Azimuthal charged-particle correlations and possible local strong parity violation

Parity-odd domains, corresponding to nontrivial topological solutions of the QCD vacuum, might be created during relativistic heavy-ion collisions. These domains are predicted to lead to charge separation of quarks along the system's orbital momentum axis. We investigate a three-particle azimuthal correlator which is a P even observable, but directly sensitive to the charge separation effect. We report measurements of charged hadrons near center-of-mass rapidity with this observable in Au + Au and Cu + Cu collisions at square root of s(NN) = 200 GeV using the STAR detector. A signal consistent with several expectations from the theory is detected. We discuss possible contributions from other effects that are not related to parity violation.

ABT-869 in Combination with Paclitaxel (P) as First-Line Treatment in Patients (Pts) with Advanced Breast Cancer

Background: ABT-869 is a novel orally active, potent and selective inhibitor of VEGF and PDGF receptor tyrosine kinases. ABT-869 potentiates the action of P in a number of preclinical tumor models including breast carcinoma (BC). This study was conducted to assess pharmacokinetic (PK) interaction and safety of ABT-869 combined with weekly P, and to guide ABT-869 dosing in the randomized portion of the trial.Methods: Pts with measurable chemotherapy naïve metastatic or unresectable locally advanced BC were eligible for this trial. Treatment consisted of weekly P (90 mg/m2) on Day (D) 1, 8 and 15 of every 28-day cycle (C) and ABT-869 0.20 orally once daily (QD) starting on D3 of C1. Treatment continued until progressive disease (PD) or unacceptable toxicity was observed. CT scans were conducted at baseline (within 21 days prior to C1 D1) and at the end of every 3 cycles. Adverse events (AE) were graded by NCI CTCAE V3.0; efficacy was evaluated by RECIST.Results: As of May 2009, 8 pts have enrolled in this study: 5 at 0.20 mg/kg and, based on the frequent need for dose reductions in this and other ongoing trials, a second cohort has enrolled 3 out of 6 planned pts at 0.15 mg/kg. Preliminary safety and efficacy results are shown (table). Of the 5 pts dosed at 0.20 mg/kg, 2 pts had confirmed partial responses (PR) and continued on drug at reduced dose for 12 and 10 cycles, and 3 discontinued (DC); 1 due to PD, 1 withdrew consent, and 1 for AE (pulmonary embolism, cycle 2). Three pts have been dosed at 0.15 mg/kg; one is early and two have PR. The most common AEs were neutropenia (n=3), stomatitis, vomiting, ALT increased, hyperglycemia, hypokalemia and hypertension (n=2 each). These events were generally grade 1 or 2 except for neutropenia.Conclusion: The combination of ABT-869 0.20 mg/kg QD with P weekly resulted in antitumor activity (2 PR) but required frequent dose reductions due to AEs. A reduced dose of 0.15 mg/kg with weekly P is being evaluated (2 PR). Updated results of this ongoing study will be presented.Pt #Initial ABT-869 Dose (mg)Current ABT-869 Dose (mg)Cycle of Dose ReductionReason for Dose ReductionEnd Cycle 3 AssessmentsEnd Cycle 6 AssessmentsCurrent status   0.20 mg/kg    1001107.54G3 hand-footPRPRCycle 121041105.03,5G3 fatiguePRPRCycle 1010022020----DC in Cycle 2 (PD)102112.512.5--SD-DC in Cycle 4 (withdrew consent due to headaches)10221515----DC in Cycle 2 (Pulmonary embolism)   0.15 mg/kg    10231052,4G2 hand painPR-Cycle 510247.57.5--PR-Cycle 410251010----Cycle 1G= grade

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5076.

Myotonic dystrophy: an anaesthetic dilemma

SUMMARY

Myotonic dystrophy (dystrophia myotonica, DM) is a chronic, slowly progressing, highly variable inherited multisystemic disease that can manifest at any age from birth to old age. We present a 32-year-old female with adenexal mass posted for exploratory laparotomy. She was a known case of dilated cardiomyopathy (DCMP).The ECG suggested incomplete RBBB & LAHB & the ECHO revealed mild mitral regurgitation, tricuspid regurgitation, pulmonary artery hypertension with severe left ventricular dysfunction (ejection fraction of 30-35%). General anaesthesia (GA) with epidural anaesthesia was planned. The patient was haemodynamically stable through out the surgical procedure. The patient was reversed and shifted to post anaesthesia care unit. On the 2nd postoperative day patient developed respiratory distress and hypotension. ABG revealed Type 1 respiratory failure. Since the patient didn't improve with oxygen therapy and nebulisation, she was intubated and shifted to ICU. Patient was tolerating the tube without sedation and relaxants so, consultant anaesthesiologist asked for neurologist referral to rule out myotonic dystrophy. Subsequent muscle biopsy and genetic analysis was suggestive of myotonic dystrophy. Despite all possible efforts we were unable to wean her off the ventilator for 390 days. Patients with myotonic dystrophy are a challenge to the attending anaesthesiologist. These patients can be very well managed with preoperative optimized medical treatment and well-planned perioperative care.

Growth of long range forward-backward multiplicity correlations with centrality in Au + Au collisions at square root of sNN = 200 GeV

Forward-backward multiplicity correlation strengths have been measured with the STAR detector for Au + Au and p + p collisions at square root of s(NN) = 200 GeV. Strong short- and long-range correlations (LRC) are seen in central Au + Au collisions. The magnitude of these correlations decrease with decreasing centrality until only short-range correlations are observed in peripheral Au + Au collisions. Both the dual parton model (DPM) and the color glass condensate (CGC) predict the existence of the long-range correlations. In the DPM, the fluctuation in the number of elementary (parton) inelastic collisions produces the LRC. In the CGC, longitudinal color flux tubes generate the LRC. The data are in qualitative agreement with the predictions of the DPM and indicate the presence of multiple parton interactions.

Imaging of ependymomas: MRI and CT

The imaging features of intracranial and spinal ependymoma are reviewed with an emphasis on conventional magnetic resonance imaging (MRI), perfusion MRI and proton magnetic resonance spectroscopy, and computed tomography. Imaging manifestations of leptomeningeal dissemination of disease are described. Finally, salient imaging features obtained in the postoperative period to evaluate completeness of surgical resection, and thereafter for long-term surveillance for disease recurrence, are reviewed.

Cervical tuberculosis detection in Papanicolaou-stained smear: case report with review of literature

Genital tract tuberculosis is usually secondary to an extragenital tubercular focus. Cervical tuberculosis, however, is rare accounting for up to 3% of all genital tract diseases. The diagnosis of tuberculosis is usually established on multiple cervical biopsies followed by bacteriological confirmation. There are only a handful of reports on the diagnosis of tubercular cervicitis in cervical smears. We hereby report a case of cervical tuberculosis which was diagnosed on cervical smear. We also carried out a brief literature review of the cases diagnosed previously on cervical smear.

Distribution of malignant neoplasms reported at different pathology centers and hospitals in Jaipur, Rajasthan

BACKGROUND

Cancer data from Rajasthan are limited. Only two studies, one from Western Rajasthan, and the other from Eastern Rajasthan have been published by Sharma et al. in 1992 and 1996.

AIMS

To put the cancer profile from this region in proper perspective, we conducted the present study on the patterns of various malignancies in Jaipur region, i.e., Eastern Rajasthan. SETTING AND DESIGN AND MATERIAL AND METHODS: The study spans over one and half decade (1990-2004) and is based on a retrospective six-year sample analysis of approximately 200,000 histopathological and cytological reports for the years 1990, 1991, 1996, 1999, 2001 and 2004.

RESULTS

A total of 21,868 cancers were recorded in the six sample years. There were 59.11% (12,926) males and 40.89% (8942) females, with the male to female ratio being 1.45:1. Organ wise, lung (8.45%), prostate (7.12%), brain (6.04%), urinary bladder (5.31%), esophagus (4.67%) and tongue (4.60%) are most common sites involved in males with regard to frequency, whereas breast (20.44%), cervix (14.99%), ovary (4.35%), brain (3.80%), esophagus (3.67%), uterus (3.01%) and rectum (2.80%) are common sites for malignancies in females.

CONCLUSIONS

Significant findings were a higher frequency of cancers of the prostate, urinary bladder, and brain in males along with gall bladder cancers in females. Our figures have been compared with the national data.

K/pi Fluctuations at relativistic energies

We report K/pi fluctuations from Au + Au collisions at sqrt[s(NN)]= 19.6, 62.4, 130, and 200 GeV using the STAR detector at the Relativistic Heavy Ion Collider. K/pi fluctuations in central collisions show little dependence on incident energy and are on the same order as those from NA49 at the Super Proton Synchrotron in central Pb + Pb collisions at sqrt[s(NN)]=12.3 and 17.3 GeV. We report results for the collision centrality dependence of K/pi fluctuations and results for charge-separated fluctuations. We observe that the K/pi fluctuations scale with the charged particle multiplicity density.

Intracranial aneurysms in childhood: 27-year single-institution experience

BACKGROUND AND PURPOSE

Pediatric aneurysms are rare and, thus, relatively poorly understood as compared to those in adults. Our aim was to characterize the clinical, imaging, treatment, and outcome data of patients younger than 19 years diagnosed with intracranial aneurysms at a tertiary care institution.

MATERIALS AND METHODS

We performed a retrospective medical record review of pediatric patients examined at our university hospital between 1981 and 2008.

RESULTS

We evaluated 77 patients (mean age, 12 years; 40 female, 37 male) with 103 intracranial aneurysms. Patients presented with headache (45%), cranial neuropathies (16%), nausea/vomiting (15%), vision changes (13%), trauma (13%), seizure (4%), or sensory changes (3%). Subarachnoid hemorrhage occurred in 25 patients. Thirty-one fusiform aneurysms occurred in 25 patients. Forty-seven saccular aneurysms occurred in 35 patients. Twelve infectious aneurysms occurred in 6 patients. Fifteen traumatic aneurysms occurred in 12 patients. Fifty-nine patients underwent treatment of their aneurysms; 18 patients' conditions were managed conservatively. Nineteen patients underwent primary endovascular coiling, 1 patient had endovascular stent-assisted coiling, 11 patients underwent endovascular parent artery occlusion, 19 patients underwent surgical clipping, and 10 patients had aneurysms trapped and bypassed. Mortality was 1.3%. Morbidity included 8% infarction and 4% new-onset seizures. Six patients developed new aneurysms or had enlargement of untreated aneurysms.

CONCLUSIONS

In our experience, intracranial aneurysms of childhood show a female predilection and predominantly saccular morphology. In neurovascular centers where microneurosurgical and endovascular options are available, most children with intracranial aneurysms can be successfully treated with low morbidity and mortality. Fusiform aneurysms require a combined microneurosurgical and endovascular approach more often than saccular aneurysms. The development of new aneurysms in pediatric patients during limited follow-up warrants further investigation.

Endocrine regulation in asymmetric intrauterine fetal growth retardation

OBJECTIVE

The ponderal index (PI) is a widely accepted measure of disproportionate growth or asymmetrical growth retardation by pediatricians worldwide. Identification of disproportionately grown small for gestational age (SGA) neonates by using the ponderal index as a measure of the nutritional status at birth, is important because they constitute a high-risk group among SGA neonates. Poor nutritional status of the mother could have a direct effect on the organs of the developing fetus and/or affect the endocrine milieu in the maternal feto-placental unit resulting in an increased incidence of intrauterine growth-retarded (IUGR)/SGA births. IUGR is a significant risk factor for adult disease. In this study, we have investigated the endocrine adaptation by the fetus to overcome the growth disadvantage caused due to poor nutritional status of the mother.

MATERIALS AND METHODS

We examined the quantitative variations in hormonal and growth factor profiles in paired maternal and cord blood samples obtained from mothers and their neonates who were classified based on their growth status into SGA and appropriate for gestational age (AGA).

RESULTS

(1) A total of 24.7% neonates had a PI < 2, indicating a high incidence of asymmetric IUGR in the population studied. (2) Anthropometric parameters measured in the mothers indicate that the mothers giving birth to neonates with a PI < 2 had poor nutritional status, both prior to and during pregnancy. (3) We observed increased levels of placental lactogen and prolactin and decreased levels of insulin in the cord blood of neonates with PI < 2, while lower levels of insulin-like growth factor 1 (IGF-1) and higher levels of epidermal growth factor (EGF) were observed in their mothers.

CONCLUSION

Poor maternal nutritional status results in fetal adaptation to a growth restricted environment via the modulation of the pituitary-thyroid axis thereby altering the endocrine milieu, thus affecting fetal growth.