Diagnosis of adenoid cystic carcinoma of the breast using fine‐needle aspiration cytology: A case report and review of the literature

Adenoid cystic carcinoma (ACC) of the breast is a rare variant of breast malignancy and is associated with an excellent prognosis. ACC accounts for 0.1% of all breast carcinomas. It has favorable biological characteristics and an excellent prognosis. A 77‐year‐old woman presented with a lump in the right breast. Ultrasonography and mammography showed a 12‐mm, well‐defined, lobulated mass in the retroareolar region of the right breast. The lump was diagnosed as ACC on the basis of immunohistochemical staining results for c‐kit (CD117), muscle‐specific actin, p63, estrogen receptor, and progesterone receptor using a fine‐needle aspiration cytology (FNAC) specimen. This diagnosis was subsequently confirmed by excision biopsy. To the best of our knowledge, this is the first case of ACC of the breast to date to be diagnosed on the basis of immunohistochemical staining of an FNAC cell block material. From our experience, we recommend the usage of cell block material for immunohistochemical studies to accurately diagnose ACC of the breast. Diagn. Cytopathol. 2015;43:722–726. © 2015 Wiley Periodicals, Inc.     

CSCR中盐皮质激素受体基因-2G/C的多态性及其与血浆皮质醇水平的关系

目的：评估中心性浆液性脉络膜视网膜(CSCR)病变中盐皮质激素受体基因-2G/ C 单核苷酸多态性,以及基因多态性和血浆皮质醇水平的关系。
　　方法：选取60例中心性浆液性脉络膜视网膜病变患者和50例正常人作为研究对象。患者皆患有急性中心性浆液性脉络膜视网膜病变,即浆液性视网膜脱离和视网膜色素上皮脱离或功能障碍(排除其它可能导致渗出的疾病,比如脉络膜新生血管、炎症或浸润病变)。为避免皮质醇水平的昼夜变化,上午8时到10时之间采集外周血样,检测盐皮质激素受体基因多态性(rs2070951)和血浆皮质醇水平。
　　结果：CSCR 组的基因型频率分布为 G/ C (46.6%), G/ G (26.7%)和 C/ C (26.7%)。两组间基因型分布无统计学差异(P=0.96)。研究结果显示,CSCR 组的血浆皮质醇水平为401.2依162.1 nmol / L ,对照组为296.8依130.1 nmol / L,两组间差异有统计学意义(P<0.01)。血浆皮质醇水平在 G/ C (345.0依137.0 nmol / L), G/ G (369.2依165.3 nmol / L)和 C/ C (395.3依188.8 nmol / L)基因型之间不存在差异(P=0.50)。
　　结论：盐皮质激素受体基因多态性与中心性浆液性脉络膜视网膜病变和血浆皮质醇水平无关。     

From normal response to clinical problem: definition and clinical features of fear of cancer recurrence

Purpose

Research to date on fear of cancer recurrence (FCR) shows that moderate to high FCR affects 22–87 % of cancer survivors and is associated with higher psychological morbidity (Simard et al J Cancer Surviv 7:300–322, 2013). Despite growing research interest in FCR, the lack of consensus on its definition and characteristics when it reaches a clinical level has impeded knowledge transfer into patient services.

Methods

In order to address these gaps, expert researchers, policy makers, trainees, and patient advocates attended a 2-day colloquium at the University of Ottawa in August 2015. A Delphi method was used to identify the most relevant definition of FCR, and the attendees generated possible diagnostic characteristics of clinical FCR.

Results

After three rounds of discussion and voting, the attendees reached consensus on a new definition of FCR: “Fear, worry, or concern relating to the possibility that cancer will come back or progress.” Regarding clinical FCR, five possible characteristics were proposed: (1) high levels of preoccupation, worry, rumination, or intrusive thoughts; (2) maladaptive coping; (3) functional impairments; (4) excessive distress; and (5) difficulties making plans for the future.

Conclusions

The new proposed definition of FCR reflects the broad spectrum in which patients experience FCR. A consensual definition of FCR and the identification of the essential characteristics of clinical FCR are necessary to accurately and consistently measure FCR severity and to develop effective interventions to treat FCR. We hope this broad definition can encourage further research and the development of inclusive policies for all cancer patients and survivors who are struggling with this issue.

     

Technical tips for improved retention and stabilization of a unilateral removable partial denture

An advantage of unilateral removable partial dentures (RPDs) is the lack of a major connector, but easy dislodgement of this design may cause several complications. Implant support of a unilateral RPD can provide additional stability and retention and may prevent such complications as aspiration or swallowing.     

Placental transmission of novel pandemic influenza a virus

The effects of maternal influenza on the fetus are not well understood. Viremia is believed to occur infrequently and thus vertical transmission appears to be rare. Highly pathogenic strains of influenza virus, such as avian influenza A (H5N1), are more likely to be transmitted across the placenta. Placental tissues of seven women with confirmed H1N1 infection were examined molecularly with RT-PCR and microscopically to investigate whether H1N1 virus vertically transmitted. We found no evidence for placental transmission of H1N1 virus in this study. In the absence of vertical transmission, adverse effects like neonatal seizures, encephalopathy, cerebral palsy, and even neonatal death can still occur. Since a significant knowledge gap exists for the effects of this novel virus on the fetus, further studies will be beneficial.     

Microworm optode sensors limit particle diffusion to enable in vivo measurements

There have been a variety of nanoparticles created for in vivo uses ranging from gene and drug delivery to tumor imaging and physiological monitoring. The use of nanoparticles to measure physiological conditions while being fluorescently addressed through the skin provides an ideal method toward minimally invasive health monitoring. Here we create unique particles that have all the necessary physical characteristics to serve as in vivo reporters, but with minimized diffusion from the point of injection. These particles, called microworms, have a cylindrical shape coated with a biocompatible porous membrane that possesses a large surface-area-to-volume ratio while maintaining a large hydrodynamic radius. We use these microworms to create fluorescent sodium sensors for use as in vivo sodium concentration detectors after subcutaneous injection. However, the microworm concept has the potential to extend to the immobilization of other types of polymers for continuous physiological detection or delivery of molecules.     

Microsurgical anatomy of membranous layers of the pituitary gland and the expression of extracellular matrix collagenous proteins

Background  

There are several reports about the microanatomical and histological features of sellar and parasellar membranous structures and clinical studies about MMP proteinase as a predictive factor. However, studies on collagen contents of sellar and parasellar membranous structures are limited. We demonstrated the membranous structures surrounding the pituitary gland and defined extracellular matrix (ECM) collagenous proteins, collagen I-IV expression patterns of sellar and parasellar connective tissues.     

The importance of transmission time in HIV infections and an epidemiological prospective follow-up study for 1 year in the Marmara Region of Turkey

It is important to detect recent and new HIV/1 infections and to take preventative measures in order to prevent rapid disease progression in AIDS and to decrease the incidence of infection. We aimed to detect long standing or recent HIV infections by determining transmission times for the cases in which first-time HIV/1 seropositivity were detected. The serum samples of 323 cases which were found to be seropositive by ELISA and Western-blotting were included in this study. The discrimination between long-term and recent HIV/1 infection was made by determining transmission-time with the Aware BED-EIA, HIV-1 incidence test (IgG capture HIV-EIA) tests. Ninety-six healthy blood donors who did not have a positive anti-HIV test and a chronic infectious disease for at least 1 year were included in this study as a negative healthy control group. In the discrimination of long-term and recent HIV/1 infections, only in vitro ODn values were used. The cases with normalized optical density (OD) (OD(specimen)/OD(calibrator))<0.8 by commercial kit were accepted as recent HIV infection (155 days history or seroconversion less than 6 months). The cases with ODn >1.2 were accepted as long-term HIV/1 infections (more than 155 days history or more than 6 months). The cases with ODn between 0.8 and 1.2 were accepted as "additional tests needed" cases. We detected recent HIV/1 infections (<6 months) in 60 (18.5%) out of 323 cases and long-term HIV/1 infections (>6 months) in 263 (81.5%) out of 323 cases. The most frequently encountered transmission route in long-term and recent HIV/1 infections was heterosexual sexual intercourse as 54 (50%) and 257 (97%), respectively. 63.3% of newly infected patients were married females and 65.3% of recently infected patients were males. In conclusion, the detection of the high ratio of long-term HIV/1 infection cases (81.5%) compared to recent infections (18.5%) suggested to us, that the long standing cases may have some activities related with transmission of HIV/1 in the past. The detection of higher HIV/1-infections in individuals which had heterosexual sex and also in married males suggested that this situation poses a very great threat for the health of society.     

Could interleukin-33 and its suppressor of tumorigenicity 2 (ST2) receptor have a role in cervical human papillomavirus (HPV) infections?

Why most women can clear human papillomavirus (HPV) infections while others can develop permanent infections. The stimulation of immunotolerance of the immune system of the host by the persistent HPV infection may be the answer to this question. Interleukin-33 (IL-33) may play a role in the pathogenesis of HPV infection, this hypothesis was thought to be due to the rapid release of IL-33 from damaged cells following tissue damage, necrosis, and activation of the inflammasome. Thus, in this study, the role of IL-33/suppressor of tumorigenicity 2 (ST2) was emphasized in HPV positive and HPV negative cervical tissues. A total of 80 were assessed. The reduced levels of IL-33 and ST2 are associated with cervical HPV infections. There was a statistically significant 42% positive correlation between IL-33 and ST2 in the HPV-positive group. Surprisingly, our data showed no significant difference between the expression levels of IL-33 or ST2 and working status, type of delivery, pre- and post-operative pathology, cigarette, educational status, locality, birth control method, gynecological, and colposcopic findings. We found that as a result of our study; low IL-33 and ST2 levels were associated with HPV infections