Extended indications for nipple-sparing mastectomy

Ablative breast cancer surgery still includes the routine excision of the nipple-areola complex (NAC). Nipple-sparing mastectomy (NSM) removes the breast tissue leaving no or little retroareolar ductal tissue but preserves the entire skin of the breast and the NAC. There is some consensus that NSM might be an oncologically safe option for patients with small and peripherally located tumors and probably for high-risk patients with prophylactic mastectomy. Several studies demonstrated that NSM may be feasible even in patients with large centrally located tumors or multicentric invasive carcinoma. So far, no generally applicable indications for NSM have been defined because long-term data are still limited. However, from our review of the literature obtained from a MEDLINE search (2003-2009) we conclude that the range of indications for NSM needs not to be limited to small peripheral tumors or to prophylactic treatment.     

Juvenile myoclonic epilepsy: A benign disorder? Personality traits and psychiatric symptoms

OBJECTIVE: Since the clinical observations published by Janz in 1957, the presence of personality irregularities in patients with juvenile myoclonic epilepsy (JME) has been described repeatedly, but never quantified using standardized assessments. The aim of the present study was to investigate whether juveniles with a short history of JME exhibit psychopathological symptoms and/or personality irregularities. METHOD: We used standardized assessments, the Youth Self Report (YSR) and the Weinberger Adjustment Inventory (WAI). RESULTS: Of 38 patients who fulfilled the study entry criteria, 25 agreed to participate and completed all surveys. On the YSR, our sample exhibited twice the amount of psychiatric symptoms than age-matched norms. Furthermore, psychopathological symptoms increased with duration of JME. According to WAI results, JME significantly affected self-restraint: patients with longer disease duration showed less self-control. CONCLUSION: Adolescents with JME present not only with neurological abnormalities but also with significant psychopathology and personality irregularities. Our data suggest that psychological and behavioral changes are dynamic processes dependent on the progression of the disease.     

N'-(alpha-aminoacyl)- and N'-alpha-(N-alkylamino)acyl derivatives of vancomycin and eremomycin. II. Antibacterial activity of N'-(alpha-aminoacyl)- and N'-alpha-(N-alkylamino)acyl derivatives of vancomycin and eremomycin

The antibacterial activities of the series of novel N'-(alpha-aminoacyl)- and N'-alpha-(N-akylamino)acyl derivatives of eremomycin and vancomycin containing hydrophobic moieties have been investigated. The N'-(N-alkylglycyl) derivatives of vancomycin are more active against vancomycin-susceptible staphylococci and enterococci and glycopeptide intermediate-resistant Staphylococcus aureus (GISA) than the corresponding eremomycin derivatives, but except for N'-[N-(p-octyloxybenzyl)glycyl-vancomycin] (28) and N'-[N-(p-octyloxybenzyl)-L-alanyl-vancomycin (33)--they are less active against glycopeptide-resistant enterococci (GRE). Derivatives 28 and 33 are the most active compounds (MIC's for glycopeptide-sensitive staphylococci and enterococci are 0.25 approximately 1 microg/ml, for GISA 1 approximately 2 microg/ml, for GRE 2 approximately 6 microg/ml). In in vivo studies, derivative 28 was active against S. aureus infections in mice with ED(50) 1 mg/kg versus 2 mg/kg for vancomycin (iv). In general N'-(N-alkylglycyl)-derivatives of vancomycin and eremomycin were more active than the corresponding N'-aminoacylated derivatives of these antibiotics containing other than glycin amino acids (L-Lys, L-Met, L-Orn, L- and D-Ala) and also L- and D-Phe or benzyl-O-L-Tyr.     

A proton pumping pyrophosphatase in acidocalcisomes of Herpetomonas sp

Acidocalcisomes are acidic calcium storage organelles found in several microorganisms. They are characterized by their acidic nature, high electron density, high content of polyphosphates and several cations. Electron microscopy contrast tuned images of Herpetomonas sp. showed the presence of several electron dense organelles ranging from 100 to 300 nm in size. In addition, X-ray element mapping associated with energy-filtering transmission electron microscopy showed that most of the cations, namely Na, Mg, P, K, Fe and Zn, are located in their matrix. Using acridine orange as an indicator dye, a pyrophosphate-driven H⁺ uptake was measured in cells permeabilized by digitonin. This uptake has an optimal pH of 6.5–6.7 and was inhibited by sodium fluoride (NaF) and imidodiphosphate (IDP), two H⁺-pyrophosphatase inhibitors. H⁺ uptake was not promoted by ATP. Addition of 50 μM Ca²⁺ induced the release of H⁺, suggesting the presence of a Ca²⁺/H⁺ countertransport system in the membranes of the acidic compartments. Na⁺ was unable to release protons from the organelles. The pyrophosphate-dependent H⁺ uptake was dependent of ion K⁺ and inhibited by Na⁺ Herpetomonas sp. immunolabeled with monoclonal antibodies raised against a Trypanosoma cruzi V-H⁺-pyrophosphatase shows intense fluorescence in cytoplasmatic organelles of size and distribution similar to the electron-dense vacuoles.

Together, these results suggest that the electron dense organelles found in Herpetomonas sp. are homologous to the acidocalcisomes described in other trypanosomatids. They possess a vacuolar H⁺-pyrophosphatase and a Ca²⁺/H⁺ antiport. However, in contrast to the other trypanosomatids so far studied, we were not able to measure any ATP promoted H⁺ transport in the acidocalcisomes of this parasite.