Inflammatory Breast Cancer Survival: The Role of Obesity and Menopausal Status at Diagnosis

No previous studies have evaluated the effect of body size and menopausal status at diagnosis on survival from inflammatory breast cancer (IBC). We evaluated whether obesity and menopausal status had an impact on IBC survival in a cohort of 177 female IBC patients seen from 1974 to 1993 at The University of Texas MD Anderson Cancer Center. Survival time was defined as time from diagnosis until death or censorship at last date of contact. We categorized women by body size by using the National Institutes of Health/National Heart, Lung, and Blood Institute's definitions of obesity as body mass index ((BMI)=weight in kg/(height in m)²)30, overweight as 25BMI <30kg/m², and normal/lean as BMI <25kg/m². Cox proportional hazards analysis, adjusting for axillary lymph node involvement and chemotherapy protocol, revealed a modifying effect of menopausal status at diagnosis on the association between obesity and IBC survival (P=0.02). Relative to postmenopausal women, premenopausal women had significantly worse survival (hazard ratio (HR)=1.51, 95% confidence interval (CI)=1.03–2.22). After stratifying by menopausal status, premenopausal obese women had non-significantly better survival than their leaner premenopausal counterparts (HR=0.63, 95% CI=0.34–1.15) while postmenopausal obese women had significantly worse survival than their leaner counterparts (HR=1.86, 95% CI=1.02–3.40). These findings suggest that factors associated with larger body size at diagnosis may contribute to shorter IBC survival among postmenopausal women but not premenopausal women, who were found to have poorer survival regardless of body size.     

Inflammatory demyelinating polyneuropathy: A complication of immunotherapy in malignant melanoma

Paraneoplastic syndromes (PNS) involving the central nervous system are arare manifestation of malignant disease. As they commonly precede thediagnosis of malignancy their acute manifestations do not often presentthemselves to oncologists in the first instance. It is currently believed thatmost, if not all, neurological PNS are autoimmune in nature. Proteinsexpressed ectopically on the surface of tumour cells generate an immuneresponse which cross-reacts with the same, or similar, proteins in the nervoussystem resulting in damage. This can involve a single cell type of the nervoussystem whilst in other cases the impairment is more widespread.The following report is of a case of chronic inflammatory demyelinatingpolyneuropathy (CIDP) occurring in metastatic malignant melanoma, followingtreatment with interferon-. We review the current literature on this rareassociation and speculate on its pathogenesis, and the implications for futuretherapeutic strategies in melanoma targeting tumour antigens.     

Mycosis fungoides mimicking inflammatory linear verrucous epidermal nevus

We experienced an unusual case of mycosis fungoides with the clinical and histological features mimicking inflammatory linear verrucous epidermal nevus (ILVEN) in an 11-year-old boy. Localized linear multiple pruritic verrucous confluent papules and plaques appeared on the his left elbow, forearm and hand for 7 months. Skin biopsies showed characteristic findings of mycosis fungoides (e.g. Pautrier's microabscesses, follicular epitheliotropism, wiry bundles of collagen, etc.). T-cell receptor gene rearrangement analysis in the lesional skin demonstrated rearrangement of the gamma chain. RePUVA (systemic PUVA with retinoic acid) therapy improved his skin lesions and pruritus, but these progressed after discontinuation of treatment. Thus, lesions mimicking ILVEN can be an unusual and potentially misleading presentation of mycosis fungoides.     

炎症痛引起的猫背根节Aβ神经元自发放电特性的分析

应用角叉菜胶后肢局部致炎作为炎症痛的实验动物模型，通过在细胞内记录技术，观察和分析了猫脊髓背根节Aβ神经元的自发放电特性和诱因。结果表明炎症痛导致猫背根节有自发放电的Aβ神经元数明显增加，并表现为持续高频、簇状和不规则等多种型式的放电；在炎症痛不同时程（4和12h），静息膜电位有一定程度的去极化；大多数有自发放电活动的神经元（91％）对外周机械性刺激表现为兴奋反应，其中有部分神经元（9％）同时具有兴奋性和抑制性感受野。胞体给予TTX能阻断这种自发放电；切断外周神经干能使这种自发放电消失，而切断其背根不影响这种自发放电活动。提示炎症痛猫背根节Aβ神经元的兴奋性增强与炎症部位持续性痛的存在相关，可能是炎症性触诱发痛（Allodynia）形成的基础。     

POSTPARTUM AVULSION OF THE TERMINAL ILEAL WALL IN CROHN'S DISEASE

A case of acute perforation of the terminal ileum induced by avulsion of the bowel wall in a segment of acutely inflamed Crohn's disease is presented. This case is unusual in that the avulsion developed after delivery following the rapid retraction of the uterus which had been compressing a small localized perforation and abscess. A review of the literature has failed to demonstrate a similar case report.     

Granulocyte proteins in serum in childhood asthma: relation to spirometry and therapy

Background Measurement of markers of eosinophil activation in asthmatics provides information indicative of ongoing inflammatory processes in the airways. Objectives This study was eonducted to determine the correlations between serum markers of allergie inflammation with spirometry parameters in asthmatic children in different treatment groups. Methods Blood eosinophils. serum levels of eosinophil cationic protein (ECP). eosinophil protein X (EPX), myeloperoxidase (MPO) and tryptase were measured simultaneously with serial measurements of FEV₁/FVC, FEF_25–75 and FEF in 60 children with acute asthma on admission and after 2, 14, 30 and 60 days. Group A received bronchodilators only (n= 20). group B received sodium cromoglycate (SCG) (n= 20) and group C received oral and/or inhaled corticosteroids (n= 20). Results Oral steroid treatment (2 mg /kg/day). given at the onset of the asthma attack, resulted in significant reduction in the ECP and EPX levels in all the children. However, these reduced ECP and EPX levels were not sustained in the children, even in those who continued on maintenance steroid treatment. Significant, but inconsistent, correlations between ECP, EPX with total eosinophil count, percentage eosinophils and spirometry parameters were observed at the different time-points. Tryptase levels were normal in all subjects. There were no significant correlations between myeloperoxidase levels and the spirometry parameters or eosinophil parameters. Serial monitoring of ECP and EPX levels was found to be of some use in predicting clinical outcome in certain steroid-dependent asthmatics (group C) but of no value in the mild asthmatics (group A). Conclusion While elevation of ECP, EPX and MPO in the serum of childhood asthmatics suggests ongoing inflammation and may inversely correlate with spirometry parameters in some patients, the relationship between these markers and airway function is not a simple one.     

Glycine--an important neurotransmitter and cytoprotective agent

BACKGROUND: Glycine, the simplest of the amino acids, is an essential component of important biological molecules, a key substance in many metabolic reactions, the major inhibitory neurotransmitter in the spinal cord and brain stem, and an anti-inflammatory, cytoprotective, and immune modulating substance. MATERIAL AND METHODS: Based on available literature, we discuss some of the important biological properties of glycine. In addition, we describe some clinical disorders where glycine plays a central role, either as an essential structural element, or through its metabolism or receptors. RESULTS: The past few years have witnessed a broadening of glycine research. The traditional prime interest in aspects related to its role as an inhibitory neurotransmitter in the central nervous system has been expanded to equally emphasize other organs and tissues. With the demonstration of glycine-gated chloride channels on neurons in the central nervous system, on most leukocytes, and subsequently on other cells as well, a unifying mechanism of action accounting for many of the widespread effects of glycine has been found. CONCLUSIONS: Glycine is a simple, easily available, and inexpensive substance with few and innocuous side-effects. The diversity of biological activities is well documented in the literature. Despite this, glycine has only gained a modest place in clinical medicine.     

Complete surgical resection of inflammatory myofibroblastic tumor with carinal reconstruction in a 4-year-old boy

Inflammatory myofibroblastic tumor of the carina and the main bronchus is a rare tumor. The authors report here on a case of a 4-year-old boy with an inflammatory myofibroblastic tumor at the carina and extending to the left main bronchus. He presented with fever and a cough of 2 months' duration. Preoperative assessment of the tumor revealed an intraluminal round mass arising from the carina and extending into the left main bronchus, and this caused near-total obstruction of the left main bronchus and the subsequent total collapse of the entire left lung. The complete resection of the mass with carinal reconstruction was successful. The tumor was a round mass measuring 1.5 × 1 cm. It had characteristic features of an inflammatory myofibroblastic tumor, namely, the proliferation of spindle-shaped fibroblasts and myofibroblasts.     

Region-of-interest-based analysis of clustered BOLD MRI data in experimental arthritis

RATIONALE AND OBJECTIVES: BOLD MRI provides functional information based on minimal changes. Problems inherent in data processing of the very low signal-to-noise-ratio of BOLD experiments have created obstacles for validation of certain techniques using standard strength-field MR scanners. Measures of diagnostic accuracy of clustered data are directly related to the reading parameters used to define regions-of-interest (ROIs). Our primary aim was to determine the combination of ROI-related reading parameters that provides highest accuracy for discrimination of presence or absence of arthritis in acute and subacute stages of the disease using paired comparisons of BOLD MRI data. MATERIALS AND METHODS: Six male New Zealand white rabbits were injected with albumin into one knee and saline into the contralateral knee, 3 animals had albumin injected into only one of the knees, 2 had saline injected into one of the knees, and 3 animals were not injected. The rabbits' knees underwent BOLD MRI on days 1 and 28 after induction of arthritis, except for the knees of 3 animals (albumin- vs saline-injected knees, n = 2 animals; saline- vs noninjected knees, n = 1 animal) that died before expected and had only the first MRI examination done. Percentage of activated voxels and differences in on-and-off signal intensities were the BOLD MRI methods applied. Data were analyzed using anatomic-driven small ROI, voxel-chaser-driven small ROI and anatomic-driven large ROI techniques. RESULTS: Diagnostic areas-under-the curve (AUCs) were obtained only for acute arthritis and only when percentage of activated voxels was used. Low threshold, positive voxel activations and small ROIs generated the largest AUCs (AUC +/- SE, .911 +/- .092, P = .014) using either anatomic-driven or voxel-chaser-driven techniques. A sensitivity analysis confirmed the importance of threshold as a parameter for analysis. CONCLUSION: Low threshold, positive voxel activations and small ROIs constituted the set of reading parameters that provided the most accurate BOLD MRI results.     

降钙素原在全身炎症反应综合征鉴别诊断和监测中的作用

目的评价在出现全身炎症反应综合征(SIRS)表现早期,降钙素原(PCT)、白细胞介素-6(IL-6)以及传统指标对于感染性和非感染性病因的鉴别作用,及其与病情严重程度的相关性.方法采用前瞻性研究,共有30例非感染性SIRS和27例感染性SIRS患者人选,在出现临床表现24 h内测定血清PCT、IL-6和C反应蛋白(CRP)水平,同时记录最高体温、白细胞计数、中性粒细胞比例及绝对计数等,做急性生理和慢性健康评分(APACHEⅡ)及全身性感染相关器官衰竭评分(SOFA).结果感染性SIRS患者与非感染性SIRS患者相比,血清PCT(5.54[1.20,32.74]μg/L vs 0.77[0.22,3.90]μg/L,P=0.001)、IL-6(163.66[33.60,505.26]ng/L vs 37.72[22.52,110.78]ng/L,P=0.004)、CRP([15.28±8.41]g/L vs [9.51±7.65]g/L,P=0.010)和中性粒细胞比例(0.91±0.04 vs 0.88±0.04,P=0.010)水平显著升高.受试者工作特征曲线表明,PCT和IL-6的鉴别力最佳.血清PCT和IL-6水平与患者的APACHEⅡ评分及SOFA评分显著相关,血清PCT水平和住院日呈正相关.结论与传统炎症指标相比,PCT和IL-6有助于鉴别感染性和非感染性SIRS,并且和病情严重程度有一定相关性.