Correspondence of cytological and histopathological diagnoses in diagnostic category V of the Bethesda system: "suspicious for malignancy".

The progress in imaging methods enables fine needle aspiration (FNA) biopsy to be performed on smaller and smaller lesions, including malignant ones (papillary microcarcinomas). The follicular variant predominates in this group, with cytological features often not permitting an unbiased interpretation. The aim of the study was to determine the degree of reliability of the "suspicious for malignancy" (SM) diagnosis in material from the Institute of Oncology in Gliwice (IO). 290 primary SM diagnoses were established from 2010 to 2015 in the IO, including the consultations. None of the patients was treated surgically after the first FNA resulting in diagnostic category V (DC V). After the second FNA 80 patients underwent surgery, after the third 58, and after subsequent FNA 10. Together, 148 surgical resections were performed. Among 148 patients treated surgically, 111 were diagnosed with malignant lesions, which constitutes 75%. Predominantly - in 91 cases - the histopathological outcome was papillary carcinoma. The others were: 16 medullary carcinomas, 2 follicular carcinomas, and 2 poorly differentiated carcinoma cases. Moreover, 8 follicular adenomas and 28 nonneoplastic lesions were found. The high positive predictive value (PPV = 75%) of SM diagnosis established in the IO testifies to the high reliability of this test. Diagnostic category V in FNA should be an indication for surgical treatment.

The diagnosis of cancer in thyroid fine needle aspiration biopsy. Surgery, repeat biopsy or specimen consultation?

Fine needle aspiration biopsy (FNA) is the only diagnostic method that allows a preoperative diagnosis of thyroid carcinoma. An unequivocal diagnosis of a malignant change is achievable only in cases in which all cytological criteria of carcinoma are met. The aim of the study was to evaluate the necessity of repeat thyroid FNA in patients with papillary thyroid carcinoma verified on consultative examination (CE). We analyzed cytology reports of thyroid FNA and CE that resulted in the diagnosis of papillary carcinoma. Evaluation of the correlation of the cytological diagnosis with the histopathology report was based on data obtained after the surgery. Between 2010 and 2015 in the Institute of Oncology (IO) there were 184 cancers diagnosed on CE or in thyroid FNA performed primarily in IO. Additionally, 74 patients were subjected to repeat biopsy after confirmation of cancer in CE. Histopathological diagnosis of cancer was obtained in 62 (100%) cases that were doubly confirmed with cytological examination. The remaining 12 patients were operated on outside the institute. From 110 FNA primarily performed in the IO, histopathological verification was achievable in 92 cases, from which 92 (100%) provided a confirmation of cancer, and the remaining 18 patients were operated on outside the institute. High (100%) specificity of cancer diagnosis in FNA established primarily and verified on CE (second independent assessment) indicates that repeat FNA in order to confirm the diagnosis is unnecessary.

Disturbances of autonomic nervous system activity and diminished response to stress in patients with celiac disease.

Celiac disease (CED) is immune-mediated enteropathy caused by gluten intolerance affecting genetically predisposed individuals. CED may exert a number of various symptoms, including extra intestinal manifestations. Neurological symptoms can be the first sign of gluten intolerance. However, affected autonomic nervous system (ANS) activity may be linked to other symptoms. We evaluated the frequency of ANS impairment and resting ANS response to several stimuli in CED patients without neurological manifestations. Twenty five neurologically asymptomatic patients with CED were studied. The medical history was taken and ANS activity was determined. ANS tests included heart rate variability (HRV) at rest and after stimulation (sympathetic - stress, and parasympathetic - deep breathing). The results were compared with those of the control group comprising of 30 healthy asymptomatic volunteers. Both the resting HRV parameters and the HRV indices recorded after deep breathing (parasympathetic stimulation) were significantly lower in patients with CED than in the controls (P<0.05). Also the stress-induced increase in normalized low frequency parameter (LFnu) was significantly lower in the CED group than in the control group (P<0.05). Overall, about 20% of CED patients presented with parasympathetic dominancy but 36% with sympathetic dominancy, and 44% of patients did not show changes in sympathetic-vagal balance of the autonomic nervous system. We conclude that sympathetic-parasympathetic imbalance, in favour of more often sympathetic than parasympathetic overactivity occurs among neurologically asymptomatic CED patients. The ANS impairment observed in the course of CED may result from prolonged intestinal inflammation. Therefore, routine ANS testing might be considered in patients presenting with this condition.

ABCD-treatment of a propagating doughnut beam generated by a spiral phase plate.

We apply the Collins-Huygens integral to analytically describe propagation of a doughnut beam generated by a spiral phase plate. Measured beam profiles in free space and through an ABCD-lens system illustrate excellent agreement with theory. Applications range from the creation of optical beams with angular momentum to microscopy to trapping neutral atoms. The method extends to other beam shaping components, too.

Quantum jumps and spin dynamics of interacting atoms in a strongly coupled atom-cavity system.

We experimentally investigate the spin dynamics of one and two neutral atoms strongly coupled to a high finesse optical cavity. We observe quantum jumps between hyperfine ground states of a single atom. The interaction-induced normal-mode splitting of the atom-cavity system is measured via the atomic excitation. Moreover, we observe the mutual influence of two atoms simultaneously coupled to the cavity mode.

Nearest-neighbor detection of atoms in a 1D optical lattice by fluorescence imaging.

We overcome the diffraction limit in fluorescence imaging of neutral atoms in a sparsely filled one-dimensional optical lattice. At a periodicity of 433 nm, we reliably infer the separation of two atoms down to nearest neighbors. We observe light induced losses of atoms occupying the same lattice site, while for atoms in adjacent lattice sites, no losses due to light induced interactions occur. Our method points towards characterization of correlated quantum states in optical lattice systems with filling factors of up to one atom per lattice site.

Expansion of a quantum gas released from an optical lattice.

We analyze the interference pattern produced by ultracold atoms released from an optical lattice, commonly interpreted as the momentum distributions of the trapped quantum gas. We show that for finite times of flight the resulting density distribution can, however, be significantly altered, similar to a near-field diffraction regime in optics. We illustrate our findings with a simple model and realistic quantum Monte Carlo simulations for bosonic atoms and compare the latter to experiments.

Direct observation of second-order atom tunnelling.

Tunnelling of material particles through a classically impenetrable barrier constitutes one of the hallmark effects of quantum physics. When interactions between the particles compete with their mobility through a tunnel junction, intriguing dynamical behaviour can arise because the particles do not tunnel independently. In single-electron or Bloch transistors, for example, the tunnelling of an electron or Cooper pair can be enabled or suppressed by the presence of a second charge carrier due to Coulomb blockade. Here we report direct, time-resolved observations of the correlated tunnelling of two interacting ultracold atoms through a barrier in a double-well potential. For the regime in which the interactions between the atoms are weak and tunnel coupling dominates, individual atoms can tunnel independently, similar to the case of a normal Josephson junction. However, when strong repulsive interactions are present, two atoms located on one side of the barrier cannot separate, but are observed to tunnel together as a pair in a second-order co-tunnelling process. By recording both the atom position and phase coherence over time, we fully characterize the tunnelling process for a single atom as well as the correlated dynamics of a pair of atoms for weak and strong interactions. In addition, we identify a conditional tunnelling regime in which a single atom can only tunnel in the presence of a second particle, acting as a single atom switch. Such second-order tunnelling events, which are the dominating dynamical effect in the strongly interacting regime, have not been previously observed with ultracold atoms. Similar second-order processes form the basis of superexchange interactions between atoms on neighbouring lattice sites of a periodic potential, a central component of proposals for realizing quantum magnetism.

[Biofeedback as a conservative treatment of fecal incontinence]. / Biofeedback jako zachowawcza metoda leczenia nietrzymania stolca.

Faecal incontinence (SI) is defined as uncontrolled evacuation of stool in an inappropriate time or place, occurring at least two times a month. The other definition of SI is an inability to refrain from defecation till the moment thought to be appropriate from sociologic point of view. SI is an extremely stressful disease, which according to different sources, concerns about 2.5 to 7% of the adult population. The frequency of SI incidence raises with age, and it concerns about 60% of patients in geriatric health--care institutions. Nowadays there are many types of casual treatment of SI. One of the "first line" methods, if there is no extensive mechanical injury of sphincteric complex, is biofeedback (BF) training. In our study we presented principles of biofeedback treatment, a historical outline of the mentioned method and other conservative methods of SI treatment. We also presented, on the basis of literature, actual state of art concerning effectiveness and possibilities of therapeutic application of BF and results of clinical research, concerning application of BF training in faecal continence impairment in the adult population.

Mechanisms of TfR-mediated transcytosis and sorting in epithelial cells and applications toward drug delivery.

Transferrin receptor has been an important protein for many of the advances made in understanding the intricacies of the intramolecular sorting pathways of endocytosed molecules. The unique internalization and recycling functions of transferrin receptor have also made it an attractive choice for drug targeting and delivery of large protein-based therapeutics and toxins. Recent advances in elucidating the role of the intracellular controllers of transferrin recycling and sorting, such as Rab proteins and their effectors, have led to enhancement of transferrin receptor as a drug delivery vehicle. This review focuses on the use of transferrin receptor as an agent for facilitating drug delivery and targeting, and the role that mechanisms of transferrin receptor sorting and transcytosis play in these events.

Phenotype-dependent synthesis of transferrin receptor in rat alveolar epithelial cell monolayers.

The iron carrier protein transferrin plays a prominent antioxidant and anti-bacterial role in the lower respiratory tract and is present at elevated concentrations in lung epithelial lining fluid relative to plasma. The level of transferrin receptor synthesis in primary cultures of rat alveolar epithelial cells (AECs) was investigated. Transferrin receptor was found to be synthesized early in AEC cultures with the alveolar type II cell-like phenotype. Cell-surface receptor localization was attenuated upon apparent transdifferentiation to the alveolar type I cell-like phenotype later in culture. Binding of (125)I-labeled transferrin to the receptor indicated that surface and total cellular transferrin receptor levels were decreased in the type I-like cells. Inclusion of keratinocyte growth factor (KGF) in culture media (10 ng/ml) resulted in retention of transferrin receptor localized to the basolateral surface. Transferrin-receptor-specific internalization of (59)Fe-transferrin was also limited to the basolateral surface of KGF-treated monolayers. These data suggest that alveolar type II (but not type I) cells express functional transferrin receptor in adult rat alveolar epithelium.