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In the 2016 WHO classification of genitourinary tumors Muellerian tumors of the urinary tract (MTUT) comprise clear cell adenocarcinomas and endometrioid carcinomas. Since these rare tumors remained understudied, we aimed to characterize their molecular background by performing DNA- and RNA-based targeted panel sequencing. All tumors ( n = 11) presented single nucleotide alterations (SNVs), with ARID1A mutations being the most prevalent (5/11, 45%). Besides frequent ARID1A mutations, loss of ARID1A protein is not a suitable marker since protein expression is (partly) preserved also in mutated cases. Copy number alterations (CNVs) were found in 64% of cases (7/11), exclusively gene amplifications. Interestingly, a functionally relevant RSPO2 gene fusion/microdeletion was discovered in the endometrioid adenocarcinoma case. Comparing our findings with mutational profiles of other tumor entities, absence of TERT promoter mutations argues for a non-urothelial origin. No similarities were also found between MTUT and kidney cancers while parallels were observed for specific SNVs with endometrial carcinomas. In conclusion, immunohistochemical PAX8-positivity and lack of TERT promoter mutations could serve as key diagnostic features in difficult cases. Thus, understanding the molecular background of these tumors helps to refine treatment options and offers the possibility of targeted therapies in cases where needed.

Successful interaction with the environment requires the dissociation of self-induced from externally induced sensory stimulation. Temporal proximity of action and effect is hereby often used as an indicator of whether an observed event should be interpreted as a result of own actions or not. We tested how the delay between an action (press of a touch bar) and an effect (onset of simulated self-motion) influences the processing of visually simulated self-motion in the ventral intraparietal area (VIP) of macaque monkeys. We found that a delay between the action and the start of the self-motion stimulus led to a rise of activity above the baseline activity before motion onset in a subpopulation of 21% of the investigated neurons. In the responses to the stimulus, we found a significantly lower sustained activity when the press of a touch bar and the motion onset were contiguous compared to the condition when the motion onset was delayed. We speculate that this weak inhibitory effect might be part of a mechanism that sharpens the tuning of VIP neurons during self-induced motion and thus has the potential to increase the precision of heading information that is required to adjust the orientation of self-motion in everyday navigational tasks. NEW & NOTEWORTHY Neurons in macaque ventral intraparietal area (VIP) are responding to sensory stimulation related to self-motion, e.g. visual optic flow. Here, we found that self-motion induced activation depends on the sense of agency, i.e., it differed when optic flow was perceived as self- or externally induced. This demonstrates that area VIP is well suited for study of the interplay between active behavior and sensory processing during self-motion.

Background: It has been shown that humans adapt their postural sway to oscillatory, visually simulated self-motion. However, little is still known about the way individual body segments contribute to this adjustment of body sway and how this contribution varies with different environmental conditions., Research Question: How do the centre of pressure (COP) and individual body segments phase-lock to a sinusoidal visual drive depending on the frequency of stimulation?, Methods: In this study, we introduce phase coupling as a method for assessing full body motion in response to visual stimuli presented in virtual reality (VR). 12 participants (mean age: 31 ± 9 years) stood inside a virtual tunnel which oscillated sinusoidally in the anterior-posterior direction at a frequency of 0.2 Hz, 0.8 Hz or 1.2 Hz. Primary outcome measures were the trajectories of their COP as well as of 25 body segments obtained by a motion tracking system., Results: Subjects significantly coupled the phase of their COP and body segments to the visual drive. Our analysis yielded significant phase coupling of the COP to the stimulus for all tested frequencies. The phase coupling of body segments revealed a shift in postural response as a function of frequency. At the low frequency of 0.2 Hz, we found strong and significant phase coupling homogeneously distributed across the body. At the higher frequencies of 0.8 Hz and 1.2 Hz, however, overall phase coupling became weaker and was centred around the lower torso and hip segments., Significance: Information on how the visual percept of self-motion affects balance control is crucial for understanding visuomotor processing in health and disease. Our setup and methods constitute a reliable tool for assessing perturbed balance control, which can be utilized in future clinical trials., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

Aims: Malignant germ cell tumours (GCTs) of the testis are rare neoplasms, but the most common solid malignancies in young men. World Health Organization guidelines divide GCTs into five types, for which numerous immunohistochemical markers allow exact histological subtyping in the majority of cases. In contrast, a germ cell origin is often hard to prove in metastatic GCTs that have developed so-called somatic malignant transformation. A high percentage, up to 89%, of GCTs are characterised by the appearance of isochromosome 12p [i(12p)]. Fluorescence in-situ hybridisation has been the most common diagnostic method for the detection of i(12p) so far, but has the disadvantages of being time-consuming, demanding, and not being a stand-alone method. The aim of the present study was to establish a quantitative real-time polymerase chain reaction assay as an independent method for detecting i(12p) and regional amplifications of the short arm of chromosome 12 by using DNA extracted from formalin-fixed paraffin-embedded tissue., Methods and Results: A cut-off value to distinguish between the presence and absence of i(12p) was established in a control set consisting of 36 tumour-free samples. In a training set of 149 GCT samples, i(12p) was detectable in 133 tumours (89%), but not in 16 tumours (11%). In a test set containing 27 primary and metastatic GCTs, all 16 tumours with metastatic spread and/or somatic malignant transformation were successfully identified by the detection of i(12p)., Conclusion: In summary, the qPCR assay presented here can help to identify, further characterise and assign a large proportion of histologically inconclusive malignancies to a GCT origin., (© 2020 The Authors. Histopathology published by John Wiley & Sons Ltd.)

The accurate processing of temporal information is of critical importance in everyday life. Yet, psychophysical studies in humans have shown that the perception of time is distorted around saccadic eye movements. The neural correlates of this misperception are still poorly understood. Behavioral and neural evidence suggest that it is tightly linked to other known perisaccadic modulations of visual perception. To further our understanding of how temporal processing is affected by saccades, we studied the representations of brief visual time intervals during fixation and saccades in area V4 of two awake macaques. We presented random sequences of vertical bar stimuli and extracted neural responses to double-pulse stimulation at varying interstimulus intervals. Our results show that temporal information about very brief intervals of as brief as 20 ms is reliably represented in the multiunit activity in area V4. Response latencies were not systematically modulated by the saccade. However, a general increase in perisaccadic activity altered the ratio of response amplitudes within stimulus pairs compared with fixation. In line with previous studies showing that the perception of brief time intervals is partly based on response levels, this may be seen as a possible correlate of the perisaccadic misperception of time. NEW & NOTEWORTHY We investigated for the first time how temporal information on very brief timescales is represented in area V4 around the time of saccadic eye movements. Overall, the responses showed an unexpectedly precise representation of time intervals. Our finding of a perisaccadic modulation of relative response amplitudes introduces a new possible correlate of saccade-related perceptual distortions of time.

Yolk-sac tumours (YSTs), a germ cell tumour subtype, occur in newborns and infants as well as in young adults of age 14-44 years. In clinics, adult patients with YSTs face a poor prognosis, as these tumours are often therapy-resistant and count for many germ cell tumour related deaths. So far, the molecular and (epi)genetic mechanisms that control development of YST are far from being understood. We deciphered the molecular and (epi)genetic mechanisms regulating YST formation by meta-analysing high-throughput data of gene and microRNA expression, DNA methylation and mutational burden. We validated our findings by qRT-PCR and immunohistochemical analyses of paediatric and adult YSTs. On a molecular level, paediatric and adult YSTs were nearly indistinguishable, but were considerably different from embryonal carcinomas, the stem cell precursor of YSTs. We identified FOXA2 as a putative key driver of YST formation, subsequently inducing AFP, GPC3, APOA1/APOB, ALB and GATA3/4/6 expression. In YSTs, WNT-, BMP- and MAPK signalling-related genes were up-regulated, while pluripotency- and (primordial) germ cell-associated genes were down-regulated. Expression of FOXA2 and related key factors seems to be regulated by DNA methylation, histone methylation / acetylation and microRNAs. Additionally, our results highlight FOXA2 as a promising new biomarker for paediatric and adult YSTs., (© 2021 The Authors. Journal of Cellular and Molecular Medicine published by Foundation for Cellular and Molecular Medicine and John Wiley & Sons Ltd.)

Background: Testicular type II germ cell tumours (GCTs) are an exemplar of a curable cancer and the most common malignancy in males aged ≤35 years. Even in metastatic stages, about 70% of patients can be cured by cisplatin-based chemotherapy and multimodal treatments. For patients failing platinum-based standard therapy, prognosis is poor and novel biomarkers and therapeutic options are urgently needed., Objectives: Discussion of desired histopathological information to guide urologists' and oncologists' decision making in the treatment of male GCTs., Material and Methods: A narrative review of histopathological key features of male GCT tissue samples for clinical decision making., Results: Histopathological workup is crucial to identify (i) a GCT origin in cancers of unknown primary based on isochromosome 12p (i(12p)) detection, (ii) the different type II GCT subtypes, and (iii) risk factors, i.e. lymphovascular or rete testis invasion, among others. Proper histopathological diagnosis is indispensable for guideline-endorsed, histology-driven, and risk-adapted treatment decisions, hereby helping to maintain treatment success while reducing the therapeutic burden and potential long-term sequelae of multimodal treatments. For refractory patients failing standard treatment options, prognosis remains poor and, so far, neither predictive or prognostic biomarkers nor novel therapeutic targets have been established., Conclusions: Close interaction and interdisciplinary discussion of histopathologic and radiologic findings and established risk factors including serum tumour markers is crucial for successful treatment including intensified strategies, where necessary, or prevention of overtreatment, where possible.

This study evaluates the diagnostic performance of radiomic features and machine learning algorithms for renal tumor subtype assessment in venous computed tomography (CT) studies from clinical routine. Patients undergoing surgical resection and histopathological assessment of renal tumors at a tertiary referral center between 2012 and 2019 were included. Preoperative venous-phase CTs from multiple referring imaging centers were segmented, and standardized radiomic features extracted. After preprocessing, class imbalance handling, and feature selection, machine learning algorithms were used to predict renal tumor subtypes using 10-fold cross validation, assessed as multiclass area under the curve (AUC). In total, n = 201 patients were included (73.7% male; mean age 66 ± 11 years), with n = 131 clear cell renal cell carcinomas (ccRCC), n = 29 papillary RCC, n = 11 chromophobe RCC, n = 16 oncocytomas, and n = 14 angiomyolipomas (AML). An extreme gradient boosting algorithm demonstrated the highest accuracy (multiclass area under the curve (AUC) = 0.72). The worst discrimination was evident for oncocytomas vs. AML and oncocytomas vs. chromophobe RCC (AUC = 0.55 and AUC = 0.45, respectively). In sensitivity analyses excluding oncocytomas, a random forest algorithm showed the highest accuracy, with multiclass AUC = 0.78. Radiomic feature analyses from venous-phase CT acquired in clinical practice with subsequent machine learning can discriminate renal tumor subtypes with moderate accuracy. The classification of oncocytomas seems to be the most complex with the lowest accuracy.

Urachal carcinoma (UrC) is a rare tumor with remarkable histological and molecular similarities to colorectal cancer (CRC). Adenomatous polyposis coli (APC) is the most frequently affected gene in CRC, but the prevalence and significance of its alterations in UrC is poorly understood. In addition, loss of phosphatase and tensin homologue (PTEN) was shown to be associated with therapy resistance in CRC. Our primary aim was to assess specific genetic alterations including APC and PTEN in a large series of UrC samples in order to identify clinically significant genomic alterations. We analyzed a total of 40 UrC cases. Targeted 5-gene (APC, PTEN, DICER1, PRKAR1A, TSHR, WRN) panel sequencing was performed on the Illumina MiSeq platform (n = 34). In addition, ß-catenin (n = 38) and PTEN (n = 30) expressions were assessed by immunohistochemistry. APC and PTEN genes were affected in 15% (5/34) and 6% (2/34) of cases. Two of five APC alterations (p.Y1075*, p.K1199*) were truncating pathogenic mutations. One of the two PTEN variants was a pathogenic frameshift insertion (p.C211fs). In 29% (11/38) of samples, at least some weak nuclear ß-catenin immunostaining was detected and PTEN loss was observed in 20% (6/30) of samples. The low prevalence of APC mutations in UrC represents a characteristic difference to CRC. Based on APC and ß-catenin results, the Wnt pathway seems to be rarely affected in UrC. Considering the formerly described involvement of PTEN protein loss in anti-EGFR therapy-resistance its immunohistochemical testing may have therapeutic relevance.

Primary glandular bladder tumours (bladder adenocarcinoma [BAC], urachal adenocarcinoma [UAC], urothelial carcinoma with glandular differentiation [UCg]) are rare malignancies with histological resemblance to colorectal adenocarcinoma (CORAD) in the majority of this subgroup. Definite case numbers are very low, molecular data are limited and the pathogenesis remains poorly understood. Therefore, this study was designed to complement current knowledge by in depth analysis of BAC (n = 12), UAC (n = 13), UCg (n = 11) and non-invasive glandular lesions (n = 19). In BAC, in addition to known alterations in TP53, Wnt, MAP kinase and MTOR pathway, mutations in SMAD4, ARID1A and BRAF were identified. Compared to published data on muscle invasive bladder cancer (BLCA) and CORAD, UCg exhibited frequent "urothelial" like alterations while BAC and UAC were characterised by a more "colorectal" like mutational pattern. Immunohistochemically, there was no evidence of DNA mismatch repair deficiency or PD-L1 tumour cell positivity in any sample. Depending on the used antibody 0-45% of BAC, 0-30% of UCg and 0% UAC cases exhibited PD-L1 expressing tumour associated immune cells. A single BAC (9%, 1/11) showed evidence of ARID1A protein loss, and two cases of UCg (20%, 2/10) showed loss of SMARCA1 and PBRM1, respectively. Taken together, our data suggest at least in part involvement of similar pathways driving tumourigenesis of adenocarcinomas like BAC, UAC and CORAD independent of their tissue origin. Alterations of TERT and FBXW7 in single cases of intestinal metaplasia further point towards a possible precancerous character in line with previous reports.

Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht.

Background: Germ cell tumours (GCTs) are the most common solid malignancies in young men. Although high cure rates can be achieved, metastases, resistance to cisplatin-based therapy and late toxicities still represent a lethal threat, arguing for the need of new therapeutic options. In this study, we analysed the potential of cyclin-dependent kinase 4/6 (CDK4/6) inhibitors palbociclib and ribociclib (PaRi) as molecular drugs to treat cisplatin-resistant and -sensitive paediatric and adult GCTs., Methods: Ten GCT cell lines, including cisplatin-resistant subclones and non-malignant controls, were treated with PaRi and screened for changes in viability (triphenyl tetrazolium chloride (XTT) assay), apoptosis rates (flow cytometry, caspase assay), the cell cycle (flow cytometry), the transcriptome (RNA-sequencing, quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) and on protein level (western blot). Expression profiling was performed on paediatric and adult GCT tissues (expression microarrays, qRT-PCR, immunohistochemistry, 'The Cancer Genome Atlas' database)., Results: We demonstrate that adult GCTs highly express CDK4, while paediatric GCTs strongly express CDK6 instead. Thus, both GCT types are potentially treatable by PaRi. GCTs presented as highly sensitive towards PaRi, which caused a decrease in viability, cell cycle arrest and apoptosis. Although GCTs mainly arrested in the G1/G0 phase, some embryonal carcinoma cell lines were able to bypass the G1/S checkpoint and progressed to the G2/M phase. We found that upregulation of CDK3 and downregulation of many mitosis regulation factors, like the HAUS genes, might be responsible for bypassing the G1/S checkpoint and termination of mitosis, respectively. We postulate that GCT cells do not tolerate these alterations in the cell cycle and eventually induce apoptosis., Conclusion: Our study highlights PaRi as therapeutic options for cisplatin-resistant and -sensitive paediatric and adult GCTs.

Previous studies in the macaque monkey have provided clear causal evidence for an involvement of the medial-superior-temporal area (MST) in the perception of self-motion. These studies also revealed an overrepresentation of contraversive heading. Human imaging studies have identified a functional equivalent (hMST) of macaque area MST. Yet, causal evidence of hMST in heading perception is lacking. We employed neuronavigated transcranial magnetic stimulation (TMS) to test for such a causal relationship. We expected TMS over hMST to induce increased perceptual variance (i.e., impaired precision), while leaving mean heading perception (accuracy) unaffected. We presented 8 human participants with an optic flow stimulus simulating forward self-motion across a ground plane in one of 3 directions. Participants indicated perceived heading. In 57% of the trials, TMS pulses were applied, temporally centered on self-motion onset. TMS stimulation site was either right-hemisphere hMST, identified by a functional magnetic resonance imaging (fMRI) localizer, or a control-area, just outside the fMRI localizer activation. As predicted, TMS over area hMST, but not over the control-area, increased response variance of perceived heading as compared with noTMS stimulation trials. As hypothesized, this effect was strongest for contraversive self-motion. These data provide a first causal evidence for a critical role of hMST in visually guided navigation., (© The Author(s) 2020. Published by Oxford University Press.)

Background: The prognostic role of human chorionic gonadotropin (hCG) and lactate dehydrogenase (LDH) serum levels in seminoma patients remains uncertain. This observational study evaluates the prognostic impact of tumour marker levels, and other clinicopathological findings, in hCG-positive seminoma patients., Methods: Seminoma patients with serum hCG levels above normal at first diagnosis were eligible for recruitment. Statistical analysis, including multivariate regression, was performed to identify risk factors. Primary end-points were overall survival (OS) and recurrence-free survival (RFS)., Results: We recruited 1031 hCG-positive patients (stage I: n = 586; stage II + III: n = 427) diagnosed between 1981 and 2018. In metastatic disease, LDH levels ≥3 above upper normal limit (UNL) pre- (n = 109) or post-orchiectomy (n = 73) and patients aged ≥40 years (n = 187) were associated with poor prognosis: 5-year OS rates of 84% (LDH ≥3 UNL pre-orchiectomy) versus 92% (<3 UNL pre-orchiectomy) (hazard ratio [HR]: 3.155, [95% confidence interval {CI}: 1.28-7.75], P = 0.012), 82% (≥3 UNL post-orchiectomy) versus 92% (<3 UNL post-orchiectomy) (HR: 6.877, [95% CI: 1.61-29.34]; P = 0.009) and 86% (≥40 years) versus 91% (<40 years) (HR: 6.870, [95% CI: 1.45-13.37], P = 0.009), respectively. A subset of patients with hCG levels ≥2000 IU/l pre-orchiectomy (n = 17) exhibited a poor prognosis, with 5-year OS rates of 73% (≥2000 IU/l) versus 94% (<2000 IU/l) (HR: 3.936, [95% CI: 1.02-12.61], P = 0.047)., Conclusions: Age and LDH levels are significantly associated with poor prognosis in hCG-positive seminoma patients. A small number of patients, with levels of hCG ≥2000 IU/l, may represent a separate prognostic subgroup associated with impaired survival rates., Competing Interests: Conflict of interest statement None declared., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Vision plays a central role in maintaining balance. When humans perceive their body as moving, they trigger counter movements. This results in body sway, which has typically been investigated by measuring the body's center of pressure (COP). Here, we aimed to induce visually evoked postural responses (VEPR) by simulating self-motion in virtual reality (VR) using a sinusoidally oscillating "moving room" paradigm. Ten healthy subjects participated in the experiment. Stimulation consisted of a 3D-cloud of random dots, presented through a VR headset, which oscillated sinusoidally in the anterior-posterior direction at different frequencies. We used a force platform to measure subjects' COP over time and quantified the resulting trajectory by wavelet analyses including inter-trial phase coherence (ITPC). Subjects exhibited significant coupling of their COP to the respective stimulus. Even when spectral analysis of postural sway showed only small responses in the expected frequency bands (power), ITPC revealed an almost constant strength of coupling to the stimulus within but also across subjects and presented frequencies. Remarkably, ITPC even revealed a strong phase coupling to stimulation at 1.5 Hz, which exceeds the frequency range that has generally been attributed to the coupling of human postural sway to an oscillatory visual scenery. These findings suggest phase-locking to be an essential feature of visuomotor control.

The visual impulse-response function to random input as measured by EEG is dominated by the perceptual echo, a reverberation of stimulus information in the alpha range believed to represent active rhythmic sampling. How this response is generated on a cortical level is unknown. To characterize the underlying mechanisms, we investigated the echoes' dynamics following short-term visual deprivation, which is known to modify the excitation/inhibition balance in visual cortex. We subjected observers to 150 min of light deprivation (LD) and monocular contrast deprivation (MD). Perceptual echoes were measured by binocular and dichoptic stimulation, respectively, and compared with a baseline condition. Our results show that the echo response is enhanced after LD, but not affected in temporal frequency or spatial propagation. Consistent with previous studies, MD shifted early response (0-150 ms) amplitudes in favor of the deprived eye, but had no systematic effect on the echoes. Our findings demonstrate that the echoes' synchrony scales with cortical excitability, adding to previous evidence that they represent active visual processing. Their insensitivity to modulation at the monocular level suggests they are generated by a larger region of visual cortex. Our study provides further insight into how mechanisms of rhythmic sampling are implemented in the visual system., (© The Author(s) 2020. Published by Oxford University Press.)

Keeping track of objects in our environment across body and eye movements is essential for perceptual stability and localization of external objects. As of yet, it is largely unknown how this perceptual stability is achieved. A common behavioral approach to investigate potential neuronal mechanisms underlying spatial vision has been the presentation of one brief visual stimulus across eye movements. Here, we adopted this approach and aimed to determine the reference frame of the perceptual localization of two successively presented flashes during fixation and smooth pursuit eye movements (SPEMs). To this end, eccentric flashes with a stimulus onset asynchrony of zero or ± 200 ms had to be localized with respect to each other during fixation and SPEMs. The results were used to evaluate different models predicting the reference frame in which the spatial information is represented. First, we were able to reproduce the well-known effect of relative mislocalization during fixation. Second, smooth pursuit led to a characteristic relative mislocalization, different from that during fixation. A model assuming that relative localization takes place in a nonretinocentric reference frame described our data best. This suggests that the relative localization judgment is performed at a stage of visual processing in which retinal and nonretinal information is available.

Vision represents the most important sense of primates. To understand visual processing, various different methods are employed-for example, electrophysiology, psychophysics, or eye-tracking. For the latter method, researchers have recently begun to step outside the artificial environments of laboratory setups toward the more natural conditions we usually face in the real world. To get a better understanding of the advantages and limitations of modern mobile eye-trackers, we quantitatively compared one of the most advanced mobile eye-trackers available, the EyeSeeCam, with a commonly used laboratory eye-tracker, the EyeLink II, serving as a gold standard. We aimed to investigate whether or not fully mobile eye-trackers are capable of providing data that would be adequate for direct comparisons with data recorded by stationary eye-trackers. Therefore, we recorded three different, commonly used eye movements-fixations, saccades, and smooth-pursuit eye movements-with both eye-trackers, in successive standardized paradigms in a laboratory setting with eight human subjects. Despite major technical differences between the devices, most eye movement parameters were not statistically different between the two systems. Differences could only be found in overall gaze accuracy and for time-critical parameters such as saccade duration, for which a higher sample frequency is especially useful. Although the stationary EyeLink II system proved to be superior, especially on a single-subject or even a single-trial basis, the ESC showed similar performance for the averaged parameters across both trials and subjects. We concluded that modern mobile eye-trackers are well-suited to providing reliable oculomotor data at the required spatial and temporal resolutions.

Background:  The cestode Echinococcus granulosus causes hydatid disease. In addition to manifestations in the liver and lung, it can lead to cystic lesions in the spine., Case Description:  We report a 42-year-old male patient with primary hydatid disease in the eighth thoracic vertebra. The only clinical symptom was chronic back pain. Although laboratory findings were normal, imaging displayed lytic destruction that raised the suspicion of a metastatic disease. Diagnostics of the thoraces and abdomen did not reveal other pathologic abnormalities. Follow-up magnetic resonance imaging (MRI) depicted a progressive compression of the spinal cord and inhomogeneous structure in the fat-suppressed sequences. Because the Jamshidi biopsy was inconclusive, the tumor board recommended surgery. Dorsal decompression, spondylodesis of T6-T10, and vertebral column resection of T8 with complete cyst removal were performed. The resected vertebrae showed a mucous-like lesion with white granular tissue interfusing the whole vertebral body. A pathologic examination and enzyme-linked immunosorbent assay confirmed E. granulosus . Thus chemotherapy with albendazole was initiated. A follow-up MRI of the whole spine confirmed complete remission and found no additional resettlements. The patient's back pain was resolved without neurologic deficits., Conclusions:  For lytic manifestations of the vertebral column, hydatid cysts should be considered a differential diagnosis in addition to malignant metastasis, tuberculosis, and osteomyelitis. Thorough surgical resection and strict follow-up are necessary., Competing Interests: None declared., (Georg Thieme Verlag KG Stuttgart · New York.)

Motile cilia serve vital functions in development, homeostasis, and regeneration. We recently demonstrated that TAp73 is an essential transcriptional regulator of respiratory multiciliogenesis. Here, we show that TAp73 is expressed in multiciliated cells (MCCs) of diverse tissues. Analysis of TAp73 mutant animals revealed that TAp73 regulates Foxj1, Rfx2, Rfx3, axonemal dyneins Dnali1 and Dnai1, plays a pivotal role in the generation of MCCs in male and female reproductive ducts, and contributes to fertility. However, the function of MCCs in the brain appears to be preserved despite the loss of TAp73, and robust activity of cilia-related networks is maintained in the absence of TAp73. Notably, TAp73 loss leads to distinct changes in ciliogenic microRNAs: miR34bc expression is reduced, whereas the miR449 cluster is induced in diverse multiciliated epithelia. Among different MCCs, choroid plexus (CP) epithelial cells in the brain display prominent miR449 expression, whereas brain ventricles exhibit significant increase in miR449 levels along with an increase in the activity of ciliogenic E2F4/MCIDAS circuit in TAp73 mutant animals. Conversely, E2F4 induces robust transcriptional response from miR449 genomic regions. To address whether increased miR449 levels in the brain maintain the multiciliogenesis program in the absence of TAp73, we deleted both TAp73 and miR449 in mice. Although loss of miR449 alone led to a mild ciliary defect in the CP, more pronounced ciliary defects and hydrocephalus were observed in the brain lacking both TAp73 and miR449. In contrast, miR449 loss in other MCCs failed to enhance ciliary defects associated with TAp73 loss. Together, our study shows that, in addition to the airways, TAp73 is essential for generation of MCCs in male and female reproductive ducts, whereas miR449 and TAp73 complement each other to support multiciliogenesis and CP development in the brain.

Malignant germ cell tumors (GCT) are the most common malignant tumors in young men between 18 and 40 years. The correct identification of histological subtypes, in difficult cases supported by immunohistochemistry, is essential for therapeutic management. Furthermore, biomarkers may help to understand pathophysiological processes in these tumor types. Two GCT cell lines, TCam-2 with seminoma-like characteristics, and NTERA-2, an embryonal carcinoma-like cell line, were compared by a quantitative proteomic approach using high-resolution mass spectrometry (MS) in combination with stable isotope labelling by amino acid in cell culture (SILAC). We were able to identify 4856 proteins and quantify the expression of 3936. 347 were significantly differentially expressed between the two cell lines. For further validation, CD81, CBX-3, PHF6, and ENSA were analyzed by western blot analysis. The results confirmed the MS results. Immunohistochemical analysis on 59 formalin-fixed and paraffin-embedded (FFPE) normal and GCT tissue samples (normal testis, GCNIS, seminomas, and embryonal carcinomas) of these proteins demonstrated the ability to distinguish different GCT subtypes, especially seminomas and embryonal carcinomas. In addition, siRNA-mediated knockdown of these proteins resulted in an antiproliferative effect in TCam-2, NTERA-2, and an additional embryonal carcinoma-like cell line, NCCIT. In summary, this study represents a proteomic resource for the discrimination of malignant germ cell tumor subtypes and the observed antiproliferative effect after knockdown of selected proteins paves the way for the identification of new potential drug targets., Competing Interests: The authors declare that they have no conflict of interest., (Copyright © 2019 Felix Bremmer et al.)

During self-motion through an environment, our sensory systems are confronted with a constant flow of information from different modalities. To successfully navigate, self-induced sensory signals have to be dissociated from externally induced sensory signals. Previous studies have suggested that the processing of self-induced sensory information is modulated by means of predictive coding mechanisms. However, the neural correlates of processing self-induced sensory information from different modalities during self-motion are largely unknown. Here, we asked if and how the processing of visually simulated self-motion and/or associated auditory stimuli is modulated by self-controlled action. Participants were asked to actively reproduce a previously observed simulated self-displacement (path integration). Blood oxygen level-dependent (BOLD) activation during this path integration was compared with BOLD activation during a condition in which we passively replayed the exact sensory stimulus that had been produced by the participants in previous trials. We found supramodal BOLD suppression in parietal and frontal regions. Remarkably, BOLD contrast in sensory areas was enhanced in a modality-specific manner. We conclude that the effect of action on sensory processing is strictly dependent on the respective behavioral task and its relevance.

Natural orienting of gaze often results in a retinal image that is rotated relative to space due to ocular torsion. However, we perceive neither this rotation nor a moving world despite visual rotational motion on the retina. This perceptual stability is often attributed to the phenomenon known as predictive remapping, but the current remapping literature ignores this torsional component. In addition, studies often simply measure remapping across either space or features (e.g., orientation) but in natural circumstances, both components are bound together for stable perception. One natural circumstance in which the perceptual system must account for the current and future eye orientation to correctly interpret the orientation of external stimuli occurs during movements to or from oblique eye orientations (i.e., eye orientations with both a horizontal and vertical angular component relative to the primary position). Here we took advantage of oblique eye orientation-induced ocular torsion to examine perisaccadic orientation perception. First, we found that orientation perception was largely predicted by the rotated retinal image. Second, we observed a presaccadic remapping of orientation perception consistent with maintaining a stable (but spatially inaccurate) retinocentric perception throughout the saccade. These findings strongly suggest that our seamless perceptual stability relies on retinocentric signals that are predictively remapped in all three ocular dimensions with each saccade.

Intestinal tuberculosis is an infectious disease of the extrapulmonary manifestation with the Mycobacteria tuberculosis complex. In developed countries, this disease is rarely seen. The clinical features are heterogeneous and unspecific. Furthermore, intestinal tuberculosis poses diagnostic challenges. Regarding intestinal tuberculosis the Ziehl-Neelsen staining for acid-fast bacillus, PCR examination and culture methods show only poor sensitivity and specificity. In this case series, we present three patients suffering from intestinal tuberculosis, who were diagnosed and treated successfully. Furthermore, we review the literature about the pitfalls of the diagnostic approaches and the treatment options of intestinal tuberculosis., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Objectives: The detection of microbial volatile organic compounds or host response markers in the exhaled gas could give an earlier diagnosis of ventilator-associated pneumonia. Gas chromatography-ion mobility spectrometry enables noninvasive, rapid, and sensitive analysis of exhaled gas. Using a rabbit model of ventilator-associated pneumonia we determined if gas chromatography-ion mobility spectrometry is able to detect 1) ventilator-associated pneumonia specific changes and 2) bacterial species-specific changes in the exhaled gas., Design: Experimental in vivo study., Setting: University research laboratory., Subjects: Female New Zealand White rabbits., Interventions: Animals were anesthetized and mechanically ventilated. To induce changes in the composition of exhaled gas we induced ventilator-associated pneumonia via endobronchial instillation of either Escherichia coli group (n = 11) or Pseudomonas aeruginosa group (n = 11) after 2 hours of mechanical ventilation. In a control group (n = 11) we instilled sterile lysogeny broth endobronchially., Measurements and Main Results: Gas chromatography-ion mobility spectrometry gas analysis, CT scans of the lungs, and blood samples were obtained at four measurement points during the 10 hours of mechanical ventilation. The volatile organic compound patterns in the exhaled gas were compared and correlated with ventilator-associated pneumonia severity. Sixty-seven peak areas showed changes in signal intensity in the serial gas analyses. The signal intensity changes in 10 peak regions differed between the groups. Five peak areas (P&#95;648&#95;36, indole, P&#95;714&#95;278, P&#95;700&#95;549, and P&#95;727&#95;557) showed statistically significant changes of signal intensity., Conclusions: This is the first in vivo study that shows the potential of gas chromatography-ion mobility spectrometry for early detection of ventilator-associated pneumonia specific volatile organic compounds and species differentiation by noninvasive analyses of exhaled gas.

In addition to germ cell tumors and tumors of the sex cord stroma, the WHO classification of testis and paratesticular tumors also contains malignant soft tissue tumors. Among them, liposarcomas of the spermatic cord are the most common entities. Other mesenchymal tumors with smooth muscle, skeletal muscle, fibroblastic/myofibroblastic, or nerve sheath differentiation are rare. Ewing sarcoma is composed of uniform small round cells and typically characterized by translocations of the EWSR1 gene. In rare cases, Ewing sarcoma-like tumors lack an EWSR1 gene fusion. Some of these tumors harbor a specific CIC translocation. However, Ewing-like sarcoma has up to now never been described in the testis or spermatic cord. The present case describes the first EWSR1-negative, undifferentiated round cell sarcoma with CIC translocation of the spermatic cord. Potential differential diagnoses are discussed.

Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht.

Direct comparison of results of humans and monkeys is often complicated by differences in experimental conditions. We replicated in head unrestrained macaques experiments of a recent study comparing human directional precision during smooth pursuit eye movements (SPEM) and saccades to moving targets (Braun & Gegenfurtner, 2016). Directional precision of human SPEM follows an exponential decay function reaching optimal values of 1.5°-3° within 300 ms after target motion onset, whereas precision of initial saccades to moving targets is slightly better. As in humans, we found general agreement in the devel-opment of directional precision of SPEM over time and in the differences between direc-tional precision of initial saccades and SPEM initiation. However, monkeys showed over-all lower precision in SPEM compared to humans. This was most likely due to differences in experimental conditions, such as in the stabilization of the head, which was by a chin and a head rest in human subjects and unrestrained in monkeys., Competing Interests: The authors declare that the contents of the article are in agreement with the ethics described in http://biblio.unibe.ch/portale/elibrary/BOP/jemr/ethics.html and that there is no conflict of interest regarding the publication of this paper.

Self-motion induces spontaneous eye movements which serve the purpose of stabilizing the visual image on the retina. Previous studies have mainly focused on their reflexive nature and how the perceptual system disentangles visual flow components caused by eye movements and self-motion. Here, we investigated the role of eye movements in distance reproduction (path integration). We used bimodal (visual-auditory)-simulated self-motion: visual optic flow was paired with an auditory stimulus whose frequency was scaled with simulated speed. The task of the subjects in each trial was, first, to observe the simulated self-motion over a certain distance (Encoding phase) and, second, to actively reproduce the observed distance using only visual, only auditory, or bimodal feedback (Reproduction phase). We found that eye positions and eye speeds were strongly correlated between the Encoding and the Reproduction phases. This was the case even when reproduction relied solely on auditory information and thus no visual stimulus was presented. We believe that these correlations are indicative of a contribution of eye movements to path integration., (© 2018 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.)

Urachal cancer (UrC) is a rare but aggressive malignancy often diagnosed in advanced stages requiring systemic treatment. Although cytotoxic chemotherapy is of limited effectiveness, prospective clinical studies can hardly be conducted. Targeted therapeutic treatment approaches and potentially immunotherapy based on a biological rationale may provide an alternative strategy. We therefore subjected 70 urachal adenocarcinomas to targeted next-generation sequencing, conducted in situ and immunohistochemical analyses (including PD-L1 and DNA mismatch repair proteins [MMR]) and evaluated the microsatellite instability (MSI) status. The analytical findings were correlated with clinicopathological and outcome data and Kaplan-Meier and univariable/multivariable Cox regression analyses were performed. The patients had a mean age of 50 years, 66% were male and a 5-year overall survival (OS) of 58% and recurrence-free survival (RFS) of 45% was detected. Sequence variations were observed in TP53 (66%), KRAS (21%), BRAF (4%), PIK3CA (4%), FGFR1 (1%), MET (1%), NRAS (1%), and PDGFRA (1%). Gene amplifications were found in EGFR (5%), ERBB2 (2%), and MET (2%). We detected no evidence of MMR-deficiency (MMR-d)/MSI-high (MSI-h), whereas 10 of 63 cases (16%) expressed PD-L1. Therefore, anti-PD-1/PD-L1 immunotherapy approaches might be tested in UrC. Importantly, we found aberrations in intracellular signal transduction pathways (RAS/RAF/PI3K) in 31% of UrCs with potential implications for anti-EGFR therapy. Less frequent potentially actionable genetic alterations were additionally detected in ERBB2 (HER2), MET, FGFR1, and PDGFRA. The molecular profile strengthens the notion that UrC is a distinct entity on the genomic level with closer resemblance to colorectal than to bladder cancer., (© 2018 UICC.)

Patients with head-and-neck cancer can develop both lung metastasis and primary lung cancer during the course of their disease. Despite the clinical importance of discrimination, reliable diagnostic biomarkers are still lacking. Here, we have characterised a cohort of squamous cell lung (SQCLC) and head-and-neck (HNSCC) carcinomas by quantitative proteomics. In a training cohort, we quantified 4,957 proteins in 44 SQCLC and 30 HNSCC tumours. A total of 518 proteins were found to be differentially expressed between SQCLC and HNSCC, and some of these were identified as genetic dependencies in either of the two tumour types. Using supervised machine learning, we inferred a proteomic signature for the classification of squamous cell carcinomas as either SQCLC or HNSCC, with diagnostic accuracies of 90.5% and 86.8% in cross- and independent validations, respectively. Furthermore, application of this signature to a cohort of pulmonary squamous cell carcinomas of unknown origin leads to a significant prognostic separation. This study not only provides a diagnostic proteomic signature for classification of secondary lung tumours in HNSCC patients, but also represents a proteomic resource for HNSCC and SQCLC., (© 2018 The Authors. Published under the terms of the CC BY 4.0 license.)

Interaction with the environment requires fast and reliable sensory processing. The visual system is confronted with a continuous flow of high-dimensional input (e.g. orientation, color, motion). From a theoretical point of view, it would be advantageous if critical information was processed independent of attentional load, i.e. preattentively. Here, we hypothesized that visual motion is such a critical signal and aimed for a neural signature of its preattentive encoding. Furthermore, we were interested in the neural correlates of predictability of linear motion trajectories based on the presence or absence of preceding motion. We presented a visual oddball paradigm and studied event-related potentials (ERPs). Stimuli were linearly moving Gabor patches that disappeared behind an occluder. The difference between deviant and standard trials was a trajectory change which happened behind the occluder in deviant trials only, inducing a prediction error. As hypothesized, we found a visual mismatch negativity-component over parietal and occipital electrodes. In a further condition, trials without preceding motion were presented in which the patch just appeared from behind the occluder and, hence, was not predictable. We found larger ERP-components for unpredictable stimuli. In summary, our results provide evidence for a preattentive and predictive processing of linear trajectories of visual motion.

Objective: Adenoid cystic carcinoma (ACC) is characterized by a high rate of local recurrence and late distant metastasis. The status of an elective neck dissection (END) is controversial in the literature., Study Design: In this study we retrospectively analyzed the surgical treatment and follow-up examinations of 59 patients with ACCs of a salivary gland treated in a single center between 1980 and 2016., Results: The incidence of occult nodal metastases among all patients who underwent END was 20.6%. The overall survival and the disease-free survival of patients who underwent END versus patients without END had no significant differences. Even in the case of positive lymph nodes metastasis there was no significant benefit in survival or local recurrence control., Conclusion: The incidence of occult neck metastases in patients with ACC was 20.6%. There was no significant enhanced survival in the group of patients who underwent an END., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Novel treatments for castration-resistant prostate cancer (CRPC) such as abiraterone acetate (AA) or enzalutamide effectively target the androgen pathway to arrest aberrant signalling and cell proliferation. Testosterone is able to inhibit tumour cell growth in CRPC. Estrogen receptor-beta (ERβ) binds the testosterone-metabolites 3β-androstanediol and 3α-androstanediol in parallel to the canonical estradiol. In the prostate it is widely accepted that ERβ regulates estrogen signalling, mediating anti-proliferative effects. We used the prostate cancer cell lines LNCaP, PC-3, VCaP, and the non-neoplastic BPH-1. VCaP cells were treated with 1 nmol/L testosterone over 20 passages, yielding the cell line VCaPrev, sensitive to hormone therapies. In contrast, LNCaP cells were grown for more than 100 passages yielding a high passage therapy resistant cell line ( hiP LNCaP). VCaP and hiP LNCaP cell lines were treated with 5 μmol/L AA for more than 20 passages, respectively, generating the AA-tolerant-subtypes VCaP AA and hiPLNCaP AA . Cell lines were treated with testosterone, dihydrotestosterone (DHT), R1881, and the androgen-metabolites 3β-androstanediol and 3α-androstanediol. 3β-androstanediol or 3α-androstanediol significantly reduced proliferation in all cell lines except the BPH-1 and androgen receptor-negative PC-3 and markedly downregulated AR and estrogen receptor alpha (ERα). Whereas ERβ expression was increased in all cell lines except BPH-1 or PC-3. In summary, 3β-adiol or 3α-adiol, as well as DHT and R1881, significantly reduced tumour cell growth in CRPC cells. Thus, these compounds represent novel potential therapeutic approaches to overcome drug-resistance in CRPC, especially with regard to AR-V7 function in therapy resistance. Furthermore, these data confirm the tumour suppressor properties of ERβ in CRPC., Competing Interests: CONFLICTS OF INTEREST P.T. received consulting from Janssen-Cilag.

High rates of telomerase reverse transcriptase (TERT) promoter mutations have recently been described in urothelial carcinoma (UC). Unlike UC in the bladder, adenocarcinomas account for the majority of urachal cancer (UrC) cases. As data in UrC is unclear, we analyzed TERT promoter mutations in a large cohort of UrC for its differential diagnostic, clinicopathological and prognostic significance. UrC cases from six academic centers were analyzed for c.-146C>T (C250T) and c.-124C>T (C228T) TERT promoter mutations by PCR and Sanger sequencing. Clinicopathological and survival data were collected. The cohort consisted of 15 men (56%) and 12 women (44%) with a median age of 50 years including 23 adenocarcinomas, two squamous cell carcinomas (SCC), one UC and one undifferentiated carcinoma. In one case of (mucinous) urachal adenocarcinoma a C228T mutation was detected (1/23; 4%), like in a case of SCC in addition to one C250T mutation in the UC case. TERT promoter mutations are very rare in urachal adenocarcinomas (unlike in UC) with differential diagnostic implications. Additionally, the low TERT promoter mutation rate in urachal adenocarcinomas is more comparable to colorectal adenocarcinomas than to UC, giving further support to recent genetic findings and therapeutic considerations., (© 2017 Japanese Society of Pathology and John Wiley & Sons Australia, Ltd.)

In vivo electrophysiology is a powerful technique to investigate the relationship between brain activity and behavior at a millisecond and micrometer scale. However, current methods mostly rely on tethered cable recordings or only use unidirectional systems, allowing either recording or stimulation of neural activity, but not at the same time or same target. Here, a new wireless, bidirectional device for simultaneous multichannel recording and stimulation of neural activity in freely behaving rats is described. The system operates through a single portable head stage that both transmits recorded activity and can be targeted in real-time for brain stimulation using a telemetry-based multichannel software. The head stage is equipped with a preamplifier and a rechargeable battery, allowing stable long-term recordings or stimulation for up to 1 h. Importantly, the head stage is compact, weighs 12 g (including battery) and thus has minimal impact on the animal´s behavioral repertoire, making the method applicable to a broad set of behavioral tasks. Moreover, the method has the major advantage that the effect of brain stimulation on neural activity and behavior can be measured simultaneously, providing a tool to assess the causal relationships between specific brain activation patterns and behavior. This feature makes the method particularly valuable for the field of deep brain stimulation, allowing precise assessment, monitoring, and adjustment of stimulation parameters during long-term behavioral experiments. The applicability of the system has been validated using the inferior colliculus as a model structure.

Purpose: Adenoid cystic carcinomas are rare malignant tumors of the salivary glands. They are characterized by a high rate of local recurrence, late distant metastasis and a poor disease-free survival. In this study, we analyzed a series of 61 patients who were all treated at the University of Göttingen over a period of 21.0 years., Materials and Methods: In all 61 patients with salivary adenoid cystic carcinoma, clinical data, demographic data, risk factors, tumor location, tumor stage, status of surgical margin, surgical treatment, postoperative radiotherapy and follow-up interval were assessed., Results: The overall survival (OS) and the disease-free survival (DFS) of patients who underwent surgery and those who underwent combined surgery with radiotherapy showed no significant differences. Neither did the T-stage (T1/T2 vs. T3/T4) show significant differences in OS and DFS. Only the status of the surgical margin was significantly associated with a longer OS and a longer DFS., Conclusion: The present results confirm that the radical surgical resection with clear tumor-free margins is the most important predictor for a longer survival. Adjuvant radiotherapy should be discussed from case to case, but should not be seen as an absolute prognostic factor for OS., (Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Overexpression and activation of receptor tyrosine kinases (RTKs), such as the insulin-like growth factor 1 receptor (IGF1R) and the epidermal growth factor receptor (EGFR), are frequent phenomena in colorectal cancer (CRC). Here, we evaluated the effect and the cellular mechanisms of the simultaneous inhibition of these two RTKs both in vitro and in vivo in addition to a 5-fluoruracil (5-FU)-based radiochemotherapy (RCT), which is a standard treatment scheme for CRC. Using the small molecule inhibitors AEW541 and erlotinib, specific against IGF1R and EGFR, respectively, different CRC cell lines exhibited a reduced survival fraction after RCT, with the highest effect after the simultaneous inhibition of IGF1R/EGFR. In vivo, xenograft mice simultaneously treated with low dose AEW541/erlotinib plus RCT revealed a significant reduction in tumour volume and weight compared with the tumours of mice treated with either AEW541 or erlotinib alone. In vitro, the combined inhibition of IGF1R/EGFR resulted in a stronger reduction of downstream signalling, an increase in DNA double strand breaks (DSBs), apoptosis and mitotic catastrophe after RCT depending on the cell line. Moreover, the existence of IGF1R/EGFR heterodimers in CRC cells and human rectal cancer samples was proven. The heterodimerisation of these RTKs was dependent on the presence of both ligands, IGF-1 and EGF, and functional receptors. In conclusion, these results demonstrate that the strategy of targeting both IGF1R and EGFR, in addition to basic RCT, could be of intriguing importance in CRC therapy., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Perceptual illusions help to understand how sensory signals are decoded in the brain. Here we report that the opposite approach is also applicable, i.e., results from decoding neural activity from monkey extrastriate visual cortex correctly predict a hitherto unknown perceptual illusion in humans. We record neural activity from monkey medial superior temporal (MST) and ventral intraparietal (VIP) area during presentation of self-motion stimuli and concurrent reflexive eye movements. A heading-decoder performs veridically during slow eye movements. During fast eye movements (saccades), however, the decoder erroneously reports compression of heading toward straight ahead. Functional equivalents of macaque areas MST and VIP have been identified in humans, implying a perceptual correlate (illusion) of this perisaccadic decoding error. Indeed, a behavioral experiment in humans shows that perceived heading is perisaccadically compressed toward the direction of gaze. Response properties of primate areas MST and VIP are consistent with being the substrate of the newly described visual illusion.Macaque higher visual areas MST and VIP encode heading direction based on self-motion stimuli. Here the authors show that, while making saccades, the heading direction decoded from the neural responses is compressed toward straight-ahead, and independently demonstrate a perceptual illusion in humans based on this perisaccadic decoding error.

In the natural world, self-motion always stimulates several different sensory modalities. Here we investigated the interplay between a visual optic flow stimulus simulating self-motion and a tactile stimulus (air flow resulting from self-motion) while human observers were engaged in a distance reproduction task. We found that adding congruent tactile information (i.e., speed of the air flow and speed of visual motion are directly proportional) to the visual information significantly improves the precision of the actively reproduced distances. This improvement, however, was smaller than predicted for an optimal integration of visual and tactile information. In contrast, incongruent tactile information (i.e., speed of the air flow and speed of visual motion are inversely proportional) did not improve subjects' precision indicating that incongruent tactile information and visual information were not integrated. One possible interpretation of the results is a link to properties of neurons in the ventral intraparietal area that have been shown to have spatially and action-congruent receptive fields for visual and tactile stimuli. NEW & NOTEWORTHY This study shows that tactile and visual information can be integrated to improve the estimates of the parameters of self-motion. This, however, happens only if the two sources of information are congruent-as they are in a natural environment. In contrast, an incongruent tactile stimulus is still used as a source of information about self-motion but it is not integrated with visual information., (Copyright © 2017 the American Physiological Society.)

Objectives: Deep neck infections are among the most dangerous acute diseases in the head and neck region. This analysis gives an overview of the bacterial and histopathologic findings of deep neck infections., Study Design: From January 2002 to December 2012, 63 patients were diagnosed with and treated for deep neck infections at the University Medical Center Göttingen. Bacterial and histopathologic examinations were made, and the occurrence of bacterial pathogens and histopathologic findings were analyzed., Results: The most commonly isolated aerobic gram-positive pathogen was Streptococcus viridans (26.7%); Staphylococcus epidermidis and Staphylococcus aureus were each found in 16.7% of infections. The most commonly isolated aerobic gram-negative pathogens were Escherichia coli, Klebsiella oxytoca, and Haemophilus influenzae. In 1.6% of patients, a malignant cancer was detected., Conclusion: For clear diagnosis and effective therapy, a bacteriologic investigation of deep neck infections is essential because of the heterogeneous spectrum of the detected bacteria. In contrast to Asia, where Klebsiella pneumoniae is the most common pathogen, in South Lower Saxony, Germany, we discovered a dominating spectrum of aerobic gram-positive cocci. Biopsy obtained from an abscess cavity for histologic examination should always be part of the diagnostic process in order to exclude a malignant process., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Advanced prostate cancer can develop into castration-resistant prostate cancer (CRPC). This process is mediated either by intratumoral ligand synthesis or by mutations or aberrations of the androgen receptor (AR) or its cofactors. To date, no curative therapy for CRPC is available, as AR-targeted therapies eventually result in the development of resistance. The human prostate cancer cell line VCaP (vertebral cancer of the prostate) overexpresses AR and its splice variants (ARVs) as a mechanism of resistance to androgen-deprivation therapy (ADT) of external and intratumoral origin. In the present study, we demonstrate that stimulating estrogen receptor β activity with the specific agonist 8β-VE2 in VCaP cells in successive stages of ADT induced a time- and dose-dependent decrease in cell survival and an increase in apoptosis. Furthermore, 8β-VE2 treatment reduced the overexpression of the AR as well as ARVs in VCaP cells under maximum ADT. Our results indicate that decreased survival of the androgen-dependent CRPC cells employing apoptosis together with the regulative effect on AR expression could have beneficial effects over current AR-targeting therapies.

Overall, diseases of the vascular system are rarely observed entities among nonhuman primates that are commonly associated with systemic infections, septicemia or bacteremia. Rhesus monkeys infected with simian immunodeficiency virus (SIV) may develop a chronic occlusive arteriopathy of unknown etiology in late stages of the disease. This SIV associated arteriopathy is the only well-known specific vascular entity described in nonhuman primates. We herein report a unique case of granulomatous arteritis in a grey mouse lemur affecting multiple organs, which is not comparable to other disease entities formerly described in nonhuman primates. The features of the entity most closely resemble disseminated visceral giant cell arteritis in humans. A concise description of the disease is given, and the differential diagnoses are discussed. An idiopathic pathogenesis is suspected., Competing Interests: The authors declare that they have no conflict of interest., (Copyright: © 2017 Nicole Cichon et al.)

The pathomechanisms underlying the development of thrombofibrotic pulmonary artery occlusions in Chronic Thromboembolic Pulmonary Hypertension (CTEPH) are largely unknown. The aim of this study was to allocate distinct cellular processes playing a role in thrombus resolution, such as inflammation, hypoxia, proliferation, apoptosis and angiogenesis, to different stages of thrombofibrotic remodelling. A total of 182 pulmonary endarterectomy (PEA) specimens were collected from 31 CTEPH patients. To facilitate co-localisation, Tissue MicroArrays were prepared and processed for (immuno)-histochemistry and confocal fluorescence microscopy. Murine venous thrombus formation and resolution was examined after inferior vena cava ligation. PEA tissues exhibited five morphologically distinct regions predominantly consisting of either fibrin-, erythrocyte- or extracellular matrix-rich thrombus, myofibroblasts, vessels or fibrotic tissue, and were found to resemble chronological stages of thrombus resolution in mice. Cellularity was highest in vessel-rich regions, and numerous cells were strongly positive for HIF1α or HIF2α as well as markers of activated VEGF signalling, including endothelial nitric oxide synthase. On the other hand, negative regulators of angiogenic growth factor signalling and reactive oxygen species were also highly expressed. Immune cells, primarily macrophages of the M2 subtype and CD117 haematopoietic progenitors were detected and highest in vascularised regions. Our findings demonstrate the simultaneous presence of different stages of thrombus organisation and suggest that hypoxia-induced endothelial, mesenchymal and immune cell activation may contribute to thrombofibrosis in CTEPH. This systematic histological characterisation of the material obstructing pulmonary vessels in CTEPH may provide a valuable basis for further studies aimed at determining causal factors underlying this disease.

The WHO classification of testis tumours includes the group of sex cord-stromal tumours. They are divided into several histological types, i.e. Leydig cell (LCT) and Sertoli cell tumours (SCT). Based on the physiological expression of β-catenin in normal testis/Sertoli cells, it was previously shown that SCT can carry a β-catenin mutation, causing a nuclear positivity for β-catenin and cyclin D1. Furthermore, it could be shown that the stabilization of β-catenin in Sertoli cells causes the loss of the Sertoli cell marker SOX9. We wanted to know whether the stabilization of β-catenin in sex cord-stromal tumours influences SOX-9 expression and thus could be used in the diagnosis of sex cord-stromal tumours. Therefore, 53 cases of sex cord-stromal tumours and tumour-like lesions were investigated for their immunohistochemical expressions of β-catenin, cyclin D1 and SOX9. In addition, mutation analyses of the β-catenin gene (exon 3; CTNNB1) were performed. β-catenin mutation in SCT results in nuclear β-catenin and cyclin-D1 expressions on immunohistochemical analysis. The nuclear expression/stabilization of β-catenin causes the loss of SOX9 in these tumours. In contrast, SOX9 is considerably expressed in non-mutated SCT as well as in Sertoli cells of non-neoplastic testes. In summary, immunohistochemical analyses of β-catenin and SOX9 are useful to distinguish SCT from other sex cord-stromal tumours of the testis. Furthermore, the presence of SOX9 indicates that the cells of origin may be Sertoli cells.

Humans can perceive and estimate approximate numerical information, even when accurate counting is impossible e.g., due to short presentation time. If the number of objects to be estimated is small, typically around 1-4 items, observers are able to give very fast and precise judgments with high confidence-an effect that is called subitizing. Due to its speed and effortless nature subitizing has usually been assumed to be preattentive, putting it into the same category as other low level visual features like color or orientation. More recently, however, a number of studies have suggested that subitizing might be dependent on attentional resources. In our current study we investigated the potentially preattentive nature of visual numerical perception in the subitizing range by means of EEG. We presented peripheral, task irrelevant sequences of stimuli consisting of a certain number of circular patches while participants were engaged in a demanding, non-numerical detection task at the fixation point drawing attention away from the number stimuli. Within a sequence of stimuli of a given number of patches (called "standards") we interspersed some stimuli of different numerosity ("oddballs"). We compared the evoked responses to visually identical stimuli that had been presented in two different conditions, serving as standard in one condition and as oddball in the other. We found significant visual mismatch negativity (vMMN) responses over parieto-occipital electrodes. In addition to the event-related potential (ERP) analysis, we performed a time-frequency analysis (TFA) to investigate whether the vMMN was accompanied by additional oscillatory processes. We found a concurrent increase in evoked theta power of similar strength over both hemispheres. Our results provide clear evidence for a preattentive processing of numerical visual information in the subitizing range.

The existence of an association between numbers and space is known for a long time. The most prominent demonstration of this relationship is the spatial numerical association of response codes (SNARC) effect, describing the fact that participants' reaction times are shorter with the left hand for small numbers and with the right hand for large numbers, when being asked to judge the parity of a number (Dehaene et al., J. Exp. Psychol., 122, 371-396, 1993). The SNARC effect is commonly seen as support for the concept of a mental number line, i.e. a mentally conceived line where small numbers are represented more on the left and large numbers are represented more on the right. The SNARC effect has been demonstrated for all three cardinal axes and recently a transverse SNARC plane has been reported (Chen et al., Exp. Brain Res., 233(5), 1519-1528, 2015). Here, by employing saccadic responses induced by auditory or visual stimuli, we measured the SNARC effect within the same subjects along the horizontal (HM) and vertical meridian (VM) and along the two interspersed diagonals. We found a SNARC effect along HM and VM, which allowed predicting the occurrence of a SNARC effect along the two diagonals by means of linear regression. Importantly, significant differences in SNARC strength were found between modalities. Our results suggest the existence of a frontoparallel mental number plane, where small numbers are represented left and down, while large numbers are represented right and up. Together with the recently described transverse mental number plane our findings provide further evidence for the existence of a three-dimensional mental number space., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

The mediastinum is among the most frequent anatomic region in which germ cell tumors (GCT) arise, second only to the gonads. Mediastinal GCT (mGCT) account for 16 % of all mediastinal neoplasms. Although the morphology and (according to all available data) the molecular genetics of mediastinal and gonadal GCT are identical, a number of unique aspects exist. There is a highly relevant bi-modal age distribution. In pre-pubertal children of both sexes, mGCT consist exclusively of teratomas and yolk sac tumors. The prognosis is generally favorable with modern treatment. In post-pubertal adults, virtually all patients with malignant mGCT are males; the prognosis is more guarded and depends (among other factors) on the histological GCT components and is similar to GCT in other organs. So-called somatic type malignancies (i. e. clonally related, non-germ cell neoplasias arising in a GCT) are much more frequent in mGCT than in other organs, and the association between mediastinal yolk sac tumors and hematological malignancies, such as myelodysplasias and leukemias, is unique to mediastinal tumors. The prognosis of GCT with somatic type malignancies is generally dismal.