Indication of electron neutrino appearance from an accelerator-produced off-axis muon neutrino beam

The T2K experiment observes indications of ν(μ) → ν(e) appearance in data accumulated with 1.43×10(20) protons on target. Six events pass all selection criteria at the far detector. In a three-flavor neutrino oscillation scenario with |Δm(23)(2)| = 2.4×10(-3)  eV(2), sin(2)2θ(23) = 1 and sin(2)2θ(13) = 0, the expected number of such events is 1.5±0.3(syst). Under this hypothesis, the probability to observe six or more candidate events is 7×10(-3), equivalent to 2.5σ significance. At 90% C.L., the data are consistent with 0.03(0.04) < sin(2)2θ(13) < 0.28(0.34) for δ(CP) = 0 and a normal (inverted) hierarchy.

Second primary tumors in patients with cutaneous malignant melanoma

BACKGROUND

Several studies report coexistent or subsequent primary tumors (SPT) among patients with malignant melanoma (MM), with the rate of incidence ranging from 1.5-20% depending on the sample size and the length and completeness of follow-up.

METHODS

The authors followed a cohort of patients with cutaneous MM who were diagnosed and treated at the City of Hope National Medical Center to determine the incidence rate of SPT and associated risk factors. Five hundred eighty-five patients (median age at diagnosis, 43 years) were diagnosed and treated for MM between 1952 and 1996 and followed for a median of 6.5 years (range, 0.0-37.0 years). Ninety-six percent of the cohort had been treated by surgery alone.

RESULTS

Thirty-seven patients developed an SPT. These included skin cancers (n = 23), carcinoma of the urinary bladder, breast carcinoma, and lymphoma (n = 3 each), lung carcinoma and prostate carcinoma (n = 2 each), and cervical carcinoma (n = 1). The estimated cumulative rate of incidence after MM was 5% at 5 years for any SPT, 3.7% for a second skin cancer, and 1.1% for a second solid tumor. Overall, the current cohort of MM patients was found to be at an increased risk for developing a subsequent melanoma (standardized incidence ratio [SIR], 4.5; 95% confidence interval [95% CI], 1.2-10.0) when compared with the general population. Older men (age > 50 years at the time of diagnosis of MM) were at an increased risk of developing subsequent bladder carcinoma (SIR, 6.4; 95% CI, 1.2-15.7).

CONCLUSIONS

Patients diagnosed with MM are at an increased risk of developing subsequent MM and bladder carcinoma. Issues to be addressed in future studies include interactions between environmental exposures and genetic susceptibility and the identification of individuals at increased risk.

Prevalence and functional significance of transient ST-segment depression during daily life activity: comparisons of ambulatory ECG with stress redistribution thallium 201 single-photon emission computed tomographic imaging

To assess the prevalence and functional significance of ischemic ambulatory ECG responses, we prospectively performed ambulatory ECG monitoring in 244 patients (mean age 61 +/- 10 years) referred for stress redistribution thallium 201 myocardial perfusion scintigraphy. The prevalence of ST-segment depression during ambulatory ECG was 33% among patients with a positive exercise ECG, but prevalence varied in selected patient subgroups. Among three groups with coronary artery disease (CAD), the group with ambulatory ECG ischemia (group 1) had a greater frequency of ischemic thallium responses (p = 0.07), a greater median number of reversible thallium defects (p < 0.05), and a greater summed thallium "reversibility" score (p < 0.05) than did the group with a positive exercise ECG but negative ambulatory ECG response (group 2) or that with negative exercise and ambulatory ECG responses (group 3). Exercise ST depression in group 1 versus group 2 was significantly greater (p = 0.002), occurred at a lower heart rate threshold (p = 0.002), and lasted longer after exercise (p = 0.001). Notably, one third of group 1 patients also manifested evidence of transient ischemic dilation of the left ventricle after exercise (p < 0.01 vs groups 2 and 3), a sign of severe ischemia. However, although functionally less "sick" than group 1 patients, 66% of group 2 patients and 50% of group 3 patients still had an ischemic thallium response, which was sometimes severe. Thus transient ischemia during ambulatory ECG monitoring identifies a functionally sicker cohort of patients with CAD and occurs in approximately one third of CAD patients with positive results of exercise tests. A negative ambulatory ECG response, however, does not exclude functionally significant disease among CAD patients. These results imply that caution should be applied in the interpretation of a negative ambulatory ECG response for the purpose of patient risk stratification.