Viscoelastic Imaging of Breast Tumor Microenvironment With Ultrasound

Imaging systems are most effective for detection and classification when they exploit contrast mechanisms specific to particular disease processes. A common example is mammography, where the contrast depends on local changes in cell density and the presence of microcalcifications. Unfortunately the specificity for classifying malignant breast disease is relatively low for many current diagnostic techniques. This paper describes a new ultrasonic technique for imaging the viscoelastic properties of breast tissue. The mechanical properties of glandular breast tissue, like most biopolymers, react to mechanical stimuli in a manner specific to the microenvironment of the tissue. Elastic properties allow noninvasive imaging of desmoplasia while viscous properties describe metabolism-dependent features such as pH. These ultrasonic methods are providing new tools for studying disease mechanisms as well as improving diagnosis.     

A prospective, partially randomized study of pregnancy outcomes and hematologic responses to oral and intramuscular iron treatment in moderately anemic pregnant women

BACKGROUND: Daily oral iron supplementation during pregnancy fails to reduce the prevalence of anemia. However, 2 or 3 intramuscular doses of iron given at monthly intervals were recently found to be effective. OBJECTIVE: We compared the safety and efficacy in treating pregnancy anemia of 3 intramuscular doses of iron given at monthly intervals with those of daily oral iron supplementation. DESIGN: In a prospective, partially randomized study, 148 pregnant women received daily oral doses of 100 mg elemental Fe and 500 micro g folic acid, and 106 pregnant women received 3 intramuscular doses of 250 mg elemental Fe as iron dextran at 1-mo intervals and oral doses of 5 mg folic acid twice weekly. One hundred women in each group completed the study. Changes in hemoglobin, iron indicators, pregnancy outcomes, and birth weight were compared between the 2 groups. RESULTS: Hemoglobin and iron indicators improved significantly with both treatments. The increase in serum ferritin concentration after parenteral iron treatment was significantly higher than that after oral iron treatment. No significant differences between the 2 groups in pregnancy outcomes and birth weight were observed. Systemic side effects were more common in the parenteral iron group, whereas gastrointestinal side effects were more common in the oral iron group. CONCLUSIONS: The intramuscular administration of 3 doses of 250 mg Fe at monthly intervals appears to have good compliance and efficacy and may be used in women who cannot tolerate oral administration of iron. However, intramuscular administration of iron is appropriate only in hospital settings well equipped to treat anaphylactic crises.     

Thymic carcinoma with rhabdoid features

A case of thymic carcinoma with rhabdoid differentiation is presented. A 67-year-old man who presented with chest pain and hemoptysis was referred to The University of Texas M. D. Anderson Cancer Center (Houston, TX). Radiologic studies revealed a large anterior mediastinal mass. After the initial biopsy and preoperative chemotherapy, a radical thymectomy revealed a stage III thymic carcinoma with a rhabdoid component. The rhabdoid component was characterized by large cells with an eccentric nucleus, prominent nucleolus, and typical paranuclear cytoplasmic inclusions. Immunohistochemical and electron microscopic studies confirmed the presence of rhabdoid cells with the paranuclear cytoplasmic inclusions staining for both pancytokeratin and vimentin. The patient was given postoperative chemotherapy and radiation. He has since developed metastases to the pelvis and is alive with disease at 20 months of follow-up. To our knowledge, this is the first reported case of thymic carcinoma with rhabdoid features.     

What are the major arguments in favour of the genetic susceptibility for inflammatory bowel disease?

Epidemiological data, notably concordance rates in twin pairs and familial aggregation, have provided strong evidence for the importance of the genetic contribution in inflammatory bowel diseases. Genome wide scanning has been remarkably successful in identifying a number of susceptibility loci. The identification of the IBD1 gene on chromosome 16 as NOD2/CARD15 definitely establishes that a significant proportion of Crohn's disease has an underlying genetic cause. In addition, our knowledge of the clinical impact of other genes in modelling disease phenotypes has increased in parallel. These results have led to great optimism that important clinical applications will result from genetic research in the near future.     

Approximate entropy of symptoms of mood: an effective technique to quantify regularity of mood

Objectives:  Several psychiatric conditions are associated with lability of affect. In this study, we investigated regularity of mood using APEN (Approximate Entropy) on daily subjective ratings using a Visual Analog Scale with 11 items pertaining to mood.
Methods:  APEN was applied to the data in a double-blind placebo controlled investigation on the effects of fluoxetine (n=19), pemoline (n=18) and placebo (n=20) in normal controls. These subjects rated their subjective feelings daily at the end of each day. We analysed 56 data point time series (each value was obtained on each day) after the three experimental conditions.
Results:  While the mean or the SD of all the 56 points was not significantly different among the three conditions, APEN was highly and significantly lower for pemoline compared with fluoxetine and placebo. There was no significant correlation between average APEN and mean or SD (standard deviation). The one symptom that explained most of this difference among the groups after drug administration was the feeling of 'happiness'.
Conclusions:  This result indicates that there was a more consistent subjective sense of happiness during the 8-week period of pemoline administration compared with the other two drugs. Though this study was not designed to address the efficacy of mood stabilizing drugs, such daily subjective ratings may be useful in future studies that evaluate the stability of mood. APEN has been used in several different fields of research with small data sets and this study extends its possible use to evaluate changes in mood in certain populations such as patients with bipolar disorders.     

Effect of occupation on lipid peroxidation and antioxidants' status in masons

Effect of occupation on haematological factors, lipid peroxidation and antioxidants' status was studied in masons and compared with normal subjects. Red blood corpuscles (RBC), haemoglobin (Hb), Vitamin C, Vitamin E, beta-carotene levels and glutathione peroxidase (GSHPx), superoxide dismutase (SOD) and catalase (CAT) activities decreased. Thiobarbituric acid reacting substances (TBARS) level increased. Occupational exposure to cement increased lipid peroxidation but decreased antioxidants' levels in masons. Increased lipid peroxidation seems to be responsible for the reduction in RBC and Hb.     

Genetic analysis of the dihydrofolate reductase-thymidylate synthase gene from geographically diverse isolates of Plasmodium malariae

Plasmodium malariae, the parasite responsible for quartan malaria, is transmitted in most areas of malaria endemicity and is associated with significant morbidity. The sequence of the gene coding for the enzyme dihydrofolate reductase-thymidylate synthase (DHFR-TS) was obtained from field isolates of P. malariae and from the closely related simian parasite Plasmodium brasilianum. The two sequences were nearly 100% homologous, adding weight to the notion that they represent genetically distinct lines of the same species. A survey of polymorphisms of the dhfr sequences in 35 isolates of P. malariae collected from five countries in Asia and Africa revealed a low number of nonsynonymous mutations in five codons. In five of the isolates collected from southeast Asia, a nonsynonymous mutation was found at one of the three positions known to be associated with antifolate resistance in other Plasmodium species. Five isolates with the wild-type DHFR could be assayed for drug susceptibility in vitro and were found to be sensitive to pyrimethamine (mean 50% inhibitory concentration, 2.24 ng/ml [95% confidence interval, 0.4 to 3.1]).     

Oncocytic renal neoplasms: diagnostic considerations

Advances in our understanding of renal neoplasia have resulted in recognition of numerous tumors that are composed predominantly of cells with abundant eosinophilic cytoplasm. This article discusses the features of renal oncocytoma (including oncocytosis), chromophobe renal cell carcinoma (RCC), and clear cell RCC; explores the relationship between renal oncocytoma and chromophobe RCC; briefly discusses other tumors with abundant eosinophilic cytoplasm; and emphasizes the differential diagnosis of such tumors.