27 research outputs found
Adrenal cyst with both Müllerian and mesothelial differentiation - a clinicopathological and immunohistochemical study with implications for histogenesis
No full textTrue epithelial-lined cysts are rare forms of
adrenal cystic lesions, the pathogenesis of which is still
not fully understood. In this report we present a case of
an adrenal cyst diagnosed incidentally on imaging in a
31-year-old, previously healthy, obese woman. Due to
non-specific hormonal disorders and enlargement of the
lesion, a right-sided laparoscopic adrenalectomy was
performed. The cyst was lined predominantly by ciliated
cuboidal-to-columnar, Müllerian-type epithelium, and
focally by flat-to-cuboidal, mesothelium-like lining.
Immunohistochemistry demonstrated a strong positive
reaction in the cells of both types of lining for
CKAE1/AE3, CK19, CK7 and WT1, and both had a
negative reaction for CK20, CD34, Melan-A, SF1,
TTF1, SMA and CDX2. The cells of the ciliated
cuboidal-to-columnar epithelium were strongly positive
for PAX8, ER, Ep-CAM and EMA, focally positive for
PR, and were negative for calretinin, whereas the cells of
the flat-to-cuboidal lining were positive for calretinin
and podoplanin and showed only a weak positive
response in individual cells for PAX8, EMA and EpCAM, but were negative for ER and PR. This is the first
reported case of an adrenal ciliated epithelial cyst with
Müllerian differentiation (confirmed immunohistochemically) in the English literature. The differences in
morphology and immunophenotype of the two types of
lining (epithelial Müllerian phenotype versus
mesothelial phenotype), suggest that some adrenal
epithelial cysts probably form due to metaplasia of
mesothelium-derived lining. A similar mechanism may
also be involved in the pathogenesis of at least some of
the so-called Müllerian cysts (or inclusions) in other
location
Comorbidity of Histamine Intolerance and Polyvalent Allergy: A Case Report and Literature Review
No full textBackground/Objectives: Histamine intolerance is becoming a critical medical problem across numerous clinical specialties, due to the absence of a standardized diagnostic and therapeutic strategy to manage patients with a suspicion of or diagnosis of this condition. Histamine intolerance is a type of non-immune food hypersensitivity, characterized by heterogenous etiologies and a very broad range of symptoms. The condition is the result of an imbalance between the amount of histamine accumulated within the body and the body’s systemic ability to degrade it. In regard to the diagnostics of histamine intolerance, the need to preliminarily exclude other potential conditions associated with increased histamine levels in the blood has been highlighted. The co-occurrence of allergies and histamine intolerance is not uncommon, and the similarity of the clinical manifestations can lead to diagnostic, as well as therapeutic, difficulties. This paper details the diagnostic and clinical workflow for a patient with histamine intolerance and polyvalent allergy comorbidity, with the aim being to help outline a protocol that may be helpful to clinicians managing patients with histamine intolerance. Case Presentation: This article presents the case of a 30-year-old patient with a polyvalent allergy and multimorbidity (allergic rhinitis, asthma, a food allergy, and eosinophilic esophagitis), with comorbid histamine intolerance. Due to the violent and severe symptoms, including facial erythema, urticaria, pruritus, abdominal pain, and tachycardia, experienced after meals, the patient received intramuscular epinephrine injections three times a week. The diagnostic protocol and the course of therapeutic management are presented. Conclusions: The diagnosis of histamine intolerance is difficult due to the high variability and heterogeneity of clinical symptoms in individual patients. Many studies on the issue recommend ruling out an allergic background in terms of the complaint. However, the possibility of the symptoms of an IgE-dependent allergy overlapping with those of histamine intolerance should be taken into account in every case. This is particularly important in patients presenting with an atypical and severe course of allergic diseases. The clinical case presented herein may be helpful for the daily practice of allergologists and physicians with other specialties, as an example of multimorbidity with both allergic and non-allergic backgrounds
Clinicopathological and immunohistochemical analysis of epithelial-lined (true) cysts of the adrenal gland with proposal of a new histogenetic categorization
No full textTheoretische Untersuchungen zur Bestimmung des kavitationsfreien Primaerdurchsatzes nach Kernkompaktierung des Reaktors FRG-1
No full textAuf der Basis einer umfangreichen Analyse des Einflusses einer Kernkompaktierung des Reaktors FRG-1 auf die Aenderung der Stroemungs-, Waermeaustausch- und Kavitationsverhaeltnisse im Reaktorkuehlkreislauf wurden theoretische Grundlagen der Vorgehensweise zur Bestimmung des kavitationsfreien Primaerdurchsatzes entwickelt. Es wurde nachgewiesen, dass das Problem komplex, d.h. unter Beruecksichtigung der gegenseitigen Kopplung von Stroemungs-, Temperatur- und Kavitationsfeldern betrachtet werden muss und, dass es zur erfolgreichen Loesung der Aufgabe noch unbedingt erforderlich ist, parallel eine optimale Festlegung der Hauptprimaerumwaelzpumpe herbeizufuehren. (orig.)Basing on an extensive analysis of the influence of compacting the FRG-1 reactor core upon the change in flow, heat exchange, as well as cavitation behavior of the primary circuit the underlying principles of the determination procedure for a cavitations-free primary flow have been developed theoretically. It was found that the problem has to be treated in a complex manner, i.e. considering the coupled flow, temperature, as well as cavitation fields, and that for a successful solution of the problem it is absolutely necessary to simultaneously induce an optimized fixation of the main primary coolant pump. (orig.)SIGLEAvailable from TIB Hannover: RA 3251(97/E/27) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman
Zur Bestimmung der Reibungseigenschaften von Suspensionen ueber Drehzahl und Leistungsaufnahme einer Verdraengerpumpe Theoretische Ueberlegungen zur Realisierbarkeit
No full textA method to investigate the feasibility of a direct determination of the viscosity of suspensions by measuring the speed and input power of a displacement pump is developed. For that purpose, the first theoretical procedures are worked out. This refers to the completion of a qualitative analysis of the interrelation between the dominating physical parameters and to the development of a procedure for the selection and optimisation of the displacement pump. Some important simplistic assumptions for the formation of a mathematical model are formulated and a measuring program for their verification is suggested. (orig.)Es wird eine methodische Vorgehensweise zur Pruefung der Realisierbarkeit einer direkten Bestimmung der Reibungseigenschaften von Suspensionen ueber Drehzahl und Leistungsaufnahme einer Verdraengerpumpe entwickelt. Dazu werden die ersten theoretischen Verfahren abgeleitet. Dabei handelt es sich um die Duruchfuehrung einer qualitativen Analyse der Abhaengigkeit zwischen den wichtigsten physikalischen Groessen des Messverfahrens sowie um die Ableitung einer Prozedur zur Auswahl und Optimierung der Verdraengerpumpe. Es werden fuer die Entwicklung des mathematischen Modells des Messverfahrens wichtige vereinfachende Voraussetzungen formuliert und ein Messprogramm fuer ihre Verifizierung vorgeschlagen. (orig.)SIGLEAvailable from FIZ Karlsruhe / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman
Verfahren zur Bestimmung der optimalen Kenndaten der Hauptprimaerumwaelzpumpe nach der Kernkompaktierung des Reaktors FRG-1 T.1: Entwicklungskonzept, Optimierungskriterien und allgemeine logische Struktur des Verfahrens
No full textZuerst wurde ein Konzept zur Entwicklung des Verfahrens erstellt. Nach dem Konzept soll das Verfahren stufenweise, auf nacheinander folgenden logischen Ebenen abgeleitet werden. Ausserdem enthaelt die Abhandlung noch die auf den zwei anfaenglichen logischen Ebenen des Entwicklungsprozesses erzielten Resultate. Auf der ersten Ebene (Grundebene) wurden die Optimierungskriterien formuliert. Die allgemeine logische Struktur des Verfahrens ergibt sich als Resultat der zweiten logischen Ebene (Makroebene) des Entwicklungsprozesses. Diese Struktur setzt sich aus vier Bestimmungsbloecken, einer Identifikationseinheit und einigen Bestimmungselementen sowie ihrer logischen Verknuepfung in Form der Entscheidungs- und Ergebniseinheiten zusammen. Die Bloecke dienen zur Realisierung der geschlossenen und zusammengesetzten Teilaufgaben des Verfahrens. Sie bilden selbst die komplizierten, jedoch noch nicht abgeleiteten Teilstrukturen, die wieder die logischen Verbindungen der Bestimmungselemente sind. Im Unterschied zu den Bloecken sind alle Bestimmungselemente ausreichend elementar, so dass ihre direkte mathematische Erfassung schon moeglich wird. Sie dienen zur Loesung der einfachen Teilaufgaben. (orig.)First a development concept of the procedure was derived. Following this concept the procedure has to be derived stepwise, i.e. on subsequent logical levels. Furthermore, the report contains the results of the first two logical levels. On the first (basic) level the optimization criteria had been formulated. The general logical structure of the procedure results from the second logical level (macro level) of the evaluation process. This structure consists of four determination blocks, one identification unit and some determination elements as well as their logical interconnections in the form of decision and result units. The blocks serve for the realization of the closed and composed partial tasks of the procedure. They themselves form the complicated but not yet deviced partial structures, which again are the logical connections of the determination elements. In contrast to the blocks all determination elements are simple enough, so that their direct mathematical determination becomes possible. They serve for the solution of simple partial tasks. (orig.)SIGLEAvailable from TIB Hannover: RA 3251(98/E/30) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman
Serum and tissue expression of neuropilin 1 in precancerous and malignant vocal fold lesions.
No full textObjectivesThe study was designed to evaluate the tissue expression of NRP-1 and serum level of sNRP-1 in the same patients with intraepithelial laryngeal lesions or early staged laryngeal cancer to identify the clinical significance of these biomarkers in the diagnosis of laryngeal lesions.Material and methodsA prospective analysis of tissue was performed on specimens and blood samples from 49 patients, who were admitted for surgical resection due to suspicious vocal fold lesions and were diagnosed as non-dysplasia, low-grade dysplasia, high-grade dysplasia and invasive cancers.ResultsELISA was conducted on 48 blood samples. The minimum level of sNRP-1 was 0.15 ng/ml and maximum- 37.71 ng/ml. The Kruskal-Wallis one-way analysis of variance revealed no differences in sNRP-1 levels between different histopathological stages of vocal fold lesions (p = 0.234). IHC was conducted in 49 tissue samples. The evaluated mean scores of NRP-1 tissue expression were compared to histopathological stage of the lesion. The Kruskal-Wallis one-way analysis of variance revealed no differences in NRP-1 tissue expression between different histopathological stages of vocal fold lesions (p = 0.536). The correlation of tissue NRP-1 expression and serum levels of NRP-1 within analyzed group was insignificant. The Spearman's rank correlation coefficient was 0.076 (p = 0.606).ConclusionsThe NRP-1 tissue expression and serum levels are unlikely to be a prognostic factor for identification of laryngeal dysplasia or early stage laryngeal cancer. Further studies investigating biomolecules involved in laryngeal carcinogenesis are necessary
Theoretisches Verfahren zur Fehlerbestimmung bei nicht-isokinetischer Probenahme aus Suspensionen. T. 1 Entwicklungskonzept, mathematische Erfassung des Stroemungsfeldes und der Partikelbahnen, Bestimmung des Messfehlers
No full textFirst a development concept of the procedure was derived. Following this concept the procedure will be derived stepwise, i.e. on subsequent logical levels. Furthermore the report contains the following results of the main logical levels: formulation of the simplifying assumptions, elaboration of a method for the mathematical determination of the velocity field and the particle trajectories and derivation of the general formula to determine the measuring error. (orig.)Available from TIB Hannover: RA 3251(2000/14) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman
Verfahren zur Bestimmung der optimalen Kenndaten der Hauptprimaerumwaelzpumpe nach der Kernkompaktierung des Reaktors FRG-1. T. 2 Teilstrukturen des Verfahrens
No full textOn the basis of an extensive physical and technical analysis the partial structures of the procedure had been developed. They represent a logical linkage of determination elements in the form of decision and result units. The developed partial structures enable to determine the physical parameters, which characterize the primary circuit together with the compact core as well as the main primary coolant pump coming into question after compacting the core. The report also contains a discussions and a comparison of the partial structures. (orig.)Auf Basis einer umfangreichen physikalischen und technischen Analyse sind die Teilstrukturen des Verfahrens entwickelt. Sie stellen eine logische Verbindung von Bestimmungselementen in Form von Entscheidungs- und Ergebniseinheiten dar. Die entwickelten Teilstrukturen ermoeglichen die physikalischen Groessen zu bestimmen, die sowohl den Primaerkreislauf mit dem kompakten Kern als auch die nach der Kernkompaktierung in Betracht kommenden Hauptprimaerumwaelzpumpen charakterisieren. Die Arbeit enthaelt auch eine Diskussion und einen Vergleich der Teilstrukturen. (orig.)Available from TIB Hannover: RA 3251(99/E/21) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman
The clinical relevance of oliguria in the critically ill patient: analysis of a large observational database.
No full textBACKGROUND
Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output < 0.5 ml/kg/h) in acutely ill patients and its association with the need for renal replacement therapy (RRT) and outcome.
METHODS
International observational study. All adult (> 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis.
RESULTS
Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient-oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged-oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent-oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103).
CONCLUSIONS
Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome
