Clinical and histological predictors of contralateral breast cancer

AIMS: Women previously treated for primary operable breast cancer are at increased risk of developing cancer in the contralateral breast. The purpose of this study was to assess the annual incidence of metachronous contralateral breast cancer (CBC) and to identify factors that predict for its development. METHODS: A retrospective study was performed on 3211 women aged 相似文献   

Plasticity of the human motor cortex in patients with arteriovenous malformations: a functional MR imaging study

BACKGROUND AND PURPOSE: The capacity of the human brain to recover from damage has been explained on the basis of plasticity, according to which remaining areas assume functions that would normally have been performed by the damaged brain. Patients with cerebral arteriovenous malformations (AVMs) involving primary motor areas may present without significant neurologic deficits. We used functional MR imaging to investigate the organization of cortical motor areas in patients with AVMs. METHODS: Cortical motor hand and foot representations were mapped in nine right-handed patients harboring AVMs occupying the hand (n = 6) or foot (n = 3) region of the primary motor cortex (M1). None of the patients exhibited motor deficits. Simple movements of the hand and foot were performed. In eight patients, both right and left extremities were tested; in one patient, only the hand contralateral to the AVM was examined. Localization of activation in the affected hemisphere was compared with that in the unaffected hemisphere and evaluated with respect to the normal M1 somatotopic organization shown in earlier functional MR imaging investigations. RESULTS: Cortical activation showed three patterns: 1) functional displacement within the affected M1 independent of the structural distortion induced by the AVM (n = 4), 2) presence of activation within the unaffected M1 ipsilateral to the moving extremity without activation in the affected M1 (n = 3), and 3) prominent activation in nonprimary motor areas without activation in either the affected or unaffected M1 (n = 2). CONCLUSION: Preliminary evidence suggests that brain AVMs lead to reorganization within the somatotopic representation in M1 and to occasional abnormal expansion into nonprimary motor areas.     

Topical Drug Delivery in Humans with a Single Photomechanical Wave

Purpose. Assess the feasibility ofin vivo topical drug delivery in humans with a single photomechanical wave. Methods. Photomechanical waves were generated with a 23 nsec Q-switched ruby laser. In vivo fluorescence spectroscopy was used as an elegant non-invasive assay of transport of 5-aminolevulinic acid into the skin following the application of a single photomechanical wave. Results. The barrier function of the human stratum corneum in vivo may be modulated by a single (110 nsec) photomechanical compression wave without adversely affecting the viability and structure of the epidermis and dermis. Furthermore, the stratum corneum barrier always recovers within minutes following a photomechanical wave. The application of the photomechanical wave did not cause any pain. The dose delivered across the stratum corneum depends on the peak pressure and has a threshold at 350 bar. A 30% increase in peak pressure, produced a 680% increase in the amount delivered. Conclusions. Photomechanical waves may have important implications for transcutaneous drug delivery.     

Application of Silicate-Based Coating on Pyrite and Arsenopyrite to Inhibit Acid Mine Drainage

The prevention of acid generation from sulfidic mine wastes is a problem that challenges the global scientific community for decades. A promising strategy is related to the formation of coating layer around sulfides for inhibiting surface oxidation. In the current research, the conditions favoring the formation of an efficient silicate-based coating around pyrite and arsenopyrite were studied, using batch tests. The coating solutions contained silicate-oxyanions, an oxidant (H₂O₂) and buffered at pH 6. The effect of Si concentration (0.1–50 mM), liquid/solid ratio (5–100 mL/g) and contact time (up to 24 h) was investigated. Pyrite tailings treated with a solution of 1 mM Si/0.1 M H₂O₂ at L/S:100 mL/g for 24 h resulted in the optimum formation of a coating, which reduced the amount of SO₄^?2-released by 72%, compared to the sample treated in the absence of Si. However, silicate treatment had a negative effect on arsenopyrite tailings inducing As mobilization.

     

Patterns of Surgical Treatment for Women with Breast Cancer in Relation to Age

Abstract: Although treatment recommendations have been advocated for all women with early breast cancer regardless of age, it is generally accepted that different treatments are preferred based on the age of the patient. The aim of this study was to assess the pattern of breast cancer surgery after adjusting for other major prognostic factors in relation to patient age. Data on cancer characteristics and surgical procedures in 31,298 patients with early breast cancer reported to the National Breast Cancer Audit between 1999 and 2006 were used for the study. There was a close association between age and surgical treatment pattern after adjusting for other prognostic factors, including tumor size, histologic grade, number of tumors, lymph node positivity, lymphovascular invasion (LVI), and extensive intraduct component. Breast Conserving Surgery (BCS) was highest among women aged ≤40 years (OR = 1.140; 95% CI: 1.004–1.293) compared to women aged 51–70 years (reference group). BCS was lowest in women aged >70 years (OR = 0.498, 95% CI: 0.455–0.545). Significantly more women aged ≤50 years underwent more than one operation for breast conservation (20.4–24.8%) compared with women aged >50 years (11.4–17.0%). Women aged >70 years were more likely to receive no surgical treatment, 3.5% versus 1.0–1.3% in all other age groups (≤40, 41–50 51–70 years). There is an association between patient age and the type of breast cancer surgery for women in Australia and New Zealand. Women age ≤40 years are more likely to undergo BCS despite having adverse histologic features and have more than one procedure to achieve breast conservation. Older women (>70 years) more commonly undergo mastectomy and are more likely to receive no surgical treatment.     

Sphenoid Sinus Epidermoid Cyst

Abstract We present an unusual case of an epidermoid cyst in the sphenoid sinus with extensive bony erosions and mass effect, compressing the optic nerve causing visual disturbances. Epidermoid cysts of the paranasal sinuses are extremely rare cases. They usually present as intradural, extraaxial, benign masses of the cerebellopontine angle but they should also be considered in the differential diagnosis of sphenoid sinus lesions. The typical imaging appearance of craniocerebral epidermoid cysts is demonstrated and pathophysiological considerations of formation in the paranasal sinuses are discussed.      

Adult craniocervical and pharyngeal changes--a longitudinal cephalometric study between 22 and 42 years of age. Part I: Morphological craniocervical and hyoid bone changes.

The purpose of this study was to investigate longitudinally, by cephalometric means, alterations in craniocervical morphology and hyoid bone position in adult males and females, in three different age groups at 10-year intervals, and to compare the changes between the two genders. The material consisted of three series of cephalograms of 26 males and 24 females with approximately a 10-year interval between each series. Alterations with increasing age in males and females included: 1 An increase in anterior and posterior facial height in both genders, a reduction in mandibular prognathism, and an increase in the mandibular plane angle in females only. 2 The hyoid bone assumed a more inferior position in relation to different skeletal structures for both sexes. 3 Head posture alterations were similar for the male and female group over time. The overall significant inter-sex changes over a 20-year period were a reduction in mandibular prognathism, an increase in the mandibular plane angle in females, and a more inferior position of the hyoid bone in males.     

Safety and efficacy of contra-lateral breast reduction for women with mammary hypertrophy undergoing mastectomy for breast cancer

Women with mammary hypertrophy undergoing mastectomy for breast cancer suffer disability because of disproportionate asymmetry. The case notes of all women with mammary hypertrophy undergoing mastectomy and immediate contra-lateral reduction mammaplasty for primary breast cancer from February 2001 to December 2008 were reviewed. Thirty-three women were identified of whom twenty-seven underwent inferior pedicle reduction mammaplasty and six inferior dermoglandular pedicle reduction with free nipple graft. The duration of surgery ranged from 75 to 146 (median 110) minutes. Between 475 and 2350 (median 1090) grams of breast tissue was excised from the contra-lateral breast. No immediate or delayed complications were observed and there were no delays in commencing adjuvant therapy. Immediate contra-lateral breast reduction in women with mammary hypertrophy undergoing mastectomy for breast cancer is safe and effective means of reducing the physical, psychological and cosmetic problems associated with unilateral mammary hypertrophy following mastectomy.     

Diffuse reflectance spectroscopy for ultraviolet A protection factor measurement: correlation studies between in vitro and in vivo measurements

Background/purpose: Assessing the ultraviolet (UVA) protection factor of sunscreen formulations has been discussed for the past 20 years. The purpose of this study is to correlate the measurements of the UVA protection factor value (PFA value) via in vivo diffuse reflectance spectroscopy (DRS) and to compare this method with the in vitro method of measuring the PFA value, as well as with the in vivo persistent pigment darkening (PPD) and PFA methodologies.
Methods: The UVA protection factor via DRS technique was assessed in two clinical studies. The first study was performed in 12 subjects and the second one consisting of 10 subjects. All subjects in these studies had Fitzpatrick skin phototypes II–IV. DRS measurements were performed using a SkinScan spectrofluorimeter (Spex SkinScan, Yvon Horiba). The in vitro PFA measurements were performed using Labsphere^™ UV-1000s UV Transmission Analyzer.
Results: The results obtained from the non-invasive DRS studies were used to correlate with the in vitro testing and with the in vivo PFA/PPD multicenter study. A positive relationship (regression coefficient r ²=0.90) of PFA values was found between in vitro PFA testing and the in vivo DRS testing. There was also a very good correlation (regression coefficient r ²=0.99) between the in vivo PFA/PPD values and UVA protection factor obtained from the DRS method.
Conclusion: This paper presents studies using the DRS technique to assess the UVA protection factor in different sunscreen formulae correlating with in vitro and in vivo PFA/PPD values. It is a fast method, non-invasive and does not involve any subject irradiation. The technique is a good estimator for the in vivo UVA protection factor as well as a way to assess, in vivo , the photostability of sunscreen formulation in the UVA.