Extraluminal colonic carcinoma invading into kidney: a case report and review of the literature

Renal metastasis from primary colon cancer is very rare, comprising less than 3% of secondary renal neoplasms. There are just 11 cases reported in the medical literature of colonic adenocarcinoma metastatic to the kidney. Of these cases, none occurred via direct invasion. We report a unique case of a 51-year-old female with extraluminal colonic adenocarcinoma which directly invaded into the kidney. Additionally, we investigate the causal relationship between the site of invasion and a previous stab injury by reviewing the role of the peritoneum and Gerota's fascia in preventing the spread of metastatic cancer into the perirenal space. Due to the rarity of this event, we present this case including a review of the existing literature relative to the diagnosis and treatment.

Weight versus volume in breast surgery: an observational study

Objectives

The study hypothesis is to assess correlation of breast specimen weight versus volume.

Design

Consecutive patients undergoing breast surgery at a single tertiary referral centre during a 6-month period were included. Specimen weight was measured in grams. Direct volume measurements were performed using water displacement. Data including side of the breast, age and menstrual status of the patient were noted.

Setting

Knowledge of breast volume provides an objective guide in facilitating the achievements of balance in reconstructive operations. Surgeons use intraoperative weight measurements from individual breasts to calculate the breast volume assuming that weight is equal to the volume of the specimen. However, it is unclear whether weight accurately reveals the true volume of resection.

Participants

Forty-one patients were included in the study with 28 having bilateral surgeries, 13 having unilateral procedures giving a total of 69 breast specimens.

Main outcome measures

Breast specimen weight correlation to breast specimen volume.

Results

The mean age of the group was 42.4 years. Fifty-two specimens were from premenopausal patients and 17 were of postmenopausal. Thirty-five were left-sided. Twenty-six patients had bilateral breast reduction, two had bilateral mastectomy, nine had a unilateral mastectomy and four patients had a unilateral breast reduction. The difference between weight and volume of these breasts was 36.4 units (6.6% difference). The difference in measurement of weight and volume in premenopausal was 37.6 units compared to 32.6 units in postmenopausal women. The density was 1.07 and 1.06, respectively. This was statistically not significant.

Conclusions

No significant difference between volume and weight was seen in this series. Furthermore, we are unable to support the notion that premenopausal patients have a significant difference in the proportion of fatty and glandular tissue as there was little difference between the weight and the volume. An easy, clinically proper formula for the quantification of actual breast volume has yet to be derived.

Translational, rotational, and vibrational coupling into phase in diffractively coupled optical cavities

All-reflective optical systems are under consideration for future gravitational wave detector topologies. A key feature of these all-reflective systems is the use of Fabry-Perot cavities with diffraction gratings as input couplers; however, theory predicts and experiment has shown that translation of the grating surface across the incident laser light will introduce additional phase into the system. This translation can be induced through simple side-to-side motion of the coupler, yaw motion of the coupler around a central point (i.e., rotation about a vertical axis), and even via internal resonances (i.e., vibration) of the optical element. In this Letter we demonstrate on a prototype-scale suspended cavity that conventional cavity length-sensing techniques used to detect longitudinal changes along the cavity axis will also be sensitive to translational, rotational, and vibrational motion of the diffractive input coupler. We also experimentally verify the amplitude response and frequency dependency of the noise coupling as given by theory.

Widespread divergence between incipient Anopheles gambiae species revealed by whole genome sequences

The Afrotropical mosquito Anopheles gambiae sensu stricto, a major vector of malaria, is currently undergoing speciation into the M and S molecular forms. These forms have diverged in larval ecology and reproductive behavior through unknown genetic mechanisms, despite considerable levels of hybridization. Previous genome-wide scans using gene-based microarrays uncovered divergence between M and S that was largely confined to gene-poor pericentromeric regions, prompting a speciation-with-ongoing-gene-flow model that implicated only about 3% of the genome near centromeres in the speciation process. Here, based on the complete M and S genome sequences, we report widespread and heterogeneous genomic divergence inconsistent with appreciable levels of interform gene flow, suggesting a more advanced speciation process and greater challenges to identify genes critical to initiating that process.

Demonstration of the echo-enabled harmonic generation technique for short-wavelength seeded free electron lasers

We report the first experimental demonstration of the echo-enabled harmonic generation technique, which holds great promise for generation of high-power, fully coherent short-wavelength radiation. In this experiment, coherent radiation at the 3rd and 4th harmonics of the second seed laser is generated from the so-called beam echo effect. The experiment confirms the physics behind this technique and paves the way for applying the echo-enabled harmonic generation technique for seeded x-ray free electron lasers.

Hyporesponsiveness to re-challenge dose following pneumococcal polysaccharide vaccine at 12 months of age, a randomized controlled trial

BACKGROUND

To evaluate the immunological impact of the 23-valent pneumococcal polysaccharide vaccine (23vPPS) at 12 months, for children who have received zero to three infant doses of seven-valent pneumococcal conjugate vaccine (PCV), on responses to a subsequent exposure to a small dose of 23vPPS (mPPS).

METHODS

Five hundred and fifty-two Fijian infants were stratified by ethnicity and randomized into eight groups to receive zero, one, two, or three PCV doses at 14 weeks, six and 14 weeks, or six, ten, and 14 weeks. Within each group, half received 23vPPS at 12 months and all received mPPS at 17 months. Sera were taken prior and one month post-mPPS.

FINDINGS

By 17 months, geometric mean antibody concentrations (GMC) to all 23 serotypes in 23vPPS were significantly higher in children who had received 23vPPS at 12 months compared to those who had not. Post-mPPS, children who had not received the 12 month 23vPPS had a significantly higher GMC for all PCV serotypes compared with those who had (each p<0.02). For the non-PCV serotypes, children who had not received the 12 month 23vPPS had significantly higher GMC for six of 16 non-PCV serotypes (7F, 9N, 12F, 19A, 22F, 33F) than those who did (each p<0.02). After adjusting for the pre-mPPS level, exposure to 23vPPS was associated with a lower response to mPPS for all serotypes (each p<0.001).

INTERPRETATION

Despite higher antibody concentrations at 17 months in children who had received 23vPPS at 12 months, the response to a re-challenge was poor for all 23 serotypes compared to children who had not received the 12 month 23vPPS.

Periventricular heterotopia in common microdeletion syndromes

Periventricular heterotopia (PH) is a brain malformation characterised by heterotopic nodules of neurons lining the walls of the cerebral ventricles. Mutations in FLNA account for 20-24% of instances but a majority have no identifiable genetic aetiology. Often the co-occurrence of PH with a chromosomal anomaly is used to infer a new locus for a Mendelian form of PH. This study reports four PH patients with three different microdeletion syndromes, each characterised by high-resolution genomic microarray. In three patients the deletions at 1p36 and 22q11 are conventional in size, whilst a fourth child had a deletion at 7q11.23 that was larger in extent than is typically seen in Williams syndrome. Although some instances of PH associated with chromosomal deletions could be attributed to the unmasking of a recessive allele or be indicative of more prevalent subclinical migrational anomalies, the rarity of PH in these three microdeletion syndromes and the description of other non-recurrent chromosomal defects do suggest that PH may be a manifestation of multiple different forms of chromosomal imbalance. In many, but possibly not all, instances the co-occurrence of PH with a chromosomal deletion is not necessarily indicative of uncharacterised underlying monogenic loci for this particular neuronal migrational anomaly.

Breast Cancer Patients Are 30% More Likely To Develop Arterial Thromboembolic Events after Diagnosis Compared with Cancer-Free Women: Results from a Large Population-Based Study

Background: Population-based prevalence and incidence data of arterial thromboembolic events (ATEE) in breast cancer (BC) patients are lacking in the published literature.Objectives: The occurrence of ATEE before and after BC diagnosis was compared with cancer-free controls in a population-based setting.Methods: Women who had a first hospitalization for BC between 2002 and 2007 were selected from the PHARMO Record Linkage System (RLS), which includes drug use and hospitalization data from approximately 3 million residents in the Netherlands. BC patients were matched 1:10 by age with cancer-free controls, using the date of diagnosis as the index date for both BC patients and controls. ATEE were defined as a myocardial infarction, unstable angina, ischemic stroke, and transient ischemic attack requiring hospitalization and were assessed 12 mo before and after the index date.Results: The analysis included 11,437 BC patients, with a mean ± SD age of 59 ± 14 years. ATEE before the index date were twice as frequent among BC patients compared with cancer-free controls (Table 1), though prevalence was &lt; 1% in both groups. The incidence of developing ATEE in the 12-mo follow-up period was 6.2 per 1000 person years among patients and 3.8 among controls (Table 2). BC patients experienced 1.7 times higher risk of ATEE compared with controls. This risk was attenuated but remained statistically significant after adjusting for prior cardiovascular or thromboembolic event hospitalization and prior antithrombotic or cardiovascular drug use (HR=1.3 [95%CI: 1.0-1.7]). The increase in risk was slightly higher for cerebrovascular compared with coronary events. Independent risk factors for developing ATEE were age (≥ 65 vs &lt; 65 years), prior use of antihypertensives or antidiabetic drugs, and total hospital stay &gt; 10 days during the first 6 months of follow-up.Table 1. Prevalence of ATEE 12 mo Before BC Diagnosis BC Patients (N=11,473) %Cancer-free Patients (N=114,730) %Odds Ratio (95% CI)ATEE0.70.32.0 (1.6-2.6)Myocardial Infarction0.30.12.9 (1.9-4.2)Unstable Angina0.20.11.5 (0.9-2.3)Ischemic Stroke0.10.11.8 (1.0-3.1)Transcient Ischemic Attack0.10.02.1 (1.2-4.0) Table 2. Incidence of ATEE 12 mo After BC Diagnosis BC Patients (N=11,473) IR per 1000 PYCancer-free Controls (N=114,730) IR per 1000 PYHazard Ratio (95% CI)ATEE6.23.81.7 (1.3-2.2)Myocardial Infarction1.71.31.4 (0.8-2.2)Unstable Angina1.61.21.4 (0.8-2.2)Ischemic Stroke1.60.82.0 (1.2-3.3)Transcient Ischemic Attack1.40.82.5 (1.4-4.3) Conclusions: In this large population-based study, the occurrence of the arterial thromboembolic events was low. However, BC patients were at significantly higher risk of developing ATEE compared with cancer-free controls. These results emphasize the need for careful observation of BC patients after diagnosis.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 2050.

Experimental demonstration of a suspended diffractively coupled optical cavity

All-reflective optical systems are under consideration for future gravitational wave detector topologies. One approach in proposed designs is to use diffraction gratings as input couplers for Fabry-Perot cavities. We present an experimental demonstration of a fully suspended diffractively coupled cavity and investigate the use of conventional Pound-Drever-Hall length sensing and control techniques to maintain the required operating condition.

Correlates of the perceived health risks of marijuana use among Australian adults

A quota sample of 3272 people from the Australian population was surveyed by telephone about the health risks of marijuana use. Three-fifths of the sample (62%) believed that there were health problems caused by marijuana use and one in four (27%) were uncertain. The most commonly cited health effects were: lung cancer, mental problems, memory loss and respiratory disease. The health risks of marijuana use were perceived to increase with increasing frequency of use, and to be greater when the user was a teenager rather than an adult. The perceived health risks of marijuana increased with age, were higher among women than men, decreased with increasing education and frequency and quantity of alcohol and were substantially lower among those who had used marijuana, and those who knew someone who had used marijuana.