 5 was the most frequent alteration observed in LPTAs, it was only detected in a small proportion (4/58 cases, 7%) of parathyroid adenomas. A significant positive correlation was observed between parathyroid hormone level and total copy number gain (r=0.48, P=0.031). These results support that LPTAs represent a group of patients with pronounced parathyroid hyperfunction and associated with specific genomic features. PMID:22454399

  20. Laparoscopic ampullectomy for an ampullarian adenoma.

    PubMed

    Borie, Frédéric; Zarzavadjian Le Bian, Alban

    2013-11-01

    Lesions involving the ampulla of Vater are rare entities (0.1-0.2 %) with high malignant potential (90 %) [1]. As a treatment, the surgical procedure known as duodenopancreatectomy was the main option, whatever the tumor's stage or nature. Yet with improvements of endoscopic diagnostic and therapeutic techniques, management of these lesions has been modified, enabling endoscopic removal of adenoma and adenocarcinoma-in situ. Thus, when endoscopic treatment is not possible, surgical ampullectomy is still an alternative option to duodenopancreatectomy [1, 2]. The continuous improvements in surgical techniques and instruments now allow the safe realization of laparoscopic ampullectomy, despite the few cases described in the literature [3, 4]. Here we present a surgical technique in a 52-year-old patient with an ampulloma. The ampulloma was discovered during a gastroscopy for abdominal pain. The endoscopic ultrasound with biopsy revealed a 15-mm adenoma with moderate-grade dysplasia. The thoracoabdominal CT scan was normal. The procedure was performed as shown. The tumor histology showed a R0 resection (5-mm surgical margin) of an adenoma with focal high-grade dysplasia. At 3-year follow-up, outcomes were unremarkable, without any complications. PMID:23836126

  1. Are metaplasias in colorectal adenomas truly metaplasias?

    PubMed Central

    Bansal, M.; Fenoglio, C. M.; Robboy, S. J.; King, D. W.

    1984-01-01

    Five thousand seven hundred seventy-eight adenomas or adenomas containing carcinoma from 3215 patients were examined by routine histologic methods for the presence of epithelial metaplasias. Three forms of epithelial metaplasia were encountered: squamous cell metaplasia (0.44%), Paneth cell metaplasia (0.20%), and melanocytic metaplasia (0.017%). In several instances multiple forms of metaplasia were encountered in the same polyp. In those cases in which the paraffin blocks were available, a Grimelius stain was performed. Grimelius-positive cells were present in 63% of the adenomas containing a metaplastic cell type. All cases with Paneth cell differentiation were immunoreactive for lysozyme; all lesions containing areas of squamous differentiation were immunoreactive for keratin except 2. The histopathologic features of these cases are discussed, and it is concluded that rather than representing a true metaplastic process, Paneth cell, squamous cell, and melanocyte differentiation represent the full range of cellular differentiation that endodermally derived tissues can exhibit, particularly when they undergo neoplastic alterations. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 PMID:6202148

  2. Reoperation for parathyroid adenoma: A contemporary experience

    PubMed Central

    Powell, Anathea C.; Alexander, H. Richard; Chang, Richard; Marx, Stephen J.; Skarulis, Monica; Pingpank, James F.; Bartlett, David L.; Hughes, Marybeth; Weinstein, Lee S.; Simonds, William F.; Collins, Michael F.; Shawker, Thomas; Chen, Clara C.; Reynolds, James; Cochran, Craig; Steinberg, Seth M.; Libutti, Steven K.

    2012-01-01

    Background We reviewed reoperations for persistent or recurrent sporadic parathyroid adenoma to evaluate and compare our current results and outcomes to our previous experience. Methods From 1996 to 2008, 237 patients with persistent or recurrent hyperparathyroidism after failed operation underwent reoperation. Patients were re-explored with the assistance of non-invasive and sometimes invasive imaging. Results A missed adenoma was suspected pre-operatively in 163 patients. Reoperation resulted in long-term resolution of hypercalcemia in 92%. Adenomas were in entopic locations in 32%; the most frequent ectopic location was the thymus (20%). Sestamibi scanning and ultrasonography were the most successful non-invasive imaging studies (96% positive predictive value (PPV) and 84% PPV respectively). Forty-four percent of patients had a reoperation based solely on non-invasive imaging. Of the invasive procedures performed, arteriography resulted in the best localization (92% PPV). Permanent recurrent laryngeal nerve injury occurred in 1.8%. Conclusion Compared to our prior experience (1982–1995), outcomes remained similar (92% resolution of hypercalcemia and 1.8% recurrent nerve injury currently versus 96% and 1.3% previously). Fewer patients received invasive studies for pre-operative localization (56% vs 73%, respectively). The decreased use of invasive imaging is due to technical improvements and greater confidence in the combination of ultrasonography and sestamibi scanning. PMID:19958942

  3. Gallium-68 PSMA uptake in adrenal adenoma.

    PubMed

    Law, W Phillip; Fiumara, Frank; Fong, William; Miles, Kenneth A

    2016-08-01

    Gallium-68 (Ga-68) labelled prostate-specific membrane antigen (PSMA) imaging by positron emission tomography (PET) has emerged as a promising tool for staging of prostate cancer and restaging of disease in recurrence or biochemical failure after definitive treatment of prostate cancer. Ga-68 PSMA PET produces high target-to-background images of prostate cancer and its metastases which are reflective of the significant overexpression of PSMA in these cells and greatly facilitates tumour detection. However, relatively little is known about the PSMA expression of benign neoplasms and non-prostate epithelial malignancies. This is a case report of PSMA uptake in an adrenal adenoma incidentally discovered on PET performed for restaging of biochemically suspected prostate cancer recurrence. With the increasing use of PSMA PET in the management of prostate cancer - and the not infrequent occurrence of adrenal adenomas - the appearance of low- to moderate-grade PSMA uptake in adrenal adenomas should be one with which reporting clinicians are familiar. PMID:26394552

  4. Giant mediastinal parathyroid adenoma: a case report.

    PubMed

    Costanzo, Mario; Terminella, Alberto; Marziani, Alessia; Chisari, Antonio; Missiato, Alfredo; Cannizzaro, Matteo Angelo

    2009-01-01

    A 65 year old female patient suffering from multinodular goitre and from hypercalcaemic syndrome which had been and was being treated with drugs for a number of years. The patient undergoes total thyroidectomy. Surgical neck and anterior mediastinum exploration was negative for sick parathyroids. Neck and chest TC and 'TC sestamibi scintigraphy showed the presence of a 7 cm hyperfunctional ectopic parathyroid tissue in the postero-superior mediastinum infiltrating oesophagus. Video bronchoscopy revealed an extrinsic compression of the trachea. The patient underwent surgery. Through right postero-lateral thoracotomy and mediastinal pleura incision, the adenoma excision was carried out. The histological examination revealed a potentially malignant parathyroid adenoma with infiltration, without over-reaching the capsule. The surgical treatment resulted in an immediate resolution of the clinical symptomatology. One year later, the follow up was shown no observable relapse with normal calcium and PTH values. Today, the tendency to minimally invasive surgery, an accurate preoperative localization of the adenoma and the use of techniques such as intra-surgical nuclear mapping through manual gamma probes, selective angiography, venous intraoperative dosage of PTH and intra-surgical ultrasound scan. PMID:19537125

  5. Pituitary Adenoma Volumetry with 3D Slicer

    PubMed Central

    Nimsky, Christopher; Kikinis, Ron

    2012-01-01

    In this study, we present pituitary adenoma volumetry using the free and open source medical image computing platform for biomedical research: (3D) Slicer. Volumetric changes in cerebral pathologies like pituitary adenomas are a critical factor in treatment decisions by physicians and in general the volume is acquired manually. Therefore, manual slice-by-slice segmentations in magnetic resonance imaging (MRI) data, which have been obtained at regular intervals, are performed. In contrast to this manual time consuming slice-by-slice segmentation process Slicer is an alternative which can be significantly faster and less user intensive. In this contribution, we compare pure manual segmentations of ten pituitary adenomas with semi-automatic segmentations under Slicer. Thus, physicians drew the boundaries completely manually on a slice-by-slice basis and performed a Slicer-enhanced segmentation using the competitive region-growing based module of Slicer named GrowCut. Results showed that the time and user effort required for GrowCut-based segmentations were on average about thirty percent less than the pure manual segmentations. Furthermore, we calculated the Dice Similarity Coefficient (DSC) between the manual and the Slicer-based segmentations to proof that the two are comparable yielding an average DSC of 81.97±3.39%. PMID:23240062

  6. Oncocytic changes in pleomorphic adenoma: Report of a rare case

    PubMed Central

    Kaur, Milanjeet; Bhogal, Jasmine

    2015-01-01

    Pleomorphic adenoma is the most common benign salivary gland tumor, accounting for almost three-fourths of all such tumors. Cells with oncocytic change are a common finding in salivary glands and in salivary gland tumors. When found within pleomorphic adenomas, cells with oncocytic changes may be perceived as evidence of malignancy, and lead to a misdiagnosis of carcinoma ex-pleomorphic adenoma. A case of pleomorphic adenoma arising de novo in the minor salivary glands with oncocytic changes is discussed here. PMID:26392734

  7. Paneth Cell in Adenomas of the Distal Colorectum Is Inversely Associated with Synchronous Advanced Adenoma and Carcinoma

    PubMed Central

    Mahon, Megan; Xu, Jie; Yi, Xianghua; Liu, Xiuli; Gao, Nan; Zhang, Lanjing

    2016-01-01

    Recent studies have linked appearance of Paneth cells in colorectal adenomas to adenoma burden and male gender. However, the clinical importance of Paneth cells’ associations with synchronous advanced adenoma (AA) and colorectal carcinoma (CRC) is currently unclear. We performed a comprehensive case-control study using 1,900 colorectal adenomas including 785 from females, and 1,115 from males. We prospectively reviewed and recorded Paneth cell status in the colorectal adenomas consecutively collected between February 2014 and June 2015. Multivariable logistic regression analyses revealed that, in contrast to the adenomas without Paneth cells, the Paneth cell-containing adenomas at distal colorectum were inversely associated with presence of a synchronous AA or CRC (odds ratio [OR] 0.39, P = 0.046), whereas no statistical significance was reached for Paneth cell-containing proximal colorectal adenomas (P = 0.33). Synchronous AA and CRC were significantly associated with older age (60 + versus <60 years, OR 1.60, P = 0.002), male gender (OR 1.42, P = 0.021), and a history of AA or CRC (OR 2.31, P < 0.001). However, synchronous CRC was not associated with Paneth cell status, or a history of AA or CRC. Paneth cell presence in the adenomas of distal colorectum may be a negative indicator for synchronous AA and CRC, and seems to warrant further studies. PMID:27188450

  8. Paneth Cell in Adenomas of the Distal Colorectum Is Inversely Associated with Synchronous Advanced Adenoma and Carcinoma.

    PubMed

    Mahon, Megan; Xu, Jie; Yi, Xianghua; Liu, Xiuli; Gao, Nan; Zhang, Lanjing

    2016-01-01

    Recent studies have linked appearance of Paneth cells in colorectal adenomas to adenoma burden and male gender. However, the clinical importance of Paneth cells' associations with synchronous advanced adenoma (AA) and colorectal carcinoma (CRC) is currently unclear. We performed a comprehensive case-control study using 1,900 colorectal adenomas including 785 from females, and 1,115 from males. We prospectively reviewed and recorded Paneth cell status in the colorectal adenomas consecutively collected between February 2014 and June 2015. Multivariable logistic regression analyses revealed that, in contrast to the adenomas without Paneth cells, the Paneth cell-containing adenomas at distal colorectum were inversely associated with presence of a synchronous AA or CRC (odds ratio [OR] 0.39, P = 0.046), whereas no statistical significance was reached for Paneth cell-containing proximal colorectal adenomas (P = 0.33). Synchronous AA and CRC were significantly associated with older age (60 + versus <60 years, OR 1.60, P = 0.002), male gender (OR 1.42, P = 0.021), and a history of AA or CRC (OR 2.31, P < 0.001). However, synchronous CRC was not associated with Paneth cell status, or a history of AA or CRC. Paneth cell presence in the adenomas of distal colorectum may be a negative indicator for synchronous AA and CRC, and seems to warrant further studies. PMID:27188450

  9. Intraductal papillary mucinous neoplasm of the bile duct with gastric and duodenal fistulas

    PubMed Central

    Hong, Man Yong; Yu, Dong Wook; Hong, Seung Goun

    2014-01-01

    Intraductal papillary mucinous neoplasm (IPMN) of the bile duct is still rare and not yet understood despite of its increased incidence and similar clinicopathologic characteristics compared with IPMN of the pancreas. The fistula formation into other organs can occur in IPMN, especially the pancreatic type. To our knowledge, only two cases of IPMN of the bile duct with a choledochoduodenal fistula were reported and we have recently experienced a case of IPMN of the bile duct penetrating into two neighboring organs of the stomach and duodenum presenting with abdominal pain and jaundice. Endoscopy showed thick mucin extruding from two openings of the fistulas. Endoscopic suction of thick mucin using direct peroral cholangioscopy with ultra-slim endoscope through choledochoduodenal fistula was very difficult and ineffective because of very thick mucin and next endoscopic suction through the stent after prior insertion of biliary metal stent into choledochogastric fistula also failed. Pathologic specimen obtained from the proximal portion of the choledochogastric fistula near left intrahepatic bile duct through the metal stent showed a low grade adenoma. The patient declined the surgical treatment due to her old age and her abdominal pain with jaundice was improved after percutaneous transhepatic biliary drainage with the irrigation of N-acetylcysteine three times daily for 10 d. PMID:25031793

  10. Laparoscopic common bile duct exploration.

    PubMed

    Vecchio, Rosario; MacFadyen, Bruce V

    2002-04-01

    In recent years, laparoscopic common bile duct exploration has become the procedure of choice in the management of choledocholithiasis in several laparoscopic centers. The increasing interest for this laparoscopic approach is due to the development of instrumentation and technique, allowing the procedure to be performed safely, and it is also the result of the revised role of endoscopic retrograde cholangiopancreatography, which has been questioned because of its cost, risk of complications and effectiveness. Many surgeons, however, are still not familiar with this technique. In this article we discuss the technique and results of laparoscopic common bile duct exploration. Both the laparoscopic transcystic approach and choledochotomy are discussed, together with the results given in the literature. When one considers the costs, morbidity, mortality and the time required before the patient can return to work, it would appear that laparoscopic cholecystectomy with common bile duct exploration is more favorable than open surgery or laparoscopic cholecystectomy with preoperative or postoperative endoscopic sphincterotomy. However, the technique requires advanced laparoscopic skills, including suturing, knot tying, the use of a choledochoscope, guidewire, dilators and balloon stone extractor. Although laparoscopic common bile duct exploration appears to be the most cost-effective method to treat common bile duct stones, it should be emphasized that this procedure is very challenging, and it should be performed by well-trained laparoscopic surgeons with experience in biliary surgery. PMID:11981684

  11. Contemporary issues in the evaluation and management of pituitary adenomas.

    PubMed

    Pekic, S; Stojanovic, M; Popovic, V

    2015-12-01

    Pituitary adenomas are common benign monoclonal neoplasms accounting for about 15% of intracranial neoplasms. Data from postmortem studies and imaging studies suggest that 1 of 5 individuals in the general population may have pituitary adenoma. Some pituitary adenomas (mainly microadenomas which have a diameter of less than 1 cm) are exceedingly common and are incidentally diagnosed on magnetic resonance imaging (MRI) performed for an unrelated reason (headache, vertigo, head trauma). Most microadenomas remain clinically occult and stable in size, without an increase in tumor cells and without local mass effects. However, some pituitary adenomas grow slowly, enlarge by expansion and become demarcated from normal pituitary (macroadenomas have a diameter greater than 1 cm). They may be clinically silent or secrete anterior pituitary hormones in excess such as prolactin, growth hormone (GH), or adrenocorticotropic hormone (ACTH) causing diseases like prolactinoma, acromegaly, Cushing's disease or rarely thyroid-stimulating hormone (TSH) or gonadotropins (LH, FSH). The incidence of the various subtypes of pituitary adenoma varies but the most common is prolactinoma. Clinically non-functioning pituitary adenomas (NFPAs), which do not secrete hormones often cause local mass symptoms and represent one-third of pituitary adenomas. Given the high prevalence of pituitary adenomas and their heterogeneity (different tumor subtypes), it is critical that clinicians have a thorough understanding of the potential abnormalities in pituitary function and prognostic factors for behavior of pituitary adenomas in order to timely implement specific treatment modalities. Regarding pathogenesis of these tumors genetics, epigenetics and signaling pathways are the focus of current research yet our understanding of pituitary tumorigenesis remains incomplete. Although several genes and signaling pathways have been identified as important factors in the development of pituitary tumors, current

  12. Risk factors associated with missed colorectal flat adenoma: A multicenter retrospective tandem colonoscopy study

    PubMed Central

    Xiang, Li; Zhan, Qiang; Zhao, Xin-Hua; Wang, Ya-Dong; An, Sheng-Li; Xu, Yang-Zhi; Li, Ai-Min; Gong, Wei; Bai, Yang; Zhi, Fa-Chao; Liu, Si-De

    2014-01-01

    AIM: To determine the miss rate for colorectal flat adenomas during colonoscopy and the risk factors. METHODS: Flat adenomas are frequently missed during colonoscopy. However, the risk factors that influence their miss rates are unclear. This was a multicenter, retrospective study in which patients diagnosed with colorectal adenomas at a diagnostic colonoscopy and followed within 3 mo by a second therapeutic colonoscopy were pooled out from the established database. The “per-patient” and “per-adenoma” adenoma miss rates (AMR) for overall adenomas and flat adenomas, and patient-, adenoma-, and procedure-related risk factors potentially associated with the “per-adenoma” AMR for flat adenomas were determined. RESULTS: Chromoscopy and high-definition colonoscopy were not taken under consideration in the study. Among 2093 patients with colorectal adenomas, 691 (33.0%) were diagnosed with flat adenomas, 514 with concomitant protruding adenomas and 177 without. The “per-patient” AMR for flat adenomas was 43.3% (299/691); the rates were 54.3% and 11.3%, respectively, for those with protruding adenomas and those without (OR = 9.320, 95%CI: 5.672-15.314, χ2 = 99.084, P < 0.001). The “per-adenoma” AMR for flat adenomas was 44.3% (406/916). In multivariate analysis, older age, presence of concomitant protruding adenomas, poor bowel preparation, smaller adenoma size, location at the right colon, insufficient experience of the colonoscopist, and withdrawal time < 6 min were associated with an increased “per-adenoma” AMR for flat adenomas. The AMR for flat adenomas was moderately correlated with that for overall adenomas (r = 0.516, P < 0.0001). The AMR for flat adenomas during colonoscopy was high. CONCLUSION: Patient’s age, concomitant protruding adenomas, bowel preparation, size and location of adenomas, proficiency of the colonoscopist, and withdrawal time are factors affecting the “per-adenoma” AMR for flat adenomas. PMID:25152596

  13. Evaporation duct communication: Test Plan

    NASA Astrophysics Data System (ADS)

    Anderson, K. D.

    1991-02-01

    The Evaporation Duct Communication (EDCOM) project is an effort to provide an alternative ship-to-ship communications channel using the natural environment. A microwave communication link can be used on an over-the-water, over-the-horizon path through the evaporation duct. This report shows how a microwave communication link, operating at a range separation of more than twice the line-of-sight range, can be constructed. This link can achieve about 80-percent availability at a transmission frequency of 14.5 GHz and can be constructed using off-the-shelf RF equipment. Operation of this link will provide the first set of measurements of channel capacity that can be critically dependent on the existence of an oceanic evaporation duct. Construction of this link presents a unique opportunity to study and evaluate an alternative communications channel that can be used to alleviate naval battlegroup communications load.

  14. [Acute complications after endoscopic resection of duodenal adenomas].

    PubMed

    König, J; Kaiser, A; Opfermann, P; Manner, H; Pohl, J; Ell, C; May, A D

    2014-02-01

    With the increasing technological development of endoscopy in recent years the diagnosis of and endoscopic therapy for duodenal adenomas has gained in importance. Due to its potentially malignant transformation an effective and safe therapy is necessary. The endoscopic resection has been shown to be safe and effective, even in cases of resection of large duodenal adenomas. Several studies have supported this thesis but are based on relatively small numbers of patients. In our clinic we have performed endoscopic resections of 178 duodenal adenomas over a period of 14 years, including sporadic duodenal adenomas as well as adenomas in familial polyposis syndromes. The aim of this retrospective analysis was to determine the acute complications associated with this technique. The rate of severe complications such as major bleeding or perforations was 9%. Further complications were minor bleeding (15.7%), pain needing treatment with analgesia (6.7%), fever (2.8%) and pancreatitis (0.6%). Summing up our experience with the endoscopic resection of adenomas of the small bowel we also consider the endoscopic resection of duodenal adenomas in most cases as a safe and effective alternative to surgical therapy. Because of the potential complications and their management especially in the resection of large adenomas with a size more than 2 cm, the endoscopic resection should be performed on an inpatient basis in experienced centres. PMID:24526403

  15. Combined transcervical and thoracoscopic mediastinal parathyroid adenoma resection.

    PubMed

    Siddiqi, Mohammad Salman; Al Badai, Yahya; Al Kemyani, Nasser A; Al Kindi, Adil H

    2016-07-01

    The routine approach for excision of a parathyroid adenoma is transcervical, but this approach is inadequate when the gland is located in the mediastinum. Traditionally, these cases have required a sternotomy or thoracotomy. We used a combined transcervical and video-assisted thoracoscopic surgery approach to resect a parathyroid adenoma that extended to the middle mediastinum. PMID:27206778

  16. Parathyroid adenoma imaged by gallium-67 citrate. A case report

    SciTech Connect

    Katagiri, M.; Harada, T.; Kawano, R.; Okamura, Y.; Miyake, K.; Otsuka, N.; Fukunaga, M.; Morita, R.

    1987-10-01

    A parathyroid adenoma imaged by Ga-67 citrate in a 17-year-old man with primary hyperparathyroidism and a palpable solid tumor in the neck is presented. Although preoperative examination and intraoperative findings suggested a parathyroid carcinoma, histologic studies showed a parathyroid adenoma with predominant chief cell type.

  17. Hyperthyroidism associated with a thyroid adenoma in a dog.

    PubMed

    Lawrence, D; Thompson, J; Layton, A W; Calderwood-Mays, M; Ellison, G; Mannella, C

    1991-07-01

    Hyperthyroidism associated with thyroid adenoma was diagnosed in a dog. Typical clinical signs of hyperthyroidism were resolved with surgical excision of the adenoma. Hyperthyroidism in dogs usually is associated with thyroid carcinoma, which has a poor prognosis. This case emphasizes the importance of obtaining a histologic diagnosis of thyroid tumors in hyperthyroid dogs before giving a prognosis. PMID:1885334

  18. Congenital Atresia of Wharton's Duct.

    PubMed

    Hseu, Anne; Anne, Premchand; Anne, Samantha

    2016-02-01

    This is a case report of a three-month-old male who presented to clinic with a cystic lesion under the tongue. On clinical examination, a cystic lesion was observed in the, floor-of-mouth. The patient was referred to Paediatric Otorhinolaryngology service for further management. The differential diagnoses for floor-of-mouth lesions should be reviewed with primary focus on the Wharton's duct atresia and its management. It is crucial to recognize submandibular duct atresia in the primary Paediatric clinic in order to expedite management of lesion before complications arise including infection, enlargement of cyst, and feeding and breathing difficulties. PMID:27042492

  19. Multiple Pituitary Adenomas: A Systematic Review

    PubMed Central

    Budan, Renata M.; Georgescu, Carmen E.

    2016-01-01

    PubMed, Scopus, and Web of Science Core Collection databases were systematically searched for studies reporting synchronous double or multiple pituitary adenomas (MPA), a rare clinical condition, with a vague pathogenesis. Multiple adenomas of the pituitary gland are referred to as morphologically and/or immunocytochemically distinct tumors that are frequently small-sized and hormonally non-functional, to account for the low detection rate. There is no general agreement on how to classify MPA, various criteria, such as tumor contiguity, immunoreactivity, and clonality analysis are being used. Among the component tumors, prolactin (PRL)-immunopositive adenomas are highly prevalent, albeit mute in the majority of cases. The most frequent clinical presentation of MPA is Cushing’s syndrome, given the fact that in more than 50% of reported cases at least one lesion stains for adrenocorticotrophic hormone (ACTH). Plurihormonal hyperactivity may be diagnosed in a patient with MPA when more than one tumor is clinically active (e.g., ACTH and PRL) or in cases with at least one composite tumor (e.g., GH and PRL), to complicate the clinical scenario. Specific challenges associated with MPA include high surgical failure rates, enforcing second-look surgery in certain cases, and difficult preoperative neuroradiological imaging evaluation, with an overall sensitivity of only 25% for magnetic resonance imaging to detect distinct multiple tumors. Alternatively, minor pituitary imaging abnormalities may raise suspicion, as these are not uncommon. Postoperative immunohistochemistry is mandatory and in conjunction to electron microscopy scanning and testing for transcription factors (i.e., Pit-1, T-pit, and SF-1) accurately define and classify the distinct cytodifferentiation of MPA. PMID:26869991

  20. Immunostains Used to Subtype Hepatic Adenomas Do Not Distinguish Hepatic Adenomas From Hepatocellular Carcinomas.

    PubMed

    Liu, Liping; Shah, Sejal S; Naini, Bita V; French, Samuel; Wu, Tsung-Teh; Torbenson, Michael S; Chandan, Vishal S

    2016-08-01

    Immunostains are used to subtype hepatic adenomas to stratify for the risk of malignant transformation. The most common panel of immunostains used for this purpose includes liver fatty acid-binding protein (LFABP), serum amyloid A (SAA) protein, C-reactive protein (CRP), and glutamine synthetase (GS). Importantly, some pathologists use these stains in an attempt to distinguish hepatocellular carcinomas (HCC) from hepatic adenomas. However, there are limited data on the performance of these stains in HCCs. To investigate the staining characteristics of HCCs, we studied 159 HCCs (92 well-differentiated, 67 moderately differentiated, and 7 poorly differentiated) and 7 fibrolamellar carcinomas for the expression of LFABP, SAA, CRP, and GS. All of the stains were positive in at least a subset of HCCs: SAA was positive in 27 of 159 (17%), CRP in 86 of 159 (54%), and GS in 23 of 47 (49%) cases; LFABP showed loss of staining in 36 of 159 (23%) cases. Fibrolamellar carcinomas were consistently CRP positive (7 of 7 cases) and frequently showed loss of LFABP (4 of 7 cases). There was no association between expression of SAA, CRP, and GS as well as loss of LFABP expression and other clinicopathologic features. HCCs with loss of LFABP were more frequently associated with negative GS expression (11 of 14 cases, P=0.02). These data show that immunostains used to subtype hepatic adenomas are not useful for distinguishing HCCs from hepatic adenomas and should be used only after a diagnosis of hepatic adenoma has been made using other criteria. PMID:26927891

  1. Research Advances in Pituitary Adenoma and DNA Methylation.

    PubMed

    Wei, Zhen-Qing; Li, Yang; Li, Wei-Hua; Lou, Jia-Cheng; Zhang, Bo

    2016-08-01

    DNA methylation is closely related to the genesis and development of pituitary adenoma. Studies have shown that high methylation in the promoter region of potassium voltage-gated chanel,shaker related subfamily,beta member 2,O-6-methylguanine-DNA methyltransferase,echinoderm microtubule associated protein like 2 ,ras homolog family member D ,homeobox B1 ,NNAT, and P16 inhibits the expression of these genes and regulates of the proliferation of pituitary adenoma. DNA methylation is also closely related to invasive pituitary adenoma. Therefore,further study on molecular mechanism of DNA methylation of pituitary adenoma will offer a new strategy for the diagnosis and treatment of pituitary adenoma. PMID:27594164

  2. Spontaneous cervical haemorrhage of a parathyroid adenoma

    PubMed Central

    Knee, Graham; Todd, Colin

    2015-01-01

    Summary Haemorrhage of a parathyroid adenoma is a rare clinical presentation. This report describes a previously fit and well 54-year-old woman who presented with acute neck swelling and pain with an overlying ecchymosis. Admission laboratory tests revealed a raised parathyroid hormone and hypercalcaemia. A computed tomography (CT) scan showed widespread anterior cervical haemorrhage and a lesion at the inferior pole of the left thyroid gland. A working diagnosis of spontaneous haemorrhage from a parathyroid adenoma was made. As she was haemodynamically stable, she was treated conservatively with a period of observation in hospital to monitor for signs of neck organ compression. Follow-up imaging with CT, ultrasound and sestamibi confirmed the likely source of haemorrhage as a parathyroid nodule with significant vascularity. The diagnosis was confirmed on histopathological analysis after elective surgical exploration of the neck 6 months after her presentation. This revealed a benign parathyroid adenoma with evidence of acute and chronic bleeding. The patient made a full recovery with immediate normalisation of her biochemistry post-operatively. Despite developing a hoarse voice in the immediate post-operative period, this resolved completely within 1 month. This case report provides further evidence to support a minimal delay for elective surgery after conservative management to reduce the risks associated with recurrent bleeding. Learning points Haemorrhage of a parathyroid adenoma should be a differential for all cases of acute cervical swelling or ecchymosis with no precipitating factor.The clerking should identify any risk factors for endocrine disease.Blood tests to screen for abnormal parathyroid biochemistry should be performed on admission.Detailed imaging of the neck is essential to identify the source of haemorrhage and risk of compression to vital neck organs.Conservative management is a suitable option for patients who remain haemodynamically stable

  3. Radiosurgery for infundibulum adenoma: stalk dose implications.

    PubMed

    Sokolowski, Jennifer D; Cohen-Inbar, Or; Sheehan, Jason P

    2016-09-01

    Treating pituitary adenomas in the infundibulum with stereotactic radiosurgery (SRS), achieving tumor volume control while preserving pituitary endocrine function and visual function, is challenging. We present a case of a recurrent remnant infundibular lesion treated with Gamma Knife surgery (GKS). The mass was treated with microsurgical resection twice, and the residual stalk lesion was treated with single-session SRS employing a margin dose of 15 Gy to the infundibulum. Five years after GKS, tumor regression persists without visual dysfunction or hypopituitarism. Radiosurgical doses of 30 Gy to the pituitary stalk may be tolerated by patients while maintaining endocrine function. PMID:27435739

  4. General Information about Extrahepatic Bile Duct Cancer

    MedlinePlus

    ... Bile Duct Cancer Treatment (PDQ®)–Patient Version General Information About Bile Duct Cancer Go to Health Professional ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  5. What Are the Key Statistics about Bile Duct Cancer?

    MedlinePlus

    ... for bile duct cancer? What are the key statistics about bile duct cancer? Bile duct cancer is ... it is when it is found. For survival statistics, see the section “ Survival statistics for bile duct ...

  6. Effect of Hypoxia on DDR1 Expression in Pituitary Adenomas

    PubMed Central

    Li, Shouchun; Zhang, Zhiwen; Xue, Jinghui; Guo, Xiaoming; Liang, Shuli; Liu, Aijun

    2015-01-01

    Background Pituitary adenoma is a common intracranial tumor in neurosurgery. Some pituitary adenomas have the characteristics of invasive growth make them unable to be removed completely by surgery leading to easy relapse. Discoidin domain receptor l (DDR1) is a new kind of tyrosine kinase receptor on the cell surface. DDR1 can be activated by tumor microenvironment signal in tumorigenesis, increasing MMP-2/9 expression and promoting the invasive ability of tumor cells. Anoxia can promote tumor growth and metastasis. This study investigated the impact of anoxic environment DDR1 expression in pituitary adenoma. Material/Methods A primary hypoxia pituitary adenoma cell model was established and treated with DDR1 inhibitor nilotinib. Real-time PCR and Western blot were used to detect DDR1 mRNA and protein expression. ELISA was used to detect MMP-2/9 changes. MTT method was used to detect pituitary adenoma cell proliferation. We used a transwell chamber to determine pituitary adenoma cell invasion ability. Results DDR1 mRNA and protein were significantly overexpressed under hypoxia (P<0.05). MMP-2 and MMP-9 expression was obviously increased in supernatant (P<0.05). Pituitary adenoma cell proliferation and invasive ability improved markedly under hypoxia (P<0.05). Nilotinib could reduce DDR1 expression, decrease MMP-2 and MMP-9 expression, and inhibit pituitary adenoma cells proliferation and invasion. Conclusions Hypoxia can increase DDR1 expression in pituitary adenoma cells, leading to improved MMP-2 and MMP-9 secretion, and promoting pituitary adenoma cell proliferation and invasion. PMID:26286316

  7. Wind Turbine With Concentric Ducts

    NASA Technical Reports Server (NTRS)

    Muhonen, A. J.

    1983-01-01

    Wind Turbine device is relatively compact and efficient. Converging inner and outer ducts increase pressure difference across blades of wind turbine. Turbine shaft drives alternator housed inside exit cone. Suitable for installation on such existing structures as water towers, barns, houses, and commercial buildings.

  8. Vitellointestinal Duct Anomalies in Infancy

    PubMed Central

    Kadian, Yogender Singh; Verma, Anjali; Rattan, Kamal Nain; Kajal, Pardeep

    2016-01-01

    Background: Vitellointestinal duct (VID) or omphalomesenteric duct anomalies are secondary to the persistence of the embryonic vitelline duct, which normally obliterates by weeks 5–9 of intrauterine life. Methods: This is a retrospective analysis of a total of 16 patients of symptomatic remnants of vitellointestinal duct from period of Jan 2009 to May 2013. Results: Male to female ratio (M:F) was 4.3:1 and mean age of presentation was 2 months and their mode of presentation was: patent VID in 9 (56.25%) patients, umbilical cyst in 2(12.25%), umbilical granuloma in 2 (12.25%), and Meckel diverticulum as content of hernia sac in obstructed umbilical hernia in 1 (6.25%) patient. Two patients with umbilical fistula had severe electrolyte disturbance and died without surgical intervention. Conclusion: Persistent VID may have varied presentations in infancy. High output umbilical fistula and excessive bowel prolapse demand urgent surgical intervention to avoid morbidity and mortality. PMID:27433448

  9. Design and performance of duct acoustic treatment

    NASA Technical Reports Server (NTRS)

    Motsinger, R. E.; Kraft, R. E.

    1991-01-01

    The procedure for designing acoustic treatment panels used to line the walls of aircraft engine ducts and for estimating the resulting suppression of turbofan engine duct noise is discussed. This procedure is intended to be used for estimating noise suppression of existing designs or for designing new acoustic treatment panels and duct configurations to achieve desired suppression levels.

  10. 46 CFR 116.610 - Ventilation ducts.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... requirements relative to the passage of smoke and flame as the fire control boundary penetrated; (2) A steel duct penetrating an A-Class fire control boundary must be of at least 11 USSG, and a steel duct... duct penetrating an A-Class fire control boundary and opening into a space formed by that boundary...

  11. 46 CFR 116.610 - Ventilation ducts.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... requirements relative to the passage of smoke and flame as the fire control boundary penetrated; (2) A steel duct penetrating an A-Class fire control boundary must be of at least 11 USSG, and a steel duct... duct penetrating an A-Class fire control boundary and opening into a space formed by that boundary...

  12. Cystic Change in Pleomorphic Adenoma: A Rare Finding and a Diagnostic Dilemma

    PubMed Central

    Khetrapal, Shaan; Jetley, Sujata; Hassan, Mohd. Jaseem

    2015-01-01

    Pleomorphic adenoma forms the majority of salivary gland neoplasms. Cystic change in pleomorphic adenomas is a diagnostic dilemma and can mimic mucoepidermoid carcinoma, mucocele or carcinoma ex pleomorphic adenoma and squamous cell carcinoma. Hereby we report this interesting and rare case of cystic pleomorphic adenoma in a 32-year-old male. PMID:26675071

  13. Cystic Change in Pleomorphic Adenoma: A Rare Finding and a Diagnostic Dilemma.

    PubMed

    Khetrapal, Shaan; Jetley, Sujata; Hassan, Mohd Jaseem; Jairajpuri, Zeeba

    2015-11-01

    Pleomorphic adenoma forms the majority of salivary gland neoplasms. Cystic change in pleomorphic adenomas is a diagnostic dilemma and can mimic mucoepidermoid carcinoma, mucocele or carcinoma ex pleomorphic adenoma and squamous cell carcinoma. Hereby we report this interesting and rare case of cystic pleomorphic adenoma in a 32-year-old male. PMID:26675071

  14. Clinical Impact of the Current WHO Classification of Pituitary Adenomas.

    PubMed

    Saeger, W; Honegger, J; Theodoropoulou, M; Knappe, U J; Schöfl, C; Petersenn, S; Buslei, R

    2016-06-01

    WHO classifications should be used for comparing the results from different groups of pathologist and clinicians by standardized histopathological methods. Our present report describes the important parameters of pituitary adenoma pathology as demand of the WHO classification for correlation to endocrine data and prognosis. The combination of HE stain based structures with immunostainings for pituitary hormones allows subclassification of adenomas as the best method not only for correlations to clinical hyperfunctions but also for statements to the sensitivity of drug therapies (somatostatin analogs, dopamine agonists). GH-, PRL- and ACTH-secreting pituitary adenomas are further classified based on the size and number of their secretory granules by electron microscopy, or as is mostly the case nowadays by cytokeratin staining pattern, into densely and sparsely granulated. Granulation pattern may be considered for the prediction of treatment response in patients with GH-secreting adenomas, since the sparsely granulated subtype was shown to be less responsive to somatostatin analog treatment. For prognosis, it is important to identify aggressive adenomas by measurements of the Ki-67 index, of the number of mitoses, and of nuclear expression of p53. Among the criteria for atypical adenomas, high Ki-67 labeling index and invasive character are the most important adverse prognostic factors. Promising molecular markers have been identified that might supplement the currently used proliferation parameters. For defining atypical adenomas in a future histopathological classification system, we propose to provide the proliferative potential and the invasive character separately. PMID:26860936

  15. Plasma selenium levels and the risk of colorectal adenomas.

    PubMed

    Russo, M W; Murray, S C; Wurzelmann, J I; Woosley, J T; Sandler, R S

    1997-01-01

    Previous research has suggested that selenium may protect against the development of colorectal neoplasia. We examined the potential chemopreventive properties of selenium against colorectal adenomas while controlling for a number of dietary and life-style factors. We conducted a cross-sectional study among patients referred for colonoscopy to University of North Carolina Hospitals. Cases had one or more pathologically confirmed adenomas, and noncases had none. Plasma selenium levels were determined using graphite furnace atomic absorption spectrometry with Zeeman background correction and platform technique. Odds ratios were calculated using logistic regression analysis adjusting for potential confounders. The mean plasma selenium concentrations for cases (n = 37) and noncases (n = 36) were 107 and 120 micrograms/l, respectively (p = 0.06). Those in the fourth quartile of plasma selenium level had 0.24 times the risk (95% confidence interval = 0.06-1.04) for colorectal adenomas of those in the first quartile. The adjusted odds ratio for colorectal adenomas was 0.58 (95% confidence interval = 0.31-1.08) for a 30 microgram/l increase in plasma selenium level. Lower plasma selenium levels were associated with multiple adenomas but not with adenoma size or location. These data support a protective effect of selenium against colorectal adenomas after adjustment for possible confounders. Selenium might be a potentially useful chemopreventive agent for colorectal neoplasia. PMID:9290116

  16. Is height a risk factor for colorectal adenoma?

    PubMed Central

    Pyo, Jeung Hui; Hong, Sung Noh; Min, Byung-Hoon; Chang, Dong Kyung; Son, Hee Jung; Rhee, Poong-Lyul; Kim, Jae J.; Kim, Young-Ho

    2016-01-01

    Background/Aims: Although it is generally known that the risk for all types of cancer increases with adult height, combined and for several common site-specific cancers (including colon and rectal), evidence is limited for adenomas, which are precursors to colorectal cancer. We evaluated the association between height and risk of colorectal adenoma at various stages of the adenoma-carcinoma pathway. Methods: We conducted a retrospective study using data from patients who had undergone a complete colonoscopy as part of a health examination at the Health Promotion Center of Samsung Medical Center between October 13, 2009 and December 31, 2011. A total of 1,347 male subjects were included in our study. Multivariate logistic regression analysis was used to evaluate the association between height and colorectal adenoma. Results: Each 5-cm increase in height was associated with 1.6% and 5.3% higher risks of advanced colorectal adenoma and high-risk colorectal adenoma, respectively, but associations were not significant after adjusting for age, body mass index, metabolic syndrome, alcohol intake, smoking, family history of colorectal cancer, and regular aspirin use (p = 0.840 and p = 0.472, respectively). Conclusions: No clear association was found between colorectal adenoma risk and height. Unlike other site-specific tumors reported to have a consistent relationship with height, the association between colorectal tumor and height remains controversial. PMID:26701232

  17. Isolated double pituitary adenomas: A silent corticotroph adenoma and a microprolactinoma.

    PubMed

    Eytan, Shira; Kim, Ki-Yoon; Bleich, David; Raghuwanshi, Maya; Eloy, Jean Anderson; Liu, James K

    2015-10-01

    We report a 27-year-old woman with amenorrhea and galactorrhea with mildly elevated serum prolactin levels. Her MRI demonstrated a cystic macroadenoma in the left aspect of the sella and a small microadenoma in the right aspect of the sella. Endoscopic transsphenoidal resection of the tumors revealed two histologically distinct tumors. The left tumor was consistent with a silent corticotroph macroadenoma and the right tumor was a prolactin producing microadenoma. Isolated double pituitary adenomas that are clearly separated by normal pituitary gland tissue are extremely rare. The incidence is approximately 0.37-2.6%. The coexistence of double adenomas can pose diagnostic and management challenges for the pituitary neuroendocrine team. PMID:26067545

  18. Designing insulation for cryogenic ducts

    NASA Astrophysics Data System (ADS)

    Love, C. C.

    1984-03-01

    It is pointed out that the great temperature difference between the outside of a cryogenic duct and the liquified gas it carries can cause a high heat input unless blocked by a high thermal resistance. High thermal resistance for lines needing maximum insulation is provided by metal vacuum jackets. Low-density foam is satisfactory in cases in which higher heat input can be tolerated. Attention is given to the heat transfer through a duct vacuum jacket, the calculation of heat input and the exterior surface's steady-state temperature for various thicknesses of insulation, the calculation of the heat transfer through gimbal jackets, and design specifications regarding the allowable pressure rise in the jacket's annular space.

  19. Tear-ducts in wine

    NASA Astrophysics Data System (ADS)

    Bush, John W. M.

    1999-11-01

    We examine the radial spoke pattern evident in the meniscus region in glasses of strong alcoholic beverages exhibiting the `tears-in-wine' phenomenon. We demonstrate that the pattern results from ridge-like elevations of the free surface which are supported by evaporatively-driven Marangoni convection in the meniscus region. Vortices associated with the convective motions are aligned in the radial direction by the surface tension gradient responsible for the generation of tears. The radial flow is focussed into the ridges, which thus serve as the principal conduits of fluid for the tears; consequently, we refer to the ridges as `tear-ducts'. The phenomenon is examined experimentally, and a numerical model of evaporatively-driven Marangoni convection is developed which reproduces the salient features of the tear-duct phenomenon.

  20. HAARP-Induced Ionospheric Ducts

    SciTech Connect

    Milikh, Gennady; Vartanyan, Aram

    2011-01-04

    It is well known that strong electron heating by a powerful HF-facility can lead to the formation of electron and ion density perturbations that stretch along the magnetic field line. Those density perturbations can serve as ducts for ELF waves, both of natural and artificial origin. This paper presents observations of the plasma density perturbations caused by the HF-heating of the ionosphere by the HAARP facility. The low orbit satellite DEMETER was used as a diagnostic tool to measure the electron and ion temperature and density along the satellite orbit overflying close to the magnetic zenith of the HF-heater. Those observations will be then checked against the theoretical model of duct formation due to HF-heating of the ionosphere. The model is based on the modified SAMI2 code, and is validated by comparison with well documented experiments.

  1. Advanced colorectal adenoma related gene expression signature may predict prognostic for colorectal cancer patients with adenoma-carcinoma sequence

    PubMed Central

    Li, Bing; Shi, Xiao-Yu; Liao, Dai-Xiang; Cao, Bang-Rong; Luo, Cheng-Hua; Cheng, Shu-Jun

    2015-01-01

    Background: There are still no absolute parameters predicting progression of adenoma into cancer. The present study aimed to characterize functional differences on the multistep carcinogenetic process from the adenoma-carcinoma sequence. Methods: All samples were collected and mRNA expression profiling was performed by using Agilent Microarray high-throughput gene-chip technology. Then, the characteristics of mRNA expression profiles of adenoma-carcinoma sequence were described with bioinformatics software, and we analyzed the relationship between gene expression profiles of adenoma-adenocarcinoma sequence and clinical prognosis of colorectal cancer. Results: The mRNA expressions of adenoma-carcinoma sequence were significantly different between high-grade intraepithelial neoplasia group and adenocarcinoma group. The biological process of gene ontology function enrichment analysis on differentially expressed genes between high-grade intraepithelial neoplasia group and adenocarcinoma group showed that genes enriched in the extracellular structure organization, skeletal system development, biological adhesion and itself regulated growth regulation, with the P value after FDR correction of less than 0.05. In addition, IPR-related protein mainly focused on the insulin-like growth factor binding proteins. Conclusion: The variable trends of gene expression profiles for adenoma-carcinoma sequence were mainly concentrated in high-grade intraepithelial neoplasia and adenocarcinoma. The differentially expressed genes are significantly correlated between high-grade intraepithelial neoplasia group and adenocarcinoma group. Bioinformatics analysis is an effective way to study the gene expression profiles in the adenoma-carcinoma sequence, and may provide an effective tool to involve colorectal cancer research strategy into colorectal adenoma or advanced adenoma. PMID:26131062

  2. Middle Ear Adenoma: Case Report and Discussion

    PubMed Central

    Vrugt, B.; Huber, A. M.

    2014-01-01

    Introduction. Despite modern radiological workup, surgeons can still be surprised by intraoperative findings or by the pathologist's report. Materials & Methods. We describe the case of a 52-year-old male who was referred to our clinic with a single sided conductive hearing loss. He ultimately underwent middle ear exploration and excision of a middle ear tumour followed by second look and ossiculoplasty a year later. Results. Though preoperative CT and MRI scanning were suggestive of a congenital cholesteatoma, the pathologist's report diagnosed a middle ear adenoma. Discussion. Middle ear glandular tumors are extremely rare and, despite numerous histological techniques, continue to defy satisfactory classification. Most surgeons advocate surgical excision though evidence of the tumour's natural course and risk of recurrence is lacking. PMID:25045567

  3. Small duct primary sclerosing cholangitis without inflammatory bowel disease is genetically different from large duct disease

    PubMed Central

    Næss, Sigrid; Björnsson, Einar; Anmarkrud, Jarl A.; Al Mamari, Said; Juran, Brian D.; Lazaridis, Konstantinos N.; Chapman, Roger; Bergquist, Annika; Melum, Espen; Marsh, Steven G. E.; Schrumpf, Erik; Lie, Benedicte A.; Boberg, Kirsten Muri; Karlsen, Tom H.; Hov, Johannes R.

    2014-01-01

    Background & aims Small duct primary sclerosing cholangitis (PSC) is phenotypically a mild version of large duct PSC, but it is unknown whether these phenotypes share aetiology. We aimed to characterize their relationship by investigating genetic associations in the HLA complex, which represent the strongest genetic risk factors in large duct PSC. Methods Four classical HLA loci (HLA-A, HLA-B, HLA-C, HLA-DRB1) were genotyped in 87 small duct PSC patients, 485 large duct PSC patients and 1117 controls across three geographical regions. Results HLA-DRB1*13:01 (OR=2.0, 95% CI 1.2–3.4, P=0.01) and HLA-B*08 (OR=1.6, 95% CI 1.1–2.4, P=0.02) were significantly associated with small duct PSC compared with healthy controls. Based on the observed frequency of HLA-B*08 in small duct PSC, the strongest risk factor in large duct PSC, an estimated 32% (95% CI 4%–65%) of this population can be hypothesized to represent early stages or mild variants of large duct PSC. This subgroup may be constituted by small duct PSC patients with inflammatory bowel disease (IBD), which greatly resembled large duct PSC in its HLA association. In contrast, small duct PSC without IBD was only associated with HLA-DRB1*13:01(P=0.03) and was otherwise distinctly dissimilar from large duct PSC. Conclusions Small duct PSC with IBD resembles large duct PSC in its HLA association and may represent early stages or mild variants of large duct disease. Different HLA associations in small duct PSC without IBD could indicate that this subgroup is a different entity. HLA-DRB1*13:01 may represent a specific risk factor for inflammatory bile duct disease. PMID:24517468

  4. [Salivary duct carcinoma--a clinicopathological analysis of five cases].

    PubMed

    Bień, Stanisław; Sygut, Jacek; Kopczyński, Janusz; Postuła, Sylwia; Ziółkowska, Magdalena

    2007-01-01

    The 5 cases of salivary duct carcinoma (SDC); very rare, but distinct group of highly malignant salivary gland tumor are presented, and difficulties with pathological and clinical diagnosis is discussed. The SDC developed in single cases in parotid salivary gland, submandibular salivary and in mucosa of maxillary sinus, pyriform fossa and oral cavity (check). In 3 cases the second malignant tumor was present--synchronously (SDC + pleomorphic adenoma in parotid gland; SDC + squamous cell carcinoma in hypopharynx) or metachroneously (squamous cell carcinoma of upper lip followed by SDC). In one case the high levels of PSA suggesting of metastases from unknown primary within the prostate gland, or PSA expression related to SDC was observed. The four patients received radical treatment - surgical resection followed by radiotherapy; in one case only palliative treatment was applied, due to patient's poor general condition and high advancement of the primary disease. The observation ranged from 10 to 77 months (average time--31 months). The one patient died 13 months after diagnosis and palliative treatment. The three patients are alive with distant metastases to the lung and bones (77, 38 and 18 months after primary treatment was completed). Only one patient with 10 months observation after treatment is living without symptoms of recurrence or metastases. PMID:17605416

  5. Modeling particle loss in ventilation ducts

    SciTech Connect

    Sippola, Mark R.; Nazaroff, William W.

    2003-04-01

    Empirical equations were developed and applied to predict losses of 0.01-100 {micro}m airborne particles making a single pass through 120 different ventilation duct runs typical of those found in mid-sized office buildings. For all duct runs, losses were negligible for submicron particles and nearly complete for particles larger than 50 {micro}m. The 50th percentile cut-point diameters were 15 {micro}m in supply runs and 25 {micro}m in return runs. Losses in supply duct runs were higher than in return duct runs, mostly because internal insulation was present in portions of supply duct runs, but absent from return duct runs. Single-pass equations for particle loss in duct runs were combined with models for predicting ventilation system filtration efficiency and particle deposition to indoor surfaces to evaluate the fates of particles of indoor and outdoor origin in an archetypal mechanically ventilated building. Results suggest that duct losses are a minor influence for determining indoor concentrations for most particle sizes. Losses in ducts were of a comparable magnitude to indoor surface losses for most particle sizes. For outdoor air drawn into an unfiltered ventilation system, most particles smaller than 1 {micro}m are exhausted from the building. Large particles deposit within the building, mostly in supply ducts or on indoor surfaces. When filters are present, most particles are either filtered or exhausted. The fates of particles generated indoors follow similar trends as outdoor particles drawn into the building.

  6. Parotid Tail Pleomorphic Adenoma Extending to the Parapharyngeal Space

    PubMed Central

    Polat, Kerem; Doğan, Mansur; Yüce, Salim; Uysal, İsmail Önder; Müderris, Suphi

    2012-01-01

    Parapharyngeal space tumors are rare, accounting for 0.5% of head and neck neoplasms. Most of them are benign and originate in the salivary glands, especially the pleomorphic adenoma. We presented a 47-year-old male with parotid tail pleomorphic adenoma extending to the parapharyngeal space. The patient applied to our clinic with the complaints of a painless mass on his neck and in his mouth for three months. After fine needle aspiration biopsy the mass was diagnosed as pleomorphic adenoma. The patient hospitalized and operated in our clinic. As we see in literature review parapharyngeal space tumors are rare and most of them are pleomorphic adenomas arising from deep lobe of the parotid gland and extend into the PPS. PMID:23524806

  7. [Unusual location of a parathyroid adenoma: the carotid sheath].

    PubMed

    Smayra, T; Abi Khalil, S; Abboud, B; Halabi, G; Slaba, S

    2006-01-01

    We report the imaging features of an occult parathyroid adenoma with unusual location in the carotid sheath. Our patient presented with primary hyperparathyroidism. Following negative neck ultrasound and scintigraphy, exploratory neck dissection with partial thyroidectomy was performed twice over a 2 day period without biological response. Cervical and mediastinal CT and MRI were performed with no result. Digital angiography showed a tumoral blush supplied by the left inferior thyroid artery and located in close contact with the carotid artery. Venous sampling of the neck confirmed the left location of the adenoma and a third surgical intervention found the adenoma embedded in the left carotid sheath. This is an unusual case of parathyroid adenoma that necessitated the use of several imaging techniques. PMID:16415782

  8. Growth hormone secreting pituitary adenoma with admixed gangliocytoma and ganglioglioma.

    PubMed

    Jukes, Alistair; Allan, Rodney; Rawson, Robert; Buckland, Michael E

    2016-09-01

    Pituitary adenomas are the most common tumours found in the sellar region and, when both functioning and non-functioning adenomas are combined, account for 7-15% of primary brain tumours in adults. Rarely, admixed or discrete groups of cells comprising two or more tumour subtypes are seen; the so-called 'collision tumour'. We present a case of a 54-year-old-woman with a growth hormone-secreting pituitary adenoma admixed with both ganglioglioma and gangliocytoma. The possible mechanisms by which this may occur include a pre-existing gangliocytoma promoting the development of pituitary adenoma by hypersecretion of releasing hormones or aberrant migration of hypothalamic neurons in early embryogenesis. PMID:27068013

  9. Molecular screening of pituitary adenomas for gene mutations and rearrangements

    SciTech Connect

    Herman, V.; Drazin, N.Z.; Gonskey, R.; Melmed, S. )

    1993-07-01

    Although pituitary tumors arise as benign monoclonal neoplasms, genetic alterations have not readily been identified in these adenomas. The authors studied restriction fragment abnormalities involving the GH gene locus, and mutations in the p53 and H-, K-, and N-ras genes in 22 human GH cell adenomas. Twenty two nonsecretory adenomas were also examined for p53 and ras gene mutations. Seven prolactinoma DNA samples were tested for deletions in the multiple endocrine neoplasia-1 (MEN-1) locus, as well as for rearrangements in the hst gene, a member of the fibroblast growth factor family. In DNA from GH-cell adenomas, identical GH restriction patterns were detected in both pituitary and lymphocyte DNA in all patients and in one patient with a mixed GH-TSH cell adenoma. Using polymerase chain reaction (PCR)-single stranded conformation polymorphism analysis, no mutations were detected in exons 5, 6, 7 and 8 of the p53 gene in GH cell adenomas nor in 22 nonsecretory adenomas. Codons 12/13 and 61 of H-ras, K-ras, and N-ras genes were also intact on GH cell adenomas and in nonsecretory adenomas. Site-specific probes for chromosome 11q13 including, PYGM, D11S146, and INT2 were used in 7 sporadic PRL-secreting adenomas to detect deletions of the MEN-1 locus on chromosome 11. One patient was identified with a loss of 11p, and the remaining 6 patients did not demonstrate loss of heterozygosity in the pituitary 11q13 locus, compared to lymphocyte DNA. None of these patients demonstrated hst gene rearrangements which also maps to this locus. These results show that p53 and ras gene mutations are not common events in the pathogenesis of acromegaly and nonsecretory tumors. Although hst gene rearrangements and deletions of 11q13 are not associated with sporadic PRl-cell adenoma formation, a single patient was detected with a partial loss of chromosome 11, including the putative MEN-1 site. 31 refs., 5 figs., 2 tabs.

  10. Pleomorphic adenoma of the frontal sinus masquerading as a mucocele.

    PubMed

    Chew, Yok Kuan; Brito-Mutunayagam, Sushil; Chong, Aun Wee; Prepageran, Narayanan; Chandran, Patricia Ann; Khairuzzana, Baharudin; Lingham, Omkara Rubini

    2015-12-01

    Pleomorphic adenoma is the most common type of benign salivary gland tumor. It can also be found in the larynx, ear, neck, and nasal septum. It is rarely found in the maxillary sinus, and it has never been reported in the frontal sinus. We report a case of pleomorphic adenoma of the frontal sinus that masqueraded as a mucocele. We discuss the clinical presentation, diagnosis, and treatment of this patient, and we review the literature. PMID:26670764

  11. 026. Papillary adenoma of the lung: a case report

    PubMed Central

    Baliaka, Aggeliki; Tryfon, Stavros; Papaemmanouil, Styliani; Cheva, Angeliki; Papastergiou, Christos; Sakkas, Leonidas

    2015-01-01

    Background Papillary adenoma of the lung is a rare neoplasm with only 24 cases reported in the current literature. It occurs in individuals range in age, from 7-60 years with a male predominance and is usually detected incidentally on chest radiographs. Objective The report of a rare case of pulmonary papillary adenoma. Methods A 70-year-old male presented to our Hospital with cough and expectoration. The chest radiological examination demonstrated a nodular shadow two cm in size at the upper lobe of the left lung. Bronchoscopic lung biopsy was performed and the tissue sample was sent for histological examination. Results Pathology examination revealed a lesion consisting of a papillary growth pattern of cuboidal to columnar, ciliated epithelial cells lining the surface of fibrovascular cores. Occasional eosinophilic intranuclear inclusions were noted, but nuclear atypia or mitosis were almost absent. The histological features were consistent with pulmonary papillary adenoma. Conclusions Papillary adenoma of the lung is a benign, circumscribed papillary neoplasm (WHO 2004). Its rarity and shared histologic features of other benign and malignant tumors, such as alveolar adenoma, papillary adenocarcinomas including metastatic thyroid carcinoma, bronchoalveolar carcinoma and papillary carcinoid tumor, demand special attention for diagnosis. In our case, the pathologic criteria, such as papillary growth pattern and cytologic features, were sufficient to confirm the diagnosis of papillary adenoma of the lung.

  12. Ramjet bypass duct and preburner configuration

    NASA Technical Reports Server (NTRS)

    Orlando, Robert J. (Inventor)

    1994-01-01

    A combined turbofan and ramjet aircraft engine includes a forward bypass duct which allows the engine to operate more efficiently during the turbofan mode of operation. By mounting a ramjet preburner in the forward duct and isolating this duct from the turbofan bypass air, a transition from turbofan operation to ramjet operation can take place at lower flight Mach numbers without incurring pressure losses or blockage in the turbofan bypass air.

  13. Parotid salivary duct stenosis following caudal maxillectomy.

    PubMed

    Mestrinho, Lisa A; Faísca, Pedro B; Niza, Maria M R E

    2014-01-01

    Parotid salivary duct dilation was diagnosed in a 9-year-old male dog. The dog had undergone caudal maxillectomy on the ipsilateral side 2-years prior to presentation. Treatment consisted of parotid salivary duct excision and superficial parotidectomy that lead to the resolution of clinical signs. Transient facial neuropraxia was observed immediately after surgery and resolved spontaneously after 2-weeks. Parotid salivary duct dilation should be considered as a chronic postoperative complication following caudal maxillectomy. PMID:24902412

  14. Lightweight Forms for Epoxy/Aramid Ducts

    NASA Technical Reports Server (NTRS)

    Mix, E. W.; Anderson, A. N.; Bedford, Donald L., Sr.

    1986-01-01

    Aluminum mandrels easy to remove. Lightweight aluminum mandrel for shaping epoxy/aramid ducts simplifies and speeds production. In new process, glass-reinforced epoxy/aramid cloth wrapped on aluminum mandrel. Stainless-steel flanges and other hardware fitted on duct and held by simple tooling. Entire assembly placed in oven to cure epoxy. After curing, assembly placed in alkaline bath dissolves aluminum mandrel in about 4 hours. Epoxy/aramid shell ready for use as duct. Aluminum mandrel used to make ducts of various inside diameters up to 6 in. Standard aluminum forms used. Conventional tube-bending equipment produces requisite curves in mandrels.

  15. Traumatic injury of the thoracic duct.

    PubMed

    Guzman, A E; Rossi, L; Witte, C L; Smyth, S

    2002-03-01

    Injuries to the thoracic duct are infrequent but may become life-threatening when chylous leakage persists. This report describes 6 patients with such injuries in whom the leakage resolved spontaneously in one, was corrected using microsurgical lymphatic repair or lymphatic-venous anastomosis in two, successfully treated either by ligation of the thoracic duct or insertion of a peritoneovenous shunt in two, and was eventually controlled after bilateral pleurodesis and thoracic duct ligation by insertion of a peritoneo-venous shunt in one. Conventional lymphography is superior to lymphoscintigraphy and is usually required to document disruption of the thoracic duct. PMID:11939572

  16. Generator stator core vent duct spacer posts

    DOEpatents

    Griffith, John Wesley; Tong, Wei

    2003-06-24

    Generator stator cores are constructed by stacking many layers of magnetic laminations. Ventilation ducts may be inserted between these layers by inserting spacers into the core stack. The ventilation ducts allow for the passage of cooling gas through the core during operation. The spacers or spacer posts are positioned between groups of the magnetic laminations to define the ventilation ducts. The spacer posts are secured with longitudinal axes thereof substantially parallel to the core axis. With this structure, core tightness can be assured while maximizing ventilation duct cross section for gas flow and minimizing magnetic loss in the spacers.

  17. Wastefree in-duct FGD

    SciTech Connect

    Nelson, S. Jr.

    1995-12-31

    The first generation of easily-retrofitable duct-injection technologies experienced problems with modest performance, particulate non-compliance, and difficult waste disposal. A new sorbent concept, called Fluesorbent, has been developed specifically to address these problems. Based on a new lime sorbent material, the technology results in 80+% SO{sub 2} removal, net particulate reductions, and a valuable agricultural by-product instead of wastes. A 6,500 acfm, 2-MWe Fluesorbent pilot plant was recently constructed at Ohio Edison`s R.E. Burger station. This paper describes the technology and the Burger demonstration project.

  18. 14 CFR 29.1103 - Induction systems ducts and air duct systems.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Induction systems ducts and air duct systems. 29.1103 Section 29.1103 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Induction System § 29.1103 Induction systems ducts and air...

  19. Optimization of the mechanical performance of a two-duct semicircular duct system--part 1: dynamics and duct dimensions.

    PubMed

    Muller, M; Verhagen, J H G

    2002-06-21

    The classical representation of the semicircular duct system consists of three separate duct circuits. The ducts are, however, in reality, hydrodynamically interconnected. Muller & Verhagen (1988a,b) derived equations for the mechanical behaviour of an interconnected system with three ducts (anterior, posterior and horizontal). An analytical solution of these equations would, however, be too complex to provide surveyable formulae. A system of two interconnected ducts avoids this complexity whilst keeping the essentials of the coupling of ducts intact. The solution of the equation of motion leads to expressions for time constants and maximal endolymph excursions which are functions of morphological parameters, viz. the ratios of radii (gamma) and lengths (lambda) of the common vestibular part (crus commune or utriculus) and the ducts. The system possesses two short time constants which are shown to have similar values. The maximum endolymph displacements in the two ducts after a steplike stimulus are the products of the respective initial velocities and combinations of time constants. The initial velocities depend strongly on the position of the labyrinth with respect to the excitating rotation vector. Measured data of gamma and lambda are compared with the theoretical results. For gamma, excellent agreement was found. lambda is treated elsewhere. PMID:12151258

  20. Treatment Options for Villous Adenoma of the Ampulla of Vater

    PubMed Central

    Cugat, E.; Veloso, E.; Marco, C.

    2000-01-01

    Introduction: Duodenal villous adenoma arising from the ampulla of Vater has a high risk of malignant development. Excluding associated malignant disease prior to resection of an adenoma of the ampulla is not always possible. Therefore, the surgical procedure of choice to treat this rare tumour is still controversial. Objective: To evaluate retrospectively results of treatment of villous adenoma arising from ampulla of Vater with dysplasia or associated carcinoma limited to the ampulla. Patients and Methods: From 1985 to 1996, eight patients have been diagnosed with ampullary villous adenoma suitable for resection. We have reviewed treatment, morbidity, mortality, follow-up and final outcome. Results: Pancreatoduodenectomy (PD) was performed in 4 patients. Transduodenal ampullectomy and endoscopic resection was performed in 2 patients each. There was no perioperative mortality. None of the patients had biliary, pancreatic or intestinal leakage but two patients who underwent PD had minor postoperative complications. The mean follow-up was 44 (range: 6–132) months. Villous adenoma was associated with adenocarcinoma in 50% of the cases (4/8 patients). During the followup both patients who underwent transduodenal ampullectomy developed recurrent disease. All patients initially treated by PD are alive without evidence of recurrent disease. Conclusions: Treatment of villous adenoma of the ampulla must be individualized within certain limits. In our series, PD achieve good results and it appears to be the procedure of choice in order to treat villous adenomas with proved presence of carcinoma, carcinoma in situ or severe dysplasia. Endoscopic or local resection may be appropriate for small benign tumours in high risk patients. PMID:10674748

  1. Overview of Hepatocellular Adenoma in Japan

    PubMed Central

    Sasaki, Motoko; Nakanuma, Yasuni

    2012-01-01

    Hepatocellular adenoma (HCA) is generally a benign hepatocellular tumor arising in a nonfibrotic/cirrhotic liver, and recently four major subgroups were identified based on genotype and phenotype classification from Europe. HCA is rare in Asian countries including Japan, and there have been few studies regarding the subgroups of HCA in Japan. We surveyed subgroups of HCA in 13 patients (7 women) in Japan, based on the phenotypic classification. As results, we identified 2 hepatocyte nuclear factor (HNF) 1α-inactivated HCAs (15%), two β-catenin-activated HCAs (15%), 5 inflammatory HCAs (39%), and 4 unclassified HCAs (29%). The use of oral contraceptives was found only in 2 unclassified HCAs (29%). Rather low percentage of female patients and use of oral contraceptives appear to be common clinicopathological features in Japan and also East Asian countries. Furthermore, a group of possible inflammatory HCAs characterized by strong immunoreactivity for serum amyloid A (SAA) was found in patients with alcoholic cirrhosis. The inflammatory HCA/SAA-positive hepatocellular neoplasm in alcoholic cirrhosis may be a new entity of HCA, which may have potential of malignant transformation. Further studies are needed to clarify genetic changes, monoclonality, and pathogenesis of this new type of hepatocellular neoplasm. PMID:22973519

  2. Autofluorescence ratio imaging of human colonic adenomas

    NASA Astrophysics Data System (ADS)

    Imaizumi, Katsuichi; Harada, Yoshinori; Wakabayashi, Naoki; Yamaoka, Yoshihisa; Dai, Ping; Tanaka, Hideo; Takamatsu, Tetsuro

    2011-02-01

    Recently autofluorescence imaging (AFI) endoscopy, visualizing tissue fluorescence in combination with reflected light, has been adopted as a technique for detecting neoplasms in the colon and other organs. However, autofluorescence colonoscopy is not infallible, and improvement of the detection method can be expected to enhance the performance. Colonic mucosa contains metabolism-related fluorophores, such as reduced nicotinamide adenine dinucleotide, which may be useful for visualizing neoplasia in autofluorescence endoscopy. We examined sliced cross-sections of endoscopically resected tubular adenomas under a microscope. Fluorescence images acquired at 365-nm excitation (F365ex) and 405-nm excitation (F405ex), and reflectance images acquired at 550 nm (R550) were obtained. Fluorescence ratio (F365ex/F405ex) images and reflectance/fluorescence ratio (R550/F405ex) images were calculated from the acquired images. The fluorescence ratio images could distinguish adenomatous mucosa from normal mucosa more clearly than the reflectance/fluorescence ratio images. The results showed that the autofluorescence ratio imaging is a potential technique for increasing the diagnostic power of autofluorescence endoscopy.

  3. Measure Guideline: Sealing and Insulating of Ducts in Existing Homes

    SciTech Connect

    Aldrich, R.; Puttagunta, S.

    2011-12-01

    This document begins with a discussion on potential cost and performance benefits of duct sealing and insulating. It continues with a review of typical duct materials and components and the overall procedures for assessing and improving the duct system.

  4. What's New in Bile Duct Cancer Research and Treatment?

    MedlinePlus

    ... Topic Additional resources for bile duct cancer What’s new in bile duct cancer research and treatment? Bile ... is tumor blood vessels. Bile duct tumors need new blood vessels to grow beyond a certain size. ...

  5. Measure Guideline. Sealing and Insulating Ducts in Existing Homes

    SciTech Connect

    Aldrich, R.; Puttagunta, S.

    2011-12-01

    This document begins with a discussion on potential cost and performance benefits of duct sealing and insulating. It continues with a review of typical duct materials and components and the overall procedures for assessing and improving the duct system.

  6. Do We Know What Causes Bile Duct Cancer?

    MedlinePlus

    ... duct cancer be prevented? Do we know what causes bile duct cancer? We don’t know the exact cause of ... to top » Guide Topics What Is Bile Duct Cancer? Causes, Risk Factors, and Prevention Early Detection, Diagnosis, and ...

  7. Salivary duct carcinoma of parotid gland.

    PubMed

    Kinnera, Vijay Sreedhar Babu; Mandyam, Kumaraswamy Reddy; Chowhan, Amit Kumar; Nandyala, Rukmangadha; Bobbidi, Venkata Phaneendra; Vutukuru, Venkatarami Reddy

    2009-07-01

    A 40-year old male presented with rapidly growing swelling in the right parotid region. Based on the fine needle aspiration cytology report of adenocarcinoma not otherwise specified, superficial parotidectomy was performed, which showed the features of salivary duct carcinoma by histopathological examination. The smears were reviewed to identify the potential pitfalls in the cytological diagnosis of salivary duct carcinoma. PMID:21887008

  8. Salivary duct carcinoma of parotid gland

    PubMed Central

    Kinnera, Vijay Sreedhar Babu; Mandyam, Kumaraswamy Reddy; Chowhan, Amit Kumar; Nandyala, Rukmangadha; Bobbidi, Venkata Phaneendra; Vutukuru, Venkatarami Reddy

    2009-01-01

    A 40-year old male presented with rapidly growing swelling in the right parotid region. Based on the fine needle aspiration cytology report of adenocarcinoma not otherwise specified, superficial parotidectomy was performed, which showed the features of salivary duct carcinoma by histopathological examination. The smears were reviewed to identify the potential pitfalls in the cytological diagnosis of salivary duct carcinoma. PMID:21887008

  9. Double-duct liquid metal magnetohydrodynamic engine

    DOEpatents

    Haaland, Carsten M.

    1995-01-01

    An internal combustion, liquid metal (LM) magnetohydrodynamic (MHD) engine and an alternating current (AC) magnetohydrodynamic generator, are used in combination to provide useful AC electric energy output. The engine design has-four pistons and a double duct configuration, with each duct containing sodium potassium liquid metal confined between free pistons located at either end of the duct. The liquid metal is forced to flow back and forth in the duct by the movement of the pistons, which are alternatively driven by an internal combustion process. In the MHD generator, the two LM-MHD ducts pass in close proximity through a Hartmann duct with output transformer. AC power is produced by operating the engine with the liquid metal in the two generator ducts always flowing in counter directions. The amount of liquid metal maintained in the ducts may be varied. This provides a variable stroke length for the pistons. The engine/generator provides variable AC power at variable frequencies that correspond to the power demands of the vehicular propulsion. Also the engine should maintain nearly constant efficiency throughout the range of power usage. Automobiles and trucks could be powered by the invention, with no transmission or power converter devices being required.

  10. Double-duct liquid metal magnetohydrodynamic engine

    DOEpatents

    Haaland, Carsten M.

    1997-01-01

    An internal combustion, liquid metal (LM) magnetohydrodynamic (MHD) engine and an alternating current (AC) magnetohydrodynamic generator, are used in combination to provide useful AC electric energy output. The engine design has four pistons and a double duct configuration, with each duct containing sodium potassium liquid metal confined between free pistons located at either end of the duct. The liquid metal is forced to flow back and forth in the duct by the movement of the pistons, which are alternatively driven by an internal combustion process. In the MHD generator, the two LM-MHD ducts pass in close proximity through a Hartmann duct with output transformer. AC power is produced by operating the engine with the liquid metal in the two generator ducts always flowing in counter directions. The amount of liquid metal maintained in the ducts may be varied. This provides a variable stroke length for the pistons. The engine/generator provides variable AC power at variable frequencies that correspond to the power demands of the vehicular propulsion. Also the engine should maintain nearly constant efficiency throughout the range of power usage. Automobiles and trucks could be powered by the invention, with no transmission or power converter devices being required.

  11. Tear-Duct Obstruction and Surgery

    MedlinePlus

    ... could block a duct, but reconstructive surgery right after the accident or injury may prevent this. Signs of Blocked Tear Ducts ... kids. It may take up to a week after surgery before symptoms improve. Your doctor will give you antibiotic ointment or drops along with ... Injuries Pinkeye (Conjunctivitis) Retinopathy of Prematurity Preparing Your Child ...

  12. Predicting vibrational failure of flexible ducting

    NASA Technical Reports Server (NTRS)

    Henry, R. H.

    1971-01-01

    Technique applies to liquid or gas transfer through flexible ducting and proves valuable in high velocity fluid flow cases. Fluid mechanism responsible for free bellows vibrational excitation also causes flexible hose oscillation. Static pressure stress influences flexible ducting fatigue life and is considered separately.

  13. Rocket-in-a-Duct Performance Analysis

    NASA Technical Reports Server (NTRS)

    Schneider, Steven J.; Reed, Brian D.

    1999-01-01

    An axisymmetric, 110 N class, rocket configured with a free expansion between the rocket nozzle and a surrounding duct was tested in an altitude simulation facility. The propellants were gaseous hydrogen and gaseous oxygen and the hardware consisted of a heat sink type copper rocket firing through copper ducts of various diameters and lengths. A secondary flow of nitrogen was introduced at the blind end of the duct to mix with the primary rocket mass flow in the duct. This flow was in the range of 0 to 10% of the primary massflow and its effect on nozzle performance was measured. The random measurement errors on thrust and massflow were within +/-1%. One dimensional equilibrium calculations were used to establish the possible theoretical performance of these rocket-in-a-duct nozzles. Although the scale of these tests was small, they simulated the relevant flow expansion physics at a modest experimental cost. Test results indicated that lower performance was obtained at higher free expansion area ratios and longer ducts, while, higher performance was obtained with the addition of secondary flow. There was a discernable peak in specific impulse efficiency at 4% secondary flow. The small scale of these tests resulted in low performance efficiencies, but prior numerical modeling of larger rocket-in-a-duct engines predicted performance that was comparable to that of optimized rocket nozzles. This remains to be proven in large-scale, rocket-in-a-duct tests.

  14. Fabrication process of a high temperature polymer matrix engine duct

    NASA Technical Reports Server (NTRS)

    Pratt, R. D.; Wilson, A. J.

    1985-01-01

    The process that was used in the molding of an advanced composite outer by-pass duct planned for the F404 engine is discussed. This duct was developed as a potential replacement for the existing titanium duct in order to reduce both the weight and cost of the duct. The composite duct is now going into the manufacturing technology portion of the program. The duct is fabricated using graphite cloth impregnated with the PMR-15 matrix system.

  15. CT scan diagnosis of hepatic adenoma in a case of von Gierke disease

    PubMed Central

    Daga, Bipin Valchandji; Shah, Vaibhav R; More, Rahul B

    2012-01-01

    Hepatic adenoma is a well-defined, benign, solitary tumor of the liver. In individuals with glycogen storage disease I, adenoma tends to occur at a relatively younger age and can be multiple (adenomatosis). Imaging plays a pivotal role in diagnosing hepatic adenoma and in differentiating adenoma from other focal hepatic lesions. Especially in patients with von Gierke disease, in addition to the associated hepatomegaly caused by steatohepatitis and the diffusely reduced attenuation of the liver parenchyma seen on CT, there may be more than one hepatic adenoma in up to 40% of patients. Malignant degeneration of hepatic adenoma into hepatocellular carcinoma can occur and hence imaging is important for prompt diagnosis of adenoma and its complications. In this case report, we present a case of liver adenoma diagnosed by CT scan in a patient with von Gierke disease. PMID:22623817

  16. Mucosal adherent bacterial dysbiosis in patients with colorectal adenomas.

    PubMed

    Lu, Yingying; Chen, Jing; Zheng, Junyuan; Hu, Guoyong; Wang, Jingjing; Huang, Chunlan; Lou, Lihong; Wang, Xingpeng; Zeng, Yue

    2016-01-01

    Recent reports have suggested that the gut microbiota is involved in the progression of colorectal cancer (CRC). The composition of gut microbiota in CRC precursors has not been adequately described. To characterize the structure of adherent microbiota in this disease, we conducted pyrosequencing-based analysis of 16S rRNA genes to determine the bacterial profile of normal colons (healthy controls) and colorectal adenomas (CRC precursors). Adenoma mucosal biopsy samples and adjacent normal colonic mucosa from 31 patients with adenomas and 20 healthy volunteers were profiled using the Illumina MiSeq platform. Principal coordinate analysis (PCoA) showed structural segregation between colorectal adenomatous tissue and control tissue. Alpha diversity estimations revealed higher microbiota diversity in samples from patients with adenomas. Taxonomic analysis illustrated that abundance of eight phyla (Firmicutes, Proteobacteria, Bacteroidetes, Actinobacteria, Chloroflexi, Cyanobacteria, Candidate-division TM7, and Tenericutes) was significantly different. In addition, Lactococcus and Pseudomonas were enriched in preneoplastic tissue, whereas Enterococcus, Bacillus, and Solibacillus were reduced. However, both PCoA and cluster tree analyses showed similar microbiota structure between adenomatous and adjacent non-adenoma tissues. These present findings provide preliminary experimental evidence supporting that colorectal preneoplastic lesion may be the most important factor leading to alterations in bacterial community composition. PMID:27194068

  17. Overview of genetic testing in patients with pituitary adenomas.

    PubMed

    Beckers, Albert; Rostomyan, Liliya; Daly, Adrian F

    2012-04-01

    Clinically-relevant pituitary adenomas occur with a prevalence of one case per 1000-1300 of the general population. Although most are sporadic, there are several inherited conditions that incur an increased risk of developing a pituitary adenoma. Multiple endocrine neoplasia type 1 and Carney complex (due to mutations in MEN1 and PRKAR1A, respectively) are established pituitary adenoma predisposition conditions, while multiple endocrine neoplasia type 4 (due to CDKN1B mutations) is an emerging rare condition. Familial isolated pituitary adenomas (FIPA) is a novel condition not associated with these multiple endocrine neoplasias. Mutations in the aryl hydrocarbon receptor interacting protein gene account for about 15% of FIPA kindreds and are associated with about 10-20% of macroadenomas that occur in children, adolescents and young adults. When treating a pituitary adenoma patient, relevant familial and clinical factors such as associated tumors or syndromic features should be assessed at the outset in order to guide the correct choice of genetic testing in appropriate individuals. PMID:22503805

  18. Mucosal adherent bacterial dysbiosis in patients with colorectal adenomas

    PubMed Central

    Lu, Yingying; Chen, Jing; Zheng, Junyuan; Hu, Guoyong; Wang, Jingjing; Huang, Chunlan; Lou, Lihong; Wang, Xingpeng; Zeng, Yue

    2016-01-01

    Recent reports have suggested that the gut microbiota is involved in the progression of colorectal cancer (CRC). The composition of gut microbiota in CRC precursors has not been adequately described. To characterize the structure of adherent microbiota in this disease, we conducted pyrosequencing-based analysis of 16S rRNA genes to determine the bacterial profile of normal colons (healthy controls) and colorectal adenomas (CRC precursors). Adenoma mucosal biopsy samples and adjacent normal colonic mucosa from 31 patients with adenomas and 20 healthy volunteers were profiled using the Illumina MiSeq platform. Principal coordinate analysis (PCoA) showed structural segregation between colorectal adenomatous tissue and control tissue. Alpha diversity estimations revealed higher microbiota diversity in samples from patients with adenomas. Taxonomic analysis illustrated that abundance of eight phyla (Firmicutes, Proteobacteria, Bacteroidetes, Actinobacteria, Chloroflexi, Cyanobacteria, Candidate-division TM7, and Tenericutes) was significantly different. In addition, Lactococcus and Pseudomonas were enriched in preneoplastic tissue, whereas Enterococcus, Bacillus, and Solibacillus were reduced. However, both PCoA and cluster tree analyses showed similar microbiota structure between adenomatous and adjacent non-adenoma tissues. These present findings provide preliminary experimental evidence supporting that colorectal preneoplastic lesion may be the most important factor leading to alterations in bacterial community composition. PMID:27194068

  19. Salivary Duct Cyst: Histo-pathologic Correlation

    PubMed Central

    Vinayachandran, Divya; Sankarapandian, Sathasivasubramanian

    2013-01-01

    Non-neoplastic cysts of the salivary glands are uncommon and represent 2-5% of all salivary gland lesions. They are mainly mucoceles or salivary duct cysts. Unlike a mucocele, which is surrounded by granulation tissue, the salivary duct cyst is lined by epithelium. Salivary duct cysts are more common in the oral minor salivary glands and rarely occur in the major salivary glands, show a marked predilection for the superficial lobe of the parotid, and represent 10% of all salivary gland cysts. Neoplastic differentiation of the lining of the salivary duct cyst has been reported. We report a case of a salivary duct cyst of the left parotid gland, with a review of radiographic and histopathologic features. PMID:23878772

  20. Salivary Duct Cyst: Histo-pathologic Correlation.

    PubMed

    Vinayachandran, Divya; Sankarapandian, Sathasivasubramanian

    2013-01-01

    Non-neoplastic cysts of the salivary glands are uncommon and represent 2-5% of all salivary gland lesions. They are mainly mucoceles or salivary duct cysts. Unlike a mucocele, which is surrounded by granulation tissue, the salivary duct cyst is lined by epithelium. Salivary duct cysts are more common in the oral minor salivary glands and rarely occur in the major salivary glands, show a marked predilection for the superficial lobe of the parotid, and represent 10% of all salivary gland cysts. Neoplastic differentiation of the lining of the salivary duct cyst has been reported. We report a case of a salivary duct cyst of the left parotid gland, with a review of radiographic and histopathologic features. PMID:23878772

  1. Electromagnetic propagation in PEC and absorbing curved S-ducts

    NASA Technical Reports Server (NTRS)

    Baumeister, Kenneth J.

    1988-01-01

    A finite-element Galerkin formulation has been developed to study transverse magnetic (TM) wave propagation in 2-D S-curved ducts with both perfectly conducting and absorbing walls. The reflection and transmission at the entrances and the exits of the curved ducts are determined by coupling the finite-element solutions in the curved ducts to the eigenfunctions of an infinite, uniform, perfectly conducting duct. Example solutions are presented for a double mitred and S-ducts of various lengths. The length of the S-duct is found to significantly effect the reflective characteristics of the duct. Also, the effect of curvature on an absorbing duct is illustrated.

  2. Adrenal imaging for adenoma characterization: imaging features, diagnostic accuracies and differential diagnoses.

    PubMed

    Park, Jung Jae; Park, Byung Kwan; Kim, Chan Kyo

    2016-06-01

    Adrenocortical adenoma is the most common adrenal tumour. This lesion is frequently encountered on cross-sectional imaging that has been performed for unrelated reasons. Adrenal adenoma manifests various imaging features on CT, MRI and positron emission tomography/CT. The learning objectives of this review are to describe the imaging findings of adrenocortical adenoma, to compare the sensitivities of different imaging modalities for adenoma characterization and to introduce differential diagnoses. PMID:26867466

  3. Matrix metalloproteinase-13 expression in the progression of colorectal adenoma to carcinoma : Matrix metalloproteinase-13 expression in the colorectal adenoma and carcinoma.

    PubMed

    Foda, Abd Al-Rahman Mohammad; El-Hawary, Amira K; Abdel-Aziz, Azza

    2014-06-01

    Most colorectal carcinomas (CRCs) are considered to arise from conventional adenoma based on the concept of the adenoma-carcinoma sequence. Matrix metalloproteinases (MMPs) are known to be overexpressed as normal mucosa progresses to adenomas and carcinomas. There has been little previous investigation about MMP-13 expression in adenoma-carcinoma sequence. In this study, we aimed to investigate the immunohistochemical expression of MMP-13 in colorectal adenoma and CRC specimens using tissue microarray (TMA) technique. A total of 40 cases of CRC associated with adenoma were collected from files of the Pathology laboratory at Mansoura Gastroenterology Center between January 2007 and January 2012. Sections from TMA blocks were prepared and stained for MMP-13. Immunoreactivity to MMP-13 staining was localized to the cytoplasm of mildly, moderately, and severely dysplatic cells of adenomas and CRC tumor cells that were either homogenous or heterogeneous. There was no significant difference in MMP-13 expression between adenomas and CRCs either non-mucinous or mucinous. Adenomas with high MMP-13 expression were significantly associated with moderate to marked degree of inflammatory cellular infiltrate and presence of familial adenomatous polyps. In conclusion, MMP-13 may be a potential biological marker of early tumorigenesis in the adenoma-carcinoma sequence. PMID:24563279

  4. Familial Isolated Pituitary Adenomas (FIPA) and the Pituitary Adenoma Predisposition due to Mutations in the Aryl Hydrocarbon Receptor Interacting Protein (AIP) Gene

    PubMed Central

    Aaltonen, Lauri A.; Daly, Adrian F.

    2013-01-01

    Pituitary adenomas are one of the most frequent intracranial tumors and occur with a prevalence of approximately 1:1000 in the developed world. Pituitary adenomas have a serious disease burden, and their management involves neurosurgery, biological therapies, and radiotherapy. Early diagnosis of pituitary tumors while they are smaller may help increase cure rates. Few genetic predictors of pituitary adenoma development exist. Recent years have seen two separate, complimentary advances in inherited pituitary tumor research. The clinical condition of familial isolated pituitary adenomas (FIPA) has been described, which encompasses the familial occurrence of isolated pituitary adenomas outside of the setting of syndromic conditions like multiple endocrine neoplasia type 1 and Carney complex. FIPA families comprise approximately 2% of pituitary adenomas and represent a clinical entity with homogeneous or heterogeneous pituitary adenoma types occurring within the same kindred. The aryl hydrocarbon receptor interacting protein (AIP) gene has been identified as causing a pituitary adenoma predisposition of variable penetrance that accounts for 20% of FIPA families. Germline AIP mutations have been shown to associate with the occurrence of large pituitary adenomas that occur at a young age, predominantly in children/adolescents and young adults. AIP mutations are usually associated with somatotropinomas, but prolactinomas, nonfunctioning pituitary adenomas, Cushing disease, and other infrequent clinical adenoma types can also occur. Gigantism is a particular feature of AIP mutations and occurs in more than one third of affected somatotropinoma patients. Study of pituitary adenoma patients with AIP mutations has demonstrated that these cases raise clinical challenges to successful treatment. Extensive research on the biology of AIP and new advances in mouse Aip knockout models demonstrate multiple pathways by which AIP may contribute to tumorigenesis. This review assesses

  5. Management of Hepatocellular Adenoma: Recent Advances.

    PubMed

    Agrawal, Shefali; Agarwal, Sheela; Arnason, Thomas; Saini, Sanjay; Belghiti, Jacques

    2015-07-01

    Hepatocellular adenoma (HCA) is a rare benign liver cell neoplasm that occurs more frequently in young women with a history of prolonged use of oral contraceptives. Surgical resection is considered because of the risk of hemorrhage in 25% and of malignant transformation in 5% of patients with HCA. HCA is a heterogeneous disease comprising 3 subtypes with distinct molecular and complication profiles. The inflammatory or telangiectatic subtype is at increased risk for hemorrhage, the β-catenin-activated subtype is at increased risk for malignant transformation, and the hepatocyte nuclear factor-1α-inactivated or steatotic subtype is at the least risk for complications. One-third of the patients with HCA have multiple tumors on imaging with no increased risk of complications. Magnetic resonance imaging is the modality of choice for the diagnosis and subtype characterization of HCA. Systematic resection of HCA is recommended in male patients owing to the higher incidence of malignant transformation, and surgical excision in women should be reserved for tumors 5 cm or larger associated with an increased risk of complications. Cessation of hormonal therapy and radiologic surveillance in women with HCA tumors smaller than 5 cm shows that the vast majority of HCA remain stable or undergo spontaneous regression. Percutaneous core needle biopsy is of limited value because the therapeutic strategy is based primarily on patient sex and tumor size. Transarterial embolization is the initial treatment for HCA complicated by hemorrhage. Pregnancy should not be discouraged in the presence of HCA, however, frequent sonographic surveillance is recommended. PMID:24909909

  6. Nonfunctioning giant pituitary adenomas: Invasiveness and recurrence

    PubMed Central

    Landeiro, José Alberto; Fonseca, Elissa Oliveira; Monnerat, Andrea Lima Cruz; Taboada, Giselle Fernandes; Cabral, Gustavo Augusto Porto Sereno; Antunes, Felippe

    2015-01-01

    Background: We report our surgical series of 35 patients with giant nonfunctioning pituitary adenomas (GNFPA). We analyzed the rule of Ki-67 antigen expression in predicting recurrence. Methods: Thirty-five patients were operated between 2000 and 2010. Suprassellar extension of the tumors were classified according to Hardy and Mohr based on magnetic resonance (MR) studies. Pituitary endocrine function and MR scans were assessed preoperatively and at 1, 6, and 12 months postoperatively. Immunohistochemical studies were based in regard to the expression of the proliferative Ki-67 index and the hormonal receptor for luteinizing hormone, follicle stimulating hormone, growth hormone, thyroid stimulating hormone, adrenocorticotropic hormone, and prolactin. Tumors specimens were obtained from 35 patients with GNFPA. Endoscopic transsphenoidal surgery was the approach of choice. Results: Thirty-five patients were submitted to 49 surgeries, 44 (89.8%) were transsphenoidal and 5 (10.2%) were transcranial. The most frequent preoperative complaints were visual acuity impairment and visual field defect in 25 (71.2%) and 23 (65.7%) cases, respectively. Improvement of visual acuitiy and visual field deficit after surgery was seen in 20 (80%) and 17 (73.9%) patients, respectively. Endocrinological deficits were encountered in 20 patients (57.1%). After surgery, 18 patients (51.4%) required hormonal replacement. Three patients had visual symptoms related to pituitary apoplexy and recovered after surgery. The Ki-67 labeling index (LI) ranged from <1% to 4.8%. The rate of recurrence in tumors with Ki-67 <3% was 7.7% (2 patients), Ki-67 >3% was present in 5 patients and the recurrence committed 3 patients. Conclusion: In our series, regardless the improvement of visual function and compressing symptoms, 5 patients with expression of Ki-67 LI more than 3% experienced a recurrence. PMID:26674325

  7. Hepatocellular adenoma: what is new in 2008.

    PubMed

    Bioulac-Sage, Paulette; Laumonier, Hervé; Laurent, Christophe; Zucman-Rossi, Jessica; Balabaud, Charles

    2008-09-01

    Patients (85%) with hepatocellular adenoma (HCA) are women taking oral contraceptives. They can be divided into four subgroups according to their genotype/phenotype features. (1) Hepatocyte nuclear factor 1alpha (HNF1alpha) biallelic somatic mutations are observed in 35% of the HCA cases. It occurs in almost all cases in women. HNF1alpha-mutated HCA are most of the time, highly steatotic, with a lack of expression of liver fatty acid binding protein (LFABP) in immunohistochemistry analyses. Adenomatosis is frequently detected in this context. An HNF1alpha germline mutation is observed in less than 5% of HCA cases and can be associated with MODY 3 diabetes. (2) An activating beta-catenin mutation was found in 10% of HCA. These beta-catenin activated HCAs are observed in men and women, and specific risk factors, such as male hormone administration or glycogenosis, are associated with their development. Immunohistochemistry studies show that these HCAs overexpress beta-catenin (nuclear and cytoplasmic) and glutamine synthetase. This group of tumours has a higher risk of malignant transformation into hepatocellular carcinoma. (3) Inflammatory HCAs are observed in 40% of the cases, and they are most frequent in women but are also found in men. Lesions are characterised by inflammatory infiltrates, dystrophic arteries, sinusoidal dilatation and ductular reaction. They express serum amyloid A and C-reactive protein. In this group, GGT is frequently elevated, with a biological inflammatory syndrome present. Also, there are more overweight patients in this group. An additional 10% of inflammatory HCAs express beta-catenin, and are also at risk of malignant transformation. (4) Currently, less than 10% of HCAs are unclassified. It is hoped that in the near future it will be possible with clinical, biological and imaging data to predict in which of the 2 major groups (HNF1alpha-mutated HCA and inflammatory HCA) the patient belongs and to propose better guidelines in terms of

  8. Colorectal villous and tubulovillous adenomas equal to or greater than four centimeters.

    PubMed Central

    Stulc, J P; Petrelli, N J; Herrera, L; Mittelman, A

    1988-01-01

    The records of 237 patients treated for benign and malignant villous and tubulovillous adenomas at Roswell Park Memorial Institute from 1963 to 1987 were reviewed. Sixty-five adenomas were greater than or equal to 4 cm and form the basis of this report. Fifteen (23%) were in the cecum, 3 (5%) in the right colon, 1 (1%) in the splenic flexure, 10 (15%) in the sigmoid colon, and 36 (55%) in the rectum. The most common symptoms were rectal bleeding (70%), mucus diarrhea (44%), constipation (22%), and tenesmus (19%). Fifty-five (85%) of these large adenomas contained invasive adenocarcinoma and one in situ carcinoma. Two thirds of invasive carcinomas arose from predominantly villous adenomas and one third from tubulovillous adenomas. Half of all malignant adenomas demonstrated metastases to regional lymph nodes or distant metastases. Seven malignant adenomas (12%) were associated with synchronous adenocarcinomas of the colon, and 29% of malignant adenomas were associated with synchronous adenomatous polyps, principally tubular type. Four of nine benign, large adenomas were associated with synchronous adenomas but with no adenocarcinomas. No relationship was found between the size of the adenoma, location, or Dukes' stage. Though the incidence of in situ and invasive carcinomas is clearly related to the size of the adenoma, a linear relationship could not be demonstrated. PMID:3337563

  9. Remarkable Triple Pleomorphic Adenoma Affecting both Parotid and Submandibular Glands

    PubMed Central

    Pingarrón-Martín, Lorena; Arias-Gallo, L. J.; Demaría-Martínez, G.; Chamorro Pons, M.

    2014-01-01

    The objective of this article is to present the first case reported in the literature of metachronous pleomorphic adenoma of bilateral parotid glands and submaxillary gland. The authors report the case of a 27-year-old female with metachronous mixed tumors in her right parotid and submandibular glands. The patient has no history of previous radiotherapy. All three lesions were diagnosed by fine-needle aspiration. The histopathologic evaluation of all three major salivary gland masses demonstrated pleomorphic adenomas, with no occult malignancy observed on serial sections. The presentation of pleomorphic adenomas in the parotids and submandibular glands probably represents three unrelated primary sites of tumor, yet the possibility of metastasis from one gland to the other cannot be excluded. PMID:26000084

  10. Adenoma of the Papillae of Vater. Report of Eleven Cases

    PubMed Central

    Mäkelä, Jyrki; Palm, Jukka; Saarela, Arto

    2000-01-01

    Eleven patients with a preoperative diagnosis of adenoma of the papillae of Vater were followed up during the fifteen-year period from 1984 till 1998 in the Oulu University Hospital. Seven patients were treated primarily by transduodenal excision without any recurrences so far. One of these seven patients was found to have adenocarcinoma in a histological examination. Active surgery for adenoma of the papillae of Vater is recommended because of the precancerous nature of the lesion, and because malignancy cannot always be detected by endoscopic biopsies. Transduodenal excision could be recommend for patients at high operative risk, especially in cases with small adenomas and low-grade dysplasia, where histologically free resection margins can be achieved, but pancreaticoduodenectomy should still be performed on patients at low operative risk. PMID:10674750

  11. An Unusual Localization of a Pleomorphic Adenoma in the Rhinopharynx

    PubMed Central

    Pagella, Fabio; Chu, Francesco; Pusateri, Alessandro; Matti, Elina

    2012-01-01

    Pleomorphic adenoma is the most common benign tumor of the parotid glands. Rarely it may arise from minor salivary glands of the upper aerodigestive tract. A 57-year-old woman was admitted at our institution presenting with nasal obstruction. Endoscopic evaluation revealed a pedicled mass in the rhinopharynx. After radiological examination, we opted for a transnasal endoscopic-assisted excision of the mass under general anaesthesia. Histological evaluation deponed for pleomorphic adenoma with clear surgical margins. No endoscopic evidence of local recurrence has been shown after 48 months of followup. In the literature, few cases of pleomorphic adenoma arising in the rhinopharynx have been reported. The introduction of endoscopy, as shown by our experience, leads to important benefits in the identification, treatment, and followup of such rhinopharyngeal benign tumors. PMID:22927861

  12. Parathyroid adenoma on the ipsilateral side of thyroid hemiagenesis.

    PubMed

    Kroeker, Teresa R; Stancoven, Kevin M; Preskitt, John T

    2011-04-01

    We present a case of a parathyroid adenoma on the ipsilateral side of thyroid hemiagenesis-which, to our knowledge, is the third reported case of this entity. A 41-year-old man with nephrolithiasis was found to have elevated calcium and intact parathyroid hormone levels. Both ultrasound and technetium sestamibi scintigraphy with single photon emission computed tomography confirmed left thyroid hemiagenesis and an adenoma in the left inferior thyroid bed. The patient underwent left neck exploration, which confirmed left thyroid hemiagenesis and a left inferior parathyroid adenoma. The left inferior parathyroid gland was resected. The patient was discharged home the same day of surgery and has remained normocalcemic for 14 months without evidence of hyperparathyroidism. PMID:21566751

  13. Parathyroid adenoma presenting as a brown tumour of the mandible.

    PubMed

    Amin, Kavit; Fu, Bertram; Barbaccia, Carmelo

    2012-01-01

    Background. Parathyroid adenoma is the commonest cause of primary hypercalcaemia and usually presents with symptoms/signs of hypercalcaemia. This paper highlights an unusual presentation. Case Report. A 27-year-old female presented with a painful left mandibular swelling, suspicious of neoplasia. A computed tomography (CT) guided biopsy was performed. Based on the histology result, serum calcium was carried out, confirming hypercalcaemia. A left inferior parathyroid adenoma was subsequently removed. CT mandible showed extensive erosive lesions at the left 2nd/3rd inferior molar roots with protrusion to adjacent soft tissues. USS revealed a hypoechoic lesion on the left inferior parathyroid gland. Sestamibi scan showed a focus of MIBI uptake and retention at the inferior aspect of the left thyroid lobe. Conclusion. This case highlights the importance of a thorough history and examination. Clinicians should always bear in mind atypical presentations of parathyroid adenomas, with the need to exclude this differential in the presence of hypercalcaemia. PMID:23251179

  14. DNA profiles in mitotic cells from gastric adenomas.

    PubMed Central

    Rubio, C. A.; Kato, Y.

    1988-01-01

    Quantitative DNA measurements were done in mitotic figures from 17 gastric adenomas having slight (3 cases), moderate (8 cases), or severe dysplasia (3 cases) or foci of invasive adenocarcinoma (3 cases). Values higher than for normal diploid control cells (2c) or their estimated tetraploid values (4c) were found to increase gradually from slight dysplasia to invasive adenocarcinoma through moderate and severe dysplasia. While none of the adenomas having slight or moderate dysplasia demonstrated aneuploid mitoses (ie, values higher than 5c), 1% of the mitoses in severe dysplasia and 27% of those with invasive adenocarcinoma had values higher than 5c. The present results thus suggest that aneuploid mitotic figures may help to recognize those gastric adenomas having invasive growth. Images Figure 1 PMID:3348355

  15. Pleomorphic Adenoma of the Larynx: A Case Report

    PubMed Central

    Motahari, Seyyed Jafar; Khavarinejad, Fereshteh; Salimi, Shahram; Bahari, Milad

    2016-01-01

    Introduction: Pleomorphic adenomas are tumors mostly originating from salivary glands. These lesions in the larynx are very rare. Case Report: We report a rare case of pleomorphic adenoma that originated from the mucosal lining, just above the glottic area at the level of the laryngeal ventricle in a 55-year-old female patient. The tumor could not be palpated easily but was observed in the CT scan. We resected the large and firm tumor using trans hyoid pharyngotomy as the surgical approach. Conclusion: Pleomorphic adenoma in the ventricle of the larynx is an extremely rare lesion. Trans-hyoid pharyngotomy can have good results as the surgical approach in removing such lesions. PMID:26878007

  16. [Intrasellar small TSH secreting pituitary adenomas, 2 case reports].

    PubMed

    Ogawa, Yoshikazu; Tominaga, Teiji; Ikeda, Hidetoshi

    2007-07-01

    Thyroid-stimulating hormone (TSH)-secreting pituitary adenoma accounts for 1% of pituitary adenoma and often manifests as invasive macroadenoma. If the TSH value is not high enough to cause clinical symptoms presenting as inappropriate secretion of TSH, the tumor may be missed or misdiagnosed as Graves disease. Some of these patients receive inadequate treatment with the antithyroid agent, radioiodine treatment, and thyroidectomy. This tumor is also known as a tough and firm tumor because of the significant interstitial fibrosis. We report two cases of TSH-secreting pituitary adenomas which were comparatively small. Although a tough and difficult operation was expected, actual tumor dissection was easy and gross total removal was achieved within less than 3 hours. We discuss the relationship between the intraoperative findings and histopathology, as well as the ultrastructure and endocrinology. PMID:17633511

  17. Pictures of focal nodular hyperplasia and hepatocellular adenomas

    PubMed Central

    Sempoux, Christine; Balabaud, Charles; Bioulac-Sage, Paulette

    2014-01-01

    This practical atlas aims to help liver and non liver pathologists to recognize benign hepatocellular nodules on resected specimen. Macroscopic and microscopic views together with immunohistochemical stains illustrate typical and atypical aspects of focal nodular hyperplasia and of hepatocellular adenoma, including hepatocellular adenomas subtypes with references to clinical and imaging data. Each step is important to make a correct diagnosis. The specimen including the nodule and the non-tumoral liver should be sliced, photographed and all different looking areas adequately sampled for paraffin inclusion. Routine histology includes HE, trichrome and cytokeratin 7. Immunohistochemistry includes glutamine synthase and according to the above results additional markers such as liver fatty acid binding protein, C reactive protein and beta catenin may be realized to differentiate focal nodular hyperplasia from hepatocellular adenoma subtypes. Clues for differential diagnosis and pitfalls are explained and illustrated. PMID:25232451

  18. Advanced Turbofan Duct Liner Concepts

    NASA Technical Reports Server (NTRS)

    Bielak, Gerald W.; Premo, John W.; Hersh, Alan S.

    1999-01-01

    The Advanced Subsonic Technology Noise Reduction Program goal is to reduce aircraft noise by 10 EPNdB by the year 2000 relative, to 1992 technology. The improvement goal for nacelle attenuation is 25% relative to 1992 technology by 1997 and 50% by 2000. The Advanced Turbofan Duct Liner Concepts Task work by Boeing presented in this document was in support of these goals. The basis for the technical approach was a Boeing study conducted in 1993-94 under NASA/FAA contract NAS1-19349, Task 6, investigating broadband acoustic liner concepts. As a result of this work, it was recommended that linear double layer, linear and perforate triple layer, parallel element, and bulk absorber liners be further investigated to improve nacelle attenuations. NASA LaRC also suggested that "adaptive" liner concepts that would allow "in-situ" acoustic impedance control also be considered. As a result, bias flow and high-temperature liner concepts were also added to the investigation. The major conclusion from the above studies is that improvements in nacelle liner average acoustic impedance characteristics alone will not result in 25% increased nacelle noise reduction relative to 1992 technology. Nacelle design advancements currently being developed by Boeing are expected to add 20-40% more acoustic lining to hardwall regions in current inlets, which is predicted to result in and additional 40-80% attenuation improvement. Similar advancements are expected to allow 10-30% more acoustic lining in current fan ducts with 10-30% more attenuation expected. In addition, Boeing is currently developing a scarf inlet concept which is expected to give an additional 40-80% attenuation improvement for equivalent lining areas.

  19. Resection of a large ectopic parathyroid adenoma: A case report

    PubMed Central

    Sato, Seijiro; Kitahara, Akihiko; Koike, Terumoto; Hashimoto, Takehisa; Ohashi, Riuko; Motoi, Noriko; Tsuchida, Masanori

    2016-01-01

    Introduction Parathyroid adenomas are the most common cause of primary hyperparathyroidism. However, cases of parathyroid adenomas greater than 4 cm with osteitis fibrosa cystica are extremely rare. Herein, we report a case of resection of a large ectopic mediastinal parathyroid adenoma. Case presentations A 46-year-old female with chief complaints of bone pain and gait disturbance was referred to our hospital. Physical examination revealed many mobile teeth in her oral cavity, distortion of the vertebral body, and bowlegs. Laboratory tests showed hypercalcemia, hypophosphatemia, and elevated serum levels of intact parathyroid hormone. Chest CT revealed a 42-mm well–defined, enhancing mass in front of the left-sided tracheal bifurcation. Her findings were diagnosed as primary hyperparathyroidism due to an ectopic mediastinal parathyroid tumor. We performed a median sternotomy and resected the tumor. The tumor was a solid, yellowish-brown mass measuring 42 × 42 mm. Pathologically, the tumor consisted mainly of chief cells with some oxyphil cells; there were no necrotic areas or nuclear atypia, and few mitotic figures. We diagnosed the tumor as an ectopic mediastinal parathyroid adenoma. Eight months after the resection, her serum calcium, phosphorus, and intact PTH levels were normal. Discussion and conclusions Parathyroid adenomas and parathyroid carcinomas have disparate natural histories, but they can be difficult to differentiate on the basis of preoperative clinical characteristics. We believe that long-term follow-up of these cases is required because there have been few reports on the postoperative natural history of large parathyroid adenomas. PMID:27078868

  20. No association between mitochondrial DNA copy number and colorectal adenomas.

    PubMed

    Thyagarajan, Bharat; Guan, Weihua; Fedirko, Veronika; Barcelo, Helene; Tu, Huakang; Gross, Myron; Goodman, Michael; Bostick, Roberd M

    2016-08-01

    Despite previously reported associations between peripheral blood mtDNA copy number and colorectal cancer, it remains unclear whether altered mtDNA copy number in peripheral blood is a risk factor for colorectal cancer or a biomarker for undiagnosed colorectal cancer. Though colorectal adenomas are well-recognized precursor lesions to colorectal cancer, no study has evaluated an association between mtDNA copy number and colorectal adenoma risk. Hence, we investigated an association between peripheral blood mtDNA copy number and incident, sporadic colorectal adenoma in 412 colorectal adenoma cases and 526 cancer-free controls pooled from three colonoscopy-based case-control studies that used identical methods for case ascertainment, risk factor determination, and biospecimen collection. We also evaluated associations between relative mtDNA copy number and markers of oxidative stress, including circulating F2 -isoprostanes, carotenoids, and fluorescent oxidation products. We measured mtDNA copy number using a quantitative real time polymerase chain reaction (PCR). We used unconditional logistic regression to analyze the association between mtDNA copy number and colorectal adenoma risk after multivariable adjustment. We found no association between logarithmically transformed relative mtDNA copy number, analyzed as a continuous variable, and colorectal adenoma risk (odds ratio = 1.02, 95%CI: 0.82-1.27; P = 0.86). There were no statistically significant associations between relative mtDNA copy number and other markers of oxidative stress. Our findings, taken together with those from previous studies, suggest that relative mtDNA copy number in peripheral blood may more likely be a marker of early colorectal cancer than of risk for the disease or of in vivo oxidative stress. © 2015 Wiley Periodicals, Inc. PMID:26258394

  1. Vesical nephrogenic adenoma: an unusual presentation of a bladder tumour

    PubMed Central

    Martínez-Sanchíz, Carlos; Martínez-Ruiz, Jesús; Anguita-Fernandez, Pedro J.; Giménez-Bachs, José M.; Atiénzar-Tobarra, Manuel; Rodríguez, Julio Antonio Virseda; Salinas-Sánchez, Antonio S.

    2011-01-01

    Vesical nephrogenic adenoma is a rare, benign entity that appears most commonly in middle-aged males. Its etiology is unknown, but it has been linked to chronic irritating factors, such as infection, trauma, urological surgery, kidney stones, foreign bodies and chemical agents, such as Bacille Calmette-Guerin. We report 2 new cases with a history of transurethral resection of the bladder and the prostate and a history of prolonged voiding symptoms. In both cases, the findings of encysted tubular structures lined with flattened cuboidal cells without atypia were consistent with the diagnosis of vesical nephrogenic adenoma. PMID:21989174

  2. Intrasellar schwannoma mimicking pituitary adenoma: a case report.

    PubMed

    Whee, Sung Mock; Lee, Jung Il; Kim, Jong Hyun

    2002-02-01

    Intrasellar location of schwannoma is extremely rare, although intracranial schwannomas account for up to 8% of all primary brain tumors. An unusual case of an intrasellar schwannoma radiographically and clinically simulating a pituitary adenoma is reported. A 39-yr-old man presented a 10-month history of visual disturbance and decreased libido. Neurological examination showed poor visual acuity of both eyes with bitemporal hemianopsia. Computed tomography and magnetic resonance imaging showed a sellar tumor with suprasellar extension. Pituitary adenoma was considered as a preoperative diagnosis. The tumor was removed through a trans-sphenoidal approach. Microscopic examination of the tumor revealed schwannoma. PMID:11850608

  3. Giant Bauhin valve adenoma and laparoscopically assisted colonoscopic polypectomy.

    PubMed

    Mikalauskas, Saulius; Račkauskas, Rokas; Zeromskas, Paulius; Strupas, Kęstutis

    2014-09-01

    Nowadays colonoscopic polypectomy has become a routine procedure, which is performed daily. Almost every colorectal benign tumor can be removed endoscopically, although there are some problematic adenomas which are either large in size or difficult to approach. In the past two decades laparoscopically assisted colonoscopic polypectomy has become established in the endoscopic world, which reduced the need of operations for those patients with lesions that are large or hard to approach. The first laparoscopically monitored colonoscopic polypectomy was performed by Franklin in 1991, and reported publicly in 1993. We present a case report of a patient who was diagnosed with Bauhin valve giant adenoma and underwent laparoscopically assisted polypectomy. PMID:25337179

  4. Fenofibrate-induced massive regression of mutiple inflammatory hepatocellular adenoma.

    PubMed

    Poupon, Raoul; Cazals-Hatem, Dominique; Arrivé, Lionel

    2016-02-01

    Inflammatory hepatocellular adenomas (IHCA), which accounts for 40% to 50% of all hepatocellular adenomas are characterized by the activation of the IL6/JAK/STAT pathway. We herein report the case of a 52-year-old woman presenting with severe multiple typical IHCA that regressed dramatically on treatment with fenofibrate, a PPAR agonist known to prevent IL6-induced inflammation experimentally and in humans. Further similar observations are needed to ascertain the potential benefit of this therapeutic approach for large or unresectable IHCA. PMID:26572747

  5. Neuroendocrine Adenoma of the Middle Ear: A Rare Histopathological Diagnosis

    PubMed Central

    McGinness, Sam; Coleman, Hedley; Varikatt, Winny; da Cruz, Melville

    2016-01-01

    Neuroendocrine tumours occur throughout the body but are rare in the head and neck region and particularly rare in the middle ear. Clinical findings are often nonspecific and therefore pose a diagnostic challenge. Furthermore, the nomenclature of neuroendocrine tumours of the middle ear is historically controversial. Herein a case is presented of a middle ear adenoma in a 33-year-old patient who presented with otalgia, hearing loss, and facial nerve palsy. A brief discussion is included regarding the histopathological features of middle ear adenomas and seeks to clarify the correct nomenclature for these tumours. PMID:27429819

  6. Duct Remediation Program: Remediation operations and implementation

    SciTech Connect

    Beckman, T.d.; Davis, M.M.; Karas, T.M.

    1992-11-01

    Plutonium holdup material has accumulated in the process ventilation duct systems at Rocky Flats. Non-Destructive Assay (NDA) measurements identified ducts containing this material. The Defense Nuclear Facility Safety Board and the Department of Energy established the criteria for remediation of these ducts. A remediation team was assembled and a program plan created. This program plan included activities such as fissile material accumulation identification, criticality safety assessments, radiation dose determinations, facility safety evaluations, prevention of future accumulation, and removal of holdup material. Several operational considerations had to be evaluated in determining completion of remediation.

  7. Magnetospheric whistler ducts observed by ISIS satellites

    NASA Technical Reports Server (NTRS)

    Ondoh, T.

    1976-01-01

    The latitudinal width of the magnetospheric whistler duct has been estimated by the first and final invariant latitudes of whistler echoes and the conservation of the magnetic flux for the centered dipole field, using 105 whistler echoes in ISIS VLF data received at Kashima, Japan for 1972-1973. The latitudinal distribution of whistler duct occurrence shows a maximum at invariant latitudes of 40-45 degrees near the maximum occurrence latitude of ground whistlers. The radial width of magnetospheric whistler duct in the geomagnetically equatorial plane increases with invariant latitude of the geomagnetic flux tube in which whistlers propagate.

  8. Emerging Histopathological and Genetic Parameters of Pituitary Adenomas: Clinical Impact and Recommendation for Future WHO Classification.

    PubMed

    Saeger, W; Petersenn, S; Schöfl, C; Knappe, U J; Theodoropoulou, M; Buslei, R; Honegger, J

    2016-06-01

    The review assesses immunohistochemical findings of somatostatin receptors and of metalloproteinases in different pituitary adenoma types and the significance of molecular genetic data. Current evidence does not support routine immunohistochemical assessment of somatostatin or dopamine receptor subtype expression on hormone-secreting or nonfunctioning pituitary adenomas. Further prospective studies are needed to define its role for clinical decision making. Until then we suggest to restrict membrane receptor profiling to individual cases or for study purposes. The problems of adenoma expansion and invasion are discussed. Despite partially contradictory publications, proteases clearly play a major role in permission of infiltrative growth of pituitary adenomas. Therefore, detection of at least MMP-2, MMP-9, TIMP-2, and uPA seems to be justified. Molecular characterization is important for familial adenomas, adenomas in MEN, Carney complex, and McCune-Albright syndrome and can gain insight into pathogenesis of sporadic adenomas. PMID:26874696

  9. Transmission of wave energy in curved ducts

    NASA Technical Reports Server (NTRS)

    Rostafinski, W.

    1973-01-01

    A formation of wave energy flow was developed for motion in curved ducts. A parametric study over a range of frequencies determined the ability of circular bends to transmit energy for the case of perfectly rigid walls.

  10. How Is Bile Duct Cancer Diagnosed?

    MedlinePlus

    ... line through which a different kind of contrast dye (IV contrast) is injected. This helps better outline ... common bile duct. A small amount of contrast dye is injected through the tube to help outline ...

  11. Treatment Options for Extrahepatic Bile Duct Cancer

    MedlinePlus

    ... checked to measure the amounts of bilirubin and alkaline phosphatase released into the blood by the liver. ... which a stent (a thin, flexible tube or metal tube) is placed in the bile duct to ...

  12. Treatment Option Overview (Extrahepatic Bile Duct Cancer)

    MedlinePlus

    ... checked to measure the amounts of bilirubin and alkaline phosphatase released into the blood by the liver. ... which a stent (a thin, flexible tube or metal tube) is placed in the bile duct to ...

  13. Stages of Extrahepatic Bile Duct Cancer

    MedlinePlus

    ... checked to measure the amounts of bilirubin and alkaline phosphatase released into the blood by the liver. ... which a stent (a thin, flexible tube or metal tube) is placed in the bile duct to ...

  14. Bile Duct (Cholangiocarcinoma) Cancer: Radiation Therapy

    MedlinePlus

    ... form of radiation for bile duct cancer. External beam radiation therapy (EBRT) This type of radiation therapy ... determine the correct angles for aiming the radiation beams and the proper dose of radiation. The treatment ...

  15. Intraoperative cholangiography and bile duct injury.

    PubMed

    Sarli, L; Costi, R; Roncoroni, L

    2006-01-01

    We are not in agreement with the opinion that the credit for excellent results after laparoscopic cholecystectomy is to be attributed to the routine performing of intraoperative cholangiography. We performed 2538 laparoscopic cholecystectomies without routine intraoperative cholangiography and we obtained very low rate and severity of common bile duct injuries: there was a total of four common bile duct injuries (0.16%), in no case was the injury a major transaction, and injuries were detected intraoperatively and easily repaired with a T-tube. Cholangiography could prevent bile duct transaction, but that it is not necessary for intraoperative cholangiography to be routinely performed for this purpose. It is sufficient for intraoperative cholangiography to be performed whenever the surgeon is in doubt as to the biliary anatomy or common bile duct clearance, and that when dissection of the cholecystic peduncle proves difficult he does not hesitate to convert to open access. PMID:16333543

  16. Investigation of heat transfer in porous duct

    NASA Astrophysics Data System (ADS)

    Athani, Abdulgaphur; Khan, T. M. Yunus

    2016-05-01

    Investigation of heat transfer in a square porous duct is carried out. The porous medium is sandwiched between inner and outer surface of a square duct. The flow is assumed to follow the Darcy law. The governing momentum and energy equations are non-dimensionalised and then converted to algebraic form of equations using finite element method. Galerkin method is used to transform the partial differential equations into simpler algebraic equations then solved in a iterative manner to arrive at the solution. The results are presented with respect to various geometric and physical parameters such as depth of porous medium, Rayleigh number etc. It is found that the isotherms and the streamlines take symmetrical position along the vertical central line of square duct. The isotherms are penetrated into deeper area at upper half of duct as compared to lower half.

  17. Model for coal dust duct explosions

    SciTech Connect

    Pickles, J.H.

    1982-01-01

    A theoretical discussion is given of the propagation of a dust explosion in a linear duct or pipeline. The particular aim is to investigate the experimental observation that propagating explosions are much harder to initiate in small laboratory scale ducts than in, say, coal mine galleries. A model is proposed in which a turbulent mixing phenomenon first identified by G.I. Taylor gives, for large ducts, very high flame velocities, which in turn lead to large fluid velocities and further increases in flame velocity. In small ducts, the time scale of the turbulent mixing is less than the time needed for the burning of individual coal particles. The particle burning time becomes an additional constraint on the rate of flame propagation and the development of explosions is inhibited.

  18. Rotating Rake Turbofan Duct Mode Measurement System

    NASA Technical Reports Server (NTRS)

    Sutliff, Daniel L.

    2005-01-01

    An experimental measurement system was developed and implemented by the NASA Glenn Research Center in the 1990s to measure turbofan duct acoustic modes. The system is a continuously rotating radial microphone rake that is inserted into the duct. This Rotating Rake provides a complete map of the acoustic duct modes present in a ducted fan and has been used on a variety of test articles: from a low-speed, concept test rig, to a full-scale production turbofan engine. The Rotating Rake has been critical in developing and evaluating a number of noise reduction concepts as well as providing experimental databases for verification of several aero-acoustic codes. More detailed derivation of the unique Rotating Rake equations are presented in the appendix.

  19. [Isolated neurofibroma of the common bile duct].

    PubMed

    Carbia, S; Pagola, J; Flaster, N; Guida, A; Jufe, L; González, B; Caniparoli, A

    1995-01-01

    The neurogenic tumors in the biliary tract are rare and usually are amputation neuroma that occur after cholecystectomy. We describe a case of isolated neurofibroma of the common bile duct in a young man not cholecystectomized. The patient suffered recurrent episodes of abdominal pain, vomiting and weight loss without clinical signs of Von Recklinghausen's disease or jaundice. The hepatogram was normal. The echography indicated a solid formation with obstruction of the proximal common bile duct. In the ERCP the stenosis was found. Surgical excision of the tumor and anastomosis of bilateral hepatic ducts and jejunum were carried out. At microscopic examination intraparietal neurofibroma of the common bile duct was found. As isolated entity, we know of only one reported case. PMID:8731581

  20. INTERIOR DUCT SYSTEM DESIGN, CONSTRUCTION, AND PERFORMANCE

    SciTech Connect

    Janet E.R. Mcllvaine; David Beal; Philip Fairey

    2001-10-10

    By removing air distribution and conditioning equipment from unconditioned spaces, homeowners stand to benefit substantially with respect to both energy savings and indoor air quality. Duct leakage introduces: Greater heating and cooling loads from air at extreme temperatures and humidity levels; Outside air and air from unconditioned spaces that may contain air borne contaminants, combustion gases, pollen, mold spores, and/or particles of building materials; and Higher whole-house infiltration/exfiltration rates. Exemplary studies conducted since 1990 have demonstrated the prevalence of duct leakage throughout the United States and measured energy savings of approximately 20% during both heating and cooling seasons from leakage reduction. These all dealt with duct leakage to and/or from unconditioned spaces. In the building science community, leakage within the conditioned space is generally presumed to eliminate the negative consequences of duct leakage with the exception of possibly creating pressure imbalances in the house which relates to higher infiltration and/or exfiltration. The practical challenges of isolating ducts and air handlers from unconditioned spaces require builders to construct an air-tight environment for the ducts. Florida Solar Energy Center researchers worked with four builders in Texas, North Carolina, and Florida who build a furred-down chase located either in a central hallway or at the edges of rooms as an architectural detail. Some comparison homes with duct systems in attics and crawl spaces were included in the test group of more than 20 homes. Test data reveals that all of the duct/AHU systems built inside the conditioned space had lower duct leakage to unconditioned spaces than their conventional counterparts; however, none of the homes was completely free of duct leakage to unconditioned spaces. Common problems included wiring and plumbing penetrations of the chase, failure to treat the chase as an air tight space, and misguided

  1. Functional Characteristics of Multipotent Mesenchymal Stromal Cells from Pituitary Adenomas

    PubMed Central

    Megnis, Kaspars; Mandrika, Ilona; Petrovska, Ramona; Stukens, Janis; Rovite, Vita; Balcere, Inga; Jansone, Laima Sabine; Peculis, Raitis; Pirags, Valdis

    2016-01-01

    Pituitary adenomas are one of the most common endocrine and intracranial neoplasms. Although they are theoretically monoclonal in origin, several studies have shown that they contain different multipotent cell types that are thought to play an important role in tumor initiation, maintenance, and recurrence after therapy. In the present study, we isolated and characterized cell populations from seven pituitary somatotroph, nonhormonal, and lactotroph adenomas. The obtained cells showed characteristics of multipotent mesenchymal stromal cells as observed by cell morphology, cell surface marker CD90, CD105, CD44, and vimentin expression, as well as differentiation to osteogenic and adipogenic lineages. They are capable of growth and passaging under standard laboratory cell culture conditions and do not manifest any hormonal cell characteristics. Multipotent mesenchymal stromal cells are present in pituitary adenomas regardless of their clinical manifestation and show no considerable expression of somatostatin 1–5 and dopamine 2 receptors. Most likely obtained cells are a part of tissue-supportive cells in pituitary adenoma microenvironment. PMID:27340409

  2. Functional Characteristics of Multipotent Mesenchymal Stromal Cells from Pituitary Adenomas.

    PubMed

    Megnis, Kaspars; Mandrika, Ilona; Petrovska, Ramona; Stukens, Janis; Rovite, Vita; Balcere, Inga; Jansone, Laima Sabine; Peculis, Raitis; Pirags, Valdis; Klovins, Janis

    2016-01-01

    Pituitary adenomas are one of the most common endocrine and intracranial neoplasms. Although they are theoretically monoclonal in origin, several studies have shown that they contain different multipotent cell types that are thought to play an important role in tumor initiation, maintenance, and recurrence after therapy. In the present study, we isolated and characterized cell populations from seven pituitary somatotroph, nonhormonal, and lactotroph adenomas. The obtained cells showed characteristics of multipotent mesenchymal stromal cells as observed by cell morphology, cell surface marker CD90, CD105, CD44, and vimentin expression, as well as differentiation to osteogenic and adipogenic lineages. They are capable of growth and passaging under standard laboratory cell culture conditions and do not manifest any hormonal cell characteristics. Multipotent mesenchymal stromal cells are present in pituitary adenomas regardless of their clinical manifestation and show no considerable expression of somatostatin 1-5 and dopamine 2 receptors. Most likely obtained cells are a part of tissue-supportive cells in pituitary adenoma microenvironment. PMID:27340409

  3. CT of adenomas of the middle ear and mastoid cavity

    SciTech Connect

    Van Thong Ho; Rao, V.J.; Mikaelian, D.O.

    1996-03-01

    A case of mixed type adenoma of the middle ear and mastoid is presented in which CT showed complete opacification of the middle ear and mastoid air cells with bulging of the tympanic membrane but without ossicular or bony destruction. 7 refs., 1 figs.

  4. Concurrent somatotroph and plurihormonal pituitary adenomas in a cat.

    PubMed

    Sharman, Mellora; FitzGerald, Louise; Kiupel, Matti

    2013-10-01

    An 8-year-old, male neutered, domestic longhair cat was referred for investigation of insulin-resistant diabetes mellitus. Routine haematology, serum biochemistry, urinalysis (including culture), total T4 and urine creatinine:cortisol ratio were unremarkable, but markedly increased insulin-like growth factor-1 concentration was identified and a pituitary mass was subsequently documented. The cat was treated conservatively with the dopamine agonist L-deprenyl and was re-presented 16 months later for worsening polyuria, polydipsia, polyphagia, marked lumbar muscle atrophy, development of a pendulous abdomen and marked thinning of the abdominal skin. Hyperadrenocorticism was diagnosed based on abdominal ultrasonography, dexamethasone suppression testing and endogenous adrenocorticotropic hormone (ACTH). The cat was treated with trilostane (30 mg q24h PO) and showed some clinical improvement, but developed an opportunistic fungal infection and skin fragility syndrome 4.5 months after commencing treatment, and was euthanased. A double-pituitary adenoma comprising a discrete somatotroph adenoma and a separate plurihormonal adenoma (positive immunoreactivity for ACTH, melanocyte-stimulating hormone and follicle-stimulating hormone) was identified on post-mortem examination. These two pituitary adenomas were suspected to have arisen as independent neoplastic entities with the plurihormonal tumour either being clinically silent at the initial presentation or having developed over the subsequent 16 months. PMID:23553410

  5. cAMP signaling in cortisol-producing adrenal adenoma.

    PubMed

    Calebiro, Davide; Di Dalmazi, Guido; Bathon, Kerstin; Ronchi, Cristina L; Beuschlein, Felix

    2015-10-01

    The cAMP signaling pathway is one of the major players in the regulation of growth and hormonal secretion in adrenocortical cells. Although its role in the pathogenesis of adrenocortical hyperplasia associated with Cushing's syndrome has been clarified, a clear involvement of the cAMP signaling pathway and of one of its major downstream effectors, the protein kinase A (PKA), in sporadic adrenocortical adenomas remained elusive until recently. During the last year, a report by our group and three additional independent groups showed that somatic mutations of PRKACA, the gene coding for the catalytic subunit α of PKA, are a common genetic alteration in patients with Cushing's syndrome due to adrenal adenomas, occurring in 35-65% of the patients. In vitro studies revealed that those mutations are able to disrupt the association between catalytic and regulatory subunits of PKA, leading to a cAMP-independent activity of the enzyme. Despite somatic PRKACA mutations being a common finding in patients with clinically manifest Cushing's syndrome, the pathogenesis of adrenocortical adenomas associated with subclinical hypercortisolism seems to rely on a different molecular background. In this review, the role of cAMP/PKA signaling in the regulation of adrenocortical cell function and its alterations in cortisol-producing adrenocortical adenomas will be summarized, with particular focus on recent developments. PMID:26139209

  6. Metachronous tubulovillous and tubular adenomas of the anal canal.

    PubMed

    Nozawa, Hiroaki; Ishihara, Soichiro; Morikawa, Teppei; Tanaka, Junichiro; Yasuda, Koji; Ohtani, Kensuke; Nishikawa, Takeshi; Tanaka, Toshiaki; Kiyomatsu, Tomomichi; Kawai, Kazushige; Hata, Keisuke; Kazama, Shinsuke; Yamaguchi, Hironori; Sunami, Eiji; Kitayama, Joji; Fukayama, Masashi; Watanabe, Toshiaki

    2015-01-01

    Anal canal adenoma is an extremely rare disease that has the potential to transform into a malignant tumor. We herein presented a rare case of metachronous multiple adenomas of the anal canal. A 48-year-old woman underwent total colonoscopy following a positive fecal blood test. A 9-mm villous polyp arising from the posterior wall of the anal canal was removed by snare polypectomy. Histologically, the tumor was tubulovillous adenoma with high-grade dysplasia and the cut end was negative for tumor cells. Six years later, an elevated lesion, macroscopically five millimeters in size, was detected in the left wall of the anal canal in a follow-up colonoscopy. Local excision of the tumor was performed, and the lesion was pathologically confirmed to be tubular adenoma with high-grade dysplasia limited to the mucosa. The patient is currently alive without any evidence of recurrence for six months after surgery. Although she had a past history of cervical cancer, the multiple tumors arising in the anal canal were unlikely to be related to human papilloma virus infection. Our case report underscores the importance of careful observations throughout colonoscopy to detect precancerous lesions, particularly in anatomically narrow segments. PMID:26249723

  7. Ampullary Adenoma Treated by Endoscopic Double-Snare Retracting Papillectomy.

    PubMed

    Soma, Hiromitsu; Miyata, Naoteru; Hozawa, Shigenari; Higuchi, Hajime; Yamagishi, Yoshiyuki; Nakamura, Yuji; Saeki, Keita; Kameyama, Kaori; Masugi, Yohei; Yahagi, Naohisa; Kanai, Takanori

    2015-09-23

    We report herein improved methods for the safe and successful completion of endoscopic papillectomy (EP). Between January 2008 and November 2011, 12 patients underwent double-snare retracting papillectomy for the treatment of lesions of the major duodenal papilla. The main outcomes were en bloc resection rates, pathological findings, and adverse events. All of the patients (mean age, 60.1 years; range, 38 to 80 years) were diagnosed with ampullary adenoma by endoscopic forceps biopsies prior to endoscopic snare papillectomy. En bloc resection by double-snare retracting papillectomy was successfully performed for all lesions (median size, 12.3 mm), comprising six tubular adenomas, one tubulovillous adenoma, three cases of epithelial atypia, one hamartomatous polyp, and one case of duodenitis with regenerative change. Significant hemorrhage and pancreatitis were observed in one case after EP. Adenoma recurrence occurred in three patients during follow-up (median, 28.5 months) at a mean interval of 2 months postoperatively (range, 1 to 3 months). No serious adverse events were observed. Double-snare retracting papillectomy is effective and feasible for treating lesions of the major duodenal papilla. Further treatment experience, including a single-arm phase II study, needs to be accumulated before conducting a randomized controlled study. PMID:26087781

  8. Upper alveolar brown tumor as initial presentation of parathyroid adenoma

    PubMed Central

    Hakeem, Arsheed Hussain; Hakeem, Imtiyaz Hussain; Wani, Fozia Jeelani

    2015-01-01

    Parathyroid adenoma usually presents with the signs and symptoms of hypercalcemia due to hyperparathyroidism. Brown's tumor is the late clinical consequence of untreated hyperparathyroidism and is rarely seen now-a-days due to improved screening biochemical tests. These tumors are characterized by high orthoclastic activity and bone resorption. These are usually located in the pelvis, ribs, clavicles, and extremities. This manuscript highlights a rare presentation of brown's tumor of upper alveolus in a 35-year-old female with a previously undiagnosed case of hyperparathyroidism due to a parathyroid adenoma. Blood analysis depicted high levels of serum calcium and parathyroid hormone. The patient was subjected to selective left lower parathyroidectomy and will receive follow-up to prevent further developments of the disease. Clinicians should be aware of such rare presentation of parathyroid adenomas so that unnecessary extensive surgery of brown's tumor is avoided. This case also highlights the need of detailed work up to arrive at an exact diagnosis and direct surgical intervention to the adenoma rather the secondary manifestation of the disease. PMID:27390503

  9. Intrarenal Adrenocortical Adenoma Treated by Robotic Partial Nephrectomy with Adrenalectomy

    PubMed Central

    Sulek, Jay; Smith, Steven C.; Hampton, Lance J.

    2016-01-01

    Abstract Background: We present an intrarenal adrenocortical adenoma discovered incidentally after robot-assisted partial nephrectomy and total adrenalectomy for a suspicious renal mass. Current literature describes the rare occurrence of an adrenocortical adenoma arising from a renal–adrenal fusion. This case represents an uncommon, benign pathology that should be considered in the differential diagnosis of an enhancing renal mass. Case Presentation: The patient is a 62-year-old female found to have an enhancing mass at the anterolateral aspect of the upper pole of the right kidney concerning for renal-cell carcinoma. CT imaging was performed to work up a cause for hyperparathyroidism. During robot-assisted partial nephrectomy, the lesion was found to be partially adherent to the lateral limb of the right adrenal gland. Microscopic evaluation with Melan-A staining showed the mass to be of adrenal origin with benign features and lack of capsulation, indicating an adrenal adenoma arising from intrarenal ectopic adrenal rests. Conclusion: An intrarenal adrenal adenoma arising from ectopic adrenal tissue is a unique pathology that represents a benign differential diagnosis in the evaluation of an enhancing renal mass. However, it cannot be differentiated from renal-cell carcinoma based on cross-sectional imaging alone and requires postoperative pathologic assessment to confirm the diagnosis. PMID:27579413

  10. Clinical Concerns about Recurrence of Non-Functioning Pituitary Adenoma

    PubMed Central

    Lee, Min Ho; Lee, Ju Hee; Seol, Ho Jun; Lee, Jung-Il; Kim, Jong Hyun; Kong, Doo-Sik

    2016-01-01

    Background Non-functioning pituitary adenomas (NFPA) are clinically challenging because they present at a late stage with local mass effects or hypopituitarism. Surgery for non-functioning pituitary adenoma requires a special strategic approach for both minimal morbidity and radical resection. However, the clinical predictive factors associated with recurrence are limited. Here, we investigated optimal treatment of non-functioning pituitary adenoma. Methods We enrolled 289 patients who presented with non-functioning pituitary adenoma between January 2000 and January 2012 and who had received follow-up for at least one year for this retrospective study. Of these patients, 152 were male and 137 were female, with a median age of 51 years (range 15.79 years) and a median follow-up of four years (range 1.12.6 years). Characteristics of patients and tumors were reviewed with electronic medical records and radiologic images, retrospectively. Results Of the tumors, 193 were gross-totally resected, 53 were near-totally resected, and 43 were sub-totally resected. The extent of resection and adjuvant radiotherapy were both statistically significant prognostic factors of recurrence. Immunohistochemistry of tumor specimens did not yield consistent results. Conclusion With a high rate of recurrence, NFPA should be closely followed-up over a long-term period. Improvement of surgical techniques with advanced surgical equipment and adjuvant radiosurgery would lead to reduce the recurrence rate and improve patients' outcome. PMID:27195254

  11. [A case of parathyroid adenoma with oxyphil cells].

    PubMed

    Enomoto, Katsuhisa; Sakurai, Kenichi; Amano, Sadao

    2014-11-01

    A 56-year-old woman who was undergoing dialysis for renal failure that occurred 4 years previously was identified with hypercalcemia and high levels of intact parathyroid hormone (iPTH), as observed on blood analysis results. Blood analysis also indicated high levels of Ca (12.7 mg/dL) and parathyroid hormone (PTH 1,280 ng/mL). Secondary hyperparathyroidism was suspected to be the cause of hypercalcemia. Cervical neck ultrasonography revealed a 13-× 4-mm hypoechoic mass in the lower left pole of the thyroid gland. Tc-99 metaiodobenzylguanidine (MIBG )imaging revealed aberrant accumulation at the lower region of the left accessory thyroid. Cervical neck computed tomography revealed a 12-mm mass at the inferior pole of the left thyroid gland. Considering the above observations, a diagnosis of lower left parathyroid adenoma was made. Lumpectomy was performed, and the final pathology report indicated oxyphilic adenoma. Chief cells are often observed in parathyroid adenoma, but, to our knowledge, this is the first case of a parathyroid adenoma with oxyphil cells. PMID:25731384

  12. Propagation Of Sound In Curved Ducts

    NASA Technical Reports Server (NTRS)

    Rostafinski, Wojciech

    1992-01-01

    Monograph presents concise, comprehensive summary of knowledge of propagation of acoustic waves in ducts and pipes including bends. Pulls together information from Lord Rayleigh's book Theory Of Sound, published in 1878, and from 33 papers scattered throughout various scientific journals published between 1945 and 1989. Monograph useful to scientists and engineers interested in such diverse topics as musical instruments, air-conditioning ducts, and jet engines. Material not available in current texts.

  13. Evaporation duct communication: Test plan, part 2

    NASA Astrophysics Data System (ADS)

    Anderson, K. D.; Rogers, L. T.

    1991-11-01

    This document is a continuation and expansion of an earlier study that examines the feasibility of using the evaporation duct to support an alternative high-speed communication system for Navy applications. This Evaporation Duct Communication (EDCOM) experiment is a unique opportunity to evaluate another communication channel that can alleviate Navy ship-to-ship communication problems. Therefore, it is strongly recommended to proceed with this measurement program.

  14. A Comparison of Simulation Capabilities for Ducts

    SciTech Connect

    Miller, William A.; Smith, Matt K.; Gu, Lixing; New, Joshua Ryan

    2014-11-01

    Typically, the cheapest way to install a central air conditioning system in residential buildings is to place the ductwork in the attic. Energy losses due to duct-attic interactions can be great, but current whole-house models are unable to capture the dynamic multi-mode physics of the interactions. The building industry is notoriously fragmented and unable to devote adequate research resources to solve this problem. Builders are going to continue to put ducts in the attic because floor space is too expensive to closet them within living space, and there are both construction and aesthetic issues with other approaches such as dropped ceilings. Thus, there is a substantial need to publicly document duct losses and the cost of energy used by ducts in attics so that practitioners, builders, homeowners and state and federal code officials can make informed decisions leading to changes in new construction and additional retrofit actions. Thus, the goal of this study is to conduct a comparison of AtticSim and EnergyPlus simulation algorithms to identify specific features for potential inclusion in EnergyPlus that would allow higher-fidelity modeling of HVAC operation and duct transport of conditioned air. It is anticipated that the resulting analysis from these simulation tools will inform energy decisions relating to the role of ducts in future building energy codes and standards.

  15. Mucoepidermoid carcinoma in a thyroglossal duct remnant

    PubMed Central

    Warner, E.; Ofo, E.; Connor, S.; Odell, E.; Jeannon, J.P.

    2015-01-01

    Introduction Thyroglossal duct cysts (TDC) are common midline neck swellings resulting from embryological remnants of the thyroglossal duct. They often contain ectopic thyroid tissue and malignant transformation has been reported, most commonly to papillary thyroid carcinoma. Mucoepidermoid carcinoma (MEC) usually occurs in the salivary glands and only rarely in the thyroid. This is the first case of a MEC occurring within a thyroglossal duct remnant. Presentation of a case A 73 year old lady presented with a thyroglossal duct cyst. She declined surgical excision, as she was adamant she wanted to avoid surgery. The neck mass rapidly enlarged at two years following initial diagnosis. Fine needle aspiration cytology was suspicious for carcinoma. She underwent total thyroidectomy and selective central compartment neck dissection with adjuvant radiotherapy. She remains alive and well two years post treatment. Discussion Mucoepidermoid carcinoma is the most common malignant neoplasm of salivary glands, although it has rarely been reported in diverse locations including the thyroid, lung and pancreas. To the best of our knowledge, this is the first reported case of mucoepidermoid carcinoma arising from a thyroglossal duct remnant. Conclusion This case adds weight to the literature favouring surgical excision of thyroglossal duct remnants due to the risk of malignant transformation. PMID:26101054

  16. 11C-Methionine positron emission tomography-computed tomography in localization of methoxyisobutyl isonitrile negative ectopic parathyroid adenoma

    PubMed Central

    Seniaray, Nikhil; Sharma, Harshul; Arbind, Arpana; Jaimini, Abhinav; D’souza, Maria; Saw, Sanjeev; Hazari, Puja Panwar; Mishra, A. K.; Sharma, Rajnish; Mondal, Anupam

    2016-01-01

    Primary hyperparathyroidism is caused by parathyroid adenomas in 85% of the cases. Since parathyroid adenomas are known for their ectopic location, presurgical localization of the suspected site of adenoma is desirable. However, current imaging modalities are not always successful in localizing ectopic parathyroid adenomas. The aim of this case report is to show that 11C-methionine positron emission tomography could accurately localize ectopic parathyroid adenomas in patients in whom conventional imaging had failed or is inconclusive. PMID:26917896

  17. Long-Term Outcomes of Radiotherapy for Pituitary Adenomas

    SciTech Connect

    Snead, Felicia E. Amdur, Robert J. M.D.; Morris, Christopher G. M.S.; Mendenhall, William M.

    2008-07-15

    Purpose: To evaluate long-term local control and toxicity for pituitary adenomas treated with fractionated radiotherapy (RT). Methods and Materials: The records of 100 patients with pituitary adenomas treated between 1983 and 2003 were retrospectively reviewed. Thirty-one patients had hormone-secreting tumors; 69 patients were treated with surgery and postoperative RT. Median follow-up was 6.7 years (range, 0.6-20.2 years) for all patients and 6.2 years (range, 2-20.2 years) for living patients. The mean dose delivered was 45 Gy (range, 43-50.4 Gy). Results: The 10-year actuarial local control rates for nonsecreting and secreting adenomas were 98% and 73%, respectively (p 0.0015). Actuarial 10-year cause-specific survival (CSS) rates were 95% and 88%, and overall survival rates were 66% and 79% for nonsecreting and secreting adenomas, respectively. Involvement of the sphenoid sinus was found to be significantly associated with decreased 10-year CSS (p = 0.0453). When compared with the two- or three-field techniques, stereotactic RT was associated with improved CSS (p = 0.0775). CSS was not significantly associated with hormone excretion, extent of surgery, or whether RT was administrated postoperatively or for salvage after a postsurgical recurrence. New cases of hypopituitarism occurred in 35 patients. One patient experienced vision loss, and one patient developed a post-treatment glioma. Conclusions: This is one of the most mature series in the literature that documents excellent results with fractionated RT for pituitary adenoma. We recommend 45 Gy at 1.8 Gy per fraction using stereotactic noncoplanar fields.

  18. Expression pattern of the Hedgehog signaling pathway in pituitary adenomas.

    PubMed

    Yavropoulou, Maria P; Maladaki, Anna; Topouridou, Konstantina; Kotoula, Vasiliki; Poulios, Chris; Daskalaki, Emily; Foroglou, Nikolaos; Karkavelas, George; Yovos, John G

    2016-01-12

    Several studies have demonstrated the role of Wnt and Notch signaling in the pathogenesis of pituitary adenomas, but data are scarce regarding the role of Hedgehog signaling. In this study we investigated the differential expression of gene targets of the Hedgehog signaling pathway. Formalin-fixed, paraffin-embedded specimens from adult patients who underwent transphenoidal resection and normal human pituitary tissues that were obtained from autopsies were used. Clinical information and data from pre-operative MRI scan (extracellular tumor extension, tumor size, displacement of the optic chiasm) were retrieved from the Hospital's database. We used a customized RT(2) Profiler PCR Array, to investigate the expression of genes related to Notch and Hedgehog signaling pathways (PTCH1, PTCH2, GLI1, GLI3, NOTCH3, JAG1, HES1, and HIP). A total of 52 pituitary adenomas (32 non-functioning adenomas, 15 somatotropinomas and 5 prolactinomas) were used in the final analysis. In non-functioning pituitary adenomas there was a significant decrease (approximately 75%) in expression of all Hedgehog related genes that were tested, while Notch3 and Jagged-1 expression was found significantly increased, compared with normal pituitary tissue controls. In contrast, somatotropinomas demonstrated a significant increase in expression of all Hedgehog related genes and a decrease in the expression of Notch3 and Jagged-1. There was no significant difference in the expression of Hedgehog and Notch related genes between prolactinomas and healthy pituitary tissues. Hedgehog signalling appears to be activated in somatotropinomas but not in non-functioning pituitary adenomas in contrast to the expression pattern of Notch signalling pathway. PMID:26620835

  19. Clinicopathological correlates of extrasellar growth patterns in pituitary adenomas.

    PubMed

    Sarkar, Sauradeep; Chacko, Ari G; Chacko, Geeta

    2015-07-01

    We reviewed clinical, imaging and histopathology details of 297 patients who underwent surgery for pituitary adenomas, with an equal distribution of functional and non-functioning tumors, to examine clinicopathological correlates of extrasellar growth. Knosp grades of 3 and 4 on MRI defined cavernous sinus invasion, Hardy grades of C and D defined significant suprasellar/subfrontal extension, and intraoperative evidence of tumor eroding through the clivus or sellar floor defined infrasellar invasion. Disease status at follow-up was known in 246 patients overall, including 35 patients who were evaluated for progression of residual disease on serial imaging. On univariate analysis, we found several statistically significant associations (p < 0.05) including adenoma size with age, sex and tumor protein p53 reactivity; cavernous sinus invasion with size, non-functional status, increased mitotic activity, an elevated MIB-1 proliferation index and p53 reactivity; suprasellar/subfrontal extension with p53 reactivity; and infrasellar invasion with age and tumor size. When adjusting for confounders with logistic regression, several significant associations were evident including adenoma size with male sex and p53 reactivity; cavernous sinus invasion with size and elevated MIB-1 proliferation index; suprasellar/subfrontal extension with p53 reactivity; and infrasellar invasion with adenoma size alone. Patients with early progression of postoperative residual tumor were younger with a non-significant trend towards higher MIB-1 proliferation indices. Individual patterns of extrasellar growth in pituitary adenomas are associated with unique clinical and immunohistochemical profiles. Younger patients with elevated MIB-1 values are probably at high risk for early recurrence of non-functioning tumors. Definitions of atypia must be standardized before more robust assumptions about tumor biology can be established. PMID:25979255

  20. Circulating levels of inflammatory cytokines and risk of colorectal adenomas

    PubMed Central

    Kim, Sangmi; Keku, Temitope O.; Martin, Christopher; Galanko, Joseph; Woosley, John T.; Schroeder, Jane C.; Satia, Jessie A.; Halabi, Susan; Sandler, Robert S.

    2009-01-01

    The association between obesity and colorectal neoplasia may be mediated by inflammation. Circulating levels of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) are elevated in the obese. Adipose tissue can produce and release the inflammatory cytokines that are potentially procarcinogenic. We examined circulating levels of CRP, IL-6, and TNF-α in relation to risk factors and the prevalence of colorectal adenomas. Plasma levels of CRP, IL-6, and TNF-α were quantified in 873 participants (242 colorectal adenoma cases and 631 controls) in a colonoscopy-based cross-sectional study conducted between 1998 and 2002. Multivariable logistic regression was used to estimate associations between levels of inflammatory cytokines, colorectal adenomas, and known risk factors. Several known risk factors for colorectal neoplasia were associated with higher levels of inflammatory cytokines such as older age, current smoking, and increasing adiposity. The prevalence of colorectal adenomas was associated with higher concentrations of IL-6 and TNF-α, and to a lesser degree, with CRP. For IL-6, adjusted odds ratios for colorectal adenomas were 1.78 (95% confidence interval [CI]: 1.18–2.68) for the second highest plasma level, and 1.84 (95% CI: 1.24– 2.74) for the highest level compared with the reference level. A similar association was found with TNF-α, with adjusted odds ratios of 1.54 (95% CI: 1.02–2.33) and 1.65 (95% CI: 1.09–2.50), respectively. Our findings indicate that inflammation might be involved in the early development of colorectal neoplasia, and suggest that systemic inflammatory cytokines might be an indicator of obesity and other risk factors for colorectal neoplasia. PMID:18172326

  1. Silent subtype 3 pituitary adenomas are not always silent and represent poorly differentiated monomorphous plurihormonal Pit-1 lineage adenomas.

    PubMed

    Mete, Ozgur; Gomez-Hernandez, Karen; Kucharczyk, Walter; Ridout, Rowena; Zadeh, Gelareh; Gentili, Fred; Ezzat, Shereen; Asa, Sylvia L

    2016-02-01

    Originally classified as a variant of silent corticotroph adenoma, silent subtype 3 adenomas are a distinct histologic variant of pituitary adenoma of unknown cytogenesis. We reviewed the clinical, biochemical, radiological, immunohistochemical and ultrastructural features of 31 silent subtype 3 adenomas to clarify their cellular origin. Among 25 with clinical and/or radiological data, all were macroadenomas; there was cavernous sinus invasion in 30% of cases and involvement of the clivus in 17% of cases. Almost 90% of patients were symptomatic; 67% had mass effect symptoms, 37% were hypogonadal and 8% had secondary adrenal insufficiency. Significant hormonal excess in 29% of cases included hyperthyroidism in 17%, acromegaly in 8% and hyperprolactinemia above 150 μg/l in 4%. Two individuals with hyperprolactinemia who were younger than 30 years had multiple endocrine neoplasia type 1. Immunohistochemically, all 31 tumors were diffusely positive for the pituitary lineage-specific transcription factor Pit-1. Although three only expressed Pit-1, others revealed variable positivity for one or more hormones of Pit-1 cell lineage (growth hormone, prolactin, thyroid-stimulating hormone), as well as alpha-subunit and estrogen receptor. Most tumors exhibited perinuclear reactivity for keratins with the CAM5.2 antibody; scattered fibrous bodies were noted in five (16%) tumors. The mean MIB-1 labeling index was 4% (range, 1-9%). Fourteen cases examined by electron microscopy were composed of a monomorphous population of large polygonal or elongated cells with nuclear spheridia. Sixty-five percent of patients had residual disease after surgery; after a mean follow-up of 48.4 months (median 41.5; range=2-171) disease progression was documented in 53% of those cases. These data identify silent subtype 3 adenomas as aggressive monomorphous plurihormonal adenomas of Pit-1 lineage that may be associated with hyperthyroidism, acromegaly or galactorrhea and amenorrhea. Our

  2. Gene expression profiling analysis of MENX-associated rat pituitary adenomas contributes to understand molecular mechanisms of human pituitary adenomas

    PubMed Central

    ZHANG, HONGZHI; XU, CHUAN; SUN, NINGYANG; ZHOU, YINTING; YU, XIAOFEI; YAN, XUE; ZHANG, QIUJUAN

    2016-01-01

    The present study aimed to screen potential genes associated with pituitary adenomas to obtain further understanding with regard to the pathogenesis of pituitary adenomas. The microarray GSE23207 dataset, containing 16 pituitary adenoma samples from multiple endocrine neoplasia syndrome-associated rats and 5 normal pituitary tissue samples, was downloaded from Gene Expression Omnibus. The Linear Models for Microarray Data package was used to identify the differentially-expressed genes (DEGs) with the cut-off criteria of a |log2fold change (FC)|>1 and adjusted P-values of <0.05. The potential functions of the DEGs were predicted by functional and pathway enrichment analysis with the Database for Annotation, Visualization and Integrated Discovery. Furthermore, the interaction associations of the up- and downregulated DEGs obtained from the Search Tool for the Retrieval of Interacting Genes database were respectively revealed by the protein-protein interaction networks visualized with Cytoscape. A total of 391 upregulated and 238 downregulated DEGs in were screened in the pituitary adenoma samples. The upregulated DEGs with a higher degree in the protein-protein interaction network (e.g., CCNA2, CCNB1 and CDC20) were significantly involved in cell cycle and cell division. Notably, PTTG1 was enriched in every functional term. These DEGs interacted with each other. The downregulated DEGs (e.g., GABRA1, GABRA4 and GABRB1) also interacted with each other, and were relevant to neuroactive ligand-receptor interaction; the DEG POU1F1, interacting with POMC, was correlated with the development of the pituitary gland, adenohypophysis and endocrine system. Certain DEGs, including CCNB1, CCNA2, CDC20, GABRA1, GABRA4, GABRB1, POU1F1 and POMC, and particularly PTTG1, were shown to be closely involved in the pathogenesis of pituitary adenomas. PMID:26870179

  3. Nonampullary duodenal adenoma: Current understanding of its diagnosis, pathogenesis, and clinical management

    PubMed Central

    Lim, Chul-Hyun; Cho, Young-Seok

    2016-01-01

    Nonampullary duodenal adenomas are relatively common in familial adenomatous polyposis (FAP), but nonampullary sporadic duodenal adenomas (SDAs) are rare. Emerging evidence shows that duodenal adenomas, regardless of their anatomic location and whether they are sporadic or FAP-related, share morphologic and molecular features with colorectal adenomas. The available data suggest that duodenal adenomas develop to duodenal adenocarcinomas via similar mechanisms. The optimal approach for management of duodenal adenomas remains to be determined. The techniques for endoscopic resection of duodenal adenoma include snare polypectomy, endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), and argon plasma coagulation ablation. EMR may facilitate removal of large duodenal polyps. Although several studies have reported cases of successful ESD for duodenal adenomas, the procedure is technically difficult to perform safely because of the anatomical properties of the duodenum. Although current clinical practice recommends endoscopic resection of all large duodenal adenomas in patients with FAP, endoscopic treatment is usually insufficient to guarantee a polyp-free duodenum. Surgery is indicated for FAP patients with severe polyposis or nonampullary SDAs or FAP-related polyps not amenable to endoscopic resection. Further studies are needed to develop newer endoscopic techniques to guide diagnostic and therapeutic decisions for future management of nonampullary duodenal adenomas. PMID:26811631

  4. Mutational Profiles Reveal an Aberrant TGF-β-CEA Regulated Pathway in Colon Adenomas

    PubMed Central

    Jogunoori, Wilma; Menon, Vipin; Majumdar, Avijit; Chen, Jiun-Sheng; Gi, Young Jin; Jeong, Yun Seong; Phan, Liem; Belkin, Mitchell; Gu, Shoujun; Kundra, Suchin; Mistry, Nipun A.; Zhang, Jianping; Su, Xiaoping; Li, Shulin; Lin, Sue-Hwa; Javle, Milind; McMurray, John S.; Rahlfs, Thomas F.; Mishra, Bibhuti; White, Jon; Rashid, Asif; Beauchemin, Nicole; Weston, Brian R.; Shafi, Mehnaz A.; Stroehlein, John R.; Davila, Marta; Akbani, Rehan; Weinstein, John N.; Wu, Xifeng; Mishra, Lopa

    2016-01-01

    Mutational processes and signatures that drive early tumorigenesis are centrally important for early cancer prevention. Yet, to date, biomarkers and risk factors for polyps (adenomas) that inordinately and rapidly develop into colon cancer remain poorly defined. Here, we describe surprisingly high mutational profiles through whole-genome sequence (WGS) analysis in 2 of 4 pairs of benign colorectal adenoma tissue samples. Unsupervised hierarchical clustered transcriptomic analysis of a further 7 pairs of adenomas reveals distinct mutational signatures regardless of adenoma size. Transitional single nucleotide substitutions of C:G>T:A predominate in the adenoma mutational spectrum. Strikingly, we observe mutations in the TGF-β pathway and CEA-associated genes in 4 out of 11 adenomas, overlapping with the Wnt pathway. Immunohistochemical labeling reveals a nearly 5-fold increase in CEA levels in 23% of adenoma samples with a concomitant loss of TGF-β signaling. We also define a functional role by which the CEA B3 domain interacts with TGFBR1, potentially inactivating the tumor suppressor function of TGF-β signaling. Our study uncovers diverse mutational processes underlying the transition from early adenoma to cancer. This has broad implications for biomarker-driven targeting of CEA/TGF-β in high-risk adenomas and may lead to early detection of aggressive adenoma to CRC progression. PMID:27100181

  5. Mutational Profiles Reveal an Aberrant TGF-β-CEA Regulated Pathway in Colon Adenomas.

    PubMed

    Chen, Jian; Raju, Gottumukkala S; Jogunoori, Wilma; Menon, Vipin; Majumdar, Avijit; Chen, Jiun-Sheng; Gi, Young Jin; Jeong, Yun Seong; Phan, Liem; Belkin, Mitchell; Gu, Shoujun; Kundra, Suchin; Mistry, Nipun A; Zhang, Jianping; Su, Xiaoping; Li, Shulin; Lin, Sue-Hwa; Javle, Milind; McMurray, John S; Rahlfs, Thomas F; Mishra, Bibhuti; White, Jon; Rashid, Asif; Beauchemin, Nicole; Weston, Brian R; Shafi, Mehnaz A; Stroehlein, John R; Davila, Marta; Akbani, Rehan; Weinstein, John N; Wu, Xifeng; Mishra, Lopa

    2016-01-01

    Mutational processes and signatures that drive early tumorigenesis are centrally important for early cancer prevention. Yet, to date, biomarkers and risk factors for polyps (adenomas) that inordinately and rapidly develop into colon cancer remain poorly defined. Here, we describe surprisingly high mutational profiles through whole-genome sequence (WGS) analysis in 2 of 4 pairs of benign colorectal adenoma tissue samples. Unsupervised hierarchical clustered transcriptomic analysis of a further 7 pairs of adenomas reveals distinct mutational signatures regardless of adenoma size. Transitional single nucleotide substitutions of C:G>T:A predominate in the adenoma mutational spectrum. Strikingly, we observe mutations in the TGF-β pathway and CEA-associated genes in 4 out of 11 adenomas, overlapping with the Wnt pathway. Immunohistochemical labeling reveals a nearly 5-fold increase in CEA levels in 23% of adenoma samples with a concomitant loss of TGF-β signaling. We also define a functional role by which the CEA B3 domain interacts with TGFBR1, potentially inactivating the tumor suppressor function of TGF-β signaling. Our study uncovers diverse mutational processes underlying the transition from early adenoma to cancer. This has broad implications for biomarker-driven targeting of CEA/TGF-β in high-risk adenomas and may lead to early detection of aggressive adenoma to CRC progression. PMID:27100181

  6. Size limitations in semicircular duct systems

    PubMed

    Muller

    1999-06-01

    The present article discusses mechanical requirements and limitations which are applicable to the construction of the system of semicircular ducts, especially to its size. The simplified case of a single, uniform duct system has been considered which can be described by a second order equation of motion. The principal functional quantities for this rotation-sensor are: (1) response speed; (2) sensitivity; and (3) regular flow. The response speed of a single, uniform semicircular duct is characterized by the short time constant (T2) which is dependent on the duct radius (r). Its estimated range is from 0.04 ms in the smallest to 140 ms in the largest known labyrinth. The sensitivity is characterized by the maximal endolymph displacement after a step stimulus (xmax). Its estimated range is from 0.0016 &mgr;m to 5.97 mm (6.56 decades!), assuming an input angular velocity of omega=1 rad s-1. The Reynolds number is a measure for an undisturbed laminar flow. Its estimated range varies from 7.38.10(-4)to 45.1 for omega=1 rad s-1. The above data follow from graphs in which, for a single uniform duct, circuit radius (R) is plotted against duct radius (r) for labyrinths of 233 species belonging to different vertebrate-groups. A relation R =38.9. r1.60was determined. The smallest labyrinth was found in a carp larva (Cyprinus), the largest in a whale shark (Rhincodon). Large whales possess labyrinths of average mammalian size. It is revealed that semicircular duct size is bound by requirements concerning regular flow and by a too low response speed for large labyrinths, and by a too low sensitivity for small labyrinths. Other important quantities are mechanical amplification factors which are a consequence of more complex vestibular constructions than a single uniform duct circuit. Allometric relationships are interpreted as compromises between the quantities mentioned. A hypothesis for the relatively large semicircular duct sizes of fishes, especially Elasmobranchii, compared

  7. Remodeling of the Fetal Collecting Duct Epithelium

    PubMed Central

    Hiatt, Michael J.; Ivanova, Larissa; Toran, Nuria; Tarantal, Alice F.; Matsell, Douglas G.

    2010-01-01

    Congenital urinary tract obstruction induces changes to the renal collecting duct epithelium, including alteration and depletion of intercalated cells. To study the effects of obstruction on the ontogeny of intercalated cell development, we examined normal and obstructed human fetal and postnatal kidneys. In the normal human fetal kidney, intercalated cells originated in the medullary collecting duct at 8 weeks gestation and remained most abundant in the inner medulla throughout gestation. In the cortex, intercalated cells were rare at 18 and 26 weeks gestation and observed at low abundance at 36 weeks gestation. Although early intercalated cells exhibit an immature phenotype, Type A intercalated cells predominated in the inner and outer medullae at 26 and 36 weeks gestation with other intercalated cell subtypes observed rarely. Postnatally, the collecting duct epithelium underwent a remodeling whereby intercalated cells become abundant in the cortex yet absent from the inner medulla. In 18-week obstructed kidneys with mild to moderate injury, the intercalated cells became more abundant and differentiated than the equivalent age-matched normal kidney. In contrast, more severely injured ducts of the late obstructed kidney exhibited a significant reduction in intercalated cells. These studies characterize the normal ontogeny of human intercalated cell development and suggest that obstruction induces premature remodeling and differentiation of the fetal collecting duct epithelium. PMID:20035053

  8. Convolution seal for transition duct in turbine system

    SciTech Connect

    Flanagan, James Scott; LeBegue, Jeffrey Scott; McMahan, Kevin Weston; Dillard, Daniel Jackson; Pentecost, Ronnie Ray

    2015-05-26

    A turbine system is disclosed. In one embodiment, the turbine system includes a transition duct. The transition duct includes an inlet, an outlet, and a passage extending between the inlet and the outlet and defining a longitudinal axis, a radial axis, and a tangential axis. The outlet of the transition duct is offset from the inlet along the longitudinal axis and the tangential axis. The transition duct further includes an interface feature for interfacing with an adjacent transition duct. The turbine system further includes a convolution seal contacting the interface feature to provide a seal between the interface feature and the adjacent transition duct.

  9. Presentation of parathyroid adenoma with genu valgum and thoracic deformities.

    PubMed

    Zil-E-Ali, Ahsan; Latif, Aiza; Rashid, Anam; Malik, Asim; Khan, Haseeb Ahmed

    2016-01-01

    Parathyroid adenoma is the main cause of primary hyperparathyroidism. It is usually asymptomatic and occurs more commonly in adults. It presents with raised parathormone (PTH) and Ca+ levels in serum. Its presentation in adolescence is rare. We report one such incidence of a 14 years old girl who presented with bone pains short stature, and generalized muscle wasting. She was found to have genu valgum at the knee joint, pectus carniatum, scoliosis and cystic changes in pelvis and calvarium. Biochemical investigations and parathyroid Tc-99mMIBI scan confirmed the diagnosis of a parathyroid adenoma. The gland was removed by parathyroidectomy. Till date 12 such cases are reported and none had thoracic, vertebral or calvarium involvement. PMID:26712192

  10. Pituitary adenomas: historical perspective, surgical management and future directions

    PubMed Central

    Theodros, Debebe; Patel, Mira; Ruzevick, Jacob; Lim, Michael; Bettegowda, Chetan

    2016-01-01

    Pituitary adenomas are among the most common central nervous system tumors. They represent a diverse group of neoplasms that may or may not secrete hormones based on their cell of origin. Epidemiologic studies have documented the incidence of pituitary adenomas within the general population to be as high as 16.7%. A growing body of work has helped to elucidate the pathogenesis of these tumors. Each subtype has been shown to demonstrate unique cellular changes potentially leading to tumorigenesis. Surgical advancements over several decades have included microsurgery and the employment of the endoscope for surgical resection. These advancements increase the likelihood of gross-total resection and have resulted in decreased patient morbidity. PMID:26497533

  11. Non-functioning pituitary adenomas: growth and aggressiveness.

    PubMed

    Øystese, Kristin Astrid; Evang, Johan Arild; Bollerslev, Jens

    2016-07-01

    Pituitary adenomas (PAs) are common, comprising approximately one third of all intracranial tumors. Non-functioning pituitary adenomas (NFPAs) are the most common PAs. Although usually benign, the NFPAs represent therapeutic challenges because of their location close to the optic chiasm and nerves, and the proximity to the pituitary gland. The therapeutic alternatives are surgery and radiation. To date there is no effective medical treatment. NFPAs are classified according to different modalities, but there are no reliable marker of aggressiveness to guide the clinician in monitoring the patient. More information on growth patterns with constituent biological markers are needed to tailor the care of this patient group. Studies characterizing the membrane receptors of NFPAs have shown promising results, which may give rise to the development of medical treatment. PMID:27066792

  12. Basal cell adenoma of maxillary sinus mimicking ameloblastoma.

    PubMed

    Bhagde, Priya Anil; Barpande, Suresh Ramchandra; Bhavthankar, Jyoti Dilip; Humbe, Jayanti G

    2016-01-01

    Basal cell adenoma (BCA) is a rare basaloid tumor, with only 20% of cases occurring in minor salivary glands. Histologically, BCA is characterized by the presence of basaloid cells and may frequently be mistaken with canalicular adenoma, basal cell adenocarcinoma, adenoid cystic carcinoma and basaloid squamous cell carcinoma. Immunohistochemistry may aid in arriving at a final diagnosis as in the present case. Reported here is a case of locally aggressive BCA. Histologically, the lesion mimicked ameloblastoma and other entities which posed a diagnostic challenge. There are no reports of BCA presenting as an aggressive lesion available in English literature so far; moreover, merely a single case of BCA of maxillary sinus has been previously reported to the best of our cognition. This case report highlights the rarity of this tumor with regards to its site of origin, clinical behavior and histopathological mimics. PMID:27194878

  13. Basal cell adenoma of maxillary sinus mimicking ameloblastoma

    PubMed Central

    Bhagde, Priya Anil; Barpande, Suresh Ramchandra; Bhavthankar, Jyoti Dilip; Humbe, Jayanti G

    2016-01-01

    Basal cell adenoma (BCA) is a rare basaloid tumor, with only 20% of cases occurring in minor salivary glands. Histologically, BCA is characterized by the presence of basaloid cells and may frequently be mistaken with canalicular adenoma, basal cell adenocarcinoma, adenoid cystic carcinoma and basaloid squamous cell carcinoma. Immunohistochemistry may aid in arriving at a final diagnosis as in the present case. Reported here is a case of locally aggressive BCA. Histologically, the lesion mimicked ameloblastoma and other entities which posed a diagnostic challenge. There are no reports of BCA presenting as an aggressive lesion available in English literature so far; moreover, merely a single case of BCA of maxillary sinus has been previously reported to the best of our cognition. This case report highlights the rarity of this tumor with regards to its site of origin, clinical behavior and histopathological mimics. PMID:27194878

  14. Pleomorphic Adenoma with Sarcomatous Change in a Lacrimal Gland

    PubMed Central

    Sung, Kyoung-Su; Kim, Dae-Cheol; Ahn, Hee-Bae

    2015-01-01

    A 69-year-old man was referred with left exophthalmos. Computed tomographic (CT) findings detected a well-circumscribed mass in the left side of the intraorbital cavity. At that time, he refused the further evaluation and treatment. About three years later, the size of the mass had enlarged, and the patient's symptoms were getting worse. The mass was completely removed with frontotemporal craniotomy and superolateral orbitotomy. In operative findings, the mass had originated in the lacrimal gland and was well-encapsulated without invasion to the surrounding tissue. In the pathologic findings, the tumor consisted of pleomorphic adenoma with osteosarcomatous change of stromal components. Postoperatively, the adjuvant radiotherapy was done four weeks later. The patient's symptoms were improved. The pleomorphic adenoma with osteosarcomatous change is extremely rare and appropriate treatment is not clearly established. We would like to report this rare case with a review of the literature. PMID:26180619

  15. Ovarian Hyperstimulation Caused by Gonadotroph Pituitary Adenoma--Review.

    PubMed

    Halupczok, Jowita; Kluba-Szyszka, Anna; Bidzińska-Speichert, Bożena; Knychalski, Bartłomiej

    2015-01-01

    Ovarian hyperstimulation syndrome (OHSS) occurs mostly as an iatrogenic complication of assisted reproductive technology. Gonadotroph pituitary adenomas are rarely associated with OHSS. To the authors' knowledge, to date only 30 cases of spontaneous ovarian stimulation associated with gonadotroph adenomas have been reported in women and only 2 in children. The most common symptoms in such cases included menstrual disturbances, abdominal or pelvic pain, abdominal distension and increased girth. Galactorrhea, nausea and vomiting were also reported. Neurological symptoms occurred when the size of the pituitary tumor reached at least 20 mm. Transvaginal ultrasound examination usually demonstrated enlarged multicystic ovaries. MRIs of the pituitary revealed macroadenomas up to 61 mm in maximum diameter. The hormonal profiles of the reported cases showed normal or elevated FSH levels, suppressed LH levels, elevated estradiol levels and supranormal concentrations of prolactin. Transsphenoidal surgery is the therapy of choice, however other treatment modalities can be utilized in selected cases. PMID:26469116

  16. Congenital renal tumor: metanephric adenoma, nephrogenic rest, or malignancy?

    PubMed

    Yin, Minzhi; Cai, Jiaoyang; Thorner, Paul Scott

    2015-01-01

    We report a renal tumor detected by prenatal ultrasound and resected at 2 months of age. This 9-cm, solid mass was composed of tubular and papillary structures lined by small, uniform epithelial cells. There was local invasion into renal parenchyma and a tumor deposit in a hilar lymph node. The tumor was immunopositive for WT1, pankeratin, and CD10; focally positive for CK7; and negative for EMA and TFE3. Based on morphology and immunophenotype, the favored diagnosis was metanephric adenoma over Wilms tumor, renal cell carcinoma, and nephrogenic rest. However, metanephric adenoma only occasionally occurs in children and has never been reported prenatally. Alternatively, this tumor might be a congenital Wilms tumor that differentiated completely. Although the nature of the tumor remains unconfirmed, resection appears to have been curative; the patient remains disease-free 18 months following surgery alone. PMID:25734608

  17. A thyrotropin-secreting pituitary adenoma as a cause of thyrotoxic periodic paralysis.

    PubMed

    Alings, A M; Fliers, E; de Herder, W W; Hofland, L J; Sluiter, H E; Links, T P; van der Hoeven, J H; Wiersinga, W M

    1998-11-01

    We describe a patient with thyrotoxic periodic paralysis (TPP) caused by a thyrotropin-secreting pituitary adenoma. The diagnosis TPP was based on the combination of episodes of reversible hypokalaemic paralysis, hyperthyroidism and electrophysiological findings. A thyrotropin-secreting pituitary adenoma was diagnosed on the basis of endocrinological function tests and MRI of the pituitary gland. Before transsphenoidal resection of the adenoma, treatment with octreotide restored euthyroidism both clinically and biochemically. Immunocytochemistry of the pituitary adenoma was positive for TSH exclusively. Incubation with octreotide or quinagolide induced decreased TSH and alpha-subunit production by the cultured adenoma cells, in agreement with the pre-operative in vivo data. This paper is the first to describe in vivo and in vitro characteristics of a thyrotropin-secreting pituitary adenoma in a patient presenting with periodic paralysis. PMID:9854688

  18. Huge Parathyroid Adenoma with Dysphagia Presentation; A Case Report from Southern Iran.

    PubMed

    Ziaeean, Bizhan; Sohrabi-Nazari, Sahar

    2016-09-01

    Parathyroid adenoma is a benign tumor of the parathyroid glands. The cause of most parathyroid adenomas is unknown. Parathyroid adenoma increases the secretion of parathyroid hormone and results in primary hyperparathyroidism. High amounts of parathyroid hormone in the blood cause the imbalance of calcium, which leads to various complications such as kidney stones, depression, lethargy, nausea, vomiting, abdominal pain, myalgia, bone and joint pain, hoarseness, etc. Oropharyngeal dysphagia is defined as having problem in swallowing due to abnormalities in the structure and function of oropharynx and other related organs. The exact prevalence of dysphagia caused by parathyroid adenoma is unknown, but since this complication can lead to increased mortality and morbidity, its diagnosis is important. It is difficult to distinguish parathyroid malignancies from parathyroid adenoma even after surgery. Therefore, the final diagnosis is possible through surgery and histopathological evaluation. Here, a case of parathyroid adenoma with first presentation of generalized weakness and dysphagia has been reported. PMID:27582595

  19. Huge Parathyroid Adenoma with Dysphagia Presentation; A Case Report from Southern Iran

    PubMed Central

    Ziaeean, Bizhan; Sohrabi-Nazari, Sahar

    2016-01-01

    Parathyroid adenoma is a benign tumor of the parathyroid glands. The cause of most parathyroid adenomas is unknown. Parathyroid adenoma increases the secretion of parathyroid hormone and results in primary hyperparathyroidism. High amounts of parathyroid hormone in the blood cause the imbalance of calcium, which leads to various complications such as kidney stones, depression, lethargy, nausea, vomiting, abdominal pain, myalgia, bone and joint pain, hoarseness, etc. Oropharyngeal dysphagia is defined as having problem in swallowing due to abnormalities in the structure and function of oropharynx and other related organs. The exact prevalence of dysphagia caused by parathyroid adenoma is unknown, but since this complication can lead to increased mortality and morbidity, its diagnosis is important. It is difficult to distinguish parathyroid malignancies from parathyroid adenoma even after surgery. Therefore, the final diagnosis is possible through surgery and histopathological evaluation. Here, a case of parathyroid adenoma with first presentation of generalized weakness and dysphagia has been reported. PMID:27582595

  20. User's Manual for DuctE3D: A Program for 3D Euler Unsteady Aerodynamic and Aeroelastic Analysis of Ducted Fans

    NASA Technical Reports Server (NTRS)

    Srivastava, R.; Reddy, T. S. R.

    1997-01-01

    The program DuctE3D is used for steady or unsteady aerodynamic and aeroelastic analysis of ducted fans. This guide describes the input data required and the output files generated, in using DuctE3D. The analysis solves three dimensional unsteady, compressible Euler equations to obtain the aerodynamic forces. A normal mode structural analysis is used to obtain the aeroelastic equations, which are solved using either the time domain or the frequency domain solution method. Sample input and output files are included in this guide for steady aerodynamic analysis and aeroelastic analysis of an isolated fan row.

  1. Film condensation in a horizontal rectangular duct

    NASA Technical Reports Server (NTRS)

    Lu, Qing; Suryanarayana, N. V.

    1993-01-01

    Condensation heat transfer in a horizontal rectangular duct was experimentally and analytically investigated. To prevent the dripping of condensate on the film, the experiment was conducted inside a horizontal rectangular duct with vapor condensing only on the bottom cooled plate of the duct. R-113 and FC-72 (Fluorinert Electronic Fluid developed by the 3M Company) were used as the condensing fluids. The experimental program included measurements of film thickness, local and average heat transfer coefficients, wave length, wave speed, and a study of wave initiation. The measured film thickness was used to obtain the local heat transfer coefficient. The wave initiation was studied both with condensation and with an adiabatic air-liquid flow. The test sections used in both experiments were identical.

  2. "Mustache sign" due to Stensen duct dilation.

    PubMed

    Yoruk, O; Kılıc, K; Kantarcı, M

    2013-12-01

    An 80-year-old woman presented with a 5-year history of painless swellings of the left and right cheeks. The degree of swelling did not change with mastication. On palpation, the cheeks were soft, well defined, and movable. Compression and massage of the swollen areas caused increased salivary discharge from the orifices of the Stensen ducts. Three-dimensional computed tomography showed well-bordered, 15- to 20-mm wide, bilateral, tube-like dilatations of the ducts. The ductal origin of the swellings was explained to the patient, but she refused invasive procedures, thus no sialogram or surgical procedure was performed. We describe the clinical and radiographic features of a case of bilateral, congenital Stensen duct dilatation with bilateral swelling of the cheeks. PMID:24209996

  3. Acoustic energy in ducts - Further observations

    NASA Technical Reports Server (NTRS)

    Eversman, W.

    1979-01-01

    The transmission of acoustic energy in uniform ducts carrying uniform flow is investigated with the purpose of clarifying two points of interest. The two commonly used definitions of acoustic 'energy' flux are shown to be related by a Legendre transformation of the Lagrangian density exactly as in deriving the Hamiltonian density in mechanics. In the acoustic case the total energy density and the Hamiltonian density are not the same which accounts for two different 'energy' fluxes. When the duct has acoustically absorptive walls neither of the two flux expressions gives correct results. A reevaluation of the basis of derivation of the energy density and energy flux provides forms which yield consistent results for soft walled ducts.

  4. Childhood parathyroid adenoma: a rare but important cause of nephrolithiasis.

    PubMed

    Menon, Prema; Dayal, Devi; Rao, Suhitha G; Bhattacharya, Anish; Narasimha Rao, Katragadda Lakshmi

    2016-07-01

    Primary hyperparathyroidism is very rare in children and adolescents. The management of a 12-year-old boy with renal calculi due to parathyroid adenoma is discussed. The single tumor after localization with sestamibi scintigraphy and SPECT-CT scan was excised with amelioration of symptoms. The case is reported due to the rarity of the disease and successful unilateral exploration. The association with hypopigmented areas of skin has also not been previously reported in literature. PMID:27054596

  5. [Hyperthyroidism caused by a TSH producing pituitary adenoma].

    PubMed

    Prasch, F; Knosp, S E; Steinbach, R; Wogritsch, S; Hurtl, I; Greifeneder, M; Holm, C; Najemnik, C; Dudczak, R

    1999-01-01

    Elevated levels of free triiodothyronine (fT3) of 8.8 ng/dl (normal range 2.0 to 4.2) and free thyroxin (fT4) of 3.5 pg/ml (0.8 to 1.7) were found in the course of an examination of a 53-year old patient due to a planned hysterectomy. As thyrotropin (TSH) also was elevated with 5.8 mU/l (0.4 to 4.5), these findings corresponded to an inappropriate secretion of TSH (IST). Additional examinations revealed a blunted rise of TSH secretion after i.v. injection of 200 micrograms thyrotropin releasing hormone (TRH) as well as lacking suppression of TSH secretion after oral doses of 75 micrograms T3 during one week. alpha-TSH levels with 3.7 micrograms/l were elevated in comparison to a matched normal sample just as the molar ratio alpha-TSH/TSH with 6.95 and sex hormone-binding globulin (SHBG) with 175 nmol/l and showed an absence of inhibition in the T3 suppression test. These results were suggestive of neoplastic inappropriate secretion of TSH (nIST) due to a TSH-secreting pituitary adenoma. In concordance, the magnetic resonance imaging (MRI) showed a 1 cm tumor in the sella. The adenoma could also be visualized by 111In-octreotide and 123I-epidepride scintigraphies of the pituitary gland. After transsphenoidal resection, histological examination of the tumor resulted in the finding of a TSH-secreting adenoma. Postoperative TSH levels were not detectable, indicating the complete removal of the adenoma. Levels of fT3 and fT4 were slightly below normal with 1.9 pg/ml and 0.7 ng/dl, respectively. A control scintigraphy with 111In-octreotide following an equivocal MRI showed no uptake in the pituitary. PMID:10230475

  6. Cell Competition Drives the Growth of Intestinal Adenomas in Drosophila

    PubMed Central

    Suijkerbuijk, Saskia J.E.; Kolahgar, Golnar; Kucinski, Iwo; Piddini, Eugenia

    2016-01-01

    Summary Tumor-host interactions play an increasingly recognized role in modulating tumor growth. Thus, understanding the nature and impact of this complex bidirectional communication is key to identifying successful anti-cancer strategies. It has been proposed that tumor cells compete with and kill neighboring host tissue to clear space that they can expand into; however, this has not been demonstrated experimentally. Here we use the adult fly intestine to investigate the existence and characterize the role of competitive tumor-host interactions. We show that APC−/−-driven intestinal adenomas compete with and kill surrounding cells, causing host tissue attrition. Importantly, we demonstrate that preventing cell competition, by expressing apoptosis inhibitors, restores host tissue growth and contains adenoma expansion, indicating that cell competition is essential for tumor growth. We further show that JNK signaling is activated inside the tumor and in nearby tissue and is required for both tumor growth and cell competition. Lastly, we find that APC−/− cells display higher Yorkie (YAP) activity than host cells and that this promotes tumor growth, in part via cell competition. Crucially, we find that relative, rather than absolute, Hippo activity determines adenoma growth. Overall, our data indicate that the intrinsic over-proliferative capacity of APC−/− cells is not uncontrolled and can be constrained by host tissues if cell competition is inhibited, suggesting novel possible therapeutic approaches. PMID:26853366

  7. Management of clinically non-functioning pituitary adenoma.

    PubMed

    Chanson, Philippe; Raverot, Gerald; Castinetti, Frédéric; Cortet-Rudelli, Christine; Galland, Françoise; Salenave, Sylvie

    2015-07-01

    Clinically NFPA is currently the preferred term for designing all the pituitary adenomas which are not hormonally active (in other words, not associated with clinical syndromes such as amenorrhea-galactorrhea in the context of prolactinomas, acromegaly, Cushing's disease or hyperthyroidism secondary to TSH-secreting adenomas). They account for 15-30% of pituitary adenomas. Diagnosis is usually made either in the context of mass effect due to a macroadenoma or, increasingly, fortuitously during imaging performed for some unrelated purpose; the latter case is known as pituitary incidentaloma. Surgery is indisputably indicated in case of tumoral syndrome, but other aspects of NFPA (hormonal work-up, follow-up, and especially postoperative follow-up, management of remnant or recurrence, the special case of incidentaloma, or apoplexy) remain controversial. The French Endocrinology Society (SFE) therefore set up an expert working group of endocrinologists, neurosurgeons, ophthalmologists, neuroradiologists, pathologists and biologists to draw up guidelines, at the 2012 SFE Congress in Toulouse, France. The present article presents the guidelines suggested by this group of French-speaking experts. PMID:26072284

  8. Cushing Disease After Treatment of Nonfunctional Pituitary Adenoma

    PubMed Central

    Fang, Hongjuan; Tian, Rui; Wu, Huanwen; Xu, Jian; Fan, Hong; Zhou, Jian; Zhong, Liyong

    2015-01-01

    Abstract We describe a very rare case of nonfunctional pituitary adenoma (NFPA) that exhibited corticotrophic activity after resection and radiotherapy. The possible mechanisms of the transformation from NFPA to Cushing disease (CD) are discussed. A 43-year-old man presented with impaired vision, bilateral frontal headaches, and hyposexuality. He had no symptoms suggestive of hypercortisolism, and 8 am plasma cortisol concentration was 67.88 ng/mL. Brain imaging revealed a 15 × 15 × 21-mm sellar mass suggestive of a macroadenoma. The tumor was resected by transsphenoidal surgery and identified by immunohistochemical analysis as a chromophobic adenoma that did not stain for pituitary hormones. The patient was treated with prednisone and levothyroxine replacement therapy. After a third recurrence, the patient presented with clinical features and physical signs of Cushing syndrome. Plasma adrenocorticotropic hormone (ACTH) and cortisol concentrations were elevated, and there was a loss of circadian rhythms. Inferior petrosal sinus sampling after desmopressin showed the central–peripheral ACTH ratio was greater than 3:1. A repeat transsphenoidal resection was undertaken. Immunohistochemistry revealed ACTH positivity. Three months following surgery, imaging showed little residual tumor, but plasma ACTH remained elevated. He was referred for postoperative Gamma Knife radiotherapy. The immunological activity and biological features of the hormones secreted from a pituitary adenoma vary with time. Because long-term outcomes are unpredictable, postoperative follow-up is essential to detect postoperative transformation from NFPA to CD. PMID:26705201

  9. A Case of Metanephric Adenoma and Acute Myocardial Infarction.

    PubMed

    Dusan, Ruzicic; Relja, Kovacevic; Marija, Mirkovic; Jelena, Radovanovic; Vesna, Krstevska; Milijana, Terzic; Vladimir, Pantelic; Irena, Matic; Dragan, Hrncic

    2016-07-01

    Metanephric adenoma (MA) is a rare neoplasm that acounts for 0.2% of adult renal neoplasms. MAs are typically discover incidentally during detailed examinations for nonspecific symptoms such as abdominal or flank pain, hematuria, fever and palpable abdominal mass. Additionally, polycythemia has occasionally been reported as well. Herein we describe a case of metanephric adenoma which was an incidental finding in the course of a clinical autopsy in a patient with complete AV block and polycythemia. Histologically, the tumor was composed of small and uniform tubular structures reminiscent of renal tubuli, without signs of cellular atypia and pleomorphism. Such tumor histomorphology was consistent with the diagnosis of metanephric adenoma. Thrombosis is a common complication of polycythemia that often causes death. Polycythemia with an increasing number of blood cells causes hyperviscosity and, in 20-40% of cases, lethal thrombosis or hemorrhage. Hyperviscosity and coronary artery disease in our patient caused acute myocardial infarction with the subsequent rupture of posterior left ventricle wall and hemopericardium. PMID:27471365

  10. A Case of Metanephric Adenoma and Acute Myocardial Infarction

    PubMed Central

    Dusan, Ruzicic; Relja, Kovacevic; Marija, Mirkovic; Jelena, Radovanovic; Vesna, Krstevska; Milijana, Terzic; Vladimir, Pantelic; Irena, Matic; Dragan, Hrncic

    2016-01-01

    Metanephric adenoma (MA) is a rare neoplasm that acounts for 0.2% of adult renal neoplasms. MAs are typically discover incidentally during detailed examinations for nonspecific symptoms such as abdominal or flank pain, hematuria, fever and palpable abdominal mass. Additionally, polycythemia has occasionally been reported as well. Herein we describe a case of metanephric adenoma which was an incidental finding in the course of a clinical autopsy in a patient with complete AV block and polycythemia. Histologically, the tumor was composed of small and uniform tubular structures reminiscent of renal tubuli, without signs of cellular atypia and pleomorphism. Such tumor histomorphology was consistent with the diagnosis of metanephric adenoma. Thrombosis is a common complication of polycythemia that often causes death. Polycythemia with an increasing number of blood cells causes hyperviscosity and, in 20-40% of cases, lethal thrombosis or hemorrhage. Hyperviscosity and coronary artery disease in our patient caused acute myocardial infarction with the subsequent rupture of posterior left ventricle wall and hemopericardium. PMID:27471365

  11. Clinicopathologic analysis of pituitary adenoma: a single institute experience.

    PubMed

    Cho, Hwa Jin; Kim, Hanna; Kwak, Yoon Jin; Seo, Jeong Wook; Paek, Sun Ha; Sohn, Chul-Ho; Yun, Jung Min; Kim, Da Seu Ran; Kang, Peter; Park, Peom; Park, Sung-Hye

    2014-03-01

    Pituitary adenoma (PA) is a common benign neuroendocrine tumor; however, the incidence and proportion of hormone-producing PAs in Korean patients remain unknown. Authors analyzed 506 surgically resected and pathologically proven pituitary lesions of the Seoul National University Hospital from 2006 to 2011. The lesions were categorized as: PAs (n = 422, 83.4%), Rathke's cleft cysts (RCCs) (n = 54, 10.6%), inflammatory lesions (n = 8, 1.6%), meningiomas (n = 4), craniopharyngiomas (n = 4), granular cell tumors (n = 1), metastatic renal cell carcinomas (n = 2), germinomas (n = 1), ependymomas (n = 1), and unsatisfactory specimens (n = 9, 1.8%). PAs were slightly more prevalent in women (M: F = 1:1.17) with a mean age of 48.8 yr (9-80 yr). Immunohistochemical analysis revealed that prolactin-producing PAs (16.6%) and growth hormone-producing adenomas (9.2%) were the most common functional PAs. Plurihormonal PAs and nonfunctioning (null cell) adenomas were found in 14.9% and 42.4% of patients with PAs, respectively. The recurrence rate of PAs was 11.1%, but nearly 0% for the remaining benign lesions such as RCCs. 25.4% of patients with PAs were treated by gamma-knife after surgery due to residual tumors or regrowth of residual tumor. In conclusion, the pituitary lesions and the proportions of hormone-producing PAs in Korean patients are similar to those of previous reports except nonfunctioning (null cell) PAs, which are unusually frequent. PMID:24616591

  12. Thyrotropin receptor gene alterations in thyroid hyperfunctioning adenomas

    SciTech Connect

    Russo, D.; Arturi, F.; Filetti, S.

    1996-04-01

    Forty-four thyroid autonomously hyperfunctioning adenomas were analyzed to assess the frequency of mutations occurring in the TSH receptor (TSHR). PCR-amplified fragments encompassing the entire exon 10 of the TSHR gene were obtained from the genomic DNA extracted from the tumors and their adjacent normal tissues and were examined by direct nucleotide sequencing. Point mutations were found in 9 of 44 adenomas examined (20%). One mutation occurred in codon 619 (Asp to Gly), four in codon 623 (three were Ala to Ser, one Ala to substitution), two in codon 632 (both Thr to Ile), and two in codon 633 (Asp to Tyr or His). All the alterations were located in a part of the gene coding for an area including the third intracellular loop and the sixth transmembrane domain of the TSH receptor. All mutations were somatic and heterozygotic, and none was simultaneous with alterations of ras or gsp oncogenes. Thus, our data show that in our series of 44 hyperfunctioning thyroid adenomas, a somatic mutation of the TSHR, responsible for the constitutive activation of the cAMP pathway, occurs in 20% of the tumors. 28 refs., 2 tabs.

  13. Laparoscopic simple prostatectomy: A reasonable option for large prostatic adenomas

    PubMed Central

    Al-Aown, Abdulrahman; Liatsikos, Evangelos; Panagopoulos, Vasileios; Kyriazis, Iason; Kallidonis, Panagiotis; Georgiopoulos, Ioannis; Vasilas, Marinos; Jens-Uwe, Stolzenburg

    2015-01-01

    Aim of the Study: In this work, surgical technique followed by two academic departments on laparoscopic simple prostatectomy (LSP) of large prostatic adenomas is being described. Materials and Methods: The initial cumulative experience from 11 patients with lower urinary tract symptoms of benign prostatic hyperplasia origin subjected to LSP is being presented. Results: All cases had prostatic adenomas greater than 80 ml. Mean operation time was 99.5 min (values from 70 to 150 min) and mean blood loss was 205 ml (values from 100 to 300 ml). Blood transfusion was deemed necessary in one case. Bladder catheter was removed successfully on postoperative day 5 in all cases. No significant postoperative complication was noted. At a 3 months follow-up a significant decrease in International Prostate Symptom Score (IPSS) was evident in all patients (mean IPSS 27.7 vs. 15.3 preoperative vs. postoperative accordingly). Conclusions: According to our data and similarly to the rest of the LSP literature, laparoscopic excision of voluminous prostatic adenomas is a feasible and safe procedure. Nevertheless, further investigation including a larger number of patients and long-term follow-up is deemed necessary before making definite conclusions regarding the approach. PMID:26229313

  14. Multifocal canalicular adenoma of the minor labial salivary glands

    PubMed Central

    Samar, María Elena; Avila, Rodolfo Esteban; Fonseca, Ismael Bernardo; Anderson, William; Fonseca, Gabriel M; Cantín, Mario

    2014-01-01

    Canalicular adenoma (CA) is an uncommon benign neoplasia of salivary glands which is clinically difficult to recognise. Despite having an excellent prognosis, the histological diagnosis and clinical management of this entity can be troublesome. While the main differential diagnosis to consider is basal cell adenoma (BCA), similar histological patterns and multifocality have been observed in adenoid cystic carcinoma (ACC) and polymorphous low-grade adenocarcinoma (PLGA), both locally-aggressive malignancies which require radically different treatment to CA. An emphasis has been placed on the value of immunohistochemistry in avoiding diagnostic and surgical errors. CA is positive for AE1/AE3, CD117 and S-100 protein, and negative for p63, α-SMA, Ki 67 and vimentin. Here we discuss the case of a 61-year-old female with CA in her right upper lip, showing multifocal growth histologically. The differential diagnosis with other adenomas is discussed in addition to the role of immunohistochemical studies that can confirm the clinical and surgical findings. PMID:25550873

  15. Computing Propagation Of Sound In Engine Ducts

    NASA Technical Reports Server (NTRS)

    Saylor, Silvia

    1995-01-01

    Frequency Domain Propagation Model (FREDOM) computer program accounts for acoustic loads applied to components of engines. Models propagation of noise through fluids in ducts between components and through passages within components. Used not only to analyze hardware problems, but also for design purposes. Updated version of FREQPL program easier to use. Devised specifically for use in analyzing acoustic loads in rocket engines. Underlying physical and mathematical concepts implemented also applicable to acoustic propagation in other enclosed spaces; analyzing process plumbing and ducts in industrial buildings with view toward reducing noise in work areas.

  16. Modern management of common bile duct stones.

    PubMed

    Buxbaum, James

    2013-04-01

    It is imperative for gastroenterologists to understand the different formations of bile duct stones and the various medical treatments available. To minimize the complications of endoscopic retrograde cholangiopancreatography (ERCP), it is critical to appropriately assess the risk of bile duct stones before intervention. Biliary endoscopists should be comfortable with the basic techniques of stone removal, including sphincterotomy, mechanical lithotripsy, and stent placement. It is important to be aware of advanced options, including laser and electrohydraulic stone fragmentation, and papillary dilatation for problematic cases. The timing and need for ERCP in those who require a cholecystectomy is also a consideration. PMID:23540960

  17. Fundamental investigation of duct/ESP phenomena

    SciTech Connect

    Brown, C.A. ); Durham, M.D. ); Sowa, W.A. . Combustion Lab.); Himes, R.M. ); Mahaffey, W.A. )

    1991-10-21

    Radian Corporation was contracted to investigate duct injection and ESP phenomena in a 1.7 MW pilot plant constructed for this test program. This study was an attempt to resolve problems found in previous studies and answer remaining questions for the technology using an approach which concentrates on the fundamental mechanisms of the process. The goal of the study was to obtain a better understanding of the basic physical and chemical phenomena that control: (1) the desulfurization of flue gas by calcium-based reagent, and (2) the coupling of an existing ESP particulate collection device to the duct injection process. Process economics are being studied by others. (VC)

  18. Preconditioning the Helmholtz Equation for Rigid Ducts

    NASA Technical Reports Server (NTRS)

    Baumeister, Kenneth J.; Kreider, Kevin L.

    1998-01-01

    An innovative hyperbolic preconditioning technique is developed for the numerical solution of the Helmholtz equation which governs acoustic propagation in ducts. Two pseudo-time parameters are used to produce an explicit iterative finite difference scheme. This scheme eliminates the large matrix storage requirements normally associated with numerical solutions to the Helmholtz equation. The solution procedure is very fast when compared to other transient and steady methods. Optimization and an error analysis of the preconditioning factors are present. For validation, the method is applied to sound propagation in a 2D semi-infinite hard wall duct.

  19. Congenital Atresia of Wharton’s Duct

    PubMed Central

    Hseu, Anne; Anne, Premchand

    2016-01-01

    This is a case report of a three-month-old male who presented to clinic with a cystic lesion under the tongue. On clinical examination, a cystic lesion was observed in the, floor-of-mouth. The patient was referred to Paediatric Otorhinolaryngology service for further management. The differential diagnoses for floor-of-mouth lesions should be reviewed with primary focus on the Wharton’s duct atresia and its management. It is crucial to recognize submandibular duct atresia in the primary Paediatric clinic in order to expedite management of lesion before complications arise including infection, enlargement of cyst, and feeding and breathing difficulties. PMID:27042492

  20. Ectopic Intrathymic Parathyroid adenoma demonstrated on Tc-99m Sestamibi SPECT-CT.

    PubMed

    Usmani, S; Oteifa, M; Abu Huda, F; Javaid, A; Amanguno, H G; Al Kandari, F

    2016-05-01

    Intrathymic parathyroid adenoma is a rare cause of primary hyperparathyroidism. In this case, Tc-99m Sestamibi SPECT-CT successfully localized abnormal tracer uptake in the mediastinum with corresponding low density lesion on CT images suggestive of mediastinal parathyroid adenoma which late on confirmed on histopathology. After the median sternotomy a large intrathymic parathyroid adenoma was identified and excised. With the help of gamma probe the surgeons detect the lesion early and with more confidence as well as reducing the total operation time. Tc-99m Sestamibi SPECT-CT scintigraphy and gamma probe localization is recommended for preoperative and intra operative localization of ectopic parathyroid adenomas. PMID:27250890

  1. What Should You Ask Your Doctor about Bile Duct Cancer?

    MedlinePlus

    ... treatment for bile duct cancer? What should you ask your doctor about bile duct cancer? It is ... your own. For instance, you might want to ask about clinical trials for which you may qualify. ...

  2. Experimental evaluation of a pilot multinozzle-duct apparatus

    NASA Technical Reports Server (NTRS)

    Puster, R. L.

    1979-01-01

    A pilot multinozzle and duct were tested at ambient enthalpy to evaluate the suitability of such apparatus for testing thermal protection system panels mounted in the sidewalls of the duct downstream of the nozzle array. The flow field in the duct was complex: effects of wakes and shock waves from the nozzle dominated the flow field; the wakes continually mixed with the surrounding fluid; the boundary layer on the sidewalls of the duct was nonuniform; and near the exit of the duct the sidewall pressure variation was as much as 8.5 percent about the mean wall pressure. Starting loads on the duct walls were higher than those of a similar conventional nozzle and duct. It was concluded that the multinozzle-duct apparatus was not suitable for testing TPS panels, although the design and flow-field information should be of interest to designers of high-energy gasdynamic lasers.

  3. Low-cost orbiting grinder for cutting ducts

    NASA Technical Reports Server (NTRS)

    Lang, E. J.

    1970-01-01

    Low-cost, portable machine cuts ducts made from heat-treated alloys. An abrasive wheel, powered by a high-speed air motor mounted on an expandible plug against the inner wall of the duct, gives precise cutting.

  4. Radiotherapy for pituitary adenomas: long-term outcome and complications

    PubMed Central

    Rim, Chai Hong; Yang, Dae Sik; Park, Young Je; Yoon, Won Sup; Lee, Jung Ae

    2011-01-01

    Purpose To evaluate long-term local control rate and toxicity in patients treated with external beam radiotherapy (EBRT) for pituitary adenomas. Materials and Methods We retrospectively reviewed the medical records of 60 patients treated with EBRT for pituitary adenoma at Korea University Medical Center from 1996 and 2006. Thirty-five patients had hormone secreting tumors, 25 patients had non-secreting tumors. Fifty-seven patients had received postoperative radiotherapy (RT), and 3 had received RT alone. Median total dose was 54 Gy (range, 36 to 61.2 Gy). The definition of tumor progression were as follows: evidence of tumor progression on computed tomography or magnetic resonance imaging, worsening of clinical sign requiring additional operation or others, rising serum hormone level against a previously stable or falling value, and failure of controlling serum hormone level so that the hormone level had been far from optimal range until last follow-up. Age, sex, hormone secretion, tumor extension, tumor size, and radiation dose were analyzed for prognostic significance in tumor control. Results Median follow-up was 5.7 years (range, 2 to 14.4 years). The 10-year actuarial local control rates for non-secreting and secreting adenomas were 96% and 66%, respectively. In univariate analysis, hormone secretion was significant prognostic factor (p = 0.042) and cavernous sinus extension was marginally significant factor (p = 0.054) for adverse local control. All other factors were not significant. In multivariate analysis, hormone secretion and gender were significant. Fifty-three patients had mass-effect symptoms (headache, dizziness, visual disturbance, hypopituitarism, loss of consciousness, and cranial nerve palsy). A total of 17 of 23 patients with headache and 27 of 34 patients with visual impairment were improved. Twenty-seven patients experienced symptoms of endocrine hypersecretion (galactorrhea, amenorrhea, irregular menstruation, decreased libido, gynecomastia

  5. Epithelial and organ-related marker expression in pituitary adenomas.

    PubMed

    Cykowski, Matthew D; Takei, Hidehiro; Baskin, David S; Rivera, Andreana L; Powell, Suzanne Z

    2016-08-01

    The histologic expression of epithelial and organ-related immunohistochemical markers in primary sellar region tumors has received little attention to date. This lack of empirical data may lead to mistaken assumptions in the evaluation of sellar region neoplasms. To address this issue, the frequency and specificity of epithelial (cytokeratin 7(CK7), CK20) and organ-related differentiation markers (gross cystic disease fluid protein-15 (GCDFP-15), thyroid transcription factor-1 (TTF-1), Napsin A, paired box 8 (PAX-8), hepatocyte paraffin 1 (HepPar1) and estrogen receptor (ER)) were studied in 40 patients with adenomas comprising five hormonal sub-types. Non-parametric statistical procedures were used to examine associations between marker expression and tumor sub-type. CK7 and CK20 immunoreactivity were seen in 48% and 8% of tumors, respectively, although never in a diffuse pattern. CK20 expression was nearly exclusive to corticotrophs, whereas CK7 frequently highlighted cells with dendritic-type morphology. The specificity of organ-related differentiation markers was 100% (monoclonal Napsin A, GCDFP-15 and TTF-1), 97% (HepPar1 and PAX-8), 90% (polyclonal Napsin A) and 72% (ER); no tumors demonstrated significant co-expression of these organ-related markers with either CK7 or CK20. The first major conclusion of this study is that CK7 staining in adenoma is more frequent than has been previously than has been previously described. CK7 immunoreactive cells often displayed a dendritic-type morphology, including within large macroadenomas, which raises the question as to whether these represent tumor cells with folliculo-stellate cell-type differentiation, as these also have dendritic cell-type morphology and express CK7 in non-neoplastic glands. The second major conclusion, which confirms earlier findings, is that CK20 staining is a very infrequent immunohistochemical finding in adenomas that is virtually limited to corticotrophs and thus is helpful in diagnostic

  6. MUC-1 expression in pleomorphic adenomas using two human milk fat globule protein membrane antibodies (HMFG-1 and HMFG-2)

    PubMed Central

    PONCE-BRAVO, Santa; LEDESMA-MONTES, Constantino; GARCÉS-ORTÍZ, Maricela

    2015-01-01

    Pleomorphic adenoma (PA) is the most common salivary gland tumor and its microscopic features and histogenesis are a matter of debate. Human milk fat globule protein membrane (HMFG) monoclonal antibodies (MoAbs) comprise a set of antibodies against the mucin 1 (MUC-1) protein detected in several salivary gland tumors. Objective The aim of this study was to assess the immunoexpression of the PA neoplastic cells to MUC-1 protein using HMFG-1 and HMFG-2 MoAbs, contrasting these results with those from normal salivary gland tissue. Material and Methods Immunohistochemical detection of MUC-1 protein using HMFG-1 and HMFG-2 MoAbs was made in 5 mm thick, paraffin embedded slides, and the avidin-biotin method was used. Results Positivity to HMFG-1 and HMFG-2 MoAbs was found in ductal, squamous metaplastic and neoplastic myoepithelial cells, keratin pearls and intraductal mucous material. Two kinds of myoepithelial cells were identified: classic myoepithelial cells around ducts were negative to both MoAbs, and modified myoepithelial cells were positive to both MoAbs. This last cellular group of the analyzed tumors showed similar MUC-1 immunoexpression to ductal epithelial cells using both HMFG antibodies. Intraductal mucous secretion was also HMFG-1 and HMFG-2 positive. Conclusions Our results showed there are two kinds of myoepithelial cells in PA. The first cellular group is represented by the different kinds of neoplastic myoepithelial cells and is HMFG-positive. The second one is HMFG-negative and represented by the neoplastic myoepithelial cells located around the ducts. PMID:26221920

  7. Expression of Cold-Inducible RNA-Binding Protein (CIRP) in Pituitary Adenoma and its Relationships with Tumor Recurrence

    PubMed Central

    Wang, Mingguang; Zhang, Huan; Heng, Xueyuan; Pang, Qi; Sun, Aigang

    2015-01-01

    Background The aim of this study was to detect the expression of cold-inducible RNA-binding protein in pituitary adenoma and to determine its effects on tumor recurrence. Material/Methods We collected a total of 60 post-op samples collected from pituitary adenoma patients (including 20 cases of invasive pituitary adenoma, 20 cases of non-invasive adenoma, and 20 cases of non-invasive recurrent adenoma) admitted in our hospital. Both protein and mRNA levels of CIRP in 3 types of pituitary adenoma samples were quantified by Western blotting and real-time PCR, respectively. Results Western blotting revealed significantly elevated CIRP expression levels in invasive pituitary adenoma compared to non-invasive tumors, with statistical significance (p<0.05). Recurrent pituitary adenoma expressed significantly higher CIRP levels compared to non-recurrent tumors (p<0.05). Real-time PCR for CIRP mRNA obtained consistent results: transcript levels were significantly higher in invasive pituitary adenoma compared to non-invasive adenoma (p<0.05); recurrent adenoma also had significantly higher CIRP mRNA levels compared to non-recurrent tumors (p<0.05). Among all 3 types of pituitary adenoma, recurrent tumors had the highest levels of CIRP mRNA and protein. Conclusions The expression of CIRP in pituitary adenoma is closely related with tumor proliferation and invasion, and its significantly elevated expression level indicates post-op recurrence. PMID:25934796

  8. Thyroglossal Duct Carcinoma in a Cat.

    PubMed

    Moorer, Jeremiah D; Breshears, Melanie A; Dugat, Danielle R

    2016-01-01

    A 14 yr old castrated domestic shorthair cat presented for a fluid-filled structure in the ventral cervical region that had been present for 1 yr and had not resolved after repeated aspiration and drainage. Cervical computed tomography showed an approximately 10 cm, fluid-filled, multilobulated mass located on the ventrolateral right side of the cervical region extending into the thoracic inlet. Cytologic examination of the fluid revealed cystic fluid with evidence of chronic hemorrhage. The mass was surgically removed, and histopathologic examination revealed a thyroglossal duct carcinoma. Thyroid and parathyroid gland origin were ruled out by negative immunohistochemical staining for thyroglobulin, parathyroid hormone, calcitonin, and synaptophysin. No adjunctive treatment was performed and no recurrence was noted at 14 mo. Thyroglossal duct carcinoma has not been previously reported in a cat. There are two previous reports of squamous cell carcinoma of the thyroglossal duct in dogs. In humans, with complete removal and no evidence of metastasis, carcinoma of the thyroglossal duct has a good prognosis for recovery. PMID:27259027

  9. Idea Bank: Duct Tape Note Twister

    ERIC Educational Resources Information Center

    McHenry, Molly

    2008-01-01

    In this article, the author relates how she observed a middle school math teacher deliver a miserable class. She realized that she did the same thing to her music students. To engage her students, she developed "Note Twister," a music reading game using duct tape to form musical notes and the basic premise behind the game, "Twister." She finds…

  10. Starting flow in regular polygonal ducts

    NASA Astrophysics Data System (ADS)

    Wang, C. Y.

    2016-06-01

    The starting flows in regular polygonal ducts of S = 3, 4, 5, 6, 8 sides are determined by the method of eigenfunction superposition. The necessary S-fold symmetric eigenfunctions and eigenvalues of the Helmholtz equation are found either exactly or by boundary point match. The results show the starting time is governed by the first eigenvalue.

  11. Thoracoscopic Ligation of the Thoracic Duct

    PubMed Central

    Teixeira, Julio A.

    2000-01-01

    Objective: When nonoperative treatment of chylothorax fails, thoracic duct ligation is usually performed through a thoracotomy. We describe two cases of persistent chylothorax, in a child and an adult, successfully treated with thoracoscopic ligation of the thoracic duct. Methods: A 4-year-old girl developed a right chylothorax following a Fontan procedure. Aggressive nonoperative management failed to eliminate the persistent chyle loss. A 72-year-old insulin-dependent diabetic man was involved in a motor vehicle accident, in which he sustained multiple fractured ribs, a right hemopneumothorax, a right femoral shaft fracture, and a T-11 thoracic vertebral fracture. Subsequently, he developed a right chylothorax, which did not respond to nonoperative management. Both patients were successfully treated with thoracoscopic ligation of the thoracic duct. Results: The child had significant decrease of chyle drainage following surgery. Increased drainage that appeared after the introduction of full feedings five days postoperatively was controlled with the somatostatin analog octreotide. The chest tube was removed two weeks after surgery. After two years' follow-up, she has had no recurrence of chylothorax. The adult had no chyle drainage following surgery. He was maintained on a medium-chain triglyceride diet postoperatively for two weeks. The chest tube was removed four days after surgery. After six months' follow-up, he has had no recurrence of chylothorax. Conclusions: Thoracoscopic ligation of the thoracic duct provides a safe and effective treatment of chylothorax and may avoid thoracotomy and its associated morbidity. PMID:10987402

  12. 46 CFR 116.610 - Ventilation ducts.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... prevent corrosion; (4) Fire dampers must be capable of manual operation from outside the space served, be... damper, automatic damper, or vent cover, must be provided in an accessible location outside the space... duct penetrating an A-Class fire control boundary and opening into a space formed by that boundary...

  13. 46 CFR 116.610 - Ventilation ducts.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... prevent corrosion; (4) Fire dampers must be capable of manual operation from outside the space served, be... damper, automatic damper, or vent cover, must be provided in an accessible location outside the space... duct penetrating an A-Class fire control boundary and opening into a space formed by that boundary...

  14. Detonation duct gas generator demonstration program

    NASA Technical Reports Server (NTRS)

    Wortman, Andrew; Brinlee, Gayl A.; Othmer, Peter; Whelan, Michael A.

    1991-01-01

    The feasibility of the generation of detonation waves moving periodically across high speed channel flow is experimentally demonstrated. Such waves are essential to the concept of compressing requirements and increasing the engine pressure compressor with the objective of reducing conventional compressor requirements and increasing the engine thermodynamic efficiency through isochoric energy addition. By generating transient transverse waves, rather than standing waves, shock wave losses are reduced by an order of magnitude. The ultimate objective is to use such detonation ducts downstream of a low pressure gas turbine compressor to produce a high overall pressure ratio thermodynamic cycle. A 4 foot long, 1 inch x 12 inch cross-section, detonation duct was operated in a blow-down mode using compressed air reservoirs. Liquid or vapor propane was injected through injectors or solenoid valves located in the plenum or the duct itself. Detonation waves were generated when the mixture was ignited by a row of spark plugs in the duct wall. Problems with fuel injection and mixing limited the air speeds to about Mach 0.5, frequencies to below 10 Hz, and measured pressure ratios of about 5 to 6. The feasibility of the gas dynamic compression was demonstrated and the critical problem areas were identified.

  15. Sound attenuation of fiberglass lined ventilation ducts

    NASA Astrophysics Data System (ADS)

    Albright, Jacob

    Sound attenuation is a crucial part of designing any HVAC system. Most ventilation systems are designed to be in areas occupied by one or more persons. If these systems do not adequately attenuate the sound of the supply fan, compressor, or any other source of sound, the affected area could be subject to an array of problems ranging from an annoying hum to a deafening howl. The goals of this project are to quantify the sound attenuation properties of fiberglass duct liner and to perform a regression analysis to develop equations to predict insertion loss values for both rectangular and round duct liners. The first goal was accomplished via insertion loss testing. The tests performed conformed to the ASTM E477 standard. Using the insertion loss test data, regression equations were developed to predict insertion loss values for rectangular ducts ranging in size from 12-in x 18-in to 48-in x 48-in in lengths ranging from 3ft to 30ft. Regression equations were also developed to predict insertion loss values for round ducts ranging in diameters from 12-in to 48-in in lengths ranging from 3ft to 30ft.

  16. Turbofan aft duct suppressor study program listing and user's guide

    NASA Technical Reports Server (NTRS)

    Joshi, M. C.; Kraft, R. E.

    1983-01-01

    A description of the structure of the Annular Flow Duct Program (AFDP) for the calculation of acoustic suppression due to treatment in a finite length annular duct carrying sheared flow is presented. Although most appropriate for engine exhaust ducts, this program can be used to study sound propagation in any duct that maintains annular geometry over a considerable length of the duct. The program is based on the modal analysis of sound propagation in ducts with axial segments of different wall impedances. For specified duct geometry, wall impedance, flow and acoustic conditions in the duct (including mode amplitude distribution of the source) and duct termination reflection characteristics, the program calculates the suppression due to the treatment in the duct. The presence of forward and backward traveling modes in the duct due to the reflection and redistribution of modes at segment interfaces and duct end terminations are taken into account in the calculations. The effects of thin wall boundary layers (with a linear or mean flow velocity profile) on the acoustic propagation are also included in the program. A functional description of the major subroutines is included and a sample run is provided with an explanation of the output.

  17. A bidirectional microphone for the measurement of duct noise

    NASA Astrophysics Data System (ADS)

    La Fontaine, R. F.; Shepherd, I. C.; Cabelli, A.

    1985-08-01

    A bidirectional microphone which resolves acoustic plane waves in ducts into forward and backward propagating components is described. The microphone has a flat frequency response and finds applications in the analysis of duct noise and in the determination of reflection coefficients for various duct configurations. It can also be employed as a unidirectional microphone in active noise attenuators.

  18. 14 CFR 25.1103 - Induction system ducts and air duct systems.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... between the air duct source and the airplane unit served by the air. (e) Each auxiliary power unit... other compartment or area of the airplane in which a hazard would be created resulting from the entry...

  19. 14 CFR 25.1103 - Induction system ducts and air duct systems.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... between the air duct source and the airplane unit served by the air. (e) Each auxiliary power unit... other compartment or area of the airplane in which a hazard would be created resulting from the entry...

  20. 14 CFR 25.1103 - Induction system ducts and air duct systems.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... the auxiliary power unit must be capable of resisting the maximum heat conditions likely to occur. (f) Each auxiliary power unit induction system duct must be constructed of materials that will not...

  1. 14 CFR 25.1103 - Induction system ducts and air duct systems.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... the auxiliary power unit must be capable of resisting the maximum heat conditions likely to occur. (f) Each auxiliary power unit induction system duct must be constructed of materials that will not...

  2. 14 CFR 29.1103 - Induction systems ducts and air duct systems.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... resisting the maximum heat conditions likely to occur. (f) Each auxiliary power unit induction system duct must be constructed of materials that will not absorb or trap hazardous quantities of flammable...

  3. 14 CFR 29.1103 - Induction systems ducts and air duct systems.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... resisting the maximum heat conditions likely to occur. (f) Each auxiliary power unit induction system duct must be constructed of materials that will not absorb or trap hazardous quantities of flammable...

  4. 14 CFR 25.1103 - Induction system ducts and air duct systems.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... the auxiliary power unit must be capable of resisting the maximum heat conditions likely to occur. (f) Each auxiliary power unit induction system duct must be constructed of materials that will not...

  5. 14 CFR 29.1103 - Induction systems ducts and air duct systems.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... resisting the maximum heat conditions likely to occur. (f) Each auxiliary power unit induction system duct must be constructed of materials that will not absorb or trap hazardous quantities of flammable...

  6. A systematic comparison of microsimulation models of colorectal cancer: the role of assumptions about adenoma progression

    PubMed Central

    Kuntz, Karen M.; Lansdorp-Vogelaar, Iris; Rutter, Carolyn M.; Knudsen, Amy B.; van Ballegooijen, Marjolein; Savarino, James E.; Feuer, Eric J.; Zauber, Ann G.

    2012-01-01

    Background As the complexity of microsimulation models increases, however, concerns about model transparency are heightened. Methods We conducted model “experiments” to explore the impact of variations in “deep” model parameters using three colorectal cancer (CRC) models. All natural history models were calibrated to match observed data on adenoma prevalence and cancer incidence, but varied in their underlying specification of the adenoma-carcinoma process. We projected CRC incidence among individuals with an underlying adenoma or preclinical cancer vs. those without any underlying condition and examined the impact of removing adenomas. We calculated the percentage of simulated CRC cases arising from adenomas that developed within 10 or 20 years prior to cancer diagnosis, and estimated dwell time – defined as the time from the development of an adenoma to symptom-detected cancer in the absence of screening among individuals with a CRC diagnosis. Results The 20-year CRC incidence among 55-year-old individuals with an adenoma or preclinical cancer was 7 to 75 times greater than in the condition-free group. The removal of all adenomas among the subgroup with an underlying adenoma or cancer resulted in a reduction of 30% to 89% in cumulative incidence. Among CRCs diagnosed at age 65, the proportion arising from adenomas formed within 10 years ranged between 4% and 67%. The mean dwell time varied from 10.6 years to 25.8 years. Conclusions Models that all match observed data on adenoma prevalence and cancer incidence can produce quite different dwell times and very different answers with respect to the effectiveness of interventions. When conducting applied analyses to inform policy, using multiple models provides a sensitivity analysis on key (unobserved) “deep” model parameters and can provide guidance about specific areas in need of additional research and validation. PMID:21673186

  7. Heat Transfer in a Superelliptic Transition Duct

    NASA Technical Reports Server (NTRS)

    Poinsatte, Philip; Thurman, Douglas; Hippensteele, Steven

    2008-01-01

    Local heat transfer measurements were experimentally mapped using a transient liquid-crystal heat transfer technique on the surface of a circular-to-rectangular transition duct. The transition duct had a length-to-diameter ratio of 1.5 and an exit-plane aspect ratio of 3. The crosssectional geometry was defined by the equation of a superellipse. The cross-sectional area was the same at the inlet and exit but varied up to 15 percent higher through the transition. The duct was preheated to a uniform temperature (nominally 64 C) before allowing room temperature air to be suddenly drawn through it. As the surface cooled, the resulting isothermal contours on the duct surface were revealed using a surface coating of thermochromic liquid crystals that display distinctive colors at particular temperatures. A video record was made of the surface temperature and time data for all points on the duct surfaces during each test. Using this surface temperature-time data together with the temperature of the air flowing through the model and the initial temperature of the model wall, the heat transfer coefficient was calculated by employing the classic one-dimensional, semi-infinite wall heat transfer conduction model. Test results are reported for inlet diameter-based Reynolds numbers ranging from 0.4x106 to 2.4x106 and two grid-generated freestream turbulence intensities of about 1 percent, which is typical of wind tunnels, and up to 16 percent, which may be more typical of real engine conditions.

  8. SOX10 is a novel marker of acinus and intercalated duct differentiation in salivary gland tumors: a clue to the histogenesis for tumor diagnosis.

    PubMed

    Ohtomo, Rie; Mori, Taisuke; Shibata, Shinsuke; Tsuta, Koji; Maeshima, Akiko M; Akazawa, Chihiro; Watabe, Yukio; Honda, Kazufumi; Yamada, Tesshi; Yoshimoto, Seiichi; Asai, Masao; Okano, Hideyuki; Kanai, Yae; Tsuda, Hitoshi

    2013-08-01

    Salivary gland tumors are relatively rare and morphologically diverse and heterogeneous tumors; therefore, histogenesis-based tumor markers are sorely needed to aid in diagnosing and determining the cell type of origin. SRY-related HMG-box 10 (SOX10) protein is a transcription factor known to be crucial in the specification of the neural crest and maintenance of Schwann cells and melanocytes. In addition, positive expression has also been implicated in the major salivary gland. Here, we examined SOX10 expression in various salivary gland tumors to correlate this expression with myoepithelial markers. Overall, 76 malignant and 14 benign tumors were examined. SOX10 expression clearly delineated two distinct subtypes of human salivary gland tumors; acinic cell carcinomas, adenoid cystic carcinomas, epithelial-myoepithelial carcinomas, myoepithelial carcinomas, and pleomorphic adenomas, including the pleomorphic adenoma component of carcinoma, were SOX10 positive, while salivary duct carcinomas, mucoepidermoid carcinomas, an oncocytic carcinoma, Oncocytomas, and Warthin tumors were SOX10 negative. Also, SOX10 was expressed in solid-type or non-specific morphology salivary gland tumors, but was not expressed in poorly differentiated squamous cell carcinomas. In normal human salivary gland tissue, SOX10 expression was specific to the nuclei of acini and both luminal and abluminal cells of intercalated ducts but not in other sites. Moreover, the murine model suggested that SOX10 continued to be expressed from the developmental stage to adulthood in the acinar and both luminal and abluminal intercalated ducts in the major salivary gland. Thus, SOX10 is a novel marker for diagnosing and understanding the histogenesis of salivary gland tumors. PMID:23558573

  9. Reducing Uncertainty for the DeltaQ Duct Leakage Test

    SciTech Connect

    Walker, Iain S.; Sherman, Max H.; Dickerhoff, Darryl J.

    2004-05-01

    The thermal distribution system couples the HVAC components to the building envelope, and shares many properties of the buildings envelope including moisture, conduction and most especially air leakage performance. Duct leakage has a strong influence on air flow rates through building envelopes (usually resulting in much greater flows than those due to natural infiltration) because unbalanced duct air flows and leaks result in building pressurization and depressurization. As a tool to estimate this effect, the DeltaQ duct leakage test has been developed over the past several years as an improvement to existing duct pressurization tests. It focuses on measuring the air leakage flows to outside at operating conditions that are required for envelope infiltration impacts and energy loss calculations for duct systems. The DeltaQ test builds on the standard envelope tightness blower door measurement techniques by repeating the tests with the system air handler off and on. The DeltaQ test requires several assumptions to be made about duct leakage and its interaction with the duct system and building envelope in order to convert the blower door results into duct leakage at system operating conditions. This study examined improvements to the DeltaQ test that account for some of these assumptions using a duct system and building envelope in a test laboratory. The laboratory measurements used a purpose-built test chamber coupled to a duct system typical of forced air systems in US homes. Special duct leaks with controlled air-flow were designed and installed into an airtight duct system. This test apparatus allowed the systematic variation of the duct and envelope leakage and accurate measurement of the duct leakage flows for comparison to DeltaQ test results. This paper will discuss the laboratory test apparatus design, construction and operation, the various analysis techniques applied to the calculation procedure and present estimates of uncertainty in measured duct

  10. Experimental testing and computational modeling of flat oval duct deflection

    SciTech Connect

    Smolinski, P.J.; Palmer, G.S.

    1998-10-01

    The deflection characteristics of spiral seam flat oval HVAC duct are examined in this study, and the effects of duct size, wall thickness, and the size spacing, and type of external reinforcement on the duct deformation are investigated. A duct test setup and a deflection measurement frame were developed for measuring the deformation of flat oval duct, and experimental testing was performed on a variety of duct configurations to measure the duct deflections at various positive and negative internal pressures. Finite element computer models of the ducts were developed to predict the deflections. The correlation between the predictions of the computer model and the data from the experimental testing is highly variable with differences ranging from a few percent to several hundred percent. In general, it was found that there was closer agreement between the finite element results and the experimental measurements for smaller duct and at locations of type 2 external reinforcements. This may be due to the fact that the finite element model assumed the idealized flat oval shape and this shape was better matched by smaller ducts and near the external reinforcement. It was also found that in some cases, unreinforced duct could achieve higher pressures than type 1 reinforced duct before exceeding the deflection limits. Sources of error include the uneven surface of the mastic in the measurement of the duct joint deflection and the variance of the actual duct shape from the idealized shape used in the finite element model. This study did not examine the variability of the experimental results due to differences in duct shape or manufacture.

  11. A case of carcinoma in an adenoma of the duodenal minor papilla successfully treated with endoscopic mucosal resection

    PubMed Central

    Matsui, Toru; Matsubayashi, Hiroyuki; Hotta, Kinichi; Sasaki, Keiko; Ito, Hiroaki; Ono, Hiroyuki

    2016-01-01

    Background and study aims: Endoscopic papillectomy is currently used to treat noninvasive tumors of the papilla of Vater, but it is seldom reported for treatment of similar tumors of the minor papilla. This report describes the case of a 69-year-old female with a tumor located at the duodenal minor papilla. Findings of duodenoscopy, biopsy, and pancreatography indicated that her noninvasive tumor of the minor papilla was suitable for treatment with endoscopic resection. Glycerol-injected endoscopic mucosal resection (EMR) was performed, and the resected material histologically showed carcinoma in the adenoma, negative for neoplastic extension at the cut margin. No complications occurred during the treatment course, and no recurrence has been recognized for 80 months. Unlike the major papilla of Vater, the minor papilla can be lifted up by submucosal injection. Noninvasive epithelial tumors of the duodenal minor papilla without extension to the pancreatic duct can be successfully treated with EMR, as the technique is easy, it is minimally invasive, and it is curative. PMID:27004240

  12. Performance Study and CFD Predictions of a Ducted Fan System

    NASA Technical Reports Server (NTRS)

    Abrego, Anita I.; Chang, I-Chung; Bulaga, Robert W.; Rutkowski, Michael (Technical Monitor)

    2002-01-01

    An experimental investigation was completed in the NASA Ames 7 by 10-Foot Wind Tunnel to study the performance characteristics of a ducted fan. The goal of this effort is to study the effect of ducted fan geometry and utilize Computational Fluid Dynamics (CFD) analysis to provide a baseline for correlation. A 38-inch diameter, 10-inch chord duct with a five-bladed fixed-pitch fan was tested. Duct performance data were obtained in hover, vertical climb, and forward flight test conditions. This paper will present a description of the test, duct performance results and correlation with CFD predictions.

  13. Transition duct with divided upstream and downstream portions

    SciTech Connect

    McMahan, Kevin Weston; LeBegue, Jeffrey Scott; Maldonado, Jaime Javier; Dillard, Daniel Jackson; Flanagan, James Scott

    2015-07-14

    Turbine systems are provided. In one embodiment, a turbine system includes a transition duct comprising an inlet, an outlet, and a duct passage extending between the inlet and the outlet and defining a longitudinal axis, a radial axis, and a tangential axis. The outlet of the transition duct is offset from the inlet along the longitudinal axis and the tangential axis. The duct passage includes an upstream portion extending from the inlet and a downstream portion extending from the outlet. The turbine system further includes a rib extending from an outer surface of the duct passage, the rib dividing the upstream portion and the downstream portion.

  14. Particle deposition in ventilation ducts: Connectors, bends anddeveloping flow

    SciTech Connect

    Sippola, Mark R.; Nazaroff, William W.

    2004-03-01

    In ventilation duct flow the turbulent flow profile is commonly disturbed or not fully developed and these conditions are likely to influence particle deposition to duct surfaces. Particle deposition rates at eight S-connectors, in two 90{sup o} duct bends and in two ducts where the turbulent flow profile was not fully developed were measured in a laboratory duct system with both galvanized steel and internally insulated ducts with hydraulic diameters of 15.2 cm. In the steel duct system, experiments with nominal particle diameters of 1, 3, 5, 9 and 16 {micro}m were conducted at each of three nominal air speeds: 2.2, 5.3 and 9.0 m/s. In the insulated duct system, deposition of particles with nominal diameters of 1, 3, 5, 8 and 13 {micro}m was measured at nominal air speeds of 2.2, 5.3 and 8.8 m/s. Fluorescent techniques were used to directly measure the deposition velocities of monodisperse fluorescent particles to duct surfaces. Deposition at S-connectors, in bends and in straight ducts with developing turbulence was often greater than deposition in straight ducts with fully developed turbulence for equal particle sizes, air speeds and duct surface orientations. Deposition rates at all locations were found to increase with an increase in particle size or air speed. High deposition rates at S-connectors resulted from impaction and these rates were nearly independent of the orientation of the S-connector. Deposition rates in the two 90{sup o} bends differed by more than an order of magnitude in some cases, probably because of the difference in turbulence conditions at the bend inlets. In straight steel ducts where the turbulent flow profile was developing, the deposition enhancement relative to fully developed turbulence generally increased with air speed and decreased with downstream distance from the duct inlet. This enhancement was greater at the duct ceiling and wall than at the duct floor. In insulated ducts, deposition enhancement was less pronounced overall

  15. Acoustic radiation from lined, unflanged ducts: Acoustic source distribution program

    NASA Technical Reports Server (NTRS)

    Beckemeyer, R. J.; Sawdy, D. T.

    1971-01-01

    An acoustic radiation analysis was developed to predict the far-field characteristics of fan noise radiated from an acoustically lined unflanged duct. This analysis is comprised of three modular digital computer programs which together provide a capability of accounting for the impedance mismatch at the duct exit plane. Admissible duct configurations include circular or annular, with or without an extended centerbody. This variation in duct configurations provides a capability of modeling inlet and fan duct noise radiation. The computer programs are described in detail.

  16. Disulfiram sensitizes pituitary adenoma cells to temozolomide by regulating O6-methylguanine-DNA methyltransferase expression.

    PubMed

    Zhao, Yachao; Xiao, Zheng; Chen, Wenna; Yang, Jinsheng; Li, Tao; Fan, Bo

    2015-08-01

    O6-methylguanine-DNA methyltransferase (MGMT) activity is responsible for temozolomide (TMZ) resistance in patients harboring aggressive pituitary adenomas. Recently, disulfiram (DSF) has been shown to induce the loss of MGMT protein and increase TMZ efficacy in glioblastoma cells, while CD133+ nestin+ cells isolated from the cell population have been implicated as pituitary adenoma stem-like cells. However, whether DSF is able to potentiate the cytotoxic effects of TMZ on human pituitary adenoma cells has not been investigated to date. In the present study, CD133+ nestin+ phenotype cells were isolated from primary cultured human pituitary adenoma cells using microbeads. It was found that DSF reduced MGMT protein expression and sensitized human pituitary adenoma cells and stem-like cells to TMZ in vitro, while the proteasome inhibitor PS-341 abrogated the inhibitory effect of DSF on MGMT in vitro. The sensitizing effect of DSF was also verified in primary cultured human pituitary adenoma cells in vivo. The results of the present study suggested that DSF can increase the efficacy of the anti-tumor effect of TMZ on human pituitary adenoma cells and CD133+ nestin+ stem like cells via the ubiquitin-proteasomal MGMT protein elimination route. DSF combined with TMZ may be an effective therapeutic strategy against aggressive pituitary adenomas. PMID:25937029

  17. Isolated double adrenocorticotropic hormone-secreting pituitary adenomas: A case report and review of the literature

    PubMed Central

    PU, JIUJUN; WANG, ZHIMING; ZHOU, HUI; ZHONG, AILING; JIN, KAI; RUAN, LUNLIANG; YANG, GANG

    2016-01-01

    Only a few cases of double or multiple pituitary adenomas have previously been reported in the literature; however, isolated double adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas are even more rare. The present study reports a rare case of a 50-year-old female patient who presented with typical clinical features of Cushing's disease and was diagnosed with isolated double ACTH-secreting pituitary adenomas. Endocrinological examination revealed an ACTH-producing pituitary adenoma, and preoperative magnetic resonance imaging (MRI) demonstrated a microadenoma with a lower intensity on the right side of the pituitary gland. The patient underwent endoscopic endonasal transsphenoidal surgery, which revealed another pituitary tumor in the left side of the pituitary gland. The two, clearly separated, pituitary adenomas identified in the same gland were completely resected. Immunohistochemistry and pathology revealed that the clearly separated double pituitary adenomas were positive for ACTH, thyroid-stimulating, growth and prolactin hormones. Postoperatively, the levels of ACTH and cortisol hormone decreased rapidly. The case reported in the present study is considerably rare, due to the presence of a second pituitary adenoma in the same gland, which was not detected by preoperative MRI scan, but was noticed during surgery. Intraoperative evaluation may be important in the identification of double or multiple pituitary adenomas. PMID:27347184

  18. Parathyroid Adenoma Associated with Granulomatous Inflammation: A Curious Cause of Hypercalcaemia

    PubMed Central

    Singh, Hena Paul; Sood, Neena; Puri, Harpreet

    2016-01-01

    Primary Hyperparathyroidism (PHPT) due to solitary parathyroid adenoma followed by parathyroid hyperplasia and carcinoma are the most frequent cause of hypercalcaemia. The most common granulomatous disorders causing hypercalcaemia are sarcoidosis and tuberculosis. We have reported a case where unexplained granulomas were seen along with parathyroid adenoma. PMID:27190821

  19. Hyperplasia-adenoma sequence in pituitary tumorigenesis related to aryl hydrocarbon receptor interacting protein gene mutation.

    PubMed

    Villa, Chiara; Lagonigro, Maria Stefania; Magri, Flavia; Koziak, Maria; Jaffrain-Rea, Marie-Lise; Brauner, Raja; Bouligand, Jerome; Junier, Marie Pierre; Di Rocco, Federico; Sainte-Rose, Christian; Beckers, Albert; Roux, François Xavier; Daly, Adrian F; Chiovato, Luca

    2011-06-01

    Mutations of the aryl hydrocarbon receptor interacting protein (AIP) gene are associated with pituitary adenomas that usually occur as familial isolated pituitary adenomas (FIPA). Detailed pathological and tumor genetic data on AIP mutation-related pituitary adenomas are not sufficient. Non-identical twin females presented as adolescents to the emergency department with severe progressive headache caused by large pituitary macroadenomas require emergency neurosurgery; one patient had incipient pituitary apoplexy. Post-surgically, the patients were found to have silent somatotrope adenomas on pathological examination. Furthermore, the light microscopic, immunohistochemical, and electron microscopic studies demonstrated tumors of virtually identical characteristics. The adenomas were accompanied by multiple areas of pituitary hyperplasia, which stained positively for GH, indicating somatotrope hyperplasia. Genetic analyses of the FIPA kindred revealed a novel E216X mutation of the AIP gene, which was present in both the affected patients and the unaffected father. Molecular analysis of surgical specimens revealed loss of heterozygosity (LOH) in the adenoma but showed that LOH was not present in the hyperplastic pituitary tissue from either patient. AIP immunostaining confirmed normal staining in the hyperplastic tissue and decreased staining in the adenoma in the tumors from both patients. These results demonstrate that patients with AIP germline mutation can present with silent somatotrope pituitary adenomas. The finding of somatotrope hyperplasia unaccompanied by AIP LOH suggests that LOH at the AIP locus might be a late event in a potential progression from hyperplastic to adenomatous tissue. PMID:21450940

  20. Dysbiosis of Fungal Microbiota in the Intestinal Mucosa of Patients with Colorectal Adenomas

    PubMed Central

    Luan, Chunguang; Xie, Lingling; Yang, Xi; Miao, Huifang; Lv, Na; Zhang, Ruifen; Xiao, Xue; Hu, Yongfei; Liu, Yulan; Wu, Na; Zhu, Yuanmin; Zhu, Baoli

    2015-01-01

    The fungal microbiota is an important component of the human gut microbiome and may be linked to gastrointestinal disease. In this study, the fungal microbiota of biopsy samples from adenomas and adjacent tissues was characterized by deep sequencing. Ascomycota, Glomeromycota and Basidiomycota were identified as the dominant phyla in both adenomas and adjacent tissues from all subjects. Among the 60 genera identified, the opportunist pathogens Phoma and Candida represented an average of 45% of the fungal microbiota. When analyzed at the operational taxonomic unit (OTU) level, however, a decreased diversity in adenomas was observed, and three OTUs differed significantly from the adjacent tissues. Principal Component Analysis (PCA) revealed that the core OTUs formed separate clusters for advanced and non-advanced adenomas for which the abundance of four OTUs differed significantly. Moreover, the size of adenomas and the disease stage were closely related to changes in the fungal microbiota in subjects with adenomas. This study characterized the fungal microbiota profile of subjects with adenomas and identified potential diagnostic biomarkers closely related to different stages of adenomas. PMID:25613490

  1. Parafibromin and APC as screening markers for malignant potential in atypical parathyroid adenomas.

    PubMed

    Juhlin, C Christofer; Nilsson, Inga-Lena; Johansson, Kenth; Haglund, Felix; Villablanca, Andrea; Höög, Anders; Larsson, Catharina

    2010-09-01

    The identification of parathyroid carcinomas is based upon histopathological criteria in which an invasive growth pattern or distant metastasis is demonstrated. A dilemma arises when tumours present with atypical histopathological features but lack direct evidence of malignancy. Recently, reduced expression or loss of the tumour suppressor proteins parafibromin and adenomatous polyposis coli (APC) has been associated with parathyroid malignancy. We report results from APC and parafibromin expression analyses by immunohistochemistry and Western blot in five cases of atypical adenoma, a single case of carcinoma and 54 adenomas without atypical features. Complete loss of APC immunoreactivity and reduced expression of parafibromin was evident in two of the atypical adenomas and in the parathyroid carcinoma. By contrast, all adenomas displayed APC expression, including two cases with hyperparathyroidism 2 gene (HRPT2) mutations and loss of parafibromin expression. We conclude that loss of APC is a frequent molecular event in atypical adenomas and carcinomas, but not in adenomas. Following verification in an independent material, APC could become a valuable tool when assessing parathyroid tumours in the clinical setting. Furthermore, the molecular resemblance of atypical adenomas with carcinoma concerning parafibromin and APC expression indicates that atypical adenomas should be subjects to watchful follow-up. PMID:20473645

  2. Next-generation Genomic Profiling of Hepatocellular Adenomas: A New Era of Individualized Patient Care

    PubMed Central

    Marquardt, Jens U.; Thorgeirsson, Snorri S.

    2014-01-01

    Hepatocellular Adenomas (HCAs) are clinically relevant benign liver lesions that commonly occur in women on hormonal contraceptives. In this issue of Cancer Cell Pilati and colleagues present an integrative multi–“omics”-based analyses of HCA and identified recurrent genetic alterations associated with adenoma-carcinoma transition and new drug-able targets. PMID:24735920

  3. Coexisiting adenoma and granuloma involving the right inferior parathyroid gland with adjacent ectopic thymic tissue

    PubMed Central

    Gupta, Mayank; Kandasamy, Subramaniam

    2014-01-01

    Inflammatory lesions, particularly granulomas, involving adenoma of the parathyroid gland are rare. Ectopic thymic tissue is commonly associated with the thyroid and/or parathyroid gland due to their close embryonic relationship. We report a rare case of coexisting adenoma and granuloma of the parathyroid gland with adjacent ectopic thymic tissue. PMID:24957592

  4. Hypertrophic osteopathy associated with a renal adenoma in a cat.

    PubMed

    Johnson, Robert L; Lenz, Stephen D

    2011-01-01

    Hypertrophic osteopathy is a hyperostotic syndrome of the appendicular skeleton that is most commonly associated with intrathoracic neoplasia or inflammation. The condition is rarely associated with intra-abdominal lesions. The majority of cases have occurred in dogs and human beings, with fewer cases reported in cats, horses, and other species. A 15-year-old male neutered Domestic Shorthair cat presented for swollen limbs and difficulty in ambulation. Radiographs and gross postmortem revealed severe periosteal hyperostosis of the diaphysis and metaphysis of all 4 limbs, including the humerus, radius, ulna, carpi, metacarpi, femur, tibia, tarsi, metatarsi, and phalanges. The axial skeleton was spared. Hyperostotic lesions were characterized microscopically by lamellar bony trabeculae separated by adipocytes and scant hematopoietic tissue. In several areas, fibrovascular connective tissue, woven bone, and islands of cartilage were also present. A 2.5 cm × 2.5 cm perirenal neoplasm compressed the left kidney and adrenal gland. This mass consisted of well-differentiated tubules of cuboidal epithelial cells and was most consistent with a renal tubular adenoma, because mitotic figures were rare, and no distant metastases were found. Thoracic pathology was absent. Hyperostosis was consistent with hypertrophic osteopathy secondary to the renal adenoma. The pathogenesis of hypertrophic osteopathy is uncertain, but predominant theories point to increased peripheral circulation and angiogenesis as a key initiating event. Recent literature highlights the potential role of vascular endothelial growth factor and platelet-derived growth factor in the human condition. The mechanism by which this renal adenoma caused hypertrophic osteopathy is unknown. PMID:21217054

  5. Hepatic adenoma and focal nodular hyperplasia: differential diagnosis and treatment.

    PubMed

    Herman, P; Pugliese, V; Machado, M A; Montagnini, A L; Salem, M Z; Bacchella, T; D'Albuquerque, L A; Saad, W A; Machado, M C; Pinotti, H W

    2000-03-01

    The diagnosis of benign hepatic tumors as hepatic adenoma (HA) and focal nodular hyperplasia (FNH) remains a challenge for clinicians and surgeons. The importance of differentiating between these lesions is based on the fact that HA must be surgically resected and FNH can be only observed. A series of 23 female patients with benign liver tumors (13 FNH, 10 HA) were evaluated, and a radiologic diagnostic algorithm was employed with the aim of establishing preoperative criteria for the differential diagnosis. All patients were submitted to surgical biopsy or hepatic resection to confirm the diagnosis. Based only on clinical and laboratory data, distinction was not possible. According to the investigative algorithm, the diagnosis was correct in 82.6% of the cases; but even with the development of imaging methods, which were used in combination, the differentiation was not possible in four patients. For FNH cases scintigraphy presented a sensitivity of 38.4% and specificity of 100%, whereas for HA the sensitivity reached 60% and specificity 85.7%. Magnetic resonance imaging, employed when scintigraphic findings were not typical, presented sensitivities of 71.4% and 80% and specificities of 100% and 100% for FNH and HA, respectively. Preoperative diagnosis of FNH was possible in 10 of 13 (76.9%) patients and was confirmed by histology in all of them. In one case, FNH was misdiagnosed as HA. The diagnosis of HA was possible in 9 of 10 (90%) adenoma cases. Surgical biopsy remains the best method for the differential diagnosis between HA and FNH and must be performed in all doubtful cases. Surgical resection is the treatment of choice for all patients with adenoma and can be performed safely. With the evolution of imaging methods it seems that the preoperative diagnosis of FNH may be considered reliable, thereby avoiding unnecessary surgical resection. PMID:10658075

  6. Coupled parametric design of flow control and duct shape

    NASA Technical Reports Server (NTRS)

    Florea, Razvan (Inventor); Bertuccioli, Luca (Inventor)

    2009-01-01

    A method for designing gas turbine engine components using a coupled parametric analysis of part geometry and flow control is disclosed. Included are the steps of parametrically defining the geometry of the duct wall shape, parametrically defining one or more flow control actuators in the duct wall, measuring a plurality of performance parameters or metrics (e.g., flow characteristics) of the duct and comparing the results of the measurement with desired or target parameters, and selecting the optimal duct geometry and flow control for at least a portion of the duct, the selection process including evaluating the plurality of performance metrics in a pareto analysis. The use of this method in the design of inter-turbine transition ducts, serpentine ducts, inlets, diffusers, and similar components provides a design which reduces pressure losses and flow profile distortions.

  7. Curved Duct Noise Prediction Using the Fast Scattering Code

    NASA Technical Reports Server (NTRS)

    Dunn, M. H.; Tinetti, Ana F.; Farassat, F.

    2007-01-01

    Results of a study to validate the Fast Scattering Code (FSC) as a duct noise predictor, including the effects of curvature, finite impedance on the walls, and uniform background flow, are presented in this paper. Infinite duct theory was used to generate the modal content of the sound propagating within the duct. Liner effects were incorporated via a sound absorbing boundary condition on the scattering surfaces. Simulations for a rectangular duct of constant cross-sectional area have been compared to analytical solutions and experimental data. Comparisons with analytical results indicate that the code can properly calculate a given dominant mode for hardwall surfaces. Simulated acoustic behavior in the presence of lined walls (using hardwall duct modes as incident sound) is consistent with expected trends. Duct curvature was found to enhance weaker modes and reduce pressure amplitude. Agreement between simulated and experimental results for a straight duct with hard walls (no flow) was excellent.

  8. Increased rectal microbial richness is associated with the presence of colorectal adenomas in humans.

    PubMed

    Sanapareddy, Nina; Legge, Ryan M; Jovov, Biljana; McCoy, Amber; Burcal, Lauren; Araujo-Perez, Felix; Randall, Thomas A; Galanko, Joseph; Benson, Andrew; Sandler, Robert S; Rawls, John F; Abdo, Zaid; Fodor, Anthony A; Keku, Temitope O

    2012-10-01

    Differences in the composition of the gut microbial community have been associated with diseases such as obesity, Crohn's disease, ulcerative colitis and colorectal cancer (CRC). We used 454 titanium pyrosequencing of the V1-V2 region of the 16S rRNA gene to characterize adherent bacterial communities in mucosal biopsy samples from 33 subjects with adenomas and 38 subjects without adenomas (controls). Biopsy samples from subjects with adenomas had greater numbers of bacteria from 87 taxa than controls; only 5 taxa were more abundant in control samples. The magnitude of the differences in the distal gut microbiota between patients with adenomas and controls was more pronounced than that of any other clinical parameters including obesity, diet or family history of CRC. This suggests that sequence analysis of the microbiota could be used to identify patients at risk for developing adenomas. PMID:22622349

  9. S100 protein expression distinguishes metanephric adenomas from other renal neoplasms.

    PubMed

    Azabdaftari, Gissou; Alroy, Joseph; Banner, Barbara F; Ucci, Angelo; Bhan, Ina; Cheville, John C

    2008-01-01

    Metanephric adenoma is a benign renal neoplasm with morphologic features similar to those of malignant renal neoplasms, such as papillary renal cell carcinoma (RCC) and Wilms' tumor. Different methods have been used to distinguish between metanephric adenoma and papillary RCC and Wilms' tumor. However, some techniques are not always available, such as certain immunohistochemical stains, cytogenetics, molecular genetics, and electron microscopy. In the current study, we compared the expression of S100 protein in 15 cases of metanephric adenoma, 10 cases of Wilms' tumor, and 13 cases of papillary RCC. Our results revealed strong expression of S100 proteins in all cases of metanephric adenoma, weak expression in two cases of Wilms' tumor, and no expression in any of the cases of papillary RCC. These findings indicate that S100 could be a useful and accessible tool for the diagnosis of metanephric adenoma. PMID:18621486

  10. Dietary Lignan and Proanthocyanidin Consumption and Colorectal Adenoma Recurrence in the Polyp Prevention Trial

    PubMed Central

    Bobe, Gerd; Murphy, Gwen; Albert, Paul S.; Sansbury, Leah B.; Lanza, Elaine; Schatzkin, Arthur; Cross, Amanda J.

    2011-01-01

    Lignans and proanthocyanidins are plant polyphenols that have shown protective properties against colorectal neoplasms in some human studies. Using logistic regression, we estimated odds ratios (ORs) and 95% confidence intervals (CIs) to prospectively evaluate the association between lignan and proanthocyanidin intake, estimated from databases linked to a food frequency questionnaire, and adenoma recurrence in 1,859 participants of the Polyp Prevention Trial. Overall, individual or total lignans or proanthocyanidins were not associated with colorectal adenoma recurrence. However, in sex-specific analyses, total lignan intake was positively associated with any adenoma recurrence in women (highest versus lowest lignan intake quartile OR = 2.07, 95% CI: 1.22-3.52, P trend = 0.004) but not in men (P interaction = 0.04). To conclude, dietary lignan and proanthocyanidin consumption was not generally related to colorectal adenoma recurrence; however, high lignan intake may increase the risk of adenoma recurrence in women. PMID:21618513

  11. Challenging neck mass: non-functional giant parathyroid adenoma.

    PubMed

    Mossinelli, Chiara; Saibene, Alberto Maria; De Pasquale, Loredana; Maccari, Alberto

    2016-01-01

    A 46-year-old man was referred to our ear, nose and throat department after the accidental discovery of a large retrotracheal mass. In order to obtain the diagnosis and to plan treatment he underwent a full battery of tests (CT, MRI, blood tests, hormonal assays, ultrasounds, thyroid scintigraphy, urine tests and fine-needle aspiration of the mass), but none of these was able to define the true nature of such cervical mass. Only after surgical excision and histological evaluation, it was diagnosed as an exceptional case of giant non-functional parathyroid adenoma. PMID:27535730

  12. Non-functioning adrenal adenomas discovered incidentally on computed tomography

    SciTech Connect

    Mitnick, J.S.; Bosniak, M.A.; Megibow, A.J.; Naidich, D.P.

    1983-08-01

    Eighteen patients with unilateral non-metastatic non-functioning adrenal masses were studied with computed tomography (CT). Pathological examination in cases revealed benign adrenal adenomas. The others were followed up with serial CT scans and found to show no change in tumor size over a period of six months to three years. On the basis of these findings, the authors suggest certain criteria of a benign adrenal mass, including (a) diameter less than 5 cm, (b) smooth contour, (c) well-defined margin, and (d) no change in size on follow-up. Serial CT scanning can be used as an alternative to surgery in the management of many of these patients.

  13. [Rare giant salivary gland pleomorphic adenoma on the neck].

    PubMed

    Shi, Dongling; Li, Qinghuai

    2013-12-01

    The patient has found his neck mass for more than 30 years, and the neck mass has slowly growed into giant tumor. Five days ago, the neck giant mass suddenly burst, hemorrhage and overflow liquid. The giant mass with irregular in shape, surface uneven, skin highly tension and superficial venous engorgement, was seen in left lateral neck. CT scan demonstrates a mixture of solid, cystic and lobulated mass shadow within subcutaneous fat spaces of left lateral neck. Postoperative pathological examination proved that it is salivary gland pleomorphic adenoma. PMID:24620671

  14. SNM holdup assessment of Los Alamos exhaust ducts. Final report

    SciTech Connect

    Marshall, R.S.

    1994-02-01

    Fissile material holdup in glovebox and fume hood exhaust ducting has been quantified for all Los Alamos duct systems. Gamma-based, nondestructive measurements were used to quantify holdup. The measurements were performed during three measurement campaigns. The first campaign, Phase I, provided foot-by-foot, semiquantitative measurement data on all ducting. These data were used to identify ducting that required more accurate (quantitative) measurement. Of the 280 duct systems receiving Phase I measurements, 262 indicated less than 50 g of fissile holdup and 19 indicated fissile holdup of 50 or more grams. Seven duct systems were measured in a second campaign, called Series 1, Phase II. Holdup estimates on these ducts ranged from 421 g of {sup 235}U in a duct servicing a shut-down uranium-machining facility to 39 g of {sup 239}Pu in a duct servicing an active plutonium-processing facility. Measurements performed in the second campaign proved excessively laborious, so a third campaign was initiated that used more efficient instrumentation at some sacrifice in measurement quality. Holdup estimates for the 12 duct systems measured during this third campaign ranged from 70 g of {sup 235}U in a duct servicing analytical laboratories to 1 g of {sup 235}U and 1 g of {sup 239}Pu in a duct carrying exhaust air to a remote filter building. These quantitative holdup estimates support the conclusion made at the completion of the Phase I measurements that only ducts servicing shut-down uranium operations contain about 400 g of fissile holdup. No ventilation ducts at Los Alamos contain sufficient fissile material holdup to present a criticality safety concern.

  15. Prevalence of colorectal adenomas in asymptomatic young adults: a window to early intervention?

    PubMed

    Kwak, Ji Yeong; Kim, Kwang Min; Yang, Hae Jin; Yu, Kil Jong; Lee, Jae Gon; Jeong, Yeon Oh; Shim, Sang Goon

    2016-06-01

    Objective The prevalence of colorectal adenoma is increasing in the average-risk population. However, little research is available on colorectal adenoma in young adults under age 40. The aim of this study was to investigate the prevalence and risk factors of colorectal adenoma in 20- to 39-year-old adults. Methods We evaluated 4286 asymptomatic young adults aged 20 to 39 years who underwent first colonoscopy screening as part of an employer-provided health wellness programme at the Health Promotion Centre of Samsung Changwon Hospital, Korea from January 2011 to December 2013. Logistic regression modelling was used to identify risk factors for colorectal adenoma in asymptomatic young adults. Results The prevalence of colorectal adenoma and advanced adenoma was 11.6% (497/4286) and 0.9% (39/4286), respectively. By age group, the prevalence of colorectal adenoma was 5.4% (33/608) in participants aged 20 to 29 years and 12.6% (464/3678) in participants aged 30 to 39. Colorectal adenoma was found in 13.1% (403/3072) of men and 7.7% (94/1214) of women. Increased risk of colorectal adenoma was associated with age over 30 years (OR, 2.37; 95% CI, 1.64-3.42), current smoker status (OR, 1.48; 95% CI, 1.14-1.91), and alcohol consumption (OR, 1.29; 95% CI, 1.03-1.63). Conclusions Our findings indicate that even if the prevalence of colorectal adenoma was low in young adults aged 20 to 39, being over 30, cigarette smoking, and alcohol consumption can affect young adults who have no other CRC risks. PMID:26863602

  16. Optimization of the mechanical performance of a two-duct semicircular duct system--part 2: excitation of endolymph movements.

    PubMed

    Muller, M; Verhagen, J H G

    2002-06-21

    The endolymph flow inside the semicircular ducts is analytically investigated by considering a system of two hydrodynamically interconnected ducts. Rotation of this system adds an amount of motion (momentum) to parts of it. This results in an endolymph flow in generally all vestibular parts. The "external impulses" are the impulses which emerge by rotation of exclusively a particular vestibular part. The real impulses can be calculated from a set of equations which contain the external impulses. Analytical expressions are derived for the initial velocities in the ducts and for the maximum endolymph displacements. These formulae contain the external impulses and the ratios of: (1) the radii of crus commune and ducts (gamma), (2) the lengths of crus commune and ducts (lambda). It was proven that an interconnected system composed of two ducts, and also a system composed of two such semicircular duct systems, behaves as a pure rotation transducer (like a single duct does), also when it is rotated excentrically. Duct systems with polygonal and circular geometries were used to evaluate whether an optimal value of lambda would exist (gamma was already considered elsewhere). Optimum values of lambda in a range of about 0.10-0.52 were found. This rather wide range of values agrees with values from measurements. Optimization of an interconnected duct system appeared to be equal to optimization of a system composed of separate ducts. PMID:12151259

  17. Contrasting the efficiency of radiation belt losses caused by ducted and non-ducted whistler mode waves from manmade transmitters

    NASA Astrophysics Data System (ADS)

    Rodger, C. J.; Carson, Bonar; Cummer, Steven A.; Gamble, R. J.; Clilverd, Mark; Sauvaud, Jean-Andre; Parrot, Michel; Green, Janet

    Electromagnetic waves in the VLF range generated at or near the Earth's surface can penetrate the ionosphere and propagate through the plasmasphere. It has long been recognized that whistler-mode waves can be trapped in localized field-aligned enhancements in plasmaspheric ionization density termed "whistler ducts", which guide the waves from one hemisphere to the other. For the non-guided cases, the whistler mode waves are said to be "nonducted". The nature of wave-particle interactions are affected by the wave being ducted or non-ducted through influence on the wave-normal angles. In the field-aligned ducted case, the dominant resonance possible is first-order cyclotron, whereas non-ducted interactions open up a much wider range of energies through equatorial and off-equatorial gyro-resonance. Thus the significance of these VLF waves as drivers of radiation belt losses is strongly influenced by whether these waves are dominantly ducted or non-ducted. At this point there is conflicting information in the literature as to whether the most significant loss processes are driven by ducted or non-ducted waves. In this study we use loss cone observations from instruments onboard the DEMETER and POES low-altitude satellites to focus on losses driven by powerful VLF communications transmitters. We wish to better characterise the losses previously reported and explained through interactions with ducted VLF transmissions. We also plan to examine losses into the atmosphere driven by non-ducted transmissions.

  18. Theoretical analysis of HVAC duct hanger systems

    NASA Technical Reports Server (NTRS)

    Miller, R. D.

    1987-01-01

    Several methods are presented which, together, may be used in the analysis of duct hanger systems over a wide range of frequencies. The finite element method (FEM) and component mode synthesis (CMS) method are used for low- to mid-frequency range computations and have been shown to yield reasonably close results. The statistical energy analysis (SEA) method yields predictions which agree with the CMS results for the 800 to 1000 Hz range provided that a sufficient number of modes participate. The CMS approach has been shown to yield valuable insight into the mid-frequency range of the analysis. It has been demonstrated that it is possible to conduct an analysis of a duct/hanger system in a cost-effective way for a wide frequency range, using several methods which overlap for several frequency bands.

  19. Porokeratotic Eccrine Ostial and Dermal Duct Nevus

    PubMed Central

    Naraghi, Mona Masoumeh; Goodarzi, Azadeh

    2013-01-01

    PEODDN is a rare benign cutaneous disorder that clinically resembles comedo nevus but favors the palms and soles, where pilosebaceous follicles are absent. Widespread involvement along Blaschko's lines can also occur. It is a disorder of keratinization involving the intraepidermal eccrine duct (acrosyringium) and is characterized by eccrine hamartoma and cornoid lamellation in pathology. The patient is a 29-year-old man with an 8-year history of pruritic skin lesions on his right lateral ankle. In the pathologic examination, multiple small epidermal invagination with overlying parakeratotic cornoid lamellation, loss of granular layer, and few dyskeratotic cells at the base of epidermal invagination are revealed. After clinic-pathologic correlation, the diagnosis of porokeratotic eccrine ostial and dermal duct nevus (PEODDN) was made. Late-onset and rare clinical presentation as pruritic lesion are the characteristic features that make this patient an extraordinary presentation of PEODDN. PMID:24307955

  20. Sea echo in tropospheric ducting environments

    NASA Astrophysics Data System (ADS)

    Pappert, R. A.; Paulus, R. A.; Tappert, F. D.

    1992-04-01

    Path loss formulas for sea surface backscatter are developed for horizontally stratified tropospheric ducting environments. First-order Bragg backscatter results coupled with ray and waveguide formalism serve as the basis for the development. Two features of composite model formalism, namely shadowing and tilting of the surface normal in the plane of incidence, are included in the development. Though developed for hh polarization, conventional composite model modifications for vertical polarization and depolarization can be incorporated into the echo models. Comparisons are made with previously generated parabolic equation results and with empirical model results generated by Engineers Refractive Effects Prediction System. These comparisons are for a frequency of 9.6 GHz for the standard atmosphere and for 14- and 28-m evaporation ducts. Results apply to wind speeds of 10, 20, 30, and 40 knots (about 5, 10, 15, and 20 m/s).

  1. Evaporation duct assessment from meteorological buoys

    NASA Astrophysics Data System (ADS)

    Hitney, Herbert V.

    2002-07-01

    The evaporation duct over the sea is usually assessed using bulk meteorological measurements. This paper investigates the utility of meteorological buoys as a source for these bulk measurements and compares evaporation duct assessments using two buoys in southern California waters separated by 128 km. A simple radio propagation experiment at 2.4 GHz between one of the buoys and the coast on an 18.2 km path is described. Observed propagation loss from this experiment is compared to modeled loss based on the meteorological measurements at each buoy. The purpose of this paper is to investigate radio propagation effects using established and accepted methods already described in the literature. Accordingly, no discussion of atmospheric surface layer meteorology affecting radio propagation is given.

  2. Ontogeny of the nasopalatine duct in primates.

    PubMed

    Shimp, Kristin L; Bhatnagar, Kunwar P; Bonar, Christopher J; Smith, Timothy D

    2003-09-01

    Ecological explanations have been put forward to account for the precocious or delayed development of patency in ducts leading to the vomeronasal organ (VNO) in certain mammals. Perinatal function may be related, in part, to the patency or fusion of the vomeronasal and nasopalatine (NPD) ducts. However, few studies have focused on NPD development in primates, which generally have a prolonged period of dependence during infancy. In this study we examined 24 prenatal primates and 13 neonatal primates, and a comparative sample of fetal mice and insectivores. In embryonic and early fetal Microcebus murinus, the NPD was completely fused, whereas in fetuses of later stages the duct was partially fused or completely patent. M. myoxinus of all stages demonstrated some degree of NPD fusion. In all other prenatal primates, the NPD was fused to some extent. Four prenatal insectivores (Tenrec ecaudatus) showed some degree of NPD fusion. In Mus musculus at 19 days gestation, the NPD was patent, although the anatomically separate VNO duct was fused. T. ecaudatus and most of the neonatal primates revealed complete NPD patency. An exception was Saguinus geoffroyi, which exhibited fusion of the NPD near the VNO opening. These observations may relate to differences in perinatal VNO function. The differences noted in our study suggest that M. murinus and M. myoxinus may differ in perinatal VNO functionality and perhaps in related behavior. Observations of neonatal primates suggest that NPD patency may be relatively common at birth and could serve other purposes in addition to being an access route for VNO stimuli. PMID:12923897

  3. Acoustic-Liner Admittance in a Duct

    NASA Technical Reports Server (NTRS)

    Watson, W. R.

    1986-01-01

    Method calculates admittance from easily obtainable values. New method for calculating acoustic-liner admittance in rectangular duct with grazing flow based on finite-element discretization of acoustic field and reposing of unknown admittance value as linear eigenvalue problem on admittance value. Problem solved by Gaussian elimination. Unlike existing methods, present method extendable to mean flows with two-dimensional boundary layers as well. In presence of shear, results of method compared well with results of Runge-Kutta integration technique.

  4. Zero leakage separable and semipermanent ducting joints

    NASA Technical Reports Server (NTRS)

    Mischel, H. T.

    1973-01-01

    A study program has been conducted to explore new methods of achieving zero leakage, separable and semipermanent, ducting joints for space flight vehicles. The study consisted of a search of literature of existing zero leakage methods, the generation of concepts of new methods of achieving the desired zero leakage criteria and the development of detailed analysis and design of a selected concept. Other techniques of leak detection were explored with a view toward improving this area.

  5. Laminar heat transfer in annular sector ducts

    SciTech Connect

    Soliman, H.M. )

    1987-02-01

    The continuing interest in compact heat exchangeers has created the need for friction factor and Nusselt number data for different passage shapes. It has long been recognized that circular tube results are generally not applicable to noncircular passages even when the hydraulic diameter is used as the characteristic dimension. Hence, design data should be generated for each passage individually, and a good source of such information is Shah and London. One duct geometry for which complete design information does not appear to be available in the open literature is that of annular sector ducts. Such configuration is encountered in multipassage internally finned tubes and many other compact het exchanger applications. The fluid flow problem for this configuration has been solved by Sparrow et al., and more recently by Niida. However, to the beest of the author's knowledge, the heat transfer results are not available yet. The purpose of this note is to summarize the analysis and results of fluid flow and heat transfer in annular sector ducts.

  6. Autoignitions and detonations in engines and ducts.

    PubMed

    Bradley, Derek

    2012-02-13

    The origins of autoignition at hot spots are analysed and the pressure pulses that arise from them are related to knock in gasoline engines and to developing detonations in ducts. In controlled autoignition engines, autoignition is benign with little knock. There are several modes of autoignition and the existence of an operational peninsula, within which detonations can develop at a hot spot, helps to explain the performance of various engines. Earlier studies by Urtiew and Oppenheim of the development of autoignitions and detonations ahead of a deflagration in ducts are interpreted further, using a simple one-dimensional theory of the generation of shock waves ahead of a turbulent flame. The theory is able to indicate entry into the domain of autoignition in an 'explosion in the explosion'. Importantly, it shows the influence of the turbulent burning velocity, and particularly its maximum attainable value, upon autoignition. This value is governed by localized flame extinctions for both turbulent and laminar flames. The theory cannot show any details of the transition to a detonation, but regimes of eventually stable or unstable detonations can be identified on the operational peninsula. Both regimes exhibit transverse waves, triple points and a cellular structure. In the case of unstable detonations, transverse waves are essential to the continuing propagation. For hazard assessment, more needs to be known about the survival, or otherwise, of detonations that emerge from a duct into the same mixture at atmospheric pressure. PMID:22213665

  7. The transient response above an evaporation duct

    NASA Astrophysics Data System (ADS)

    Abo-Seliem, Adel A. S.

    1998-11-01

    The transient electromagnetic field generated by a vertical electric dipole above an evaporation duct is investigated theoretically. The evaporation duct model used is that previously described by Kahan and Eckart. A vertical electric dipole, above the surface layer, is taken as the source of the electromagnetic field. We determine the electrical field strength exactly at some fixed point above the duct layer, having chosen a certain polarization of the primary source whose moment is allowed to vary arbitrarily with time. A series expansion with respect to the images of the primary source permits us to apply the method first reported by Cagniard and later extended by de Hoop and Frankena to the case where the source is positioned in a medium of lesser permittivity. Hence, we can give a physically intuitive description of the polarization dependence of the time history of the electrical field strength. The distinction of different cases where the distances between the receiving and transmitting ends are greater or lesser than the total reflection distance is studied. The electrical field strength is evaluated for different excitation functions at some fixed but arbitrary positions of the point of observation in the half-space.

  8. Radiative interactions in laminar duct flows

    NASA Technical Reports Server (NTRS)

    Trivedi, P. A.; Tiwari, S. N.

    1990-01-01

    Analyses and numerical procedures are presented for infrared radiative energy transfer in gases when other modes of energy transfer occur simultaneously. Two types of geometries are considered, a parallel plate duct and a circular duct. Fully developed laminar incompressible flows of absorbing-emitting species in black surfaced ducts are considered under the conditions of uniform wall heat flux. The participating species considered are OH, CO, CO2, and H2O. Nongray as well as gray formulations are developed for both geometries. Appropriate limiting solutions of the governing equations are obtained and conduction-radiation interaction parameters are evaluated. Tien and Lowder's wide band model correlation was used in nongray formulation. Numerical procedures are presented to solve the integro-differential equations for both geometries. The range of physical variables considered are 300 to 2000 K for temperature, 0.1 to 100.0 atm for pressure, and 0.1 to 100 cm spacings between plates/radius of the tube. An extensive parametric study based on nongray formulation is presented. Results obtained for different flow conditions indicate that the radiative interactions can be quite significant in fully developed incompressible flows.

  9. Human Pituitary Adenoma Proteomics: New Progresses and Perspectives.

    PubMed

    Zhan, Xianquan; Wang, Xiaowei; Cheng, Tingting

    2016-01-01

    Pituitary adenoma (PA) is a common intracranial neoplasm that impacts on human health through interfering hypothalamus-pituitary-target organ axis systems. The development of proteomics gives great promises in the clarification of molecular mechanisms of a PA and discovery of effective biomarkers for prediction, prevention, early-stage diagnosis, and treatment for a PA. A great progress in the field of PA proteomics has been made in the past 10 years, including (i) the use of laser-capture microdissection, (ii) proteomics analyses of functional PAs (such as prolactinoma), invasive and non-invasive non-functional pituitary adenomas (NFPAs), protein post-translational modifications such as phosphorylation and tyrosine nitration, NFPA heterogeneity, and hormone isoforms, (iii) the use of protein antibody array, (iv) serum proteomics and peptidomics, (v) the integration of proteomics and other omics data, and (vi) the proposal of multi-parameter systematic strategy for a PA. This review will summarize these progresses of proteomics in PAs, point out the existing drawbacks, propose the future research directions, and address the clinical relevance of PA proteomics data, in order to achieve our long-term goal that is use of proteomics to clarify molecular mechanisms, construct molecular networks, and discover effective biomarkers. PMID:27303365

  10. Testosterone-secreting adrenal adenoma in a peripubertal girl

    SciTech Connect

    Kamilaris, T.C.; DeBold, C.R.; Manolas, K.J.; Hoursanidis, A.; Panageas, S.; Yiannatos, J.

    1987-11-13

    A 15-year-old girl who presented with primary amenorrhea and virilization had an adrenocortical adenoma that secreted predominantly testosterone. To the authors' knowledge, she is the first peripubertal and second youngest patient with a testosterone-secreting adrenal tumor described. Serum dehydroepiandrosterone sulfate and urinary 17-ketosteroid an 17-hydroxycorticosteroid levels were normal. A tumor was located by a computed tomographic (CT) scan and by uptake of 6-..beta..-(/sup 75/Se) selenomethylnorcholesterol. Microscopic examination of the tumor showed typical features of an adrenocortical adenoma with no histologic features characteristic of Leydig cells. Postoperatively, her hirsutism regressed, she rapidly went through puberty, and regular monthly menstruation started four months later. Finding the source of testosterone in a virilized patient can be difficult. Eleven of the 14 previously described patients with testosterone-secreting adrenal tumors initially underwent misdirected surgery on the ovaries. Review of these cases revealed that results of hormone stimulation and suppression tests are unreliable and that these tumors are usually large. Therefore, CT scanning of the adrenal glands is recommended in all patients suspected of having a testosterone-secreting tumor.

  11. Acute appendicitis following endoscopic mucosal resection of cecal adenoma.

    PubMed

    Nemoto, Yukako; Tokuhisa, Junya; Shimada, Nagasato; Gomi, Tatsuya; Maetani, Iruru

    2015-07-21

    Endoscopic mucosal resection (EMR) allows the removal of flat or sessile lesions, laterally spreading tumors, and carcinoma of the colon or the rectum limited to the mucosa or the superficial submucosa. Acute appendicitis is the most common abdominal emergency requiring emergency surgery, and it is also a rare complication of diagnostic colonoscopy and therapeutic endoscopy, including EMR. In the case presented here, a 53-year-old female underwent colonoscopy due to a positive fecal occult blood test and was diagnosed with cecal adenoma. She was referred to our hospital and admitted for treatment. The patient had no other symptoms. EMR was performed, and 7 h after the surgery, the patient experienced right -lower abdominal pain. Laboratory tests performed the following day revealed a WBC count of 16000/mm(3), a neutrophil count of 14144/mm(3), and a C-reactive protein level of 2.20 mg/dL, indicating an inflammatory response. Computed tomography also revealed appendiceal wall thickening and swelling, so acute appendicitis following EMR was diagnosed. Antibiotics were initiated leading to total resolution of the symptoms, and the patient was discharged on the sixth post-operative day. Pathological analysis revealed a high-grade cecal tubular adenoma. Such acute appendicitis following EMR is extremely rare, and EMR of the cecum may be a rare cause of acute appendicitis. PMID:26217100

  12. Oral rehabilitation after surgical removal of pleomorphic adenoma.

    PubMed

    Goiato, Marcelo Coelho; Tamae, Adriano Caires; Silva, Pedro Ivo Santos; dos Santos, Daniela Micheline; Iyda, Mariana Garib; Moreno, Amalia; Magro-Filho, Osvaldo; Bertoz, André Pinheiro Magalhães

    2011-11-01

    Although tumors of minor salivary glands are rare, the pleomorphic adenoma is the most common pathology among the benign neoplasm and can be found with high prevalence in the junction between hard palate and soft palate. The treatment of choice for most of maxillary tumors is surgical through either a total or partial maxillectomy. However, surgical defects caused by such type of treatment lead to both clinical and psychologic disorders for the patient. The immediate oral rehabilitation using interim palate obturator after maxillectomy provides optimization on the healing process, recovers the stomatognathic functions after surgery, and avoids psychosocial sequelae for the patients. This clinical report aimed to present the rehabilitation with immediate palate obturator of a patient who underwent a partial maxillectomy due to a hard palate pleomorphic adenoma of minor salivary glands. We report the clinical importance of the prosthetic rehabilitation and the improvements on both quality of life and stomatognathic functions of this patient. It can be concluded that the immediate rehabilitation of the patient after partial maxillectomy by using an interim palate obturator was a great option and provided clinical benefits in the immediate postoperative period, improving the patient’s quality of life, allowing the patient’s reinsertion into society, and reducing the surgical treatment sequelae. PMID:22067849

  13. Human Pituitary Adenoma Proteomics: New Progresses and Perspectives

    PubMed Central

    Zhan, Xianquan; Wang, Xiaowei; Cheng, Tingting

    2016-01-01

    Pituitary adenoma (PA) is a common intracranial neoplasm that impacts on human health through interfering hypothalamus–pituitary–target organ axis systems. The development of proteomics gives great promises in the clarification of molecular mechanisms of a PA and discovery of effective biomarkers for prediction, prevention, early-stage diagnosis, and treatment for a PA. A great progress in the field of PA proteomics has been made in the past 10 years, including (i) the use of laser-capture microdissection, (ii) proteomics analyses of functional PAs (such as prolactinoma), invasive and non-invasive non-functional pituitary adenomas (NFPAs), protein post-translational modifications such as phosphorylation and tyrosine nitration, NFPA heterogeneity, and hormone isoforms, (iii) the use of protein antibody array, (iv) serum proteomics and peptidomics, (v) the integration of proteomics and other omics data, and (vi) the proposal of multi-parameter systematic strategy for a PA. This review will summarize these progresses of proteomics in PAs, point out the existing drawbacks, propose the future research directions, and address the clinical relevance of PA proteomics data, in order to achieve our long-term goal that is use of proteomics to clarify molecular mechanisms, construct molecular networks, and discover effective biomarkers. PMID:27303365

  14. Pleomorphic adenoma of a deep orbital ectopic lacrimal gland.

    PubMed

    Misra, Somen; Bhandari, Akshay; Misra, Neeta; Gogri, Pratik; Mahajan, Shruti

    2016-10-01

    Ectopic lacrimal gland, being one of the choristomas, is comprised of lacrimal gland tissue outside the lacrimal gland fossa in the fronto-lateral part of the orbital roof. Ectopic lacrimal gland is a rare condition where the gland may be found in the orbit, eyelids, ocular adnexa or within the globe. Neoplastic transformation of such tissue may occur. A sixty-two-year old male patient presented with right eye proptosis and slight nasal displacement of the globe. Computerized tomography scan revealed a well-defined hypodense lesion of size 19 x 18 x 20 mm supero-lateral to lateral rectus muscle, with mild proptosis and thinning of the right lateral orbital wall. Excisional biopsy was performed through a lateral orbitotomy approach. A well circumscribed globular mass was removed from the right orbit, well behind the fossa for the lacrimal gland in the retrobulbar space. Histopathology was suggestive of pleomorphic adenoma of lacrimal gland. Pleomorphic adenoma is an epithelial tumor of the lacrimal gland which is extremely rare from an ectopic lacrimal gland and only few cases have been reported in literature till date. PMID:27541944

  15. Acute appendicitis following endoscopic mucosal resection of cecal adenoma

    PubMed Central

    Nemoto, Yukako; Tokuhisa, Junya; Shimada, Nagasato; Gomi, Tatsuya; Maetani, Iruru

    2015-01-01

    Endoscopic mucosal resection (EMR) allows the removal of flat or sessile lesions, laterally spreading tumors, and carcinoma of the colon or the rectum limited to the mucosa or the superficial submucosa. Acute appendicitis is the most common abdominal emergency requiring emergency surgery, and it is also a rare complication of diagnostic colonoscopy and therapeutic endoscopy, including EMR. In the case presented here, a 53-year-old female underwent colonoscopy due to a positive fecal occult blood test and was diagnosed with cecal adenoma. She was referred to our hospital and admitted for treatment. The patient had no other symptoms. EMR was performed, and 7 h after the surgery, the patient experienced right -lower abdominal pain. Laboratory tests performed the following day revealed a WBC count of 16000/mm3, a neutrophil count of 14144/mm3, and a C-reactive protein level of 2.20 mg/dL, indicating an inflammatory response. Computed tomography also revealed appendiceal wall thickening and swelling, so acute appendicitis following EMR was diagnosed. Antibiotics were initiated leading to total resolution of the symptoms, and the patient was discharged on the sixth post-operative day. Pathological analysis revealed a high-grade cecal tubular adenoma. Such acute appendicitis following EMR is extremely rare, and EMR of the cecum may be a rare cause of acute appendicitis. PMID:26217100

  16. Thyrotropin-secreting pituitary adenomas: epidemiology, diagnosis, and management.

    PubMed

    Amlashi, Fatemeh G; Tritos, Nicholas A

    2016-06-01

    Inappropriate secretion of TSH was first described in 1960 in a patient with evidence of hyperthyroidism and expanded sella on imaging. It was later found that a type of pituitary adenoma that secretes TSH (thyrotropinoma) was the underlying cause. The objective of the present review article is to summarize data on the epidemiology, pathogenesis, diagnosis, and management of thyrotropinomas. The prevalence of thyrotropinomas is lower than that of other pituitary adenomas. Early diagnosis is now possible thanks to the availability of magnetic resonance imaging and sensitive laboratory assays. As a corollary, many patients now present earlier in the course of their disease and have smaller tumors at the time of diagnosis. Treatment also has evolved over time. Transsphenoidal surgery is still considered definitive therapy. Meanwhile, radiation therapy, including radiosurgery, is effective in achieving tumor control in the majority of patients. In the past, radiation therapy was used as second line treatment in patients with residual or recurrent tumor after surgery. However, the availability of somatostatin analogs, which can lead to normalization of thyroid function as well as shrink these tumors, has led to an increase in the role of medical therapy in patients who are not in remission after pituitary surgery. In addition, dopamine agonists have shown some efficacy in the management of these tumors. Better understanding of the molecular pathogenesis of thyrotropinomas may lead to rationally designed therapies for patients with thyrotropinomas. PMID:26792794

  17. Immunohistochemical phenotype and molecular pathological characteristics of metanephric adenoma.

    PubMed

    Sun, Zhulei; Kan, Shihai; Zhang, Leilei; Zhang, Yan; Jing, Hong; Huang, Gui; Yu, Qichun; Wu, Jiang

    2015-01-01

    To assess the clinicopathological, immunohistochemical and molecular features of metanephric adenoma (MA). Clinicopathologic data were obtained for 5 cases of MA with follow-up information. Specimens from these patients were stained by HE and immunohistochemistry for the detection of WT1, vimentin, S-100 protein, CK7, P504s, CD10 and renal cell carcinoma marker (RCC). Fluorescence in situ hybridization (FISH) was performed on 4 tumors. The patients included 1 male and 4 females, aged from 30 to 49 (mean=39) years. Tumor diameters ranged from 3 to 5.5 cm. Histologically, the tumors had tubular, papillary, or glomeruloid architectures, and were composed of cells with uniform and round nuclei, inconspicuous nucleoli, and high ratio of nucleus to cytoplasm. Nuclear polymorphism and mitotic figures were not observed. Immunohistochemically, they expressed WT1 (5/5), vimentin (5/5), S-100 (4/5), CK7 (2/5), P504s (2/5), and CD10 (1/5) and not RCC. FISH study was carried out on 4 metanephric adenoma cases, and no abnormalities were observed in chromosomes 3, 7, 17, and P16 gene of chromosomes 9. MA is an uncommon renal tumor. Its diagnosis depends on morphological, immunohistochemical and molecular features. PMID:26261480

  18. A double pituitary adenoma presenting as a prolactin-secreting tumor with partial response to medical therapy. Case report.

    PubMed

    Coiré, Claire I; Smyth, Harley S; Rosso, Dominic; Horvath, Eva; Kovacs, Kalman

    2010-06-01

    Double pituitary adenomas are difficult to recognize pre-operatively as only a single mass may be appreciated on imaging. We present herein a giant prolactin-secreting pituitary adenoma in a middle-aged man that had responded partially to dopamine agonist therapy. The excised specimen demonstrated a double adenoma. The prolactin-producing one displayed the expected morphological changes resulting from medical therapy, while the other, a gonadotroph adenoma, did not. The failure of tumor shrinkage can be attributed to the presence of a double adenoma, a previously unreported cause of failure of medical therapy in prolactinoma. PMID:20058099

  19. AMACR is associated with advanced pathologic risk factors in sporadic colorectal adenomas

    PubMed Central

    Lakis, Sotiris; Papamitsou, Theodora; Panagiotopoulou, Constantina; Kotakidou, Rodoula; Kotoula, Vassiliki

    2010-01-01

    AIM: To analyze α-methylacyl CoA racemase (AMACR) expression in relation to various dysplasia phenotypes and clinicopathological parameters of sporadic colorectal adenomas. METHODS: Fifty-five cases of sporadic colorectal adenomas were categorized according to the Vienna classification for Gastrointestinal Neoplasia. These corresponded to a total of 98 different intra-lesion microscopic fields that were further independently assigned a histological grade based on the old nomenclature (mild, moderate, severe dyplasia and carcinoma in situ). AMACR expression was evaluated by immunohistochemistry and statistical analysis was performed to investigate possible associations with various clinicopathologic parameters of adenomas i.e. gender, age, localization, grade of dysplasia, size and configuration. RESULTS: Patient age ranged from 41 to 84 years (mean 65 ± 13.2 years); 37 patients were males and 18 were females. Adenomas ranged in size between 0.5 and 30 cm (mean 2 ± 1.3 cm), including 18 tubular, 16 villous, 20 mixed or tubulovillous, and 1 giant sessile villous adenoma. AMACR expression was observed in 3 out of 16 (18.8%) of low-grade vs 23 out of 35 (62.8%) of high-grade lesions (P = 0.002). Most adenomas exhibiting high grade dysplasia with in situ carcinoma-like areas stained positive for AMACR (15/17 or 88.2%) as compared to adenomas with high grade dysplasia which contained severe dysplasia-like foci (6/15 or 40%), (P = 0.005). In AMACR positive adenomas featuring severe dysplasia-like or in situ carcinoma-like areas, AMACR staining was not necessarily observed in the in situ component. Positivity in intra-lesion of mild, moderate or severe dysplasia-like foci was more often encountered in adenomas harboring in situ, intramucosal or infiltrative carcinoma [21/33 (63.6%) vs 9/40 (22.5%), P < 0.001]. Strong AMACR expression was found in 11 out of 17 villous adenomas, but in only 1 out of 18 tubular lesions (P = 0.005). Larger lesions, i.e. > 1 cm stained more

  20. Subsequent Adenomas of Ileal Pouch and Anorectal Segment after Prophylactic Surgery for Familial Adenomatous Polyposis

    PubMed Central

    M'Koma, A.E.; Herline, A.J.; Adunyah, S.E.

    2014-01-01

    Familial adenomatous polyposis (FAP) is an autosomally dominant disease characterized by the early development of colorectal adenomas and carcinoma in untreated patients. Patients with FAP may develop rectal cancer at their initial presentation (primary) or after prophylactic surgery (secondary). Controversies exist regarding which surgical procedure represents the best first-line treatment. The options for FAP are ileorectal anastomosis (IRA) or a restorative proctocolectomy (RPC) with either a handsewn or a stapled ileal pouch-anal anastomosis (IPAA), with or without mucosectomy. The purpose of these surgeries is to stop progression to an adenoma-cancer sequence by eradicating the colon, a disease prone organ. Unfortunately, these surgical procedures, which excise the entire colon and rectum while maintaining transanal fecal continence, do not guarantee that patients still won't develop adenomas. Based on the available literature, we therefore reviewed reported incidences of pouch-related adenomas that occurred post prophylactic surgery for FAP. The review consists of a collection of case, descriptive, prospective and retrospective reports. Objectives To provide available data on the natural history of subsequent adenomas after prophylactic surgery (by type) for FAP. Methods A review was conducted of existing case, descriptive, prospective and retrospective reports for patients undergoing prophylactic surgery for FAP (1975 – August, 2013). In each case, the adenomas were clearly diagnosed in one of the following: the ileal pouch mucosa (above the ileorectal anastomosis), within the anorectal segment (ARS) below the ileorectal anastomosis, or in the afferent ileal loop. Results A total of 515 (36%) patients with pouch-related adenomas have been reported. Two hundred and eleven (211) patients had adenomas in the ileal pouch mucosa, 295 had them in the ARS and in 9 were in the afferent ileal loop. Patients with pouch adenomas without dysplasia or cancer were

  1. Pronephric duct extension in amphibian embryos: migration and other mechanisms.

    PubMed

    Drawbridge, Julie; Meighan, Christopher M; Lumpkins, Rebecca; Kite, Mary E

    2003-01-01

    Initiation of excretory system development in all vertebrates requires (1) delamination of the pronephric and pronephric duct rudiments from intermediate mesoderm at the ventral border of anterior somites, and (2) extension of the pronephric duct to the cloaca. Pronephric duct extension is the central event in nephric system development; the pronephric duct differentiates into the tubule that carries nephric filtrate out of the body and induces terminal differentiation of adult kidneys. Early studies concluded that pronephric ducts formed by means of in situ segregation of pronephric duct tissue from lateral mesoderm ventral to the forming somites; more recent studies highlight caudal migration of the pronephric duct as the major morphogenetic mechanism. The purpose of this review is to provide the historical background on studies of the mechanisms of amphibian pronephric duct extension, to review evidence showing that different amphibians perform pronephric duct morphogenesis in different ways, and to suggest future studies that may help illuminate the molecular basis of the mechanisms that have evolved in amphibians to extend the pronephric duct to the cloaca. PMID:12508219

  2. Accessory Pancreatic Duct Patterns and Their Clinical Implications

    PubMed Central

    Prasanna, Lokadolalu Chandracharya; Rajagopal, KV; Thomas, Huban R

    2015-01-01

    Context and Objective: Accessory pancreatic duct (APD) designed to reduce the pressure of major pancreatic duct by forming a secondary drainage channel. Few studies have mentioned the variant types of accessory ducts and their mode of formation, some of these have a clear clinical significance. Present study is aimed to evaluate the possible variations in the APD and its terminations. Materials and Methods: Forty formalin fixed adult human pancreas with duodenum in situ specimens were studied by injecting 1% aqueous eosin, followed by piece meal dissection of the head of the pancreas from posterior surface. Formation, tributaries, relations, and the termination of the accessory pancreatic duct were noted and photographed. Results: Accessory ducts revealed 50% belonged to long type, 22.5% were of short and ansa pancreatica type each, and embryonic type of duct pattern was seen in 5% specimens. 75% of long type ducts showed positive patency with eosin dye, followed by ansa type (44.4%), and least patency was found in short type (22.2%). With regard to the patency of the accessory pancreatic ducts towards their termination, we found 52.5% of the accessory ducts and 5% of the embryonic type pancreatic ducts were patent and in 42.5% of the specimen the ducts were obliterated. In 85% of specimens the minor duodenal papillae was anterosuperior to the major papilla and superior to the major papillae in 10% of the cases, and in 5% minor papillae was absent. The average distance between the two papillae was 2.35 cm. Conclusion: The knowledge of the complex anatomical relations of the gland with its duct, duodenum and bile ducts are essential for the surgeons and sinologists to plan and perform both the diagnostic as well as therapeutic procedures effectively. PMID:25954609

  3. Optimizing Electrospray Interfaces Using Slowly Diverging Conical Duct (ConDuct) Electrodes

    PubMed Central

    Krutchinsky, Andrew N.; Padovan, Júlio C.; Cohen, Herbert; Chait, Brian T.

    2015-01-01

    We demonstrate that the efficiency of ion transmission from atmosphere to vacuum through stainless steel electrodes that contain slowly divergent conical duct (ConDuct) channels can be close to 100%. Here, we explore the properties of 2.5 cm long electrodes with angles of divergence of 0°, 1°, 2°, 3°, 5°, 8°, 13°, and 21°, respectively. The ion transmission efficiency was observed to jump from 10–20% for the 0° (straight) channels to 90–95% for channels with an angle of divergence as small as 1°. Furthermore, the 2–3° ConDuct electrodes produced extraordinarily low divergence ion beams that propagated in a laser-like fashion over long distances in vacuum. To take advantage of these newly discovered properties, we constructed a novel atmosphere-to-vacuum ion interface utilizing a 2° ConDuct as an inlet electrode and compared its ion transmission efficiency with that of the interface used in the commercial (Thermo) Velos Orbitrap and Q Exactive mass spectrometers. We observed that the ConDuct interface transmitted up to 17 times more ions than the commercial reference interface and also yielded improved signal-to-noise mass spectra of peptides. We infer from these results that the performance of many current atmosphere-tovacuum interfaces utilizing metal capillaries can be substantially improved by replacing them with 1° or 2° metal ConDuct electrodes, which should preserve the convenience of supplying ion desolvation energy by heating the electrode while greatly increasing the efficiency of ion transmission into the mass spectrometer. PMID:25667060

  4. Different imaging characteristics of concurrent pituitary adenomas in a patient with Cushing's disease.

    PubMed

    Mehta, Gautam U; Montgomery, Blake K; Raghavan, Pooja; Sharma, Susmeeta; Nieman, Lynnette K; Patronas, Nicholas; Oldfield, Edward H; Chittiboina, Prashant

    2015-05-01

    We report a patient with Cushing's disease (CD) and two pituitary adenomas that demonstrated different imaging characteristics and therefore suggest an alternative imaging strategy for these patients. A 42-year-old woman presented with signs and symptoms of CD. Biochemical evaluation confirmed hypercortisolemia and suggested CD. On pituitary MRI with spoiled gradient recalled acquisition in the steady-state and T1-weighted spin echo protocols, a 5mm hypoenhancing region typical for a pituitary adenoma was identified on the left. However, after surgical resection the patient remained hypercortisolemic and pathology revealed a non-functional adenoma. At early repeat surgical exploration a 10mm adenoma was found in the right side of the gland. Postoperatively the patient became hypocortisolemic and pathology demonstrated an adrenocorticotropic hormone (ACTH)-staining adenoma. On review of the initial MRI this tumor corresponded to a region of contrast retention best visualized on delayed fluid attenuated inversion recovery (FLAIR) imaging. While the incidentaloma in this case demonstrated classical imaging characteristics of a pituitary adenoma the larger ACTH-secreting tumor was best appreciated by contrast retention. This suggests a role for delayed postcontrast FLAIR imaging in the preoperative evaluation of CD. ACTH-secreting tumors causing CD cause significant morbidity. Due to their small size, a pituitary adenoma is frequently not identified on imaging despite endocrinologic testing suggesting CD. Regardless of improvements in MRI, many tumors are only identified at surgical exploration. PMID:25827866

  5. Clonal origins and parallel evolution of regionally synchronous colorectal adenoma and carcinoma

    PubMed Central

    Rhee, Je-Keun; Jung, Seung-Hyun; Lee, Sung Hak; Baek, In-Pyo; Kim, Min Sung; Lee, Sug Hyung; Chung, Yeun-Jun

    2015-01-01

    Although the colorectal adenoma-to-carcinoma sequence represents a classical cancer progression model, the evolution of the mutational landscape underlying this model is not fully understood. In this study, we analyzed eight synchronous pairs of colorectal high-grade adenomas and carcinomas, four microsatellite-unstable (MSU) and four -stable (MSS) pairs, using whole-exome sequencing. In the MSU adenoma-carcinoma pairs, we observed no subclonal mutations in adenomas that became fixed in paired carcinomas, suggesting a ‘parallel’ evolution of synchronous adenoma-to-carcinoma, rather than a ‘stepwise’ evolution. The abundance of indel (in MSU and MSS pairs) and microsatellite instability (in MSU pairs) was noted in the later adenoma- or carcinoma-specific mutations, indicating that the mutational processes and functional constraints operative in early and late colorectal carcinogenesis are different. All MSU cases exhibited clonal, truncating mutations in ACVR2A, TGFBR2, and DNA mismatch repair genes, but none were present in APC or KRAS. In three MSS pairs, both APC and KRAS mutations were identified as both early and clonal events, often accompanying clonal copy number changes. An MSS case uniquely exhibited clonal ERBB2 amplification, followed by APC and TP53 mutations as carcinoma-specific events. Along with the previously unrecognized clonal origins of synchronous colorectal adenoma-carcinoma pairs, our study revealed that the preferred sequence of mutational events during colorectal carcinogenesis can be context-dependent. PMID:26336987

  6. Histogenesis of human colorectal adenomas and hyperplastic polyps: the role of cell proliferation and crypt fission

    PubMed Central

    Wong, W-M; Mandir, N; Goodlad, R A; Wong, B C Y; Garcia, S B; Lam, S-K; Wright, N A

    2002-01-01

    Background: The histogenesis of human colorectal hyperplastic polyps and colorectal adenomas is poorly understood even now. Method: Human colorectal adenomas, hyperplastic polyps, and normal colorectal mucosae (patients with familial adenomatous polyposis and hereditary non-polyposis colorectal carcinoma were excluded) were obtained during colonoscopy and microdissected into individual crypts. Morphology, cell proliferation characteristics, and fission indices of crypts isolated from these lesions were then studied. Results: Crypts isolated from colorectal adenomas and colorectal hyperplastic polyps were significantly larger (p<0.001) than crypts from normal colorectal mucosae. Crypt fission was an uncommon event in normal colonic mucosae but common in crypts isolated from adenomas and hyperplastic polyps (p<0.001). Analysis of the distribution of mitoses suggested an upward expansion of the proliferation compartment in adenomas to the surface of the crypt with no reversal of proliferating cell distribution, as has previously been described. Conclusions: Sporadic human colorectal adenomas and hyperplastic polyps grow by the process of crypt fission. Expansion of the proliferative compartment was demonstrated in crypts from adenomas, consistent with deregulation of cell cycle control. PMID:11788562

  7. Risk Factors of Advanced Adenoma in Small and Diminutive Colorectal Polyp.

    PubMed

    Jeong, Yo Han; Kim, Kyeong Ok; Park, Chan Seo; Kim, Sung Bum; Lee, Si Hyung; Jang, Byung Ik

    2016-09-01

    The aims of this study were to review the clinicopathological characteristics of diminutive (≤ 5 mm) and small polyps (> 5 mm but < 10 mm) and to evaluate the risk factors of advanced adenoma for polyps of diameter < 10 mm in the colon. The medical records of 4,711 patients who underwent first colonoscopy at outpatient clinics or health promotion center were reviewed retrospectively. We analyzed the presence and risk factors of advanced adenoma, which was defined as a villous or tubulovillous polyp, high-grade dysplasia or intramucosal carcinoma histologically. Total 5,058 polyps were detected in the 4,711 patients, and 93.0% (4,704/5,058) polyps were < 10 mm in size. Among them, advanced adenoma was noted in 0.6% (28/4,704) with a villous component in 19, high-grade dysplasia in 3, and adenocarcinoma in 6. Advanced and non-advanced adenomas differed significantly in age group, gender, and polyp size. Multivariate analysis showed that an advanced age (> 65 years), a male gender, and a polyp size of > 5 mm were risk factors of advanced adenoma. The incidence of advanced adenoma in polyps of < 10 mm was 0.6%. Polyp size, male gender, and age of > 65 years are independent risk factors of advanced adenoma. PMID:27510386

  8. Undescended parathyroid adenoma: an important etiology for failed operations for primary hyperparathyroidism.

    PubMed

    Fraker, D L; Doppman, J L; Shawker, T H; Marx, S J; Spiegel, A M; Norton, J A

    1990-01-01

    From July, 1982 to April, 1989, a total of 145 patients with persistent or recurrent primary hyperparathyroidism (HPT) were explored; 105 patients had an adenoma as the cause of HPT, and in 9 patients (9%), the abnormal gland was located at or superior to the carotid bifurcation (undescended parathyroid gland). These 9 patients had 14 prior explorations for HPT including 4 median sternotomies and 5 thyroidectomies. Each of the 9 patients was symptomatic of HPT, including bone disease in 8 of 9 patients and renal stones in 4 of 9 patients. Seven patients had an undescended parathyroid adenoma correctly localized preoperatively by ultrasound (n = 5), angiography (n = 5), venous sampling (n = 1), or computed tomography scan (n = 4). These 7 patients with accurate preoperative localization were explored by an incision anterior to the sternocleidomastoid muscle high in the neck that avoided the previous operative field and allowed rapid resection of the parathyroid adenoma. In the 2 patients who did not have accurate preoperative localization, the undescended adenoma was found after long tedious exploration including median sternotomy in 1 patient. Each patient (n = 9) who had an undescended parathyroid adenoma removed was cured of hypercalcemia, and 5 patients required postoperative 1,25-dihydroxy vitamin D3 for hypocalcemia. We conclude that undescended parathyroid adenomas comprise a significant proportion (9%) of adenomas during reoperations for persistent HPT.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2368436

  9. Promoter CpG methylation of multiple genes in pituitary adenomas: frequent involvement of caspase-8.

    PubMed

    Bello, M Josefa; De Campos, Jose M; Isla, Alberto; Casartelli, Cacilda; Rey, Juan A

    2006-02-01

    The epigenetic changes in pituitary adenomas were identified by evaluating the methylation status of nine genes (RB1, p14(ARF), p16(INK4a), p73, TIMP-3, MGMT, DAPK, THBS1 and caspase-8) in a series of 35 tumours using methylation-specific PCR analysis plus sequencing. The series included non-functional adenomas (n=23), prolactinomas (n=6), prolactinoma plus thyroid-stimulating hormone adenoma (n=1), growth hormone adenomas (n=4), and adrenocorticotropic adenoma (n=1). All of the tumours had methylation of at least one of these genes and 40% of samples (14 of 35) displayed concurrent methylation of at least three genes. The frequencies of aberrant methylation were: 20% for RB1, 17% for p14(ARF), 34% for p16(INK4a), 29% for p73, 11% for TIMP-3, 23% for MGMT, 6% for DAPK, 43% for THBS1 and 54% for caspase-8. No aberrant methylation was observed in two non-malignant pituitary samples from healthy controls. Although some differences in the frequency of gene methylation between functional and non-functional adenomas were detected, these differences did not reach statistical significance. Our results suggest that promoter methylation is a frequent event in pituitary adenoma tumourigenesis, a process in which inactivation of apoptosis-related genes (DAPK, caspase-8) might play a key role. PMID:16391867

  10. A Case of Cushing's Syndrome with Multiple Adrenocortical Adenomas Composed of Compact Cells and Clear Cells.

    PubMed

    Asakawa, Masahiro; Yoshimoto, Takanobu; Ota, Mitsutane; Numasawa, Mitsuyuki; Sasahara, Yuriko; Takeuchi, Takato; Nakano, Yujiro; Oohara, Norihiko; Murakami, Masanori; Bouchi, Ryotaro; Minami, Isao; Tsuchiya, Kyoichiro; Hashimoto, Koshi; Izumiyama, Hajime; Kawamura, Naoko; Kihara, Kazunori; Negi, Mariko; Akashi, Takumi; Eishi, Yoshinobu; Sasano, Hironobu; Ogawa, Yoshihiro

    2016-06-01

    A 58-year-old woman was referred to our hospital for Cushingoid features and diagnosed as adrenal Cushing's syndrome due to a right adrenocortical mass (60 × 55 mm). The mass was composed of three different tumors; the first one was homogeneously lipid-poor neoplasm measuring 20 × 13 mm located at the most dorsal region, the second one was heterogeneous and lipid-rich tumor containing multiple foci of calcification measuring 50 × 32 mm located at the central region, and the last one was heterogeneous harboring dilated and tortuous vessels and lipid-poor one measuring 35 × 18 mm at the most ventral region of the adrenal gland. A right adrenalectomy was subsequently performed by open surgery. Macroscopic and microscopic analyses revealed that all three tumors were adrenocortical adenomas; the first one represents a pigmented adrenocortical adenoma, the second one adrenocortical adenoma associated with degeneration, and the third one adrenocortical adenoma harboring extensive degeneration. Immunohistochemical analysis of the steroidogenic enzymes also revealed that all of the tumors had the capacity of synthesizing cortisol. This is a very rare case of Cushing's syndrome caused by multiple adrenocortical adenomas including a pigmented adenoma. Immunohistochemical analysis of steroidogenic enzymes contributed to understanding of steroidogenesis in each of these three different adrenocortical adenomas in this case. PMID:26961704

  11. Clonal origins and parallel evolution of regionally synchronous colorectal adenoma and carcinoma.

    PubMed

    Kim, Tae-Min; An, Chang Hyeok; Rhee, Je-Keun; Jung, Seung-Hyun; Lee, Sung Hak; Baek, In-Pyo; Kim, Min Sung; Lee, Sug Hyung; Chung, Yeun-Jun

    2015-09-29

    Although the colorectal adenoma-to-carcinoma sequence represents a classical cancer progression model, the evolution of the mutational landscape underlying this model is not fully understood. In this study, we analyzed eight synchronous pairs of colorectal high-grade adenomas and carcinomas, four microsatellite-unstable (MSU) and four-stable (MSS) pairs, using whole-exome sequencing. In the MSU adenoma-carcinoma pairs, we observed no subclonal mutations in adenomas that became fixed in paired carcinomas, suggesting a 'parallel' evolution of synchronous adenoma-to-carcinoma, rather than a 'stepwise' evolution. The abundance of indel (in MSU and MSS pairs) and microsatellite instability (in MSU pairs) was noted in the later adenoma- or carcinoma-specific mutations, indicating that the mutational processes and functional constraints operative in early and late colorectal carcinogenesis are different. All MSU cases exhibited clonal, truncating mutations in ACVR2A, TGFBR2, and DNA mismatch repair genes, but none were present in APC or KRAS. In three MSS pairs, both APC and KRAS mutations were identified as both early and clonal events, often accompanying clonal copy number changes. An MSS case uniquely exhibited clonal ERBB2 amplification, followed by APC and TP53 mutations as carcinoma-specific events. Along with the previously unrecognized clonal origins of synchronous colorectal adenoma-carcinoma pairs, our study revealed that the preferred sequence of mutational events during colorectal carcinogenesis can be context-dependent. PMID:26336987

  12. Adenoma development in familial adenomatous polyposis and MUTYH-associated polyposis: somatic landscape and driver genes.

    PubMed

    Rashid, Mamunur; Fischer, Andrej; Wilson, Cathy H; Tiffen, Jessamy; Rust, Alistair G; Stevens, Philip; Idziaszczyk, Shelley; Maynard, Julie; Williams, Geraint T; Mustonen, Ville; Sampson, Julian R; Adams, David J

    2016-01-01

    Familial adenomatous polyposis (FAP) and MUTYH-associated polyposis (MAP) are inherited disorders associated with multiple colorectal adenomas that lead to a very high risk of colorectal cancer. The somatic mutations that drive adenoma development in these conditions have not been investigated comprehensively. In this study we performed analysis of paired colorectal adenoma and normal tissue DNA from individuals with FAP or MAP, sequencing 14 adenoma whole exomes (eight MAP, six FAP), 55 adenoma targeted exomes (33 MAP, 22 FAP) and germline DNA from each patient, and a further 63 adenomas by capillary sequencing (41 FAP, 22 MAP). With these data we examined the profile of mutated genes, the mutational signatures and the somatic mutation rates, observing significant diversity in the constellations of mutated driver genes in different adenomas, and loss-of-function mutations in WTX (9%; p < 9.99e-06), a gene implicated in regulation of the WNT pathway and p53 acetylation. These data extend our understanding of the early events in colorectal tumourigenesis in the polyposis syndromes. PMID:26414517

  13. Early signet ring cell carcinoma arising from colonic adenoma: the molecular profiling supports the adenoma-carcinoma sequence.

    PubMed

    Bellan, Alberto; Cappellesso, Rocco; Lo Mele, Marcello; Peraro, Laura; Balsamo, Laura; Lanza, Cristiano; Fassan, Matteo; Rugge, Massimo

    2016-04-01

    Among colorectal cancers, the prevalence of signet ring cell carcinoma (SRCC) is lower than 1%; to date, only 6 cases of early SRCCs arising in colonic adenoma have been reported. In spite of the well-established understanding of the phenotypic and genetic changes occurring in conventional colonic carcinogenesis, the molecular landscape of colon SRCC is still far to be elucidated. We describe the histologic and immunohistochemical phenotype and the molecular profile of a case of intramucosal SRCC developed within a 4.5-cm large sigmoid adenoma. The DNA sequencing of the 2 microdissected neoplastic components (adenomatous and SRCC) showed the same G12V KRAS mutation. Interestingly, although the adenomatous epithelium showed unequivocal p53 overexpression, no signet ring cancer cells featured p53 nuclear immunostain. This molecular pattern supports the unique histogenesis of the 2 coexisting neoplastic oncotypes, also suggesting that the signet ring cell component is derived from the molecular de-differentiation (p53 loss) of the preexisting adenomatous lesion. PMID:26997454

  14. Experimental validation of a ducted propeller analysis method

    NASA Astrophysics Data System (ADS)

    Hughes, M. J.; Kinnas, S. A.; Kerwin, J. E.

    1992-06-01

    A ducted propeller model was tested in the MIT water tunnel. A hub apparatus was designed which allowed for the duct and propeller forces to be measured separately. The forces on the duct and propeller were measured over a range of advance coefficients. Velocities were measured upstream and downstream from the duct using a Laser Doppler Velocimetry system. Using these velocities the exprimental values for the spanwise distribution of circulation on the propeller blades were then calculated. The experimental results were compared to the results from a propeller lifting surface/duct and hub surface panel analysis code over the same range of advance coefficients showing very good agreement for the duct and propeller forces and the circulation in the region of attached flow.

  15. Hepatic adenomas with synchronous or metachronous fibrolamellar carcinomas: both are characterized by LFABP loss.

    PubMed

    Graham, Rondell P; Terracciano, Luigi M; Meves, Alexander; Vanderboom, Patrick M; Dasari, Surendra; Yeh, Matthew M; Torbenson, Michael S; Cruise, Michael W

    2016-06-01

    Rare hepatic adenomas are associated with synchronous or metachronous fibrolamellar carcinomas. The morphology of these adenomas has not been well described and they have not been subclassifed using the current molecular classification schema. We examined four hepatic adenomas co-occurring with or preceding a diagnosis of fibrolamellar carcinoma in three patients. On histological examination, three of the adenomas showed the typical morphology of HNF1-α inactivated adenomas, whereas one showed a myxoid adenoma morphology. All of the adenomas were negative for PRKACA rearrangements by Fluorescence in situ Hybridization (FISH) analysis. All four of the adenomas showed complete loss or significant reduction of liver fatty acid binding protein (LFABP) expression by immunohistochemistry. Interestingly, the fibrolamellar carcinomas in each case also showed loss of LFABP by immunohistochemistry. One of the fibrolamellar carcinomas was negative for PRKACA rearrangements by FISH, whereas the others were positive. To investigate if LFBAP loss is typical of fibrolamellar carcinomas in general, an additional cohort of tumors was studied (n=19). All 19 fibrolamellar carcinomas showed the expected PRKACA rearrangements and immunostains showed loss of LFABP in each case, consistent with HNF1-α inactivation. To validate this observation, mass spectrometry-based proteomics was performed on tumor-normal pairs of six fibrolamellar carcinomas and showed an average 10-fold reduction in LFABP protein levels, compared with matched normal liver tissue. In conclusion, hepatic adenomas co-occurring with fibrolamellar carcinomas show LFABP loss and are negative for PRKACA rearrangements, indicating they are genetically distinct lesions. These data also demonstrate that LFABP loss, which characterizes HNF1-α inactivation, is a consistent feature of fibrolamellar carcinoma, indicating HNF1-α inactivation is an important event in fibrolamellar carcinoma pathogenesis. PMID:27015136

  16. Optimization of the mechanical performance of a two-duct semicircular duct system--part 3: the positioning of the ducts in the head.

    PubMed

    Muller, M; Verhagen, J H G

    2002-06-21

    In the majority of vertebrates, the horizontal duct of the vestibular system lies approximately in the yawing plane of the head. The positioning of the vertical ducts, however, is not in the pitch- and roll planes but the vertical ducts generally lie under an angle of about 30-45 degrees relative to the medial plane. Using the equations for a hydrodynamically interconnected two-duct system, optimal positions of the vertical and horizontal ducts in different vertebrate groups can be derived. It was stated that the mean response of the vertical ducts should be optimized. This leads to a symmetrical positioning of the vertical ducts with respect to the medial plane. In all observed vertebrate groups, a solution of mu =(pi-alpha)/2 is found (mu is the angle of the vertical ducts relative to the medial plane, alpha is the angle between the vertical duct planes). For alpha=90 degrees, this provides an equal sensitivity for pitch- and roll- movements. For alpha>90 degrees, a larger sensitivity for pitch movements is obtained, at the expense of a lower sensitivity for roll movements. It is argued that the angle alpha between the vertical ducts may vary from 90 to 120 degrees. In most vertebrates, the centre of mass is stabilized by e.g. fins, tri- or quadrupedal stability, a crawling body or upside-down resting positions (e.g. bats). Birds are generally biped, so in walking they are also rather sensitive to roll. These features are related to labyrinth positioning in the head. PMID:12151260

  17. Flexible sigmoidoscopy or colonoscopy as a screening modality for colorectal adenomas in older age groups? Findings in a cohort of the normal population aged 63-72 years

    PubMed Central

    Thiis-Evensen, E; Hoff, G; Sauar, J; Majak, B; Vatn, M

    1999-01-01

    BACKGROUND—Most cases of colorectal cancer originate from adenomas. Removing adenomas has been shown to reduce the incidence of colorectal cancer. The design of cost effective endoscopic screening programmes requires a knowledge of the distribution of adenomas in different age groups.
AIM—To investigate the distribution of colorectal adenomas in older age groups in the normal population.
METHOD—A total of 356 men and women selected randomly from the population register were offered a colonoscopic screening examination to detect and remove polyps.
RESULTS—In all, 241(68%) subjects, mean age 67.4 years (range 62-73), attended. The caecum was intubated in 193 (80%), and in this group 32 (38%) women and 51 (47%) men had adenomas. One hundred and ten (54%) of the adenomas and 11 (39%) of the "high risk adenomas" (adenomas larger than 10 mm in diameter, adenomas containing villous components, and adenomas with severe dysplasia) were found proximal to the sigmoid colon. In 36 (43%) of the subjects with adenomas, the adenomas were only found proximal to the sigmoid colon. Twenty two (11%) subjects had more than two adenomas. Of 203 adenomas discovered, 189 (93%) were less than 10 mm in diameter.
CONCLUSION—More than half of the adenomas were localised proximal to the sigmoid colon, and, in nearly half of the adenoma bearing subjects examined, the adenoma was proximal to the descending colon. This indicates that a sigmoidoscopic screening examination in this age group would miss a substantial number of adenomas, but this may be acceptable as the vast majority of proximal adenomas do not progress to clinical cancer within the life expectancy of this age group.


Keywords: adenoma; colon; colorectal neoplasms; endoscopy; epidemiology; polyps PMID:10562581

  18. Resistant arterial hypertension: association with syncronous kidney cancer and adrenal adenoma.

    PubMed

    Pittavini, Loretta; De Gaetano, Andrea; Solano, Giuseppe; Losito, Attilio

    2010-01-01

    The coexistence of renal cancer and adrenal adenoma is rare. We report the case of a 60-year-old patient with synchronous hypernephroma and adrenal adenoma. The patient presented with resistant hypertension, high plasma renin activity and aldosterone and target organ damage. Removal of the affected kidney cured the hypertension and normalized the plasma renin activity (PRA) and circulating aldosterone. This suggests that the coexistence of kidney cancer and adrenal adenoma may be a curable cause of resistant hypertension. The potential mechanisms accounting for the lack of suppression of PRA are discussed. PMID:20383873

  19. Adenoma malignum of uterine cervix in Peutz-Jeghers syndrome: CT and US features.

    PubMed

    Choi, C G; Kim, S H; Kim, J S; Chi, J G; Song, E S; Han, M C

    1993-01-01

    We report CT and ultrasound (US) features of adenoma malignum of the uterine cervix in a patient with Peutz-Jeghers syndrome (PJS) in whom bilateral ovarian mucinous cystadenomas and sex cord tumors with annular tubules were associated. Adenoma malignum was shown as a hyperechoic mass mixed with multiple cysts on US and a low attenuated endocervical mass on CT. We think that imaging demonstration of an endocervical mass is important for the correct diagnosis of adenoma malignum in a female with PJS. PMID:8370843

  20. Localization of Parathyroid Adenoma With Real-Time Ultrasound: Freehand SPECT Fusion.

    PubMed

    Bluemel, Christina; Kirchner, Paul; Kajdi, Georg W; Werner, Rudolf A; Herrmann, Ken

    2016-03-01

    Preoperative localization of parathyroid adenoma in primary hyperparathyroidism gains in importance as there is a trend toward minimally invasive parathyroid surgery. Besides MRI, 4-dimensional CT, PET/CT, invasive-selective venous sampling, or angiography, both ultrasound and scintigraphy are standard of care for lesion localization. Here we report on a 53-year-old woman with suspicion of primary hyperparathyroidism using real-time fusion of scintigraphic (freehand SPECT) and ultrasound imaging for adenoma localization. Real-time fusion of ultrasound and freehand SPECT allowed noninvasive dedicated metabolic and anatomic adenoma localization and treatment planning. PMID:26284776

  1. Pleomorphic adenoma of the cheek in a child: A case report

    PubMed Central

    Jagadishkumar, Kalenahalli; Anilkumar, Mathod Ganeshrao; Krishna Kumar, Halasahalli Chowdegowda; Maggad, Rangaswamy

    2014-01-01

    Salivary gland tumors are rare in children and, when they do arise, they mainly affect the major salivary glands. Minor salivary gland tumors are rare in children and are responsible for less than 10% of the cases. Pleomorphic adenoma is the most common tumor of the salivary glands. The most common sites of pleomorphic adenoma of the minor salivary glands are the palates, followed by the lips and the cheeks. Pleomorphic adenoma of the cheek is rare in children and only few cases have been reported so far. PMID:25225569

  2. Pleomorphic Adenoma in Retromolar Area: A Very Rare Case Report and Review of Literature

    PubMed Central

    Khan, Tahseen Ali; Dhurjati, Venkata Naga Nalini; Gaddikeri, Kavitha; Khany, MD Zainuddin E.

    2016-01-01

    Among all neoplasms affecting head and neck region, salivary gland neoplasms are rare. Pleomorphic adenomas are the most common benign salivary gland tumours making up to 50% of major and minor salivary gland tumours. Intraorally pleomorphic adenoma is mostly found on palate and lips and very rarely in retromolar area. Here we are reporting a rare case of pleomorphic adenoma in right lower retromolar area in a 31-year-old female, the lesion was excised in toto with safety margins under local anaesthesia and postoperative follow up after six months didn’t showed any recurrence. PMID:26894184

  3. Vulvar lactating adenoma associated to a fibroadenoma: common neoplasms in an uncommon site

    PubMed Central

    Dhaoui, Amen; Nfoussi, Haifa; Kchir, Nidhameddine; Haouet, Slim

    2012-01-01

    Ectopic breast tissue is defined as glands located outside of the breast. Ectopic breast tissue should be excised because it may develop benign (fibroadenoma) or malignant pathologic processes. Less than forty cases of fibroadenomas have been reported in the literature. Although lactation changes can occur, lactating adenoma in the vulva are extremely rare. Only four cases have been reported. We report a case of a young woman who presented with vulvar mass during her lactation. The mass was excised, and histology confirmed vulvar lactating adenoma associated with fibroadenoma. This is the first case of vulvar heterotopic breast lesion associating lactating adenoma and fibroadenoma. PMID:23330038

  4. Medical therapies in pituitary adenomas: Current rationale for the use and future perspectives.

    PubMed

    Cuny, Thomas; Barlier, Anne; Feelders, Richard; Weryha, Georges; Hofland, Leo J; Ferone, Diego; Gatto, Federico

    2015-02-01

    Pituitary adenomas (PA) represent in the majority of cases, benign tumors whose treatment currently associate surgery, medical therapies and radiotherapy in a multidisciplinary approach. While trans-sphenoidal surgery remains, except for prolactin-secreting adenomas, the first-line treatment of PA, it can considerably be hampered by the existence of an invasive and/or aggressive tumor for which medical therapies are often requested. In this review, we extensively discuss, both at molecular and clinical levels, the medical therapies currently used and in development in the different phenotypes of pituitary adenomas. PMID:25556152

  5. An intelligent system for automatic detection of gastrointestinal adenomas in video endoscopy.

    PubMed

    Iakovidis, Dimitris K; Maroulis, Dimitris E; Karkanis, Stavros A

    2006-10-01

    Today 95% of all gastrointestinal carcinomas are believed to arise from adenomas. The early detection of adenomas could prevent their evolution to cancer. A novel system for the support of the detection of adenomas in gastrointestinal video endoscopy is presented. Unlike other systems, it accepts standard low-resolution video input thus requiring less computational resources and facilitating both portability and the potential to be used in telemedicine applications. It combines intelligent processing techniques of SVMs and color-texture analysis methodologies into a sound pattern recognition framework. Concerning the system's accuracy this was measured using ROC analysis and found to exceed 94%. PMID:16293240

  6. Patent vitellointestinal duct as paraumblical abcess: A rare presentation

    PubMed Central

    Rekhi, Harnam Singh; Mittal, Sushil; Singh, Gurtej; Rekhi, Balwinder Kaur; Dugg, Pankaj

    2015-01-01

    Introduction Umbilical and paraumblical abscess can occur in children with presenting complaint of discharge from umbilical region. However, patent vitello intestinal duct presenting as paraumblical abscess is rare phenomenon. Presentation of case One year old male child presented with complain of discharge from umbilical region since birth. Incision & drainage done twice thinking it to be paraumblical abscess. Discussion Vitellointestinal duct as abscess is rare presentation but it should be considered as a differential diagnosis of discharging umbilicus as management of abscess and patent duct are different. Conclusion Patent vitellointestinal duct can present as paraumbilical abscess, and it should be kept in differential diagnosis specifically in children. PMID:26301682

  7. BTS Fact Sheet: Improving the efficiency of your duct system

    SciTech Connect

    BNL

    1999-12-28

    The duct system, used in air heating and air cooling your home, is a collection of tubes that distributes the heated or cooled air to the various rooms. The duct system can have an important effect on health of the occupants through the distribution of indoor air pollution. Changes and repairs to a duct system should always be performed by a qualified professional. This brochure is meant to help you understand the problems that can affect the duct system and how you can save money, improve comfort, and protect against potential health hazards.

  8. Duct injection technology prototype development: Evaluation of engineering data

    SciTech Connect

    Not Available

    1990-07-01

    The objective of the Duct Injection Technology Prototype Development Project is to develop a sound design basis for applying duct injection technology as a post-combustion SO{sub 2}emissions control method to existing coal-fired power plants. The necessary engineering design and scale-up criteria will be developed for the commercialization of duct injection technology for the control of SO{sub 2} emissions from coal-fired boilers in the utility industry. The primary focus of the analyses summarized in this Topical Report is the review of the known technical and economic information associated with duct injection technology. (VC)

  9. Duct Remediation Program: Engineered access research and construction

    SciTech Connect

    Beckman, T.D.; Davis, M.M.; Karas, T.M.

    1992-11-01

    The Rocky Flats Plant, Duct Remediation mission concentrated on removing Plutonium Oxide from the process ductwork in the primary Plutonium processing facility. When possible, remediation took place from existing process gloveboxes. Fifteen locations were identified, however, that required accessing duct runs where no process gloveboxes existed. The building`s second floor utility areas had many locations where long, inaccessible duct runs were prevalent. Consequently, an extensive program for design, procurement and construction was initiated to contain and isolate ducts for penetration when existing glovebox sites were not present.

  10. Leaf seal for transition duct in turbine system

    SciTech Connect

    Flanagan, James Scott; LeBegue, Jeffrey Scott; McMahan, Kevin Weston; Dillard, Daniel Jackson; Pentecost, Ronnie Ray

    2013-06-11

    A turbine system is disclosed. In one embodiment, the turbine system includes a transition duct. The transition duct includes an inlet, an outlet, and a passage extending between the inlet and the outlet and defining a longitudinal axis, a radial axis, and a tangential axis. The outlet of the transition duct is offset from the inlet along the longitudinal axis and the tangential axis. The transition duct further includes an interface member for interfacing with a turbine section. The turbine system further includes a leaf seal contacting the interface member to provide a seal between the interface member and the turbine section.

  11. Convolution seal for transition duct in turbine system

    SciTech Connect

    Flanagan, James Scott; LeBegue, Jeffrey Scott; McMahan, Kevin Weston; Dillard, Daniel Jackson; Pentecost, Ronnie Ray

    2015-03-10

    A turbine system is disclosed. In one embodiment, the turbine system includes a transition duct. The transition duct includes an inlet, an outlet, and a passage extending between the inlet and the outlet and defining a longitudinal axis, a radial axis, and a tangential axis. The outlet of the transition duct is offset from the inlet along the longitudinal axis and the tangential axis. The transition duct further includes an interface member for interfacing with a turbine section. The turbine system further includes a convolution seal contacting the interface member to provide a seal between the interface member and the turbine section.

  12. Flexible metallic seal for transition duct in turbine system

    SciTech Connect

    Flanagan, James Scott; LeBegue, Jeffrey Scott; McMahan, Kevin Weston; Dillard, Daniel Jackson; Pentecost, Ronnie Ray

    2014-04-22

    A turbine system is disclosed. In one embodiment, the turbine system includes a transition duct. The transition duct includes an inlet, an outlet, and a passage extending between the inlet and the outlet and defining a longitudinal axis, a radial axis, and a tangential axis. The outlet of the transition duct is offset from the inlet along the longitudinal axis and the tangential axis. The transition duct further includes an interface member for interfacing with a turbine section. The turbine system further includes a flexible metallic seal contacting the interface member to provide a seal between the interface member and the turbine section.

  13. Buried and Encapsulated Ducts, Jacksonville, Florida (Fact Sheet)

    SciTech Connect

    Not Available

    2013-11-01

    Ductwork installed in unconditioned attics can significantly increase the overall heating and cooling costs of residential buildings. In fact, estimated duct thermal losses for single-family residential buildings with ductwork installed in unconditioned attics range from 10% to 45%. In a study of three single-story houses in Florida, the Building America research team Consortium for Advanced Residential Buildings (CARB) investigated the strategy of using buried and/or encapsulated ducts (BED) to reduce duct thermal losses in existing homes. The BED strategy consists of burying ducts in loose-fill insulation and/or encapsulating them in closed cell polyurethane spray foam (ccSPF) insulation. There are three possible combinations of BED strategies: (1) buried ducts; (2) encapsulated ducts (with ccSPF); and (3) buried and encapsulated ducts. The best solution for each situation depends on the climate, age of the house, and the configuration of the HVAC system and attic. For new construction projects, the team recommends that ducts be both encapsulated and buried as the minimal planning and costs required for this will yield optimal energy savings. The encapsulated/buried duct strategy, which utilizes ccSPF to address condensation concerns, is an approach that was developed specifically for humid climates.

  14. Analysis of nephric duct specification in the avian embryo

    PubMed Central

    Attia, Lital; Yelin, Ronit; Schultheiss, Thomas M.

    2012-01-01

    Vertebrate kidney tissue exhibits variable morphology that in general increases in complexity when moving from anterior to posterior along the body axis. The nephric duct, a simple unbranched epithelial tube, is derived in the avian embryo from a rudiment located in the anterior intermediate mesoderm (IM) adjacent to somites 8 to 10. Using quail-chick chimeric embryos, the current study finds that competence to form nephric duct is fixed when IM precursor cells are still located in the primitive streak, significantly before the onset of duct differentiation. In the primitive streak, expression of the gene HoxB4 is associated with prospective duct IM, whereas expression of the more posterior Hox gene HoxA6 is associated with more posterior, non-duct-forming IM. Misexpression of HoxA6, but not of HoxB4, in prospective duct-forming regions of the IM resulted in repression of duct formation, suggesting a mechanism for the restriction of duct formation to the anterior-most IM. The results are discussed with respect to their implications for anterior-posterior patterning of kidney tissue and of mesoderm in general, and for the loss of duct-forming ability in more posterior regions of the IM that has occurred during vertebrate evolution. PMID:23034630

  15. Postoperative Chemoradiotherapy for Extrahepatic Bile Duct Cancer

    SciTech Connect

    Park, Jin-hong; Choi, Eun Kyung; Ahn, Seung Do; Lee, Sang-wook; Song, Si Yeol; Yoon, Sang Min; Kim, Young Seok; Lee, Yu Sun; Lee, Sung-Gyu; Hwang, Shin; Lee, Young-Joo; Park, Kwang-Min; Kim, Tae Won; Chang, Heung Moon; Lee, Jae-Lyun; Kim, Jong Hoon

    2011-03-01

    Purpose: To evaluate the effect of postoperative concurrent chemoradiotherapy using three-dimensional conformal radiotherapy and to identify the prognostic factors that influence survival in patients with extrahepatic bile duct cancer. Methods and Materials: We retrospectively analyzed the data from 101 patients with extrahepatic bile duct cancer who had undergone postoperative concurrent chemoradiotherapy using three-dimensional conformal radiotherapy. Of the 101 patients, 52 (51%) had undergone complete resection (R0 resection) and 49 (49%) had microscopic or macroscopic residual tumors (R1 or R2 resection). The median radiation dose was 50 Gy. Also, 85 patients (84%) underwent concurrent chemotherapy with 5-fluorouracil. Results: The median follow-up period was 47 months for the surviving patients. The 5-year overall survival rate was 34% for all patients. A comparison between patients with R0 and R1 resection indicated no significant difference in the 5-year overall survival (44% vs. 33%, p = .2779), progression-free survival (35% vs. 22%, p = .3107), or locoregional progression-free survival (75% vs. 63%, p = .2784) rates. An analysis of the first failure site in the 89 patients with R0 or R1 resection indicated isolated locoregional recurrence in 7 patients. Elevated postoperative carbohydrate antigen 19-9 level was an independent prognostic factor for overall survival (p = .001) and progression-free survival (p = .033). A total of 3 patients developed Grade 3 or greater late toxicity. Conclusion: Adjuvant concurrent chemoradiotherapy using three-dimensional conformal radiotherapy appears to improve locoregional control and survival in extrahepatic bile duct cancer patients with R1 resection. The postoperative carbohydrate antigen 19-9 level might be a useful prognostic marker to select patients for more intensified adjuvant therapy.

  16. Radiation of sound from unflanged cylindrical ducts

    NASA Technical Reports Server (NTRS)

    Hartharan, S. L.; Bayliss, A.

    1983-01-01

    Calculations of sound radiated from unflanged cylindrical ducts are presented. The numerical simulation models the problem of an aero-engine inlet. The time dependent linearized Euler equations are solved from a state of rest until a harmonic solution is attained. A fourth order accurate finite difference scheme is used and solutions are obtained from a fully vectorized Cyber-203 computer program. Cases of both plane waves and spin modes are treated. Spin modes model the sound generated by a turbofan engine. Boundary conditions for both plane waves and spin modes are treated. Solutions obtained are compared with experiments conducted at NASA Langley Research Center.

  17. Levitated Duct Fan (LDF) Aircraft Auxiliary Generator

    NASA Technical Reports Server (NTRS)

    Eichenberg, Dennis J.; Emerson, Dawn C.; Gallo, Christopher A.; Thompson, William K.

    2011-01-01

    This generator concept includes a novel stator and rotor architecture made from composite material with blades attached to the outer rotating shell of a ducted fan drum rotor, a non-contact support system between the stator and rotor using magnetic fields to provide levitation, and an integrated electromagnetic generation system. The magnetic suspension between the rotor and the stator suspends and supports the rotor within the stator housing using permanent magnets attached to the outer circumference of the drum rotor and passive levitation coils in the stator shell. The magnets are arranged in a Halbach array configuration.

  18. Anatomy of the nipple and breast ducts.

    PubMed

    Zucca-Matthes, Gustavo; Urban, Cícero; Vallejo, André

    2016-02-01

    Over time, variations of mastectomy came up and started allowing the oncological safety and the possibility of an immediate breast reconstruction. Nipple sparing mastectomy (NSM) procedures have strongly increased in frequency and have become one of the best alternatives to treat breast cancer, also improving overall aesthetic outcomes and the achievement of contralateral breast symmetry. The nipple areola-complex (NAC) must be considered the identity of the breast concerning self-esteem of patients. This paper will remind the main anatomical topics around the nipple and breast ducts. PMID:26855906

  19. [Carcinoma of the extrahepatic bile ducts].

    PubMed

    Cappelletti, F; Marzano, P F; Giacinti, I; Di Bello, M G; Maturo, A; Di Matteo, F M; Micacchi, M; Zaccagnino, P; Morucci, R; Petrassi, P; Ascenzi, P; Di Curzio, B

    1996-01-01

    In the last 5 years 25 patients (11 men, 14 women) with carcinoma of the extrahepatic biliary duct were studied. The most frequent localization of the carcinoma was the hepatic hilum. D.C.P. according to Whipple was possible only in one patient, while in 20 patients a palliative approach with external and internal biliary derivations was the choice. In the remaining 4 patients an explorative laparotomy with biopsy was performed. It is concluded that palliative resection allows for a better quality of life. PMID:9162182

  20. Porokeratotic eccrine ostial and dermal duct nevus

    PubMed Central

    Bandyopadhyay, Debabrata; Saha, Abanti; Das, Dipti; Das, Anupam

    2015-01-01

    Porokeratotic eccrine ostial and dermal duct nevus (PEODDN) is a rare nevoid condition characterized by asymptomatic grouped keratotic papules and plaques with a linear pattern on the extremities, having distinct porokeratotic histopathological features. The lesions usually present at birth or in childhood. We present here a case of late-onset PEODDN in a 23-year-old man who had lesions on the palm, forearm, arm and the chest along the lines of Blaschko, strictly localized to the left side of the body. PMID:25821735

  1. Anatomy of the nipple and breast ducts

    PubMed Central

    Urban, Cícero; Vallejo, André

    2016-01-01

    Over time, variations of mastectomy came up and started allowing the oncological safety and the possibility of an immediate breast reconstruction. Nipple sparing mastectomy (NSM) procedures have strongly increased in frequency and have become one of the best alternatives to treat breast cancer, also improving overall aesthetic outcomes and the achievement of contralateral breast symmetry. The nipple areola-complex (NAC) must be considered the identity of the breast concerning self-esteem of patients. This paper will remind the main anatomical topics around the nipple and breast ducts. PMID:26855906

  2. [Liver, bile ducts and pancreatic diseases].

    PubMed

    Kanno, T

    1995-06-01

    A fundamental guideline for the use of test results concerning liver, bile duct and pancreatic diseases was proposed in 1991 from the Japan Society of Clinical Pathology (JSCP). This guideline was principally based on the document of 1988 from the Committee on liver function tests of the Japanese Society of Gastroenterology (JSG). The document from the JSG was revised in May, 1994. Also a guideline for selection of markers of hepatitis virus in hepatic disorders, was proposed in January, 1994 from the same Committee of JSG. Here, we reevaluated and discussed the JSCP guideline as taking into consideration the two 1994 JSG documents. PMID:7602802

  3. Detonation duct gas generator demonstration program

    NASA Technical Reports Server (NTRS)

    Wortman, A.; Othmer, P.; Rostafinski, W.

    1992-01-01

    An experimental demonstration is presented for the generation of detonation waves that move periodically across high speed channel flow; these waves can compress the outflow from a low pressure compressor, and thereby both reduce the compressor requirements associated with conventional gas turbines and enhance thermodynamic efficiency through isochoric energy addition. By generating transient transverse waves, rather than standing waves, shock-wave losses are reduced by an order of magnitude; the result is a Humphrey cycle augmenting the basic Brayton-cycle gas turbine. Attention is presently given to results from an experimental detonation duct.

  4. Effectiveness of duct sealing and duct insulation in multi-family buildings. Final report

    SciTech Connect

    Karins, N.H.; Tuluca, A.; Modera, M.

    1997-07-01

    This research investigated the cost-effectiveness of sealing and insulating the accessible portions of duct systems exposed to unconditioned areas in multifamily housing. Airflow and temperature measurements were performed in 25 apartments served by 10 systems a 9 multi-family properties. The measurements were performed before and after each retrofit, and included apartment airflow (supply and return), duct system temperatures, system fan flow and duct leakage area. The costs for each retrofit were recorded. The data were analyzed and used to develop a prototypical multifamily house. This prototype was used in energy simulations (DOE-2.1E) and air infiltration simulations (COMIS 2.1). The simulations were performed for two climates: New York City and Albany. In each climate, one simulation was performed assuming the basement was tight, and another assuming the basement was leaky. Simulation results and average retrofit costs were used to calculate cost-effectiveness. The results of the analysis indicate that sealing leaks of the accessible ductwork is cost-effective under all conditions simulated (simple payback was between 3 and 4 years). Insulating the accessible ductwork, however, is only cost-effective for buildings with leaky basement, in both climates (simple paybacks were less than 5 years). The simple payback period for insulating the ducts in buildings with tight basements was greater than 10 years, the threshold of cost-effectiveness for this research. 13 refs., 5 figs., 27 tabs.

  5. Does the corticoadrenal adenoma with ''pre-Cushing's syndrome'' exist

    SciTech Connect

    Charbonnel, B.; Chatal, J.F.; Ozanne, P.

    1981-12-01

    An adrenal tumor was discovered fortuitously in a patient with no clinical features of Cushing's syndrome. On adrenal imaging, there was good uptake in the nodule but no visualization of the contralateral adrenal. The latter was seen, however, in a second scan performed under ACTH treatment. In the hormone assessment, basal cortisol and 17-hydroxycorticoids were normal and cortisol diurnal variation was near normal, but a dexamethasone suppression test and ACTH responses to metyrapone and insulin hypoglycemia were abnormal. Eight months after excision of a spongiocytic-type adenoma, the remaining adrenal was visible on scintigram and the hormonal tests were normal. This pattern suggests that the clinical Cushing's syndrome was enough to partially suppress ACTH and, consequently, visualization of the contralateral gland.

  6. The Coexistence of Rathke Cleft Cyst and Pituitary Adenoma.

    PubMed

    Gao, Mingtong; An, Yanyan; Huang, Zhihong; Niu, Jianyi; Yuan, Xunhui; Bai, Yun'an; Guo, Liemei

    2016-03-01

    Both of Pituitary adenoma (PA) and Rathke cleft cyst (RCC) are the most common and benign sellar lesions. Generally, the origin of RCC is considered to be derived from remnants of Rathke punch, while PA is formed by proliferation of the anterior wall of Rathke pouch. Although they have a possibility to share a common embryological origin, the coexistence of PA and RCC is extremely rare. Here, the authors report a 50-year-old male patient who was found to have a large cystic sellar lesion, and surgical resection revealed components of a RCC coexisting with a PA. This collision reminded us of the possibility of RCC coexisting with PA. Furthermore, a clinicopathologic relation of them were reviewed and investigated. PMID:26845092

  7. Juvenile pleomorphic adenoma of masticator space: The first case report

    PubMed Central

    Panigrahi, Rajat G.; Sahoo, Sujit Ranjan; Panda, Swagatika; Lenka, Sthitaprajna; Padhiary, Subrat Kumar; Bhuyan, Ruchi; Bhuyan, Sanat

    2013-01-01

    Pleomorphic adenoma (PA), also called benign mixed tumor, is the most common tumor of the salivary glands. About 90% of these tumors occur in the parotid gland and 10% in the minor salivary glands. Juvenile PAs are uncommon and about 5-10% of minor salivary gland PA affects patients aged 20 years and under. The most common sites of PA of the minor salivary glands are the palate followed by lips and cheek. Other rare reported sites include the throat, floor of the mouth, tongue, tonsil, pharynx, retromolar area and nasal cavity. The masticator space is a deep facial space with a complex anatomical structure where PA is not known to occur. Here, we report an unusual case of PA of left masticator space in a 16-year-old girl patient, which to the best of our knowledge is the first reported case in English language literature. PMID:24403803

  8. New technologies and techniques to improve adenoma detection in colonoscopy

    PubMed Central

    Bond, Ashley; Sarkar, Sanchoy

    2015-01-01

    Adenoma detection rate (ADR) is a key component of colonoscopy quality assessment, with a direct link between itself and future mortality from colorectal cancer. There are a number of potential factors, both modifiable and non-modifiable that can impact upon ADR. As methods, understanding and technologies advance, so should our ability to improve ADRs, and thus, reduce colorectal cancer mortality. This article will review new technologies and techniques that improve ADR, both in terms of the endoscopes themselves and adjuncts to current systems. In particular it focuses on effective techniques and behaviours, developments in image enhancement, advancement in endoscope design and developments in accessories that may improve ADR. It also highlights the key role that continued medical education plays in improving the quality of colonoscopy and thus ADR. The review aims to present a balanced summary of the evidence currently available and does not propose to serve as a guideline. PMID:26265990

  9. Diagnostic imaging of dopamine receptors in pituitary adenomas.

    PubMed

    de Herder, Wouter W; Reijs, Ambroos E M; Feelders, Richard A; van Aken, Maarten O; Krenning, Eric P; van der Lely, Aart-Jan; Kwekkeboom, Dik J

    2007-04-01

    Dopamine D2 receptor scintigraphy of pituitary adenomas is feasible by single-photon emission computed tomography using (123)I-S-(-)-N-[(1-ethyl-2-pyrrolidinyl)methyl]-2-hydroxy-3-iodo-6-methoxybenzamide ((123)I-IBZM) and (123)I-epidepride. (123)I-epidepride is generally superior to (123)I-IBZM for the visualization of D2 receptors on pituitary macroadenomas. However, (123)I-IBZM and (123)I-epidepride scintigraphy are generally not useful to predict the response to dopaminergic treatment in pituitary tumour patients. These techniques might allow discrimination of non-functioning pituitary macroadenomas from other non-tumour pathologies in the sellar region. Dopamine D2 receptors on pituitary tumours can also be studied using positron emission tomography with (11)C-N-raclopride and (11)C-N-methylspiperone. PMID:17413189

  10. Genetics of Aldosterone-Producing Adenoma in Korean Patients

    PubMed Central

    Song, Young Shin; Lee, Kyu Eun; Seo, Soo Hyun; Seong, Moon-Woo; Shin, Chan Soo; Kim, Sang Wan; Kim, Seong Yeon

    2016-01-01

    Objectives Recently, somatic mutations in KCNJ5, ATP1A1, ATP2B3, and CACNA1D genes were found to be associated with the pathogenesis of aldosterone-producing adenoma (APA). This study aimed to investigate the prevalence of somatic mutations in KCNJ5, ATP1A1, ATP2B3, and CACNA1D and examine the correlations between these mutations and the clinical and biochemical characteristics in Korean patients with APA. Methods We performed targeted gene sequencing in 66 patients with APA to detect somatic mutations in these genes. Results Somatic KCNJ5 mutations were found in 47 (71.2%) of the 66 patients with APA (31 cases of p.G151R and 16 cases of p.L168R); these two mutations were mutually exclusive. Somatic mutations in the ATP1A1, ATP2B3, and CACNA1D genes were not observed. Somatic KCNJ5 mutations were more prevalent in female patients (66% versus 36.8%, respectively; P = 0.030). Moreover, patients with KCNJ5 mutations comprised a significantly higher proportion of patients younger than 35 years of age (19.1% versus 0%, respectively; P = 0.040). There were no significant differences in pre-operative blood pressure, plasma aldosterone, serum potassium, lateralization index, and adenoma size according to mutational status. Patients with KCNJ5 mutations were less likely to need antihypertensive medications after adrenalectomy compared with those without mutation (36.2% versus 63.2%; P = 0.045). Conclusions The present study demonstrated the high prevalence of somatic KCNJ5 mutations in Korean patients with APA. Carriers of somatic KCNJ5 mutations were more likely to be female. Early diagnosis and better therapeutic outcomes were associated with somatic KCNJ5 mutations in APA. PMID:26807823

  11. Open mini-incision parathyroidectomy for solitary parathyroid adenoma.

    PubMed

    Kelly, Ciaran W P; Eng, Chee-Yean; Quraishi, M Shahed

    2014-03-01

    Parathyroid surgery is the acceptable definitive treatment for primary hyperparathyroidism (pHPT) due to parathyroid adenoma. Open mini-incision parathyroidectomy (O-MIP) has an excellent cure rate and minimal morbidity. We aim to demonstrate the safety, efficacy and subjective patient satisfaction of O-MIP and investigate the accuracy of pre-operative radiological localisation in relation to operative findings. A retrospective review of patients who underwent O-MIP for pHPT due to solitary parathyroid adenoma from April 2006 to August 2012 was performed. All patients were initially investigated by an endocrinologist to confirm pHPT with pre-operative localisation imaging using ultrasound scan (USS) and 99mTc-sestamibi (MIBI). One hundred and fifty consecutive patients were included with a median age of 62 years. Pre-operative USS and MIBI scans were concordant in 71 % of cases. In combined modality (USS and MIBI), localisation was 94.8 % accurate. There was 95.5 % identification of parathyroid tissue confirmed by intra-operative frozen section. Ninety-one percent of patients were treated as a day case. The median operative time was 60 min. The mean pre-operative calcium level was 2.98 mmol/l, and the short-to-medium term mean calcium level was 2.49 (Paired t test, p < 0.001). There was no significant complication. O-MIP confers significant advantages over the traditional gold standard treatment of bilateral neck exploration. Accurate localisation is the key to successful O-MIP. In experienced hands, ultrasound and MIBI may be the only pre-operative investigations required for accurate localisation. PMID:23653305

  12. Frequency of coexistent carcinoma in sessile serrated adenoma/polyps and traditional serrated adenomas removed by endoscopic resection

    PubMed Central

    Saiki, Hirotsugu; Nishida, Tsutomu; Yamamoto, Masashi; Hayashi, Shiro; Shimakoshi, Hiromi; Shimoda, Akiyoshi; Amano, Takahiro; Sakamoto, Aisa; Otake, Yuriko; Sugimoto, Aya; Takahashi, Kei; Mukai, Kaori; Matsubara, Tokuhiro; Nakajima, Sachiko; Fukui, Koji; Inada, Masami; Yamamoto, Katsumi; Tokuda, Ryozo; Adachi, Shiro

    2016-01-01

    Background and study aims: Sessile serrated adenoma/polyps (SSA/Ps) have a different potential than traditional adenomatous polyps for developing into malignant colorectal cancer. However, little is known about the coexistent cancer rate. Here, we evaluate the frequency of carcinoma in serrated polyps removed by endoscopic resection (ER). Patients and methods: This was a retrospective single-center cohort study of consecutive patients with colorectal polyps who underwent ER from March 2003 to October 2014. We determined the frequency of serrated polyps among all resected colorectal polyps and analyzed the clinicopathological findings as well as the frequency and characteristics of coexistent carcinoma in the serrated polyps resected by ER based on pathology reports. Results: A total of 21,048 polyps from 15,326 patients were identified, including 15,984 traditional adenomatous polyps (75.9 %), 621 SSA/Ps (3.0 %), 136 traditional serrated adenomas (TSAs) (0.6 %), 1,121 hyperplastic polyps (5.3 %), and 3,186 polyps of other types (15.1 %). The clinical and endoscopic findings of SSA/Ps revealed a male predominance (68.6 %), with 61.7 % of the polyps located in the proximal colon. Males accounted for 77.2 % of all patients with TSAs, and 77.2 % of these polyps were located in the distal colon. The mean sizes of the SSA/Ps and TSAs were 8.8 and 10.7 mm, respectively. Among the SSA/Ps, 8 (1.3 %) cases had coexistent carcinoma, and 1 (0.7 %) patient with TSA showed coexistent carcinoma. In the patients with SSA/Ps, female sex and a tumor size ≥ 10 mm were predictive factors for coexistent carcinoma. Conclusions: The frequency of SSA/Ps with carcinoma was lower than that for traditional adenoma. Female sex and tumor size ≥ 10 mm were significant predictive factors for coexistent carcinoma. PMID:27092327

  13. Ultrasound imaging of the mouse pancreatic duct using lipid microbubbles

    NASA Astrophysics Data System (ADS)

    Banerjee, B.; McKeown, K. R.; Skovan, B.; Ogram, E.; Ingram, P.; Ignatenko, N.; Paine-Murrieta, G.; Witte, R.; Matsunaga, T. O.

    2012-03-01

    Research requiring the murine pancreatic duct to be imaged is often challenging due to the difficulty in selectively cannulating the pancreatic duct. We have successfully catheterized the pancreatic duct through the common bile duct in severe combined immune deficient (SCID) mice and imaged the pancreatic duct with gas filled lipid microbubbles that increase ultrasound imaging sensitivity due to exquisite scattering at the gas/liquid interface. A SCID mouse was euthanized by CO2, a midline abdominal incision made, the common bile duct cut at its midpoint, a 2 cm, 32 gauge tip catheter was inserted about 1 mm into the duct and tied with suture. The duodenum and pancreas were excised, removed in toto, embedded in agar and an infusion pump was used to instill normal saline or lipid-coated microbubbles (10 million / ml) into the duct. B-mode images before and after infusion of the duct with microbubbles imaged the entire pancreatic duct (~ 1 cm) with high contrast. The microbubbles were cavitated by high mechanical index (HMI) ultrasound for imaging to be repeated. Our technique of catheterization and using lipid microbubbles as a contrast agent may provide an effective, affordable technique of imaging the murine pancreatic duct; cavitation with HMI ultrasound would enable repeated imaging to be performed and clustering of targeted microbubbles to receptors on ductal cells would allow pathology to be localized accurately. This research was supported by the Experimental Mouse Shared Service of the AZ Cancer Center (Grant Number P30CA023074, NIH/NCI and the GI SPORE (NIH/NCI P50 CA95060).

  14. Seasonal variations of surface duct conditions in Ngaoundere, North Cameroon

    NASA Astrophysics Data System (ADS)

    Kaissassou, Samuel; Lenouo, André; Nzeukou, Armand; Tchawoua, Clément; Vondou, D. A.

    2015-12-01

    The seasonal variations of refractivity gradients from 104 to 3000 m above ground level in the troposphere layer are presented based on observations from the radiosonde station located in Ngaoundere (13.5°E, 7.3°N), a middle belt savannah region of Cameroon. Six years (2006-2011) of data from in situ measurements made by Agency for the Safety of Air Navigation in Africa and Madagascar (ASECNA) of the temperature, moisture, and pressure are used to determine the surface duct conditions over Ngaoundere region. Each time that a negative gradient from the Abel-retrieved refractivity profiles is seen, it implies the presence of a duct in this study. The occurrence of ducts strongly depends on the local climate and synoptic weather conditions which have an appreciable influence on the refractivity vertical profile, especially the seasonal north-south movement of the Inter Tropical Convergence Zone (ITCZ) which provides wet and dry seasons to the region. Monthly and seasonal variations of ducts were also determined from the measured data. The highest and the lowest occurrence rate of surface ducts were observed during the wet and the dry seasons, respectively. September appears as the month when most of the ducts occur at the rate of at least one duct per day. The median duct thickness and duct strength are high and strong during the wet season, whereas they are low and weak during the dry season. When the data are separated into stable and unstable atmospheric conditions, we noticed that surface duct characteristics show some seasonal differences. Surface ducts are found to be more frequent in a stable atmosphere than in an unstable atmosphere. Statistical results are discussed alongside with local meteorological conditions and weather systems affecting the town of Ngaoundere. Besides, comments are made on their prospective significance in the region.

  15. Parathyroid Adenoma Completely Impacted within the Thyroid Gland: A Case Report.

    PubMed

    Mirhosaini, Sayed Mahmoud; Amani, Soroush; Fereidani, Rana

    2016-06-01

    Ectopic parathyroid adenoma can be seen in various locations. Sometimes ultrasound and even fine needle aspiration studies cannot distinguish this lesion from thyroid lesions. A 29-year-old woman with a prominent nodule of left thyroid lobe was referred to surgical department. Thyroid function test were normal. She had no family history of parathyroid disease, other endocrine disease, and any other malignancies and had received no radiation. Ultrasonography revealed a solid and hypoechoic mass, 25x20 mm in size, with a regular shape and contour without calcification in the inferior of left lobe of the thyroid gland. For definite diagnosis, immunohistochemistry study of the lesion with three markers was done. Finally, PTH marker was positive in cytoplasms of cells so parathyroid adenoma was confirmed. Fine needle aspiration of the nodule was suspicious for follicular neoplasm; however, postoperative histopathology and immunohistochemistry revealed a parathyroid adenoma. Ultrasonography may be helpful to identify localized thyroid lesions especially in parathyroid adenoma. PMID:27504318

  16. Treatment of Aggressive Prolactin-Secreting Pituitary Adenomas with Adjuvant Temozolomide Chemotherapy: A Review.

    PubMed

    Moisi, Marc; Cruz, Aurora S; Benkers, Tara; Rostad, Steven; Broyles, Frances Broyles; Yuen, Kevin; Mayberg, Marc

    2016-01-01

    Most prolactin-secreting pituitary adenomas demonstrate slow growth and are effectively managed with medical/surgical therapy. Rarely, these tumors can behave aggressively with rapid growth and invasion of local tissues, and are refractory to medical, surgical, or radio-surgical therapies. We report a case of a prolactin-secreting adenoma in a young woman, which became progressively aggressive and refractory to usual treatment modalities, but responded to treatment with the chemotherapeutic agent temozolomide. In addition, we review the literature for treatment of refractory adenomas with temozolomide. The clinical and pathologic characteristics of aggressive prolactin-secreting adenomas are reviewed, as well as their response to dopamine agonists, surgery, radiotherapy, and chemotherapy. PMID:27489751

  17. Basal cell adenoma of the parotid gland. Case report and review of the literature.

    PubMed

    González-García, Raúl; Nam-Cha, Syong H; Muñoz-Guerra, Mario F; Gamallo-Amat, C

    2006-03-01

    Basal cell adenoma of the salivary glands is an uncommon type of monomorphous adenoma. Its most frequent location is the parotid gland. It usually appears as a firm and mobile slow-growing mass. Histologically, isomorphic cells in nests and interlaced trabecules with a prominent basal membrane are observed. It is also characterized by the presence of a slack and hyaline stroma and the absence of myxoid or condroid stroma. In contrast to pleomorphic adenoma, it tends to be multiple and its recurrence rate after surgical excision is high. Due to prognostic implications, differential diagnosis with basal cell adenocarcinoma, adenoid cystic carcinoma and basaloid squamous cell carcinoma is mandatory. We describe a case of basal cell adenoma of the parotid gland. We also review the literature and discuss the diagnosis and management of this rare entity. PMID:16505803

  18. Treatment of Aggressive Prolactin-Secreting Pituitary Adenomas with Adjuvant Temozolomide Chemotherapy: A Review

    PubMed Central

    Cruz, Aurora S; Benkers, Tara; Rostad, Steven; Broyles, Frances Broyles; Yuen, Kevin; Mayberg, Marc

    2016-01-01

    Most prolactin-secreting pituitary adenomas demonstrate slow growth and are effectively managed with medical/surgical therapy. Rarely, these tumors can behave aggressively with rapid growth and invasion of local tissues, and are refractory to medical, surgical, or radio-surgical therapies. We report a case of a prolactin-secreting adenoma in a young woman, which became progressively aggressive and refractory to usual treatment modalities, but responded to treatment with the chemotherapeutic agent temozolomide. In addition, we review the literature for treatment of refractory adenomas with temozolomide. The clinical and pathologic characteristics of aggressive prolactin-secreting adenomas are reviewed, as well as their response to dopamine agonists, surgery, radiotherapy, and chemotherapy. PMID:27489751

  19. A rare case of giant parathyroid adenoma presenting with recurrent episodes of pancreatitis.

    PubMed

    Krishnamurthy, Arvind; Raghunandan, Gorantlu Chowdappa; Ramshankar, Vijayalakshmi

    2016-01-01

    Parathyroid adenomas are usually small in size; (weighing 70 mg-1 g) those weighing more than 2-3 g are classified as giant parathyroid adenomas. Giant parathyroid adenomas are in fact rarely encountered among patients with primary hyperparathyroidism. They are believed to have distinct clinical and biochemical features related to specific genomic alterations. We chanced to manage a unique and possibly the first case of giant parathyroid adenoma (6 cm diameter and weighing 20 g) presenting with recurrent episodes of pancreatitis and discuss its surgical management with an added emphasis on the role of nuclear imaging in its preoperative localization. Our case demonstrates that clinicians should have a high index of suspicion of primary hyperparathyroidism in patients presenting with recurrent episodes of pancreatitis. Timely diagnosis, appropriate preoperative localization techniques, which would include a parathyroid scintigraphy and a focused surgical intervention are crucial to resolve complications and improve outcomes. PMID:26917892

  20. Original technique for preoperative preparation of patients and intraoperative localization of parathyroid adenomas.

    PubMed

    Pasta, V; Monteleone, F; Del Vecchio, L; Iacobelli, S; Urciuoli, P; D'Orazi, V

    2015-01-01

    Surgical approach of single parathyroid adenoma treatment is turning to a less invasive surgery, allowing us to obtain better aesthetic results, reduction of duration of surgical operation, reduction of post-operative morbidity and hospital stay. Tc99m-sestaMIBI scintigraphy is mainly performed for preoperative localization of parathyroid adenomas. Our technique is instead based on the possibility to inhibit the interference of Tc99m-sestaMIBI uptake of the thyroid gland by means of the administration of Lugol's solution. Indeed, to confirm the identification and removal of the hyperfunctional parathyroid, it is accepted as adequate an ex vivo radioactivity count of the adenoma 20% or 40% greater than the value of the post-excisional background radioactivity, in association or not with intraoperative measurement of PTH. This method allows us to perform surgery with no timetable restriction, and to clearly distinguish the radioactivity of parathyroid adenoma from that of the surrounding tissues and thyroid gland. PMID:26188752

  1. Parathyroid Adenoma Completely Impacted within the Thyroid Gland: A Case Report

    PubMed Central

    Mirhosaini, Sayed Mahmoud; Fereidani, Rana

    2016-01-01

    Ectopic parathyroid adenoma can be seen in various locations. Sometimes ultrasound and even fine needle aspiration studies cannot distinguish this lesion from thyroid lesions. A 29-year-old woman with a prominent nodule of left thyroid lobe was referred to surgical department. Thyroid function test were normal. She had no family history of parathyroid disease, other endocrine disease, and any other malignancies and had received no radiation. Ultrasonography revealed a solid and hypoechoic mass, 25x20 mm in size, with a regular shape and contour without calcification in the inferior of left lobe of the thyroid gland. For definite diagnosis, immunohistochemistry study of the lesion with three markers was done. Finally, PTH marker was positive in cytoplasms of cells so parathyroid adenoma was confirmed. Fine needle aspiration of the nodule was suspicious for follicular neoplasm; however, postoperative histopathology and immunohistochemistry revealed a parathyroid adenoma. Ultrasonography may be helpful to identify localized thyroid lesions especially in parathyroid adenoma. PMID:27504318

  2. Parathyroid adenoma in a young male with multiple fractures and varied clinical features.

    PubMed

    Bhanu Murthy, R; Srihari, V; Lakshmi Narayana, M

    2014-01-01

    Primary hyperparathyroidism is due to parathyroid adenoma (80-85%), hyperplasia (10-15%), carcinoma (2-3%) of cases. The most common presentation is asymptomatic hypercalcemia. Multiple pathological fractures, nephrocalcinosis as a presenting feature of primary hyperparathyroidism due to parathyroid adenoma is extremely rare at the age of 19 years. A case of parathyroid adenoma with multiple fractures of left femur, renal calculi, nephrocalcinosis, weight loss, constipation, dyspepsia abdominal pain was presented. The case was investigated completely with biochemical investigations, X-ray of forearm bones and femur, ultrasonography of neck and abdomen, CT scan of neck and abdomen, MRI scan, Scintigraphy of the neck. Right inferior parathyroid adenoma was diagnosed and confirmed by histopathological examination after excision. The post operative serum calcium levels became normal. PMID:24605315

  3. A rare case of giant parathyroid adenoma presenting with recurrent episodes of pancreatitis

    PubMed Central

    Krishnamurthy, Arvind; Raghunandan, Gorantlu Chowdappa; Ramshankar, Vijayalakshmi

    2016-01-01

    Parathyroid adenomas are usually small in size; (weighing 70 mg–1 g) those weighing more than 2–3 g are classified as giant parathyroid adenomas. Giant parathyroid adenomas are in fact rarely encountered among patients with primary hyperparathyroidism. They are believed to have distinct clinical and biochemical features related to specific genomic alterations. We chanced to manage a unique and possibly the first case of giant parathyroid adenoma (6 cm diameter and weighing 20 g) presenting with recurrent episodes of pancreatitis and discuss its surgical management with an added emphasis on the role of nuclear imaging in its preoperative localization. Our case demonstrates that clinicians should have a high index of suspicion of primary hyperparathyroidism in patients presenting with recurrent episodes of pancreatitis. Timely diagnosis, appropriate preoperative localization techniques, which would include a parathyroid scintigraphy and a focused surgical intervention are crucial to resolve complications and improve outcomes. PMID:26917892

  4. Carcinoma ex pleomorphic adenoma originating from ectopic salivary gland in the neck region: case report

    PubMed Central

    Vayısoğlu, Yusuf; Arpaci, Rabia Bozdogan; Eti, Can; Pütürgeli, Tuğçe; Gorur, Kemal; Ozcan, Cengiz

    2015-01-01

    Carcinoma ex pleomorphic adenoma (CEPA) is the malignant salivary gland tumor originating from primary (de novo) or recurrent pleomorphic adenoma. Although parotid gland is the most common site, it can also be seen in submandibular gland or minor salivary glands. It can be seen rarely in head and neck region, such as oral cavity, trachea, nasal cavity and lacrimal gland. Although pleomorphic adenoma cases originating from ectopic salivary gland tissue in the neck region are present in the English literature, there is no published pleomorphic adenoma ex carcinoma case. In this case report we presented a CEPA as a 7.5 cm long neck mass in a 72-year-old woman originating from the submandibular region apart from submandibular gland. Difficulties in diagnosis and way to appropriate treatment are discussed with current literature. PMID:26645012

  5. A randomized trial on folic acid supplementation and risk of recurrent colorectal adenoma

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: Evidence from observational studies suggests that inadequate folate status enhances colorectal carcinogenesis, but results from some randomized trials do not support this hypothesis. Objective: To assess the effect of folic acid supplementation on recurrent colorectal adenoma, we conduc...

  6. Biological and radiological exploration and management of non-functioning pituitary adenoma.

    PubMed

    Raverot, Gérald; Assié, Guillaume; Cotton, François; Cogne, Muriel; Boulin, Anne; Dherbomez, Michèle; Bonneville, Jean François; Massart, Catherine

    2015-07-01

    Non-functioning pituitary adenoma may be totally asymptomatic and discovered "incidentally" during radiological examination for some other indication, or else induce tumoral signs with compression of the optic chiasm and pituitary dysfunction. Non-functioning adenomas are mainly gonadotroph, but may also be "silent". Treatment strategy depends on initial clinical, biological, ophthalmological and radiological findings. The present French Society of Endocrinology Consensus work-group sought to update the pitfalls associated with hormone assay and outline a hormonal exploration strategy for diagnosis and follow-up, without overlooking the particularities of silent adenoma. We also drew up basic rules for initial exploration and radiological follow-up of both operated and non-operated pituitary adenomas. PMID:26122495

  7. Collecting duct intercalated cell function and regulation.

    PubMed

    Roy, Ankita; Al-bataineh, Mohammad M; Pastor-Soler, Núria M

    2015-02-01

    Intercalated cells are kidney tubule epithelial cells with important roles in the regulation of acid-base homeostasis. However, in recent years the understanding of the function of the intercalated cell has become greatly enhanced and has shaped a new model for how the distal segments of the kidney tubule integrate salt and water reabsorption, potassium homeostasis, and acid-base status. These cells appear in the late distal convoluted tubule or in the connecting segment, depending on the species. They are most abundant in the collecting duct, where they can be detected all the way from the cortex to the initial part of the inner medulla. Intercalated cells are interspersed among the more numerous segment-specific principal cells. There are three types of intercalated cells, each having distinct structures and expressing different ensembles of transport proteins that translate into very different functions in the processing of the urine. This review includes recent findings on how intercalated cells regulate their intracellular milieu and contribute to acid-base regulation and sodium, chloride, and potassium homeostasis, thus highlighting their potential role as targets for the treatment of hypertension. Their novel regulation by paracrine signals in the collecting duct is also discussed. Finally, this article addresses their role as part of the innate immune system of the kidney tubule. PMID:25632105

  8. Evaporation duct effects at millimeter wavelengths

    NASA Astrophysics Data System (ADS)

    Anderson, K. D.

    1992-03-01

    The evaporation duct strongly influences low-altitude over-the-horizon propagation at millimeter wavelengths. Results from more than 2000 hours of propagation and meteorological measurements made at 94 GHz on a 40.6 km over-horizon, over-water path along the southern California coast show that the average received power was 63 dB greater than d for propagation in a nonducting, or standard, atmosphere; 90 percent of the measurements were at least 55 dB greater than diffraction. A numerical model of transmission loss based on the observed surface meteorology is discussed and results are compared to measured transmission loss. On average, modeling results underestimate observations by only 10 dB. In addition, results from modeling based on an independent climatology of evaporation duct heights for the area are shown to be adequate for most propagation assessment purposes. The reliability and reasonable accuracy of the numerical model provides a strong justification for utilizing the technique to assess millimeter wave communication and radar systems operating in many, if not all, ocean regions.

  9. Evaporation duct effects at millimeter wavelengths

    NASA Astrophysics Data System (ADS)

    Anderson, K. D.

    1990-03-01

    The evaporation duct strongly influences low-altitude over-the horizon propagation at millimeter wavelengths. Results from more than 2000 hours of propagation and meteorological measurements were made at 94 GHz on a 40.6 km over-horizon, over-water path along the southern California coast show that the average received power was 63 dB greater than expected for propagation in a nonconducting, or normal, atmosphere; 90 percent of the measurements were at least 55 dB greater than the normal atmosphere. A numerical model of transmission loss based on observed surface meteorology is discussed and results are compared to measured transmission loss. On average, modeling results underestimate the transmission loss by 10 dB. In addition, results from modeling based on an independent climatology of evaporation duct heights for the area are shown to be adequate for most propagation assessment purposes. The reliability and reasonable accuracy of the model provide a strong justification for utilizing the technique to assess millimeter wave communication and radar systems operating in many, if not all, ocean regions.

  10. Protein kinase C (PKC) activity and PKC messenger RNAs in human pituitary adenomas.

    PubMed

    Jin, L; Maeda, T; Chandler, W F; Lloyd, R V

    1993-02-01

    Protein kinase C (PKC) is involved in the differentiation and growth regulation of a variety of tissues including anterior pituitary gland cells. To determine the distribution of PKC in different types of adenomas, PKC activity was analyzed in human pituitary tumors and the effects of hypothalamic hormone stimulation on PKC activity were examined in cultured adenoma cells. Gonadotroph (LH/FSH) and null cell adenomas had significantly higher levels of particulate, soluble, and total PKC activity compared with growth hormone (GH) adenomas (P < 0.05). Chronic stimulation of null cell adenomas with gonadotropin hormone-releasing hormone or of one GH adenoma with GH-releasing hormone for 7 days did not significantly alter total PKC activity in pituitary cells cultured in serum-free medium. Localization of the calcium-dependent PKC isozymes (alpha, beta and gamma) by immunohistochemistry and in situ hybridization revealed predominantly PKC alpha in all adenomas and variable expression of PKC beta and gamma in some tumors. When the calcium-independent PKC isozymes (delta, epsilon, and zeta) were localized by in situ hybridization, normal and neoplastic pituitaries expressed abundant mRNA for PKC epsilon, whereas some tumors and one normal pituitary had a few cells positive for PKC zeta mRNA as evaluated by grain density and the number of cells labeled. These results indicate that there is a variable distribution of PKC mRNA isozymes in human pituitary adenomas and that normal pituitaries and pituitary adenoma cells express the mRNA for both the calcium-dependent and some of the calcium-independent PKC isozymes. Chronic treatment with the hypothalamic gonadotropin hormone-releasing hormone and GH-releasing hormone, which increased LH/FSH and GH secretion, respectively, did not increase PKC activity in cultured adenoma cells. The presence of calcium-dependent and calcium-independent PKC isozymes in normal and neoplastic pituitary cells indicates that PKC probably plays a

  11. Concurrent papillary thyroid cancer and parathyroid adenoma as a rare condition: a case report.

    PubMed

    Javadi, Hamid; Jallalat, Sara; Farrokhi, Shokrollah; Semnani, Shahriar; Mogharrabi, Mehdi; Riazi, Ahmad; Nabipour, Iraj; Moshtaghi, Darab; Assadi, Majid

    2012-01-01

    Although the pathological relationship between parathyroid and thyroid diseases is common, an association between parathyroid adenoma and thyroid cancer is rare. Concomitant thyroid cancer in patients with primary hyperparathyroidism (pHPT) has been reported at varying frequencies. WE present here a 23-year-old man who had papillary thyroid carcinoma in the right thyroid lobe and a parathyroid adenoma in the left thyroid lobe, which were confirmed surgically. PMID:22936512

  12. Advancing Treatment of Pituitary Adenomas through Targeted Molecular Therapies: The Acromegaly and Cushing Disease Paradigms

    PubMed Central

    Mooney, Michael A.; Simon, Elias D.; Little, Andrew S.

    2016-01-01

    The current treatment of pituitary adenomas requires a balance of conservative management, surgical resection, and in select tumor types, molecular therapy. Acromegaly treatment is an evolving field where our understanding of molecular targets and drug therapies has improved treatment options for patients with excess growth hormone levels. We highlight the use of molecular therapies in this disease process and advances in this field, which may represent a paradigm shift for the future of pituitary adenoma treatment. PMID:27517036

  13. Associations Between Markers of Colorectal Cancer Stem Cells and Adenomas Among Ethnic Groups

    PubMed Central

    Leavell, Bonita J.; Van Buren, Eric; Antaki, Fadi; Axelrod, Bradley N.; Rambus, Mary Ann; Majumdar, Adhip P. N.

    2013-01-01

    Background and Purposes Most colorectal tumors develop from adenomatous polyps, which are detected by colonoscopy. African Americans (AAs) have higher incidence of colorectal cancer (CRC) and greater mortality from this disease than Caucasian Americans (CAs). We investigated whether differences in predisposition to CRC and its surrogate (colonic adenomas) between these ethnic groups were related to numbers of cancer stem or stem-like cells (CSCs) in colonocytes. Methods We analyzed colonic effluent from 11 AA and 14 CA patients who underwent scheduled colonoscopy examinations at the John D. Dingell Veterans Affairs Medical Center. We determined proportions of cells that expressed the CSC markers CD44 and CD166 by flow cytometry. Results The proportion of colonocytes that were CD44+CD166– in effluent from patients with adenomas was significantly greater than from patients without adenomas (P = 0.01); the proportion of CD44+CD166+ colonocytes was also greater (P = 0.07). Effluent from AAs with adenomas had 60 % more CD44+166– colonocytes than from CAs with adenomas. Using cutoff values of 8 % for AAs and 3 % for CAs, the proportion of CD44+166– colonocytes that had positive predictive value for detection of adenomas was 100 % for AAs and CAs, determined by receiver operator characteristic curve analysis. Conclusion The proportion of CD44+166– colonocytes in colonic effluent can be used to identify patients with adenoma. AAs with adenomas have a higher proportion of CD44+166– colonocytes than CA. The increased proportion of CSCs in colonic tissue from AA might be associated with the increased incidence of CRC in this population. PMID:22562538

  14. Meat, vegetables and genetic polymorphisms and the risk of colorectal carcinomas and adenomas

    PubMed Central

    Skjelbred, Camilla F; Sæbø, Mona; Hjartåker, Anette; Grotmol, Tom; Hansteen, Inger-Lise; Tveit, Kjell M; Hoff, Geir; Kure, Elin H

    2007-01-01

    Background The risk of sporadic colorectal cancer (CRC) is mainly associated with lifestyle factors, particularly dietary factors. Diets high in red meat and fat and low in fruit and vegetables are associated with an increased risk of CRC. The dietary effects may be modulated by genetic polymorphisms in biotransformation genes. In this study we aimed to evaluate the role of dietary factors in combination with genetic factors in the different stages of colorectal carcinogenesis in a Norwegian population. Methods We used a case-control study design (234 carcinomas, 229 high-risk adenomas, 762 low-risk adenomas and 400 controls) to test the association between dietary factors (meat versus fruit, berries and vegetables) genetic polymorphisms in biotransformation genes (GSTM1, GSTT1, GSTP1 Ile105Val, EPHX1 Tyr113His and EPHX1 His139Arg), and risk of colorectal carcinomas and adenomas. Odds ratio (OR) and 95% confidence interval (95% CI) were estimated by binary logistic regression. Results A higher ratio of total meat to total fruit, berry and vegetable intake was positively associated with both high and low-risk adenomas, with approximately twice the higher risk in the 2nd quartile compared to the lowest quartile. For the high-risk adenomas this positive association was more obvious for the common allele (Tyr allele) of the EPHX1 codon 113 polymorphism. An association was also observed for the EPHX1 codon 113 polymorphism in the low-risk adenomas, although not as obvious. Conclusion Although, the majority of the comparison groups are not significant, our results suggest an increased risk of colorectal adenomas in individuals for some of the higher ratios of total meat to total fruit, berry and vegetable intake. In addition the study supports the notion that the biotransformation enzymes GSTM1, GSTP1 and EPHX1 may modify the effect of dietary factors on the risk of developing colorectal carcinoma and adenoma. PMID:18093316

  15. The role of proto-oncogene GLI1 in pituitary adenoma formation and cell survival regulation.

    PubMed

    Lampichler, Katharina; Ferrer, Patricio; Vila, Greisa; Lutz, Mirjam I; Wolf, Florian; Knosp, Engelbert; Wagner, Ludwig; Luger, Anton; Baumgartner-Parzer, Sabina

    2015-10-01

    The Hedgehog (Hh) pathway is an important regulator of early tissue patterning and stem cell propagation. It was found to be aberrantly activated in numerous types of human cancer and might be relevant in cancer stem cells. The identification of adult stem cells in the pituitary raised the question if tumor-initiating cells and Hh signaling are involved in pituitary adenoma formation. The present study aimed at the evaluation of Hh signaling in relation to stem cell and cell cycle markers in 30 human pituitary adenomas and in cultured murine adenoma cells. Therefore, expression levels of components of the Hh pathway, stem cell marker SOX2, cell cycle regulator tumor-protein 53 (TP53), proliferation marker Ki67 (MKI67) and superoxide dismutase 1 (SOD1) were evaluated in 30 human pituitary adenomas in comparison to control tissue. Modulation of cell function and target gene expression by the inhibition and activation of the Hh pathway were studied in murine adenoma cells. We show that transcription factor glioma-associated oncogene 1 (GLI1) is overexpressed in 87% of all pituitary adenomas. The expression of GLI1 significantly correlated with that of SOX2, TP53, MKI67 and SOD1. Inhibition of GLI1 resulted in the downregulation of the above genes and severe cell death in mouse adenoma cells. On the other hand, activation of the Hh pathway increased cell viability and target gene expression. In conclusion, our findings point toward an alternative, ligand-independent Hh pathway activation with GLI1 playing a major role in the cell survival of pituitary adenoma cells. PMID:26219678

  16. Metalloproteinases ADAM12 and MMP-14 are associated with cavernous sinus invasion in pituitary adenomas.

    PubMed

    Wang, Junwen; Voellger, Benjamin; Benzel, Julia; Schlomann, Uwe; Nimsky, Christopher; Bartsch, Jörg W; Carl, Barbara

    2016-09-15

    Invasion of tumor cells critically depends on cell-cell or cell-extracellular matrix interactions. Enzymes capable of modulating these interactions belong to the proteinase families of ADAM (a disintegrin and metalloprotease) and MMP (matrix metalloprotease) proteins. Our objective is to examine their expression levels and evaluate the relationship between expression levels and cavernous sinus invasion in pituitary adenomas. Tissue samples from 35 patients with pituitary adenomas were analyzed. Quantitative real-time polymerase chain reaction (qPCR) was employed to assess mRNA expression levels for ADAM and MMP genes. Protein levels were examined using immunohistochemistry and Western Blot. Correlation analyses between expression levels and clinical parameters were performed. By silencing ADAM12 and MMP-14 with siRNA in a mouse pituitary adenoma cell line (TtT/GF), their cellular effects were investigated. In our study, nine women and 26 men were included, with a mean age of 53.1 years (range 15-84 years) at the time of surgery. There were 19 cases with cavernous sinus invasion. The proteins ADAM12 and MMP-14 were significantly up-regulated in invasive adenomas compared to noninvasive adenomas. Both human isoforms of ADAM12 (ADAM12L and ADAM12s) were involved in tumor invasion; moreover, ADAM12L was found to correlate positively with Ki-67 proliferation index in pituitary adenomas. In TtT/GF pituitary adenoma cells, silencing of ADAM12 and MMP-14 significantly inhibited cell invasion and migration, respectively, whereas only silencing of ADAM12 suppressed cell proliferation. We conclude that ADAM12 and MMP-14 are associated with cavernous sinus invasion in pituitary adenomas, which qualifies these proteins in diagnosis and therapy. PMID:27144841

  17. Ultrasonographic features of hepatic adenomas in type I glycogen storage disease.

    PubMed

    Bowerman, R A; Samuels, B I; Silver, T M

    1983-02-01

    Focal hepatic masses were delineated by ultrasonography in three of five patients with type I glycogen storage disease (von Gierke's disease). Small hepatic adenomas were visualized as solitary or multiple hyperechoic solid lesions within enlarged, abnormally echogenic livers of increased attenuation. Larger adenomas were heterogeneous, with hypoechoic foci presumed to be secondary to necrosis, hemorrhage, or both. A previously unreported ultrasonographic finding is the markedly enhanced sound transmission identified deep to these solid tumors. PMID:6302304

  18. 14 CFR 23.1103 - Induction system ducts.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Induction system ducts. 23.1103 Section 23.1103 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: NORMAL, UTILITY, ACROBATIC, AND COMMUTER CATEGORY AIRPLANES Powerplant Induction System § 23.1103 Induction system ducts....

  19. 14 CFR 23.1103 - Induction system ducts.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Induction system ducts. 23.1103 Section 23.1103 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: NORMAL, UTILITY, ACROBATIC, AND COMMUTER CATEGORY AIRPLANES Powerplant Induction System § 23.1103 Induction system ducts....

  20. 91. VIEW OF OBSOLETE AIRCONDITIONING DUCTS LOCATED IN NORTHWEST CORNER ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    91. VIEW OF OBSOLETE AIR-CONDITIONING DUCTS LOCATED IN NORTHWEST CORNER OF ROOM, ABOVE SLC-3E AUTOPILOT EQUIPMENT. DIGITAL COUNTDOWN AND HOLD CLOCKS ON WALL LEFT OF DUCTS - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  1. Sound waves in two-dimensional ducts with sinusoidal walls

    NASA Technical Reports Server (NTRS)

    Nayfeh, A. H.

    1974-01-01

    The method of multiple scales is used to analyze the wave propagation in two-dimensional hard-walled ducts with sinusoidal walls. For traveling waves, resonance occurs whenever the wall wavenumber is equal to the difference of the wavenumbers of any two duct acoustic modes. The results show that neither of these resonating modes could occur without strongly generating the other.

  2. 11. VIEW OF A HEATING DUCT SITUATED SOUTHWEST OF THE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    11. VIEW OF A HEATING DUCT SITUATED SOUTHWEST OF THE FAN HOUSE, ALONG THE MINE ROAD. THE BURNED RUINS OF THE MINE OFFICE ARE LOCATED ON THE FAR SIDE OF THE HEATING DUCT, TO THE NORTHWEST. - Tower Hill No. 2 Mine, Approximately 0.47 mile Southwest of intersection of Stone Church Road & Township Route 561, Hibbs, Fayette County, PA

  3. Loss of Hes1 Differentiates Sessile Serrated Adenoma/polyp from Hyperplastic Polyp

    PubMed Central

    Cui, Min; Awadallah, Amad; Liu, Wendy; Zhou, Lan; Xin, Wei

    2016-01-01

    Sessile serrated adenoma/polyp (SSA/p) is a precancerous lesion, and its differential diagnosis from hyperplastic polyp (HP) could be challenging in certain circumstances based on morphology alone. Hes1 is a downstream target of Notch signaling pathway and plays an important role in intestinal development by regulating differentiation of enterocytes. In this study, we evaluated the expression patterns of Hes1 in SSA/p and hyperplastic polyp (HP), and determine whether Hes1 immunostaining can help differentiate between these two entities. Serrated polyps with cytological dysplasia (sessile serrated adenoma with cytological dysplasia, tubular adenoma, and traditional serrated adenoma) were also studied. Hes1 is ubiquitously expressed in the nuclei of normal colon epithelial cells. The complete loss or a very weak expression of Hes1 is observed in the majority of the SSA/p in the study (58/63, 92%) compared to the normal expression of Hes1 in HP (35/35,100%). In SSA/p with cytological dysplasia, dysplastic area demonstrated cytoplasmic and/or nuclear staining for Hes1. Tubular adenoma and traditional serrated adenoma showed variability of Hes1 staining within the polyp with a mixed positive and negative staining pattern. Our study suggests that loss of Hes1 could be used as a sensitive and specific marker to differentiate SSA/p from HP, which helps the diagnosis in morphologically challenging cases. PMID:26448192

  4. Frequent PTPRK-RSPO3 fusions and RNF43 mutations in colorectal traditional serrated adenoma.

    PubMed

    Sekine, Shigeki; Yamashita, Satoshi; Tanabe, Taro; Hashimoto, Taiki; Yoshida, Hiroshi; Taniguchi, Hirokazu; Kojima, Motohiro; Shinmura, Kazuya; Saito, Yutaka; Hiraoka, Nobuyoshi; Ushijima, Toshikazu; Ochiai, Atsushi

    2016-06-01

    The molecular mechanisms underlying the serrated pathway of colorectal tumourigenesis, particularly those related to traditional serrated adenomas (TSAs), are still poorly understood. In this study, we analysed genetic alterations in 188 colorectal polyps, including hyperplastic polyps, sessile serrated adenomas/polyps (SSA/Ps), TSAs, tubular adenomas, and tubulovillous adenomas by using targeted next-generation sequencing and reverse transcription-PCR. Our analyses showed that most TSAs (71%) contained genetic alterations in WNT pathway components. In particular, PTPRK-RSPO3 fusions (31%) and RNF43 mutations (24%) were frequently and almost exclusively observed in TSAs. Consistent with the WNT pathway activation, immunohistochemical analysis showed diffuse and focal nuclear accumulation of β-catenin in 53% and 30% of TSAs, respectively. APC mutations were observed in tubular and tubulovillous adenomas and in a subset of TSAs. BRAF mutations were exclusively and frequently encountered in serrated lesions. KRAS mutations were observed in all types of polyps, but were most commonly encountered in tubulovillous adenomas and TSAs. This study has demonstrated that TSAs frequently harbour genetic alterations that lead to WNT pathway activation, in addition to BRAF and KRAS mutations. In particular, PTPRK-RSPO3 fusions and RNF43 mutations were found to be characteristic genetic features of TSAs. Copyright © 2016 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. PMID:26924569

  5. Alterations in plasminogen activation correlate with epithelial cell dysplasia grading in colorectal adenomas.

    PubMed Central

    Protiva, P.; Sordat, I.; Chaubert, P.; Saraga, E.; Trân-Thang, C.; Sordat, B.; Blum, A. L.; Dorta, G.

    1998-01-01

    Proteases are important for neoplastic invasion but a specific role for the plasminogen activator system in the progression of colorectal epithelial dysplasia to adenomatous lesions remains unclear. Consecutive tissue cryosections of 51 adenomas, 49 distant mucosa samples and five mucosa samples from control subjects were histopathologically analysed for dysplasia grade and tissue type, urokinase plasminogen activator levels and plasminogen activator inhibitor type 1 (PAI-1) using immunosorbent methods. Plasminogen activation and urokinase-mediated proteolytic activity levels were assessed using in situ zymography. Plasminogen activation and tissue-type activator levels were lower in adenomas than in mucosae (P < 0.001). PAI-1 concentration and urokinase levels were higher in adenomas than in mucosae (P < 0.001 and P < 0.001 respectively). In adenomas, urokinase concentration increased in parallel with PAI-1, but only the urokinase levels correlated with the dysplasia grade (P < 0.01). Thus, the alterations in plasminogen activation correlated with epithelial cell dysplasia grading. In the mucosa to adenoma transition, a marked decrease in tissue-type plasminogen activator occurred. In adenomas, this decrease was accompanied by a concomitant increase in urokinase and PAI-1. The urokinase level only continued to rise in parallel with the dysplasia grade. Resulting protease-antiprotease imbalance in high-grade dysplasia may represent the phenotypic change associated with malignant transformation and invasive behaviour. Images Figure 2 PMID:9461001

  6. Racial differences in obesity measures and risk of colorectal adenomas in a large screening population.

    PubMed

    Murphy, Caitlin C; Martin, Christopher F; Sandler, Robert S

    2015-01-01

    Obesity is an important risk factor for colorectal neoplasia; however, little research exists on racial differences in obesity measures [body mass index (BMI), waist circumference (WC), and waist-hip-ratio (WHR)] associated with adenoma. We used data from the Diet and Health Studies, Phases III-V to examine differences in the contribution of obesity measures to adenoma risk by race. The sample consisted of 2184 patients (1806 white, 378 African American) undergoing outpatient colonoscopy for average risk screening. Covariates included demographics, health history, and validated measures of diet and physical activity. Among whites, BMI [overweight: odds ratio (OR) = 1.31, 95% confidence interval (CI), 1.00-1.71; obese: OR = 1.89, 95% CI, 1.41-2.56), WC (OR = 1.47, 95% CI, 1.09-1.99), and WHR (OR = 1.60, 95% CI, 1.24-2.06) were associated with adenomas. BMI was not associated with adenomas in African Americans. Although the CIs were wide, the point estimates for WHR (OR = 1.07, 95% CI, 0.51-2.22) and WC (OR = 1.04, 95% CI, 0.56-1.92) were slightly elevated above the null. BMI was associated with adenomas only among whites, whereas WHR and WC appeared to be important risk factors among both races. Racial differences in adenoma risk may be due to differences in body shape and weight and/or fat distribution. PMID:25425186

  7. Emotional disorders in patients with different types of pituitary adenomas and factors affecting the diagnostic process.

    PubMed

    Flitsch, J; Spitzner, S; Lüdecke, D K

    2000-01-01

    A prospective study of 48 patients with pituitary adenomas, 19 adenomas causing Cushing's disease, 18 adenomas causing acromegaly, and 11 clinically hormone-inactive adenomas (inactive adenomas), was performed to study emotional disorders occurring before and after transsphenoidal microsurgery. Factors which led to an obvious delay in the diagnostic process were identified. - The tools utilised were an interview and repeated personality assessments. The personality assessments were begun preoperatively and continued for about half a year postoperatively. The interview data, including retrospective statements regarding somatic difficulties, was analysed. - The thesis of a uniform psychopathology due to the influence of elevated hormone levels, and a lack in patients' sensitivity towards their changed appearance in acromegaly could not be confirmed. A high variability of reported emotional problems was found. The most common psychopathological signs for Cushing's disease were excitability and depression, for acromegaly fatigue/loss of energy was the most frequent complaint. Six to eight months postoperatively, a majority of patients noticed an increase of physical well-being. In acromegaly, the time span between first consultation and diagnosis averaged 6.2 years, in Cushing's disease it was 4.3 years, and in inactive adenomas it was 3.9 years. Only a small part of the delay in diagnosis, less than two years, could be attributed to the patients' hesitation to consult a physician. PMID:11083069

  8. The Impact of Colonoscopy Quality Control Table on Adenoma Detection Rates

    PubMed Central

    Deng, Bin; Zhi, Jiehua; Chen, Yaosheng; Liang, Lanyu; Wu, Jian; Gao, Xuefen; Xiao, Weiming; Ding, Yanbing

    2016-01-01

    Objective. This study aims to investigate the effects of reporting colonoscopy findings and the regular review of outcomes on adenoma detection rates. Methods. Patients who underwent colonoscopy from August 2013 to February 2014 were selected as the intervention group. The preintervention group included patients who underwent colonoscopy from January 2013 to July 2013, in which the procedure sheet for this group of patients was not accomplished. The primary outcome was adenoma detection rate (ADR), and secondary outcomes included the success rate of intubation and withdrawal time. Results. This study included 2,467 cases: 1,302 cases in the intervention group and 1,165 cases in the preintervention group. There was no significant difference in demographic characteristics between the two groups. In the intervention group, withdrawal time of colonoscopy was longer (P < 0.01), and the success rate of intubation (92.5% versus 89.1%, P < 0.05) and detection rate of polyps (32.6% versus 27.6%, P < 0.05) and adenomas (20.0% versus 16.1%, P < 0.05) were higher. Significantly high detection rates for proximal adenomas, flat adenomas, and adenomas with a diameter <5 mm were observed in the intervention group (all P < 0.01). Conclusion. The reporting and review of procedure details help to improve quality indicators of colonoscopy. PMID:27340398

  9. Duct thermal performance models for large commercial buildings

    SciTech Connect

    Wray, Craig P.

    2003-10-01

    Despite the potential for significant energy savings by reducing duct leakage or other thermal losses from duct systems in large commercial buildings, California Title 24 has no provisions to credit energy-efficient duct systems in these buildings. A substantial reason is the lack of readily available simulation tools to demonstrate the energy-saving benefits associated with efficient duct systems in large commercial buildings. The overall goal of the Efficient Distribution Systems (EDS) project within the PIER High Performance Commercial Building Systems Program is to bridge the gaps in current duct thermal performance modeling capabilities, and to expand our understanding of duct thermal performance in California large commercial buildings. As steps toward this goal, our strategy in the EDS project involves two parts: (1) developing a whole-building energy simulation approach for analyzing duct thermal performance in large commercial buildings, and (2) using the tool to identify the energy impacts of duct leakage in California large commercial buildings, in support of future recommendations to address duct performance in the Title 24 Energy Efficiency Standards for Nonresidential Buildings. The specific technical objectives for the EDS project were to: (1) Identify a near-term whole-building energy simulation approach that can be used in the impacts analysis task of this project (see Objective 3), with little or no modification. A secondary objective is to recommend how to proceed with long-term development of an improved compliance tool for Title 24 that addresses duct thermal performance. (2) Develop an Alternative Calculation Method (ACM) change proposal to include a new metric for thermal distribution system efficiency in the reporting requirements for the 2005 Title 24 Standards. The metric will facilitate future comparisons of different system types using a common ''yardstick''. (3) Using the selected near-term simulation approach, assess the impacts of

  10. An electronically tunable duct silencer using dielectric elastomer actuators.

    PubMed

    Lu, Zhenbo; Godaba, Hareesh; Cui, Yongdong; Foo, Choon Chiang; Debiasi, Marco; Zhu, Jian

    2015-09-01

    A duct silencer with tunable acoustic characteristics is presented in this paper. Dielectric elastomer, a smart material with lightweight, high elastic energy density and large deformation under high direct current/alternating current voltages, was used to fabricate this duct silencer. The acoustic performances and tunable mechanisms of this duct silencer were experimentally investigated. It was found that all the resonance peaks of this duct silencer could be adjusted using external control signals without any additional mechanical part. The physics of the tunable mechanism is further discussed based on the electro-mechanical interactions using finite element analysis. The present promising results also provide insight into the appropriateness of the duct silencer for possible use as next generation acoustic treatment device to replace the traditional acoustic treatment. PMID:26428819

  11. Heat Transfer in Conical Corner and Short Superelliptical Transition Ducts

    NASA Technical Reports Server (NTRS)

    Poinsatte, Philip; Thurman, Douglas; Hippensteele, Steven

    2008-01-01

    Local surface heat transfer measurements were experimentally mapped using a transient liquid-crystal heat-transfer technique on the surface of two circular-to-rectangular transition ducts. One has a transition cross section defined by conical corners (Duct 1) and the other by an elliptical equation with changing coefficients (Duct 2). Duct 1 has a length-to-diameter ratio of 0.75 and an exit plane aspect ratio of 1.5. Duct 2 has a length-to-diameter ratio of 1.0 and an exit plane aspect ratio of 2.9. Test results are reported for various inlet-diameter-based Reynolds numbers ranging from 0.45 106 to 2.39 106 and two freestream turbulence intensities of about 1 percent, which is typical of wind tunnels, and up to 16 percent, which may be more typical of real engine conditions.

  12. Anicteric early bile duct carcinoma detection with magnetic resonance cholangiopancreatography.

    PubMed

    Oshikiri, Taro; Morita, Takayuki; Fujita, Miyoshi; Miyasaka, Yuji; Senmaru, Naoto; Yamada, Hidehisa; Kondo, Satoshi; Katoh, Hiroyuki

    2005-01-01

    The poor prognosis of extrahepatic bile duct carcinoma makes early detection and diagnosis essential for positive patient outcomes. We describe 2 cases of jaundice-free early extrahepatic bile duct carcinoma detected by magnetic resonance cholangiopancreatography. Extrahepatic bile duct carcinoma was discovered incidentally in patient 1 by magnetic resonance cholangiopancreatography during evaluation of a gallbladder stone. In patient 2, extrahepatic bile duct carcinoma was found during a routine health maintenance exam. Both patients underwent radical surgical intervention. Both patient 1 and 2 have remained in good health for over one year, 3.5 and one year, respectively, and have not exhibited any signs or symptoms of relapse or cancer recurrence. Based on these cases, it appears that magnetic resonance cholangiopancreatography can play a significant role in the early detection of extrahepatic bile duct carcinoma and improve disease prognosis. PMID:15816438

  13. Extravasation Mucocele Arising from a Lingual Thyroglossal Duct Remnant

    PubMed Central

    Nakahira, Mitsuhiko; Nakatani, Hiroaki

    2015-01-01

    Although a thyroglossal duct cyst is a congenital anomaly, it can also appear in adults. Despite the presence of embryological remnants, it is still unclear why the cyst should suddenly develop later in life. We report a case of a 46-year-old male with an extravasation mucocele arising from a long-standing lingual thyroglossal duct remnant. MRI demonstrated a lingual cystic lesion near the hyoid bone associated with a suprahyoid tract-like structure masquerading as a thyroglossal duct cyst. However, histopathological examination demonstrated a mucocele secondary to a rupture of a thyroglossal duct remnant with numerous intramural heterotopic salivary glands. We propose a new mechanism of an acquired cystic formation of this congenital disease that excessive production of mucus from heterotopic salivary glands and a physical trauma such as swallowing may lead to extravasation of mucus from the thyroglossal duct. PMID:25861502

  14. Extravasation mucocele arising from a lingual thyroglossal duct remnant.

    PubMed

    Nakahira, Mitsuhiko; Nakatani, Hiroaki

    2015-01-01

    Although a thyroglossal duct cyst is a congenital anomaly, it can also appear in adults. Despite the presence of embryological remnants, it is still unclear why the cyst should suddenly develop later in life. We report a case of a 46-year-old male with an extravasation mucocele arising from a long-standing lingual thyroglossal duct remnant. MRI demonstrated a lingual cystic lesion near the hyoid bone associated with a suprahyoid tract-like structure masquerading as a thyroglossal duct cyst. However, histopathological examination demonstrated a mucocele secondary to a rupture of a thyroglossal duct remnant with numerous intramural heterotopic salivary glands. We propose a new mechanism of an acquired cystic formation of this congenital disease that excessive production of mucus from heterotopic salivary glands and a physical trauma such as swallowing may lead to extravasation of mucus from the thyroglossal duct. PMID:25861502

  15. The surface evaporative duct height product: An evaluation

    NASA Astrophysics Data System (ADS)

    Thompson, William T.

    1987-12-01

    The existence of a surface evaporative duct has many serious operational implications. One of the most serious and obvious implications is that the extended range of the radar will allow distant hostile units to detect the radar (and to be detected by the radar). Thus, the existence of a surface evaporative duct is an important component of the decision on whether or not to radiate. Another consequence of the duct is that a radar hole will exist between the top of the duct and the base of the lobes unaffected by the duct (see figure 1). Hostile aircraft or missiles will thus be able to approach the radar undetected. Conversely, knowledge of the refractivity profile in the vicinity of enemy radars can be turned to tactical advantage.

  16. A new evaporation duct climatology over the South China Sea

    NASA Astrophysics Data System (ADS)

    Shi, Yang; Yang, Kunde; Yang, Yixin; Ma, Yuanliang

    2015-10-01

    The climatology of evaporation ducts is important for shipborne electromagnetic system design and application. The evaporation duct climatology that is currently used for such applications was developed in the mid 1980s; this study presents efforts to improve it over the South China Sea (SCS) by using a state-of-the-art evaporation duct model and an improved meteorology dataset. This new climatology provides better evaporation duct height (EDH) data over the SCS, at a higher resolution of 0.312°×0.313°. A comparison between the new climatology and the old one is performed. The monthly average EDH in the new climatology is between 10 and 12 m over the SCS, higher than that in the old climatology. The spatiotemporal characteristics of the evaporation duct over the SCS in different months are analyzed in detail, based on the new climatology.

  17. Regeneratively cooled transition duct with transversely buffered impingement nozzles

    SciTech Connect

    Morrison, Jay A; Lee, Ching-Pang; Crawford, Michael E

    2015-04-21

    A cooling arrangement (56) having: a duct (30) configured to receive hot gases (16) from a combustor; and a flow sleeve (50) surrounding the duct and defining a cooling plenum (52) there between, wherein the flow sleeve is configured to form impingement cooling jets (70) emanating from dimples (82) in the flow sleeve effective to predominately cool the duct in an impingement cooling zone (60), and wherein the flow sleeve defines a convection cooling zone (64) effective to cool the duct solely via a cross-flow (76), the cross-flow comprising cooling fluid (72) exhausting from the impingement cooling zone. In the impingement cooling zone an undimpled portion (84) of the flow sleeve tapers away from the duct as the undimpled portion nears the convection cooling zone. The flow sleeve is configured to effect a greater velocity of the cross-flow in the convection cooling zone than in the impingement cooling zone.

  18. Rhinosporidiosis in the parotid duct: a rare case report.

    PubMed

    Panda, Swagatika; Lenka, Sthitaprajna; Padhiary, Subrat K; Sahoo, Sujit R; Srivastava, Gunjan

    2013-11-01

    Endemic to South India and Sri Lanka, Rhinosporidiosis is a chronic granulomatous infection caused by an agent of uncertain taxonomy: Rhinosporidium seeberi. Although it commonly manifests as a proliferative nasal lesion, many cases of Rhinosporidiosis have been reported where it has appeared as an extranasal lesion. The reported extranasal sites include the eye, ear, trachea, and parotid duct. However, the involvement of the parotid duct is quite rare, even among extranasal sites. The case presented is an adult female from the non-endemic zone of East India with a proliferative mass in the parotid duct. Although Rhinosporidiosis was not taken into consideration in the clinical differential diagnosis, eventual histopathological diagnosis confirmed Rhinosporidiosis. As this appears to be the second case of Rhinosporidiosis in the parotid duct in East India in 4 years, we encourage clinicians to be flexible in the differential diagnosis of proliferative growth in the parotid duct, even in those from non-endemic areas. PMID:23371913

  19. Disseminated cervical adenoma malignum and bilateral ovarian sex cord tumors with annular tubules associated with Peutz-Jeghers syndrome.

    PubMed

    Srivatsa, P J; Keeney, G L; Podratz, K C

    1994-05-01

    Adenoma malignum is a highly differentiated mucinous adenocarcinoma of the cervix with a deceptively innocent histologic appearance but a highly aggressive behavior. We describe a patient who had adenoma malignum associated with Peutz-Jeghers syndrome (PJS) and bilateral ovarian sex cord tumor with annular tubules (SCTAT). The relatively frequent occurrence of cervical adenoma malignum in women with PJS warrants close surveillance by gynecologists for early detection and treatment of this cancer. We report the 16th known case of PJS with adenoma malignum and only the 8th known case of PJS with adenoma malignum and bilateral SCTAT. The highly aggressive nature of cervical adenoma malignum is exemplified, and the difficulties associated with early diagnosis are discussed. The clinical significance of cervical and ovarian tumors associated with PJS is reviewed. PMID:8188091

  20. [Intrapituitary adenoma metastasis from lung cancer with progressive cranial nerve palsies: a case report and literature review].

    PubMed

    Fujimori, Takeshi; Okauchi, Masanobu; Shindo, Atsushi; Kawanishi, Masahiko; Miyake, Keisuke; Kawai, Nobuyuki; Tamiya, Takashi

    2014-10-01

    We report a rare case of metastasis to a preexisting pituitary adenoma. An 80-year-old man with a history of pituitary adenoma and lung cancer presented with recent onset of bilateral visual impairment, oculomotor nerve palsies, and severe headache. A CT scan revealed a pituitary tumor expanding into the suprasellar region and infiltrating the bilateral cavernous sinuses. We performed transsphenoidal surgery and diagnosed the tumor as lung cancer metastasis to the pituitary adenoma. After the surgery, visual impairment and severe headache were resolved, and the patient underwent radiation therapy for the residual tumor. To the best of our knowledge, 20 cases of metastases to pituitary adenomas have been reported in the literature. Clinical features of metastasis to a pituitary adenoma are different from those of metastasis to normal pituitary gland. In the case of a pituitary lesion with acute aggravation, one should be aware of the possibility of metastasis to preexisting pituitary adenomas. PMID:25266586

  1. Metabolic syndrome is a risk factor for adenoma occurrence at surveillance colonoscopy

    PubMed Central

    Kim, Nam Hee; Park, Jung Ho; Park, Dong Il; Sohn, Chong Il; Choi, Kyuyong; Jung, Yoon Suk

    2016-01-01

    Abstract We investigated the risk factors for adenoma occurrence at surveillance colonoscopy, especially focusing on patient characteristics, including metabolic factors. Surveillance colonoscopy intervals depend on baseline adenoma characteristics. However, patients’ characteristics may also influence the occurrence of adenomas. Of 62,171 asymptomatic subjects who underwent colonoscopy for a health check-up between 2010 and 2011, 4869 subjects who underwent follow-up colonoscopy between 2012 and 2013 were included in this longitudinal study. The risk of adenoma occurrence was assessed using Cox proportional hazards modeling. Of 4869 subjects, 2827 (58.1%), 1619 (33.3%), and 423 (8.7%) were assigned to the normal, low-risk, and high-risk groups, respectively, according to baseline adenoma characteristics. The mean interval between initial and follow-up colonoscopy was 2.2 ± 0.6 years. Certain patient factors, including older age (≥50 years; adjusted hazard ratio [aHR], 2.08; 95% CI, 1.73–2.49), male sex (aHR, 1.69; 95% CI, 1.30–2.19), metabolic syndrome (MetS) (aHR, 1.28; 95% CI, 1.09–1.51), obesity (aHR, 1.17; 95% CI, 1.02–1.34), elevated fasting blood glucose levels (aHR, 1.37; 95% CI, 1.19–1.58), and elevated triglyceride levels (aHR, 1.19; 95% CI, 1.03–1.37), as well as baseline adenoma characteristics, were associated with a higher risk of adenoma occurrence at follow-up colonoscopy. The cumulative incidence of adenoma occurrence in the high-risk group was higher than that in the low-risk group, whereas the incidence in the high-risk group without MetS was comparable with that in the low-risk group with MetS. Patient characteristics, such as MetS, obesity, older age, and male sex, in addition to adenoma characteristics, were independent risk factors for adenoma occurrence at surveillance colonoscopy. These patient characteristics may be considered in surveillance colonoscopy intervals. PMID:27512862

  2. Aeroacoustic interaction in a corrugated duct

    NASA Astrophysics Data System (ADS)

    Kop'ev, V. F.; Mironov, M. A.; Solntseva, V. S.

    2008-03-01

    The sound generation by an air flow in a corrugated tube is studied experimentally for different values of the corrugation pitch and different tube lengths. The Strouhal numbers of sound generated in different tubes with different flow velocities lie within 0.4-0.6. As the flow velocity increases, the Strouhal number decreases. The effect of sound absorption by an air flow in a corrugated duct is described: in a corrugated tube with a flow, at frequencies below the generation frequency, the absorption of sound produced by an external source is observed. A semiempirical model of aeroacoustic interaction in a corrugated tube is proposed. The model provides a qualitative agreement with the experiment.

  3. Acoustic propagation in rigid ducts with blockage

    NASA Technical Reports Server (NTRS)

    El-Raheb, M.; Wagner, P.

    1982-01-01

    Acoustic levitation has been suggested for moving nonmagnetic material in furnaces for heat processing in space experiments. Basically, acoustic standing waves under resonant conditions are excited in the cavity of the furnace while the material blockage is located at a pressure node and thus at a maximum gradient. The position of the blockage is controlled by displacing the node as a result of frequency change. The present investigation is concerned with the effect of blockage on the longitudinal and transverse resonances of a cylindrical cavity, taking into account the results of a one-dimensional and three-dimensional (3-D) analysis. Based on a Green's function surface element method, 3-D analysis is tested experimentally and proved to be accurate over a wide range of geometric parameters and boundary shapes. The shift in resonance depends on the change in pressure gradient and duct shortening caused by the blockage.

  4. Technology readiness for advanced ducted engines

    SciTech Connect

    Eckardt, D.; Brines, G.L.

    1989-01-01

    The Advanced Ducted Engines (ADEs) currently undergoing development for next-generation passenger aircraft typically possess bypass ratios of the order of 12-25 and specific fuel consumption figures 12-17 percent lower than current advanced turbofans. An extensive technology-readiness program has been mounted on behalf of ADE design definition over the last two years, encompassing among its concerns aircraft/engine-installation interference, low pressure-ratio fan aerodynamics, fan/nacelle interactions (including windmilling and thrust-reversal), acoustic characteristics, transonic-drive turbines, and slender nacelle aerodynamic and mechanical design. Both turbine-driven and geared ADE fans, which may be of single-rotating or contrarotating type, are discussed. 5 refs.

  5. ADAM: An Axisymmetric Duct Aeroacoustic Modeling system

    NASA Astrophysics Data System (ADS)

    Abrahamson, A. L.

    1983-01-01

    An interconnected system of computer programs for analyzing the propagation and attenuation of sound in aeroengine ducts containing realistic compressible subsonic mean flows, ADAM was developed primarily for research directed towards the reduction of noise emitted from turbofan aircraft engines. The two basic components are a streamtube curvature program for determination of the mean flow, and a finite element code for solution of the acoustic propagation problem. The system, which has been specifically tailored for ease of use, is presently installed at NASA Langley Reseach Center on a Control Data Cyber 175 Computer under the NOS Operating system employing a Tektronix terminal for interactive graphics. The scope and organization of the ADAM system is described. A users guide, examples of input data, and results for selected cases are included.

  6. Live 3D image overlay for arterial duct closure with Amplatzer Duct Occluder II additional size.

    PubMed

    Goreczny, Sebstian; Morgan, Gareth J; Dryzek, Pawel

    2016-03-01

    Despite several reports describing echocardiography for the guidance of ductal closure, two-dimensional angiography remains the mainstay imaging tool; three-dimensional rotational angiography has the potential to overcome some of the drawbacks of standard angiography, and reconstructed image overlay provides reliable guidance for device placement. We describe arterial duct closure solely from venous approach guided by live three-dimensional image overlay. PMID:26358032

  7. Tumoral angiogenesis in both adrenal adenomas and nonadenomas: a promising computed tomography biomarker for diagnosis

    PubMed Central

    Wang, Xifu; Li, Kangan; Sun, Haoran; Zhao, Jinglong; Zhang, Zhuoli; Zheng, Linfeng; Li, Weiguo; Bai, Renju; Zhang, Guixiang

    2016-01-01

    To explore the correlation between the typical findings of dynamic contrast-enhanced computed tomography (DCE-CT) and tumoral angiogenesis (microvessel density [MVD] and vascular endothelial growth factor [VEGF]) in adenomas and nonadenomas such that the enhancement mechanism of DCE-CT in adrenal masses can be explained more precisely. Forty-two patients with 46 adrenal masses confirmed by surgery and pathology were included in the study; these masses included 23 adenomas, 18 nonadenomas, and 5 hyperplastic nodules. The findings of DCE-CT and angiogenesis in adrenal masses were studied. The features of DCE-CT in adenomas and nonadenomas were evaluated to determine whether the characteristics of DCE-CT in adrenal masses were closely correlated with tumoral angiogenesis. Adrenal adenomas were significantly different from nonadenomas in the time density curve and the mean percentage of enhancement washout at the 7-minute delay time in DCE-CT. The mean MVD and VEGF expression exhibited significant differences between the rapid washout group (types A and C) and the slow washout group (types B, D, and E) and between the relative washout (Washr) ≥34% and the absolute washout (Washa) ≥43% on the 7-minute enhanced CT scans (P=0.000). Adenomas were suggested when adrenal masses presented as types A and C, and/or the Washr ≥34%, and/or the Washa ≥43%, and the opposite was suggested for nonadenomas. These results showed a close correlation between the characteristics of DCE-CT and both MVD and VEGF expression in adrenal masses. There was also a significant difference in MVD and VEGF expression between adenomas and nonadenomas. In conclusion, MVD and VEGF expression are two important pathological factors that play important roles in the characterization of DCE-CT in adrenal masses because they cause different time density curve types, the Washr and the Washa for adrenal adenomas and nonadenomas. PMID:27099515

  8. Serum IGF1, IGF2 and IGFBP3 and risk of advanced colorectal adenoma.

    PubMed

    Gao, Ying; Katki, Hormuzd; Graubard, Barry; Pollak, Michael; Martin, Michael; Tao, Yuzhen; Schoen, Robert E; Church, Timothy; Hayes, Richard B; Greene, Mark H; Berndt, Sonja I

    2012-07-15

    The insulin-like growth factor (IGF) signaling pathway is involved in cell proliferation and differentiation. Elevated serum IGF1 levels have been associated with increased colorectal cancer risk; however, studies of this association with colorectal adenoma are inconclusive. We examined serum IGF1, IGF2 and IGFBP3 levels in relation to risk of advanced colorectal adenoma in a case-control study within the prostate, lung, colorectal and ovarian cancer screening trial. A total of 764 advanced, left-sided colorectal adenoma cases and 775 controls frequency-matched on gender and ethnicity, without evidence of a left-sided polyp on sigmoidoscopy were included in the current study. Serum levels of IGF1, IGF2 and IGFBP3 were measured using an enzyme linked immunosorbent assay in serum samples collected at baseline. Logistic regression was used to estimate the odds ratios (OR) and 95% confidence intervals (CI) for the associations adjusting for age, race, sex, year of blood draw, body mass index, smoking and education. Higher IGF1 levels were associated with increased adenoma risk: ORs = 1.58 (95% CI = 1.16-2.16), 1.42 (95% CI = 1.04-1.93), and 1.80 (95% CI = 1.30-2.47) for the second, third and fourth quartiles, respectively (p(trend) = 0.002). Elevated IGF2 levels were also associated with increased adenoma risk (OR = 1.43, 95% CI = 1.05-1.96 for the fourth vs. first quartile, p(trend) = 0.02), but the association was no longer significant after adjustment for IGF1 (p(trend) = 0.28). IGFBP3 levels were not associated with adenoma risk. Our analysis showed a significant positive association between circulating IGF1 levels and risk of advanced colorectal adenoma, suggesting that IGF1 is associated with the pivotal precursor to colorectal cancer. PMID:21932422

  9. Generation of Higher Order Modes in a Rectangular Duct

    NASA Technical Reports Server (NTRS)

    Gerhold, Carl H.; Cabell, Randolph H.; Brown, Donald E.

    2004-01-01

    Advanced noise control methodologies to reduce sound emission from aircraft engines take advantage of the modal structure of the noise in the duct. This noise is caused by the interaction of rotor wakes with downstream obstructions such as exit guide vanes. Mode synthesis has been accomplished in circular ducts and current active noise control work has made use of this capability to cancel fan noise. The goal of the current effort is to examine the fundamental process of higher order mode propagation through an acoustically treated, curved duct. The duct cross-section is rectangular to permit greater flexibility in representation of a range of duct curvatures. The work presented is the development of a feedforward control system to generate a user-specified modal pattern in the duct. The multiple-error, filtered-x LMS algorithm is used to determine the magnitude and phase of signal input to the loudspeakers to produce a desired modal pattern at a set of error microphones. Implementation issues, including loudspeaker placement and error microphone placement, are discussed. Preliminary results from a 9-3/8 inch by 21 inch duct, using 12 loudspeakers and 24 microphones, are presented. These results demonstrate the ability of the control system to generate a user-specified mode while suppressing undesired modes.

  10. Modeling low elevation GPS signal propagation in maritime atmospheric ducts

    NASA Astrophysics Data System (ADS)

    Zhang, Jinpeng; Wu, Zhensen; Wang, Bo; Wang, Hongguang; Zhu, Qinglin

    2012-05-01

    Using the parabolic wave equation (PWE) method, we model low elevation GPS L1 signal propagation in maritime atmospheric ducts. To consider sea surface impedance, roughness, and the effects of earth's curvature, we propose a new initial field model for the GPS PWE split-step solution. On the basis of the comparison between the proposed model and the conventional initial field model for a smooth, perfectly conducting sea surface on a planar earth, we conclude that both the amplitude and phase of the initial field are influenced by surface impedance and roughness, and that the interference behavior between direct and reflected GPS rays is affected by earth's curvature. The performance of the proposed model is illustrated with examples of low elevation GPS L1 signal propagation in three types of ducts: an evaporation duct, a surface-based duct, and an elevated duct. The GPS PWE is numerically implemented using the split-step discrete mixed Fourier transform algorithm to enforce impedance-type boundary conditions at the rough sea surface. Because the GPS signal is right hand circularly polarized, we calculate its power strength by combining the propagation predictions of the horizontally and the vertically polarized components. The effects of the maritime atmospheric ducts on low elevation GPS signal propagation are demonstrated according to the presented examples, and the potential applications of the GPS signals affected by ducts are discussed.

  11. Ducted fan type gas turbine engine power plants

    SciTech Connect

    Balzer, R.L.

    1992-02-25

    This patent describes a ducted fan type power plant which is cable of generating reverse thrust. It comprises: a gas turbine engine; a fan driven by the engine; an elongated bypass duct which is open at its front and rear ends and surrounds the fan, the bypass duct having a fixed forward section and a rear section which can be translated away from the fixed section as the pitch of the fan blades is reversed to reverse the flow of air through the bypass duct and generate a thrust directed from the front toward the rear of the power plant, thereby allowing air to be induced into the bypass duct through the downstream end thereof and also through the annular gap between the fixed and translated, rear sections of the bypass duct; means for generating a supply of high velocity fluid; means for injecting the high velocity fluid into the bypass duct from a locus to the rear means for delivering the high velocity fluid from the generating means to the injecting means.

  12. Hepatocellular adenomas associated with hepatic granulomas: experience in five cases.

    PubMed

    Bieze, Matthanja; Bioulac-Sage, Paulette; Verheij, Joanne; Balabaud, Charles; Laurent, Christophe; van Gulik, Thomas M

    2012-09-01

    We present five cases in whom two rare entities were simultaneously found within the liver, i.e. hepatocellular adenomas (HCAs) and granulomas. Coexistence of both entities confuses diagnosis. Our aim is to disclose the association between HCA and hepatic granulomas. Five patients presented with HCA for which they underwent resection. During laparotomy or at pathological examination, granulomas were found in tumorous and non-tumorous tissue. No specific cause for the granulomas was found. Immunohistochemistry showed overexpression of C-reactive protein and serum amyloid A in 4/5 patients, classifying these lesions as inflammatory HCA. HCA and especially the inflammatory subtype may cause formation of granulomas in (peri-)tumorous tissue as a local response to persistent inflammation and/or the presence of a tumor. Both HCA and hepatic granulomas have also been associated with oral contraceptive use. In conclusion, HCAs associated with hepatic granulomas derive from a local response to (inflammatory) HCA or neoplasm, chronic use of oral contraceptives, or a combination of these factors. PMID:23185149

  13. Hepatocellular Adenomas Associated with Hepatic Granulomas: Experience in Five Cases

    PubMed Central

    Bieze, Matthanja; Bioulac-Sage, Paulette; Verheij, Joanne; Balabaud, Charles; Laurent, Christophe; van Gulik, Thomas M.

    2012-01-01

    We present five cases in whom two rare entities were simultaneously found within the liver, i.e. hepatocellular adenomas (HCAs) and granulomas. Coexistence of both entities confuses diagnosis. Our aim is to disclose the association between HCA and hepatic granulomas. Five patients presented with HCA for which they underwent resection. During laparotomy or at pathological examination, granulomas were found in tumorous and non-tumorous tissue. No specific cause for the granulomas was found. Immunohistochemistry showed overexpression of C-reactive protein and serum amyloid A in 4/5 patients, classifying these lesions as inflammatory HCA. HCA and especially the inflammatory subtype may cause formation of granulomas in (peri-)tumorous tissue as a local response to persistent inflammation and/or the presence of a tumor. Both HCA and hepatic granulomas have also been associated with oral contraceptive use. In conclusion, HCAs associated with hepatic granulomas derive from a local response to (inflammatory) HCA or neoplasm, chronic use of oral contraceptives, or a combination of these factors. PMID:23185149

  14. Activating mutations in CTNNB1 in aldosterone producing adenomas.

    PubMed

    Åkerström, Tobias; Maharjan, Rajani; Sven Willenberg, Holger; Cupisti, Kenko; Ip, Julian; Moser, Ana; Stålberg, Peter; Robinson, Bruce; Alexander Iwen, K; Dralle, Henning; Walz, Martin K; Lehnert, Hendrik; Sidhu, Stan; Gomez-Sanchez, Celso; Hellman, Per; Björklund, Peyman

    2016-01-01

    Primary aldosteronism (PA) is the most common cause of secondary hypertension with a prevalence of 5-10% in unreferred hypertensive patients. Aldosterone producing adenomas (APAs) constitute a large proportion of PA cases and represent a surgically correctable form of the disease. The WNT signaling pathway is activated in APAs. In other tumors, a frequent cause of aberrant WNT signaling is mutation in the CTNNB1 gene coding for β-catenin. Our objective was to screen for CTNNB1 mutations in a well-characterized cohort of 198 APAs. Somatic CTNNB1 mutations were detected in 5.1% of the tumors, occurring mutually exclusive from mutations in KCNJ5, ATP1A1, ATP2B3 and CACNA1D. All of the observed mutations altered serine/threonine residues in the GSK3β binding domain in exon 3. The mutations were associated with stabilized β-catenin and increased AXIN2 expression, suggesting activation of WNT signaling. By CYP11B2 mRNA expression, CYP11B2 protein expression, and direct measurement of aldosterone in tumor tissue, we confirmed the ability for aldosterone production. This report provides compelling evidence that aberrant WNT signaling caused by mutations in CTNNB1 occur in APAs. This also suggests that other mechanisms that constitutively activate the WNT pathway may be important in APA formation. PMID:26815163

  15. Giant parotid pleomorphic adenoma in a Nigerian male.

    PubMed

    Akintububo, O B; Ogundipe, O K; Kaltungo, Z Y; Guduf, M I; Pindiga, U H; Abdullahi, Y M

    2016-01-01

    Pleomorphic adenoma (PA) is the most common benign salivary gland tumor, accounting for up to 60% of all tumors of the salivary gland and 75-80% of all parotid tumors. It has a slow but progressive growth pattern and if untreated can become greatly enlarged in size. However, giant PA is uncommon. We report a case of giant parotid PA of more than 10 years duration in a 60-year-old male Nigerian. A 60-year-old male patient with 10-year history of painless, massive, and pedunculated swelling in the left side of lower face measuring 25 cm × 23 cm × 17 cm in dimension. Computerized tomographic scan and percutaneous fine needle aspiration cytology returned a preliminary diagnosis of PA. Superficial parotidectomy with facial nerve preservation via the transcervical approach was performed. The excised mass weighed 5.5 kg while the postoperative healing was satisfactory. Benign PAs may attain a giant size if left untreated. Socioeconomic problems are some of the reasons for late presentation. Adequate excision of the tumor sparing the facial nerve is possible but intraoperative and reactionary hemorrhage are likely complications. PMID:27538561

  16. Nephrogenic adenoma in elderly patients: Three case reports

    PubMed Central

    Sakatani, Toru; Adachi, Yasushi; Sakaida, Noriko; Atsuta, Takeshi; Magaribuchi, Toshihiro; Taki, Yoji; Nakano, Yorika; Li, Ming; Ikehara, Susumu

    2016-01-01

    Nephrogenic adenoma (NA), referred to as nephrogenic metaplasia, is a rare benign lesion of the urinary tract. NA is histologically characterized by tubular and papillary formations lined by low cuboidal to columnar epithelial cells. NA is also immunohistochemically characterized by positivity for paired box (PAX) 2, PAX8 and cytokeratin 7, and negative for p63 and prostate-specific antigen. In this study, we present 3 cases of NA arising in the urinary bladder of elderly male patients with predisposing factors: patient 1 had undergone transurethral lithotripsy due to a ureteral stone; patient 2 had undergone transurethral resection of a urothelial carcinoma in the urinary bladder; and patient 3 had been treated with Bacillus-Calmettle-Guérin due to a urothelial carcinoma in the urinary bladder. The characteristics of the NAs of our 3 cases were histologically and immunohistologically consistent with previously reported cases, although 1 patient exhibited a pseudoinvasive pattern. Since NA is a tumor-like benign lesion, it should be clearly differentiated morphologically and immunohistologically from other tumors arising in the urinary tract and from invasion by prostate cancer. PMID:27446559

  17. Undescended parathyroid adenomas as cause of persistent hyperparathyroidism

    PubMed Central

    Mateu, Germán; Lorente-Poch, Leyre; Sancho, Juan J.; Sitges-Serra, Antonio

    2015-01-01

    Background Undescended glands are a rare cause of primary and secondary hyperparathyroidism (HPT), but they are more common, however, among patients with recurrent HPT or those who have undergone a failed initial cervical exploration. The currently development of more precise noninvasive imaging techniques has improved the results of preoperative diagnosis of these ectopic lesions. Methods The operative reports of patients undergoing parathyroidectomy at our institution were reviewed to identify patients with an undescended parathyroid gland adenomas. Demographic, clinical, imaging and surgical variables were recorded. Results Three patients were included: 2/598 parathyroidectomies performed for primary HPT and 1/93 performed for secondary HPT. One case is presented as jaw tumor syndrome (JTS). All the patients had undergone at least one operation before the definitive focused surgery and represented 6% of our parathyroid reoperations. No significant complications and no recurrences were observed in the long-term follow up. Conclusions Accurate preoperative localization of these lesions was possible with noninvasive studies. High cure rate is possible through selective approach when accurate preoperative localization. Thorough knowledge of parathyroid embryology and meticulous surgical technique are essential, particularly in patients with previous unsuccessful explorations. PMID:26312215

  18. Notch as a Possible Cell Differentiation Factor in Pleomorphic Adenomas

    PubMed Central

    Takamine, Keisuke; Ueda, Yukiko; Nakano, Keisuke; Ochiai, Takanaga; Sugita, Yoshihiko; Kubo, Katsutoshi; Maeda, Hatsuhiko; Hasegawa, Hiromasa; Kawakami, Toshiyuki

    2015-01-01

    The expression of Notch in 30 cases of pleomorphic adenoma was examined by immunohistochemistry. Comparing the results of our study with previous literatures, from the partial CK7 expression and substantial Notch expression in ductal epithelial cells as well as the Notch expression in solid tumor nests, it can be inferred that Notch is involved in cell differentiation. CK13 expression was observed in cells undergoing squamous metaplasia and Notch expression was seen in the nucleus of basal and squamous cells. The intense Notch expression in basal cells and weak expression in squamous cells suggests that Notch is involved in the differentiation from basal to squamous cell. Moreover, the loss of nuclear expression on the inner layer would signify that differentiation is about to end or has been terminated. Notch was expressed in the cytoplasm of cartilage cells and in the cell membrane of mucous cells but not in the nucleus indicating that differentiation has been concluded. Notch involvement is suspected in cell differentiation in areas showing ductal structures and squamous metaplasia. In summary, Notch is involved in cell differentiation of ductal cells in PA. Nuclear expression was shown in tumor cells in solid nests and surrounding structures. Moreover, Notch is expressed by basal cells undergoing squamous metaplasia suggesting the participation of Notch in cell differentiation in PA. PMID:26516303

  19. Activating mutations in CTNNB1 in aldosterone producing adenomas

    PubMed Central

    Åkerström, Tobias; Maharjan, Rajani; Sven Willenberg, Holger; Cupisti, Kenko; Ip, Julian; Moser, Ana; Stålberg, Peter; Robinson, Bruce; Alexander Iwen, K.; Dralle, Henning; Walz, Martin K.; Lehnert, Hendrik; Sidhu, Stan; Gomez-Sanchez, Celso; Hellman, Per; Björklund, Peyman

    2016-01-01

    Primary aldosteronism (PA) is the most common cause of secondary hypertension with a prevalence of 5–10% in unreferred hypertensive patients. Aldosterone producing adenomas (APAs) constitute a large proportion of PA cases and represent a surgically correctable form of the disease. The WNT signaling pathway is activated in APAs. In other tumors, a frequent cause of aberrant WNT signaling is mutation in the CTNNB1 gene coding for β-catenin. Our objective was to screen for CTNNB1 mutations in a well-characterized cohort of 198 APAs. Somatic CTNNB1 mutations were detected in 5.1% of the tumors, occurring mutually exclusive from mutations in KCNJ5, ATP1A1, ATP2B3 and CACNA1D. All of the observed mutations altered serine/threonine residues in the GSK3β binding domain in exon 3. The mutations were associated with stabilized β-catenin and increased AXIN2 expression, suggesting activation of WNT signaling. By CYP11B2 mRNA expression, CYP11B2 protein expression, and direct measurement of aldosterone in tumor tissue, we confirmed the ability for aldosterone production. This report provides compelling evidence that aberrant WNT signaling caused by mutations in CTNNB1 occur in APAs. This also suggests that other mechanisms that constitutively activate the WNT pathway may be important in APA formation. PMID:26815163

  20. Medical Management of Functioning Pituitary Adenoma: An Update

    PubMed Central

    OKI, Yutaka

    2014-01-01

    The treatment of functioning pituitary adenoma (FPA) must achieve endocrinological remission as well as tumor size reduction. The first-line treatment of FPA except prolactinoma is transsphenoidal surgery (TSS). Medical treatments and/or radiation will be applied as adjuvant therapies succeeding to TSS. In patients with prolactinoma, dopamine agonists, especially cabergoline, are quite efficient. Dopamine agonists decrease plasma prolactin levels and induce shrinkage in most patients and can be ceased in some of them. In patients with acromegaly, dopamine agonists, somatostatin analogues, and growth hormone receptor antagonist have been used as a monotherapy or the combination, and the high remission rate can be achieved. Pasireotide having high affinity to type 5 somatostatin receptors will be available for the patients presenting resistance against type 2 receptor agonists, such as octreotide and lanreotide. The preceding treatment with somatostatin analogues is beneficial for improving the success rate of TSS. The chimera compounds of somatostatin analogues and dopamine agonists have been investigated. The medical treatments of Cushing's disease are challenging, if TSS is not successful. To suppress ACTH secretion, dopamine agonists and somatostatin analogues have been examined, but neither came to show a sufficient effect. Pasireotide reduces urinary cortisol excretion with a high remission rate. Adrenal enzyme inhibitors (AEIs), such as metyrapone, can inhibit cortisol synthesis form adrenal glands promptly and sufficiently in most of patients. LCI699, a newly developed AEI, is more potent than metyrapone and will be available. We should use available medical treatments for improving the prognosis and quality of life. PMID:25446388

  1. Post-surgical management of non-functioning pituitary adenoma.

    PubMed

    Cortet-Rudelli, Christine; Bonneville, Jean-François; Borson-Chazot, Françoise; Clavier, Lorraine; Coche Dequéant, Bernard; Desailloud, Rachel; Maiter, Dominique; Rohmer, Vincent; Sadoul, Jean Louis; Sonnet, Emmanuel; Toussaint, Patrick; Chanson, Philippe

    2015-07-01

    Post-surgical surveillance of non-functioning pituitary adenoma (NFPA) is based on magnetic resonance imaging (MRI) at 3 or 6 months then 1 year. When there is no adenomatous residue, annual surveillance is recommended for 5 years and then at 7, 10 and 15 years. In case of residue or doubtful MRI, prolonged annual surveillance monitors any progression. Reintervention is indicated if complete residue resection is feasible, or for symptomatic optic pathway compression, to create a safety margin between the tumor and the optic pathways ahead of complementary radiation therapy (RT), or in case of post-RT progression. In case of residue, unless the tumor displays elevated growth potential, it is usually recommended to postpone RT until progression is manifest, as efficacy is comparable whether treatment is immediate or postponed. The efficacy of the various RT techniques in terms of tumor volume control is likewise comparable. RT-induced hypopituitarism is frequent, whatever the technique. The choice thus depends basically on residue characteristics: size, delineation, and proximity to neighboring radiation-sensitive structures. Reduced rates of vascular complications and secondary brain tumor can be hoped for with one-dose or hypofractionated stereotactic RT, but there has been insufficient follow-up to provide evidence. Somatostatin analogs and dopaminergic agonists have yet to demonstrate sufficient efficacy. Temozolomide is an option in aggressive NFPA resistant to surgery and RT. PMID:26116412

  2. Confocal laser endomicroscopy features of sessile serrated adenomas/polyps

    PubMed Central

    Parikh, Neil D; Gibson, Joanna; Nagar, Anil; Ahmed, Ali A

    2015-01-01

    Background and aims Sessile serrated adenomas/polyps (SSA/Ps) are difficult to differentiate from non-neoplastic tissue on white-light endoscopy. Confocal laser endomicroscopy (CLE) provides subcellular imaging and real-time “optical biopsy”. The aim of this study was to prospectively describe CLE features of SSA/Ps. Patients and methods Consecutive patients with SSA/Ps were prospectively evaluated with probe-based CLE imaging. CLE images and polyp histology were independently reviewed by three endoscopists and an expert gastrointestinal (GI) pathologist. Distinguishing CLE features of SSA/Ps were identified in conjunction with pathologic correlation. Results In total, 260 CLE images were generated from nine SSA/Ps evaluated in seven patients. Four consensus CLE features of SSA/P were identified: (1) a mucus cap with a bright, cloud-like appearance; (2) thin, branching crypts; (3) increased number of goblet cells and microvesicular mucin-containing cells; and (4) architectural disarray, with dystrophic goblet cells and lack of regular circular crypts Conclusion This is a novel description of characteristic CLE features of SSA/Ps. The four features we identified are easy to detect and may allow for CLE to serve as a diagnostic modality. PMID:27536371

  3. Satellite tumors surrounding primary pleomorphic adenomas of the parotid gland.

    PubMed

    Orita, Yorihisa; Hamaya, Kazuo; Miki, Kentaroh; Sugaya, Akiko; Hirai, Misato; Nakai, Kiyoko; Nose, Sohichiroh; Yoshino, Tadashi

    2010-05-01

    The occasional local recurrence of benign pleomorphic adenoma (PA) has generally been attributed to the vulnerability of the tumor capsule. Although some reports have also noted the presence of satellite tumors associated with PA recurrence, only few reports have focused on this issue. We paid special attention to the satellite lesions apart from the main tumors and discussed their frequency, origin, nature and the ways of treating them. A total of 108 specimens of primary parotid gland PA resected at the Okayama Saiseikai General Hospital from 1988 to 2008 were microscopically reviewed. Four (3.7%) patients displayed a main mass with satellite tumors in a single parotid gland. The immunohistochemical analysis of p53 and Ki-67 index showed no distinct difference between PAs with satellite tumors and those without. Satellite tumors surrounding the main mass of parotid PA is relatively rare. In most cases, such satellite tumors will arise from capsular perforation of the primary tumor cells. Preoperative evaluation to recognize the existence of satellite tumors would be important and capsular dissection should be discouraged. We could not find any evidence suggesting that primary PA with satellite tumors could be more biologically aggressive than those without. PMID:19898859

  4. Remnant cystic duct adenocarcinoma presenting as gastric outlet obstruction

    PubMed Central

    Lo, Samuel Tsoon Wuan; Cheng, Yue; Cheung, Frances; Tang, Chung Ngai

    2016-01-01

    Only a few case reports of remnant cystic duct carcinoma exist. The presented case of remnant cystic duct carcinoma with invasion to pylorus and bulbus of duodenum leading to gastric outlet obstruction was the first of its kind. We reviewed all cases of remnant cystic duct carcinoma that we found in the literature and summarized its definition, presentation, extent of invasion and clinical outcome after operation. The diagnosis can be difficult due to the rarity of disease, locally advanced nature of disease and distorted postoperative anatomy. A high index of suspicion can increase the likelihood of a preoperative diagnosis. PMID:27154747

  5. Finite-amplitude waves in cylindrical lined ducts

    NASA Technical Reports Server (NTRS)

    Nayfeh, A. H.; Tsai, M.-S.

    1974-01-01

    A second-order uniformly valid expansion is obtained for nonlinear waves propagating in a cylindrical duct lined with a point-reacting acoustic material that consists of a porous sheet followed by honey-comb cavities and backed by the impervious walls of the duct. The effect of the liner is taken into account by coupling the waves in the duct with those in the liner. As in the two-dimensional case, the nonlinearity increases the attenuation rate at all frequencies except in narrow bandwidths around the resonant frequencies, irrespective of the geometrical dimensions of the liner or the acoustic properties of the porous sheet.

  6. Subsonic Flows through S-Ducts with Flow Control

    NASA Astrophysics Data System (ADS)

    Chen, Yi

    An inlet duct of an aircraft connects the air intake mounted on the fuselage to the engine within the aircraft body. The ideal outflow quality of the duct is steady, uniform and of high total pressure. Recently compact S-shaped inlet ducts are drawing more attention in the design of UAVs with short propulsion system. Compact ducts usually involve strong streamwise adverse pressure gradient and transverse secondary flow, leading to large-scale harmful vortical structures in the outflow. To improve the outflow quality modern flow control techniques have to be applied. Before designing successful flow control methods a solid understanding of the baseline flow field with the duct is crucial. In this work the fundamental mechanism of how the three dimensional flow topology evolves when the relevant parameters such as the duct geometry and boundary layer thickness are varied, is studied carefully. Two distinct secondary-flow patterns are identified. For the first time the sensitivity of the flow topology to the inflow boundary layer thickness in long ducts is clearly addressed. The interaction between the transverse motion induced by the transverse pressure gradient and the streamwise separation is revealed as the crucial reason for the various flow patterns existing in short ducts. A non-symmetric flow pattern is identified for the first time in both experiments and simulations in short ducts in which the intensity of the streamwise separation and the transverse invasion are in the same order of magnitude. A theory of energy accumulation and solution bifurcation is used to give a reasonable explanation for this non-symmetry. After gaining the knowledge of where and how the harmful vortical structures are generated several flow control techniques are tested to achieve a better outflow quality. The analysis of the flow control cases also provides a deeper insight into the behavior of the three-dimensional flow within the ducts. The conventional separation control method

  7. Modal density function and number of propagating modes in ducts

    NASA Technical Reports Server (NTRS)

    Rice, E. J.

    1976-01-01

    Often raised questions in duct sound propagation studies involve the total number of propagating modes, the number of propagating radial modes for a particular spinning lobe number, and the number of modes possible between two given values of cutoff ratio or eigenvalue. These questions can be answered approximately by using the modal distribution function which is the integral of the modal density function for ducts in a manner similar to that previously published for architectural acoustics. The modal density functions are derived for rectangular and circular ducts with a uniform steady flow. Results from this continuous theory are compared to the actual (discrete) modal distributions.

  8. Millimetre-wave propagation in the evaporation duct

    NASA Astrophysics Data System (ADS)

    Levy, M. F.; Craig, K. H.

    1990-03-01

    Recent developments in propagation modeling based on the Parabolic Equation Method allow the forecasting of two-dimensional antenna coverage diagrams at millimeter wavelengths, in a dispersive atmosphere with arbitrary two-dimensional variation of the refractive index. The model was applied successfully to mm-wave propagation in the evaporation duct. The evaporation duct height is not sufficient to characterize mm-wave propagation, and information on the water vapor content is essential for the correct modeling of atmospheric absorption. Turbulence simulations were carried out, showing marked scintillation, effects in the evaporation duct. The method can be applied to arbitrary refractivity spectra, and gives a complete numerical description of the field statistics.

  9. Influence of evaporation ducts on radar sea return

    NASA Astrophysics Data System (ADS)

    Reilly, J. P.; Dockery, G. D.

    1990-04-01

    Modeling of radar sea return is discussed with consideration of propagation conditions. Both the intensity and propagation direction of energy incident at the sea surface can be significantly affected by the refractive condition of the atmosphere. The paper describes and evaluates a model that incorporates both of these effects for the situation where the propagation conditions are characterized as evaporation ducts. Such ducts are the most persistent marine propagation environment on a worldwide basis for low-altitude propagation. It is shown that commonly encountered evaporation ducts can profoundly affect sea returns.

  10. Determination of the evaporation duct height from standard meteorological data

    NASA Astrophysics Data System (ADS)

    Ivanov, V. K.; Shalyapin, V. N.; Levadnyi, Yu. V.

    2007-02-01

    Four models used for evaluating the height of the evaporation duct from measured atmospheric pressure, water and air temperatures, and air humidity are considered.The calculated results are compared with the duct heights measured during two oceanographic expeditions in the tropical zone of the Atlantic Ocean and the equatorial zone of the Indian Ocean. The sensitivity of models to the errors in the meteorological parameters is investigated. It is shown that, in the case of unstable stratification, the heights of ducts in the 5 20-m range can be evaluated with an error of about 2.5 m. Recommendations for selection of optimal models are given.

  11. EFFECT OF AIRFLOW AND HEAT INPUT RATES ON DUCT EFFICIENCY.

    SciTech Connect

    ANDREWS,J.W.

    2003-05-28

    Reducing the airflow and heat input rates of a furnace that is connected to a duct system in thermal contact with unconditioned spaces can significantly reduce thermal distribution efficiency. This is a straightforward theoretical calculation based on the increased residence time of the air in the duct at the lower flow rate, which results in greater conduction losses. Experimental tests in an instrumented residential-size duct system have confirmed this prediction. Results are compared with the heat-loss algorithm in ASHRAE Standid 152P. The paper concludes with a discussion of possible remedies for this loss of efficiency in existing systems and optional design strategies in new construction.

  12. Duplicated extrahepatic bile duct identified following cholecystectomy injury

    PubMed Central

    Hoepfner, Lauren; Sweeney, Mary Katherine; White, Jared A.

    2016-01-01

    Though variations of intrahepatic biliary anatomy are quite common, duplication of the extrahepatic biliary system is extremely rare and reported infrequently in the literature. Laparoscopic cholecystectomy is one of the most common general surgery procedures performed. Unfortunately, iatrogenic bile duct injuries can contribute to significant morbidity including hospital readmissions, infectious complications and death. Anomalous extrahepatic biliary anatomy may be one of the factors, which increases the likelihood of bile duct injury during laparoscopic cholecystectomy. We present a case of an iatrogenic bile duct injury that occurred during a laparoscopic cholecystectomy, in which a duplicated extrahepatic biliary system was identified intraoperatively during the definitive operative repair. PMID:27141049

  13. Transition duct with late injection in turbine system

    SciTech Connect

    LeBegue, Jeffrey Scott; Pentecost, Ronnie Ray; Flanagan, James Scott; Kim, Won -Wook; McMahan, Kevin Weston

    2015-09-15

    A system for supplying an injection fluid to a combustor is disclosed. The system includes a transition duct comprising an inlet, an outlet, and a passage extending between the inlet and the outlet and defining a longitudinal axis, a radial axis, and a tangential axis. The outlet of the transition duct is offset from the inlet along the longitudinal axis and the tangential axis. The passage defines a combustion chamber. The system further includes a tube providing fluid communication for the injection fluid to flow through the transition duct and into the combustion chamber.

  14. Observations of Strong Surface Radar Ducts over the Persian Gulf.

    NASA Astrophysics Data System (ADS)

    Brooks, Ian M.; Goroch, Andreas K.; Rogers, David P.

    1999-09-01

    Ducting of microwave radiation is a common phenomenon over the oceans. The height and strength of the duct are controlling factors for radar propagation and must be determined accurately to assess propagation ranges. A surface evaporation duct commonly forms due to the large gradient in specific humidity just above the sea surface; a deeper surface-based or elevated duct frequently is associated with the sudden change in temperature and humidity across the boundary layer inversion.In April 1996 the U.K. Meteorological Office C-130 Hercules research aircraft took part in the U.S. Navy Ship Antisubmarine Warfare Readiness/Effectiveness Measuring exercise (SHAREM-115) in the Persian Gulf by providing meteorological support and making measurements for the study of electromagnetic and electro-optical propagation. The boundary layer structure over the Gulf is influenced strongly by the surrounding desert landmass. Warm dry air flows from the desert over the cooler waters of the Gulf. Heat loss to the surface results in the formation of a stable internal boundary layer. The layer evolves continuously along wind, eventually forming a new marine atmospheric boundary layer. The stable stratification suppresses vertical mixing, trapping moisture within the layer and leading to an increase in refractive index and the formation of a strong boundary layer duct. A surface evaporation duct coexists with the boundary layer duct.In this paper the authors present aircraft- and ship-based observations of both the surface evaporation and boundary layer ducts. A series of sawtooth aircraft profiles map the boundary layer structure and provide spatially distributed estimates of the duct depth. The boundary layer duct is found to have considerable spatial variability in both depth and strength, and to evolve along wind over distances significant to naval operations (100 km). The depth of the evaporation duct is derived from a bulk parameterization based on Monin-Obukhov similarity theory

  15. Exome capture sequencing of adenoma reveals genetic alterations in multiple cellular pathways at the early stage of colorectal tumorigenesis.

    PubMed

    Zhou, Donger; Yang, Liu; Zheng, Liangtao; Ge, Weiting; Li, Dan; Zhang, Yong; Hu, Xueda; Gao, Zhibo; Xu, Jinghong; Huang, Yanqin; Hu, Hanguang; Zhang, Hang; Zhang, Hao; Liu, Mingming; Yang, Huanming; Zheng, Lei; Zheng, Shu

    2013-01-01

    Most of colorectal adenocarcinomas are believed to arise from adenomas, which are premalignant lesions. Sequencing the whole exome of the adenoma will help identifying molecular biomarkers that can predict the occurrence of adenocarcinoma more precisely and help understanding the molecular pathways underlying the initial stage of colorectal tumorigenesis. We performed the exome capture sequencing of the normal mucosa, adenoma and adenocarcinoma tissues from the same patient and sequenced the identified mutations in additional 73 adenomas and 288 adenocarcinomas. Somatic single nucleotide variations (SNVs) were identified in both the adenoma and adenocarcinoma by comparing with the normal control from the same patient. We identified 12 nonsynonymous somatic SNVs in the adenoma and 42 nonsynonymous somatic SNVs in the adenocarcinoma. Most of these mutations including OR6X1, SLC15A3, KRTHB4, RBFOX1, LAMA3, CDH20, BIRC6, NMBR, GLCCI1, EFR3A, and FTHL17 were newly reported in colorectal adenomas. Functional annotation of these mutated genes showed that multiple cellular pathways including Wnt, cell adhesion and ubiquitin mediated proteolysis pathways were altered genetically in the adenoma and that the genetic alterations in the same pathways persist in the adenocarcinoma. CDH20 and LAMA3 were mutated in the adenoma while NRXN3 and COL4A6 were mutated in the adenocarcinoma from the same patient, suggesting for the first time that genetic alterations in the cell adhesion pathway occur as early as in the adenoma. Thus, the comparison of genomic mutations between adenoma and adenocarcinoma provides us a new insight into the molecular events governing the early step of colorectal tumorigenesis. PMID:23301059

  16. Urinary PGE-M levels are associated with risk of colorectal adenomas and chemopreventive response to anti-inflammatory drugs.

    PubMed

    Bezawada, Navya; Song, Mingyang; Wu, Kana; Mehta, Raaj S; Milne, Ginger L; Ogino, Shuji; Fuchs, Charles S; Giovannucci, Edward L; Chan, Andrew T

    2014-07-01

    Prostaglandin E2 (PGE2) promotes colorectal carcinogenesis. Overall, systemic PGE2 production can be assessed by measuring its major metabolite, PGE-M, in urine. We examined the potential role of PGE-M as a biomarker for colorectal adenoma risk and chemopreventive response to anti-inflammatory drugs. We conducted a prospective case-control study nested within the Nurses' Health Study. Among women who previously provided a urine sample, we identified 420 cases diagnosed with colorectal adenoma during follow-up and matched them to 420 endoscopy-negative controls. We measured urinary PGE-M using an LC/MS assay. Compared with women in the lowest quartile of urinary PGE-M, women in the highest quartile had a multivariate OR of 1.40 (95% confidence interval (CI), 0.92-2.14) for any adenoma; 0.91 (95% CI, 0.48-1.72) for low-risk adenoma (solitary adenoma <1 cm in greatest diameter with tubular/unspecified histology); and 1.66 (95% CI, 1.04-2.67) for high-risk adenoma (adenoma ≥1 cm in greatest diameter and/or tubulovillous, villous or high-grade dysplasia histology or multiple adenomas of any size or histology). Regular use of anti-inflammatory drugs (≥2 standard tablets of aspirin/NSAIDs per week) was associated with a significant reduction in adenoma risk (multivariate OR, 0.61; 95% CI, 0.43-0.87) in women with high baseline PGE-M (quartiles 2-4), but not low PGE-M (quartile 1).Urinary PGE-M is associated with an increased risk of high-risk adenoma. Anti-inflammatory drugs seem to reduce adenoma risk among women with high, but not low PGE-M. Urinary PGE-M may serve as a biomarker to define subsets of the population who may obtain differential chemopreventive benefit from anti-inflammatory drugs. PMID:24824037

  17. Synchronous giant hepatic adenoma in siblings-A case report and brief literature review.

    PubMed

    Zhang, Chengsheng; Shi, Xuetao; Zhao, Lei

    2016-07-01

    A 47-year-old woman was referred to our department for a hepatic mass. She denied history of hepatitis or alcohol consumption and regular oral contraceptive use, except for the emergency contraceptive pill taken once a decade ago. Hepatitis B surface antigen and anti-hepatitis C antibody were negative, α-fetoprotein was within normal limit. CT scan revealed an enormous mass measuring 26.0×16 5×13 0 cm that almost totally replaced the right hepatic lobe. The neoplasm was completely resected and pathologically diagnosed as hepatic adenoma. Literature review indicates this is the largest hepatic adenoma reported so far. At the same time, clinical examination also revealed a hepatic mass in the patient's 42-year-old brother, which was pathologically confirmed as hepatic adenoma, too. He denied history of anabolic steroid use. Immunohistochemical analysis revealed the subtypes of both tumors as the inflammatory hepatic adenoma. Literature review indicates this is the first report of synchronous hepatic adenomas in siblings. PMID:27096392

  18. Epithelial-Mesenchymal Transition Protein Expression in Basal Cell Adenomas and Basal Cell Adenocarcinomas.

    PubMed

    Tesdahl, Brennan A; Wilson, Thomas C; Hoffman, Henry T; Robinson, Robert A

    2016-06-01

    Basal cell adenomas and basal cell adenocarcinomas show marked histomorphologic similarity and are separated microscopically primarily by the invasive characteristics of the adenocarcinomas. We wished to explore potential differences in the expression of epithelial-mesenchymal transition associated proteins in these two tumor types. A tissue microarray was constructed utilizing 29 basal cell adenomas and 16 basal cell adenocarcinomas. Immunohistochemical expression of E-cadherin, beta-catenin, Twist 1 and vimentin were investigated. Both tumors expressed all proteins in a relatively similar manner. Nuclear beta-catenin was essentially limited to the abluminal cell populations in both tumor types. E-cadherin was limited largely to luminal locations but was more prevalent in the adenocarcinomas as compared to the adenomas. Primarily abluminal expression for vimentin was seen, sometimes present in an apical dot-like pattern. Distinct populations of cellular expression of these four markers of epithelial mesenchymal transition were present but were similar in locations in both tumors with no patterns discerned to separate basal cell adenoma from basal cell adenocarcinoma. Given these findings, the mechanisms by which basal cell adenocarcinoma is able to invade while its counterpart, basal cell adenoma can not, may be more complex than in other tumor types. PMID:26442856

  19. Acromegaly due to a Macroinvasive Plurihormonal Pituitary Adenoma and a Rectal Carcinoid Tumor

    PubMed Central

    Chin, Sang Ouk; Hwang, Jin-Kyung; Rhee, Sang Youl; Chon, Suk; Oh, Seungjoon; Lee, Misu; Pellegata, Natalia S.

    2015-01-01

    A macroinvasive pituitary adenoma with plurihormonality usually causes acromegaly and hyperprolactinemia, and also accompanies with neurologic symptoms such as visual disturbances. However, its concurrent presentation with a rectal carcinoid tumor is rarely observed. This study reports the history, biochemical, colonoscopic and immunohistochemical results of a 48-year-old female with acromegaly and hyperprolactinemia. Despite the large size and invasive nature of the pituitary adenoma to adjacent anatomical structures, she did not complain of any neurologic symptoms such as visual disturbance or headache. Immunohistochemical staining of the surgical specimen from the pituitary adenoma revealed that the tumor cells were positive for growth hormone (GH), prolactin (PRL), and thyroid stimulating hormone (TSH). Staining for pituitary-specific transcription factor-1 (Pit-1) was shown to be strongly positive, which could have been possibly contributing to the plurihormonality of this adenoma. Colonoscopy found a rectal polyp that was identified to be a carcinoid tumor using immunohistochemical staining. A macroinvasive pituitary adenoma with concomitant rectal carcinoid tumor was secreting GH, PRL, and TSH, which were believed to be in association with over-expression of Pit-1. This is the first case report of double primary tumors comprising a plurihormonal pituitary macroadenoma and rectal carcinoid tumor. PMID:25559714

  20. Enhanced Mixing in a Rectangular Duct

    NASA Technical Reports Server (NTRS)

    Liscinsky, D. S.; True, B.

    2003-01-01

    An experimental investigation of the mixing of non-reacting opposed rows of jets injected normal to a confined rectangular crossflow has been conducted. Planar Mie-scattering was used to measure the time-average concentration distribution of the jet fluid in planes perpendicular to the duct axis. Particular emphasis was placed on the study of closely spaced orifice configurations applicable to the mixing zone of an RQL combustor. Baseline studies were performed of mixing under "ideal" conditions, i.e., plenum fed jets injecting into a crossflow uniform in velocity and turbulence intensity. In addition, more practical ("non-ideal") issues encountered during hardware design were also studied. As in other studies, mixing effectiveness, determined using a spatial unmixedness parameter based on the variance of mean jet concentration distributions, was found to be optimum when the spacing-to-duct-height ratio was inversely proportional to the square root of the jet-to-mainstream momentum-flux ratio. This relationship is suitable for design under ideal flow conditions. Inlet flow boundary conditions of the jet and approach flow (mainstream) were found to strongly influence mixing performance, but no attempt was made to determine optimum performance under non-ideal conditions. The tests performed do offer some guidance as to expected mixing behavior for several common variables likely to be imposed by hardware constraints. Additionally, in this study it was found that for rows of orifices with opposite centerlines inline, mixing was similar for blockages up to 89 percent (previous crossflow mixing studies concerned with dilution zone configurations, blockages were typically less than 50 percent). Lower levels of unmixedness were obtained as a function of downstream location when axial injection length was minimized. Mixing may be enhanced if orifice centerlines of opposed rows are staggered, but blockage must be =50 percent in this configuration. Round hole and "square