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Rhabdoid tumour of the kidney: a clinicopathological study of 22 patients from the International Society of Paediatric Oncology (SIOP) nephroblastoma file.

We present 22 (0.9%) cases of rhabdoid tumour of the kidney diagnosed amongst 2392 renal tumours in children. The patients ages ranged from 3 weeks to 94 months (median 7 months) and the female:male ration was 1.2:1. Clinically, they presented with an abdominal mass but four (18%) children also had hypercalcaemia and one (4.5%) developed a brain tumour (primitive neuroectodermal tumour). None of the children presented with stage I disease, five (23%) had stage II, ten (46%) stage III, and five (23%) stage IV disease. Two (9%) patients had bilateral tumours. Histologically, the vast majority (20/22) of the tumours exhibited a classical pattern but other histological patterns were also noted. Immunohistochemical studies performed in 12 cases showed vimentin positivity in all cases, CAM 5.2 in eight, epithelial membrane antigen in six, neuron specific enolase in four, S-100 protein in eight, and desmin in one case. In only 12 of the 22 tumours was there agreement between the reporting pathologist and the panel on a diagnosis of rhabdoid tumour of the kidney. Eight tumours originally diagnosed as rhabdoid tumour of the kidney were found to be other renal tumours and in another ten cases the initial diagnosis was changed by the panel to rhabdoid tumour. Metastases developed in 18 (82%) of the children--in eight they were present at the time of diagnosis and in 10 they developed from 2 weeks to 9 months after initial diagnosis. Metastases were found in the lung, abdomen, lymph nodes, liver, bone and brain. Of the 19 children with adequate follow-up, only two (10.5%) with stage II disease are alive, while 17 (89.5%) died 2 weeks to 20 months after the diagnosis.

Adolescent↗

Influence of rotational speed, torque and operator proficiency on failure of Greater Taper files.

AIM: The purpose of this study was to evaluate the influence of rotational speed. torque, and operator experience on the incidence of locking, deformation, and separation of instruments when using a specific Ni-Ti rotary instrumentation technique in extracted human teeth. METHODOLOGY: Greater Taper Ni-Ti rotary instruments (GT) were used in a crown-down technique. In one group (rotational speed evaluation) of canals (n = 300) speeds of 150, 2 50 and 350 r.p.m. (subgroups 1, 2 and 3) were used. Each one of the subgroups included 100 canals. In a second group (evaluation of torque) (n = 300) torque was set at 20, 30 and 55 Ncm (subgroups 4, 5 and 6). In the third group (evaluation of operator proficiency) (n = 300 three operators with varying experience (subgroups 7, 8 and 9) were also compared. Each subgroup included the use of 10 sets of GT rotary instruments and 100 canals of extracted human molars. Each set of instruments was used in up to 10 canals and sterilized before each case. NaOCl 2.5% was used as an irrigant. The number of locked, deformed, and separated instruments was recorded for each group. Statistical analysis was carried out with pairwise comparisons using Fisher's exact tests for each of the failure type. RESULTS: When the influence of rotational speed was evaluated, instrument deformation and separation did not occur in subgroups 1 (150) r.p.m.), 2 (250 r.p.m.), and 3 (350) r.p.m.). Instrument locking occurred in subgroup 3 only. Statistical analysis demonstrated a significant difference between the 150 and 350 r.p.m. groups and between the 250 and 350 r.p.m. groups with respect to instrument locking. In torque evaluation, neither separation, deformation nor locking occurred during the use of the instruments, at 150 r.p.m., and at the different torque values. When the operators were compared, although two instruments were separated in canals prepared by the least experienced operator. Fisher's exact tests did not demonstrate a significant difference between the three subgroups. Instrument locking, deformation, and separation did not occur with the most experienced operator. None of the instruments separated with the trained operator. CONCLUSIONS: Preclinical training in the use of the GT rotary instruments when used with a crown-down technique at 150 r.p.m. was crucial in avoiding instrument separation and reducing the incidence of instrument locking and deformation.

Dental Alloys↗

Will accident reports filed in hospitals in Japan be used in the future as evidence in malpractice lawsuits?

A major drawback of submission of so-called incident reports for medical institutions is that such reports may be able to be obtained on request by patients and to be used as evidence in malpractice lawsuits. In Japan, there are no established rules concerning the use of accident reports in medical lawsuits. More debate is needed for voluntary report systems to become established in medical institutions throughout Japan.

Disclosure↗

Patient file management with a database using a personal computer.

With the development of the personal computer, an advanced and more efficient way of storing patients' records was created. A personal computer may be set up to store, retrieve, sort, recall, graph, combine, and evaluate all aspects of your patients' care. This article introduces the impressive array of the personal computer's patient charting capabilities and the most popular programs that are designed to perform this task.

Database Management Systems↗

Responding to object files: automatic integration of spatial information revealed by stimulus-response compatibility effects.

Spatial information is assumed to play a central, organizing role in object perception and to be an important ingredient of object representations. Here, evidence is provided to show that automatically integrated spatial object information is also functional in guiding spatial action. In particular, retrieving nonspatial information about a previewed object facilitates responses that spatially correspond to this object. This is true whether the object is still in sight or has already disappeared. So, forming an object representation entails the integration and storage of action-related information concerning the action that the object affords.

Adult↗