Diagnostic ultrasound: an aid in the differentiation of anterior segment lesions of the eye

Because the part of the globe in direct contact with the transducer cannot be visualised and focussed transducers have poor imaging qualities at a distance less than 5–8 mm from their surface, diagnostic ultrasound of the anterior eye segment has been treated in a stepmotherly way.With a simplified immersion technique we can visualize quite accurately a variety of pathologic conditions of the cornea, anterior chamber, iris, lens and ciliary body.The B-mode information is superior to the A-mode in this part of the eye.     

Menstruation pattern and month of birth]

By using the Nijmegen data base on breast cancer we attempted to determine whether a relationship exists between menstrual pattern and month of birth and if so, if its agreed with the hypothesis of Seasonal Preovulatory Overripening Ovopathy (SPrOO). On the basis of the birth curve of women who participated in the Nijmegen breast cancer screening programme (1975) risk months for SPrOO and reference months were defined. We found that more women born in a risk month had an early menarche (< or = 11 years), a long menstrual cycle (> or = 5 weeks; QI: 20-25 kg/m2), menorrhagia, and an early (35-40 years) or late (> or = 56 years) menopause age. This relationship was in line with the predictions according to the SPrOO hypothesis. In all, a positive (but not always significant) relationship appeared to exist in 12 of the 15 associations studied. We conclude that there is a relationship between menstrual pattern and month of birth, which can be explained by the SPrOO hypothesis.     

MODIFIED BROMOPHENOL BLUE DYE BINDING METHOD FOR QUANTITATION OF MICROALBUMINURIA IN DIABETES MELLITUS

Albumin excretion in microalbuminuria range is one of the earliest manifestation of nephropathy, specially in diabetes mellitus. The modified dye binding method using bromo-phenol blue was studied in 27 healthy controls and 54 patients of diabetes mellitus, negative for albuminuria by albustix test. The analytical recovery (99.4 to 104.0%), within run coefficient of variation (0.8 to 0.36%) and day-to-day coefficient of variation (2.39 to 0.82%), for low and higher range were within acceptable limits. The values in controls ranged as follows: urinary albumin concentration (mg/L) 7.7 – 28.4 in 2-hour specimen and 10.3 – 29.2 in overnight specimen; albumin excretion rate (µg/min) 7.8 – 29.7 in 2-hour and 9.2 – 29.6 in overnight specimen; and albumin creatinine ratio (mg/g) 10.6 – 29.6 in 2-hour and 11.9 – 29.6 in overnight specimens.Correlation analysis of various albumin excretion parameters revealed excellent correlation between estimations from overnight and 2-hour samples for albumin-creatinine ratio (r = 1.00) and albumin excretion rate (r=0.96). Equally good correlation was observed between 2-hour albumin-creatinine ratio and albumin excretion rate (r=0.95). In 10 of 54 patients excretion rate was more than 200 µg/min and could have been detected by repeat albustix test. Of the 36 positive for microalbuminuria, 21 had one or more target organ involvement. There was no target organ involvement in 8 patients negative for microalbuminuria. Screening for microalbuminuria by this simple and economic method, using 2-hour albumin-excretion rate or albumin-creatinine ratio could be one of the earliest investigations in diabetic patients.KEY WORDS: Microalbuminuria, Spectrophotometeric method, Diabetes mellitus     

Changes in mammographic breast density and concomitant changes in breast cancer risk.

Among participants of the biennial Nijmegen breast cancer screening programme, we examined whether diminution of mammographic breast density lowered breast cancer risk. Post-menopausal breast cancer cases (n = 108), who had to have participated in all the five screening rounds prior to their diagnosis, were matched to 400 controls on year of birth and screening history. Controls had to be free of breast cancer at the time of the case's diagnosis. Changes in breast density were measured over a 10-year period, by a fully computerized method. Women in whom 5-25% or >25% of the breast was composed of fibro-glandular density showed a threefold increased 10-year risk compared to women with <5% density. In women with 5-25% density initially, we observed a trend of decreasing risk with diminishing density: when women with <5% density throughout the whole period formed the reference category, the odds ratio (OR) for those who decreased from 5-25% to <5% density was 1.9 [95% confidence interval (CI) = 0.6-6.1] in contrast to the OR of 5.7 (95% CI = 2.2-15.2) for those with persisting 5-25% density. In women who increased from 5-25% density to >25% density the OR was 6.9 (95% CI = 2.1-22.9). In women with >25% density initially, diminishing density was not clearly associated with lowering risk, which may be partly explained by the low number of women who decreased to <5% (n = 12). Due to the limited size of the study these results have to be interpreted with caution. Although the results are not conclusive, they could indicate a trend of decreasing risk with diminishing breast density. Should this effect be real, it may have great implications for the primary prevention of breast cancer or for the identification of high-risk groups who would benefit by more frequent screening. Therefore, large-scale, long-term follow-up studies on the effects of changes in breast density are needed.