Measurements of laser light attenuation following cryogen spray cooling spurt termination

BACKGROUND AND OBJECTIVES: Cryogen spray cooling (CSC) is used to minimize the risk of epidermal damage during laser dermatological surgery. However, while CSC can protect the epidermis from non-specific thermal damage, the cryogen film on the skin surface may pose a potential problem of laser light attenuation due to optical scattering. STUDY DESIGN/MATERIALS AND METHODS: This study is focused on measuring the light transmittance changes that occur following cryogen spurt termination. The wavelengths studied were chosen for their clinical relevance to treatment of hypervascular skin lesions (594 nm) and laser-assisted hair removal (785 nm). Following delivery of cryogen spurts to the surface of an epoxy skin phantom, continuous records of light transmittance for 594 and 785 nm were obtained using an integrating sphere-based light collection apparatus. RESULTS: Shortly after spurt termination, there was negligible light attenuation by the cryogen film at the two wavelengths studied. CONCLUSIONS: For the typical clinical use of a 30 milliseconds spurt duration and 30 milliseconds delay between spurt termination and delivery of the laser pulse, a minimum average transmittance value of approximately 97% was measured.     

Endometrioid adenocarcinoma treated by hysteroscopic endomyometrial resection

A 53-year-old multiparous woman, with no identifiable risk factor for endometrial cancer, presented with menorrhagia. She had been treated with oral contraceptives for 3 years. Office endometrial biopsy indicated well-differentiated villoglandular adenocarcinoma of the endometrium. The patient refused hysterectomy and would consent only to hysteroscopic resection. She remains alive and well, with no clinical evidence of recurrence 5 years after resection. We propose that skillful resectoscopic surgery, under specific circumstance, may be an appropriate alternative treatment to hysterectomy for some early uterine malignancies.     

Promoting breast health among women in the U.S. Virgin Islands: a focused study of the needs of Caribbean women.

Breast cancer is the number one cause of cancer death among women in the United States Virgin Islands. Consequently, the Bureau of Health has identified breast cancer as a priority health concern. Within the medical community, increasing emphasis is being placed on the importance of hereditary, familial, environmental, and behavioral risk factors to breast cancer control. Little research has been conducted regarding these factors, however, to explore their influence on breast cancer detection and breast cancer risk management. This report highlights the outcomes of a study undertaken to explore the associations between breast cancer risk, risk assessment, risk communication, screening, and receptivity to the management of breast cancer risk among women from the United States Virgin Islands. Results of this study suggest a need within the territory to expand the systems that are responsible for monitoring and reporting breast cancer trends; forums to discuss concerns of women relative to breast health; forums to discuss communication with health-care providers; and, research efforts that address breast cancer detection and control among women in the United States Virgin Islands.     

PARK11 gene (GIGYF2) variants Asn56Ser and Asn457Thr are not pathogenic for Parkinson's disease

The GIGYF2 (Grb10-Interacting GYF Protein-2) gene has recently been proposed to be the responsible gene for the PARK11 locus. Ten different putative pathogenic variants were identified in cohorts of Parkinson's disease (PD) patients from Italy and France. Among these variants Asn56Ser and Asn457Thr were found repeatedly. In the present study we screened 669 PD patients (predominantly of central European origin) and 1051 control individuals for the presence of these two variants. Asn56Ser was found in one patient with a positive family history of the disease and in one control individual. The affected sister of the patient did not carry this variant. Asn457Thr was found in one patient, who was exceptional for his Egyptian origin and in three control individuals. This variant was not found in 50 control individuals from Egypt. We conclude that neither of these two variants plays a major role in the pathogenesis of PD in our study population.     

Three simple steps during closed laparoscopic entry may minimize major injuries

Objectives  To describe three steps: (1) the initial Veress pressure (VIP-Pressure), (2) transient high-pressure pneumoperitoneum (HIP-Entry) prior to trocar/cannula insertion, and (3) visual entry with a trocarless cannula during closed laparoscopic entry, which may reduce major injuries. Design  Prospective observational cohort study (Canadian Task Force Classification II-2). Setting  University-affiliated teaching hospital. Interventions  VIP-Pressure. During laparoscopic entry, the initial VIP pressure was measured and correlated against the body habitus and parity of 365 consecutive women. HIP-Entry was performed in 2,498 consecutive cases. In 100 women, the CO₂ volume, heart rate, blood pressure, oxygen saturation, and pulmonary compliance were recorded at pressures of 10, 15, 20, 25, and 30 mmHg. Visual entry with a trocarless blunt cannula was performed in 776 women. The cannula, housing a 0° laparoscope, was rotated clockwise applying minimal downward force. Measurements and results  VIP-Pressure. Pneumoperitoneum was established after one, two or three Veress needle attempts at the umbilicus in 82.4%, 10.9%, and 4.0% of women, respectively. In seven (2.2%), pneumoperitoneum was established at the left upper quadrant (LUQ) during the fourth attempt, and in two (0.6%) entry was abandoned. Median initial Veress pressure was 4 mmHg (range 2–10 mmHg). The VIP pressure correlated positively with women’s weight (r = 0.518, p < 0.001) and body mass index (BMI) (r = 0.545, p < 0.001), and negatively with parity (r = −0.179, p < 0.001). HIP-Entry. The abdomen was insufflated to 25−30 mmHg prior to primary trocar/cannula insertion. There were no changes in cardiovascular parameters between 15 and 30 mmHg. A 21% decrease in pulmonary compliance from 15 to 30 mmHg was of no clinical significance. No injury has been experienced with the visual cannula in 776 cases. Conclusions  (1) A VIP-Pressure (<10 mmHg) indicates intraperitoneal placement of the Veress needle. (2) The use of transient HIP-Entry does not adversely affect cardiopulmonary function in healthy women. (3) Visual cannula offers an additional step towards safer entry.     

The CD47-signal regulatory protein alpha (SIRPa) interaction is a therapeutic target for human solid tumors

CD47, a "don't eat me" signal for phagocytic cells, is expressed on the surface of all human solid tumor cells. Analysis of patient tumor and matched adjacent normal (nontumor) tissue revealed that CD47 is overexpressed on cancer cells. CD47 mRNA expression levels correlated with a decreased probability of survival for multiple types of cancer. CD47 is a ligand for SIRPα, a protein expressed on macrophages and dendritic cells. In vitro, blockade of CD47 signaling using targeted monoclonal antibodies enabled macrophage phagocytosis of tumor cells that were otherwise protected. Administration of anti-CD47 antibodies inhibited tumor growth in orthotopic immunodeficient mouse xenotransplantation models established with patient tumor cells and increased the survival of the mice over time. Anti-CD47 antibody therapy initiated on larger tumors inhibited tumor growth and prevented or treated metastasis, but initiation of the therapy on smaller tumors was potentially curative. The safety and efficacy of targeting CD47 was further tested and validated in immune competent hosts using an orthotopic mouse breast cancer model. These results suggest all human solid tumor cells require CD47 expression to suppress phagocytic innate immune surveillance and elimination. These data, taken together with similar findings with other human neoplasms, show that CD47 is a commonly expressed molecule on all cancers, its function to block phagocytosis is known, and blockade of its function leads to tumor cell phagocytosis and elimination. CD47 is therefore a validated target for cancer therapies.     

REGULATION OF CELL-MEDIATED CYTOTOXICITY : I. AUGMENTATION OF CELL-MEDIATED CYTOTOXICITY INDUCED BY RADIATION

Mice were treated with sublethal and midlethal doses of irradiation (500–700 rads) and injected intravenously with allogeneic or semiallogeneic F₁ hybrid spleen cells. The cytotoxicity developed by their spleen cells was measured with the lysis of ⁵¹Cr-labeled target cells and was found to be stronger (although delayed in time) than the cytotoxic activity of spleen cells from nonirradiated mice. The injection of syngeneic thymus or spleen cells in the irradiated mice after their treatment with allogeneic spleen cells exerted a suppressor activity, i.e., reduced the level of cell-mediated cytotoxicity (CMC). The majority of effector cells involved in the modified CMC response of irradiated mice was shown to be of host origin and lysed specifically target cells of the same genotype as the donor. A small percentage of the cells obtained from the spleens of irradiated recipients of allogeneic spleen cells was composed of donor cells which lysed specifically target cells of the same genotype as the host. These results demonstrate that the precursors of the cytotoxic cells responsible for target cell lysis are relatively radioresistant and suggest that their response is regulated by radiosensitive thymus-dependent cells.