The risk of local recurrence after breast-conserving surgery for breast cancer

Recently, the rates of early stage breast cancers involving breast-conserving therapy have increased due to use of mammography screening. Morever, a patient's desire to keep the breast is now considered to be a factor which determines the surgery tactics. However, there has been so far no consensus on optimal extent of surgery capable of preventing local recurrence. In order to precisely estimate such risk it is essential to take into account factors such as tumor size, surgical margin status and age. Besides, correlations between certain subtypes of breast cancer and various associated risks of local recurrence are to be established. Another important factor is to devise the necessary subsequent radiotherapy.     

Variability in the lipooligosaccharide structure and endotoxicity among Bordetella pertussis strains

Bordetella endotoxins show remarkable structural variability both among each other and in comparison to other gram-negative bacteria. Here we demonstrate that, in contrast to the common Bordetella pertussis laboratory strain and Tohama I derivative BP338, lipooligosaccharide from mouse challenge strain 18-323 is a poor inducer of inflammatory cytokines in human and murine macrophages, is greatly impaired in Toll-like receptor 4-mediated activation of nuclear factor-κB in transfected HEK-293 cells, and functions as a Toll-like receptor 4 antagonist. Comparison of lipid A and lipooligosaccharide structures of B. pertussis strains BP338 and 18-323 revealed that 18-323 (1) lacks the ability to modify its lipid A phosphate groups with glucosamine, (2) is distinct in its acylation at the C3' position of the lipid A diglucosamine backbone, and (3) expresses molecular lipooligosaccharide species that lack a terminal heptose. Our findings have important implications for interpreting previous studies of host defenses to B. pertussis infection in mice and in vitro.     

Tumor necrosis factor alpha inhibitors in patients with Takayasu's arteritis refractory to standard immunosuppressive treatment: cases series and review of the literature

The objective of this study was to report the long-term use of tumor necrosis factor (TNF) inhibitors in case series of patients with Takayasu's arteritis refractory to standard immunosuppressive treatment. Nine women (median age of 29 years) with refractory Takayasu's arteritis were treated with TNF inhibitors. Prior to TNF inhibitor administration, all patients received standard immunosuppressive treatment for 16 to 112 months including steroids and immunomodulators. All but one patient presented with high activity of disease (median ESR 80 mm/h, C-reactive protein level 16.8 mg/l, interleukin-6 level 7.2 pg/ml) that was confirmed with positron emission tomography (PET) with ¹⁸F-deoxyglucose. Eight patients were treated with infliximab and one was treated with adalimumab, respectively. The median duration of treatment was 36 months (12 to 84 months). For induction treatment, we used infliximab 200–300 mg every 4–6 weeks and adalimumab 40 mg every 2 weeks. The treatment resulted in complete remission in five (55.6 %) patients and incomplete remission in three (33.3 %) patients. We were able to taper the dose of prednisone to ≤10 mg daily in all patients. Median levels of ESR, C-reactive protein, and interleukin-6 diminished to 20 mm/h, 1.0 mg/l, and 1.0 pg/ml, respectively. Repeated PET showed lower activity of vasculitis in six (85.7 %) of seven patients. The treatment was safe and well-tolerated. Only one patient developed allergic reactions after infusions of infliximab. Four patients developed relapse of vasculitis when we tried to increase the dosing interval of infliximab to 6–8 weeks. TNF inhibitors were highly effective and safe in patients with refractory Takayasu's arteritis.     

Synthesis of novel 1,4-naphthoquinone derivatives: antibacterial and antifungal agents

A novel series of substituted 1,4-naphthoquinone derivatives was synthesized and evaluated for antibacterial and antifungal activity. The structures of the novel products were characterized by spectroscopic methods. Among the tested compounds, 3a and 9 are the most effective compounds against M. luteum as potent antibacterial and C. tenuis and A. niger as potent antifungal. These two compounds are promising as biologically active compounds.     

Effective medium theory of a diffusion-weighted signal

Living tissues and other heterogeneous media generally consist of structural units with different diffusion coefficients and NMR properties. These blocks, such as cells or clusters of cells, can be much smaller than the imaging voxel, and are often comparable with the diffusion length. We have developed a general approach to quantify the medium heterogeneity when it is much finer than the sample size or the imaging resolution. The approach is based on the treatment of the medium statistically in terms of the correlation functions of the local parameters. The diffusion-weighted signal is explicity found for the case in which the local diffusivity varies in space, in the lowest order in the diffusivity variance. We demonstrate how the correlation length and the variance of the local diffusivity contribute to the time-dependent diffusion coefficient and the time-dependent kurtosis. Our results are corroborated by Monte Carlo simulations of diffusion in a two-dimensional heterogeneous medium.     

Body mass index and weight-for-length ratio references for infants born at 33-42 weeks gestation: a new tool for anthropometric assessment

Background & aims

The risk of childhood obesity, an increasingly prevalent problem worldwide, might be predictable by early body mass index measurements. This study sought to develop body mass index and weight-for-length ratio references for infants born at 33–42 weeks gestation and to validate these data against the growth curves of the World Health Organization Multicenter Growth Reference Study.

Methods

Data were collected from the Neonatal Registry of Rabin Medical Center for all healthy singleton babies born live at 33–42 weeks gestation. Crude and smoothed reference tables and graphs for body mass index and weight-for-length ratio by gestational age were created for males and females, separately.

Results

Birth weight, length, and body mass index percentiles for full-term neonates were similar to the World Health Organization study, reinforcing the generalizability of our reference charts for infants born at 33–42 weeks. Cutoff values for small for date (<5th, <10th percentile) and large for date (>85th, >95th percentile) infants differed across gestational ages in both pre-term and full-term infants.

Conclusions

As body proportionality indexes provide an assessment of body mass and fatness relative to length, we suggest that BMI and Wt/L ratio percentiles be added to weight and length growth curves as a routine intrauterine growth assessment at birth.     

Morphometrical parameters of placenta and condition of NO-dependent mechanisms in fetuses during normal pregnancy and with damages of uteroplacental blood circulation at white rats

The purpose of paper is an estimation of morphometric parameters and status of NO-dependent mechanisms of embryos placenta of white rats in normal conditions, experimental disturbance of the utero-placental circulation and after the nitric oxide donator "Deponit-10" using. The volume density of blood vessels in the placenta and placental vascular exchange area significantly increases under chronic intrauterine hypoxia. The donator of nitric oxide has a positive effect on morphometric parameters of the placenta, provides effective adaptation of feto-placental blood flow to hypoxia and could be useful for clinical practice.     

Pulmonary lesions in Wegener's granulomatosis

Pulmonary lesions are the commonest and prognostically unfavourable visceral pathology in Wegener's granulomatosis. The author discusses clinically and reongenologically detectable lesions associated with this systemic vasculitis with special reference to its most severe forms (alveolar bleeding and infectious complications frequently caused by active immunosuppressive therapy). Diagnostic (including early) and modem therapeutic modalities of Wegener's granulomatosis are considered.