Lymphoma Affecting the Breast: A Pictorial Review of Multimodal Imaging Findings

Hematological malignancies rarely affect the breast, and the majority of those that do are lymphomas. In this review, we describe the clinical aspects and multimodal imaging findings of breast lymphoma. We also illustrate the key clinical and radiological findings that allow it to be distinguished from various other malignant and benign diseases of the breast. Breast lymphoma manifests as a breast mass, a change in the subcutaneous tissue or the skin, or enlargement of the associated lymph node on radiological examination. Radiological findings associated with other breast malignancies, such as calcifications, spiculations, or architectural distortions are extremely rare. Skin and subcutaneous changes frequently accompany T-cell lymphoma. Multimodal breast imaging characteristics may aid in the diagnosis of breast lymphoma.     

Extension of the mitochondria dysfunction hypothesis of metabolic syndrome to atherosclerosis with emphasis on the endocrine‐disrupting chemicals and biophysical laws

Metabolic syndrome and its component phenotypes, hyperglycemia, hypertension, (abdominal) obesity and hypertriglyceridemia, are major risk factors for atherosclerosis. Recently, associations between exposure to endocrine‐disrupting chemicals (EDCs), mitochondrial dysfunction, metabolic syndrome and atherosclerosis have been established, suggesting a possible common mechanism underlying these phenomena. Extending a previously proposed mitochondria dysfunction theory of metabolic syndrome and using biophysical laws, such as metabolic scaling, Murray's law and fractal geometry of the vascular branching system, we propose that atherosclerosis could be explained as an ill‐adaptive change occurring in nutrient‐supplying arteries in response to the decreasing tissue energy demand caused by tissue mitochondrial dysfunction. Various aspects of this new hypothesis are discussed.     

Clinical life: expectation and the double edge of medical promise

This article introduces the concept of clinical life to capture a form of life produced in the pursuit and wake of medically achieved longevity. Relying on the retrospective accounts of 28 individuals over age 70 who have undergone cardiac bypass surgery, angioplasty or a stent procedure, as well as interviews with their families and with clinicians, we examine three features of clinical life. First, patients do not distinguish between clinical possibility and clinical promise, and thus assume that life can and will be improved by medical intervention in late life. Rather than anticipating a range of potential treatment outcomes, patients therefore expect the best-case scenario: that medical procedures will reverse aging, disease and the march of time. Second, patients then assess the value of their post-procedure lives in accordance with that expectation. Norms regarding what life 'should be like' at particular ages are continually recalibrated to the horizon of what is clinically possible. And third, the price of living longer entails a double-edged relationship with the clinic--it generates opportunities for bodily restoration and increased self-worth but also creates ambivalence about the value of life. This latter feature of clinical life is rarely publicly acknowledged in an environment that emphasizes medical promise.     

Efficacy of alphas1-casein hydrolysate on stress-related symptoms in women

OBJECTIVE: To examine the effects of alpha (s1)-casein hydrolysate on females with stress-related symptoms. DESIGN: Double-blind, randomized, crossover, placebo-controlled trial. SETTING: The alpha (s1)-casein hydrolysate was manufactured by INGREDIA (Arras, France) and the placebo was manufactured by DIETAROMA (Bourg, France). Study was designed and performed at PROCLAIM (Rennes, France), and the statistical analyses were performed by D Desor (Nancy, France). SUBJECTS: A total of 63 female volunteers suffering from at least one disorder that may be related to stress such as anxiety, sleep problems and general fatigue. INTERVENTIONS: A total of 63 volunteers participated in a double-blind, randomized, crossover, placebo-controlled study. Subjects were randomly allocated to receive either tablets containing alpha (s1)-casein hydrolysate or placebo at the dose of 150 mg/day for 30 days. After a 3 weeks washout period, they were crossed over for a new 30-day period of tablets intake. The outcome measure was a questionnaire including 44 items of symptoms that may be related stress in which the severity of each sign was evaluated using a 10-degree scale. These measures were studied repeatedly at the day of 0, 15 and 30 after the start of each interventional period. RESULTS: The 30-day treatment by alpha (s1)-casein hydrolysate in females with stress-related symptoms reduced their symptoms, particularly in digestion (P<0.01), cardiovascular (P<0.05), intellectual (P<0.01), emotional (P<0.05) and social problems (P<0.05). CONCLUSION: This study showed that a 30-day ingestion of alpha (s1)-casein hydrolysate decreased the stress-related symptoms in females suggesting that this product may be used as an effective functional ingredient alleviating such symptoms. Sponsorship: This study was partially supported by the INGREDIA of France and Neurobiology Research Program from the Korea Ministry of Science and Technology (2004-01757) of Korea.     

Salt usage behaviors are related to urinary sodium excretion in normotensive Korean adults

High sodium intake is considered to be the major risk factor for hypertension but studies about sodium intake on prevention and management of hypertension is limited due to the difficulties in assessment of sodium intake. Dietary sodium comes not only from naturally occurring sodium in foods but also from the added sodium during processing, cooking and at the table. Present study was conducted to identify salt usage behavior questions related to urinary sodium excretion among normotensive adult Koreans. The test version of the salt usage questionnaire included six items of salt usage behaviors and nine items of high salt containing foods. A survey was conducted in 189 adults over 18 years of age in three age groups in both genders. Each participant answered the questionnaire and collected one 24-hour urine and urine samples were analyzed for sodium contents. Correlation analyses between scores of the questions and sodium excretion in 24-hour urine were performed to identify question items related to sodium excretion. Among fifteen questions, scores of three questions on salt usage behaviors were significantly correlated to urinary sodium excretion (r=0.17~0.19; p <0.05) and the sum of scores of the three questions showed higher correlation coefficients. (r=0.26, p <0.001) The salt usage behavior questions developed in this study would be useful in predicting sodium intake and in studying the relationship between sodium intake and health among Korean adults.     

Intraductal ultrasonography for the selection of self expandable metal stent in extrahepatic bile duct carcinoma]

BACKGROUND/AIMS: Endoscopic stent insertion with self expandable metal stent (SEMS) is one of the standard palliative treatments for the patients with unresectable bile duct carcinoma. The aim of this study was to determine whether detection of longitudinal spread of extrahepatic bile duct carcinoma by intraductal US (IDUS) would be helpful in the selection of metal stent for the palliative drainage in bile duct carcinoma. METHODS: Seventeen patients with histologically proven unresectable extrahepatic bile duct carcinoma who underwent endoscopic retrograde cholangiography with IDUS were included. Longitudinal cancer extension along the bile duct was determined and, then, compared with the cholangiographic image. The type and length of SEMS was selected based on IDUS findings. RESULTS: IDUS demonstrated more extensive tumor spread than ERC in 7 of 17 (41.2%) patients with the hepatic side of strictures and in 7 of 16 (43.8%) patients with the duodenal side of strictures. Five of 17 (29.4%) patients have changed the plan of endoscopic biliary drainage with SEMS after IDUS. There was no early dysfunction associated with endoscopic biliary drainage. CONCLUSIONS: IDUS prior to biliary drainage would be useful in demonstrating longitudinal extension of extrahepatic bile duct carcinoma. It has a potential role in helping stent selection and identifying factors which predict early stent dysfunction.     

过度训练机制的研究进展

目的:了解训练适应的生理机制及过度训练与运动能力的定量关系,明确过度训练和疲劳的生理病理界限。资料来源:应用计算机检索万方数据库和中国知网1984/2006有关过度训练机制方面的文章,以"过度训练","机制","机理"等为检索词,限定文章语种为English或中文。资料选择:对资料进行初审,选取包括过度训练的分类、临床表现、诊断及过度训练产生的病理机制密切相关的文献。排除标准:重复性和内容单一文章。资料提炼:共收集50篇关于过度训练机制方面的研究文献。排除文献内容单一的文章20篇,剩余30篇纳入分析。资料综合:①过度训练的临床表现可分为两型,即交感型和副交感型。其症状、机制、运动项目及好发年龄都有所不同,但都表现为运动能力下降。交感型多发于爆发力及非耐力性项目,而副交感型则多发于耐力运动员。②过度训练的诊断主要建立在病史和典型的身体及心理症状上,并辅以生化指标、心电图、脑电图检查等。③内分泌系统兴奋和抑制之间的不平衡是造成过度训练的主要机制。目前在过度训练时免疫机能变化还不能用来解释和预测过度训练,因为这些变化与基础水平相比差别很小,临床意义不大。同步研究过度训练时的病理形态与机能变化对揭示其发病机制有着重要的意义。结论:对于训练适应的机制及训练与运动能力的定量关系的研究已取得了很大进展,但对训练产生适应和由于过度训练引起机能损害之间的界限仍很模糊。