Prognostic relevance of Masaoka and Müller-Hermelink classification in patients with thymic tumors.

BACKGROUND: To compare the prognostic relevance of Masaoka and Müller-Hermelink classifications. METHODS: We treated 71 patients with thymic tumors at our institution between 1980 and 1997. Complete follow-up was achieved in 69 patients (97%) with a mean follow up-time of 8.3 years (range, 9 months to 17 years). RESULTS: Masaoka stage I was found in 31 patients (44.9%), stage II in 17 (24.6%), stage III in 19 (27.6%), and stage IV in 2 (2.9%). The 10-year overall survival rate was 83.5% for stage I, 100% for stage IIa, 58% for stage IIb, 44% for stage III, and 0% for stage IV. The disease-free survival rates were 100%, 70%, 40%, 38%, and 0%, respectively. Histologic classification according to Müller-Hermelink found medullary tumors in 7 patients (10.1%), mixed in 18 (26.1%), organoid in 14 (20.3%), cortical in 11 (15.9%), well-differentiated thymic carcinoma in 14 (20.3%), and endocrine carcinoma in 5 (7.3%), with 10-year overall survival rates of 100%, 75%, 92%, 87.5%, 30%, and 0%, respectively, and 10-year disease-free survival rates of 100%, 100%, 77%, 75%, 37%, and 0%, respectively. Medullary, mixed, and well-differentiated organoid tumors were correlated with stage I and II, and well-differentiated thymic carcinoma and endocrine carcinoma with stage III and IV (p < 0.001). Multivariate analysis showed age, gender, myasthenia gravis, and postoperative adjuvant therapy not to be significant predictors of overall and disease-free survival after complete resection, whereas the Müller-Hermelink and Masaoka classifications were independent significant predictors for overall (p < 0.05) and disease-free survival (p < 0.004; p < 0.0001). CONCLUSIONS: The consideration of staging and histology in thymic tumors has the potential to improve recurrence prediction and patient selection for combined treatment modalities.

Preparation for emergency relief after biological warfare.

Upon invitation by the World Health Organization during the Gulf War, a task force "Scorpio" independent from the nations involved in the armed conflict was formed whose task was to determine whether, which and to what extent biological warfare agents had been used. risk assessment concluded that anthrax and Clostridium botulinum toxin were the major risks. The 21 civilian experts had rapidly to decide on the doctrine of operation, to assemble material which could be used and to be immunized or protected otherwise against the potential risks. Biological warfare agents may be used anywhere any time, be it by terrorists or during open or clandestine hostilities. The general population cannot rely on the military to take care of civilian relief, thus international and national organizations may wish to establish similar task forces basing on the "Scorpio" model on a national or regional basis.

Liver cirrhosis in histiocytosis X.

Cirrhosis of the liver was diagnosed in an 18-year-old man with histiocytosis X. Electron microscopy and immunohistochemistry revealed infiltration of the liver by the typical cellular elements of histiocytosis X. Endoscopic retrograde cholangiography showed alterations resembling those of sclerosing cholangitis. Sixteen months later, the patient died of recurrent variceal bleeding and cholangiosepsis. Autopsy confirmed that cirrhosis was the main manifestations of the underlying disease. Thus, cirrhosis of liver can be a main and potentially fatal manifestation of histiocytosis X beyond the pediatric age range. Histiocytosis X may lead to parenchymal infiltration of the liver and to changes of the major bile ducts resembling sclerosing cholangitis. The diagnosis of hepatic histiocytosis X can easily be missed without relying on appropriate electron microscopic and immunohistochemical investigations.

Principal cell types in the pancreatic islet of a teleost fish, Xiphorphorus helleri H.

By means of correlative light and electron microscopy, five pancreatic islet cell categories are described in the teleost fish, Xiphophorus helleri, each of which has specific light microscopic appearance and fine structure. Different histochemical techniques have been used, including immunofluorescence with antiporcine insulin and glucagon sera. In addition to B- and A1-cells, two categories of A2-cells have been observed both reacting with antiporcine glucagon serum: A2-cells with round granules gave a positive reaction for tryptophan; have been observed, both reacting with antiporcine glucagon serum: A2-cells with crystalline granules gave a negative reaction with the same staining technique on the same section. The "clear cells", the last category, were not specifically stained by any of the staining methods carried out in this investigation. The influence of fixation on staining affinities and on ultrastructure was shown to be considerable.

Determination of atmospheric structure function by using a single coherent detector.

The wave structure function associated with atmospheric turbulence is important in the effective design of telescopes for coherent optical receivers. This paper describes a method of measurement of the wave structure function by employing an already existing optical receiver. The aperture of this receiver's telescope is masked by an opaque screen with two small holes. It is then shown that when the incident beam obeys Gaussian statistics, the receiver's A.M. output can be simply related to the wave structure function of the incident beam.