Prognostic Thresholds of Mitotic Count and Ki-67 Labeling Index for Recurrence and Survival in Lung Atypical Carcinoids

Atypical carcinoid (AC) is a rare neuroendocrine neoplasm of the lung, which exhibits a varying malignant potential. In this study, we aimed to identify the prognostic thresholds of the mitotic count and Ki-67 labeling index for recurrence and survival in AC. We retrospectively reviewed 78 patients who had been radically resected for AC and calculated said thresholds using time-dependent receiver operating characteristic curves and the Youden index. We then dichotomized the patients into groups of above or below these thresholds and estimated the cumulative incidences of the groups using the Aalen-Johansen estimator. We compared the groups using univariable and multivariable Fine-Gray subdistribution hazard models. Our findings show that more patients recurred and died from this disease if their mitotic count exceeded three and four mitoses per 2 mm2, respectively, or if their Ki-67 labeling index exceeded 14% and 11%, respectively. Both thresholds independently predicted survival (p < 0.001 and p = 0.015, respectively). These thresholds may serve as a valuable tool for clinicians and researchers in making treatment plans and predicting outcomes for patients with AC.

A case of cervico-mediastinal paraganglioma mimicking an ectopic goiter

Introduction and importance

Mediastinal paragangliomas are rare neuroendocrine tumors that originate from extra-adrenal paraganglia, occasionally secreting catecholamines. Nonfunctional mediastinal paragangliomas present nonspecific clinical and radiological features and represent a diagnostic challenge.

Case presentation

A 53-year old woman presented with cough and dyspnea increasing over time. CT-scan and ultrasonography showed a large vascularized cervico-mediastinal mass, consistent with an intrathoracic ectopic goiter. Preoperative angiography showed a blood supply from neck vessels. The lesion was completely removed through a cervical approach. The diagnosis of paraganglioma was a histological surprise. The patient is alive without recurrence 30 months after surgery.

Clinical discussion

When preoperatively diagnosed, the treatment of choice of a mediastinal paraganglioma is surgical excision. However, a preoperative diagnosis of mediastinal paraganglioma is difficult to obtain, especially in cases of nonfunctional lesions. Distinction between an intrathoracic goiter and a nonfunctional paraganglioma can be extremely difficult and, given the rarity of the latter, an ectopic goiter is suspected in first instance. CT-scan and ultrasonography are of little use in the differential diagnosis. However, scintigraphy with ¹²³I-metaiodobenzylguanidine can be an useful diagnostic tool when a paraganglioma is suspected. In case of vascularized cervico-mediastinal mass, such as paragangliomas or intrathoracic goiter, preoperative angiography should be performed to study the blood supply and orient the surgical approach.

Conclusion

Although uncommon, paragangliomas should be considered in the differential diagnosis of mediastinal masses, especially when an ectopic goiter is suspected.

•

Clinical diagnosis of mediastinal nonfunctioning paragangliomas is challenging.

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Mediastinal paragangliomas can mimic intrathoracic goiters.

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If a clinical suspicion of paraganglioma is raised, ¹²³I-MIBG can be useful.

•

In case of a vascularized cervico-mediastinal mass, an angiography is recommended.

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Angiography can detect the blood supply and guide the surgical approach.

POS1252 COVID-19 IN PATIENTS WITH RHEUMATIC DISEASES ON CHRONIC USE OF HYDROXYCHLOROQUINE IN A LARGE BRAZILIAN COHORT – A 24-WEEK PROSPECTIVE STUDY

Background:

The role of chronic use of hydroxychloroquine (HCQ) in rheumatic disease (RD) patients during the SARS-CoV-2 pandemic is still subject of discussion.

Objectives:

To compare the occurrence of COVID-19 and its outcomes between RD patients on HCQ use with individuals from the same household not taking the drug during community viral transmission in an observational prospective multicenter study in Brazil.

Methods:

Participants were enrolled and monitored through 24-week (From March 29th to Sep 30th, 2020) regularly scheduled phone calls performed by trained medical professionals. Epidemiological and demographic data, as well as RD disease activity status and current treatment data, specific information about COVID-19, hospitalization, need for intensive care, and death was recorded in both groups and stored in the Research Electronic Data Capture (REDCap) database. COVID-19 was defined according to the Brazilian Ministry of Health (BMH) criteria. The statistical analysis was performed using IBM-SPSS v.20.0 software. Group comparisons were made using the Man-Whitney, Chi-Square and Fisher Exact Test, as well as multivariate regression models adjusted to confounders. Survival curves were performed using Kaplan-Meier analysis.

Results:

A total of 10,427 participants mean age (SD) of 44.04 (14.98) years were enrolled, including 6004 (57.6%) rheumatic disease patients, of whom 70.8% had systemic lupus erythematosus (SLE), 6.7% rheumatoid arthritis (RA), 4% primary Sjögren’s syndrome (pSS), 1.8% mixed connective tissue disease (DMTC), 1% systemic sclerosis (SSc) and others (15.9), including overlap syndromes. In total, 1,132 (10.8%) participants fulfilled criteria for COVID-19, being 6.7% RD patients and 4.1% controls (p=0.002). A recent influenza vaccination had a protective role (p<0.001). Moderate and severe COVID-19 included the need for hospitalization, intensive care, mechanical ventilation or death. Infection severity was not different between groups (p=0.391) (Table 1). After adjustments for multiple confounders, the main risk factors significantly associated with COVID-19 were higher education level (OR=1.29 95%CI 1.05-1.59), being healthcare professionals (OR=1.91; 95%CI 1.45-2.53), presence of two comorbidities (OR=1.31; 95%CI 1.01-1.66) and three or more comorbidities associated (OR=1.69; 95%CI 1.23-2.32). Interestingly, age >=65 years (OR=0.20; 95%CI 0.11-0.34) was negatively associated. Regarding RD, the risk factors associated with COVID-19 diagnosys were SLE (OR= 2.37; 95%CI 1.92-293), SSc (OR=2.25; 95%CI 1.05-4.83) and rituximab use (OR=1.92; 95%CI 1.13-3.26). In addition, age >=65 years (OR=5.47; 95%CI 1.7-19.4) and heart disease (OR=2.60; 95%CI 1.06-6.38) were associated with hospitalization. Seven female RD patients died, six with SLE and one with pSS, and the presence of two or more comorbidities were associated with higher mortality rate.

Conclusion:

Chronic HCQ use did not prevent COVID-19 in RD compared to their household cohabitants. Health care profession, presence of comorbidities LES, SSc and rituximab were identified as main risk factors for COVID-19 and aging and heart disease as higher risk for hospitalization. Our data suggest these outcomes could be considered to manage them in clinical practice.

Table 1.

Frequency and severity of COVID-19 in patients with rheumatic diseases on chronic use of hydroxychloroquine compared to their household controls

COVID-19 outcomesTotal(%)GroupsPPatients(%)Controls (%)DiagnosisNo9256 (89.1)5300 (88.3)3956 (90.2)0.002Yes1132 (10.9)704 (11.7)428 (9.8)SeverityMild1059 (93.6)662 (94.0)397 (92.8)0.391Moderate52 (4.6)32 (4.5)20 (4.7)Severe21 (1.9)10 (1.4)11 (2.6)

HCQ: hydroxychloroquine.

Moderate and severe COVID-19 included the need for any of the following: hospitalization, intensive care, mechanical ventilation or death.

Acknowledgements:

To the Brazilian Society of Rheumatology for technical support and rapid nationwide mobilization.

To all the 395 interviewers (medical students and physicians) who collaborated in the study and the participants

To CNPq (Number 403442/2020-6)

Disclosure of Interests:

None declared

Acidity of SiO2-Supported Metal Oxides in the Presence of H2O Using the Adsorption Equilibrium Infrared Spectroscopy Method: 1. Adsorption and Coadsorption of NH3 and H2O on SiO2

The present study is dedicated to the characterization (identification, heats of adsorption, and coverages) of the adsorbed species formed by the adsorption and coadsorption of NH₃ and H₂O on two SiO₂ solids. Adsorption equilibrium infrared spectroscopy allowed us (a) to show that NH₃ and H₂O are mostly adsorbed on free SiOH groups via H bonds and (b) to determine their individual heats of adsorption: 53 and 49 kJ/mol, whatever be their coverages (Langmuir adsorption model), for NH_3ads and H₂O_ads, respectively. These values consistent with the microcalorimetry literature data explain that their coverages are decreased upon NH₃-H₂O coadsorption, considering a competitive Langmuir model. However, the temperature-programmed adsorption equilibrium procedure achieved from MS data indicated that a minor amount of other NH₃ species (not detected using Fourier-transform infrared) is more strongly adsorbed and that hydrolysis of SiOSi siloxane by H₂O could occur in parallel. NH₃-H₂O coadsorption leads to the formation of NH₄⁺ species, which involves H₂O adsorbed species. Both NH₃ and H₂O are not adsorbed above 450 K, which means that the SiO₂ contribution to the characterization of the acidity of metal oxide catalysts supported on SiO₂ using NH₃ as the probe molecule in the presence of H₂O is negligible above this temperature.

Acidity of SiO2-Supported Metal Oxides in the Presence of H2O Using the AEIR Method: 2. Adsorption and Coadsorption of NH3 and H2O on TiO2/SiO2 Catalysts

Two different TiO₂/SiO₂ compounds containing TiO₂ nanodomains dispersed over SiO₂ were investigated applying the AEIR method at the adsorption equilibrium of NH₃ and H₂O from 300 to 723 K, particularly for the measurement of the individual heats of adsorption of the different species on Lewis acidic sites (LAS) and Brønsted acidic sites (BAS) as evaluation of the strength of the sites. It revealed two types of NH₃ adsorption sites: the first ones could correspond either to NH₃ species H-bonded to free OH groups or to coordinated weak LAS (named L1). The second ones (L2) were attributed to strongest LAS similar to those present at the surface of TiO₂ nanocrystallites. They also correspond to the stronger adsorption sites of H₂O. Two types of Brønsted acid sites (BAS) were additionally evidenced by the AEIR method and proposed to be specifically located on the Si-O-Ti bridging bonds at the TiO₂/SiO₂ interface. The heats of adsorption of the different adsorbed species provided by the AEIR method were consistent with literature data on average values of the heats of adsorption of NH₃ and H₂O from microcalorimetry measurements. The surface acidity of the two compounds in the presence of H₂O was determined using NH₃-H₂O coadsorption. At T ≥ 473 K, the NH₃ species on the L2 sites were not significantly displaced from the surface whatever the partial pressure of H₂O studied in agreement with the Temkin competitive model using the individual heats of adsorption of the NH₃ and H₂O species. This model also revealed the presence of a small amount of H₂O species adsorbed on L2 sites allowing H₂O dissociation or/and hydrolysis of SiOTi or TiOTi bridges, leading to the formation of a much higher amount of BAS. Therefore, this original work combining the AEIR method and the Temkin competitive model provided new insights for understanding water effects on acidic oxide catalysts.

ALDH Expression in Angiosarcoma of the Lung: A Potential Marker of Aggressiveness?

Background: Primary angiosarcoma of the lung is a very aggressive rare malignant disease resulting in a severe prognosis (1). This type of cancer represents about 2% of all soft tissue sarcomas and has a high rate of metastasis through the hematogenous route. For the rarity of this malignant vascular tumor it is still challenging to set a diagnosis (1). The diagnostic features that have thus far been considered include primarily clinical and radiological findings. In some cases, immunohistochemical characteristics based on the most common markers used in pathology have been described. The aim of this report is to present two cases of angiosarcoma of the lung in which the aldehyde dehydrogenase (ALDH) marker was analyzed by immunohistochemistry.

Methods: We report two cases of angiosarcoma of the lung in patients underwent lung surgery at our Unit. In addition to the standard histopathological analysis for this disease, immunohistochemistry using an ALDH1A1 antibody was performed in both of the cases. For ALDH quantification, a semi-quantitative method based on the positivity of the tumor cells was used: 0 (<5%), 1 (5–25%), 2 (>25–50%), 3 (>50–75%), 4 (>75%).

Results: One patient with recurrent lung disease survived, achieving complete remission after chemo- and radiotherapy. The second patient died of recurrent disease within 5 years of diagnosis. ALDH1A1 was evaluated in both of these cases using an immunohistochemistry scoring system based on the positivity for this marker. The scores were consistent with the patients' clinical outcomes, as the lower (score 1) was observed in the patient with the better clinical outcome, while the higher (score 3) was seen in the patient with the worse outcome.

Conclusion: Our data suggest that ALDH may be an important clinical marker in angiosarcoma of the lung. Although further studies need to be performed in a larger cohort of patients, we believe that, if the results will be confirmed, ALDH1A1 may be used to stratify patients in terms of prognosis and for targeted therapy.

Expression of ALDH and SOX-2 in Pulmonary Sclerosing Pnemocytoma (PSP) of the Lung: Is There a Meaning Behind?

Background: Pulmonary sclerosing pneumocytoma (PSP) is a rare benign pulmonary tumor that derives from primitive respiratory epithelium of the pulmonary alveolus. The etiology and pathogenesis are still unclear. Histopathological diagnosis focuses on cells that are positive for TTF1, EMA, cytokeratin-7, and CAM 5.2. The aim of our study is to highlight the elevated expression of ALDH and the presence of SOX-2 in pulmonary sclerosing pneumocytoma.

Methods: We report five cases of pulmonary sclerosing pneumocytoma undergone surgery at our Division of Thoracic Surgery, during a period between 1994 and 2011. ALDH and SOX-2 markers were also tested for positivity in all the patients.

Results: Patients showed elevated expression of ALDH during immunohistochemistry and mild expression of SOX-2, although in two cases in which SOX-2 was highly expressed. Among these two patients, one presented with lymph node recurrence while the other had no recurrence with a PET-positive nodule. In particular, the patient who had developed recurrence had an ALDH score of 4 and a SOX-2 score of 3, whereas the patient with the PET-positive nodule showed an ALDH score of 4 with a mild SOX-2 expression of score 1.

Conclusions: This is the first attempt demonstrating the elevated expression of ALDH in this disease. SOX-2 expression was noted in both the patient who developed recurrence and the patient with a PET-positive nodule. We believe that further investigation may be highly useful to better characterize these two markers as well as understand their function.

Advance directives: Addressing the obligations of support as part of the right of a person with disabilities to equal recognition before the law?

Depending upon how they are regulated in domestic law, advance directives (ADs) can enable persons to make decisions that have legal effect in the future as directed in the AD. There is some agreement in the academic literature that ADs are a legitimate way of giving effect to the obligations arising from Article 12 (3) of the United Nations Convention on the Rights of Persons with Disabilities to take appropriate measures to provide access by persons with disabilities (PWDs) to the support they may require in exercising their legal capacity. It is the purpose of this article to question when and how ADs address the obligations of support arising from Article 12 (3), concluding that it cannot and should not be assumed that ADs address those obligations only because they embody and give effect to their maker's agency. The article instead highlights the questions that must be posed to obtain legal certainty as to when and how ADs will be a form of Article 12 (3) support. The article also refutes some of the instances in the academic literature when ADs have been presented as support, while offering an account as to how the regulation of ADs should be reconsidered in order to specifically address the obligations arising from Article 12 (3) both when PWDs can and when they cannot communicate their wishes to others.

Clinical profile of the functionally selective glucocorticoid receptor agonist BI 653048 in healthy male subjects

BACKGROUND

An efficacious anti-inflammatory corticosteroid with reduced side effects has been long sought. We report the pooled results from three clinical proof-of-mechanism Phase I studies of BI 653048 in healthy subjects, a functionally selective, nonsteroidal glucocorticoid (GC).

RESEARCH DESIGN AND METHODS

Three Phase I trials were conducted: a single rising-dose study and a multiple rising-dose study to evaluate the safety, tolerability, and pharmacokinetics of BI 653048, and a multiple parallel-arm-dose study with intravenous lipopolysaccharide challenge to assess in vivo pharmacodynamics. The pharmacodynamics, efficacy, and safety of BI 653048 and prednisolone were compared.

RESULTS

Treatment with 200 mg BI 653048 was associated with a reduced expression of IL1R2, ITGB3, and SDPR versus 20 mg prednisolone; comparable levels of FKBP5, ZBTB16, and DDIT4 expression were observed. Changes in C-peptide, glucose, insulin, and cortisol were moderate compared with prednisolone. A greater reduction of osteocalcin was observed with 200 mg BI 653048 versus 20 mg prednisolone. Comparable anti-inflammatory efficacy was demonstrated for 200 mg BI 653048 and 20 mg prednisolone. BI 653048 was well tolerated in healthy subjects.

CONCLUSION

BI 653048 demonstrated the desired anti-inflammatory effects of the nonsteroidal GC; however, the undesirable side-effect profile associated with GC steroids could not be disassociated from BI 653048.

TRIAL REGISTRATION

ClinicalTrials.gov identifiers NCT02217644, NCT02217631, and NCT02224105.

Association of Reduced Factor VIII with Impaired Platelet Reactivity to Adrenalin and Collagen after Total Thyroidectomy

Twenty-one thyroprival patients, previously submitted to total thyroidectomy for tumours, were investigated during stabilized L-thyroxine supplementation and at the end of a 20-25 day “no-therapy” period, necessary for a 131I total body scintigraphy. During supplementation therapy a lower than normal mean betathromboglobulin (beta-TG) release level was found, the other blood clotting and platelet function tests being normal. After substitution therapy withdrawal, platelet function tests showed reduced adrenalin aggregation, increased collagen threshold aggregating concentrations, decreased beta-TG release values and reduced aggregation to ristocetin, whereas blood clotting tests showed prolonged aPTT values and reduced levels of factor VIII: C and vWf: Ag. We conclude that in acquired hypothyroidism the lowering of factor VIII: C and vWf: Ag (acquired von Wille brand disease) is associated with impaired platelet reactivity not only to ristocetin but also to collagen and especially adrenalin. In the patients investigated these changes were almost completely corrected by substitutive therapy with L-thyroxine at clinically effective doses.

Ca-125 Monitoring during Chemotherapy for Ovarian Cancer

Serum CA-125 was determind in 60 patients with variously extended ovarian cancer and monitored during and after chemotherapy. The study indicates that: 1) prechemotherapy CA-125 shows the presence of an active disease with an accuracy > 85%. The antigen is elevated in 97% of patients with > 2 cm disease, but sensitivity is low (67%) in patients with minimal residual disease (< 2 cm); 2) changes in CA-125 correspond well with the response to chemotherapy. CA-125 becomes negative in every patient having clinical CR and increases in every patient with progressive disease. These changes can indicate the type of response some months ahead of time; 3) CA-125 indicates in advance the recurrence of the disease after an objective remission: 4) In the conditions studied CA-125 basal levels do not seem to have prognostic value as regarding either response or survival.

Intravescical prostatic protrusion is a predictor of alpha blockers response: results from an observational study

BACKGROUND

To investigate the efficacy of tamsulosin in patients with lower urinary tract symptoms (LUTS) and benign prostatic enlargement (BPE) with intravesical prostatic protrusion (IPP). Ultrasound measurement of the IPP has been previously described as an effective instrument for the evaluation of benign prostatic obstruction (BPO) and could help in clarifying the role of alpha-blockers in patients with (BPE).

METHODS

Patients with BPE and LUTS were enrolled in this observational study. Intravesical prostatic protrusion was graded as grade 1 (< 5 ml), 2 (5 < IPP < 10 ml) and 3 (> 10 ml). Patients were treated with tamsulosin for twelve weeks. Evaluation was performed before and at the end of treatment by means of International Prostate Symptom Score (IPSS) and uroflowmetry. Patients were considered responders if a reduction of IPSS > 3 points was reported.

RESULTS

One hundred forty-two patients were enrolled. Twelve patients were excluded because of incomplete data. Fifty patients showed an IPP grade 1 (group A), 52 a grade 2 (group B) and 28 a grade 3 (group C). Treatment success was obtained in 82%, 38,5% and 7,1% of patients respectively; these differences (group A vs B-C and group B vs C) were highly significant. The odd ratio to obtain a treatment success was of 59 and 8.1 in group A and group B respectively, in comparison to group C. After a multivariate regression, the relationship between IPP grade and treatment success remained significant. Improvement of uroflowmetry parameters has been reported in all the groups especially in patients with a low grade IPP (p value = 0,016 group A vs group B; p value = 0,005 group A vs group C). Prostate volume seems not to influence this relationship.

CONCLUSIONS

Intravesical prostatic protrusion has found to be significantly and inversely correlated with treatment success in patients with LUTS and BPE under alpha-blockers therapy. Alpha blockers odd ratio of success is 59 times higher in patients with a low grade IPP in comparison to patients with a high grade.

A coupled human-Earth model perspective on long-term trends in the global marine fishery

The global wild marine fish harvest increased fourfold between 1950 and a peak value near the end of the 20th century, reflecting interactions between anthropogenic and ecological forces. Here, we examine these interactions in a bio-energetically constrained, spatially and temporally resolved model of global fisheries. We conduct historical hindcasts with the model, which suggest that technological progress can explain most of the 20th century increase of fish harvest. In contrast, projections extending this rate of technological progress into the future under open access suggest a long-term decrease in harvest due to over-fishing. Climate change is predicted to gradually decrease the global fish production capacity, though our model suggests that this is of secondary importance to social and economic factors. Our study represents a novel way to integrate human-ecological interactions within a single model framework for long-term simulations.

Neck schwannoma diagnosed by core needle biopsy: a case report

Here we present a case of a 58 year old man referred to our hospital to undergo neck and thyroid ultrasonography (US) following palpable neck mass. US revealed a solid hypoechoic nodule in right thyroid lobe, and a solid lesion on the right laterocervical neck region with ultrasound suspicious features of neoplastic lymph node. In order to achieve a diagnosis of the neck mass and to get a proper evaluation of the thyroid nodule, we decided to perform a fine-needle aspiration (FNA) of both lesions. At cytopathologic examination the thyroid nodule appeared as benign, while cytologic sampling of the neck lesion was inadequate for a proper evaluation. Thus, we performed core needle biopsy (CNB) of the neck lesion like recently proposed for thyroid lesions; also, to definitively exclude malignancy of thyroid nodule, this also underwent CNB. Histologic report of CNB confirmed benign thyroid nodule, while the neck lesion revealed a proliferation of neuronal type consistent with schwannoma. The patient has been addressed to clinical and ultrasonographic follow-up. CNB appears as a safe and minimally-invasive approach to diagnose indeterminate neck masses and avoid unnecessary diagnostic surgery.

Evaluation of the potential of volatile organic compound (di-methyl benzene) removal using adsorption on natural minerals compared to commercial oxides

This study is dedicated to the investigation of the potential of volatile organic compounds (VOC) adsorption over low cost natural minerals (bentonite and diatomite). The performances of these solids, in terms of adsorption/desorption properties, were compared to commercial adsorbents, such as silica, alumina and titanium dioxide. The solids were first characterized by different physico-chemical methods and di-methyl benzene (dMB) was selected as model VOC pollutant for the investigation of adsorptive characteristics. The experiments were carried out with a fixed bed reactor under dynamic conditions using Fourier Transform InfraRed spectrometer to measure the evolution of dMB concentrations in the gaseous stream at the outlet of the reactor. The measured breakthrough curves yields to adsorbed amounts at saturation that has been used to obtain adsorption isotherms. The latters were used for determination of the heat involved in the adsorption process and estimation of its values using the isosteric method. Furthermore, the performances of the studied materials were compared considering the adsorption efficiency/cost ratio.

Outdoor radon concentration measurements: some correlation with major urban pollutants

Air pollutants concentration in the urban air strongly depends on the properties of the planetary boundary layer (the lower region of the atmosphere), roughly up to 1 km from Earth's surface. Radioactive radon gas has been recognised by various authors as a valuable natural tracer of transport and dispersion within this layer. To achieve a better comprehension of the urban pollution dynamic in the town of Alessandria, situated in the Po Valley in the north-west of Italy, a system for continuous measurement of radon concentration in outdoor air was experimented. This paper presents the first results obtained: the hourly trend of radon concentration in the diurnal course during different seasons and its correlation with the concentration of the major urban pollutants.

[Adenoid cystic/basal cell carcinoma of the prostate:case report]

Although most prostate carcinomas belong to the conventional acinar type, unusual variants have been reported. The adenoid cystic/basal cell carcinoma of the prostate is a rare tumor with distinctive histopathologic features. There are quite few publications in the literature concerning the diagnosis, treatment, and prognosis of this neoplasm. METHODS. A 71-year-old man had an increased PSA value (5.11 ng/dL); the prostatic biopsy examination was positive for adenoid cystic/basal cell carcinoma. For this reason we proceeded with radical prostatectomy. The histology examination showed an acinar conventional carcinoma and adenoid cystic/basal cell carcinoma. At eight months the patient did not show any recurrence. CONCLUSIONS. Various histologic and immunohistochemical features are helpful in recognizing the adenoid cystic/basal cell carcinoma of the prostate. Clinically, the only difference from a conventional adenocarcinoma is that the PSA value is usually normal or only slightly increased. This tumor has a biological potential that can result in metastases in some cases; the current treatment consists primarily in the surgical resection. A close, long-term follow-up is strongly recommended.

Adenoid cystic/basal cell carcinoma of the prostate: case report

Although most prostate carcinomas belong to the conventional acinar type, unusual variants have been reported. The adenoid cystic/basal cell carcinoma of the prostate is a rare tumor with distinctive histopathologic features. There are quite few publications in the literature concerning the diagnosis, treatment, and prognosis of this neoplasm.

Methods.

A 71-year-old man had an increased PSA value (5.11 ng/dL); the prostatic biopsy examination was positive for adenoid cystic/basal cell carcinoma. For this reason we proceeded with radical prostatectomy. The histology examination showed an acinar conventional carcinoma and adenoid cystic/basal cell carcinoma. At eight months the patient did not show any recurrence.

Conclusions.

Various histologic and immunohistochemical features are helpful in recognizing the adenoid cystic/basal cell carcinoma of the prostate. Clinically, the only difference from a conventional adenocarcinoma is that the PSA value is usually normal or only slightly increased. This tumor has a biological potential that can result in metastases in some cases; the current treatment consists primarily in the surgical resection. A close, long-term follow-up is strongly recommended.

A comparative study of the adsorption and desorption of o-xylene onto bentonite clay and alumina

In this paper, adsorptive performance of natural clay of bentonite type has been investigated as a potential VOC adsorbent on the basis its promising physical-chemical and morphological properties which were compared to commercial gamma-Al(2)O(3) solid. The vapour-solid adsorption isotherms of xylene were measured at different temperatures ranging from 300 to 373 K using dynamical method and the obtained data confronted to classical models such as Langmuir and Freundlich. On the other hand, the solids physico-chemical characteristics and adsorptive performances were correlated to some cost aspects because of their importance for design and engineering of adsorption plant. The results shows the interest of a local clay natural of bentonite type for treatment of VOCs emitted in working places regarding its performances and lower cost.

Experimental Microkinetic Approach of the Photocatalytic Oxidation of Isopropyl Alcohol on TiO2. Part 1. Surface Elementary Steps Involving Gaseous and Adsorbed C3HxO Species

The present study concerns an experimental microkinetic approach of the photocatalytic oxidation (PCO) of isopropyl alcohol (IPA) into acetone on a pure anatase TiO2 solid according to a procedure previously developed. Mainly, the kinetic parameters of each surface elementary step of a plausible kinetic model of PCO of IPA are experimentally determined: natures and amounts of the adsorbed species and rate constants (preexponential factor and activation energy). The kinetics parameters are obtained by using experiments in the transient regime with either a FTIR or a mass spectrometer as a detector. The deep oxidation (CO2 and H2O formation) of low concentrations of organic pollutants in air is one of the interests of the PCO. For IPA, literature data strongly suggest that acetone is the single route to CO2 and H2O and this explains that the present study is dedicated to the elementary steps involving gaseous and adsorbed C3H(x)O species. The microkinetic study shows that strongly adsorbed IPA species (two species denoted nd-IPA(sads) and d-IPA(sads) due to non- and dissociative chemisorption of IPA, respectively) are involved in the PCO of IPA. A strong competitive chemisorption between IPA(sads) and a strongly adsorbed acetone species controls the high selectivity in acetone of the PCO at a high coverage of the surface by IPA(sads). The kinetic parameters of the elementary steps determined in the present study are used in part 2 to provide a modeling of macroscopic kinetic data such as the turnover frequency (TOF in s(-1)) of the PCO using IPA/O2 gas mixtures.

Experimental Microkinetic Approach of the Photocatalytic Oxidation of Isopropyl Alcohol on TiO2. Part 2. From the Surface Elementary Steps to the Rates of Oxidation of the C3HxO Species

The present study concerns an experimental microkinetic approach of the photocatalytic oxidation (PCO) of isopropyl alcohol (IPA) into acetone on a pure anatase TiO2 solid according to a procedure previously developed. Mainly, the kinetic parameters of each surface elementary step of a plausible kinetic model of the PCO of IPA are experimentally determined: natures and amounts of the adsorbed species and rate constants (preexponential factors and activation energies). These kinetic parameters are used to evaluate a priori the catalytic activity (turnover frequency, TOF, in s(-1)) of the solid that is compared to the experimental value. The kinetics parameters are obtained by using experiments in the transient regime with either a FTIR or a mass spectrometer as a detector. The microkinetic study shows that only strongly adsorbed IPA species (two species denoted nd-IPA(sads) and d-IPA(sads) due to non- and dissociative chemisorption of IPA respectively) are involved in the PCO of IPA. A strong competitive chemisorption between IPA(sads) and a strongly adsorbed acetone species controls the high selectivity in acetone of the PCO at a high coverage of the surface by IPA(sads). The apparent rate constant (1.4 10(-3) s(-1)) of the Langmuir-Hinshelwood elementary step between IPA(sads) and the active oxygen containing species generated by the UV irradiation provides the TOF of the PCO for IPA/O2 gas mixtures. The kinetic parameters of the elementary steps determined by the experimental microkinetic approach allow us to provide a reasonable simulation of the experimental data (coverages of the adsorbed species and partial pressures of the gases of interest) recorded during a static PCO of IPA(sads) species.

Physical disability among older Italians with diabetes. The ILSA study

AIMS/HYPOTHESIS

We studied the role of diabetic complications and comorbidity in the association between diabetes and disability in the elderly.

METHODS

Data were from a nationally representative sample of 5632 older Italians, aged 65 years and older, and who participated in the Italian Longitudinal Study on Aging. Clinical diagnoses of diabetes and other major chronic conditions were made by a physician, while disability was assessed by self-reported information on activities of daily living and physical performance tests.

RESULTS

After adjusting for age, education and BMI, disability on the basis of activities of daily living was associated with diabetes in women, but not in men (odds ratio [OR] 1.65, CI: 1.22-2.23 and OR 1.21, CI: 0.84-1.75 respectively). In contrast, the association between severe and/or total disability on the basis of physical performance tests and diabetes was strong in both sexes (OR 2.81, CI: 1.44-5.41 and OR 2.16, CI: 1.25-3.73 respectively). Adjusting for traditional complications and comorbidity reduced the excess odds of disability by 38% in women and by 16% in men.

CONCLUSIONS/INTERPRETATION

Disability in older Italians with diabetes is frequent and only partially attributable to traditional diabetic complications and comorbidity.

Heats of Adsorption of Linear CO Species Adsorbed on the Au° and Ti+δ Sites of a 1% Au/TiO2 Catalyst Using in Situ FTIR Spectroscopy under Adsorption Equilibrium

The heats of adsorption of two linear CO species adsorbed on the Au degrees particles (denoted L(Au degrees)) and on the Ti(+delta) sites (denoted L(Ti+delta)) of a 1% Au/TiO(2) catalyst are determined as the function of their respective coverage by using the AEIR procedure (adsorption equilibrium infrared spectroscopy) previously developed. Mainly, the evolutions of the IR band area of each adsorbed species (2184 cm(-1) for L(Ti+delta) and at 2110 cm(-1) for L(Au degrees)) as a function of the adsorption temperature T(a), at a constant CO adsorption pressure P(CO), provide the evolutions of the coverages theta(LTi+delta) and theta(LAu degrees ) of each adsorbed CO species with T(a) in isobar conditions that give the individual heats of adsorption. It is shown that they linearly vary from 74 to 47 kJ/mol for L(Au degrees ) and from 50 to 40 kJ/mol for L(Ti+delta) at coverages 0 and 1, respectively. These values are consistent with literature data on model Au particles and TiO(2). In particular, it is shown that the mathematical formalism supporting the AEIR procedure can be applied to literature data on Au-containing solids (single crystals and model particles).

Heats of adsorption using temperature programmed adsorption equilibrium: application to the adsorption of CO on Cu/A12O3 and H2 on Pt/Al2O3

A new simple analytical procedure is described that allows the determination of the heats of adsorption (denoted E(theta)) of adsorbed species at several coverages (theta's) using a single experiment. This procedure is an extension of an original method previously developed (denoted AEIR: adsorption equilibrium infrared spectroscopy). A mass spectrometer is used to determine the amounts of gas (in the present study, CO and H2) either desorbed from or adsorbed on a metal supported catalyst (4.7% Cu/Al2O3 and 2.9% Pt/Al2O3) during the perturbation of the adsorption equilibrium due to a controlled change of the adsorption temperature (Ta) at a quasi-constant adsorption pressure (Pa). These amounts allow us to follow the evolution of the adsorption equilibrium coverage (theta(e)) with Ta at the quasi-constant partial pressure (Pa). Then, the curve theta(e) = f(Ta) provides Etheta = f(theta) with the support of an adsorption model. This procedure presents several advantages as compared to the TPD methods, in particular, considering the theoretical supports linked to the exploitation of the experimental data. As compared to AEIR, the TPAE procedure allows one to study the heats of adsorption of adsorbed species that are not detectable by IR. However, it is not adapted if surface reactions occur in parallel to adsorption/desorption processes.