Correlation between prostate needle biopsies and radical prostatectomy specimens can we predict pathological outcome?

Aims: Prostate needle biopsy findings provide important information when considering treatment options. We examine the correlation between needle biopsy and radical prostatectomy pathology to predict patients at high risk of harbouring adverse pathological findings. Methods: We reviewed data from 100 consecutive patients who underwent radical prostatectomy between 1 January 2003 and 31 January 2005 at the Singapore General Hospital. Pre-operative clinical findings and needle biopsy pathological data were prospectively collected and compared with the final histology. Results:The mean pre-biopsy PSA level was 9.4 +/- 5.1 microg/L. Median maximum percent of tumour in any core was 50% (range 5-100) and mean percentage of positive cores was 34.5 +/- 23%. There was under-grading of the final tumour score in 27 (27%) patients on biopsy as compared with the radical prostatectomy, while over-grading occurred in eight (8%) patients. On stratifying patients pre-operatively into low risk and high risk groups, patients in the high risk group had a significantly higher chance of having adverse radical prostatectomy histology such as extraprostatic extension, positive surgical margins or tumour volume >3.0 mL (p = 0.041, OR = 3.96, 95%CI 1.13-13.86). Conclusions: Our results demonstrated good pathological correlation between prostate needle biopsies and their radical prostatectomies. Patients with Gleason scores of 7 or more, maximum percent of tumour in any core >50%, or percent of positive cores of >50% on needle biopsy had a higher risk of having adverse pathological findings at radical prostatectomy. The converse, however, is not necessarily true, as a result of sampling error during the biopsy.     

Comparative study between Pap smear cytology and FTIR spectroscopy: a new tool for screening for cervical cancer

Aims: To evaluate Fourier transform infrared (FTIR) spectroscopy as new tool for screening of cervical cancer in comparison with cervical cytology. Methods: A total of 800 cervical scrapings were taken by cytobrush and placed in ThinPrep medium. The samples were dried over infrared transparent matrix. Beams of infrared light were directed at the dried samples at frequency of 4000 to 400 cm(-1). The absorption data were produced using a Spectrum BX II FTIR spectrometer. Data were compared with the reference absorption data of known samples using FTIR spectroscopy software. FTIR spectroscopy was compared with cytology (gold standard). Results: FTIR spectroscopy could differentiate normal from abnormal cervical cells in the samples examined. The sensitivity was 85%, specificity 91%, positive predictive value 19.5% and negative predictive value of 99.5%. Conclusion: This study suggests that FTIR spectroscopy could be used as an alternative method for screening for cervical cancer.     

Gamma ventral capsulotomy for treatment of resistant obsessive-compulsive disorder: a structural MRI pilot prospective study

OBJECTIVE: The purpose of this study was to investigate regional structural abnormalities in the brains of five patients with refractory obsessive-compulsive disorder (OCD) submitted to gamma ventral capsulotomy. METHODS: We acquired morphometric magnetic resonance imaging (MRI) data before and after 1 year of radiosurgery using a 1.5-T MRI scanner. Images were spatially normalized and segmented using optimized voxel-based morphometry (VBM) methods. Voxelwise statistical comparisons between pre- and post-surgery MRI scans were performed using a general linear model. Findings in regions predicted a priori to show volumetric changes (orbitofrontal cortex, anterior cingulate gyrus, basal ganglia and thalamus) were reported as significant if surpassing a statistical threshold of p<0.001 (uncorrected for multiple comparisons). RESULTS: We detected a significant regional postoperative increase in gray matter volume in the right inferior frontal gyri (Brodmann area 47, BA47) when comparing all patients pre and postoperatively. CONCLUSIONS: Our results support the current theory of frontal-striatal-thalamic-cortical (FSTC) circuitry involvement in OCD pathogenesis. Gamma ventral capsulotomy is associated with neurobiological changes in the inferior orbitofrontal cortex in refractory OCD patients.     

Evaluation of pyrethroids lambda-cyhalothrin, deltamethrin and permethrin against Aedes albopictus in the laboratory

Three pyrethroids were evaluated in the laboratory against Aedes albopictus females by exposure to insecticide impregnated papers, and to 4th instar Ae. albopictus larvae as insecticide solutions. Lambda-cyhalothrin was found to be the most effective pyrethroid when tested against Aedes albopictus adult females and larvae compared with that of deltamethrin and permethrin.     

High dose rate intracavitary radiation therapy of carcinoma of the cervix using a linear source.

One hundred patients with carcinoma of the cervix stages 1B to 4A were treated with intracavitary high dose rate radiation using a linear cobalt source. All cases have received external beam pelvic irradiation to 4500cGy mid plane in twenty fractions over four weeks. The results in terms of patient compliance and convenience were good while acute and late morbidities were comparable to standard Manchester technique of low dose rate intracavitary therapy as practised in the Institute of Radiotherapy and Oncology General Hospital Kuala Lumpur. The four year actuarial survival rate is 76% for stage II and 48% for stage III. All three stage IV patients died within 1 year. Four out of seven stage I patients are alive (minimum follow-up 18 months, longest 43 months). One died of systemic spread at 33 months while one is lost to follow up.     

Enzymatic activity of "high-mannose" glycosylated forms of intestinal microvillar hydrolases

The "high-mannose" glycosylated forms of aminopeptidase N (EC 3.4.11.2), maltase-glucoamylase (EC 3.2.1.20), and sucrase-isomaltase (EC 3.2.1.48, EC 3.2.1.10) have been purified. The high-mannose glycosylated form of sucrase-isomaltase was found to have a lower specific activity than the complex glycosylated form, whereas no difference was observed for the two other enzymes. The change in glycosylation from high-mannose to complex form thus seems to be of importance for the enzymatic activity of sucrase-isomaltase either by direct structural involvement or by a general stabilization effect on the protein conformation.