Preoperative Ultrasonic Assessment of Thin Melanocytic Skin Lesions Using a 100-MHz Ultrasound Transducer: A Comparative Study

BACKGROUND It has been shown that tumor thickness (TT) of melanocytic skin lesions (MSL) of less than 1 mm vertical thickness assessed by 20 MHz are often incorrectly evaluated.
OBJECTIVE We aimed to evaluate the accuracy of 100-MHz ultrasound for the determination of TT of thin MSL, compared with conventional 20-MHz ultrasound and histologic findings.
METHODS Thirty-seven patients with 50 suspicious MSL, including tumor diameter up to 1 cm and maximum vertical TT of less than 1 mm, were recruited. The agreement between the histologically and ultrasographically measured TT was analyzed using Bland and Altman plots.
RESULTS Compared to histology, 20-MHz ultrasound (33.9 μm) as well as 100-MHz (16 μm) resulted in overestimation of TT that was twofold higher for 20-MHz ultrasound. The latter also revealed wider 95% limits of agreement (4.9 to 63 μm) than 100-MHz ultrasound (3.5 to 28.7 μm).
CONCLUSION Analysis of agreement clearly demonstrated that the performance of 100-MHz ultrasound is superior to conventional 20-MHz ultrasound, even though a relatively small positive bias was observed in 100-MHz ultrasound, indicating a systematic error. We consider 100-MHz ultrasound a useful tool for the noninvasive determination of TT of thin MSL in vivo.     

Programmed cell death‐10 enhances proliferation and protects malignant T cells from apoptosis

Lauenborg B, Kopp K, Krejsgaard T, Eriksen KW, Geisler C, Dabelsteen S, Gniadecki R, Zhang Q, Wasik MA, Woetmann A, Odum N. Programmed cell death‐10 enhances proliferation and protects malignant T cells from apoptosis. APMIS 2010; 118: 719–28. The programmed cell death‐10 (PDCD10; also known as cerebral cavernous malformation‐3 or CCM3) gene encodes an evolutionarily conserved protein associated with cell apoptosis. Mutations in PDCD10 result in cerebral cavernous malformations, an important cause of cerebral hemorrhage. PDCD10 is associated with serine/threonine kinases and phosphatases and modulates the extracellular signal‐regulated kinase pathway suggesting a role in the regulation of cellular growth. Here we provide evidence of a constitutive expression of PDCD10 in malignant T cells and cell lines from peripheral blood of cutaneous T‐cell lymphoma (Sezary syndrome) patients. PDCD10 is associated with protein phosphatase‐2A, a regulator of mitogenesis and apoptosis in malignant T cells. Inhibition of oncogenic signal pathways [Jak3, Notch1, and nuclear factor‐κB (NF‐κB)] partly inhibits the constitutive PDCD10 expression, whereas an activator of Jak3 and NF‐κB, interleukin‐2 (IL‐2), enhances PDCD10 expression. Functional data show that PDCD10 depletion by small interfering RNA induces apoptosis and decreases proliferation of the sensitive cells. To our knowledge, these data provide the first functional link between PDCD10 and cancer.     

骨关节炎股骨头的血管供应和髋关节表面置换

引言 随着金属对金属承重而假体的应用，存世界范围内对年龄较小的成年患者施行髋关肯表面置换的例数不断增加。据估计，新一代低磨损金属对会属假体表面置换的应用解决了笫一代金属对聚乙烯表丽假体聚乙烯磨损碎屑导致的溶骨问题。[第一段]     

Smoking cessation during pregnancy: A systematic literature review

Issues. Second‐hand smoke presents a health risk for a large group of entirely helpless nonsmokers: unborn children. Reliable data on women continuing to smoke during pregnancy are essential for effective preventive and interventional programs. The aim of this review is therefore to identify this risk group compared with spontaneous quitters of smoking. Approach. This systematic literature review is based solely on empirical original papers derived from samples of pregnant women smoking at the beginning of pregnancy. In accordance with the QUOROM Statement all population or clinic‐based samples were included. Collectives from intervention studies were not included. All studies were from developed nations and published between January 1997 and March 2008. Key Findings. A total of 19 studies were identified. The rate of quitters was between 4.0% and 69.7% for population‐based studies, and 26.5% and 47.0% for clinic‐based studies. A smoking partner, a large number of children, a high rate of tobacco consumption, as well as deficiencies in prenatal care were predictors of smoking during pregnancy. Implications. This study identifies risk factors and correlates and indicates common obstacles for women to quit smoking during pregnancy. Conclusion. The risk groups that can be defined based on our results are a key target population for preventive measures.[Schneider S, Huy C, Schütz J, Diehl K. Smoking cessation during pregnancy: A systematic literature review. Drug Alcohol Rev 2009]     

Nasal absorption of progesterone in women

Summary. Absorption profiles were obtained from women following the administration of ointment containing 20, 30 and 40 mg of progesterone to the nasal mucosa. There were no significant differences in area-under-curves between groups receiving the drug in one nostril but when 40 mg doses were divided between two nostrils there was a significantly greater area-under-curve suggesting that the area of mucosa applied with the drug is more important than dosage.     

Evaluation of Cumulative Effects of MR Imaging on Pacemaker Systems at 1.5 Tesla

Background: The purpose of this study was to evaluate possible cumulative effects of repeated magnetic resonance imaging (MRI) examinations on pacemaker systems in patients with cardiac pacemakers. Methods and Results: The records of pacemaker patients who underwent repetitive MRI examinations in our institution were reviewed to identify patients who underwent two or more MRI examinations at 1.5T of any anatomical region. Using these criteria, a total of 47 patients who underwent a total 171 MRI examinations were identified and included in this study. Institutional Review Board approval for all pacemaker investigations was obtained. Written informed consent was obtained from all patients. Pacemakers were interrogated immediately before and after MR imaging, and after 3 months, including measurement of pacing capture threshold (PCT), lead impedance (LI), and battery voltage (BV). PCT, LI, and BV were analyzed for changes dependant on the number of MRI exams performed. Mean changes over time and changes between first and last pacemaker interrogation of PCT, LI, and BV were calculated. A statistically significant (P < 0.05), but clinically irrelevant trend for decrease in PCT and BV was found. No significant or clinically relevant changes in LI were observed. Conclusion: In this first study, no clinically relevant, cumulative changes in PCT, LI, or BV could be detected in PM patients who underwent two or more MRI examinations. However, a careful benefit/risk evaluation, among other MRI‐ and pacemaker‐related safety precautions, remains mandatory, as clinically relevant alterations to the PM system cannot be excluded by all means.     

COMMENTS

The angiotensin I-converting enzyme (ACE, kininase II, CD143) shows a broad specificity for various oligopeptides. Besides the well-known conversion of angiotensin I to II, ACE degrades efficiently kinins and the tetrapeptide AcSDKP (goralatide) and thus equally participates in the renin-angiotensin system, the kallikrein-kinin system, and the regulation of stem cell proliferation. In the mammalian testis, ACE occurs in two isoforms. The testicular isoform (tACE) is exclusively expressed during spermatogenesis and is generally thought to represent the germ cell-specific isozyme. However, we have previously demonstrated that, in addition to tACE, the somatic isoform (sACE) is also present in human germ cells. Similar to other oncofoetal markers, sACE exhibits a transient expression during foetal germ cell development and appears to be a constant feature of intratubular germ cell neoplasm, the so-called carcinoma-in-situ (CIS) and, in particular, of classic seminoma. This demands the existence of specific paracrine functions during male germ cell differentiation and development of male germ cell tumours, which are mediated by either of the two ACE isoforms. Considering the complexity of current data about ACE, a logical connection is required between (I) the precise localisation of ACE isoforms, (I) the local access to potential substrates and (II) functional data obtained by knockout mice models. The present article summarises the current knowledge about ACE and its potential substrates with special emphasis on the differentiation-restricted ACE expression during human spermatogenesis and prespermatogenesis, the latter being closely linked to the pathogenesis of human germ cell tumours.     

Memory impairment in children with language impairment

Aim The aim of this study was to assess whether any memory impairment co‐occuring with language impairment is global, affecting both verbal and visual domains, or domain specific. Method Visual and verbal memory, learning, and processing speed were assessed in children aged 6 years to 16 years 11 months (mean 9y 9m, SD 2y 6mo) with current, resolved, and no language impairment using the Wide Range Assessment of Memory and Learning (WRAML), a standardized memory and learning test for children, and the Children’s Test of Non‐Word Repetition (CNRep), a test of phonological short‐term memory. Fifty‐one children (38 males, 13 females) with current speech and language impairment from 49 families were compared with 13 siblings (11 males, 2 females) with a past history of language impairment and 26 (15 males, 11 females) who had never had language impairment. Results Children with current language impairment showed impairment in all verbal memory measures compared with children who had never had language impairment, and these impairments were still evident in children with a past history of learning impairment. Visual memory and learning were not impaired compared with children who had never had language impairment. The severity of verbal memory impairment correlated with the degree of language impairment. Interpretation We concluded that in language impairment there is domain specificity of memory impairment affecting verbal processing.     

Pharmacokinetics of N4-Octadecyl-1-β-d-Arabinofuranosylcytosine in Plasma and Whole Blood after Intravenous and Oral Administration to Mice

N⁴-octadecyl-1-β-d -arabinofuranosylcytosine (NOAC) is a new cytotoxic derivative of cytosine arabinoside with improved cytotoxic activity and stability against deamination. Its pharmacokinetics were studied in mice. The drug was administered intravenously and orally to ICR mice to assess its pharmacokinetic parameters in plasma and whole blood. The lipophilic drug was administered in small unilamellar liposomes 100–400 nm in diameter. The concentrations of NOAC in plasma and erythrocytes were determined by high-performance liquid chromatography (HPLC). When given orally a rather low amount of the delivered NOAC was absorbed as the unchanged drug, resulting in a bioavailability of 11% from the plasma and 12.9% from whole blood. As shown elsewhere, the amount of drug absorbed is sufficient to provide excellent cytotoxic activity in the L1210 leukemia and in human xenograft models after oral administration. The mean residence time of NOAC after intravenous administration was 3.5 h in plasma and 6 h in whole blood giving NOAC a terminal half-life in blood substantially longer than that of cytosine arabinoside. After oral administration the mean residence time was 18 h in plasma and whole blood. In summary, NOAC has a prolonged half-life after intravenous administration compared with cytosine arabinoside. The distribution of NOAC in blood is highly dependent on its mode of administration.