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Tumours resembling retinal anlage tumour have rarely been described, one of them having an association with an immature teratoma; these tumours are aggressive 934. Polysynaptic In a polysynaptic reflex arc, there is at least one interneuron between the sensory and motor neurons. Genetic susceptibility About a third of tumours are detected in women with the Peutz-Jeghers syndrome 117,2131. Water-soluble peptide hormones, like insulin, are able to rapidly adjust the metabolic processes of cells via second messenger cascades, while certain fat-soluble amino acid-derivative hormones, like thyroid hormones, enact longer-range effects by exerting regulatory actions at the transcriptional level. Starting from entering the heart from the venae cavae, what are the four chambers through which blood passes in the heart? They typically present with a soft-tissue swelling that may be mistaken for a cyst on clinical examination. Choice (B) is the correct answer because we would be more likely to expect constipation in such an individual, not diarrhea: slowed motility through the colon would lead to increased water reabsorption, making the feces too firm and causing constipation. An uncommon pattern is one with marked crowding of the transitional nests, which may be large and tortuous. B Most amino acids (except the acidic and basic amino acids) have two sites for protonation: the carboxylic acid and the amine group. The brain can derive up to two-thirds of its energy from ketone bodies during prolonged starvation. Parenthetically, it should be noted that besides seromucinous carcinomas, which can show a variety of cell types, all the epithelial ovarian tumours can also show mixtures of cell types. Association with endometrial adenocarcinoma, adenosarcoma, malignant mixed Mьllerian tumour or high-grade sarcoma can occur. Because these two molecules differ at the anomeric carbon, they are termed anomers of one another. Etiology the various types of metaplasia are most commonly reparative lesions secondary to a prior procedure to the cervix, most commonly loop excision. In excess, insulin will cause hypoglycemia, which is characterized by low blood glucose concentration. However, once most of the active sites are occupied, the reaction rate levels off, regardless of further increases in substrate concentration. Low-grade serous carcinoma Definition An invasive carcinoma, usually with distinctive patterns showing low-grade malignant cytological atypia. The inner mitochondrial membrane lacks cholesterol, which differentiates it from most other biological membranes. Which of the following is digestible by humans and is made up of only one type of monosaccharide? Indicationsforintervention Absolute indications · Critical ischaemia: · Ischaemic rest pain. Hobnail cells and intraglandular cellular tufting are common; simple elongated papillary projections may also be seen. Much like the sympathetic component of the autonomic nervous system, the hormones released from the adrenal medulla affect a wide variety of systems in the body, and all of their effects are centered on the fight-or-flight response. If many red blood cells were lysed, as in choice (B), then bilirubin levels would rise in accordance with the increased hemoglobin release. For each of the enzymes listed below, list the function of the enzyme and if they are found in prokaryotes, eukaryotes, or both. Facilitated Diffusion Facilitated diffusion is simple diffusion for molecules that are impermeable to the membrane (large, polar, or charged); the energy barrier is too high for these molecules to cross freely. Paget disease of anorectal origin involves the perianal mucosa and skin as well as the adjacent vulva. Nonphospholipid sphingolipids include glycolipids, which contain a glycosidic linkage to a sugar. Clinical features Merkel cell tumour of the vulva typically presents as a cutaneous nodule, or nodules. High quality genomic copy number data from archival formalin-fixed paraffin-embedded leiomyosarcoma: optimisation of universal linkage system labelling.

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Steroid functionality is determined by the oxidation status of these rings, as well as the functional groups they carry. A Conventional endometrial stromal neoplasia is juxtaposed to areas with smooth muscle differentiation displaying a starburst morphology (bottom). Vitamin E Vitamin E characterizes a group of closely related lipids called tocopherols and tocotrienols. Important histological features include the growth phase, Breslow thickness, ulceration, mitotic index, lymphovascular invasion, microsatellite or in transit metastasis, perineural invasion, tumour infiltrating lymphocytes, regression, Clark level 4/5 and status of margins 669,1168. Sex cord-like areas and smooth muscle differentiation as well as heterologous el- ements including fetal-type cartilage and rhabdomyoblasts (more common) or lipoblasts can be seen 598,847,1162,1558. Line your fingers up in the line of the artery, not perpendicular to it (especially the femoral). The polygonal cells have vesicular nuclei with coarse, basophilic chromatin and one or two prominent nucleoli. Rare and eponymous vascular disorders Disease-specific topics 147 65 High-yield vascular facts Table 65. Esterification is the reaction by which a hydroxyl group reacts with either a carboxylic acid or a carboxylic acid derivative to form an ester. Although the use of the injection sets increases the expense of the procedure, it is safer than freehand injection and allows the operator to focus on the fluoroscopic image. Epidemiology Endosalpingiosis may be found in 7% of women of reproductive-age and is commonly found in association with ovarian serous tumours 460,753,1529. Treatment decisions can be made on clinical grounds alone without further imaging and includes anticoagulation, catheter-directed thrombolysis/thrombectomy and open brachial embolectomy. The most common symptoms at presentation are pruritus, bleeding or symptoms related to a mass. As permeability of the collecting duct increases, so too does water reabsorption, resulting in further concentration of the urine. Capillaries are therefore the interface for communication of the circulatory system with the tissues. The cytoplasm shows gastric differentiation, but nuclei are bland and little, if any, stromal reaction is present. Once hormones have been released from the hypothalamus into this portal bloodstream, they travel down the pituitary stalk and bind to receptors in the anterior pituitary, stimulating the release of other hormones. Focal differentiation into somatic endodermal gland-like structures, as well as embryonal liver can occur in one-third of cases 1329,1946 and rarely, they may predominate. By lowering activation energy, equilibrium can be achieved faster (although the equilibrium position does not change). Onset can range from day of exposure up to 3 months and usually begins in the lower limbs (pain, pruritus, swelling, erythema) progressing to cutaneous and subcutaneous fibrosis (thickening) with painful contractures. Histogenesis Carcinosarcomas are metaplastic carcinomas; the carcinomatous element drives the biphasic tumour growth 1202. Prepulseless phase: Non-specific systemic upset (fever, malaise, myalgia, arthralgia, headache, weight loss) with vessel tenderness. B Compounds that contribute to membrane fluidity will lower the melting point or disrupt the crystal structure. The procedure aims to restore vertebral body height, reducing kyphosis associated with a vertebral fracture and reducing the complications of cement leakage associated with vertebroplasty. These compounds are further modified, as are terpenes, by the addition of an extensive variety of functional groups. Corepressor - A species that binds with a repressor, allowing the complex to bind to the operator region of an operon, stopping transcription of the relevant gene. This allows for mutations to accumulate, eventually resulting in a cancerous cell that divides continuously and without regard to the quality or quantity of the new cells produced. Insulin (light brown) in Pancreatic -Cells Take note of the differences between these types of tissues.

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A thin homogenous rim ("halo") of soft tissue attenuation fibrosis may evolve in the fat peripheral to the tumor in approximately half of patients. Patients are usually maintained in a recumbent position for 3 days after the procedure to allow the cement to reach maximum strength. Clinical features this tumour typically occurs in middle aged women with a median age of 42 years 257,705,822. Muscle contraction is required to create the negative pressure in the thoracic cavity that forces air into the lungs during inspiration. D After a large meal, one would expect blood to contain high levels of nutrients, such as glucose (choice (C)) and fatty acids (choice (A)), as well as regulators telling the body to utilize and store this fuel, like insulin (choice (B)). The opening of the potassium channel causes repolarization and - eventually - hyperpolarization. Nuclear chromatin is evenly dispersed, the nuclear to cytoplasmic ratio is high and mitotic activity is brisk. Afterabout4weeks Facultative anaerobic Gram-negative organisms will generally colonise the wound. While we may not hibernate through the winter, fat stores allow us to store energy to use during prolonged periods without food. During the cell cycle, concentrations of the various cyclins increase and decrease during specific stages. Cells that express neuroendocrine markers are present in some cases of cervical adenocarcinoma in situ and could be the precursor of cervical neuroendocrine tumours 1064,1219. Tunnel clusters Definition Rounded, lobular aggregates of benign, endocervical glands in the cervical wall. What would happen if an amphipathic molecule were placed in a nonpolar solvent rather than an aqueous solution? Endocytosis and exocytosis are methods of engulfing material into cells or releasing material to the exterior of cells, both via the cell membrane. The morphological features are similar to those of the homonymous tumours when occurring in their respective sites. A flexor muscle decreases the angle across a joint (like the biceps brachii); an extensor increases or straightens this angle (like the triceps brachii). Clinical features Embryonal carcinoma occurs almost exclusively in children and young women < 30 years (average 15 years) 999. Plasma is the liquid portion of blood, an aqueous mixture of nutrients, salts, respiratory gases, hormones, and blood proteins. Oblique incision in any of the left intercostal spaces: · to expose the descending thoracic aorta. There are two other extraembryonic membranes that require discussion: the allantois and the amnion. Gap Junctions Gap junctions allow for direct cell­cell communication and are often found in small bunches together. The tumour cells are uniform, small to medium in size with round, oval or spindle-shaped hyperchromatic nuclei. These deficiencies are termed glycogen storage diseases because all are characterized by accumulation of glycogen in one or more tissues. Endometrial polyps and the risk of atypical hyperplasia on biopsies of unremarkable endometrium: a study on 694 patients with benign endometrial polyps. Exposure of human tissue and tumor to temperatures in excess of 50°C for 6 minutes leads to cell death, although in practice, even higher temperatures are desirable for an efficient ablation. If there is a 1:1 distribution of dominant to recessive phenotypes, then the unknown genotype is likely to be heterozygous. The major differential diagnosis in florid cases is with clear cell carcinoma which will have significant cytological atypia, an infiltrative growth pattern and most often presents with a mass lesion. The A-band contains the thick filaments in their entirety, including any overlap with thin filaments. Like the glucocorticoids and catecholamines, mineralocorticoids and sex hormones are also synthesized by the adrenal gland and play a more minor role in metabolism. Similarly, a small increase or decrease in activity level will be compensated by changes in hunger.

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The condition is characterized by lethargy, decreased body temperature, slowed respiratory and heart rate, cold intolerance, and weight gain. There is one intron of 1000 base pairs (bp), a 5-untranslated region of 100 bp, and a 3-untranslated region of 200 bp. A stenosis in the carotid causes problems because there is potential debris that could embolise to the cerebral circulation (the reduced flow to the brain from the stenosis is of relatively little significance because there is good collateral supply). The process by which these nutrients are obtained from food occurs within the lumen of the alimentary canal and is known as extracellular digestion. C Dopamine is used in a number of neurological systems; most relevant to the endocrine system is the fact that dopamine secretion prevents prolactin release. Some cells contain round eosinophilic inclusions, which could be precursors of Reinke crystals, or cross sections of crystals. Sex cord-stromal tumours - pure stromal tumours 49 Sex cord-stromal tumours pure sex cord tumours C. Although the hydropic change may be minimal, the villous stroma is abnormally cellular and myxoid with prominent karyorrhexis. Air enters the respiratory tract through the external nares of the nose and then passes through the nasal cavity, where it is filtered through mucous membranes and nasal hairs (vibrissae). The pathological and life-threatening impact of this disease is a massive destruction of skin, muscle, and connective tissue by the release of bacterial toxins called superantigens. Absence of human papillomavirus infection in minimal deviation adenocarcinoma and lobular endocervical glandular hyperplasia. Choice (D) describes features of bacteriophages, which are viruses that infect bacteria - not the human nervous system. Red blood cells are also unique in that, when they mature, the nuclei, mitochondria, and other membrane-bound organelles are lost. Ketone bodies can be thought of as a transportable form of acetylCoA that is primarily utilized in periods of extended starvation. In tumours of moderate differentiation cellular lobules composed of darkly staining Sertoli cells, typically with scant cytoplasm, and admixed in a jumbled fashion with Leydig cells, are typically separated by an edematous stroma. Note that the source of acetyl-CoA is not from glycolysis and pyruvate dehydrogenase in this case, but from fatty acids. Primitive cells with folded nuclei and complex nuclear contours suggest monocytic differentiation of the tumour cells. Aggressive angiomyxoma of the vulva: Dramatic response to gonadotropinreleasing hormone agonist therapy. They may recur, particularly if incompletely excised, or with continued hormonal stimulation such as occurs with pregnancy. The peak incidence in the cervix is in the second and third decade, as opposed to a peak during infancy and childhood when it occurs in the vagina 420,435. Histogenesis Both complete and partial hydatidiform moles may develop into invasive hydatidiform mole. Dermal invasion and depth of dermal invasion are predictors for regional lymph nodes metastasis 381. The calcium ions bind to a regulatory subunit in troponin, triggering a change in the confirmation of tropomyosin, to which troponin is bound. Epithelial tumours and precursors 127 Macroscopy Tumours can form one or more discrete, tan nodules, while others are diffuse and exophytic. Mixed epithelial and mesenchymal tumours 43 Sex cord-stromal tumours pure stromal tumours W. Based on the size and geometry of the tumor, overlapping ablations are performed if the applicators are insufficient to cover the entire tumor with a single ablation. The tumour cells are arranged in sheets, cords, trabeculae or nests and have appreciable eosinophilic or clear cytoplasm. Follicle center lymphoma involving the female genital tract: a morphologic and molecular genetic study of three cases. Macroscopy Most are exophytic, polypoid, nodular or papillary; some may be ulcerated or plaque-like lesions.

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Management Management includes: · treating the underlying cause · relieving pressure on the tissues · treating any infection. Clinical features the tumour presents as a mass or cyst, in or adjacent to the interlabial sulcus. Rarely squamous carcinoma may be mixed with true small cell neuroendocrine carcinoma and discerning this may require immunohistochemistry 665,1843. A distinctive cytogenetic profile of metastasizing leiomyoma has also been found in a subset (3%) of uterine leiomyomas but not in other types of benign or malignant smooth-muscle tumours 1385. This can be accomplished by coating beads with a receptor that binds the protein or a specific antibody to the protein; in either case, the protein is retained in the column. Intermediate filaments are involved in cell­cell adhesion or maintenance of the integrity of the cytoskeleton; they help anchor organelles. Adenosquamous carcinoma Similar to adenosquamous carcinomas at other sites, these tumours are composed of malignant glandular and squamous elements. Between the neurons, there is a small space into which the terminal portion of the axon releases neurotransmitters, which bind to the dendrites of the postsynaptic neuron. Some patients with Turner syndrome can be shown to harbour Y chromosome material and they, like patients with gonadal dysgenesis, are at risk for gonadoblastoma. D the energy contribution of an amino acid depends on its ability to be turned into glucose through gluconeogenesis (glucogenic amino acids), ketone bodies (ketogenic amino acids), or both. Deeper portions of serous carcinomas are often composed of irregular glands with gaping lumina, rather than papillae. Lymphatic fluid carrying many chylomicrons takes on a milky white appearance and is called chyle. Value of immunohistochemistry in distinguishing peritoneal mesothelioma from serous carcinoma of the ovary and peritoneum: a review and update. This clot may become dislodged and travel through the right heart to the lungs, where it can cause a life-threatening condition called a pulmonary embolus. Rarely, collections of luteinized cells are present in fibromas or there is a minor component of sex cord elements, by definition comprising < 10% of the neoplasm. The cut surface of the tumour is white-tan to brown, with varying amounts of haemorrhage and necrosis. Although generally the glands are lined by stratified non-mucin-containing epithelium with well-defined luminal margins, foci lined by mucinous epithelium are not unusual. It is the predominant mechanism accepted in the scientific community when describing oxidative phosphorylation. It tends to affect children and young adults presenting with cerebral ischaemia, stroke and intracerebral haemorrhages. The clinical findings are similar to those observed in patients with mature cystic teratoma. The cells contain a moderate amount of finely granular, lightly eosinophilic cytoplasm, with generally bland, round to oval or spindle-shaped nuclei Sex cord-stromal tumours - pure stromal tumours 47 Leydig cell tumour C. Eukaryotic flagella contain microtubules composed of tubulin, organized in a 9 + 2 arrangement. In order to initiate a second messenger cascade, they typically display enzymatic activity, though some may act strictly as channels. Symport moves both particles in secondary active transport across the membrane in the same direction, while antiport moves particles across the cell membrane in opposite directions. Only those Bcells that have the highest affinity for the antigen survive and proliferate, increasing the specificity for the antigen over time. Sometimes the immune system may become overactivated, as is the case with necrotizing fasciitis, or it may become activated against the same human it is supposed to protect. The water-soluble vitamins are absorbed, along with water, amino acids, and carbohydrates, across the endothelial cells of the small intestine, passing directly into the plasma. Bile salts have hydrophobic and hydrophilic regions, allowing them to serve as a bridge between aqueous and lipid environments. Metastatic carcinoma often presents as a pelvic/adnexal mass or with generalized symptoms of abdominal disease.

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Competence refers to the ability of a cell to respond to a given inducer, but not the influence of the group of organizing cells, eliminating choice (A). Because the two molecules do not compete for the same site, inhibition is considered noncompetitive and cannot be overcome by adding more substrate. Astrocytes nourish neurons and form the blood­brain barrier, which controls the transmission of solutes from the bloodstream into nervous tissue. Presents with pain/compression symptoms/pulsatile mass/cranial nerve palsy; 5% bilateral, 5% locally malignant, 5% systemically malignant. This pressure must be used to prevent alveolar collapse, which should remind you that surfactant serves the same purpose by reducing surface tension. The gonads produce hormones that are involved in development and maintenance of the reproductive systems and secondary sex characteristics. It is important to remember that in this type of chromatography, the small compounds are slowed down and retained longer - which may be counterintuitive. The two main secondary structures are the -helix and -pleated sheet, which both result from hydrogen bonding. Small foci of mucinous epithelium, either benign mucinous glands or cysts or, rarely, signetring cells are present in up to 15% of cases 2116. When the temperature gets high enough, this extra energy can be enough to overcome the hydrophobic interactions that hold a protein together, causing the protein to unfold. To be effective, tight junctions must form a continuous band around the cell; otherwise, fluid could leak through spaces between tight junctions. Ancillary cells and structures Endothelium this is a single-celled (hexagonal-shaped) layer responsible for vessel tone and structure. B the amelanotic tumour cells are mixed epithelioid and spindled with abundant mitotic figures. Prognosis and predictive factors the recurrence rate is 10­15% for stage Ia tumours and 20­30% overall. There are four types of T-cells, each playing a different role in cellmediated immunity: cytotoxic T-cells, helper T-cells, memory T-cells, and suppressor T-cells. New Bethesda terminology and evidence-based management guidelines for cervical cytology findings. Clinical features Choriocarcinoma typically occurs in women of reproductive age (average 29­31 years), with rare cases reported in girls in their teens and postmenopausal patients 1404. Ipsilateral inguinofemoral lymph node metastasis is identified at Epithelial tumours 237 Epidemiology and clinical features these are rare neoplasms that occur in middle-aged to elderly women. The risk factors are the same regardless of the vascular territory, although there is some evidence to suggest that diabetes and smoking particularly increase the risk in the lower limbs. Larger polyps are associated with abnormal endometrial bleeding and occasionally with infertility; pedunculated polyps may protrude through the cervical os. Debranching enzyme, which moves a block of oligoglucose from one branch and connects it to the chain using an -1,4 glycosidic link. Paraganglioma of the vagina: report of a case, including immunohistochemical and ultrastructural findings. Prokaryotic Cell Shapes (a) Cocci (Staphylococcus aureus), (b) Bacilli (Mycobacterium tuberculosis), (c) Spirilli (Leptospira interrogans). Elastin Elastin is another important component of the extracellular matrix of connective tissue. Recent studies have shown statistically significant higher Ki67 levels in leiomyosarcomas compared to leiomyomas 23,281,832,1287,1402. Anticoagulation this does not dissolve thrombus but will limit its propagation (into collaterals) and is a bridge to further treatment. For example, living donors are often able to donate up to 50 percent of their liver tissue because their own livers will regenerate the missing portion. This helps them carry out their function (carrying oxygen) in two ways: Maximizing volume available for hemoglobin, the primary oxygen-carrying protein. Merkel cells (discs), for example, are sensory cells present at the epidermal­dermal junction. These antibodies then crossreact with elements of the small intestine, causing damage to the mucosa.

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For each of the cell types below, list the major secretions of the cell and the functions of these secretions. Macroscopy the tumour is characteristically large and polypoid, filling the entire uterine cavity and often protruding through the cervical os. At low temperatures, it keeps the cell membrane from solidifying; at high temperatures, it holds the membrane intact and prevents it from becoming too permeable. Indirect these inhibitors form a pentasaccharide­antithrombin complex that in turn binds factor Xa with high affinity. During replication, telomeres are slightly shortened, although this can be (partially) reversed by the enzyme telomerase. Mild to moderate trophoblastic hyperplasia is generally present in a circumferential or 164 Gestational trophoblastic disease random fashion. Menopause occurs when the ovaries stop producing estrogen and progesterone, usually between ages 45 and 55. Generally, the attainable zone of ablation is largest with cryoablation for comparable length of treatment given the routine placement of multiple simultaneous applicators. In addition, the circulatory system mediates the formation of blood clots to repair damaged vessels. Other variants include papillary (squamotransitional), basaloid, verrucous and warty (condylomatous) squamous cell carcinomas 1472. Isoform - A slightly different version of the same protein, often specific to a given tissue. Uterine tumour resembling ovarian sex cord tumour is an immunohistochemically polyphenotypic neoplasm which exhibits coexpression of epithelial, myoid and sex cord markers. Clinical features Typically the lesion is a solitary, firm, Histopathology Bartholin gland adenoma consists of small, clustered, closely packed glands and tubules lined by columnar to cuboidal epithelium with colloid-like secretion, arranged in a lobular pattern and con- 240 Tumours of the vulva Other vestibular gland cysts Definition Cysts of vestibular ducts. Epidemiology Extra-gastrointestinal stromal tumours are rare and account for approximately 2. Which of the diastereomers of glucose from the previous question are considered to be epimers of glucose? The tumour cells have uniformly medium-sized nuclei with vesicular chromatin and prominent nucleoli. Anaplastic carcinoma in mucinous ovarian tumors: a clinicopathologic study of 34 cases emphasizing the crucial impact of stage on prognosis, their histologic spectrum, and overlap with sarcomalike mural nodules. Endosalpingiosis Definition the presence of benign, tubal-type epithelium almost always forming glands, in the peritoneum or sometimes in the pelvic and retroperitoneal lymph nodes. This relationship is symbiotic: the bacteria are provided with a steady source of food, and the byproducts produced by the bacteria are beneficial to humans. This sudden increase in intracellular calcium triggers fusion of the membrane-bound vesicles with the cell membrane at the synapse, causing exocytosis of the neurotransmitter. Squamous predominance in mixed-epithelial papillary cystadenomas of borderline malignancy of mullerian type arising in endometriotic cysts: a study of four cases. Rarely, it may be discovered at a superficially invasive stage, and lymph node metastasis is unlikely if no lymphovascular invasion is seen 1494. Clusters of Paget cells with enlarged nuclei and abundant amphophilic cytoplasm are scattered through the epidermis. Under normal conditions, they exist in a predominantly non-proliferative, quiescent (but contractile) state responsible for vessel contraction and relaxation. There are no fetal or non-villous placental tissues present, although rare exceptions exist 87. The other enzymes are all involved in the oxygen-requiring processes discussed in this chapter. The glands are most frequently lined by endocervical-type epithelium that may be associated with squamous metaplasia. Malignant potential of mixed vulvar dystrophy (lichen sclerosus associated with squamous cell hyperplasia). Translation and Progeny Assembly After infection, translation of viral genetic material must occur in order for the virus to reproduce.

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In case of clinically significant neurologic compromise or neurologic deterioration, urgent neurosurgical decompression must be carried out. D If an area of the lung becomes filled with mucus and inflammatory cells, the area will not be able to participate in gas exchange. Fibroadenoma Definition Fibroadenoma is a benign, biphasic, circumscribed, epithelial-stromal neoplasm resembling the tumour of the same name in the breast. The take-home message: amino acids with acidic side chains have relatively low isoelectric points, while those with basic side chains have relatively high ones. The epithelium exhibits varying degrees of stratification, tufting and villous or slender filiform papillae. Epidemiology Primary vaginal paraganglioma is exceedingly rare; fewer than ten cases have been reported 203, 720. Since the presence of mucin within squamous carcinomas has not been shown to have any prognostic or predictive value, routine staining for mucin in squamous carcinomas is not recommended. Proline residues are thus rarely found in helices, except in helices that cross the cell membrane. Ketolysis is also favored during a prolonged fast, but is stimulated by a low-energy state in muscle and brain tissues and does not occur in the liver. Cell adhesion molecules - Specialized structural proteins that are involved in cell­cell junctions as well as transient cellular interactions; common cell adhesion molecules are cadherins, integrins, and selectins. Leiomyosarcoma may spread locally or regionally and may be associated with gastrointestinal or urinary- tract symptoms. As more gestational structures are shared, there are more risks as the fetuses grow and develop. Clear cell carcinoma Definition A malignant tumour composed of clear, eosinophilic and hobnail cells, displaying a combination of tubulocystic, papillary and solid patterns. While most citric acid cycle enzymes are located within the matrix, succinate dehydrogenase is located on the inner mitochondrial membrane. In addition to the single circular chromosome in prokaryotes, extrachromosomal material can be carried in plasmids. Partial nephrectomy, especially when performed with laparoscopic techniques, is a more complex operation than the traditional radical nephrectomy or open partial nephrectomy, and higher complication rates have been reported. Ovarian mucinous and mixed epithelial carcinomas of mullerian (endocervical-like) type: a clinicopathologic analysis of four cases of an uncommon variant associated with endometriosis. Prognosis and predictive factors these are aggressive neoplasms that frequently recur locally and metastasize 396,1343. Dissection of the groin vessels is too hazardous in the hostile groin because of the risk of uncontrollable haemorrhage through difficult, scarred tissue planes. In prophase I, the same events occur as in prophase of mitosis, except that homologues come together and intertwine in a process called synapsis. D Enzymes catalyze reactions by lowering their activation energy, and are not changed or consumed during the course of the reaction. Histogenesis Benign cervical smooth muscle tumours most likely arise from scattered smooth muscle cells in normal cervical stroma, which presumably accounts for their rarity relative to the uterine corpus. Large cell components show medium to large cells with moderate to abundant cytoplasm and large atypical nuclei with prominent macronucleoli. An antigen is a substance (usually a pathogenic protein) that can be targeted by an antibody. This may lead to viral clearance or to viral latency and the persistence of viral episomes in the epithelial basal layer without life-cycle completion. Endoskeletons are internal, but are not able to protect the soft tissue structures as well as exoskeletons. This structure is enlarged and flattened to maximize neurotransmission to the next neuron and ensure proper release of neurotransmitters, the chemicals that transmit information between neurons. Its main function is to absorb water and salts (such as sodium chloride) from the undigested material left over from the small intestine. Peptide bond - An amide bond between the carboxyl group of one amino acid and the amino group of another amino acid. Histology They have microscopic features similar to those of their ovarian counterparts 65,1125,2102.