Specialized DNA arrays for the differentiation of pancreatic tumors.

PURPOSE: Malignant tumors of the pancreas are frequently indistinguishable from inflammatory tumors arising in the context of a chronic pancreatitis with the use of conventional imaging techniques. Thus, cytologic analysis of cells obtained by abdominal ultrasound, computed tomography, or endoscopic ultrasound-guided fine needle aspiration biopsy is required for diagnosis. However, the reliability of cytologic analyses of pancreatic fine needle aspirates remains unsatisfactory, with a diagnostic accuracy of < or =80%. The purpose of the current study was therefore to develop a novel diagnostic approach based on expression profiling of biopsy material using a specialized diagnostic cDNA array. EXPERIMENTAL DESIGN: Previous gene expression profiling studies were reevaluated to design a 558-feature diagnostic array. Minimal amounts of residual material from pancreatic cytology samples as well as surgically resected tumor and control tissue specimens were analyzed using the diagnostic array and a newly developed statistical classification system. RESULTS AND CONCLUSIONS: Our diagnostic approach resulted in 95% accurate differentiation between ductal adenocarcinomas and nonmalignant tumors of the pancreas. The diagnostic array, in conjunction with conventional diagnostic procedures, is thus suitable to significantly improve the reliability of pancreatic cancer diagnostics and can be expected to become a valuable new tool in the routine workup of suspect masses in the pancreas.     

Occurrence and elimination of cyanobacterial toxins in two Australian drinking water treatment plants.

In Australian freshwaters, Anabaena circinalis, Microcystis spp. and Cylindrospermopsis raciborskii are the dominant toxic cyanobacteria. Many of these surface waters are used as drinking water resources. Therefore, the National Health and Medical Research Council of Australia set a guideline for MC-LR toxicity equivalents of 1.3 microg/l drinking water. However, due to lack of adequate data, no guideline values for paralytic shellfish poisons (PSPs) (e.g. saxitoxins) or cylindrospermopsin (CYN) have been set. In this spot check, the concentration of microcystins (MCs), PSPs and CYN were determined by ADDA-ELISA, cPPA, HPLC-DAD and/or HPLC-MS/MS, respectively, in two water treatment plants in Queensland/Australia and compared to phytoplankton data collected by Queensland Health, Brisbane. Depending on the predominant cyanobacterial species in a bloom, concentrations of up to 8.0, 17.0 and 1.3 microg/l were found for MCs, PSPs and CYN, respectively. However, only traces (<1.0 microg/l) of these toxins were detected in final water (final product of the drinking water treatment plant) and tap water (household sample). Despite the low concentrations of toxins detected in drinking water, a further reduction of cyanobacterial toxins is recommended to guarantee public safety.     

Common polymorphisms in ERCC2 (Xeroderma pigmentosum D) are not associated with breast cancer risk.

A substantial proportion of the familial risk of breast cancer may be due to genetic variants, each contributing a small effect. The protein encoded by ERCC2 is a key enzyme involved in nucleotide excision repair, in which gene defects could lead to cancer prone syndromes such as Xeroderma pigmentosum D. We have examined the association between single nucleotide polymorphisms in the ERCC2 gene and the incidence of invasive breast cancer in three case-control series, with a maximum of 3,634 patients and of 3,340 controls. None of the three single nucleotide polymorphisms were significantly associated with the incidence of breast cancer.     

Tissue attenuation imaging and tissue scatter imaging for quantitative ultrasound evaluation of hepatic steatosis

We aimed to assess the feasibility of ultrasound-based tissue attenuation imaging (TAI) and tissue scatter distribution imaging (TSI) for quantification of liver steatosis in patients with nonalcoholic fatty liver disease (NAFLD). We prospectively enrolled 101 participants with suspected NAFLD. The TAI and TSI measurements of the liver were performed with a Samsung RS85 Prestige ultrasound system. Based on the magnetic resonance imaging proton density fat fraction (MRI-PDFF), patients were divided into ≤5%, 5–10%, and ≥10% of MRI-PDFF groups. We determined the correlation between TAI, TSI, and MRI-PDFF and used multiple linear regression analysis to identify any association with clinical variables. The diagnostic performance of TAI, TSI was determined based on the area under the receiver operating characteristic curve (AUC). The intraclass correlation coefficient (ICC) was calculated to assess interobserver reliability.Both TAI (r_s = 0.78, P < .001) and TSI (r_s = 0.68, P < .001) showed significant correlation with MRI-PDFF. TAI overperformed TSI in the detection of both ≥5% MRI-PDFF (AUC = 0.89 vs 0.87) and ≥10% (AUC = 0.93 vs 0.86). MRI-PDFF proved to be an independent predictor of TAI (β = 1.03; P < .001), while both MRI-PDFF (β = 50.9; P < .001) and liver stiffness (β = −0.86; P < .001) were independent predictors of TSI. Interobserver analysis showed excellent reproducibility of TAI (ICC = 0.95) and moderate reproducibility of TSI (ICC = 0.73).TAI and TSI could be used successfully to diagnose and estimate the severity of hepatic steatosis in routine clinical practice.     

Penicillin aerosol and negative pressure in the treatment of sinusitis

Nasal inhalation of penicillin aerosol in conjunction with negative pressure in the nasal passages has been described as a treatment for acute and chronic sinusitis. An apparatus which also produces a slight positive pressure in addition to negative pressure during inhalation of penicillin nebulin is reported.A negative pressure in the antra of 50 to 60 mm. Hg has been demonstrated with the procedure used. Washings from the antrum in selected cases revealed that penicillin was introduced following inhalation of 50,000 units of penicillin aerosol in conjunction with repeated negative pressure.Cases of acute paranasal sinusitis are reported in which clinical recovery took place with one to four treatments per day over a period of three days to two weeks. Patients with chronic sinusitis are described in which marked improvement was demonstrated by x-ray and clinically with four treatments daily over a period of twelve days or more. Cases with chronic paranasal sinusitis treated once a day have frequently shown little or no significant benefit. In those patients in whom allergy is a prominent etiological factor less favorable results may be expected. Clinical improvement has been obtained in cases in which both infectious and allergic causal factors were definitely present.Inspection of the tables and case reports illustrates the effect on the course of the disease in individual patients; a summary of the clinical results may be stated as follows, using the combined findings of hospital, home, clinic and office patients: of 122 courses of therapy in 110 patients, marked improvement took place in thirty-nine, moderate in forty-three, slight in seventeen and no improvement in twenty-three.Of sixty-five patients x-rayed before and after treatment, marked or significant improvement was observed in thirty-nine, no improvement in twenty-two and progressive involvement in four.In forty-one patients in whom comparative cultures of the nasal or sputum cultures were available, disappearance of gram-positive organisms found prior to treatment took place in twenty-four. In twenty-five of these cases gram-positive organisms were found after treatment, either as the predominating organisms or in significant numbers.The method of treating sinusitis by penicillin aerosol and negative pressure appears to be a practical procedure that produces little or no discomfort.This report is intended as an exploratory study on the principles, methods and early clinical results of its use rather than as any final appraisal of its value.