Myocardial accumulation of 99Tcm-pyrophosphate and 99Tcm-gluconate compared with morphologic findings in daunorubicin treated rabbits

In long-term daunorubicin treated rabbits increased myocardial accumulation of 99Tcm-pyrophosphate and 99Tcm-gluconate of a varying degree were recorded, visible at gamma camera examination in more than half of the animals. Chronic cardiomyopathy morphologically and topographically different from the ischemic myocardial injury was demonstrated in most animals at light microscopic examination. The myocardial abnormalities were classified in qualitative and quantitative scores and compared with the degree of isotope accumulation. The rabbits receiving a large single dose of daunorubicin had slightly increased isotope accumulation in the myocardium but no histopathologic changes.     

Prospective evaluation of chronic cardiotoxicity due to high-dose epirubicin or combination chemotherapy with cyclophosphamide,methotrexate, and 5-fluorouracil

Summary In a prospective study the left ventricular ejection fraction (LVEF), right ventricular ejection fraction (RVEF), systolic blood pressure, ECG, and heart rate were recorded at rest and during submaximal work to compare the cardiotoxic effect of epirubicin with a combination chemotherapy without known cardiotoxicity. A total of 14 females with advanced breast cancer were treated with epirubicin at a median cumulative dose of 827 mg/m² (range, 550–1244). These patients had previously received cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) or cyclophosphamide alone as adjuvant treatment, or CMF for advanced disease. The control group consisted of 11 females with advanced breast cancer given CMF only. The systolic blood pressure at rest as well as during submaximal work was significantly lower (P(0.05) after treatment in the epirubicin group than in the CMF controls. With regard to LVEF, the median value of 54% at rest was significantly lower after treatment in the epirubicin group than in the controls (59%). There was a significant fall in LVEF at rest and during exercise in the epirubicin group, whereas no such changes were found in the CMF controls after treatment. The RVEF was unaffected. In the epirubicintreated group one patient developed fatal congestive heart failure, and in the remaining 13 patients treatment was discontinued due to progression of the cancer and not to cardiotoxicity. Thus, the cardiotoxicity of epirubicin changed the clinical outcome in only 1 of 14 patients with advanced breast cancer.     

A Comparison of Speaking and Mute Individuals with Autism and Autistic-Like Conditions on the Autism Behavior Checklist

The item, total, and subscale scores on the Autism Behavior Checklist (ABC) were compared for 155 mute and 335 speaking individuals with autism spectrum disorders. Although no significant difference was observed between the groups on the ABC total score, the mute group demonstrated significantly more pathology on 21 of 57 items and 3 of 5 subscales. The speaking group obtained significantly higher scores on only 8 items and 1 subscale (Language). The appropriateness of providing greater pathology scores on expressive language items to speaking, rather than to mute, individuals is called into question. The authors speculate whether the expressive language items are weighted too heavily, in regard both to the Language subscale and to the ABC total score. If the expressive language items were removed, the mute group would have significantly higher ABC total scores and therefore a greater degree of autism severity.     

Intra-operative digital angiography as a control of the in situ saphenous vein by-pass grafts

Forty-two patients undergoing in situ saphenous vein by-pass grafting procedures, in two patients bilaterally, were examined intra-operatively with digital subtraction angiography. In 19 (43%) of the examinations the graft and the anastomoses appeared adequate. In 8 cases (18%) significant abnormalities were found, including stenoses (11%), deficient anastomoses (5%) and graft kinking (2%). Remaining arteriovenous fistulas were found in 17 patients (39%). In most cases immediate correction was possible avoiding later re-operation. At follow up 11 of the 44 grafts were occluded, 10 of these during the first five months and of these five during the first week.     

Hand-assisted laparoscopy for wandering spleen

A wandering spleen is a rare condition with an unknown incidence. The lack of short gastric vessels and suspensory ligaments is thought to result from a fusion anomaly of the dorsal mesogastrium of the spleen. The major risk in performing a splenectomy for patients with a wandering spleen is overwhelming postsplenectomy infection (OPSI). The incidence of OPSI is 0.13% to 8.1%, with a mortality rate of 30% to 60%. Laparoscopic splenopexy provides the benefits of minimally invasive surgery while avoiding the complications of splenectomy. The reported case presents a patient with a wandering spleen. The patient, an 18-year-old woman, experienced a malarial infection at the age of 5 years and had a computed tomography (CT) scan documenting her spleen in the normal anatomic position. When she was 18 years old, a CT scan showed her spleen located in the right lower quadrant (RLQ). At laparoscopy, the presence of the spleen in the RLQ was confirmed. The spleen could not be easily manipulated with laparoscopic instruments, so a hand port was used to mobilize the spleen to the left upper quadrant (LUQ). No evidence of attenuated suspensory ligaments was seen. The spleen was secured in the left subdiaphragmatic location by the use of a Vicryl mesh bag. An omental sling was used to support the spleen further. A 1-year follow up CT confirmed that the spleen still was located in the correct anatomic position. This is a unique case in that the patient was known to have a normally located spleen at a young age and then found to have a wandering spleen later in life. This could have resulted from a congenital fusion anomaly or attenuation of the patient’s suspensory ligaments caused by her previous malarial infection and splenomegaly.     

Microfluidic devices for studies of primary cilium mediated cellular response to dynamic flow conditions

We present the first microfabricated microfluidic devices designed specifically for studies of primary cilium mediated cellular response to dynamic flow. The primary cilium functions as a mechano-sensor in renal tubular epithelium, sensing the extracellular fluid flow. Malfunction of cilia has been implicated in e.g. polycystic kidney disease and other pathological conditions. Bending of the primary cilium by fluid flow has been shown to give rise to an intracellular calcium signal, however little is known about the sensitivity to flow duration, magnitude and direction. This paper presents a novel method for studying cilia forming cells in asymmetric microfluidic environments. The microfluidic devices presented here were designed for a dynamic control of the local fluid flow on a cellular level, and thus, enables studies of cellular responses to an amplitude, frequency and direction controlled cilium movement.     

Omitting radiotherapy in women ≥ 65 years with low-risk early breast cancer after breast-conserving surgery and adjuvant endocrine therapy is safe

Purpose

The aim of this study was to verify if radiotherapy (RT) safely can be omitted in older women treated for estrogen-receptor positive early breast cancer with breast-conserving surgery (BCS) and endocrine therapy (ET).