1,997 research outputs found
Extramammary Paget disease of the vulva: immunohistochemical analysis of neoangiogenesis and epithelial-mesenchymal transition markers expression
No full textAbstract Background Extra-mammary Paget’s disease of the vulva (EMPDV) is an infrequent chronic disease that often recurs. The aim of the study was to assess the presence of neoangiogenesis and the expression of epithelial-mesenchymal transition (EMT) markers in EMPDV, and their potential correlation with stromal invasion. Methods All the women consecutively treated for EMPDV at our Institute, between January 2011 and December 2014, were studied for neoangiogenesis, analysed by microvessel density (MVD) using antibodies against CD31 and CD34. Immunohistochemical expression of E- / N-cadherin, β-catenin and SLUG was also evaluated. In each slide, three fields with the highest number of capillaries and small venules were identified at low power. In these three fields, the highest vessel density (HVD) and the average vessel density (AVD) at 200× and 400× magnification were counted. Immunohistochemical reactions for non-vascular markers were semiquantitatively scored by two pathologists, using a three-tier scale. Results Seventeen cases of EMPDV (including 10 cases of invasive disease) were included. The AVD at 200× and 400× and the HVD at 400× magnification were significantly associated with invasive EMPDV (p = 0.02, 0.03, 0.03 respectively). No significant correlation between MVD, EMT-markers expression and risk of recurrence was detected. Conclusion These results indicate that MVD, as a measure of neoangiogenesis, may be associated with histological progression of EMPDV. EMT could also be linked to an invasive potential of EMPDV but larger series are required to confirm this hypothesis
ChatGPT-Based Learning And Reading Assistant (C-LARA): Second Report
No full textChatGPT-based Learning And Reading Assistant (C-LARA – pronounced “Clara”) is an AIbasedplatform which allows users to create multimodal texts designed to improve reading skillsin second languages. GPT-4/ChatGPT-4 is central to the project: as well as being the corelanguage processing component, it has in collaboration with a human partner developed thegreater part of the codebase.Following on from the initial progress report, released in July 2023, we focus on new workcarried out during the period August 2023 – March 2024. The platform is far more usable. CLARAis now packaged with a wizard-style interface (“Simple C-LARA”) that allows the nonexpertuser to create a complete illustrated multimodal text by entering a prompt and approvingdefault choices a few times, and the software is deployed on a fast dedicated server maintained bythe University of South Australia. Other substantial new pieces of functionality are support for“phonetic texts”, where words are automatically divided up into units associated with phoneticvalues; “reading histories”, which support the combination of several texts into a single virtualdocument; and the social network, rudimentary in the first version, which now includes supportfor friending, an update feed, and email alerts.To investigate the AI’s abilities as a language processor, we present an experiment where wecreated six texts for each of five languages, using the same prompts for each language, andevaluated the accuracy of the language processing. We also give the results when some of theexperiments were repeated five months later with a newer version of GPT-4, in the case ofEnglish revealing a dramatic reduction in error rates. A small questionnaire-based study probesusers’ subjective views of C-LARA projects they have created: in general, people are pleasedwith the results, to the extent that they are often sharing them.With regard to GPT-4/ChatGPT-4’s software engineer role, we present a breakdown of thevarious modules and functionalities, indicating the AI’s contribution. It is capable of writing thesimpler modules on its own or with minimal human assistance, and only had serious problemswith a small number of top-level functionalities, in particular “Simple C-LARA”, which directlyor indirectly involved most of the codebase.We describe initial use cases, including trialling of C-LARA in a school classroom, integratingit into the experimental CALL platform Basm, and creating multimodal texts in the Oceaniclanguages Drehu and Iaai. A short section summarises our policy on ethical issues concerningthe crediting of the AI as an author. The appendices present examples illustrating use of theSimple C-LARA and Advanced C-LARA versions of the platform, list functionalities and codefiles, and reproduce conversations with the AI about various aspects of the project
Proposed Molecular and miRNA Classification of Gastric Cancer
No full textGastric cancer (GC) is a common malignant neoplasm worldwide and one of the main cause of cancer-related deaths. Despite some advances in therapies, long-term survival of patients with advanced disease remains poor. Different types of classification have been used to stratify patients with GC for shaping prognosis and treatment planning. Based on new knowledge of molecular pathways associated with different aspect of GC, new pathogenetic classifications for GC have been and continue to be proposed. These novel classifications create a new paradigm in the definition of cancer biology and allow the identification of relevant GC genomic subsets by using different techniques such as genomic screenings, functional studies and molecular or epigenetic characterization. An improved prognostic classification for GC is essential for the development of a proper therapy for a proper patient population. The aim of this review is to discuss the state-of-the-art on combining histological and molecular classifications of GC to give an overview of the emerging therapeutic possibilities connected to the latest discoveries regarding GC
Serum and tissue markers in hepatocellular carcinoma and cholangiocarcinoma: clinical and prognostic implications
No full textHCC represents the sixth most common cancer worldwide and the second leading cause of cancer-related death. Despite the high incidence, treatment options for advanced HCC remain limited and unsuccessful, resulting in a poor prognosis. Despite the major advances achieved in the diagnostic management of HCC, only one third of the newly diagnosed patients are presently eligible for curative treatments. Advances in technology and an increased understanding of HCC biology have led to the discovery of novel biomarkers. Improving our knowledge about serum and tissutal markers could ultimately lead to an early diagnosis and better and early treatment strategies for this deadly disease. Serum biomarkers are striking potential tools for surveillance and early diagnosis of HCC thanks to the non-invasive, objective, and reproducible assessments they potentially enable. To date, many biomarkers have been proposed in the diagnosis of HCC. Cholangiocarcinoma (CCA) is an aggressive malignancy, characterized by early lymph node involvement and distant metastasis, with 5-year survival rates of 5%-10%. The identification of new biomarkers with diagnostic, prognostic or predictive value is especially important as resection (by surgery or combined with a liver transplant) has shown promising results and novel therapies are emerging. However, the relatively low incidence of CCA, high frequency of co-existing cholestasis or cholangitis (primary sclerosing cholangitis-PSC-above all), and difficulties with obtaining adequate samples, despite advances in sampling techniques and in endoscopic visualization of the bile ducts, have complicated the search for accurate biomarkers. In this review, we attempt to analyze the existing literature on this argument
Thyroid-like follicular carcinoma of the kidney: report of two cases with detailed immunohistochemical profile and literature review.
No full textThyroid-like follicular carcinoma of the kidney (TLFC) is an unusual histological variant of renal cell carcinoma not included in the current WHO classification of renal tumors. Its morphological features resemble a large spectrum of benign and malignant renal and extra-renal conditions which should be ruled out in the diagnostic process. Because TLFC outcome is different from the other variants of renal cell carcinoma, the exploration for disease-specific markers is mandatory. The aim of the present paper is to illustrate the histological characteristics and immunohistochemical profile of two new cases along with a brief review of the literature
Primary Non-Hodgkinʼs Lymphoma of the Vulva
No full textThe aim of this study was to add a new case of primary non-Hodgkin's malignant lymphoma of the vulva to the literature and to review the current literature.We searched the PubMed/MEDLINE databases for previous case reports using the key words "non-Hodgkin's malignant lymphoma of the vulva,'' "vulvar lymphoma,'' and "primary vulvar non-Hodgkin's lymphoma.'' We found 29 cases of primary vulvar non-Hodgkin's malignant lymphoma of the vulva reported until 2015. Among them, only 8 cases of diffuse large B-cell lymphoma (DLBCL), classified according to the most recent 2008 WHO classification, were reported.Moreover, only few studies reported the therapeutic management and clinical follow-up of patients affected by this condition.Due to its uncommon presentation, the primary non-Hodgkin's malignant lymphoma of the vulva can be undiagnosed; thus gynecologists, oncologists, and pathologists should be aware of this condition, as a correct diagnosis is essential for an appropriate therapeutic management
Extramammary Paget disease of the vulva (VEMPD) with perianal involvement: a 30-year experience
No full textLetter from The Dominguez Estate Company to Mr. B. Lara, November 24, 1943
No full textInforming Mr. Lara of the change in acreage on his lease with an attached statement
Triple synchronous invasive malignancies of the female genital tract in a patient with a history of leukemia: A case report and review of the literature
No full textBackground: Three primary synchronous cancers in the female genital tract are extremely rare. In the literature, only four studies have described three different invasive gynecologic cancers of epithelial origin identified simultaneously in the same patient.Case presentation: This is the first case in the literature that reports on triple primary ovarian, endometrial and endocervical cancers in a 38-year-old woman with a history of previously treated malignant disease (acute lymphatic leukemia). With a preoperative diagnosis of endocervical adenocarcinoma stage Ib1 (according to International Federation of Gynecology and Obstetrics-FIGO), as well as an adnexal mass, she underwent radical hysterectomy with bilateral adnexectomy. Pathologic examination of the surgical specimen revealed a mucinous adenocarcinoma of the cervix, an endometrioid adenocarcinoma of the uterine corpus, and a mucinous adenocarcinoma of the left ovary. Eighteen months after appropriate treatment, the patient is free of disease.Conclusion: The incidental diagnosis of more than one tumor is often a post-operative finding, usually with the detection of low-stage neoplasms. Multiple synchronous gynecologic cancers have a better prognosis than metastatic or advanced primitive disease. In a patient with multiple neoplasms, the prognosis is determined by the tumor with the worst prognosis
Multiple preinvasive and invasive HPV-related lesions of the anogenital tract in a female patient with HIV infection
No full textRationale: Patients with human immunodeficiency virus (HIV) infection have been shown to be at increased risk for high-risk human papillomavirus (HR-HPV) infection of the anogenital tract. Furthermore, in the last decades, the introduction of highly active antiretroviral therapy (HAART) has increased the longevity of these patients who now live long enough to develop HPV-related cancers; hence, the impact of HPV infection on HIV-positive patients is of increasing concern.Patient concerns: We reported the case of an HIV-positive female patient on HAART with a good virological and immunological response and with a long history of HPV-related intraepithelial and invasive lesions of the anogenital tract.Diagnoses: From 1996 to 2016, this patient was diagnosed with a high grade cervical intraepithelial neoplasia; a HR- HPV positive inguinal lymph node metastasis from clinically undetectableprimary squamous cell carcinoma; a HPV-related vulvar high-grade squamous intraepithelial lesion and an invasive squamous cell carcinoma of the anus.Interventions: All the intraepithelial and invasive lesions detected were properly treated, and subsequent follow up visits with gynecologic examination, anoscopy, pap smear and anal cytology were performed.Outcomes: After a recurrence of the anal cancer and a subsequent salvage surgery with abdominoperineal resection, at the last available follow up visit no sign of disease recurrence was found.Lessons: This case stresses the importance of an accurate multidisciplinary follow-up in HIV-positive patients, including not only the routine medical, immunological, and virological evaluation, but also a periodical complete examination of the anogenital tract with cervicovaginal and anal cytology, colposcopy, high resolution anoscopy, and vulvar examination
- …
