Chronic low level physical activity as a determinant of high density lipoprotein cholesterol and subfractions

Physical activity has been associated with reduced risk of coronary heart disease. A mechanism for the reduced risk may be through increased high density lipoprotein cholesterol (HDL-C) and subfractions, in particular HDL2-C. Research associated with increased physical activity investigating HLD-C have assessed the effects of intense aerobic activity. The current research evaluated the relationship between low intensity, long duration activity to HDL-C and subfractions in 35 active postal carriers. Measurements of physical activity via the Large Scale Integrated monitor and reported miles walked, and lipoproteins were assessed at 3-month intervals over a 1-year period. Reported miles walked/day (5.3) was significantly correlated with HLD2-C (r = 0.50, P = 0.003) and approached significance for HDL-C (r = 0.29, P = 0.06). The Large Scale Integrated measures were correlated with HDL-C (r = 0.44, P = 0.008) and HDL2-C (r = 0.44, P = 0.007). Controlling for either age, alcohol consumption, body mass index, or leisure time activity did not reduce the relationship between reported miles walked or Large Scale Integrated readings and HDL2-C, suggesting that the increased HDL-C was the result of long duration, low intensity physical activity.     

Digital mammography. ROC studies of the effects of pixel size and unsharp-mask filtering on the detection of subtle microcalcifications

We investigated the spatial resolution requirement and the effect of unsharp-mask filtering on the detectability of subtle microcalcifications in digital mammography. Digital images were obtained by digitizing conventional screen-film mammograms with a 0.1 X 0.1 mm2 pixel size, processed with unsharp masking, and then reconstituted on film with a Fuji image processing/simulation system (Fuji Photo Film Co., Tokyo, Japan). Twenty normal cases and 12 cases with subtle microcalcifications were included. Observer performance experiments were conducted to assess the detectability of subtle microcalcifications in the conventional, the unprocessed digital, and the unsharp-masked mammograms. The observer response data were evaluated using receiver operating characteristic (ROC) and LROC (ROC with localization) analyses. Our results indicate that digital mammograms obtained with 0.1 X 0.1 mm2 pixels provide lower detectability than the conventional screen-film mammograms. The detectability of microcalcifications in the digital mammograms is improved by unsharp-mask filtering; the processed mammograms still provide lower accuracy than the conventional mammograms, however, chiefly because of increased false-positive detection rates for the processed images at each subjective confidence level. Viewing unprocessed digital and unsharp-masked images in pairs resulted in approximately the same detectability as that obtained with the unsharp-masked images alone. However, this result may be influenced by the fact that the same limited viewing time was necessarily divided between the two images.     

The neu-oncogene product in serum and tissue of patients with breast carcinoma

BACKGROUND:: A soluble 105 kD neu-related protein is detectable in conditionedmedium from breast cancer cells expressing the neu-oncogeneproduct and in serum of nude mice bearing tumors that overexpressneu-oncogene PATIENTS AND METHODS:: In 100 patients with primary (n - 33) relapse-free (n - 6) andmetastatic (n - 61) breast carcinoma the serum levels of thesoluble new-related protein were investigated by ELISA techniques.Median age was 57 years, range 26–89 years. RESULTS:: The neu-protein serum levels were below 40 HNU/ml (human neu-antigenunit) in 72 patients and 40 or more HNU/ml in 28 patients. In30 patients with primary breast carcinoma, tested before mastectomy,all serum- neu-protein samples were negative. However, 26 of61 metastazised patients (43%) were serum-neu-protein-positive.In disseminated disease (n – 61), serum-neu-protein-positivitywas more likely to be seen in patients with visceral metastases(18/33 – 54%), than in patients with nonvisceral metastases(8/28 – 28%). Furthermore, monitoring of the serum-neu-proteinlevels reflected clinical course. For 53 patients original paraffin-embeddedtumor material was available for studying immunohistochemicalneu-protein expression. In 39/53 (73%) patients immunohistochemicaland ELISA data showed corresponding results. In 27/30 (90%)patients, from whom sera and tissue could be obtained at thesame time at primary mastectomy, results of immunohistochemistryin primary tumor and serum ELISA were negative and mutuallyconfirmatory. However, the other three patients were positivefor immunohistochemical neu-protein expression in primary tumorbut negative for serum-neu-protein expression. CONCLUSIONS:: Our results suggest that patients with advanced breast cancerand an elevated serum-neu-protein level may have a poor clinicaloutcome. This test might be a useful tool for monitoring patientswith advanced breast carcinoma, but not those with early disease.Further prospective studies are warranted to elucidate the questionof whether this test can contribute to determining prognosisand treatment strategies. breast carcinoma, c-erb-B2, HER-2, neu, oncogene, pl85     

Retention of "safe" blood donors. The Retrovirus Epidemiology Donor Study

BACKGROUND: There are obvious advantages to increasing donor retention. However, for reasons of blood safety, certain donors may, in fact, be more desirable to retain than others. “Safe” donors are defined as those who provided a blood donation that was negative on all laboratory screening tests and who subsequently reported no behavioral risks in response to an anonymous survey. This study identifies the most important factors affecting the intention of “safe” donors to provide another donation. STUDY DESIGN AND METHODS: An anonymous survey asking about donation history, sexual history, injecting drug use, and recent donation experience was mailed to 50,162 randomly selected allogeneic donors (including directed donors) who gave blood from April through July or from October through December 1993 at one of the five United States blood centers participating in the Retrovirus Epidemiology Donor Study. Before mailing, questionnaires were coded to designate donors with nonreactive laboratory screening tests at their most recent donation. RESULTS: A total of 34,726 donors (69%) responded, with substantially higher response among repeat donors. According to reported intentions only, the vast majority of “safe” donors indicated a high likelihood of donating again within the next 12 months. Only 3.4 percent reported a low likelihood of donating again. A comparison of those likely to return and those unlikely to return reveals significant differences in demographics and in ratings of the donation experience. A higher proportion of those unlikely to return were first-time donors, minority-group donors, and donors with less education. The highest projected loss among “safe” donors was seen for those who gave a fair to poor assessment of their treatment by blood center staff or of their physical well-being during or after donating. CONCLUSION: These data suggest that efforts to improve donors' perceptions of their donation experience, as well as attention to the physical effects of blood donation, may aid in the retention of both repeat and first-time donors.     

Digital radiography of subtle pulmonary abnormalities: an ROC study of the effect of pixel size on observer performance

Forty conventional radiographs with examples of mild interstitial infiltrates and subtle pneumothoraces and 40 normal studies of the chest were selected and digitized, with pixel sizes of 1.0, 0.5, 0.2, and 0.1 mm. Observer performance tests were carried out using receiver operating characteristic analysis. Conventional radiographs and digitized images were compared. The results indicate that, in such cases, diagnostic accuracy increases significantly as the pixel size is reduced, at least to the 0.1-mm level. We conclude that, for digital systems using screen-film or similar image receptors, use of a pixel size substantially larger than 0.1 mm may result in some loss of diagnostic accuracy.     

Data compression: effect on diagnostic accuracy in digital chest radiography

High-resolution digital images make up very large data sets that are relatively slow to transmit and expensive to store. Data compression techniques are being developed to address this problem, but significant image deterioration can occur at high compression ratios. In this study, the authors evaluated a form of adaptive block cosine transform coding, a new compression technique that allows considerable compression of digital radiographs with minimal degradation of image quality. To determine the effect of data compression on diagnostic accuracy, observer tests were performed with 60 digitized chest radiographs (2,048 x 2,048 matrix, 1,024 shades of gray) containing subtle examples of pneumothorax, interstitial infiltrate, nodules, and bone lesions. Radiographs with no compression, with 25:1 compression, and with 50:1 compression ratios were presented in randomized order to 12 radiologists. The results suggest that, with this compression scheme, compression ratios as high as 25:1 may be acceptable for primary diagnosis in chest radiology.     

Arteriovenous fistulas of the lung--their clinical aspects and radiologic images

Based on the data of 15 patients the typical radiological signs of pulmonary arteriovenous fistulas, their differential diagnostic implications, clinical signs and symptoms and management are reviewed. In addition, lung function parameters of 9 patients are presented. The critical role of pulmonary angiography and sequential dynamic CT for the diagnosis is stressed, particularly in those cases in which conventional chest radiographs and tomographies fail to show characteristics abnormalities. Since pulmonary arteriovenous fistulas tend to increase in size and cause complications, they should be subjected to intermediate treatment, even if they are of no haemodynamic relevance.     

Augmentation laser for proliferative diabetic retinopathy that fails to respond to initial panretinal photocoagulation.

PURPOSE: A study was performed to determine if diabetic subjects who fail to respond to initial panretinal photocoagulation with regression of retinopathy risk factors do better with supplemental panretinal photocoagulation. METHODS: Thirty-five patients with 3 or more retinopathy risk factors who failed to respond to panretinal photocoagulation with regression to less than 3 retinopathy risk factors by 3 weeks after initial panretinal photocoagulation were prospectively randomized to augmentation laser panretinal photocoagulation (MORE) or to no additional treatment (NOMORE). RESULTS: Six months after initial treatment, the MORE group (n = 16) had regressed a mean of -0.94 retinopathy risk factors (with 95% confidence interval [CI] -1.60 to -0.26), compared with -0.21 retinopathy risk factors (95% CI -0.69 to 0.27) in the NOMORE (n = 19) group (P = 0.055). However, by 1 year, there was no statistically significant difference in the amount of regression of retinopathy risk factors with a mean decrease of -1.12 (95% CI -2.0 to -0.24) versus -1.05 retinopathy risk factors (95% CI -1.80 to -0.28) in the 2 groups, respectively. Similarly, for visual acuity, there was no difference in outcome. For all study patients, the persistence of three or more retinopathy risk factors was associated with a poorer visual result than if there was regression to less than three retinopathy risk factors. CONCLUSION: This study shows that although augmentation panretinal photocoagulation achieved faster regression of retinopathy risk factors, by 1 year, there was no difference in either mean regression of retinopathy risk factors or visual acuity between eyes treated or not treated with augmentation panretinal photocoagulation. In addition, the study shows that the persistence of 3 or more retinopathy risk factors 1 year after treatment was associated with a poorer visual result. Because sample size limited the power of the study to find small differences between groups, and because in proliferative diabetic retinopathy small differences could be important clinically, the authors do not recommend changes in current clinical practice.