Bilateral angiosarcoma breast diagnosed by fine needle aspiration cytology

Concurrent or synchronous angiosarcoma (AS) of breast is a rarity. Specific recognition of this neoplasm in cytological specimens is difficult and conclusive diagnosis in the absence of ancillary methods is achieved only uncommonly. Herein, we present a case of bilateral AS of breasts in a 32-year-old lady diagnosed by fine needle aspiration (FNA) cytology, thus enabling a definitive surgical approach. This case report emphasizes that when aspiration smears show vasoformative features consisting of microacini, arborizing microtissue fragments and intracytoplasmic lumen against a bloody background, diagnosis can be made conclusively by FNA with immunohistochemical confirmation.     

Sex differences in the inflammatory response and inflammation-induced vascular dysfunction

Background

Premenopausal women have a lower incidence of cardiovascular disease, although the exact mechanism underlying this protection is unclear. Both systemic and localised inflammation have a crucial role in the progression of cardiovascular disease, and much preclinical and observational data in human beings suggest that differences in inflammation between the sexes exist. We investigated whether inflammation, and which components of the inflammatory response, might be altered in women compared with men.

Development of sustained release antipsychotic tablets using novel polysaccharide isolated from Delonix regia seeds and its pharmacokinetic studies

A natural polysaccharide was isolated from the seeds of Delonix regia. The isolated polysaccharide could maintain aqueous equilibrium between the dosage form and the surrounding medium due to its massive competence of water absorption (80.72%) and swelling index (266.7%). The Scanning Electron Micrograph of a polysaccharide exhibits rough surface with pores and crevices, hence, the drug release will be retarded because of the drug particles entrapment in the pores and crevices. Further, the surface tension of polysaccharide is higher than that of water, which may facilitate sustained release of drugs from dosage forms. An antipsychotic drug, quetiapine fumarate has a short half-life of 6 h and administered multiple times per day. Hence the quetiapine fumarate oral sustained release tablets were formulated using this polysaccharide in the concentration of 5–30% to avoid the side effects and increase patient compliance. Dissolution of the developed tablets with 25% polysaccharide content showed a better release profile than the other batches (5–20%) at the end of 12 h. The strong matrix complex has low solubility in water, it does not dissolve rapidly and the drug continues to diffuse through the gel layer at a consistent rate. Drug release from the matrix tablets follows matrix type except F-4 and F-5 which follow first order and Hix.crow type. The bioavailability study was carried out using healthy male New Zealand white rabbits that show the AUC_(0–inf) value for developed SR tablets is 1.44 times higher than the reference thus, indicating more efficient and sustained drug delivery capable of maintaining plasma drug levels better.     

Salivary gland tumors: a single institution experience in India

Between 1991 and 2006, 684 cases of salivary gland tumours were analysed retrospectively, of which 422 (62%) were benign and 262 (38%) malignant. Sixty-one percent of tumours were in the parotid gland, 22% in the minor salivary glands, and 17% in the submandibular glands. The most common benign tumour was pleomorphic adenoma (86%), and the most common malignant tumours were adenoid cystic carcinoma (25%) and mucoepidermoid carcinoma (18%). Among the minor salivary gland tumours, most were seen in the palate (68%).We analyse the incidence and distribution of all types of salivary gland tumours in an Indian series, and provide data for comparison with other epidemiological studies from different geographical sites and races. Demographic data from these studies should help us to a better understanding of the biological and clinical characteristics of the disease.     

Simulating Dual-Energy X-Ray Absorptiometry in CT Using Deep-Learning Segmentation Cascade

PurposeOsteoporosis is an underdiagnosed condition despite effective screening modalities. Dual-energy x-ray absorptiometry (DEXA) screening, although recommended in clinical guidelines, remains markedly underutilized. In contrast to DEXA, CT utilization is high and presents a valuable data source for opportunistic osteoporosis screening. The purpose of this study was to describe a method to simulate lumbar DEXA scores from routinely acquired CT studies using a machine-learning algorithm.MethodsBetween January 2010 and September 2014, 610 CT studies of the abdomen and pelvis were used to develop spinal column and L1 to L4 multiclass segmentation. DEXA simulation training and validation used 1,843 pairs of CT studies accompanied by DEXA results obtained within a 6-month interval from the same individual. Machine learning–based regression was used to determine correlation between calculated grade (on the basis of vertebrae L1-L4) and DEXA t score.ResultsAnalysis of the t score equivalent, generated by the algorithm, revealed true positives in 1,144 patients, false positives in 92 patients, true negatives in 245 patients, and false negatives in 212 patients, resulting in an accuracy of 82%. Sensitivity for the detection of osteoporosis or osteopenia was 84.4% (95% confidence interval, 82.3%-86.2%), and specificity was 72.7% (95% confidence interval, 67.7%-77.2%).ConclusionsThe presented algorithm can identify osteoporosis and osteopenia with a high degree of accuracy (82%) and a small proportion of false positives. Efforts to cull greater information using machine-learning algorithms from pre-existing data have the potential to have a marked impact on population health efforts such as bone mineral density screening for osteoporosis, in which gaps in screening currently exist.