PURPOSE.To investigate the elastic properties of human lens zonules as a function of age in presbyopes.METHODS. We studied 16 presbyopic human donor eyes (ages 47-97). Anterior eye sections with crystalline lens, zonules, ciliary body, and sclera were stretched radially. The stretching device consisted of a chamber filled with balanced salt solution and eight radial hooks to hold the anterior eye section. Radial stretching was created with a stepper motor connected to a digital outside micrometer for linear displacement and digital balance for force measurement. Three eye globes were used to test our methodology. For 13 eye globes, the spring constant, elastic modulus of the zonular system, and Young's modulus of the zonules were calculated. RESULTS.We found linear dependence for force-elongation and force-strain relationships at all ages. In young presbyopic eyes (ages 47-60), the Young's modulus of the zonules was 340 mN/ mm 2 , whereas in older eyes (ages 83-97) it was significantly lower at 270 mN/mm 2 . However, the correlation coefficient between Young's modulus and age (47-97 years) was not significant with P ¼ 0.063. CONCLUSIONS.The zonular system in presbyopic eyes was linear elastic, and the Young's modulus of the zonules decreased 20% from presbyopic age to late presbyopic age. However, there was no significant correlation between Young's modulus and age in presbyopes. (Invest Ophthalmol Vis Sci. 2012;53:6109-6114)

During peritoneal metastasis, cancer cells spread from abdominal solid tumors, disseminate through the peritoneal fluid and attach to and invade through mesothelial cells (MCs) that line the peritoneum. Intestinal adenocarcinomas originating in the mucosa infiltrate the submucosa, muscle layer, and serosa in order to finally colonize the peritoneal cavity. However, the mechanism by which metastatic cells leave the primary tumor and reach the peritoneal cavity has not been previously described. Hence, we investigate whether MCs lining visceral peritoneum, through a mesothelial-to-mesenchymal transition (MMT), are a source of carcinoma-associated fibroblasts (CAFs), which could contribute to cancer progression toward the peritoneal cavity. CAFs detected in biopsies from patients with superficially invasive colorectal cancer differed from locally advanced tumors. An aberrant accumulation of myofibroblasts expressing mesothelial markers was found in the stroma of deeply infiltrative tumors located in the neighborhood of a frequently activated mesothelium. We suggest that MMT is a key event in the early stages of peritoneal dissemination.

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Cite as: Can Urol Assoc J 2014;8(7-8):e552-3. http://dx.doi.org/10.5489/cuaj.1857 Published online August 11, 2014. AbstractSolitary fibrous tumour of the bladder is a rare mesenchymal neoplasm with a favourable prognosis. Its symptoms are usually secondary to obstructive symptoms rather than hematuria or other findings typical of other bladder neoplasms. We describe a case of solitary fibrous tumour of the bladder and review the literature. Case reportA 78-year-old man came to the emergency department because of hematuria and acute urinary retention. A cystoscopy revealed a solitary lesion at the bladder neck. A transurethral resection of the bladder tumour (TURBT) was performed. Pathologic analysis revealed a solitary fibrous tumour of the bladder without atypia. Immunohistochemistry showed positivity to CD34, Bcl-2, CD99 and vimentin and negativity for cytokeratins and S-100 protein. Five months after the first TURBT, the patient returned with recurrence and a repeat TURBT was performed. Pathological exam again revealed a solitary fibrous tumour. The patient is alive at 36 months, after the second TURBT. DiscussionSolitary fibrous tumour (SFT) of the bladder is a rare mesenchymal neoplasm. It is classified into 2 forms: pleural and extrapleural.1 It should not be confused with mesothelioma which is a tumour derived from the mesothelium. SFT is a mesenchymal tumour with a fibroblastic differentiation. 2 It was first described by Klemperer and Rabin in 1931, 3 but the first case in the urinary tract was reported in 1997. 4 About 15 cases of SFT of the bladder have been described in the literature. This type of tumour is usually asymptomatic and presents as a slow-growing well-delineated exophytic mass; therefore, obstructive symptoms are the most common. Furthermore, it can be source of paraneoplastic syndromes, like hypoglycemia secondary to insulin-like growth factor. 1,4 In our patient, the presentation was typical of any bladder neoplasm.The pathological analysis renders a proliferation of bland-looking spindly to oval epithelioid cells that form fascicles, between collagen bundles, and a prominent vasculature simulating an hemangiopericytoma (Fig. 1a). 1,4 Malignant counterparts are usually hypercellular lesions, cytologic atypia, necrosis and higher frequency of mitoses. 1Immunohistochemistry shows positivity to Bcl-2, CD34 (90-95%), CD99 (70%) and vimentin. It is probable that Bcl-2 is more sensitive than CD34 for the diagnosis (Fig. 1b). 4 Negativity for cytokeratin AE1/AE3, CD31 and S-100 protein is common. 1,4 In our case, the pathology report yielded positivity to CD34, bcl-2, CD99 and vimentin which strongly suggested a SFT. It was negative for muscle markers, cytokeratin, S-100 protein and anaplastic lymphoma kinase (ALK), which exclude other tumours, such as sarcomas with muscle differentiation, sarcomatoid carcinomas and neurofibromas.The differential diagnosis should be made with hemangiopericytoma, leiomyoma, nodular fasciitis, inflammatory myofibroblastic tumour, fibromatosis and benign ...

Background Various parameters have been considered for predicting survival in pancreatic ductal adenocarcinoma. Information about western population is missing. The aim of this study is to assess the association between Glucose transporter type 1 (GLUT-1) expression and prognosis for patients with PDAC submitted for surgical resection in a European cohort. Methods Retrospective analysis of PDAC specimens after pancreatoduodenectomy assessing GLUT-1 expression according to intensity (weak vs strong) and extension (low if < 80% cells were stained, high if > 80%) was performed. Statistical analysis was performed using the exact Fisher test, Student t test or the Mann-Whitney U test. Survival was analysed using the Kaplan-Meier method and compared with the Log-rank test. The differences were considered significant at a two-sided p value of < 0.05. All statistical analyses were performed using SPSS® 23.0 for Windows (SPSS Inc., Chicago, IL, USA). Results Our study consisted of 39 patients of which 58.9% presented with weak and 41.1% with strong intensity. The median extension was 90%: 28.2% cases presented with a low extension and 71.8% with a high extension. No significant differences related to intensity were found. The high-extension group showed a higher percentage of T3 PDAC (92.9% vs 63.6%, p = 0.042) and LNR20 (35.7% vs 0%, p = 0.037) as well as shorter disease-free survival (17.58 vs 54.46 months; p = 0.048). Conclusions Our findings suggest that GLUT-1 could be related to higher aggressivity in PDAC and could be used as a prognostic marker, identifying patients with a worse response to current therapies who could benefit from more aggressive treatments.

Background: Polymorphous adenocarcinoma (PAC) is a rare malignant tumor of the minor salivary glands. It has an infiltrative growth, variable architectural patterns, neurotropism and cellular monomorphism. Approximately 75% of the cases show a specific mutation in the protein kinase D1 (PRKD1) gene. Reflecting the rarity of the tumor and intraoral location, the cytologic experience is limited with few reported series. In this study we analyze our cytologic experience to determine if a preoperative diagnosis is possible. Methods: A retrospective study of 11 patients with PAC in which a cytologic study was available. A review of the literature was also performed. Results: Our study shows that PAC has relatively constant cytological features. The analysis of the cytological literature although it shows some heterogeneity, also reveals repetitive cytological findings. Smears are cellular with irregular groups some showing pseudopapillary branching morphology. Monolayered clusters and small acinar structures are also present. Most cases have small metachromatic globules embedded within the groups determining a cylindromatous pattern. Tumoral cells are small and uniform with scarce to moderate cytoplasm. Nuclei are round and oval with occasional grooves and small nucleoli. Conclusion: PAC has characteristic cytological features that together with its location in minor salivary gland must make us consider it preoperatively. It may resemble basal cell adenoma and epithelial-rich pleomorphic adenoma so we should be cautious in the final diagnosis. Whenever possible, the characteristic cytomorphology of PCA should make us evaluate the mutational status of PRKD1 gene since it may permit a more accurate diagnosis.

Chordomas located primarily in the sellar region are uncommon, and may be misdiagnosed non-functioning pituitary adenoma. Furthermore, the association of a persistent primitive trigeminal artery (PPTA) with an intrasellar chordoma is extremely rare, and no similar cases have been reported in the literature to date. The coexistence of intrasellar chordoma (ISC) and PPTA makes safe and complete tumor resection challenging, and preoperative endovascular occlusion of this artery may be helpful.We report a case of a 32-year-old man who developed right hemifacial paresthesias and a cranial nerve six palsy. MRI study demonstrated the presence of a primary ISC associated with a PPTA. Angiographic balloon test occlusion of the PPTA revealed no neurological changes, so this vessel was endovascularly occluded by coiling. The lesion was subtotally removed through a sublabial transsphenoidal approach, without intraoperative bleeding complications. Histological examination of the lesion was consistent with the diagnosis of chordoma.Detailed preoperative neurovascular evaluation may be useful to detect vascular anomalies associated with intracranial chordomas, such as PPTA. In this report we emphasize the importance of appropriate treatment of vascular anomalies prior intrasellar lesions resection that may facilitate surgery and avoid potential hazardous intraoperative bleeding complications. Sağ hemifasiyal parestezi ve kraniyal altıncı sinir palsisi gelişen 32 yaşında bir erkek olgu bildiriyoruz. MRG çalışması PPTA ile ilişkili bir primer ISC varlığını gösterdi. PPTA'nın anjiyografik balon test oklüzyonu nörolojik değişikliğe neden olmadığından sarmal (koil) ile bu damar endovasküler olarak tıkandı. Lezyon sublabial transsfenoidal yaklaşımla intraoperatif bir kanama komplikasyonu olmadan subtotal olarak çıkartıldı. Lezyonun histolojik incelemesi kordoma tanısıyla uyumluydu.İntrakraniyal kordomalarla ilişkili PPTA gibi vasküler anomalileri saptamak için ayrıntılı preoperatif nörovasküler değerlendirme faydalı olabilir. Bu raporda, intrasellar lezyonların rezeksiyonundan önce cerrahiyi kolaylaştırabilecek ve tehlikeli intraoperatif kanama komplikasyonlarından kaçınmayı sağlayacak şekilde vasküler anomalilerin uygun tedavisinin önemini vurguluyoruz.

The ureter is a rare location of metastasis for any kind of primary tumour. The first case of truly ureteral metastasis was described by Stow in 1909. Regarding prostatic metastasis, the frequency is much lower with only 43 cases reported in the last century. We present a case of an exceedingly rare ureteral metastasis of a prostatic adenocarcinoma. In spite of its low incidence, it should be considered in patients with ureteral obstruction and concurrent prostatic adenocarcinoma.