Heterologous type of malignant mixed Müllerian tumor of the uterus presenting as a vulvar mass.

Carcinosarcoma is a rare, extremely aggressive tumor of the uterus with a poor prognosis. The authors describe a case of a 78-year-old woman who presented with a giant mass protruding through the cervix, vagina, and vulva. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. The histopathological examination of the surgical specimen revealed a malignant mixed Müllerian tumor. The clinical and pathological features, molecular data, and prognosis of this aggressive neoplasm are discussed. Although uterine carcinosarcomas are extremely rare, when a postmenopausal woman with a vulvar mass is admitted to the gynecology clinic, the physician should consider that the mass may be a carcinosarcoma.

Human adult dental pulp CD117/c-kit-positive networks of stromal cells.

Dental pulp tissue was collected from 6 healthy adult patients, prior to prosthetic treatments, in order to evaluate the in situ phenotype of dental pulp stromal cells and compare with that of dental pulp stem cells. A CD34-/CD44+/CD105-/CD117+/CD146-/nestin- phenotype of stromal cells in the dental pulp core was found. Cells with a similar phenotype, but CD44-, were found in the cell richzone. Dental pulp stromal networks (DPSNs) were found CD117+/CD44+ in the pulp core, but CD117+/CD44- in the cell rich zone. The c-kit-positive DPSNs were contacting pulp nerves and were, in this regard only, comparable to interstitial Cajal cells. Stromal signalling in dental pulp needs further evaluation, in normal tissue as well as a possible cause of persisting pain after endodontic treatments.

Ex vivo high resolution magic angle spinning metabolic profiles describe intratumoral histopathological tissue properties in adult human gliomas.

In gliomas one can observe distinct histopathological tissue properties, such as viable tumor cells, necrotic tissue or regions where the tumor infiltrates normal brain. A first screening between the different intratumoral histopathological tissue properties would greatly assist in correctly diagnosing and prognosing gliomas. The potential of ex vivo high resolution magic angle spinning spectroscopy in characterizing these properties is analyzed and the biochemical differences between necrosis, high cellularity and border tumor regions in adult human gliomas are investigated. Statistical studies applied on sets of metabolite concentrations and metabolite ratios extracted from 52 high resolution magic angle spinning recordings coming from patients with different grades of glial tumors show a strong correlation between the histopathological tissue properties and the considered metabolic profiles, regardless of the malignancy grade. The results are in agreement with the pathology obtained by the histopathological examination that succeeded the high resolution magic angle spinning measurements. The metabolite concentration set can better differentiate between the considered histopathological tissue properties compared to the ratios. Representative reference tissue models describing the metabolic behavior are extracted for characterizing the intratumoral tissue properties. The proposed metabolic profiles reflect that the metabolites behavior is interconnected, and typical biochemical patterns emerge for each histopathological tissue property.

Non-negative blind source separation techniques for tumor tissue typing using HR-MAS signals.

Given High Resolution Magic Angle Spinning (HR-MAS) signals from several glioblastoma tumor subjects, the goal is to differentiate between tumor tissue types by separating the different sources that contribute to the profile of each spectrum. Blind source separation techniques are applied for obtaining characteristic profiles for necrosis, high cellular tumor and border tumor tissue, and providing the contribution (abundance) of each tumor tissue to the profile of the spectra. The problem is formulated as a non-negative source separation problem. We illustrate the effectiveness of the proposed methods and we analyze to which extent the dimension of the input space could influence the performance by comparing the results on the full magnitude signals and on dimensionally reduced spaces.

Preoperative ultrasonography as a mean of predicting the conversion of mini cholecystectomy into classic cholecystectomy.

UNLABELLED: Cholecystectomy is considered to be the treatment of choice in symptomatic biliary lithiasis. Lately, due to medical progress, classic cholecystectomy has been gradually replaced by laparoscopic cholecystectomy and by mini cholecystectomy. Therefore, it is very important to determine certain preoperative factors which might predict the conversion of mini cholecystectomy (MC) into classic cholecystectomy (CC). MATERIAL AND METHOD: The possibility of selecting high-risk conversion patients has important clinical implications, both for the surgeon and for the patient. Differentiating preoperative risk allows the surgeon to inform the patient about a high conversion risk to CC, and about the ensuing consequences: longer hospitalization period, longer postoperative recovery, greater costs. All the patients were examined by ultrasonography. The tests recorded six parameters: the diameter of the biliary duct (mm), the number of calculi, the diameter of the largest calculus (mm), the contracted aspect of the gallbladder, the distance between the tegument and the gallbladder fundus (cm), the distance between the tegument and the cystic duct (cm). All the variables were introduced into an initial model, which was checked using the colinearity method and significant observations, and subsequently reduced by eliminating insignificant predictive factors, revealed by Wald tests. RESULTS: The significant predictive conversion factors to CC, quantified on the basis of regression analysis, are: age > 70, calculus with a diameter > 20 mm, biliary duct with a diameter > 6 mm, contracted gallbladder, distance between the tegument and gallbladder fundus > 7.2 cm, distance between the tegument and cystic duct > 17.1 cm. CONCLUSION: Being a procedure that can be carried out on an outpatient basis and with rather low costs, ultrasonography plays a very important role in the preoperative prediction of converting MC to CC.