Assessment of interactions of diverse ternary mixtures in an estrogen receptor-alpha reporter assay

This study used an MCF-7 cell based ER-alpha reporter gene assay to assess chemical interactions within the following ternary mixtures: (1) three synthetic pesticides, methoxychlor (MXC), o,p-DDT, and dieldrin; (2) three polyaromatic hydrocarbons, benzo[a]pyrene (BAP), 1,2-benzanthracene (BENZ), and chrysene (CHRY); and (3) an endogenous estrogen, [17beta-estradiol, (E(2))]; a phytoestrogen, genistein (GEN); and a synthetic estrogen, o,p-DDT. A full factorial design in which four concentrations of each chemical were assessed in all possible combinations (64 treatment groups) was utilized. In addition, mixtures were tested in both a low range (concentrations near the individual chemical response thresholds) and a high range ( approximately 2-10x higher) experiment. A response surface was estimated using a nonlinear mixed model, and the cumulative response in each mixture was evaluated for departure from additivity. The mixture of E(2), GEN, and DDT exhibited antagonistic interactions (p < 0.001) in both concentration ranges. However, specific interactions between E(2)/GEN and E(2)/DDT differed between the low and high range concentrations. The BAP/BENZ/CHRY mixture did not depart significantly from additivity (p = 0.66) in either concentration range, although response levels were generally low. The MXC/DDT/dieldrin mixture did not depart significantly from additivity in either the high (p = 0.065), or low dose range (p = 0.506), with generally minimal responses dominated by MXC and DDT. This methodology has allowed for a rigorous statistical evaluation of potential departures from additive interactions in endocrine active mixtures. In no case was a significantly greater-than-additive (synergistic) interaction observed.     

Effect of soft contact lens on central visual field

The effect of soft contact lenses (CLs) and spectacles on central visual fields was assessed in 48 eyes. Forty-three eyes (89.5%) showed smaller pattern standard deviation in CL wearers than five eyes (10.5%) with spectacles. In addition, 38 CL wearers (79%) showed higher positive mean deviation values than 10 eyes (20.8%) with spectacles. Findings indicate the pattern of visual fields shifts toward normalcy in CL wearers. The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The authors also do not discuss the use of off-label products, which includes unlabeled, unapproved, or investigative products or devices.     

Needle localization of small pediatric tumors for surgical biopsy

Background. Small pediatric tumors may be difficult to biopsy or resect. Objective. To examine the benefits of needle localization of a variety of small pediatric tumors before surgical biopsy or excision. Materials and methods. Seven patients aged 1–19 years underwent 12 procedures for needle localization of suspected tumor. Two patients had undergone previous biopsies without needle localization with negative results. Computed tomography (four patients) or ultrasonography (three patients) guided needle placement. Each patient had suspected tumor(s) in 1–3 anatomical sites, including thigh (7), lung (2), parasacral region (2), and iliac bone (1). Results. All 12 lesions (9 less than 1 cm³ in volume) were successfully localized for excision or biopsy. Three small (<1 cm³) soft-tissue lesions (two ganglioneuroblastomas and one ganglioneuroma) were excised from one patient, a 0.65-cm³ residual soft-tissue sarcoma from another; and recurrent bilateral teratomas from a third. Two peripheral primitive neuroectodermal tumors were excised with positive margins from a fourth patient. Two lesions contained only fibrosis, as determined by histopathology. Two other patients underwent thoracoscopic removal of lung metastases that were less than 0.1 cm³. Conclusion. Needle localization allows effective and less invasive excision or biopsy of a variety of small pediatric soft-tissue lesions. Received: 5 August 1999 Accepted: 7 December 1999     

Incidental locally infiltrating malignant thymoma and coronary artery bypass surgery-excision should always be considered

The incidental finding of thymic tumors during thoracic surgery has been reported. Meticulous management planning is necessary if such tumor is found during a cardiac operation. We describe a rare case of asymptomatic invasive malignant thymoma discovered incidentally during routine elective coronary artery bypass grafting in a 48-year-old male. Total thymectomy and enbloc excision of tumor with adjacent involved pericardium, pleura, and phrenic nerve was performed. This was followed by quadruple coronary artery bypass grafting and adjuvant radiotherapy. The patient made an uneventful recovery and remains free from recurrence and angina 2 years following surgery. The different management options available for incidentally occurring malignant thymomas are discussed.     

Coronary endarterectomy for diffuse extensive coronary artery disease

Introduction Atherosclerotic coronary artery disease is in an increasing trend in India. With the advancement of non-surgical methods of revascularisation, the patients coming for surgery are of less attractive anatomy. The role of coronary endarterectomy along with coronary artery bypass grafting for a selected group of these patients is quite promising. Materials and Methods From March 2000 to March 2005, out of 362 CABGs performed, 42 patients had undergone coronary endarterectomy. The age range being from 35 to 76 years, M: F is 38∶4 Hypertension was present in 26 (61%), diabetes mellitus in 20 (47.6%), smoking in 26 (61%) and dyslipidemia in 12 (28.5%) cases. Old myocardial infarction was present in 52.3% cases, unstable angina in 16.6%, stable angina in 23.8% and cardiogenic shock in 7.1% cases. All cases had undergone coronary artery bypass grafting with endarterectomy. Out of 18 LAD endarterectomies 17 cases LIMA was used as onlay patch. Result The average number of grafts anastomosed was 3.7. Single-vessel endarterectomy was done in 37, double vessel in 4 and four vessel in one case. LAD endarterectomy was done in 18, RCA in 12, diagonal in 10, intermediate in 1 and marginals in 8 cases. Postoperatively 3 patients had arrhythmia, two perioperative MI, one recurrent angina and one congestive cardiac failure (CCF). There was 2 (4.76%) mortality. Conclusion Hypertension and smoking are major risk factors. LAD is the most common artery requiring endarterectomy. Usage of LIMA following endarterectomy of LAD is quite satisfactory and short term results are encouraging.