Angiosarcoma of the pleura.

Angiosarcoma is a rare, highly malignant tumor arising from endothelial cells of small blood vessels. They usually occur in the skin, deep soft tissues, breast and liver. Pleural angiosarcomas are extremely rare and are restricted to case reports in medical literature. It is very difficult to distinguish them from malignant mesotheliomas on clinical, radiological and even histopathological features. Immunohistochemistry is valuable in making the diagnosis, showing negative reactivity for mesothelial markers and positivity for vascular markers. Prognosis is generally dismal except in occasional cases where the disease is localized and amenable for surgical resection. We report a 55-year-old man who presented to us with chest pain, cough and hemoptysis and was diagnosed to have a pleural angiosarcoma.     

Oral mifepristone 600 mg and vaginal gemeprost for mid-trimester induction of abortion: An open multicenter study

This open multicenter study was performed in 20 hospital gynecological units in the UK. The effects of 600 mg oral mifepristone as pretreatment to vaginal prostaglandin induction of second second trimester abortion was studied in 267 women.

The primary efficacy variable was the abortion induction interval, defined as the time taken to expel the fetus from the time of administration of the first prostaglandin pessary. Induction was commenced 36 to 48 hours following mifepristone intake.

The mean abortion induction interval was 7 h. A total of 81.9% of women aborted within 12 h. There was a significant relationship between abortion induction interval and age of gestation, and a significant inverse relationship between abortion induction interval and parity.

Vomiting, pelvic pain, and nausea were the most frequently reported adverse events. Two patients required transfusion and one patient with a uterine scar from a previous cesarean section suffered a ruptured uterus and hysterotomy.     

构建玻片蛋白质芯片的实验研究

目的:探讨玻片蛋白质芯片的构建方法及其中间操作条件的选择与优化。方法:利用生物芯片点样仪将超微量蛋白质点到经特殊处理的玻璃片表面,然后选用不同的化学试剂对玻片背景进行封闭;再用荧光素标记的蛋白质与点样蛋白杂交;最后用生物芯片分析仪扫描成像并进行分析,比较不同条件下芯片的显示效果。结果:蛋白质样品与片基稳定结合,并保持原活性状态;封闭试剂选用酪蛋白或明胶效果较佳;点样探针与其特异蛋白质抗体可稳定结合,结合效果与点样蛋白浓度在一定范围内呈正相关;在1.6 cm×1.6 cm的玻璃片面积上,构建了36×36=1269点的蛋白质芯片。结论:本实验条件下,蛋白质抗原或抗体可以稳定地固定于经过处理的玻璃片表面.制成免疫型蛋白芯片,并可通过随后的抗原抗体反应与荧光素标记的相应抗体或抗原结合,用生物芯片分析仪可对其荧光信号进行检测分析。     

The challenges facing nurse-midwives in working towards Safe Motherhood in Malawi

A midwife is the only health worker most of the women of the childbearing group in Malawi will ever meet in their lifetime. A midwife plays an essential role in the promotion of health and provision of care to these women. It is therefore, very important that midwives be available for the well being of these women. However, mere presence of midwives is not adequate for women''s optimal health.     

Deterioration in quality of life and depressive symptoms during radiation therapy for head and neck cancer.

OBJECTIVE: The aim of this study was to assess the quality of life and psychologic profile during radiation therapy for head and neck cancer. STUDY DESIGN AND SETTING: The University of Washington QoL instrument and the Hospital Anxiety and Depression Scale were administered to 202 patients at two or three time points during radiation therapy. RESULTS: A total of 118 (54.6%) patients completed the questionnaires at the beginning and at the end of the study. A mid-treatment dataset was also available for 67 (31.0%) patients. There was a statistically significant deterioration in composite QoL scores (P < 0.000) and a statistically significant increase in depression (P < 0.000). There was no difference in anxiety levels (P = 0.276). CONCLUSION: Patients undergoing radiation are increasingly depressed as treatment progresses, with worsening QoL during the treatment. SIGNIFICANCE: This study underlines the need for good psychologic support during radiation therapy in head and neck cancer.     

Volatile Constituents of Dracocephalum nutans

The essential oil of DRACOCEPHALUM NUTANS L. (Lamiaceae) has been investigated for the first time. The GC-MS analysis of the oil showed the presence of about 25 monoterpenoids including pinocamphone (56.4%), beta-pinene (12.7%), isopinocamphone (4.3%), alpha-phellandrene (4.6%), and isopinocampheol (3.7%).     

Mitoxantrone, mitomycin-C, methotrexate combination chemotherapy with radiotherapy and/or surgery in stage III (T4B, NO-2, M0) breast cancer

Results of primary surgery with or without locoregional radiotherapy (LRRT) are poor in stage III (T4b, NO-2, M0) breast cancer. Combination of mitoxantrone, mitomycin-c and methotrexate (MMM) has been reported to be as efficacious as doxorubicin based protocols with advantages of reduced nausea, vomiting, alopecia and cardiotoxicity. We tested MMM chemotherapy with LRRT and surgery in locally advanced breast cancer (LABC) with a view to assess response, survival, breast conservation, cost and toxicity. Fifty two previously untreated patients were given Mitoxantrone: 8 mg/m sq by infusion on days 1 and 21, Mitomycin-C: 8 mg/m sq by infusion on day 1 and Methotrexate: 35 mg/m sq i.v. on days 1 and 21. Cycles were repeated every 42 days. After 3 cycles LRRT was given if lump reduced to less than 2 cms. Otherwise patients were subjected to modified radical mastectomy (MRM) or radical mastectomy (RM). Following this 3 more cycles of chemotherapy were given. Patients with soft tissue, skin or heavy nodal involvement also received LRRT. Tamoxifen 20 mg daily was prescribed at the end of chemotherapy to postmenopausal patients. Complete/partial responses were seen in 5 and 26 patients, respectively after chemotherapy giving an overall response of 59.5%. Twenty four patients each had LRRT and MRM/RM. Responses could be significantly enhanced by LRRT/and or surgery. Nineteen out of 25 relapses were at distant sites. Breast conservation was achieved in 24/52 (46%) patients. Three year disease free and overall survival was 54% and 65%, respectively. There was 1 toxic death. Severe prolonged myelosuppresion was seen in those who also received LRRT. Mucositis, alopecia, nausea and vomiting were minor problems. Overall, combination was less expensive than doxorubicin based protocols.     

Primary structure of human amphiphysin, the dominant autoantigen of paraneoplastic Stiff--Man syndrome, and mapping of its gene (AMPH) to chromosome 7p13-p14

Amphiphysin is a protein peripherally associated with synapticvesicles. It is expressed in many neurons, certain endocrinecell types, and spermatocytes. Autoantibodies against amphiphysinoccur in patients afflicted with a rare neurologic autoimmunedisease, paraneoplastic Stiff—Man syndrome. To providea basis for the understanding of antl-amphiphysin autolmmunity,we have cloned cDNAs and determined the primary structure ofhuman amphiphysin. Comparison with chicken amphiphysin definesdomains of low and high amino acid sequence conservation. Asa candidate for heritable disorders of the nervous system, endocrinetissues or male fertility, the human amphiphysin gene was mappedto chromosome 7, region p13–p14.     

Acquired lacrimal cyst: a rare entity

The case is reported of a 37-year-old woman who complained of a gradually progressive mass in the left medial canthus area of one year's duration associated with epiphora. Although the clinical and investigative observations were suggestive of an acquired lacrimal sac cyst, the diagnosis was clinched by the operative and histopathological findings. Excision of the cyst along with dacryocystorhinostomy provided complete cure for this patient.     

Polyglactin sutures versus nylon sutures for scleral flap suturing in trabeculectomy

BACKGROUND AND OBJECTIVES: To note the effect on filtration function of using polyglactin sutures for scleral flap suturing in trabeculectomy. PATIENTS AND METHODS: Polyglactin sutures were compared with nylon sutures to secure the scleral flap of trabeculectomy in 30 consecutive eyes. Parameters studied were intraocular pressure, central anterior chamber depth, and bleb score in this randomized prospective study. RESULTS: Observations regarding intraocular pressure, central anterior chamber depth and bleb score in the early postoperative period were comparable in the 2 groups. The results at 12 months follow-up reveal a lower mean IOP (P < 0.05) and a higher mean bleb score (P < 0.05) in the group with polyglactin sutures. Success rate (defined as IOP < 21 mm Hg) at 12 months was 100% with use of polyglactin sutures compared to 80% with nylon sutures. CONCLUSIONS: Polyglactin sutures can be used as an alternative to nylon sutures for scleral flap suturing in trabeculectomy, with the possible additional benefit of better long-term filtration function.