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Patients with CD5-expressing lymphomas presenting with splenomegaly are frequently diagnosed with chronic lymphocytic leukemia. The most important differential diagnosis is mantle cell lymphoma, both in its classical and leukemic, non-nodal forms, given its prognostic and therapeutic implications. Other small B-cell neoplasms that frequently involve the spleen and occasionally express CD5 include the splenic marginal zone lymphoma, hairy cell leukemia and, rarely, lymphoplasmacytic lymphoma. The frequency of CD5 positivity depends in part on the sensitivity of the detection methods employed. Usually, a combination of morphological, immunophenotypic and molecular findings allows for a precise sub-classification of CD5-positive, low-grade B-cell lymphomas of the spleen. Some of these tumors may display a mixture of small and larger B cells, raising the possibility of more aggressive lymphomas, such as diffuse large B-cell lymphomas (DLBCL). Approximately 5–10% of DLBCL are CD5-positive and some may manifest as primary splenic lesions. When available, the morphology of DLBCL in the splenic tissue is distinctive and a leukemic picture is very rare. In conclusion, the appropriate morphological and clinical context assisted by flow cytometry panels and/or immunohistochemistry allows the differential diagnosis of CD5-positive, non-Hodgkin, B-cell lymphomas involving the spleen.

International audience; We present and discuss the results of a field-based approach including accurate geological mapping and micro-to map-scale structural analysis to highlight the finite strain pattern recorded in Marguareis Unit, a massif deformed at shallow crustal levels at the boundary between Maritime and Ligurian Alps. We describe superposed tectonic structures developed under low-grade metamorphic conditions during the Alpine collision and nowadays exceptionally well recorded in the area of interest. We demonstrate that the structural frame of the Marguareis Unit results from superposition of fourfold systems, later segmented, but without significant displacements, by brittle faults.

Recently, Eggener et al. reignited a debate consisting to redefine Gleason Grade Group (GGG) 1 prostate cancer (PCa) as a precancerous lesion to reduce overdiagnosis and overtreatment. However, historical cohorts showed that some GGG1-labeled disease at biopsy may be underestimated by the standard PCa diagnostic workup. The aim was to assess whether the risk of adverse features at radical prostatectomy (RP) in selected GGG1 patients still exists in the era of pre-biopsy mpMRI and image-guided biopsies.We retrospectively reviewed our data from a European RP dataset to assess in contemporary patients with GGG1 at mpMRI-targeted biopsy the rate of adverse features at final pathology, defined as ≥ pT3a and/or pN+ and/or GGG ≥ 3.A total of 419 patients with cT1-T2 cN0 GGG1-PCa were included. At final pathology, 143 (34.1%) patients had adverse features. In multivariate analysis, only unfavorable intermediate-risk/high-risk disease (defined on PSA or stage) was predictive of adverse features (OR 2.45, 95% CI 1.11-5.39, p = 0.02). A significant difference was observed in the 3-year biochemical recurrence-free survival between patients with and without adverse features (93.4 vs 87.8%, p = 0.026). In sensitivity analysis restricted low- and favorable intermediate-risk PCa, 122/383 patients (31.8%) had adverse features and no preoperative factors were statistically associated with this risk.In this European study, we showed that there is still a risk of underestimating GGG1 disease at biopsy despite the routine use of image-guided biopsies. Future studies are warranted to improve the detection of aggressive disease in GGG1-labeled patients by incorporating the latest tools such as genomic testing or radiomics.

Objective Primary osteosarcoma of the jaw bones is very rare, and histological features of gnathic osteosarcoma remain obscure. The purpose of this study was to describe the clinicopathological features of gnathic osteosarcoma. Materials and methods Seven cases of gnathic osteosarcoma from Japan diagnosed during the period between 2000 and 2016 were examined retrospectively. The histology of the surgical pathology materials was reviewed by two pathologists. Clinical information was obtained from the hospital's information system. Results Of the seven cases, two patients had secondary osteosarcomas. As for the five cases of primary osteosarcoma, their ages ranged from 26 to 58 years (mean: 36.2, median: 28). Histologically, three cases were fibrotic tumors composed of spindle‐shaped cells with mild to moderate nuclear atypia and the collagenous stroma accompanied by woven bones or mature lamellar‐like bones. Two cases had cartilage formation. MDM2 and CDK4 expression was observed in two out of three cases on immunostaining. The histopathology of these three cases was regarded as the counterpart of low‐grade osteosarcomas, namely, parosteal osteosarcoma and low‐grade central osteosarcoma, arising in long bones. Conclusions The surprisingly high incidence (60%, 3/5 cases) of low‐grade osteosarcoma explains the reason why gnathic osteosarcomas present a more favorable prognosis than osteosarcomas arising in long bones. Furthermore, it provides insight into the tumorigenesis mechanism of low‐grade osteosarcomas arising in the jaw and other sites.

PurposeAlthough an increasing body of literature suggests a relationship between brain irradiation and deterioration of neurocognitive function, it remains as the standard therapeutic and prophylactic modality in patients with brain tumors. This review was aimed to abstract and evaluate the prediction models for radiation-induced neurocognitive decline in patients with primary or secondary brain tumors.MethodsMEDLINE was searched on October 31, 2021 for publications containing relevant truncation and MeSH terms related to “radiotherapy,” “brain,” “prediction model,” and “neurocognitive impairments.” Risk of bias was assessed using the Prediction model Risk Of Bias ASsessment Tool.ResultsOf 3,580 studies reviewed, 23 prediction models were identified. Age, tumor location, education level, baseline neurocognitive score, and radiation dose to the hippocampus were the most common predictors in the models. The Hopkins verbal learning (n = 7) and the trail making tests (n = 4) were the most frequent outcome assessment tools. All studies used regression (n = 14 linear, n = 8 logistic, and n = 4 Cox) as machine learning method. All models were judged to have a high risk of bias mainly due to issues in the analysis.ConclusionExisting models have limited quality and are at high risk of bias. Following recommendations are outlined in this review to improve future models: developing cognitive assessment instruments taking into account the peculiar traits of the different brain tumors and radiation modalities; adherence to model development and validation guidelines; careful choice of candidate predictors according to the literature and domain expert consensus; and considering radiation dose to brain substructures as they can provide important information on specific neurocognitive impairments.

Objectives. Mathematical modeling of heat transfer in flat channels with turbulators symmetrically located on both its sides, depending on the cross section of the turbulators.Methods. The calculation was carried out on the basis of a theoretical method based on solving the Reynolds equations factorized by the finite-volume finite-volume method, closed using the Menter shear stress transfer model, and the energy equation on multi-scale intersecting structured grids (FCOM), which was successfully tested in [23].Results. The article results of calculating the intensified heat exchange in flat channels with double turbulators of different cross sections (square, rectangular, semicircular, triangular) depending on the determining parameters were quite satisfactorily consistent with the existing experimental material, but having an indisputable advantage over the latter, since the assumptions made in their derivation cover a much wider range of defining parameters than the limitations found in the experiments (Pr=0.7÷100, Re=103÷106, h/dE =0.005÷0.2, t/h=1÷200).Conclusion. According to the results of calculations on the basis of the developed model, it is possible to optimize heat transfer intensification in flat channels with double turbulators of different cross sections, as well as control the heat transfer intensification process. As shown by the calculated data, with the intensification of heat transfer in the flat channels, symmetrical protrusions of square, rectangular and triangular cross sections, i.e. relatively sharp outlines, in the vortices up to the protrusions and behind them the production of turbulence is comparable to energy dissipation, which leads to increased hydraulic losses; for flat channels with protrusions of a semicircular cross section, i.e. relatively smooth outlines, the energy dissipation is much smaller, therefore, the hydraulic resistance in such channels is less. A detailed analysis of the structure of the vortex zones (main, angular, secondary, etc.) between periodic surface flow turbulators of square, semicircular, triangular and rectangular cross sections depending on the geometric and regime parameters of the coolant flow was carried out, the effect of the above vortex zones heat transfer and hydraulic resistance of the channel; additionally confirmed the optimality of application to abrutized turbulators, where hydraulic losses are much smaller than for sharp turbulators, which is directly or indirectly verified by existing experimental material [1—6].

Purpose Mutations in the isocitrate dehydrogenase-1 gene (IDH1) occur at high frequency in grade II–III gliomas (LGGs). IDH1 mutations are somatic, missense and heterozygous affecting codon 132 in the catalytic pocket of the enzyme. In LGG, most mutations (90%) result in an arginine to histidine substitution (IDH1R132H) providing a neo-epitope that is expressed in all tumor cells. To assess the immunogenic nature of this epitope, and its potential use to develop T cell treatments, we measured IDH1R132H-specific B and T cell reactivity in blood and tumor tissue of LGG patients. Methods Sera from IDH1R132H-mutated LGG patients (n = 27) were assayed for the presence of a neo-specific antibody response using ELISA. In addition, PBMCs (n = 36) and tumor-infiltrating lymphocytes (TILs, n = 10) were measured for T cell activation markers and IFN-γ production by flow cytometry and ELISA. In some assays, frequencies of CD4 T cells specific for mutated peptide presented by HLA-DR were enriched prior to T cell monitoring assays. Results Despite high sensitivity of our assay, we failed to detect IDH1R132H-specific IgG in sera of LGG patients. Similarly, we did not observe CD4 T cell reactivity towards IDH1R132H in blood, neither did we observe such reactivity following pre-enrichment of frequencies of IDH1R132H-specific CD4 T cells. Finally, we did not detect IDH1R132H-specific CD4 T cells among TILs. Conclusions The absence of both humoral and cellular responses in blood and tumors of LGG patients indicates that IDH1R132H is not sufficiently immunogenic and devaluates its further therapeutic exploitation, at least in the majority of LGG patients. Electronic supplementary material The online version of this article (10.1007/s11060-019-03228-6) contains supplementary material, which is available to authorized users.

Out-of-grade pine timber is an abundant material resource that is underutilised because its mechanical properties are not well understood. Increasing trends toward shorter rotation times and fast-grown plantation pines around the world such as Pinus elliottii × P. caribaea var. hondurensis hybrid (PEE × PCH) mean low-stiffness corewood is becoming a larger portion of this out-of-grade population. This study characterised the modulus and strength properties in bending, compression parallel to grain (CParG) and compression perpendicular to grain (CPerpG), shear and tension strength of low-stiffness out-of-grade PEE × PCH. The effect of resin, knots and pith on these properties were also investigated. The results show that in clear wood, the MOE in bending, CParG, CPerpG and shear modulus are 6.9 GPa, 5.78 GPa, 0.27 GPa and 0.59 GPa, respectively, while strengths are 45.8 MPa, 29.4 MPa, 6.7 MPa, 5.7 MPa, respectively. The tensile strength is 32.4 MPa. Resin significantly increased density 45% higher than clear, but performed similar with the exception of CPerpG MOE and strength which were significantly different. Resin area ratio (RAR) has a moderate correlation with density with an R2 of 0.659 but low to no correlation for mechanical properties. Knots were significantly different to clear for all test types and within a range of 48% to 196%. Knots were high in CPerpG MOE and strength but lower for all other properties and had the largest negative impact on tensile strength. Knot area ratio (KAR) had low to moderate correlation with tension strength and CPerpG MOE with R2 of 0.48 and 0.35, respectively. Pith was within the range of 76% to 121% of non-pith samples for structural performance, some of which were significantly different, and pith samples were higher in density than non-pith. This new information is crucial for the effective establishment of grading rules, design optimisation and utilisation of low-stiffness out-of-grade PEE × PCH as a new material resource in civil engineering applications.

Degenerative low-grade lumbar spondylolisthesis is the most common form of spondylolisthesis. The majority of patients are asymptomatic and do not require surgical intervention. Symptomatic patients present with a combination of lower back pain, radiculopathy and/or neurogenic claudication and may warrant surgery if non-operative measures fail. There is widespread controversy regarding the indications for surgery and appropriate treatment strategies for patients with this type of spondylolisthesis. This article provides a comprehensive evidence-based review of the available literature to support the management of degenerative low-grade spondylolisthesis. Cite this article: EFORT Open Rev 2018;3:620-631. DOI: 10.1302/2058-5241.3.180020.

Sulfidic copper–lead–zinc tailings can pose a significant environmental threat, ranging from generation of acid mine drainage (AMD) to dam failures. On the other hand, they can also be considered as low-grade ore resources for zinc and copper provided that novel economically feasible metal extraction and metal recovery techniques are developed. Due to the low metal concentrations in these resources, the leaching will generate dilute leachates from which metal recovery is a challenge. Ion flotation is a foam separation technique capable of recovering metal ions from dilute aqueous leachates. In this paper, ion flotation was applied to separate copper from ammoniacal leachates of microwave-roasted sulfidic tailings samples. The sulfidic tailings were first roasted at 550 °C for 60 min, for the oxidation of sulfide minerals to more easily soluble sulfates using microwave-assisted irradiation as heating source. The microwave-roasted material was then leached with a mixture of ammonia and ammonium carbonate solutions. The optimum leaching efficiencies of zinc (86%) and copper (75%) were obtained under the following conditions: liquid-to-solid ratio = 10 mL g−1, T = 90 °C, [NH3 + NH4+] = 4 mol L−1, NH3:NH4+ = 2:1, t = 5 h. From the generated pregnant leach solution, it was possible to selectively separate 85% of copper to the foam phase by ion flotation, with sodium dodecyl sulfate (SDS) surfactant, as colloidal copper(II) tetraamine dodecyl sulfate under the optimized conditions: [SDS]total = 5.85 mmol L−1, [EtOH] = 0.5 % (v/v), ttotal = 5 h, flotation stages = 3. The zinc that remained in the solution after ion flotation was recovered by precipitation (95%) as basic zinc carbonate. Copper and zinc extraction by ammoniacal leaching from microwave-roasted Cu-Zn-Pb sulfidic tailings followed by recovery of copper and zinc by ion flotation and precipitation.

This study presents the novel idea of a cyanide-free leaching method, i.e., glycine-ammonia leaching in the presence of permanganate, to treat a low-grade and copper-bearing gold tailing. Ammonia played a key role as a pH modifier, lixiviant and potential catalyst (as cupric ammine) in this study. Replacing ammonia with other pH modifiers (i.e., sodium hydroxide or lime) made the extractions infeasibly low (

Background Whilst the resection margin is an established factor predictive of local control of soft-tissue sarcomas (STSs), the adequacy of margin width for low-grade STSs has been rarely described. We aimed to investigate the margin adequacy and its prognostic relevance in low-grade STSs. Methods 109 patients who underwent surgical treatment for a low-grade STS were studied. The prognostic value of margin status was evaluated according to the R–, R+1–classification, and width in millimetres. Results The 10-year local recurrence (LR) rates were 6%, 27%, 54% in R0, R1, and R2, respectively (p < 0.001), according to the R–classification. The R+1–classification resulted in a decreased LR rate in R1, but no major differences in LR rates in R0 and R2; 7%, 14%, 54% in R0, R1, and R2, respectively (p < 0.001). When classified by metric distance, 10-year LR rates were 0%, 8%, and 38% by ≥ 2.0 mm, 0.1–1.9 mm, and 0 mm margins, respectively (p < 0.001). Patients with close margins (0.1–1.9 mm) who received adjuvant radiotherapy had a trend toward lower LR risk than those without radiotherapy (10-year, 4% vs. 12%; p = 0.406). The 5 and 10-year disease-specific mortality was 9% and 13%, respectively; margin width was not associated with disease-specific mortality but LR was a poor prognostic factor for survival (p = 0.003). Conclusion Whilst negative margin provided local control over 90%, excellent local control was achieved with microscopic margins ≥2 mm. The role of margins is more important than radiotherapy in local control. Margins do not determine survival, but LR is associated with a poor prognosis.

Indolent T-cell lymphoproliferative disorder of the GI tract (GI-TLPD) is a rare human gastrointestinal T cell lymphoma, with no therapeutic consensus. Meanwhile, an emerging indolent GI lymphoma affecting the ageing cat (T-cell low grade intestinal lymphoma ; T-LGIL) has been reported by the veterinary community. T-LGIL entity was prospectively defined at the clinical, paraclinical, histopathological and molecular levels in order to validate a potential model for the human disease. New histopathologic and immunohistochemical criteria were defined. Clonality analysis showed mainly monoclonal TCR rearrangement. The second part of the study led us to describe discriminating criteria to differentiate T-LGIL from lymphoplasmacytic enteritis. A new lymphomagenesis model was therefore suggested, evoking a continuity between an intestinal chronic antigenic stimulation and a clonal emergence of small T-cell lymphocytes within the intestinal mucosa. In conclusion, we assume that feline T-LGIL is a relevant model to better characterize human GI-TLPD., Les lymphoproliférations à cellules T du tractus gastro-intestinal (GI-TLPD) sont des lymphomes T rares chez l’Homme pour lesquels aucun consensus thérapeutique n’est établi. Par ailleurs, une lymphoprolifération digestive indolente à cellules T (T-LGIL) émergente est décrite dans l’espèce féline. La physiopathologie de ces entités est mal définie. Dans un premier temps, nous avons prospectivement analysé des prélèvements lésionnels chez 22 chats présentant un T-LGIL sur les plans clinique, paraclinique, histopathologique et moléculaire. Nos résultats valident que ce modèle animal est pertinent pour l’étude de la maladie humaine. Dans l’autre partie du travail, notre objectif a été l’identification de critères discriminant les lymphoproliférations indolentes félines des entérites lymphoplasmocytaires, ce diagnostic différentiel étant un défi chez le chat. Nous avons établi de nouveaux critères histologiques et immunohistochimiques. Un modèle de lymphomagenèse a été proposé : il repose sur un continuum entre une entéropathie inflammatoire chronique et l’émergence de clones néoplasiques T au sein de la muqueuse intestinale., Freiche Valérie, Cordonnier-Lefort Nathalie, Paulin Mathieu-Victor, Huet Hélène, Turba Maria-Elena, Macintyre Elizabeth, Malamut Georgia, Cerf-Bensussan Nadine, Molina Thierry Jo, Hermine Olivier, Bruneau Julie, Couronné Lucile. Lymphome intestinal de bas grade félin : validation d’un modèle spontané et émergent illustrant les lymphoproliférations digestives indolentes à cellules T de l’homme. In: Bulletin de l'Académie Vétérinaire de France tome 173, 2020. pp. 9-19.

Small cell intestinal lymphoma has not been well characterized in dogs. The objective of this study was to describe clinical characteristics and outcome in dogs with small cell intestinal lymphoma. We hypothesized that affected dogs would have prolonged survival compared with high-grade gastrointestinal (GI) lymphoma. Pathology records were searched for dogs with histologically confirmed small cell GI lymphoma. Seventeen dogs with confirmed small cell intestinal lymphoma were identified, and clinical and outcome data were retrospectively collected. Histopathology was reviewed by a board-certified pathologist, and tissue sections were subjected to immunophenotyping and molecular clonality assessment. All dogs had small cell, T-cell, lymphoma confirmed within various regions of small intestine, with 1 dog also having disease in abdominal lymph nodes. All dogs had clinical signs attributable to GI disease; diarrhoea (n = 13) was most common. Ultrasonographic abnormalities were present in 8 of 13 dogs with abnormal wall layering (n = 7) and hyperechoic mucosal striations (n = 7) representing the most common findings. In total, 14 dogs received some form of treatment. The median survival time (MST) for all dogs was 279 days and the MST for the 14 dogs that received any treatment was 628 days. Dogs with anaemia and weight loss at presentation had significantly shorter survival times and dogs that received a combination of steroids and an alkylating agent had significantly longer survival times. Small cell, T-cell, intestinal lymphoma is a distinct disease process in dogs, and those undergoing treatment may experience prolonged survival.

// Weimin Xie 1 , Xiaoning Bi 1 , Dongyan Cao 1 , Jiaxin Yang 1 , Keng Shen 1 and Yan You 2 1 Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China 2 Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China Correspondence to: Jiaxin Yang, email: yangjiaxin4022@163.com Keywords: ovarian endometrioid stromal sarcoma, low-grade, high-grade, recurrence, prognosis Received: November 16, 2016 Accepted: June 02, 2017 Published: June 28, 2017 ABSTRACT Purpose: Primary endometrioid stromal sarcomas (ESS) of the ovary are rare mesenchymal tumors with scarce data on their behavior and optimal treatment. We aimed to describe the clinicopathologic features and outcome among patients with primary ovarian ESS. Results: The age of the patients ranged from 34 to 61 years (mean: 49.1 years, median: 51.5 years). The most common symptoms were abdominal distention or pain or both. Nine (64.3%) and five patients (35.7%) had low-grade and high-grade disease, respectively. The median duration of follow-up was 65 months (range, 8–311 months). All 9 patients with low-grade ESS were alive, of these, 3 (33.3%) of them developed recurrence after surgery. Only 1 patient (20%) with high-grade ESS was alive with no evidence of disease in a short-term follow-up visit; the remaining 4 (80%) developed recurrence after surgery, and 2 (40%) died of progressive disease. Methods: Medical records of 14 patients with primary ovarian ESS in our institution were collected and analyzed. Conclusions: The behavior of primary ovarian ESS is similar to that of their uterine counterparts. Low-grade ESS is an indolent tumor with a propensity for late recurrences. The prognosis of high-grade ESS is poor.

Objectives: Although patients with grade I and II endometrioid endometrial adenocarcinoma (EEA) are considered with good prognosis, among them 15%-25% died in 5 years. It is still unknown whether integrating estrogen receptor (ER) and progesterone receptor (PR) into clinical risk stratification can help select high-risk patients with grade I-II EEA. This study was to investigate the prognostic value of ER and PR double negativity (ER/PR loss) in grade I-II EEA, and the association between ER/PR loss and The Cancer Genome Atlas (TCGA) classification. Methods: ER and PR were assessed by immunohistochemistry on hysterectomy specimens of 903 patients with grade I-II EEA. ER and PR negativity were determined when

Nonunion remains a major complication of the management of long bone fractures. The primary aim of the present study was to investigate whether raised levels of C-reactive protein (CRP) and white blood cell count (WBC), in the absence of clinical signs, are correlated with positive intraoperative tissue cultures in presumptive aseptic long-bone nonunions. Infection was classified as positive if any significant growth of microorganisms was observed from bone/tissue samples sent from the theater at the time of revision surgery. Preoperatively all patients were investigated with full blood count, white blood count differential as well as C-reactive protein (CRP). A total of 105 consecutive patients (59 males) were included in the study, with an average age of 46.76 years (range 16&ndash, 92 years) at the time of nonunion diagnosis. The vast majority were femoral (56) and tibial (37) nonunions. The median time from the index surgical procedure to the time of nonunion diagnosis was 10 months (range 9 months to 10 years). Positive cultures revealed a mixed growth of microorganisms, with coagulase-negative Staphylococcus (56.4%) being the most prevalent microorganism, followed by Staphylococcusaureus (20.5%). Pseudomonas, Methicillin-Resistant Staphylococcus aureus (MRSA), coliforms and micrococcus were present in the remainder of the cases (23.1%). Overall, the risk of infection with normal CRP levels (&lt, 10 mg/L) was 21/80 = 0.26. Elevated CRP levels (&ge, 10 mg/L) increased the risk of infection to 0.72. The relative risk given a positive CRP test was RR = 0.72/0.26 = 2.74. Overall, the WBC count was found to be an unreliable marker to predict infection. Solid union was achieved in all cases after an average of 6.5 months (3&ndash, 24 months) from revision surgery. In patients with presumed aseptic long bone nonunion and normal CRP levels, the risk of underlying low-grade indolent infection can be as high as 26%. Patients should be made aware of this finding, which can complicate their treatment course and outcomes.

// Weimin Xie 1 , Dongyan Cao 1 , Jiaxin Yang 1 , Xuan Jiang 1 , Keng Shen 1 , Lingya Pan 1 , Huifang Huang 1 , Jinghe Lang 1 , Yan You 2 and Jie Chen 2 1 Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China 2 Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China Correspondence to: Jiaxin Yang, email: // Keywords : fertility-sparing surgery, low-grade, endometrial stromal sarcoma , recurrence, pregnancy Received : August 08, 2016 Accepted : September 29, 2016 Published : October 06, 2016 Abstract Purpose: To assess the clinical outcomes and fertility of young women with stage I low-grade endometrial stromal sarcoma (ESS) treated with fertility-sparing surgery. Results: Seventeen patients with stage I low-grade ESS (stage IA, n = 6; stage IB, n = 11) were entered into this study. Adjuvant hormone therapy was administered to 15 (88.2%) patients. At a median follow-up of 39 months (range, 4–106 months), 10 (58.8%) patients developed recurrence. All 10 patients had stage IB disease; among them, the first recurrence limited to the uterus was observed in 6 patients. All 17 patients were alive and disease-free at the time of last contact. After treatment, five of eight (62.5%) patients who attempted pregnancy conceived. No offspring had congenital anomalies. Methods: Patients with stage I low-grade ESS who underwent fertility-sparing surgery between April 2001 and November 2015 were retrospectively reviewed. Conclusions: Fertility-sparing surgery may be considered for young patients with stage IA low-grade ESS who wish to preserve their fertility.

In this paper, a low-grade zinc oxide ore in Yunnan, China is investigated. A large number of argillaceous and alkaline gangue makes it infeasible to treat the ore with heap leaching. In order to solve this problem, several new technologies combining mineral processing and metallurgy technique are studied to process this refractory ore with 6.50 per cent Zn. It is shown that the reasonable new process technology of combining mineral processing of Zn oxides after sulfides and hydrometallurgy could realize efficient recovery of the zinc minerals in the ore. 85.90 per cent of Zn was recovered by flotation and totally 80.95 per cent of Zn can be recovered by this new technology of combining mineral processing and metallurgy. One merit of this new process technology is that the zinc sulfides and oxides can be recovered without desliming in the flotation cells at the different stage and make sure the concentrate products as a good feed for hydrometallurgical technology. This study provided pretty good technical support for tapping low-grade refractory zinc oxide ores.

Background: Nearly 10 years ago, the World Health Organization reported the increasing prevalence of overweight and obesity worldwide as a challenge for public health due to the associated adverse consequences. Epidemiological studies established a firm relationship between an elevated body mass index and chronic conditions such as diabetes, dyslipidemia, hypertension, heart disease, non-alcoholic fatty liver disease, and some types of cancer. Omic studies demonstrated that microRNA (miRNA) profile changes in tissues correlate with a number of diseases, including obesity. Recent studies showed a remarkable stability of miRNAs also in blood, emphasizing their potential as theranostic agents for a variety of disorders and conditions. A number of miRNAs enriched in homeostasis of obesity and metabolic disorders have been characterized in previous researches.Aim: This work was finalized to investigate the differential circulating miRNAs signature in early childhood obesity. Our cross-sectional study analyzed the signature of circulating miRNAs in plasma samples of normal weight (n = 159) and overweight/obese (n = 149) children and adolescents participating to the I.Family study, an EC-funded study finalized to investigate the etiology of overweight, obesity and related disorders and the determinants of food choice, lifestyle, and related health outcomes in children and adolescents of eight European countries (www.ifamilystudy.eu).Results: Differences in miRNA signature with respect to anthropometric and biochemical variables were analyzed. A high degree of variability in levels of circulating miRNAs was identified among children from different countries, in line with recent reports supporting the hypothesis that these molecules are likewise affected by environmental and lifestyle factors. A panel of miRNAs differentially expressed in overweight/low-grade obesity children was characterized (miR-551a and miR-501-5p resulted upregulated; miR-10b-5p, miR-191-3p, miR-215-5p, and miR-874-3p resulted downregulated). ROC curves were also constructed for experimentally confirmed miRNAs. Single miRNAs generally exhibited low AUC values with the highest values for miR-874-3p and miR-501-5p which in combination provided an interesting value (AUC = 0.782). Pearson's analysis confirmed that miR-10b-5p, miR-215-5p, miR-501-5p, miR-551a, and miR-874-3p significantly correlated with BMI z-score. Molecular interactions of obesity-associated miRNAs were also predicted by bioinformatics tools.Conclusions: Our work showed that several circulating miRNAs are differentially represented in overweight/low-grade obesity children and adolescents. Although causal pathways cannot be firmly inferred, it is conceivable that circulating miRNAs may be new biomarkers of early childhood obesity.Trial registration: ISRCTN, ISRCTN62310987. Registered 23/02/2018 - Retrospectively registered.

Polymorphous low-grade neuroepithelial tumor of the young (PLNTY) is a recently described variant of low-grade neuroepithelial tumors that exhibits infiltrative growth, histopathological variability with frequently prominent oligodendroglioma-like components, intense labeling for CD34, absence of 1P/19Q codeletion, a distinct DNA methylation signature and genetic alterations involving MAP kinase pathway constituents of either the B-Raf proto-oncogene BRAF or fibroblast growth factor receptors 2 or 3 (FGFR2 and FGFR3). We here report a newly diagnosed case of PLNTY involving the temporal lobe in a 31-year-old man with chronic focal epilepsy. This tumor had histologic and immunophenotypic features similar to the recently described PLNTY and proved BRAF V600E mutant. Biomolecular profiling is becoming increasingly important in characterizing neuroepithelial tumors. Furthermore, biomolecular features such as CD34 expression and BRAF mutation have been reported to be significantly associated with the clinical behavior of these tumors. Like other low-grade neuroepithelial tumors, PLNTYs appear to be generally indolent with excellent seizure relief after total surgical resection. It is important to recognize cases of PLNTY in order to guide clinical management including the indication for surgery. .

Background At current prognostication of low grade glioma remains suboptimal and might be improved with additional markers. These may guide treatment decisions, in particular on early adjuvant therapy versus wait and see after surgery. Methods We used a targeted Next-Generation Sequencing panel to assess mutational and copy number status of selected genes and chromosomes in a consecutive series of adult grade II supratentorial glioma, and assessed the impact of molecular markers of interest on overall survival. Results 207 IDH mutated grade II glioma samples were analyzed with a median follow-up of 6.9 years. Loss of region 9p21.3 did not show a correlation with outcome in IDH mutated 1p/19q-codeleted oligodendroglioma or IDH mutated astrocytoma. We found a significant shorter overall survival with univariable analysis in IDH mutated astrocytoma patients with trisomy of chromosome 7 (Log rank P = 0.044) and in IDH mutated 1p/19q-codeleted oligodendroglioma patients with a PTEN mutation (Log rank P = 0.033). We could not validate these findings in multivariate analysis or in the TCGA dataset. Conclusions Loss of 9p21.3 is not associated with outcome in a molecularly defined cohort of grade II glioma and therefore it remains unclear if loss of 9p21.3 can be used as additional marker of anaplasia or to guide treatment decisions. Trisomy of chromosome 7 in IDH mutated astrocytoma and PTEN mutations in IDH mutated oligodendroglioma are potential markers of poor prognosis, but require confirmation in larger series. Electronic supplementary material The online version of this article (10.1007/s11060-018-2867-8) contains supplementary material, which is available to authorized users.

Background: The current debate on overdiagnosis and overtreatment of screen-detected ductal carcinoma in situ (DCIS) urges the need for prospective studies to address this issue. A substantial number of DCIS lesions will never form a health hazard, particularly if it concerns non-to slow-growing low-grade DCIS. The LORD study aims to evaluate the safety of active surveillance in women with low-risk DCIS. Design: This is a randomised, international multicentre, open-label, phase III non-inferiority trial, led by the Dutch Breast Cancer Research Group (BOOG 2014-04) and the European Organization for Research and Treatment of Cancer (EORTC-BCG 1401). Standard treatment will be compared to active surveillance in 1240 women aged P45 years with asymptomatic, screen-detected, pure low-grade DCIS based on vacuum-assisted biopsies of microcalcifications only. Both study arms will be monitored with annual digital mammography for a period of 10 years. The primary end-point is 10-year ipsilateral invasive breast cancer free percentage. Secondary end-points include patient reported outcomes, diagnostic biopsy rate during follow-up, ipsilateral mastectomy rate and translational research. Feasibility: To explore interest in and feasibility of the LORD study we conducted a survey among EORTC and BOOG centres. A vast majority of EORTC and BOOG responding centres expressed interest in participation in the LORD study. The proposed study design is endorsed by nearly all centres. (C) 2015 The Authors. Published by Elsevier Ltd.

Solid fuel plays significant role in the development of civilization as the main fuel source. Use of low-grade (ash content ∼ 40-45%) coal is partially offset environmental problems also affect human health when it is burned. As the main industrial corporations use coal, in particular low-grade high-ash content coal from Ekibastuz coal basin because of its cheap cost the atmosphere of megacities like Almaty is polluted by noxious volatile. In this study were developed a mathematical model of turbulent heat and mass transfer process occurring in the combustion chamber of SB-39 of Aksusskaya TPP for control the concentration of volatile and to recommend the optimize methods for burning process. Based on 3D computer modeling investigated formation of harmful dust and gas emissions during the combustion of low-grade coal and offered cost-effective methods of burning.

The central nervous system (CNS) is an important area of involvement for both high-grade, aggressive primary and secondary lymphomas. Although follicular lymphoma represents a low-grade histology, it may rarely present with CNS involvement. Here, we describe a patient diagnosed with follicular lymphoma who was presented with cerebellar involvement.

Objective To investigate the CT and MR imaging findings and differential diagnosis of malignant vascular tumors of bone. Materials and methods CT and MR imaging findings of 18 patients with histopathology-proven malignant vascular tumors of bone were examined. Assessed image features included age, sex, location, CT findings, and MR imaging appearances and dynamic contrast-enhanced MR imaging. Results The study group comprised 18 cases, of which 7 were categorized as low-grade malignant vascular tumors (LMT), and 11 were categorized as high-grade malignant vascular tumors (HMT). Malignant vascular tumors of bone showed osteolytic lesions with heterogeneous signs and enhancement, and frequently associated with soft tissue masses and peritumorous edema. The mean age of patient was respectively 34.7 years in LMT with 3 patients younger than 20 and 49.9 years in HMT with 3 patients older than 60 years. The mean lesion diameter was 3.6 cm (range 2–7.2) in LMT with two lesions

Tumors in non-Hodgkin lymphoma (NHL) patients are often proximal to the major blood vessels in the abdomen or neck. In external-beam radiotherapy, these tumors present a challenge because imaging resolution prevents the beam from being targeted to the tumor lesion without also irradiating the artery wall. This problem has led to potentially life-threatening delayed toxicity. Because radioimmunotherapy has resulted in long-term survival of NHL patients, we investigated whether the absorbed dose (AD) to the artery wall in radioimmunotherapy of NHL is of potential concern for delayed toxicity. SPECT resolution is not sufficient to enable dosimetric analysis of anatomic features of the thickness of the aortic wall. Therefore, we present a model of aortic wall toxicity based on data from 4 patients treated with (131)I-tositumomab. METHODS: Four NHL patients with periaortic tumors were administered pretherapeutic (131)I-tositumomab. Abdominal SPECT and whole-body planar images were obtained at 48, 72, and 144 h after tracer administration. Blood-pool activity concentrations were obtained from regions of interest drawn on the heart on the planar images. Tumor and blood activity concentrations, scaled to therapeutic administered activities-both standard and myeloablative-were input into a geometry and tracking model (GEANT, version 4) of the aorta. The simulated energy deposited in the arterial walls was collected and fitted, and the AD and biologic effective dose values to the aortic wall and tumors were obtained for standard therapeutic and hypothetical myeloablative administered activities. RESULTS: Arterial wall ADs from standard therapy were lower (0.6-3.7 Gy) than those typical from external-beam therapy, as were the tumor ADs (1.4-10.5 Gy). The ratios of tumor AD to arterial wall AD were greater for radioimmunotherapy by a factor of 1.9-4.0. For myeloablative therapy, artery wall ADs were in general less than those typical for external-beam therapy (9.4-11.4 Gy for 3 of 4 patients) but comparable for 1 patient (32.6 Gy). CONCLUSION: Blood vessel radiation dose can be estimated using the software package 3D-RD combined with GEANT modeling. The dosimetry analysis suggested that arterial wall toxicity is highly unlikely in standard dose radioimmunotherapy but should be considered a potential concern and limiting factor in myeloablative therapy.

Low-grade non-Hodgkin lymphomas were once considered as a heterogenous group of lymphomas characterized by an indolent clinical course. Today, low-grade non-Hodgkin lymphomas are classified as a group of 10 distinct entities, each characterized by unique clinico biologic features. Follicular lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma, lymphoplasmacytic lymphoma, and marginal zone lymphoma are the most-investigated subtypes. Several studies have been performed to identify prognostic factors specific for each subtype in an effort to help clinicians in treatment decisions. The field of biologically specific associated parameters holds great potential but requires more research and work to produce translational results.

Background Patients with non-dysplastic Barrett’s esophagus (ND-BE) and low-grade dysplasia (LGD) are typically monitored by periodic endoscopic surveillance, while those with high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC) are usually treated by more aggressive interventions like endoscopic mucosal resection, ablation or surgery. Therefore, the accurate grading of dysplasia in Barrett’s esophagus (BE) is essential for proper patient care. However, there is significant interobserver and intraobserver variability in the histologic grading of BE dysplasia. The objective of this study was to create an immunohistochemical (IHC) panel that facilitates the grading of BE dysplasia and can be used as an adjunct to histology in challenging cases. Methods 100 BE biopsies were re-graded for dysplasia independently by 3 subspecialized gastrointestinal pathologists. IHC staining for CDX2, p120ctn, c-Myc and Jagged1 proteins was then performed and assessed by two separate methods of semi-quantitative scoring. Scores were integrated using a principal component analysis (PCA) and receiver operating characteristic (ROC) curve. Results Principal component analysis demonstrated the ability of this panel of proteins to segregate ND-BE/LGD and HGD/EAC, as the expression of the four proteins is significantly altered between the two subsets. Analysis of the receiver operating characteristic curve showed that this panel has the potential to aid in the grading of dysplasia in these two subcategories with both high sensitivity and specificity. While not able to discriminate between ND-BE and LGD, this panel of four proteins may be used as an adjunct to help discriminate subsets of ND-BE/LGD from HGD/EAC. Conclusions We propose that the maximum utility of this IHC panel of CDX2, p120ctn, c-Myc, and Jagged1 proteins would be to distinguish between LGD and HGD in histologically challenging cases, given the aggressive interventions still used for HGD in many institutions, and hence may aid in the optimal patient management. The results of this initial study are promising, though further validation is needed before this panel can be used clinically, including future randomized prospective studies with larger patient cohorts from diverse locations. Electronic supplementary material The online version of this article (doi:10.1186/s13000-016-0473-7) contains supplementary material, which is available to authorized users.

We report a rare case of primary pulmonary low-grade angiosarcoma on dynamic contrast-enhanced CT and (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT imaging. A 38-year-old, asymptomatic woman was hospitalized because of an abnormality on chest radiography. A dynamic contrast-enhanced chest CT showed a 1.2 cm-sized irregular-margined nodule with strong and persistent enhancement in the right lower lobe. The lesion had low metabolic activity on an (18)F-FDG PET/CT scan. The patient underwent a wedge resection for the lesion, and pathology revealed a primary pulmonary low-grade angiosarcoma.

Low-grade cribriform cystadenocarcinoma (LGCCC) is a recently described rare tumor of salivary gland which exhibits clinically indolent behavior. This tumor predominantly consists of intraductal components and frequently exhibits papillary-cystic or cribriform proliferation pattern. Considering the histological features of LGCCC, it should be distinguished with papillocystic variant of acinic cell carcinoma, conventional salivary duct carcinoma, cystadenocarcinoma, polymorphous low-grade adenocarcinoma, carcinoma ex pleomorphic adenoma and mammary analogue secretory carcinoma. Herein, we presented two cases of LGCCC. One arose in the left parotid region in a 48-year-old male, and the other one arose in the right parotid gland in a 59-year-old female. For both cases, immunohistochemically, the luminal tumor cells showed diffuse expression of CK and S100; p63 and smooth muscle actin displayed a continuous rim of myoepithelial cells around all tumor islets; no myoepithelial cells were admixed with the luminal cells. Both patients were alive with no tumor recurrence or metastasis at follow-up. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2593621568999135

STUDY DESIGN: Retrospective series. PURPOSE: Assess results of decompression-only surgery for low-grade degenerative spondylolisthesis with consideration of instability. OVERVIEW OF LITERATURE: There is no consensus on whether fusion or decompression-only surgery leads to better outcomes for patients with low-grade degenerative spondylolisthesis. Current trends support fusion but many studies are flawed due to over-generalization without consideration of radiological instability and their variable presentations and natural history. METHODS: Patients with surgically treated degenerative spondylolisthesis from 1990-2013 were included. Clinical and radiological instability measures were included. Any residual or recurrence of symptoms, revision surgery performed and functional outcome scores including the numerical global rate of change scale, visual analogue scale, and modified Barthel index were measured. Follow-up periods for patients were divided into short-term (10 years). RESULTS: A total of 64 patients were recruited. Mechanical low back pain was noted in 48 patients and most (85.4%) had relief of back pain postoperatively. Radiological instability was noted in 4 subjects by flexion-extension radiographs and 12 subjects with prone traction radiographs by increased disc height and reduction of olisthesis and slip angle. From the results of the short-term, mid-term and long-term follow-up, reoperation only occurred within the first 5-year follow-up period. All functional scores improved from preoperative to postoperative 1-year follow-up. CONCLUSIONS: Decompression-only for low-grade degenerative spondylolisthesis has good long-term results despite instability. Further higher-level studies should be performed on this patient group with radiological instability to suggest the superior surgical option., published_or_final_version

Endometrial stromal sarcomas (ESSs) are uncommon tumors of the uterus, and the cytologic features have only been reported in a number of case reports that mostly discuss the features of higher grade undifferentiated sarcomas. This article discusses the cytologic features of a unique case of hyaline vascular variant of low-grade ESSs (LGESS), which masqueraded as a ovarian tumor due to its massive extension into broad ligament. Touch imprint smears revealed bland cells occurring singly and small clusters, scant cytoplasm, small round or oval nuclei, fine chromatin pattern, and occasional small prominent nucleoli. Frequent metachromatic hyaline globules and plaques were seen between the tumor cells in all the smears. Histological examination of the tumor showed LGESS with extensive stromal and perivascular hyalinization.

An organic Rankine cycle (ORC) is a power cycle employing an organic working fluid. The term ORC is also applied generally to any Rankine cycle with a low-grade heat source (80° – 300°C). Because ORC are often employed in small-scale applications, use of positive displacement equipment is favored over the centrifugal units used in large-scale power plants. A key feature of a positive displacement expander is its built-in volume ratio. An ORC with a scroll-type expander is studied experimentally. Data for steady state tests of the ORC are presented according to a proposed steady state standard. It is shown that the adiabatic efficiency of the expander can be fully characterized by its filling factor and the expansion volume ratio imposed across it. In particular, the peak adiabatic efficiency occurs near a filling factor of unity and an expansion volume ratio near the built-in volume ratio of the expander. The influence of the expander’s performance on cycle efficiency is considered. A procedure is presented which allows prediction of cycle performance based on knowledge of the expander efficiency versus expansion volume ratio, cycle operating conditions, and working fluid. Using this procedure, an optimal expander can be chosen for a set of cycle operating conditions based on its peak efficiency and built-in volume ratio.

Sjogren's syndrome is an autoimmune disease with a known predisposition for lymphoma development. Eight of 120 patients with primary Sjogren's syndrome followed at the University of loannina over the past 7 years developed non‐Hodgkin's lymphoma diagnosed according to the Kiel classification. The lymphomas differed by location and grading. Six were called low grade (immunocytoma) and two intermediate grade non‐Hodgkin's lymphomas. Five of the immunocytomas involved the minor salivary or lacrimal glands. Immunoperoxidase staining for light chains revealed monoclonal populations. Two patients showed spontaneous regression not previously reported in Sjogren's syndrome. Thus, in Sjogren's syndrome, low grade non‐Hodgkin's lymphomas and especially immunocytomas are the most common lymphomas. These lymphomas tend to evolve very slowly and may regress spontaneously. Given these facts, a conservative approach to treatment is indicated in those patients with only localized disease. © 1992 Wiley‐Liss, Inc. Copyright © 1992 Wiley‐Liss, Inc., A Wiley Company 20 4 279 283

Infrared (IR) absorbance of cellular biomolecules generates a vibrational spectrum, which can be exploited as a “biochemical fingerprint” of a particular cell type. Biomolecules absorb in the mid-IR (2–20 μm) and Fourier-transform infrared (FTIR) microspectroscopy applied to discriminate different cell types (exfoliative cervical cytology collected into buffered fixative solution) was evaluated. This consisted of cervical cytology free of atypia (i.e. normal; n = 60), specimens categorised as containing low-grade changes (i.e. CIN1 or LSIL; n = 60) and a further cohort designated as high-grade (CIN2/3 or HSIL; n = 60). IR spectral analysis was coupled with principal component analysis (PCA), with or without subsequent linear discriminant analysis (LDA), to determine if normal versus low-grade versus high-grade exfoliative cytology could be segregated. With increasing severity of atypia, decreases in absorbance intensity were observable throughout the 1,500 cm–1 to 1,100 cm–1 spectral region; this included proteins (1,460 cm–1), glycoproteins (1,380 cm–1), amide III (1,260 cm–1), asymmetric (νas) PO2– (1,225 cm–1) and carbohydrates (1,155 cm–1). In contrast, symmetric (νs) PO2–(1,080 cm–1) appeared to have an elevated intensity in high-grade cytology. Inter-category variance was associated with protein and DNA conformational changes whereas glycogen status strongly influenced intra-category. Multivariate data reduction of IR spectra using PCA with LDA maximises inter-category variance whilst reducing the influence of intra-class variation towards an objective approach to class cervical cytology based on a biochemical profile.

Sonographic examination (10 MHz) of 25 patients with cutaneous non-Hodgkin's lymphomas of B-cell type (10 patients), of T-cell type (nine patients) and non-B non-T-cell type (six patients) demonstrated "diffuse' (11 patients) and "focal' patterns (14 patients): the former, which can be described as an homogeneous, hyperechoic thickening of the dermis, occasionally involving the subcutaneous layer, was exclusively observed in T-cell (nine cases) and non-T non-B cell (two cases) types, while the latter, characterized by small, hypoechoic and well-defined nodules, was observed in B-cell (10 cases) and non-T non-B-cell (four cases) types. These observations indicate a possible relationship between histologic and sonographic appearance.

Low-grade gliomas (LGG) are a group of uncommon neuroglial tumors of the central nervous system. They are characterized by a grade I or II according to the WHO classification. Grade I tumors are non-invasive and amenable to surgical resection with curative intent. Diffuse infiltrating LGG (WHO grade II) are tumors with a highly variable prognosis. Curative resection call only rarely be achieved and progression is characterized by transformation into a high-grade glioma (WHO grade III-IV). There are only limited evidence-based treatment recommendations for the management of progressive LGG because of a lack of data from prospective randomized trials. Most often radiotherapy is offered to patients with symptomatic and/or progressive disease. Three randomized trials have failed to demonstrate a survival improvement with either early versus delayed radiation or with a higher dose of radiation. The potential role of chemotherapy for the treatment of LGG has only been addressed in phase H trials. The PCV-chemotherapy regimen is associated with considerable toxicity that limits its applicability. The results with temozolomide (TMZ) chemotherapy have been more promising. Patients with chemosensitive LGG as predicted by heterozygotic loss of chromosomal arms 1p and 19q or methylation of the promoter of the MGMT-gene in the genome of the glioma cells respond to TMZ. Radiotherapy will be compared to chemotherapy as first line treatment for LGG in two phase III studies that are planned for by the brain tumor group of the European Organization for Research and Treatment of Cancer (BTG-EORTC) and Radiation Therapy Oncology Group (RTOG).