Giant coronary artery aneurysm formation following meningococcal septicaemia

We report a case of coronary vasculitis with formation of giant coronary artery aneurysms in a child following meningococcal septicemia. We suggest that coronary vasculitis is a rare complication of meningococcal septicemia that should be included in the list of conditions known to elicit a Kawasaki-like inflammatory response.

BK virus associated renal cell carcinoma: case presentation with optimized PCR and other diagnostic tests

Polyomaviruses, including BK and JC viruses, have been associated with graft failure, but have not commonly been associated with malignancy. We present a case of renal cell carcinoma arising in an allograft kidney, in which the tumor and metastasis contain viral DNA. Tumor and biopsy specimens from this patient were examined with hematoxylin & eosin, immunohistochemistry (IHC) and in situ hybridization (ISH). The results were confirmed by real-time polymerase chain reaction (PCR) analysis with BKV primers. Other viruses including herpes simplex 1-2, cytomegalovirus (CMV), Epstein-Barr virus (EBV), and varicella zoster were not detected. The presence of BKV DNA in a renal cell carcinoma, including a metastatic focus, adds to the evidence that this virus may play a role in cancers of the kidney and urinary tract.

Changes in insulin, glucose and ketone bodies, but not leptin or body fat content precede restoration of luteinising hormone secretion in ewes

The reproductive system, including pulsatile luteinising hormone (LH) secretion, is inhibited by deficits in energy availability and restored by energy surfeits. Plasma LH, insulin, leptin, ghrelin, glucose, ketone body, and nonesterified fatty acid concentrations were measured in ovariectomised, food-restricted ewes before and after return to ad libitum feeding to determine the factors that change in time to account for the restoration of pulsatile LH secretion. At 07.00 h, blood was sampled every 10 min for 5 h from ovariectomised, hypogonadotrophic, chronically food-restricted and ad libitum-fed ewes (Fed). At 12.00 h, four of the food-restricted sheep were given ad libitum access to food (Re-Fed), while three ewes continued to be food restricted (Restricted). Sampling continued for 5 h and resumed again on the mornings of days 2, 4, and 9. A pulse of LH was seen within 1 h of re-feeding in all Re-Fed ewes, and interpulse interval (IPI) was significantly shorter in Re-Fed compared to Restricted ewes and longer than in Fed ewes during the period after re-feeding. Re-Fed LH IPI was not restored to that of Fed ewes until sometime between days 4 and 9. The first pulse occurred within minutes, whereas restoration of IPI occurred after 4-8 days. Prior to the initial LH pulses seen in Re-Fed ewes, plasma ketone bodies first fell and then rose to levels significantly above those in Restricted ewes. Significant changes in circulating insulin, ghrelin, glucose, and total ketone body concentrations, daily food intake and lean body mass preceded restoration of Re-Fed LH IPI some time between days 4 and 9, but there were no significant changes in adiposity or circulating leptin concentrations, consistent with the hypothesis that LH pulses are reinitiated by changes in the availability of oxidisable metabolic fuels and possibly insulin, but not leptin concentrations.

Comparing the similarity of statistical shape models using the Bhattacharya metric

A variety of different methods of finding correspondences across sets of images to build statistical shape models have been proposed, each of which is likely to result in a different model. When dealing with large datasets (particularly in 3D), it is difficult to evaluate the quality of the resulting models. However, if the different methods are successfully modelling the true underlying shape variation, the resulting models should be similar. If two different techniques lead to similar models, it suggests that they are indeed approximating the true shape change. In this paper we explore a method of comparing statistical shape models by evaluating the Bhattacharya overlap between their implied shape distributions. We apply the technique to investigate the similarity of three models of the same 3D dataset constructed using different methods.

Point-of-care PSA testing: an evaluation of PSAwatch

We present a new quantitative prostate-specific antigen (PSA) assay using a portable, point-of-care test (PSAwatch) and reader system (BioScan) for measuring PSA concentrations in the range from 0.5 to < or =25 microg/l. Blood samples from patients (n=199) were submitted for laboratory PSA and also evaluated using PSAwatch and the BioScan system. PSA concentrations in 188 men were < or =25 microg/l and studied. Correlation between the two methods was good (R(2)=0.88) with a standard error of 1.588. The regression line had a bias of -0.02 at the concentration of 4.00 microg/l. This is the first report of a quantitative, portable, point-of-care PSA test and reader system. PSAwatch may reduce the number of hospital visits for patients with prostate disease.

Improving Reliability of Response Prediction to Platinum-Based Therapy by AdaBoost and Multiple Classifiers

It is a challenge to construct a reliable classifier based on microarray gene expression data for prediction of chemotherapy response, because usually only a small number of samples are available and each sample has thousands of gene expressions. This paper uses boosting and bootstrap approaches to improve the reliability of prediction. Specifically, AdaBoost and multiple classifiers based methods are used, in which support vector machines (SVMs) are utilized as the classifiers due to their good generalization ability. We compare the performance of proposed methods with a single SVM classifier system using MAS gene expression dataset in prediction of the response to platinum-based therapy for advanced-stage ovarian cancers. Statistical tests show both of the proposed methods achieve better prediction performance and have good reliability in terms of mean and standard deviation of the prediction performance for different number of selected features.

Oxidative stress in sepsis in children

BACKGROUND & OBJECTIVE

Information on oxidative damage during sepsis in children is not available, we undertook this study to assess the levels of certain antioxidants in blood of children with sepsis.

METHODS

Study group had 38 children with sepsis (<5 yr) and 39 age-and sex-matched controls admitted to a tertiary care hospital. Red cell glutathione (GSH), superoxide dismutase (SOD) and thiobarbituric acid reactive substance (TBARS) and plasma vitamin C were estimated by standard techniques.

RESULTS

There was no significant change in erythrocyte GSH, SOD and TBARS levels in sepsis when compared to controls. This may be due to the adaptive response of the body to combat the oxidative stress. However, plasma vitamin C levels were significantly reduced in patients aged one year one month to five years which may be due to active phagocytosis and due to its role as a free radical scavenger.

INTERPRETATION & CONCLUSION

Our findings show that children affected by sepsis probably adapt to the free radical toxicity induced by this condition. Further studies need to be done on a larger sample to confirm the findings.

Cantrell syndrome in one of a set of monozygotic twins

Cantrell syndrome is a rare syndrome of congenital defects involving the abdominal wall, sternum, diaphragm, pericardium and the heart. The spectrum of anomalies varies widely. A full syndrome, probable syndrome and incomplete expression have been described. Less than 160 cases have been described in the world literature. Only one set of monozygotic twins concordant with the syndrome has been reported. To our knowledge, the syndrome affecting only one of a set of twins has not been reported. We report a premature infant, the first-born twin, with the syndrome. The omphalocoele was large, and heart abnormalities included dextrocardia with atrial septal defect. The co-twin is normal.

Paraoxonase activity and antibodies to oxidized-LDL in chronic renal failure patients on renal replacement therapy

Serum paraoxonase (PON1) and antibodies to oxidized-LDL (anti ox-LDL) were measured in chronic renal failure subjects on renal replacement therapy such as hemodialysis (HD) peritoneal dialysis (PD) and transplantation (Txp). Paraoxonase activity was significantly lower in HD and PD group (P<0.001) than in control subjects. In transplant patients, paraoxonase activity was not significantly different from that of controls. Antibodies to ox-LDL was significantly higher in HD, PD and Transplant patients (P<0.0001) compared to control subjects. High titers of antibodies were observed in the HD group compared to the PD and Transplant subjects. A decrease in paraoxonase activity and high titers of Antibodies to ox-LDL in the dialysis group suggest a decreased cardio protective effect of HDL and enhanced risk of premature cardiovascular complications. Whereas in case of transplant subjects, there seems to be restoration of PON1 activity, but elevated levels of anti-oxLDL could still be a potential atherogenic factor. Hence, we propose that estimation of these two parameters can be used as a useful index to measure the cardiac risk in the above patient category.

Breast cancer followed by corpus cancer: Is there a higher risk for aggressive histologic subtypes?

OBJECTIVE

To analyze corpus cancer patients with a breast cancer history for risk of developing aggressive uterine histologic types.

METHODS

Corpus cancer patients with a history of breast cancer were identified from the Surveillance Epidemiology and End Results database from 1988 to 2001. Demographics, clinico-pathologic, and survival data were analyzed using Kaplan-Meier and logistic regression analyses.

RESULTS

Of 52,109 women diagnosed with corpus cancer, 1922 had a history of breast cancer. Women with a history of breast cancer had a significantly higher proportion of uterine papillary serous carcinomas (UPSC) and sarcomas compared to those without a breast cancer history (9.4% vs. 6.3% for UPSC and 10.3% vs. 8.4% for sarcoma; P < 0.001). Patients with endometrioid or sarcoma of the uterus after breast cancer had significantly worse 5-year survivals than patients without a breast cancer history (84.4% vs. 90.5%; P < 0.001 and 49.0% vs. 63.6%, P < 0.001, respectively). Older age, advanced stage, lack of surgery and radiation treatment, poor histologic types, and history of breast cancer were independent prognostic factors for poorer survival.

CONCLUSION

In this study, the proportional incidence of UPSC and sarcoma was significantly higher in women with a breast cancer history. These findings highlight the association of breast cancer and high-risk corpus cancer subtypes.

Critical review of complementary therapies in haemato-oncology

There is evidence of the increasing use of complementary and alternative medicine by Australians diagnosed with cancer. Given the increasing desire of cancer patients to use complementary and alternative medicine, it is important that clinicians have a good understanding of the evidence available in this field. This critical review aims to provide an overview of the current evidence pertaining to a range of complementary therapies that are used in a supportive role in the treatment of cancer patients. Treatment methods considered are acupuncture, music therapy, massage and touch therapies and psychological interventions. The efficacy of these complementary therapies in terms of improvement in symptoms and quality of life is examined. Evidence that relates to an effect on immune function and survival is also investigated.