Pancreatic primitive neuroectodermal tumors:Clinical features,treatment,and influencing factors

BACKGROUND Data on clinical characteristics,treatment outcomes,and prognosis of pancreatic primitive neuroectodermal tumors(PNETs)are limited.AIM To analyze the clinical data of 30 patients with pancreatic PNETs to identify their clinical characteristics and factors associated with prognosis.METHODS We used the keywords"primary neuroectodermal tumor,""digestive tract,""pancreas,""pancreatic,"and"gastrointestinal,"individually or in combination,to collect data from a global database for all patients with pancreatic PNET to date.Univariate and Cox regression analyses were performed to identify prognostic factors for patient survival.RESULTS A total of 30 cases of pancreatic PNET were included in this study:15 males and 15 females with a mean age of 24 years.The main symptom was abdominal pain(73.3%),and the median tumor size was 7.85 cm.Twenty-four patients(80.0%)underwent surgery and nineteen patients received adjuvant therapy.Local metastasis was observed in 13 patients(43.3%),lymph node metastasis in 10 patients(33.3%),and distant metastasis in 6 patients(20.0%).Local recurrence was observed in 13 patients(43.3%).The median survival time of all patients was 29.4 months,and the overall estimated 1-year and 3-year survival rates were approximately 66.0%and 36.4%,respectively.Univariate analysis showed that chemotherapy(P=0.036),local metastasis(P=0.041),lymph node metastasis(P=0.003),distant metastasis(P=0.049),and surgical margins(P=0.048)were the prognostic factors affecting survival.Multivariate analysis revealed only lymph node metastasis(P=0.012)as a prognostic factor.CONCLUSION Pancreatic PNET is extremely rare,occurs in young adults,has no apparent sex predisposition,has a high rate of metastasis and early recurrence,and has a very poor prognosis.The diagnosis of pancreatic PNET requires a combination of clinical symptoms,pathologic features,immunohistochemistry,and cytogenetic analysis.Univariate analysis suggested that chemotherapy,metastasis,and surgical margins were prognostic factors affecting survival,and multivariate analysis suggested that lymph node metastasis is an important prognostic factor.Therefore,early diagnosis,early and extensive resection,and adjuvant chemoradiotherapy may help improve prognosis.

Appropriate Garden Design of Primitive Ecology Based on the Indigenization of Environmental Ethics

The accelerating urbanization process leads to aggravated environmental problems, thus garden design which is a creative activity connecting human and nature has attracted much attention, and also garden designers have had to rethink about environmental ethics and morals. This study, from the perspective of environmental ethics, duly proposed the brand-new concept of 'appropriate garden of primitive ecology', proceeded from the orientation, form, value, theoretical basis, realistic significance, culture and consumption psychology of 'garden of primitive ecology', fully developed outstanding ecological wisdoms and morals in traditional Chinese garden culture, boosted garden designs to the environmental ethics level of eco-justice, to seek for the approach to 'garden of primitive ecology' with indigenous Chinese environmental ethic characteristics.

ON THE 3D VISCOUS PRIMITIVE EQUATIONS OF THE LARGE-SCALE ATMOSPHERE

This paper is devoted to considering the three-dimensional viscous primitive equations of the large-scale atmosphere. First, we prove the global well-posedness for the primitive equations with weaker initial data than that in [11]. Second, we obtain the existence of smooth solutions to the equations. Moreover, we obtain the compact global attractor in V for the dynamical system generated by the primitive equations of large-scale atmosphere, which improves the result of [11].

Peripheral primitive neuroectodermal tumor of the kidney presenting with pulmonary tumor embolism: A case report

Peripheral primitive neuroectodermal tumor(PNET) of the kidney is a rare, aggressive tumor known for its recurrence and metastatic potential. Despite the frequency of venous extension to the renal veins and inferior vena cava, pulmonary tumor embolism at the initial presentation is not common. We report a case of 22-year-old female with PNET of the kidney who presented with tumor embolism in the inferior vena cava(IVC) and bilateral pulmonary artery. The patient underwent surgical resection and histopathological analysis confirmed the presence of tumor within the IVC and pulmonary arteries. The patient received adjuvant chemotherapy and is currently doing well on follow-up.

Huge peripheral primitive neuroectodermal tumor of the small bowel mesentery at nonage:A case report and review of the literature

Extraskeletal Ewing's sarcoma/peripheral primitive neuroectodermal tumor(E-EWS/pP NET) is a rare aggressive malignant small round cell tumor. In this report, we present the case of a 15-year-old boy who suffered from acute abdominal pain accompanied by hematemesis and melena, and was eventually diagnosed with E-EWS/p PNET. To date, there have been only five reported cases of E-EWS/pP NET of the small bowel including the patient in this report. To the best of our knowledge, this is the first documentation of a pP NET of the small bowel mesentery at nonage. All these have made this report rare and significant.

Elimination of Computational Systematic Errors and Improvements of Weather and Climate System Models in Relation to Baroclinic Primitive Equations

The design of a total energy conserving semi-implicit scheme for the multiple-level baroclinic primitive equation has remained an unsolved problem for a long time. In this work, however, we follow an energy perfect conserving semi-implicit scheme of a European Centre for Medium-Range Weather Forecasts (ECMWF) type sigma-coordinate primitive equation which has recently successfully formulated. Some real-data contrast tests between the model of the new conserving scheme and that of the ECMWF-type of global spectral semi-implicit scheme show that the RMS error of the averaged forecast Height at 850 hPa can be clearly improved after the first integral week. The reduction also reaches 50 percent by the 30th day. Further contrast tests demonstrate that the RMS error of the monthly mean height in the middle and lower troposphere also be largely reduced, and some well-known systematical defects can be greatly improved. More detailed analysis reveals that part of the positive contributions comes from improvements of the extra-long wave components. This indicates that a remarkable improvement of the model climate drift level can be achieved by the actual realizing of a conserving time-difference scheme, which thereby eliminates a corresponding computational systematic error source/sink found in the currently-used traditional type of weather and climate system models in relation to the baroclinic primitive equations.

A primitive mantle source for the Neoarchean mafic rocks from the Tanzania Craton

Mafic rocks comprising tholeiitic pillow basalt, dolerite and minor gabbro form the basal stratigraphic unit in the ca. 2.8 to 2.6 Ga Geita Greenstone Belt situated in the NW Tanzania Craton. They outcrop mainly along the southern margin of the belt, and are at least 50 million years older than the supracrustal assemblages against which they have been juxtaposed. Geochemical analyses indicate that parts of the assemblage approach high Mg-tholeiite （more than 8 wt.% MgO）. This suite of samples has a restricted compositional range suggesting derivation from a chemically homogenous reservoir. Trace element modeling suggests that the mafic rocks were derived by partial melting within the spinel peridotite field from a source rock with a primitive mantle composition. That is, trace elements maintain primitive mantle ratios （Zr/Hf = 32-35, Ti/Zr - 107-147）, producing flat REE and HFSE profles [（La/Yb）pm = 0.9 -1.3], with abundances of 3-10 times primitive mantle and with minor negative anomalies of Nb [（Nb/ La）pm - 0.6-0.8] and Th [（Th/La）pm = 0.6-0.9]. Initial isotope compositions （εNd） range from 1.6 to 2.9 at 2.8 Ga and plot below the depleted mantle line suggesting derivation from a more enriched source compared to present day MORB mantle. The trace element composition and Nd isotopic ratios are similar to the mafic rocks outcropping -50 km south. The mafic rocks outcropping in the Geita area were erupted through oceanic crust over a short time period, between -2830 and-2820 Ma; are compositionally homogenous, contain little to no associated terrigenous sediments, and their trace element composition and short emplacement time resemble oceanic plateau basalts. They have been interpreted to be derived from a plume head with a primitive mantle composition.

Long-term survival of a patient with a large adrenal primitive neuroectodermal tumor: A case report

BACKGROUND Adrenal primitive neuroectodermal tumor(PNET) is an extremely rare malignant tumor with poor prognosis and of neural crest origin. Herein, we report a case of adrenal PNET and summarized its clinical and pathological characteristics on the basis of 16 patients reported recently.CASE SUMMARY A female patient aged 25 years presented with right lumbago for 12 mo, and preoperative computed tomography showed a huge right adrenal mass. She received tumorectomy, and post-operative pathological examination showed adrenal PNET. After surgery, she underwent adjuvant chemotherapy and was followed up 31 mo after surgery. She received brachytherapy for right paracolic and hepatic metastases. She was alive and followed up for 60 mo. In available studies, only 57.14%(4/7) and 44.44%(4/9) were positive for the expression of neuron-specific enolase and synaptophysin, respectively, although CD99 expression was found in all the patients(100%; 10/10).CONCLUSION It is concluded that adrenal PNET is very rare and highly malignant, and histology is a golden standard in its diagnosis. Surgery and adjuvant therapy is the main treatment.

Non-Acceleration Theorem in a Primitive Equation System: I. Acceleration of Zonal Mean Flow

Non-acceleration theorem in a primitive equation system is developed to investigate the influences of waves on the mean flow variation against external forcing. Numerical results show that mechanical forcing overwhelms thermal forcing in maintaining the mean flow in which the internal mechanical forcing associated with horizontal eddy flux of momentum plays the most important roles. Both internal forcing and external forcing are shown to be active and at the first place for the mean flow variations, whereas the forcing-induced mean meridional circulation is passive and secondary. It is also shown that the effects on mean flow of external mechanical forcing are concentrated in the lower troposphere, whereas those due to wave-mean flow interaction are more important in the upper troposphere. These act together and result in the vertically easterly shear in low latitudes and westerly shear in mid-latitudes. This vertical shear of mean flow is to some extent weakened by thermal forcing.

Evolution from Primitive Life to Homo sapiens Based on Visible Genome Structures: The Amino Acid World

It is not too much to say that molecular biology, including genome research, has progressed based on the determination of nucleotide or amino acid sequences. However, these ap-proaches are limited to the analysis of relatively small numbers of the same genes among spe-cies. On the other hand, by graphical presenta-tion of the ratios of the numbers of amino acids present to the total numbers of amino acids presumed from the target gene(s) or genome or those of the numbers of nucleotides present to the total numbers of nucleotides calculated from the target gene(s) or genome, we can readily draw conclusions from extraordinarily huge data sets integrated by human intelli-gence. 1) Assuming polymerization of amino acids or nucleotides in a simulation analysis based on a random choice, proteins were formed by simple amino acid polymerization, while nucleotide polymerization to form nucleic acids encoding specific proteins needed certain specific control. These results proposed that protein formation chronologically preceded codon formation during the establishment of primitive life forms. In the prebiotic phase, amino acid composition was a dominant factor that determined protein characteristics;the “Amino Acid World”. 2) The genome is constructed homogeneou- sly from putative small units displaying similar codon usages and coding for similar amino acid compositions;the unit is a gene assembly en-coding 3,000 - 7,000 amino acid residues and this unit size is independent not only of genome size, but also of species. 3) In codon evolution, all nucleotide alterna-tions are correlated, not only in coding regions, but also in non-coding regions;the correlations can be expressed by linear formulas;y = ax + b, where “y” and “x” represent nucleotide con-tents, and “a” and “b” are constant. 4) The basic pattern of cellular amino acid compositions obtained from whole cell lysates is conserved from bacteria to Homo sapiens, and resembles that calculated from complete genomes. This basic pattern is characterized by a “star-shape” that changes slightly among species, and changes in amino acid composi-tion seem to reflect biological evolution. 5) Organisms can essentially be classified according to two codon patterns. Biological evolution due to nucleotide sub-stitutions can be expressed by simple linear formulas based on mathematical principles, while natural selection must affect species pre- servation after nucleotide alternations. There-fore, although Darwin’s natural selection is not directly involved in nucleotide alternations, it contributes obviously to the selection of nu-cleotide alternations. Thus, Darwin’s natural selection is doubtless an important factor in biological evolution.

Huge primitive neuroectodermal tumor of the pancreas:Report of a case and review of the literature

Primitive neuroectodermal tumor (PNET) of the pancreas is an extremely rare tumor that usually occurs in children or young adults. We report a case of a 33-year-old male patient with an 18 cm × 18 cm × 16 cm mass arising from the pancreatic body and tail with a one- day history of abdominal pain. Initial CT scan showed no signs of metastatic tumor spread. The tumor caused intrabdominal bleeding and the patient underwent primary tumor resection including partial gastrectomy, left pancreatic resection and splenectomy. Diagnosis of PNET was confi rmed by histology, immunohistochemistry and FISH analysis. All neoplastic cells were stained positive for MIC2-protein (CD99). Approximately one month after surgery, several liver metastases were observed and the patient underwent chemotherapy according to the Euro- Ewing protocol. Subsequent relaparotomy excluded any residual hepatic or extrahepatic abdominal metastases. Although PNET in the pancreas is an extremely rare entity, it should be considered in the diffential diagnosis of pancreatic masses, especially in young patients. This alarming case particularly illustrates that PNET in the pancreas although in an advanced stage can present with only a short history of mild symptoms.

Genomic Instability in Cancer I: DNA-Repair Triggering Primitive Hereditary 4n-Skewed, Amitotic Division-System, the Culprit in EMT/MET/Metaplasia Cancer-Concepts

The objective was to gain proof of genome damage-repair induced mitotic slippage process (MSP) to 4n-diplochromosome skewed division-system, earlier suggested to have “cancer-deciding” consequences. Our damage-model showed two succeeding phases: molecular mutations for initiation of fitness-gained cells, and large chromosomal changes to aneuploidy from inherited DNA-breakage-repair inaccuracies. The mutations were gained while DNA-repair and DNA-replication, co-existed in the route to tetraploidy, a phenomenon also expressed for some existing unicellular organisms. These organisms also showed genome reductive, amitotic, meioticlike division, and was the origin of human genome conserved, self-inflicted 90° reorientation of the 4n nucleus relative to the cytoskeleton axis. In the in vitro DNA-damage model, this remarkable 4n-event deciding “flat-upright” cell-growth characteristics showed several consequences, for example, cancer-important, E-cadherin-β-catenin cell-to-cell adherence destruction, which gave diploid progeny cells, mobility freedom from cell contact inhibition, likely in renewal tissues. This 4n-skewed division-system with inheritance in progeny cells for repeat occurrences as mentioned for flat-up-right growth patterns is similar to claimed concepts of metaplasia-EMT/MET embryogenesis events in cancer evolution. A scrutiny of this literature, proof-wise invalidated this embryological concept by tetraploid 8C cells occurring in MET events and, was noted for small cell occurrence, i.e., diploidy from 4n-8C reductive division, an also event for tumor relapse cells, derived from genome damaging therapy agents. Pre-cancer hyperplasia reported MSP, cadherincatenin destruction and 90° perpendicularity to basal cell membrane. The DNA-damage-repair model can weed-out therapy-agents triggering 4n-skewed division. Cancer-control, beginning-information, is likely from mutational identity of the 4n derived fitness-gained cells.

Coordinating control of multiple rigid bodies based on motion primitives

This paper studies the problem of coordinated motion generation for a group of rigid bodies. Two classes of coordinated motion primitives, relative equilibria and ma- neuvers, are given as building blocks for generating coordi- nated motions. In a motion-primitive based planning frame- work, a control method is proposed for the robust execution of a coordinated motion plan in the presence of perturba- tions. The control method combines the relative equilibria stabilization with maneuver design, and results in a close- loop motion planning framework. The performance of the control method has been illustrated through a numerical sim- ulation.

Extraction of Robot Primitive Control Rules from Natural Language Instructions

A support vector rule based method is investigated for the construction of motion controllers via natural language training. It is a two-phase process including motion control information collection from natural language instructions, and motion information condensation with the aid of support vector machine （SVM） theory. Self-organizing fuzzy neural networks are utilized for the collection of control rules, from which support vector rules are extracted to form a final controller to achieve any given control accuracy. In this way, the number of control rules is reduced, and the structure of the controller tidied, making a controller constructed using natural language training more appropriate in practice, and providing a fundamental rule base for high-level robot behavior control. Simulations and experiments on a wheeled robot are carried out to illustrate the effectiveness of the method.

Total pelvic exenteration and a new model of diversion for giant primitive neuroectodermal tumor of prostate: A case report and review of the literature

The present study reports a rare primitive neuroectodermal tumor (PNET) of prostate.A 27-year-old male was admitted to Harbin Medical University Cancer Hospital (Harbin,China) for dysuria and dyschezia. Magnetic resonance imaging (MRI) revealed a large mass thatmay involve the bladder and rectum next to the prostate. Histopathological analysis of biopsyof prostate indicated mesenchymal origin tumor, and immunohistochemistric stainingconfirmed diagnosis of PNET of prostate. En bloc total pelvic exenteration and double barrelsigmoidostomy were performed. Double stomas in the skin incision were used for fecal andurinary diversion, respectively. Short-term outcome is satisfactory, while long-term efficacyremains to be poor. Clinical features of PNET of prostate should be paid much more attentionand radical surgery and adjuvant chemotherapy should be recommended.

2-Competition Index of Primitive Digraphs Using Graph Theory

Recently,scrambling index and competition index are widely applied to stochastic matrices and food webs. By analyzing the relationship of scrambling index and 2-competition index,n-「d/2」+ 1 was proved to be an upper bound of the 2-competition2 index of a primitive digraph with exact d loops in this article.Moreover,the maximum index problem and the index set problem for the 2-competition index of primitive digraphs with minimally strong digraphs were settled.

Flag-transitive point-primitive 2-(v,k,4) symmetric designs and two dimensional classical groups

Let D be a 2-（v, k, 4） symmetric design and G be a flag-transitive point-primitive automorphism group of D with X ≥G ≤Aut（X） where X ≌ PSL2（q）.Then D is a 2-（15,8,4） symmetric design with X = PSL2（9） and Xx = PGL2（3） where x is a point of D.

The Conflicts Between Primitiveness and Civilization:an Analysis of Heart of Darkness

Heart of Darkness, a chilling tale of horror set in the Congo during the period of rapid colonial expansion in the 19th century written by the renowned British novelist Joseph Conrad, is a world famous novella. Since its publication, it remains an indisputably classic text and arguably Conrad's finest work. And it has been regarded as a significant text in British literature because of its modernistic features, innovative narration and artistic style. Heart of Darkness deals with the highly disturbing effects of economic, social and political exploitation of European and African societies. It has inspired filmmakers and such authors as F. Scott Fitzgerald, Gabriel Garica Marquez, D. H. Lawrence and Virginia,Woolf. This article is aimed to analyse it from the perspective of primitiveness and civilization. Through the analysis, readers can sense Conrad's attitude towards the two aspects.

Primitive trigeminal artery-cavernous sinus fistula and ICA-primitive trigeminal artery aneurysm: report of two cases and review of literatures

The authors described two cases with primitive trigeminal artery. Case 1 was a 32-year-old woman who suffered dizziness and a serious pulsatile intracranial bruit on the left ear, and sometimes associated with pulsatile intracranial bearing-pain on the left temporal side six months before she was admitted to the hospital. She also suffered from obvious diplopia on left lateral gaze for the last 5 months. She had suffered no recent trauma. Magnetic resonance imaging(MRI) demonstrated a suspected intracranial aneurysm located in left cavernous sinus. Digital subtraction angiography (DSA) was performed and a primitive trigeminal artery-cavernous sinus fistula in left side was found. Intraluminal occlusion of the fistula was successfully performed immediately after angiography using 6 Guglielmi detachable coils (GDC), and the patient was cured finally. Case 2 was a 28-year-old woman who suffered a serious intermittent cephalodynia associated with soreness on the left body two years before she was admitted to the hospital. She had suffered no recent trauma. Magnetic resonance angiography(MRA) demonstrated a suspected intracavernous aneurysm of the right internal carotid artery, Digital subtraction angiography (DSA) was performed. Right internal carotid angiography showed a primitive trigeminal artery (PTA) run between the cavernous segment of the internal carotid artery and the distal portion of the basilar artery. On initiation of PTA of R-ICA a small wide-necked saccular aneurysm was incidentally visualized. The aneurysm was successfully embolized after angiography using 2 Stent (Neuroform, 4.5mmm × 20mmm)-assisted detachable coils (Matrix), the ICA and PTA were preserved, and the patient was cured finally.