Renal Cystic Adenocarcinoma in a Flowerhorn Cichlid with Metastatic Involvement of the Spleen.

A 480-g flowerhorn cichlid (an ornamental hybrid) with severe bilateral abdominal swelling, bulla-like structures on the skin, bilateral exophthalmia, and a prolapsed intestine was presented. Radiographs showed compression of the posterior part of the swim bladder and abdominal distention. Ultrasonography of visceral organs revealed a heterogeneous mass with hypoechoic to anechoic polycystic parenchyma and free fluid in the abdominal cavity. At necropsy, free fluid in the abdominal cavity and a large polycystic mass originating from the posterior kidney were observed. Histologically, the mass was composed of more cystic growth of tubules. The renal architecture was replaced by tubules, often irregular in shape, lined by simple to lightly stratified layers of neoplastic and pleomorphic cuboidal to columnar epithelial cells and the absence of glomeruli. Birefringent crystals were observed with polarized light within the lumen of some tubules. The apical border of the neoplastic cells was periodic acid-Schiff positive. Immunohistochemically, the neoplastic cells were positive for cytokeratin AE1/AE3 and proliferating cell nuclear antigen and were negative for p53 (tumor suppressor protein). Microscopic metastasis was seen in the spleen. The metastatic tumor was classified as a cystic adenocarcinoma of the kidney, originating from the proximal tubules. Received October 7, 2016; accepted June 18, 2017.

Sacrificial-post templating method for block copolymer self-assembly.

A sacrificial-post templating method is presented for directing block copolymer self-assembly to form nanostructures consisting of monolayers and bilayers of microdomains. In this approach, the topographical post template is removed after self-assembly and therefore is not incorporated into the final microdomain pattern. Arrays of nanoscale holes of different shapes and symmetries, including mesh structures and perforated lamellae with a bimodal pore size distribution, are produced. The ratio of the pore sizes in the bimodal distributions can be varied via the template pitch, and agrees with predictions of self consistent field theory.

Diagnoses, requests and timing of 503 psychiatric consultations in two general hospitals.

The high comorbidity of medical and psychiatric diagnoses in the general hospital population requires collaboration between various medical fields to provide comprehensive health care. This study aims to find the rate of psychiatric consultations, their timing and overall diagnostic trend in comparison to previous studies. Tehran University of Medical Sciences has got an active psychiatric consultation-liaison service which includes services provided by four faculty psychiatrists (two full-time and two part-time). This study was done in two general hospitals by simple sampling in available cases. For each consultation, a board-certified faculty psychiatrist conducted a clinical evaluation based on DSM-IV-TR. Other than psychiatric diagnoses, socio-demographic variables, relative consultation rates, reasons for referral, medical diagnoses and the time stay after admission were assessed. Among 503 patients who were visited by the consultation-liaison service, there were 54.3% female with mean age of 39.8 years. In 90.1% of consultations, at least one DSM-IV-TR diagnosis was made. The most frequent diagnosis groups were mood disorder (43.5%), adjustment disorder (10.9%) and cognitive disorder (7.6%). In about 10.9% of the consultations, multiple psychiatric diagnoses were made. The mean length of hospital stay before the consultation was 12.56 days (range=1-90, SD=13). Based on our findings, the mood and cognitive disorders still remain major foci of consultation-liaison practice in general hospitals; however our findings showed high rate of adjustment disorders diagnosis and ambiguous request for psychiatric consultation which need more interdisciplinary interaction.