An approach to analysis of large-scale correlations between genome changes and clinical endpoints in ovarian cancer

This report describes analyses of associations of genome copy number abnormalities in ovarian cancers with clinical features using genome-wide graphical and analytical procedures. These studies show that tumor grade is a better indicator of the extent of genomic progression than stage, that loss of chromosome 4 occurs preferentially in high-grade tumors, and that gains of 3q26-qter, 8q24-qter, and 20q13-qter occur frequently in low-grade and low-stage tumors and thus may be early events in ovarian cancer development. In addition, loss of chromosome 16q24 and a total number of independent genome copy number aberrations >7 are associated with reduced survival duration. The association of loss of 16q24 (D16S3026) with decreased survival duration was confirmed by quantitative PCR. Regions that frequently are abnormal and associated with altered survival duration are strong candidates for higher resolution analysis and gene discovery and may be useful markers for prediction of clinical outcome.     

Thymic cysts in mediastinal Hodgkin disease

Three cases of proved thymic cysts associated with mediastinal Hodgkin disease are presented. Two illustrate regression of lymphoma with chemotherapy but persistence of thymic cysts. The third case demonstrates a thymic cyst in untreated Hodgkin disease. These cases suggest that such cysts are probably neither coincidental with nor a consequence of therapy but are probably related to initial thymic involvement by Hodgkin disease.     

A double-blind, crossover study of Biotène Oralbalance and BioXtra systems as salivary substitutes in patients with post-radiotherapy xerostomia

This study assessed the efficacy of the Bioxtra (BX) and Biotène Oralbalance (OB) systems in the treatment of post-radiotherapy xerostomia. In a double-blind, crossover study, 20 patients with post-radiotherapy xerostomia were randomly allocated to receive either OB then BX, or vice versa, each product for 2 weeks, with a 1 week wash-out period in between. Subject-based dry mouth scores derived from 100-mm visual analogue scales were recorded at days 0 and 14 of each 2-week period, together with subjective perception of changes in dry mouth symptoms. Both treatments were effective, resulting in reduction of visual analogue scale scores from day 0-14. Between-groups comparisons identified that BX achieved significantly better improvements compared with OB for the perception of dry mouth and improvements in speech and was also rated as more pleasant to use than OB (P < 0.05). In conclusion, both treatments were effective in alleviating the symptoms of post-radiotherapy xerostomia, although BX achieved superiority in some of the outcomes assessed compared with OB.     

Opposing cartilages in the patellofemoral joint adapt differently to long-term cruciate deficiency: chondrocyte deformation and reorientation with compression

OBJECTIVE: The purposes of this study were to quantify patellofemoral histology in the feline knee 67 months post-anterior cruciate ligament transection (ACL-T) and to apply an in situ static load of physiological magnitude to the articular cartilage and evaluate the resulting cartilage and chondrocyte deformation. DESIGN: Six cats were sacrificed 67+/-6 months post-unilateral ACL-T. Static compression was applied to the cartilage surfaces of the patellofemoral joint using a cylindrical metal indentor. After fixation, full thickness osteochondral blocks were harvested and sections cut from not-indented and indented areas. Chondrocyte shape, orientation and volumetric fraction as well as cartilage thickness were evaluated. RESULTS: Experimental and contralateral patellae were histologically different compared to normal with thickened cartilage, rounded superficial chondrocytes, and uneven proteoglycan staining throughout. In contrast, no differences were apparent in 10 of the 12 femoral groove samples. The structural reorganisation of the experimental patellae cartilage that occurred with load was also different compared to normal. Specifically, the indentation shape was deeper and had steeper sides and the realignment of deep zone cells at angles of 45 degrees and 135 degrees observed in normal cartilage was no longer apparent in the experimental tissue. CONCLUSIONS: Two directly articulating cartilage surfaces of the feline patellofemoral joint have completely contrasting responses to long-term ACL-T. We speculate that this could be a result of the different nature of the loads experienced by the two surfaces (intermittent vs constant) and/or the differences in the histology and material properties of the two tissues in their normal state, and/or an inherent difference in the biological response capabilities of the articular cartilages.     

Self-neglect: the role of judgements and applied ethics

Self-neglect is more common than currently recognised. This article highlights the issue of self-neglect and the accompanying ethical values and judgements associated with it. A multidisciplinary framework for managing self-neglect is also described.