Morphological and functional polymorphism within clonal thyroid nodules

Thirty-nine thyroid nodules, removed because of recent growth, were analyzed morphologically by serial histological sections for the classical histomorphological hallmarks of follicular cell replication and for immunohistochemically demonstrable overexpression of the growth-associated ras-gene product p21ras. Clonal analysis was performed using the highly informative probe M27 beta that detects polymorphisms on the locus DXS255 of the X-chromosome. Twenty-four nodules were of clonal and 15 nodules were of poly-clonal origin. Only 3 out of the 24 clonal nodules were histomorphologically uniform. In all others, the structural hallmarks of active growth and the P21ras growth-marker expression were remarkably heterogeneous throughout the tumors. There were no histomorphological characteristics distinguishing these clonal tumors from polyclonal nodules. Even if a clonal thyroid tumor may be originally homogeneous in respect to the parameters studied here, mechanisms must exist that create wide heterogeneity of growth and of morphogenetic potential among the individual follicular cells during further expansion of the nodule. Thus, clonal nodules are much more common in nodular goiters than hitherto assumed on grounds of the classical morphological criteria. The diagnosis of a true monoclonal nodule can no longer rely on morphological and functional criteria alone but requires molecular or cytogenetic analysis of clonality.     

Study of adenovirus production in serum-free 293SF suspension culture by GFP-expression monitoring

BACKGROUND: Recently, investigators have reported the use of endoscopic myotomy in the treatment of esophageal achalasia. As with the open operation, considerable disagreement exists regarding the appropriate length of the myotomy and the need for a concomitant antireflux procedure. METHODS: Patients presenting with symptomatic achalasia between 1993 and 1997 were included in this prospective study. Preoperative studies included barium upper gastrointestinal study, endoscopy, and esophageal manometry. Laparoscopic myotomy was completed in all 20 patients; 18 had concomitant Toupet fundoplication. RESULTS: Operative times ranged from 95 to 345 minutes (mean 216). Blood loss ranged from 50 to 300 cc (mean 100 cc). There were 7 minor complications (5 mucosal injuries repaired laparoscopically, 1 bile leak and 1 splenic capsular tear). Nine patients began a liquid diet on the first day postoperatively; 19 were tolerating liquids by postoperative day 3. Hospital stay ranged from 2 to 20 days (mean 5). Eighteen patients had complete relief of dysphagia, with less than one reflux episode per month. One individual continues to have mild persistent solid food dysphagia. Another patient initially did well but subsequently developed mild recurrent dysphagia and reflux. One patient required laparoscopic take-down of the wrap because of recurrent dysphagia and now has no problems swallowing, but does complain of mild reflux. Two other patients also have mild reflux, 1 of whom did not undergo fundoplication. CONCLUSIONS: Laparoscopic Heller myotomy can be performed safely with excellent results in patients with achalasia. Adding a partial fundoplication appears to help control postoperative symptoms of reflux. This procedure should be considered the procedure of choice in patients with symptomatic esophageal achalasia.     

Drug therapy of hemiballism. Review of the literature and personal observations

Hemiballism is a rare hyperkinetic disorder which is characterized by irregular vigorous rotatory movements of the limbs of one side of the body. The disabling and exhausting movements with their high risk of severe injuries require an acute drug treatment. However, there are no common guidelines for the treatment of this disorder. Therefore we reviewed the available literature to establish a concept for a rational symptomatic drug treatment. Furthermore, own observations in 6 patients with hemiballism of different origins are reported.     

Effect of the Geometric Parameters of a Layered Powder Composite on Its Magnetic Properties

The effect of thickness of magnetic conductor and number of electrically insulating layers on the magnetic properties in an alternating field of a layered powder-metallurgy soft-magnetic material based on iron was investigated. It was determined that increasing the thickness of the magnetic conductor and frequency of the alternating current deteriorated the magnetic properties of the material. Creation of a layered structure in which ferromagnetic layers alternate with electrically insulating layers decreased specific magnetic losses.     

Analytical Calculation of Large-Scale Deflection of Pulse-Loaded Elliptic Plates

Large deflections of pulse-loaded elliptic and round plates made of hardenable elastoplastic materials are investigated analytically using an energy-based approach. Formulas that are convenient for engineering design have been derived.     

A 3D contact smoothing method using Gregory patches

In this work, a method is developed for smoothing three‐dimensional contact surfaces. The method can be applied to both regular and irregular meshes. The algorithm employs Gregory patches to interpolate finite element nodes and provide tangent plane continuity between adjacent patches. The resulting surface interpolation is used to calculate gaps and contact forces, in a variationally consistent way, such that contact forces due to normal and frictional contact vary smoothly as slave nodes transition from one patch to the next. This eliminates the ‘chatter’ which typically occurs in a standard contact algorithm when a slave node is situated near a master facet edge. The elimination of this chatter provides a significant improvement in convergence behaviour, which is illustrated by a number of numerical examples. Furthermore, smoothed surfaces also provide a more accurate representation of the actual surface, such that resulting stresses and forces can be more accurately computed with coarse meshes in many problems. This fact is also demonstrated by the numerical examples. Published in 2002 by John Wiley & Sons, Ltd.