scholarly journals A Rare Case of Mixed Ductal Neuroendocrine Tumor of the Pancreas

2021 ◽  
Vol 8 (2) ◽  
pp. C20-24
Author(s):  
Vidya Viswanathan ◽  
Harsh Kumar ◽  
Charusheela Gore ◽  
Shrikant Kurhade ◽  
Rumaanah Khan
Keyword(s):  
Neuroendocrine Tumour ◽  
Rare Condition ◽  
Collision Tumor ◽  
Definitive Diagnosis ◽  
Anatomical Site ◽  
Endocrine Tumors ◽  
Microscopic Features ◽  
To Come ◽  
Adenocarcinoma Component

Collision tumors are tumors that have at least two types of tumors in the same anatomical site with no area of mixing within the transition zone. In 2010 WHO classification of neuroendocrine tumors consists of an adenocarcinoma component and a neuroendocrine carcinoma component in which each of the components accounts for 30% of the tumor. Such tumors are defined as mixed adenoneuroendocrine carcinomas. Occurrence of exocrine and endocrine tumors of the pancreas is extremely rare. The aim of our study was to describe a case in a 60 years old male who was diagnosed with this rare tumor. Gross, microscopic features and immunohistochemistry were used to diagnose this rare condition. Immunohistochemistry markers such as synaptophysin, chromogranin, EMA and Pan CK were used to come to a definitive diagnosis. Synaptophysin and chromogranin were found to be positive in the neuroendocrine component. EMA and Pan CK were found to be positive in the ductal component. Hence a diagnosis of mixed ductal neuroendocrine tumour (collision tumor) was made.

scholarly journals Mixed Adenoneuroendocrine Carcinoma of the Stomach

2015 ◽  
Vol 9 (2) ◽  
pp. 241-245 ◽  
Author(s):  
Ching-Ming Kwok
Keyword(s):  
Local Recurrence ◽  
Total Gastrectomy ◽  
Who Classification ◽  
Rare Condition ◽  
Gastric Tumor ◽  
Endocrine Tumors ◽  
Review Of The Literature ◽  
Carcinoma Of The Stomach ◽  
Mixed Adenoneuroendocrine Carcinoma

Mixed adenoneuroendocrine carcinoma is a rare condition comprising at least 30% of each component of exocrine and endocrine tumors. The denominations were defined in the 2000 WHO classification of endocrine tumors. We report an 83-year-old male with a polypoid gastric tumor in the gastric high body who received total gastrectomy and died 8 months after the diagnosis from local recurrence and distal metastases. A review of the literature for this infrequent condition is presented.

A Prognostic Clinicopathologic Classification of Pituitary Endocrine Tumors

2015 ◽  
Vol 44 (1) ◽  
pp. 11-18 ◽  
Author(s):  
Gérald Raverot ◽  
Alexandre Vasiljevic ◽  
Emmanuel Jouanneau ◽  
Jacqueline Trouillas
Keyword(s):  
Endocrine Tumors

scholarly journals STUDIES ON EXPERIMENTAL PNEUMONIA

1920 ◽  
Vol 31 (5) ◽  
pp. 499-518 ◽  
Author(s):  
Francis G. Blake ◽  
Russell L. Cecil
Keyword(s):  
Great Majority ◽  
Sudden Onset ◽  
Epidemic Disease ◽  
Lobar Pneumonia ◽  
Type Iv ◽  
Immunological Classification ◽  
To Come ◽  
Characteristic Picture ◽  
Pneumococcus Type

Spontaneous pneumonia occurred to a considerable extent among stock monkeys at the Army Medical School. This pneumonia occurred chiefly in the form of an epidemic outbreak shortly after the arrival of a large shipment of monkeys, and was shown to be due in large part to transmission of infection from monkey to monkey, either directly or indirectly. That spread of the epidemic was facilitated by overcrowding was indicated by the fact that in a subsequent shipment of monkeys, which were kept in pairs in separate cages and were not allowed to come into contact with the monkeys among which the epidemic occurred, no cases of spontaneous pneumonia developed. The close analogy between the epidemic of lobar pneumonia that occurred among the monkeys and similar epidemics of lobar pneumonia that occurred during the war among certain groups of newly drafted troops shortly after their arrival at camp is very striking, and would seem to indicate that pneumococcus pneumonia may become an epidemic disease among groups of susceptible individuals when they are assembled under conditions that facilitate the ready transfer of infection from individual to individual. Bacteriological examination showed the spontaneous pneumonia to be due in the great majority of cases to infection with Pneumococcus Type IV. Immunological classification of the strains of pneurnococci by cross-agglutination tests showed that the majority fell into two biological groups. Two cases were apparently caused by Streptococcus hæmolyticus, two by Streptococcus viridans. The clinical course of spontaneous pneumococcus pneumonia in monkeys was characterized by sudden onset, high sustained temperature, leucocytosis, rapid respiration with expiratory grunt, cough, physical signs of consolidation, invasion of the blood by pneurnococci, and termination in death or recovery by crisis about the 7th to 9th day. In a few instances the disease was complicated by acute fibrinopurulent pericarditis, by empyema, and by purulent meningitis. It was, therefore, clinically identical with lobar pneumonia experimentally produced in monkeys and with lobar pneumonia in man. Study of the pathology of spontaneous pneumococcus pneumonia in monkeys showed that it presented the characteristic picture of lobar pneumonia, both macroscopically and microscopically, and was in all respects comparable with the pathology of lobar pneumonia experimentally produced in monkeys and of lobar pneumonia in man.

Laryngeal Clefts

1979 ◽  
Vol 88 (6) ◽  
pp. 837-845 ◽  
Author(s):  
Timothy A. Lim ◽  
Suzanne S. Spanier ◽  
Robert I. Kohut
Keyword(s):  
Literature Review ◽  
Surgical Repair ◽  
Signs And Symptoms ◽  
Endoscopic Examination ◽  
Definitive Diagnosis ◽  
Serial Sectioning ◽  
Posterior Cricoarytenoid ◽  
Histopathologic Findings

The histopathologic findings in a case of laryngeal cleft studied by serial sectioning, and a literature review of this clinical entity are presented. The primary micropathologic findings include a cleft deformity of the posterior cricoid lamina, and alterations in muscle differentiation involving the interarytenoid and posterior cricoarytenoid muscles. Possible embryogenic mechanisms are discussed. The clinical picture is characterized by signs and symptoms of aspiration with airway obstruction, and definitive diagnosis is achieved by endoscopic examination. Treatment consists of surgical repair, although some patients with type 1 laryngeal clefts may be managed on a conservative trial. The need for uniform classification of laryngeal clefts in future reporting is emphasized.

scholarly journals Towards a Validation Methodology for Macroeconomic Agent-Based Models

2021 ◽  
Author(s):  
Sebastiaan Tieleman
Keyword(s):  
Emergent Properties ◽  
Agent Based Models ◽  
Important Distinction ◽  
Agent Based ◽  
Model Classification ◽  
Classification Framework ◽  
The Difference ◽  
To Come

AbstractAgent-based models provide a promising new tool in macroeconomic research. Questions have been raised, however, regarding the validity of such models. A methodology of macroeconomic agent-based model (MABM) validation, that provides a deeper understanding of validation practices, is required. This paper takes steps towards such a methodology by connecting three elements. First, is a foundation of model validation in general. Second is a classification of models dependent on how the model is validated. An important distinction in this classification is the difference between mechanism and target validation. Third, is a framework that revolves around the relationship between the structure of models of complex systems with emergent properties and validation in practice. Important in this framework is to consider MABMs as modelling multiple non-trivial levels. Connecting these three elements provides us with a methodology of the validation of MABMs and allows us to come to the following conclusions regarding MABM validation. First, in MABMs, mechanisms at a lower level are distinct from, but provide input to higher levels of mechanisms. Since mechanisms at different levels are validated in different ways we can come to a specific characterization of MABMs within the model classification framework. Second, because the mechanisms of MABMs are validated in a direct way at the level of the agent, MABMs can be seen as a move towards a more realist approach to modelling compared to DSGE.

SPECIAL ARTICLE

PEDIATRICS ◽  
1956 ◽  
Vol 18 (5) ◽  
pp. 841-852
Author(s):  
W. L. Minear
Keyword(s):  
Cerebral Palsy ◽  
American Academy ◽  
Medical Record ◽  
Muscle Tone ◽  
Brain Lesion ◽  
Good Deal ◽  
The Other ◽  
Anatomical Site ◽  
First Choice

The majority of the members of the American Academy for Cerebral Palsy voted to exclude progressive neurological diseases and neoplastic diseases of the brain from the classification of cerebral palsy. The lesion left by the removal of a brain tumor, however, is still considered one of the etiological factors of cerebral palsy. Cerebral palsy comprises the motor and other symptom complexes caused by a non-progressive brain lesion (or lesions). The nomenclature and classification questionnaires indicate that the members of the American Academy for Cerebral Palsy wish to accept a motor classification, listing each type of cerebral palsy separately: Spastic, Athetoid, Tremor, Rigidity, Ataxic, Atonic, and Mixed. The following choices as a basis for classification of cerebral palsy were made by the American Academy for Cerebral Palsy: First choice: Motor Symptoms Second choice: Topographic Involvement Third choice: Etiology Fourth choice: Anatomical Site (of lesion) Fifth choice: Severity of Involvement Sixth choice: Degree of Muscle Tone Seventh choice: Supplemental Data The first 3 choices above should be used by the medical record librarian and by doctors discharging patients with cerebral palsy from hospitals or institutions so as to establish a common understanding and uniformity to hospital records. It is understood that the neuroanatomical classification (Fourth choice) is to be used when it can be proven, but not by presumption. The majority of the members approve of tension, non-tension, dystonic, and tremor-like types of athetosis. The other types were rejected for various reasons. Probably, some of the other types would have been accepted if understood by the members. Each type is described and defined herein. There is a general lack of agreement on the various terms used in cerebral palsy. Definitions of these terms are now being made by a committee for a meeting in 1955. There is a good deal of evidence that neurological signs and symptoms change in the child with cerebral palsy as the nervous system matures and that one must be cautious in making a final descriptive or symptomatic diagnosis in infancy. The pattern of changing neurological symptoms from infancy through childhood should be studied. The high cervical syndrome described by Fay is being confused with cerebral palsy. This syndrome needs further study. It should be determined whether the term cerebrospinal palsy would not be more appropriate for the entire neurological group. The American Medical Association's Standard Nomenclature of Diseases and Operations (Fourth Edition), commonly used by medical record librarians, is not suitable for the classification of cerebral palsy. In this edition, all cerebral palsy is coded "Cerebral spastic infantile paralysis" with supplementary terms added to denote various types. A complete classification for cerebral palsy is presented, using the majority opinion from questionnaires sent to the members of the American Academy for Cerebral Palsy during 1953 as a basis.

Platypnoea-orthodeoxia syndrome: the importance of the patient’s posture for diagnosis

2021 ◽  
Vol 14 (6) ◽  
pp. e243210
Author(s):  
Carla Pereira Fontes ◽  
Samuel Barbosa Fonseca ◽  
Mário Santos
Keyword(s):  
Transthoracic Echocardiography ◽  
Rare Condition ◽  
Definitive Diagnosis ◽  
Clinical Suspicion ◽  
Oxygen Desaturation ◽  
Arterial Oxygen ◽  
Common Cause ◽  
Intracardiac Shunt ◽  
High Clinical Suspicion ◽  
Functional Components

Platypnoea-orthodeoxia syndrome (POS) is a rare condition characterised by the association of dyspnoea and arterial oxygen desaturation induced by standing and relieved by recumbency. The precise mechanism remains poorly understood, but it appears to involve both anatomical and functional components producing a significant right-to-left shunting under certain postural conditions. This syndrome is associated with either intracardiac or extracardiac aetiologies, and the diagnosis depends on high clinical suspicion. Intracardiac shunt is the most common cause of POS and can be identified through echocardiography with bubble study. We report the case of a patient with POS secondary to a paradoxical shunt through the patent foramen oval, whose definitive diagnosis was only possible with contrasted transthoracic echocardiography in the sitting and standing positions.

The Evolution of Charity Care within the Healthcare Industry

2006 ◽  
Vol 4 (1) ◽  
pp. 101-116 ◽  
Author(s):  
Pamela C. Smith ◽  
Aaron D. Crabtree
Keyword(s):  
Charity Care ◽  
Nonprofit Hospitals ◽  
Tax Exempt ◽  
Long Time ◽  
State And Local ◽  
To Come ◽  
Definition Of ◽  
State Examination ◽  
Concise Definition

Tax-exempt classification of nonprofit hospitals has been increasingly subject to federal and state examination. Considering the benefits tax-exempt entities receive, it should not be surprising that these organizations face heavy regulatory scrutiny. The problem for tax-exempt hospitals is the lack of a clear and concise definition of charity care in order to maintain exempt status. State and local regulations aside, the IRS has not presented a consistent position regarding standards for nonprofit hospitals. This paper examines the evolution of hospital tax-exempt status and its relationship to charity care. Given the IRS's evolving and conflicting definitions of charity care, we can expect this issue to be debated for a long time to come.

From Dalton to the Discovery of the Periodic System

2013 ◽  
Author(s):  
Eric Scerri
Keyword(s):  
Periodic System ◽  
Quantitative Data ◽  
Quantitative Characteristic ◽  
Good Deal ◽  
Ancient Greek ◽  
System P ◽  
Quantitative Property ◽  
To Come ◽  
First Time

Our story begins, somewhat arbitrarily, in the English city of Manchester around the turn of the nineteenth century. There, a child prodigy by the name of John Dalton, at the tender age of fifteen is teaching in a school with his older brother. Within a few years, John Dalton’s interests have developed to encompass meteorology, physics, and chemistry. Among the questions that puzzle him is why the various component gases in the air such as oxygen, nitrogen, and carbon dioxide do not separate from each other. Why does the mixture of gases in the air remain as a homogeneous mixture? As a result of pursuing this question, Dalton develops what is to become modern atomic theory. The ultimate constituents of all substances, he supposes, are hard microscopic spheres or atoms that were first discussed by the ancient Greek philosophers and taken up again by modern scientists like Newton, Gassendi, and Boscovich. But Dalton goes a good deal further than all of these thinkers in establishing one all-important quantitative characteristic for each kind of atom, namely its weight. This he does by considering quantitative data on chemical experiments. For example, he finds that the ratio for the weight in which hydrogen and oxygen combine together is one to eight. Dalton assumes that water consists of one atom of each of these two elements. He takes a hydrogen atom to have a weight of 1 unit and therefore reasons that oxygen must have a weight of 8 units. Similarly, he deduces the weights for a number of other atoms and even molecules as we now call them. For the first time the elements acquire a quantitative property, by means of which they may be compared. This feature will eventually lead to an accurate classification of all the elements in the form of the periodic system, but this is yet to come. Before that can happen the notion of atoms provokes tremendous debates and disagreements among the experts of Dalton’s day.

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