Pulmonary function in young females of Kolkata, India - Revisited

Rapid economic and industrial growths imposed significant impact on human health including the pulmonary health. Questions were raised regarding the validity of the existing prediction norms of pulmonary function tests (PFTs) in a particular population. The present study was conducted to investigate the applicability of the existing norms for PFTs in young healthy non-smoking female university students of Kolkata, India. Significant difference was noted in vital capacity (VC), forced vital capacity (FVC), and forced expiratory volume in 1 s (FEV₁) when the present data were compared with the earlier study in similar population. Correlation statistic revealed significant relationship of age and body height with all the PFT parameters. Body mass had significant correlation with VC, FVC, FEV₁ as a percentage of FVC (FEV_1%), and peak expiratory flow rate (PEFR). Regression equations have been computed for predicting PFTs from age and body height. There has been a change of PFTs in the studied population for the last couple of decades due to increased environmental pollution in the course of economical and industrial developments. Regression equations computed in this study are not only recommended to predict PFT parameters in the studied population, but they are also considered more reliable owing to their substantially smaller standard error of estimate than those proposed in the previous study.

Natural killer cells contribute to hepatic injury and help in viral persistence during progression of hepatitis B e-antigen-negative chronic hepatitis B virus infection

Hepatitis B e-antigen negative (e(-)) chronic HBV infection (CHI) encompasses a heterogeneous clinical spectrum ranging from inactive carrier (IC) state to e(-) chronic hepatitis B (CHB), cirrhosis and hepatic decompensation. In the backdrop of dysfunctional virus-specific T cells, natural killer (NK) cells are emerging as innate effectors in CHI. We characterized CD3(-) CD56(+) NK cells in clinically well-defined, treatment-naive e(-) patients in IC, e(-)CHB or decompensated liver cirrhosis (LC) phase to appraise their role in disease progression. The NK cell frequencies increased progressively with disease severity (IC 8.2%, e(-)CHB 13.2% and LC 14.4%). Higher proportion of NK cells from LC/e(-)CHB expressed CD69, NKp46, NKp44, TRAIL and perforin, the last two being prominent features of CD56(bright) and CD56(dim) NK subsets, respectively. The frequencies of CD3(-) CD56(+) NK cells together with TRAIL(+) CD56(bright) and Perforin(+) CD56(dim) NK cells correlated positively with serum alanine transaminase levels in e(-)CHB/LC. K562 cell-stimulated NK cells from e(-)CHB/LC exhibited significantly greater degranulation but diminished interferon-γ production than IC. Further, Perforin(+) NK cell frequency inversely correlated with autologous CD4(+) T-cell count in e(-) patients and ligands of NK receptors were over-expressed in CD4(+) T cells from e(-)CHB/LC relative to IC. Co-culture of sorted CD56(dim) NK cells and CD4(+) T cells from e(-)CHB showed enhanced CD4(+) T-cell apoptosis, which was reduced by perforin inhibitor, concanamycin A, suggesting a possible perforin-dependent NK cell-mediated CD4(+) T-cell depletion. Moreover, greater incidence of perforin-expressing NK cells and decline in CD4(+) T cells were noticed intrahepatically in e(-)CHB than IC. Collectively, NK cells contribute to the progression of e(-)CHI by enhanced TRAIL- and perforin-dependent cytolytic activity and by restraining anti-viral immunity through reduced interferon-γ secretion and perforin-mediated CD4(+) T-cell lysis.

Sclerosing mesenteric panniculitis in a young patient : common cause of diagnostic dilemma and treatment refractoriness

BACKGROUND

Sclerosing mesenteric panniculitis (SMP) is an idiopathic chronic fibroinflammatory disorder of the intra-abdominal fat.

CASE PRESENTATION

Herin, we report a case of SMP, involving the omentum, mesentery and peri-colic fat in a 18 year old male, who presented with significant and recurrent abdominal distension for 4.5 years. Computed tomogram revealed ascites, with nodular and irregular omental thickening and foci of calcification. Non-specific radiological and histological features made an accurate diagnosis extremely difficult. After a thorough work up and exclusion of other differentials, diagnosis of a nodular SMP (Weber Christian disease) was given. After showing resistance to chemotherapeutic agents, slow response was noted with cyclophosphamide, followed by rapid symptomatic improvement with mesenterectomy.

CONCLUSION

SMP is an uncommon benign mesenteric/ omental inflammation, and is a diagnosis of exclusion. As treatment refractoriness is common, management should be individualized and continued for along period. Surgical omentectomy may be helpful.

Abstract P4-01-05: Improving the quality of mammographic positioning

Purpose:

Optimal breast positioning is a key component to high quality screening mammograms to allow the radiologist to make the best interpretation for the patient and referring physician. In addition, the success of newer imaging techniques also depends on breast positioning. The American College of Radiology (ACR) sets the standard of what images should include by outlining 13 criteria of breast positioning. An initial audit of over 100 mammograms at our institution in 2013 found that only a mean of 33% were achieving the ACR criteria. The goal of our project was to increase the percentage of screening mammograms achieving ACR criteria to 90% by June 2015.

Methods:

Our breast imaging center partnered with a quality improvement (QI) team driving a radiology department-wide program on quality improvement. Team members identified 5 key causes that barred achieving the ACR criteria: disagreement on what meets criteria, not having a standard work for acquiring and reading mammograms, lack of communication between the technologist and radiologist, not having a measurement system to track performance, and lack of coaching on technologist techniques for acquiring images. Developments to address these causes included: teaching modules on what meets ACR criteria, standard work for radiologists to recall mammograms that did not meet ACR criteria, system for the technologist to document why criteria were missed, auditing system to track performance, and feedback sessions between technologists and radiologists. Over 1,700 mammograms were audited from the time period of July 2014 to March 2015.

Results:

By October 2014, the percentage of mammograms achieving all 13 of the ACR criteria was 71%, with 4 criteria that prevented reaching the 90% goal. By March 2015, 10 of the 13 ACR criteria were being sustainably met by the target goal of 90% of mammograms, better in all criteria compared to our 2013 data, and better in all but one criterion compared to published 1993 data. Table 1 demonstrates that we have been able to sustain a composite percentage of 12 of the 13 ACR criteria greater than 90% for the last 2 consecutive months.

Table 1 shows the composite percentage of mammograms achieving 12 of the 13 ACR criteria over time.2013 Baseline8/20149/201410/201411/20141/20152/20153/201564%67%77%82%83%81%95%96%The excluded, most difficult criterion (visualization of the opposite breast cleavage) has been achieved at 32% per 1993 published data; we currently achieve it at 40%. 12/2014 audits were not performed due to holidays and changes in staffing.

Conclusion:

Few institutions have published positioning data, with the most recent QI publication on breast positioning dating to 1993. We have conducted a structured process to improve quality of mammographic positioning, including revision of processes that led to poor positioning outcomes and creation of an environment to sustain our improved outcomes. Three ACR criteria continue to be problematic in reaching the 90% goal, with future investigation into whether it is actually feasible to achieve the most difficult criterion at our goal of 90%. Future work also includes assessing how the recent hire of a mammography coach to spread best practices and real-time feedback is able to further improve results and maintain the infrastructure of ongoing QI.

Citation Format: Chen CA, Strain A, Mickelsen JL, Larson DA, Jesinger RA, Botelho D, Fromholz S, Obi CN, Crawley A, Lipson JA, Ikeda DM, Cooper C, Pal S. Improving the quality of mammographic positioning. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-01-05.

Study of atrial activities for abnormality detection by phase rectified signal averaging technique

Non-invasive detection of Atrial Fibrillation (AF) and Atrial Flutter (AFL) from ECG at the time of their onset can prevent forthcoming dangers for patients. In most of the previous detection algorithms, one of the steps includes filtering of the signal to remove noise and artefacts present in the signal. In this paper, a method of AF and AFL detection is proposed from ECG without the conventional filtering stage. Here Phase Rectified Signal Average (PRSA) technique is used with a novel optimized windowing method to achieve an averaged signal without quasi-periodicities. Both time domain and statistical features are extracted from a novel SQ concatenated section of the signal for non-linear Support Vector Machine (SVM) based classification. The performance of the proposed algorithm is tested with the MIT-BIH Arrhythmia database and good performance parameters are obtained, as indicated in the result section.

Defect driven ferromagnetism in SnO2: a combined study using density functional theory and positron annihilation spectroscopy

Room temperature ferromagnetic ordering has been observed in polycrystalline SnO₂. Defect characterization by positron annihilation technique and ab initio calculation indicates that tin vacancies are mainly responsible for inducing magnetic moment in oxygen irradiate SnO₂.

Targeting a chemorefractory COLO205 (BRAF V600E) cell line using substituted benzo[α]phenoxazines

Benzo[α]phenoxazine derivatives specifically toxic to a malignant COLO205 cell line with a BRAF mutation (V600E) and nontoxic to a non-malignant wild-type BRAF HEK293T cell line are studied.

Pelvic exenteration for recurrent squamous cell carcinoma of the pelvic organs arising from the cloaca--a single institution's experience over 16 years

AIM

Minimal data are available on the role of pelvic exenteration in patients with recurrent squamous cell carcinoma (SCC) of the pelvic organs. This study aimed to highlight our experience of pelvic exenteration in patients with recurrent and re-recurrent SCC of the pelvic organs.

METHOD

A retrospective review of all patients who underwent pelvic exenteration for recurrent SCC of the pelvic organs arising from the embryological cloaca from 1994 to 2010 was performed.

RESULTS

Twenty-four patients (median age 59, range, 27-79 years) underwent pelvic exenteration for recurrent SCC of the anus (18), cervix and upper vagina (2), lower vagina (1) and the vulva (3). Nine patients with anal SCC had undergone abdominoperineal excision prior to pelvic exenteration. Ten (41.7%) patients underwent a complete pelvic exenteration procedure, while sacrectomy was performed in 13 (54.2%) patients. There was no 30-day inpatient mortality. An R0 resection was achieved in 15 (62.5%) patients. Three (12.5%) had R1 resections while 6 (25%) had R2 resections. In the 15 patients with an R0 resection, 7 (46.7%) developed metastatic disease at a median of 18 (range 10-131) months. After a median follow-up of 26 (range 4-169) months, 1- and 2-year overall survival rates were 64% [95% confidence interval (CI), 44-84%] and 57% (95% CI 35-79%), respectively.

CONCLUSION

Pelvic exenteration for recurrent SCC of the cloaca is safe and feasible even after previous salvage surgery. An R0 resection can be achieved in 62.5% of the patients with reasonable early survival though less than published recurrent rectal cancer studies.

Impact of atmospheric boundary layer depth variability and wind reversal on the diurnal variability of aerosol concentration at a valley site

The development of the atmospheric boundary layer (ABL) plays a key role in affecting the variability of atmospheric constituents such as aerosols, greenhouse gases, water vapor, and ozone. In general, the concentration of any tracers within the ABL varies due to the changes in the mixing volume (i.e. ABL depth). In this study, we investigate the impact on the near-surface aerosol concentration in a valley site of 1) the boundary layer dilution due to vertical mixing and 2) changes in the wind patterns. We use a data set obtained during a 10-day field campaign in which a number of remote sensing and in-situ instruments were deployed, including a ground-based aerosol lidar system for monitoring of the ABL top height (zi), a particle counter to determine the number concentration of aerosol particles at eight different size ranges, and tower-based standard meteorological instruments. Results show a clearly visible decreasing trend of the mean daytime zi from 2900 m AGL (above ground level) to 2200 m AGL during a three-day period which resulted in increased near-surface pollutant concentrations. An inverse relationship exists between the zi and the fine fraction (0.3-0.7 μm) accumulation mode particles (AMP) on some days due to the dilution effect in a well-mixed ABL. These days are characterized by the absence of daytime upvalley winds and the presence of northwesterly synoptic-driven winds. In contrast, on the days with an onset of an upvalley wind circulation after the morning transition, the wind-driven local transport mechanism outweighs the ABL-dilution effect in determining the variability of AMP concentration. The interplay between the ABL depth evolution and the onset of the upvalley wind during the morning transition period significantly governs the air quality in a valley and could be an important component in the studies of mountain meteorology and air quality.

Assessment of phenol infiltration resilience in soil media by HYDRUS-1D transport model for a waste discharge site

The movement of contaminants through soil imparts a variety of geo-environmental problem inclusive of lithospheric pollution. Near-surface aquifers are often vulnerable to contamination from surface source if overlying soil possesses poor resilience or contaminant attenuation capacity. The prediction of contaminant transport through soil is urged to protect groundwater from sources of pollutants. Using field simulation through column experiments and mathematical modeling like HYDRUS-1D, assessment of soil resilience and movement of contaminants through the subsurface to reach aquifers can be predicted. An outfall site of effluents of a coke oven plant comprising of alarming concentration of phenol (4-12.2 mg/L) have been considered for studying groundwater condition and quality, in situ soil characterization, and effluent characterization. Hydrogeological feature suggests the presence of near-surface aquifers at the effluent discharge site. Analysis of groundwater of nearby locality reveals the phenol concentration (0.11-0.75 mg/L) exceeded the prescribed limit of WHO specification (0.002 mg/L). The in situ soil, used in column experiment, possess higher saturated hydraulic conductivity (KS  = 5.25 × 10(-4) cm/s). The soil containing 47 % silt, 11 % clay, and 1.54% organic carbon content was found to be a poor absorber of phenol (24 mg/kg). The linear phenol adsorption isotherm model showed the best fit (R(2) = 0.977, RMSE = 1.057) to the test results. Column experiments revealed that the phenol removal percent and the length of the mass transfer zone increased with increasing bed heights. The overall phenol adsorption efficiency was found to be 42-49%. Breakthrough curves (BTCs) predicted by HYDRUS-1D model appears to be close fitting with the BTCs derived from the column experiments. The phenol BTC predicted by the HYDRUS-1D model for 1.2 m depth subsurface soil, i.e., up to the depth of groundwater in the study area, showed that the exhaustion point was reached within 12 days of elapsed time. This clearly demonstrated poor attenuation capacity of the soil to retard migration of phenol to the groundwater from the surface outfall site. Suitable liner, based on these data, may be designed to inhibit subsurface transport of phenol and thereby to protect precious groundwater from contamination.