Congenital polycystic tumor of the atrioventricular node is a rare tumor of disputed histogenesis. It constant location in the atrioventricular node separates it from other cardiac cysts and tumors ...of indisputable endodermal origin. New studies of the embryogenesis of conduction tissues provide a reasonable explanation for the site of the lesion. Morphologic and histochemical features of the tumor fail to conclusively favor either a mesothelial or an endodermal genesis. A recently studied case provides some new morphologic observations (complex desmosomes, granule-containing epithelial cells) and suggests the possibility of of familial occurrence.
A 7 1/2-year-old girl had exercise intolerance and exertional dyspnea. Four months later, congestive heart failure developed, with recurrent chylous pleural effusions, and she died at age 8 1/2 ...years. Endomyocardial biopsy tissue showed abundant PAS-positive, diastase-resistant cytoplasmic deposits. Similar inclusions were seen in muscle, skin, and liver specimens. Postmortem studies showed that the abnormal polysaccharide was especially abundant in heart and muscle, but was also present in all other tissues, including the central nervous system. Glycogen isolated from heart, muscle, and spinal cord showed a shift of the iodine spectrum toward higher than normal wavelengths. Branching enzyme activity was lacking in the muscle biopsy specimen and in all postmortem tissues; glycogenolytic enzymes had normal activities. These studies show that cardiomyopathy can be the first symptom of generalized branching enzyme deficiency and that the degree of accumulation of the abnormal polysaccharide may vary in different tissues.
An integrated understanding of both social and ecological aspects of environmental issues is essential to address pressing sustainability challenges. An integrated social-ecological systems ...perspective is purported to provide a better understanding of the complex relationships between humans and nature. Despite a threefold increase in the amount of social-ecological research published between 2010 and 2015, it is unclear whether these approaches have been truly integrative. We conducted a systematic literature review to investigate the conceptual, methodological, disciplinary, and functional aspects of social-ecological integration. In general, we found that overall integration is still lacking in social-ecological research. Some social variables deemed important for addressing sustainability challenges are underrepresented in social-ecological studies, e.g., culture, politics, and power. Disciplines such as ecology, urban studies, and geography are better integrated than others, e.g., sociology, biology, and public administration. In addition to ecology and urban studies, biodiversity conservation plays a key brokerage role in integrating other disciplines into social-ecological research. Studies founded on systems theory have the highest rates of integration. Highly integrative studies combine different types of tools, involve stakeholders at appropriate stages, and tend to deliver practical recommendations. Better social-ecological integration must underpin sustainability science. To achieve this potential, future social-ecological research will require greater attention to the following: the interdisciplinary composition of project teams, strategic stakeholder involvement, application of multiple tools, incorporation of both social and ecological variables, consideration of bidirectional relationships between variables, and identification of implications and articulation of clear policy recommendations.
Adenocarcinoma of the rete testis is a rare neoplasm that usually occurs in men after the age of 60 and carries a variable prognosis. We report an occurrence of this tumor in a 91-year-old man who ...had been treated for 2 years for an hydrocele. At the time of diagnosis, metastases were not evident; and the patient was treated with local radiotherapy. The diagnosis of papillary adenocarcinoma of the rete testis was made on the basis of: (a) a transition from normal rete testis to atypical and neoplastic rete epithelium; (b) exclusion of primary germinal and nongerminal testicular tumors and spread from distant sources; and (c) electron-microscopic findings, histochemical and immunological studies, and autopsy findings supporting the diagnosis. This is the first reported case of adenocarcinoma of the rete testis that includes documentation of the tumor's metastatic pattern.
Single carotid intraplaque hemorrhage has been related to the occurrence of cerebrovascular ischemic symptoms. We were unable to reproduce these findings; therefore, our patient population was ...reinvestigated to ascertain the importance of repeated plaque hemorrhages and their possible relationship to the production of neurologic symptoms. Eighty-five consecutive patients underwent 95 carotid endarterectomies. Plaques were separated into three groups: those from patients with lateralizing symptoms, nonlateralizing symptoms, and no symptoms. All the plaques were inspected microscopically for evidence of hemorrhage, specifically, repeated hemorrhages. Repeated hemorrhages were found in 29 of 44 plaques (66%) in the lateralizing symptom group, 6 of 19 (32%) in the nonlateralizing symptom group, and 12 of 32 (37%) in the no symptom group. We conclude that repeated rather than single intraplaque hemorrhage is the critical factor related to the production of specific cerebrovascular ischemic symptoms.
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