Differentiation of benign and malignant breast tumors using Doppler spectral parameters including acceleration time index

Differentiation of breast cancer has been receiving increasing attention in attempts to minimize the numbers of excisional biopsies for benign tumors. Doppler spectral parameters, such as peak systolic velocity (PSV) and pulsatility index (PI), have been used but these are unable to differentiate breast cancers and benign tumors with adequate levels of specificity and sensitivity. The aim of this study was to determine whether the acceleration time index (ATI) could reliably differentiate breast tumors. In 102 breast masses, Doppler ultrasonography (US) was performed with a LOGIQ700MR. PSV, PI and ATI were calculated from intratumoral flow. Forty-eight malignant tumors were identified by histologic evaluation, 13 benign tumors were diagnosed by fine needle aspiration biopsy (FNAB) and 41 benign masses were diagnosed by characteristic gray-scale findings and long-term (>18 months) follow-up examinations. Doppler signals were detected in 35 of 54 (64.8%) benign lesions and in 46 of 48 (95.8%) breast cancers. PSV and PI value showed no statistical significance between malignant and benign lesions (PSV; p=0.1147, PI; 0.1506). ATI values were lower in benign lesions (p<0.0001). An ATI value of 0.14 seems to be the optimum threshold for the differentiation of benign and malignant lesions (79.4% sensitivity, 87.2% specificity). No malignant lesions were seen when the ATI value was <0.14 and the PI value was <1.1. ATI was found to be the most useful parameter for differentiating benign breast tumors from malignant ones.     

Cancer detection using infrared hyperspectral imaging

During the last few decades, many studies have been performed on the early detection of cancer using noninvasive or minimally invasive techniques in lieu of traditional excisional biopsy. Early detection can make an immense difference because cancer treatment is often simpler and more effective when diagnosed at an early stage. Cancer detecting methods may help physicians to diagnose cancer, to dissect the malignant region with a safe margin, and to evaluate the tumor bed after resection. In this paper, the advanced hyperspectral imaging system has been assessed using infrared wavelengths region for tumor detection. We were able to identify an appropriate wavelength region for cancer detection, spatially resolved images, and highlight the differences in reflectance properties of cancerous versus non-cancerous tissues. The capability of this instrument was demonstrated by observing gastric tumors in 10 human subjects. The spectral signatures were extracted and evaluated in cancerous and non-cancerous tissues. Processing means with the standard deviation of the spectral diagram, support vector machine, and first derivatives and integral of in spectral diagram were proposed to enhance and detect the cancerous regions. The first derivatives in spectral region between 1226-1251 nm and 1288-1370 nm were proposed as criteria that successfully distinguish between non-cancerous and cancerous tissue. The results of this study will lead to advances in the optical diagnosis of cancer.     

Cardiovascular disease in women: A review of spontaneous coronary artery dissection

Research has demonstrated the disproportionate quality of care for women with cardiovascular disease. These findings have prompted a renewed focus on cardiovascular disease awareness and disease prevention in women. Spontaneous coronary artery dissection (SCAD) is a significant cause of myocardial infarction (MI) and sudden death that primarily affects women. ongoing research has led to improved diagnostic capabilities and changes in approaches to initial and long-term management most importantly this research has provided evidence that SCAD is more common than previously thought and must be evaluated and treated differently from atherosclerotic MI. The difference between SCAD and atherosclerotic MI is highlighted in high rates of recurrent disease, gender distribution, association with exogenous hormones, pregnancy, migraine, physical and emotional stress triggers, concurrent systemic arteriopathies, and connective tissue disease. In this review, we provide updated insights and a summary of the epidemiology, risk factors, clinical presentation, diagnosis, treatment options, prognosis, and recurrence prevention of SCAD. We aim to provide a review of SCAD as a focus on cardiovascular disease awareness and disease prevention in women.     

Predicting gingivitis using visual gingival redness examination on 11 years old Japanese schoolchildren: A ROC analysis

AimsTo identify more reliable and cost-effective methods to detect gingivitis, such as visual examinations, questionnaires, and salivary occult blood tests (SOBT).MethodsSixty-five elementary school students in Yahiko Village, Niigata, Japan were recruited. Questionnaire was used to assess subjective gingival status. Hemoglobin (Hb) and lactate dehydrogenase (LDH) levels were measured by SOBT. Bleeding on marginal probing (BOMP) method at three labial sites per tooth for all anterior teeth was used to examine clinical gingiva condition. Occurrence of at least 1 site with BOMP positive was defined as gingivitis. Visual gingival redness examination was done at the same sites examined by probing.ResultsParticipants with gingivitis had higher numbers of sites with redness than those without [6 (0.25–12) vs 0 (0–2), p < 0.001]. Participants with more sites with redness had a 1.29-fold higher risk of suffering from gingivitis (p = 0.002). The overall model had a 77.3% probability of predicting a gingivitis event by the number of sites with gingival redness (p < 0.001). Highest Youden Index was 1.453, yielded from the cut-off value of 4–5 sites with gingival redness.Conclusion(s)This study found that a predictive model using visual gingival redness examination is a viable non-invasive screening test for gingivitis.     

Preventive effect of FK143, a 5alpha-reductase inhibitor, on chemical hepatocarcinogenesis in rats.

The incidence of hepatocellular carcinoma (HCC) is more prevalent in males than in females. 5alpha-Dihydrotestosterone is the most potent form of androgen and is converted from testosterone by 5alpha-reductase. The antitumor effect of a 5alpha-reductase inhibitor (FK143) was evaluated in a rat chemical hepatocarcinogenesis model (Solt-Farber). Male Fischer 344 rats were used in three groups: (a) control group; (b) low-dose FK143 (FKL) group (20 ppm FK143); and (c) high-dose FK143 (FKH) group (200 ppm FK143). The numbers of both glutathione S-transferase placental form-positive foci (P < 0.05) and hyperplastic nodules (HNs; P < 0.01) in the liver were significantly lower in the FKL group than in the control group. The numbers (P < 0.05) and tumor volume (P < 0.01) of HCCs per liver were significantly lower in the FKL group when compared with the control group. All HCCs were well differentiated in the FKL group, whereas 38% and 36% of HCCs were moderate to poorly differentiated in the control group and the FKH group, respectively. The proliferating cell nuclear antigen labeling index:apoptotic index ratios of enzyme-altered foci, HNs, and HCCs were significantly lower in the FKL group than in the control group. Serum 5alpha-dihydrotestosterone was significantly lower in both the FKL and FKH groups. However, a high dose of FK143 (200 ppm) provided no protection against hepatocarcinogenesis, and the level of serum testosterone was elevated in this group when compared with that in the control group. The low dose of FK143 significantly suppressed the formation of enzyme-altered foci, HNs, and HCCs in rat hepatocarcinogenesis. This may indicate that 5alpha-dihydrotestosterone enhances hepatocarcinogenesis. We conclude that an optimal dose of FK143 may have a suppressive effect on hepatocarcinogenesis.     

Relationship between oral health and physical frailty in patients with cardiovascular disease

BackgroundOral health is important for maintaining general health and is associated with components of physical frailty among the elderly. Oral health problems are common in hospitalized patients; however, no reports on oral health problems pertain to patients with cardiovascular diseases (CVD). The present study aimed to evaluate the association between oral health and physical frailty in these patients.MethodsIn this retrospective cohort study, we included consecutive patients admitted for CVD to our hospital between May 2014 and December 2018. Physical frailty was assessed using the Short Physical Performance Battery (SPPB). Oral health characteristics, such as the number of remaining teeth, denture use, occlusal support, and periodontal status, were assessed.ResultsIn our cohort (n = 457), 111 (24.3%) patients had physical frailty. Univariate linear regression showed that the number of teeth present and the prevalence of occlusal support were significantly lower in patients with than without physical frailty. Pearson correlation indicated that the number of teeth significantly correlated with the nutritional status (r = 0.27) and SPPB score (r = 0.24), grip strength (r = 0.33), and 6-minute walking distance (r = 0.26). Multiple linear regression analysis showed that the number of teeth was independently associated with physical frailty after adjusting for confounders.ConclusionsOral health was closely associated with physical frailty, and nutritional status in patients with CVD; thus, it could be an important screening marker for early frailty symptoms and a predictor of future malnutrition risk.