A young woman with a thyroid papillary carcinoma behaving as an autonomously hyperfunctioning nodule is described. Only 17 similar patients have been seen in the past 25 years. It is emphasized that hyperthyroidism does not exclude malignant disease in hot nodules. This possibility suggests that all thyroid nodules, either cold or hot, require careful management. Therefore, in "at risk" cases, surgery could be the most useful treatment.

Lymph node involvement in colorectal cancer, one of the most important prognostic factors, can be sometimes underestimated. In this study the authors report the results of two different techniques of specimen preparation and examination. In 240 patients (Group I), histologic examination was performed using a conventional procedure. In Group II (60 cases) the resected bowel and its mesentery were separately stretched, pinned on to a cork board, and fixed. The mesentery was divided according to node location (intermediate and principal) and evaluated by sight and palpation to identify lymph nodes. The bowel segment was divided from 5 cm proximally to 5 cm distally to the tumor every 10 mm in serial 3 mm slices. Three and 10 mm slices were then carefully examined by sight and palpation. Isolated lymph nodes embedded in groups (10-12 per paraffin block) were stained and investigated for neoplastic involvement. The specimen examination procedure used in Group II resulted in identification of a higher number of lymph nodes (mean = 41.1) and nodal metastases (mean = 10) compared to the standard technique used in Group I (mean = 11.3 and 2.4, respectively--P < .05). The percentage of N+ cases also was increased in Group II (48.3%) when compared to that in Group I (30.4%; P < .05). The new technique is simple, inexpensive, and efficacious for the detection of lymphatic metastases in colorectal cancer.

Introduction: The COAPT trial demonstrated a clinical benefit in pts meeting fairly strict criteria for entry. Most notable was a criteria that pts had an EROA 0.3, or a regurgitant volume (RV) 45. The Carillon device has been studied in 3 prospective trials with independent core lab echo assessments. Methods: Pts receiving a Carillon device from these trials were pooled for analysis and divided into 2 groups; those with EROA < 0.3 and RV < 45 and those with an EROA 0.3 or RV 45. Pts were then evaluated for clinical outcomes and % improvement in regurgitant volume (RV) from baseline to one year, as well as % improvement in LV end diastolic volume. Results: Baseline data are summarized in Table 1. Pts with more severe baseline MR had a higher proportion of afib and ischemic etiology of cardiomyopathy, in addition to larger LV and left atrial volumes. Echo parameter changes at one year are provided in Table 2. Marked improvements for RV,LVEDV and LVESV were observed in both groups, although there was slightly more improvements in the pts with more baseline MR. EF improved more in pts with lesser degrees of MR, suggesting a benefit to treating earlier in the disease process. Conclusions: Treatment of functional mitral regurgitation (FMR) with the Carillon Device in "COAPT eligible" patients resulted in marked remodeling. Similar outcomes were observed in patients with less severe FMR, suggesting earlier intervention may be beneficial.

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Summary:Malignant fibrous histiocytoma of the bone is a very rare tumour mainly affecting long bones, and the most common presenting symptom is local pain. A case of malignant fibrous histiocytoma presenting with pyrexia of undetermined origin and arising in the sternum, a localization not previously described, is reported. The patient died with septic shock after multi-drug chemotherapy including high dose methotrexate treatment with citrovorum factor rescue.