Cost analysis of aggressive breast cancer screening.

It is estimated that mammographic and physical examination (PE) screening would cost $3,866 per person year gained; screening with PE alone would cost $4,550. Sixty thousand person years are gained with combined screening, and 24,000 with PE alone per million women screened. The cost per cancer found is $9,046; for each highly curable cancer $26,961, and for each death averted $61,100. An estimated 16 years are added to each life saved. The cost per patient screening examination, using all techniques, is $20.04.     

Central projections of the spiral ganglion of the squirrel monkey

For establishing the relationships of the central projections of the spiral ganglion with the cytoarchitectural regions of the cochlear nuclear complex in a primate species, 23 squirrel monkeys, Saimiri sciureus were utilized. Restricted lesions of the cochlea were confirmed histologically and the resulting degeneration was traced to the cochlear nuclei in sections prepared with Nauta (′57) and Fink-Heimer (′67) technics. By following the course of degeneration, the cochlear root fibers can be seen to bifurcate into ascending and descending branches. The ascending branches from the apical through basal turns of the spiral ganglion terminate in a rostro-lateral to caudo-medial gradient in the anteroventral cochlear nucleus. The descending branches from the apical through basal segments of the spiral ganglion terminate in a ventral to dorsal pattern in the posteroventral and dorsal cochlear nuclei. Ascending branches terminate chiefly on large and small spherical cells and globular cells in the anteroventral region. Terminals of descending branches are associated with globular, multipolar and octopus cells of the posteroventral nucleus and cells of the central and granular layers of the dorsal cochlear region.     

R-CHOP-14 in patients with diffuse large B-cell lymphoma: feasibility and preliminary efficacy

Treatment of diffuse large B-cell lymphoma (DLBCL) with CHOP-21 (cyclophosphamide 750 mg/m2, doxorubicin 50 mg/m2, vincristine 1.4 mg/m2, prednisone 100 mg for 5 days every 21 days) results in long-term remission in approximately 45% of patients. Recent phase III trials have demonstrated improved survival by modifying CHOP either through adding rituximab or shortening the time between cycles to 14 days. These studies prompted our institution to treat newly diagnosed patients with DLBCL refusing or not eligible for protocol-based therapy with R-CHOP-14. In this single-institution retrospective analysis, we report our results with this regimen. Forty-nine patients with newly diagnosed DLBCL and ineligible or refusing protocol-based therapy were retrospectively identified. Patients were treated with 6-8 cycles of R-CHOP-14 given with filgrastim and prophylactic antibiotics. The main toxicities with R-CHOP-14 were hematological and neurological and were not unexpected. There were no treatment-related deaths. Patients received 90% of planned cytotoxic drug density. The complete remission/complete remission uncertain (CR/CRu) rate was 82.2%. At a median follow-up of 24 months, the event-free survival was 80% and overall survival 90%. These results demonstrate R-CHOP-14 can be given to patients safely and short-term results regarding survival are promising. Whether adding rituximab and increasing dose intensity improves survival over either alone will require randomized studies.     

Unilateral renal actinomycosis

A case report of renal actinomycosis is presented with a brief review of the literature. Pathogenesis of the lesion, diagnostic problems, and management are discussed.