Vascular density and phenotype around ductal carcinoma in situ (DCIS) of the breast

Up to 50% of recurrences of ductal carcinoma in situ of the breast are associated with invasive carcinoma but no pathological or molecular features have yet been found to predict for the development of invasive disease. For a tumour to invade, it requires the formation of new blood vessels. Previous studies have described a vascular rim around ducts involved by ductal carcinoma in situ, raising the possibility that the characteristics of periductal vascularisation may be important in determining transformation from in situ to invasive disease. Periductal vascular density and phenotype were determined using morphometry and a panel of anti-endothelial antibodies (von Willebrand factor, CD31, CD141 and CD34) and related to the presence of invasive carcinoma and other histological features. Compared to normal lobules, pure ductal carcinoma in situ exhibited a greater density of CD34+ and CD31+ vessels but a decrease in those that were immunopositive for vWF, indicating a difference in phenotype and in density. Ductal carcinoma in situ associated with invasive carcinoma showed a profile of vascular immunostaining similar to that of pure ductal carcinoma in situ but there were significantly greater numbers of CD34+ and CD141+ vessels and fewer staining for vWF. There was a significant negative correlation between vascular density and both the cross-sectional areas of the ducts involved and the extent of the necrosis of the tumour they contained. A correlation between vascular density and nuclear grade was also noted, being highest in the intermediate grade. The greater density of CD34+ and CD141+ vessels around ductal carcinoma in situ associated with invasive carcinoma could reflect a greater predisposition to invade but a direct effect of co-existent invasive carcinoma cannot entirely be ruled out in the present study. The relationship between vascular density, grade, duct size and nuclear grade suggests that periductal angiogenesis increases with tumour growth rate but is unable to keep pace with the most rapidly growing lesions.

Small-cell carcinoma of the esophagus: report of three cases and review of the literature with emphasis on therapy

Primary small-cell carcinoma (SCC) of the esophagus is rare, with about 200 cases reported up till now in the literature. Like pulmonary SCC, it is an aggressive tumor associated with a poor prognosis. Between 1994 and 1997, three patients with SCC of the esophagus were treated at Besançon University Hospital and this represented 1.85% of all esophageal malignancies diagnosed during this period: one patient had a limited tumor and underwent initial surgical resection, then chemotherapy with cisplatine and etoposide, and radiotherapy for recurrences. The other patients had extensive disease at diagnosis and were treated by the same chemotherapy. This retrospective study reports our experience of patients with this particular tumor and outlines the management strategy based on the available literature.

Measurement of inclusive antiprotons from Au+Au collisions at square root of s(NN) = 130 GeV

We report the first measurement of inclusive antiproton production at midrapidity in Au+Au collisions at square root of s(NN) = 130 GeV by the STAR experiment at RHIC. The antiproton transverse mass distributions in the measured transverse momentum range of 0.25<p( perpendicular)<0.95 GeV/c are found to fall less steeply for more central collisions. The extrapolated antiproton rapidity density is found to scale approximately with the negative hadron multiplicity density.

d Macro and (3)He macro production in square root of s(NN) = 130 GeV Au+Au collisions

The first measurements of light antinucleus production in Au+Au collisions at the Relativistic Heavy-Ion Collider are reported. The observed production rates for d macro and (3)He macro are much larger than in lower energy nucleus-nucleus collisions. A coalescence model analysis of the yields indicates that there is little or no increase in the antinucleon freeze-out volume compared to collisions at CERN SPS energy. These analyses also indicate that the (3)He macro freeze-out volume is smaller than the d macro freeze-out volume.

Comparison of physiological responses to morning and evening submaximal running

The aim of this study was to assess the effect of time of day on physiological responses to running at the speed at the lactate threshold. After determination of the lactate threshold, using a standard incremental protocol, nine male runners (age 26.3 +/- 5.7 years, height 1.77 +/- 0.07 m, mass 73.1 +/- 6.5 kg, lactate threshold speed 13.6 +/- 1.6 km x h(-1); mean +/- s) completed a standardized 30 min run at lactate threshold speed, twice within 24 h (07:00-09:00 h and 18:00-21:00 h). Core body temperature, heart rate, minute ventilation, oxygen uptake, carbon dioxide expired, respiratory exchange ratio and capillary blood lactate were measured at rest, after a warm-up and at 10, 20 and 30 min during the run. In addition, the rating of perceived exertion was reported every 10 min during the run. Significant diurnal variation was observed only for body temperature (36.9 +/- 0.9 degrees C vs 37.3 +/- 0.3 degrees C) and respiratory exchange ratio at rest (0.86 +/- 0.01 vs 0.89 +/- 0.07) (P < 0.05). Diurnal variation persisted for body temperature throughout the warm-up (37.1 +/- 0.2 degrees C vs 37.5 +/- 0.3 degrees C) and during exercise (36.2 +/- 0.6 degrees C vs 38.6 +/- 0.4 degrees C), but only during the warm-up for the respiratory exchange ratio (0.85 +/- 0.05 vs 0.87 +/- 0.02) (P < 0.05). The rating of perceived exertion was significantly elevated during the morning trial (12.7 +/- 0.9 vs 11.9 +/- 1.2) (P < 0.05). These findings suggest that, despite the diurnal variation in body temperature, other physiological responses to running at lactate threshold speed are largely unaffected. However, a longer warm-up may be required in morning trials because of a slower increase in body temperature, which could have an impact on ventilation responses and ratings of perceived exertion.

Do patients with borderline personality disorder belong to the bipolar spectrum?

BACKGROUND

This report examines clinical indicators for bipolarity in a cohort of patients suffering from Borderline Personality Disorder (BPD).

METHODS

The study was conducted in the Cornell-Westchester Hospital, famed for its expertise in BPD. To avoid biasing our sample, we excluded all BPD patients who were active patients in our anxiety and mood disorders program. Through the use of both open clinical interviews and standardized diagnostic interviews (SCID), borderline patients were examined for evidence of bipolarity by five indicators: history of spontaneous mania, history of spontaneous hypomania, bipolar temperaments, pharmacologic response typical of bipolar disorder, and a positive bipolar family history.

RESULTS

Depending on the level of bipolar disorder from the most rigorous (mania) to the most 'soft' (bipolar family history), between 13 and 81% of borderline patients showed signs of bipolarity. Based on what the emerging literature supports as rigorously defined bipolar spectrum (bipolar I and II), we submit that at least 44% of BPD belong to this spectrum; adding hypomanic switches during antidepressant pharmacotherapy, the rate of bipolarity in BPD reaches 69%. As expected from this formulation, most responded negatively to antidepressants (e.g. hostility and agitation) and positively to mood stabilizers.

LIMITATIONS

Small sample size and retrospective gathering of data on treatment response.

CONCLUSION

Patients with BPD more often than not exhibit clinically ascertainable evidence for bipolarity and may benefit from known treatments for Bipolar Spectrum Disorders. Large scale, systematic treatment studies with mood stabilizers are indicated.

Advocacy in epidemiology and demography

This paper is a summary of a panel discussion at the Conference on Epidemiology and Demography held at Georgetown University, in Washington D.C. on February 8-9, 2001. The participants were Al Hermalin, Linda Martin, Mike Stoto, Robert Wallace, Douglas Weed, and Rose Li (who chaired the session). A list of questions similar to the section headings in this paper was prepared in advance of the conference, and each of the participants was asked to address specific issues, although the presentations typically covered a range of topics. This summary also includes comments from the floor.

Electrophysiological and behavioral output of the rat basal ganglia after intrastriatal infusion of d-amphetamine: lack of support for the basal ganglia model

Dopamine, by acting upon D1 and D2 dopamine receptors located on striatonigral and striatopallidal neurons, respectively, has been postulated to inhibit output from the substantia nigra pars reticulata (SNpr) and internal pallidal segment (GPi). The inhibition of the SNpr/GPi should, in turn, disinhibit the thalamus to facilitate movement. The present study tests this prediction in intact (unlesioned) rats by attempting to correlate changes in the single unit activities of SNpr neurons with motor (i.e. behavioral) responses in the 20-30 min after infusions of d-amphetamine into the striatum. Unilateral injections of amphetamine (20 microg/microl) into either the dorsal-rostral, central, or ventral-lateral striatum failed to appreciably alter behavior and, in parallel electrophysiological studies, failed to consistently or significantly alter the activities of SNpr neurons in either chloral hydrate-anesthetized rats or awake locally anesthetized rats. However, when amphetamine was infused bilaterally into the ventral-lateral striatum (VLS; 20 microg/microl per side), a robust behavioral activation ensued (increased locomotor activity, oral movements, and sniffing) with an onset ranging from immediate to 20 min post-infusion and persisting for at least 40 min. In parallel studies, bilateral amphetamine infusions into VLS also caused changes in the firing frequency of a majority of SNpr neurons. However, the changes in firing were extremely variable and, contrary to expectation, the net population response of SNpr neurons was an increase in firing which corresponded in time with the period of peak behavioral activation. These results show that (i) bilateral but not unilateral activation of striatal dopamine receptors is needed to elicit behavioral and electrophysiological output from the basal ganglia, and (ii) motor activation is apparently not signaled by a generalized inhibition of SNpr firing, as is predicted by the basal ganglia model.

Solid-phase synthesis of peptides containing the spin-labeled 2,2,6,6-tetramethylpiperidine-1-oxyl-4-amino-4-carboxylic acid (TOAC)

2,2,6,6-Tetramethylpiperidine-1-oxyl-4-amino4-carboxylic acid (TOAC) is a nitroxide spin-labeled, achiral Calpha-tetrasubstituted amino acid recently shown to be not only an effective beta-turn and 3(10)/alpha-helix promoter in peptides, but also an excellent rigid electron paramagnetic resonance probe and fluorescence quencher. Here, we demonstrate that TOAC can be effectively incorporated into internal positions of peptide sequences using Fmoc chemistry and solid-phase synthesis in an automated apparatus.

Differentiation potential of intestinal mesenchyme and its interaction with epithelial cells: a study using beta-galactosidase-expressing fibroblast lines

Rat intestinal fibroblast lines (F1:G9 and A1:F1) differing in their potential to support intestinal mucosal development were marked with reporter genes to investigate their differentiation potential. The fibroblasts were transfected with plasmids expressing either beta-galactosidase (with or without a nuclear localisation signal) or green fluorescent protein (GFP). Transfection using Tfx50 or Fugene was more efficient than electroporation. The expression of beta-galactosidase was more stable and stronger than GFP. Cells were optimally labelled using the plasmid pL27B-GAL, and sub-clones with a strong and uniform nuclear expression of beta-galactosidase were isolated. These clones expressed beta-galactosidase even after prolonged passage in the absence of selection. The beta-galactosidase tagged lines (F1:G9gal and A1:F1gal) retained the morphological characteristics, viability and differentiation properties of the parental non-transfected lines. In co-culture with a colorectal tumour cell line Caco-2, the F1:G9gal and A1:F1gal cells differed in their morphological organisation but this did not change their expression of smooth muscle alpha-actin.

Multiplicity distribution and spectra of negatively charged hadrons in Au+Au collisions at square root of (sNN) = 130 GeV

The minimum-bias multiplicity distribution and the transverse momentum and pseudorapidity distributions for central collisions have been measured for negative hadrons ( h(-)) in Au+Au interactions at square root of ([s(NN)]) = 130 GeV. The multiplicity density at midrapidity for the 5% most central interactions is dN(h(-))/d(eta)/(eta = 0) = 280+/-1(stat)+/-20(syst), an increase per participant of 38% relative to pp collisions at the same energy. The mean transverse momentum is 0.508+/-0.012 GeV/c and is larger than in central Pb+Pb collisions at lower energies. The scaling of the h(-) yield per participant is a strong function of p( perpendicular). The pseudorapidity distribution is almost constant within /eta/<1.

Two-kaon correlations in central Pb+Pb collisions at 158 a GeV/c

Two-particle interferometry of positive kaons is studied in Pb+Pb collisions at mean transverse momenta <p(T)> approximately 0.25 and 0.91 GeV/c. A three-dimensional analysis was applied to the lower p(T) data, while a two-dimensional analysis was used for the higher p(T) data. We find that the source-size parameters are consistent with the m(T) scaling curve observed in pion-correlation measurements in the same collisions, and that the duration time of kaon emission is consistent with zero within the experimental sensitivity.

[Multiple skin and mouth squamous cell carcinomas related to long-term treatment with hydroxyurea]

INTRODUCTION

Cutaneous side-effects of hydroxyurea treatment are frequently observed. Squamous cell carcinomas are the most severe among them. We report a patient with skin and mouth carcinomas after hydroxyurea treatment. To the best of our knowledge, this is the first case reported.

OBSERVATION

A 83-year-old woman had been treated with hydroxyurea from 1985 to 1998 for polycythemia vera. She was referred to our institution in 1998 for painful erosions of both hands. Clinical examination revealed a squamous cell carcinoma leading to amputation of a finger. Hydroxyurea was stopped at this time, and the patient underwent treatment with pipobroman. From May 1998 to March 2000, the patient developed numerous skin keratoses and four squamous cell carcinomas on both hands. In September 2000 and October 2000, two additional skin carcinomas and two mouth carcinomas were diagnosed.

DISCUSSION

Cutaneous carcinomas are severe side effects of hydroxyurea therapy. They usually occur after several years of treatment and their outcome may be lethal. The chronology and clinical signs are in favour of implicating hydroxyurea in the development of skin and mouth carcinomas. Despite a bibliographic research using Medline and Embase data bases, we could not find another case-report with simultaneous occurrence of skin and mouth carcinomas after hydroxyurea therapy. This observation emphasizes the need of a long term follow-up in patients receiving hydroxyurea.

Small-cell carcinoma of the esophagus: report of three cases and review of the literature with emphasis on therapy

Primary small-cell carcinoma (SCC) of the esophagus is rare, with about 200 cases reported up till now in the literature. Like pulmonary SCC, it is an aggressive tumor associated with a poor prognosis. Between 1994 and 1997, three patients with SCC of the esophagus were treated at Besançon University Hospital and this represented 1.85% of all esophageal malignancies diagnosed during this period: one patient had a limited tumor and underwent initial surgical resection, then chemotherapy with cisplatine and etoposide, and radiotherapy for recurrences. The other patients had extensive disease at diagnosis and were treated by the same chemotherapy. This retrospective study reports our experience of patients with this particular tumor and outlines the management strategy based on the available literature.

Seven human immunodeficiency virus (HIV) antigen-antibody combination assays: evaluation of HIV seroconversion sensitivity and subtype detection

In this study, we evaluated the performance of two prototype human immunodeficiency virus (HIV) antigen-antibody (Ag-Ab) combination assays, one from Abbott Laboratories (AxSYM HIV Ag-Ab) and the other from bioMerieux (VIDAS HIV Duo Ultra), versus five combination assays commercially available in Europe. The assays were Enzygnost HIV Integral, Genscreen Plus HIV Ag-Ab, Murex HIV Ag-Ab Combination, VIDAS HIV Duo, and Vironostika HIV Uniform II Ag-Ab. All assays were evaluated for the ability to detect p24 antigen from HIV-1 groups M and O, antibody-positive plasma samples from HIV-1 groups M and O, HIV-2, and 19 HIV seroconversion panels. Results indicate that although all combination assays can detect antibodies to HIV-1, group M, subtypes A to G, circulating recombinant form (CRF) A/E, and HIV-1 group O, their sensitivity varied considerably when tested using diluted HIV-1 group O and HIV-2 antibody-positive samples. Among combination assays, the AxSYM, Murex, and VIDAS HIV Duo Ultra assays exhibited the best antigen sensitivity (at approximately 25 pg of HIV Ag/ml) for detection of HIV-1 group M, subtypes A to G and CRF A/E, and HIV-1 group O isolates. However, the VIDAS HIV Duo Ultra assay had a lower sensitivity for HIV-1 group M and subtype C, and was unable to detect subtype C antigen even at 125 pg of HIV Ag/ml. The HIV antigen sensitivity of the VIDAS HIV Duo and Genscreen Plus combination assays was approximately 125 pg of HIV Ag/ml for detection of all HIV-1 group M isolates except HIV-1 group O while the sensitivity of Vironostika HIV Uniform II Ag-Ab and Enzygnost HIV Integral Ag-Ab assays for all the group M subtypes was >125 pg of HIV Ag/ml. Among the combination assays, the AxSYM assay had the best performance for detection of early seroconversion samples, followed by the Murex and VIDAS HIV Duo Ultra assays.

[Fatal toxic respiratory epitheliolysis. Subacute tracheo-bronchial desquamation in Stevens-Johnson syndrome]

Acute bronchial mucosal sloughing related to Toxic Epidermal Necrolysis (Lyell syndrome) is widely reported in literature. On the contrary severe respiratory involvement is rare in post-infectious or toxic Epitheliolysis (Stevens-Johnson syndrome). There is no well-known predictive sign of bronchial epithelium involvement. An 18-year-old patient was admitted for Stevens-Johnson syndrome related to sulfasalazine (salazosulfapyridine). There were no respiratory signs. An acute respiratory failure occurred 36 hours after from admission due to an obstructive and desquamative necrosis of the tracheobronchial epithelium. We purpose that a fiberoptic laryngoscopy should be performed even in non-dyspneic patients suffering from Stevens-Johnson syndrome if hypersecretion is present. Fiberoptic bronchoscopy can be helpful in these cases.

Pion Interferometry of square root of (s(NN)) =130 GeV Au + Au collisions at RHIC

Two-pion correlation functions in Au+Au collisions at square root of [s(NN)] = 130 GeV have been measured by the STAR (solenoidal tracker at RHIC) detector. The source size extracted by fitting the correlations grows with event multiplicity and decreases with transverse momentum. Anomalously large sizes or emission durations, which have been suggested as signals of quark-gluon plasma formation and rehadronization, are not observed. The Hanbury Brown-Twiss parameters display a weak energy dependence over a broad range in square root of [s(NN)].