An experimental and algorithm-based study of the spectral features of breast cancer patients by a photodiagnosis approach

In the present study, the spectral diagnosis of blood plasma samples of breast cancer patients and an equal number of normal controls was investigated. A set of ratio parameters was acquired by employing SXS and FES. The samples were also analyzed statistically by employing Welch two-sample t-tests, and the effects of three ratio parameters, R₁, R₂, and R₃, were also studied by plotting them against the subject numbers. A linear discriminant was also applied to verify the exact classification of normal control and breast cancer patients. It was observed that the levels of biofluorophores such as porphyrin, NADH, tryptophan and flavins were elevated 2- to 3-fold for breast cancer patients compared to normal controls, with an accuracy of approximately 100 %. We have also confirmed the validity of the obtained experimental results by using an advanced robust diagnostic algorithm. The experimental results of the current study may have a vital and substantial impact on the detection and screening protocols used for future breast cancer patients. The spectral analysis of body fluid could be of great value to add to and enhance the current procedures with an accuracy of approximately 100 % with limited number of samples. The results and objectives of this preliminary study were encouraging and useful for the discrimination of the features of breast cancer patients compared to those of normal controls.

6q24 Transient Neonatal Diabetes - How to Manage while Waiting for Genetic Results

Diabetes, rare in the neonatal period, should be evoked in every newborn presenting with unexplained intrauterine and early postnatal growth retardation. This case report illustrates the clinical course and therapeutic approach of a newborn diagnosed with transient diabetes. The baby was born at 37 weeks of gestation with a severe intrauterine growth restriction. Except a mild macroglossia and signs of growth restriction, physical examination was normal. On the fifth day of life, hyperglycemia (180 mg/dl) was noted, and the next day, the diagnosis of diabetes was confirmed (high blood sugar, glucosuria, undetectable levels of insulin and C-peptide). Insulin infusion, initially intravenously and then subcutaneously, was started, tailored to assure the growth catch-up and normalize the blood sugar levels. At the age of 4 weeks, the baby returned at home under pump. At 8 weeks, the clinical impression of evolution to a transient diabetes (decreasing needs of insulin with very satisfactory weight gain) was genetically confirmed (paternal uniparental disomy of chromosome 6). There is no screening for neonatal diabetes, but the clinical suspicion avoids the metabolic decompensation and allows early initiation of insulin therapy. The genetic approach (for disease itself and its associated features) relies on timely clinical updates.

A parallelism between spectral grading and Gleason grading of malignant prostate tissues

Gleason score is the most common method of grading the virulence of prostate malignancy and is based on the pathological assessment of morphology of cellular matrix. Since this involves the excision of the tissue, we are working on a new, minimally invasive, non-contact, procedure of spectral diagnosis of prostate malignancy. In this preliminary in vitro study reported here, we have analyzed 27 tissue samples (normal control=7: benign=8: malignant=12) by Stokes' shift spectra (SSS) to establish a one-to-one correspondence between spectral grading and Gleason grading.

Timothy grass pollen major allergen Phl p 1 activates respiratory epithelial cells by a non-protease mechanism

BACKGROUND

Group 1 allergens from grass pollen (e.g. Phl p 1, the major allergen of timothy grass Phleum pratense) cause IgE reactivity in about 95% of allergic subjects and exist in all grass species. The respiratory epithelium represents a first line of contact of the immune system with airborne allergens, functions as physical barrier and is an important immunological regulation system.

OBJECTIVE

The aim of this study was to investigate the interaction of Phl p 1 with human respiratory epithelium to elucidate the contribution of epithelial cells to the development of allergic reactions.

METHODS

Purified Phl p 1 was used to stimulate A549 cells and transient transfected HEK293 cells. mRNA level of different mediators were investigated by real-time PCR, release of the mediators was determined by ELISA. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) test and an ex vivo model of the murine trachea were used to investigate a potential proteolytic activity of Phl p 1.

RESULTS

Phl p 1 activates respiratory epithelial cells as measured by induction of IL-6, IL-8 and TGF-beta mRNA and release. Phl p 1, in contrast to Der p 1 from the house dust mite, does not exert proteolytic activity, as investigated by microscopic observation and MTT test. In an ex vivo model of the murine trachea we were able to show that Der p 1, in contrast to Phl p 1, enhances the transportation velocity of particles by the trachea, presumably by ATP released from the injured epithelium.

CONCLUSION

We conclude that under physiological conditions Phl p 1 affects tracheal epithelial cells through a non-proteolytic activity. Enhancement of TGF-beta expression induced by Phl p 1 together with the increased release of IL-6 and IL-8 might provide an indirect mechanism through which the allergen may cross the epithelial barrier and attracts immunocompetent cells.

Interleukin-10 and interferon-gamma gene polymorphisms in patients with nasopharyngeal carcinoma

Nasopharyngeal carcinoma (NPC) is a multifactorial disease. Cytokines driving the immune response seem to be disturbed in NPC patients. Since interleukin-10 (IL-10) is known to reduce the production of interferon-gamma (IFN-gamma), we supposed that genetic differences in IL-10 and IFN-gamma expression could be a mechanism by which NPC cells escape antitumour immune response. As the production of each cytokine is affected by the genetic background, we investigated the possible association between single nucleotide polymorphisms in genes of IL-10 and IFN-gamma with NPC. Different IL-10 -1082 G/A and IFN-gamma+874 Tau/Alpha genotypes were determined in 160 patients with nasopharyngeal carcinoma and 197 healthy controls. No association was found either for each SNP studied alone or for the combined analysis for both IL-10 and IFN-gamma polymorphisms among NPC patients in comparison with controls. Compared with individuals from high incidence countries, we noted huge significant differences in genotype distribution between individuals from low and intermediate NPC incidence countries. Polymorphisms of the IL-10 and IFN-gamma do not appear to be associated with NPC risk in the Tunisian population. Nevertheless, we strongly believe that the relationship between cytokines polymorphisms and NPC susceptibility deeply depends on the ethnicity.

[Struma ovarii. Three malignant cases and one benign case]

Four cases of struma ovarii were seen among 308 ovarian tumors removed surgically at the Salah Azaiz Institute, Tunis, Tunisia, between 1980 and 1989. This yields an occurrence rate of 1.3%, which is comparable to previously publishes rates (0.3% to 2%). One of the four tumors was malignant. Malignant transformation of struma ovarii is very rare (5% to 10%). The histologic diagnosis of malignancy is difficult, particularly in well-differentiated follicular forms. The prognosis is relatively favorable even in patients with metastases. Based on their personal experience and on a review of the literature, the authors discuss the diagnosis, management, and outcome of struma ovarii, in particular with malignant transformation.

[Breast angiosarcoma. Five case reports]

The authors report 5 cases of breast angiosarcoma collected in the Salah Azaiz Institute of Tunis, the only oncology center in this country, between 1969 and 1990. They enumerated 4,000 malignant breast tumors during this period; i.e. an incidence of 1.25%, higher than that in the world literature (0.4%). The mean age of patients was 44. Three were post-menopausal, and two were of childbearing age, one of whom was pregnant. This rare tumor is virtually limited to women. Affection is scarce, it affect's almost exclusively women. It generally present as a painless, ill-defined mass, without regional lymphadenopathy. The diagnosis of angiosarcoma is difficult since the histologic appearance is sometimes identical to that of a hemangioma. Hence the value of very thorough histologic examination of the entire operative specimen. Treatment is based upon mastectomy. The usefulness of adjuvant chemotherapy and/or radiotherapy is uncertain. The prognosis remains gloomy despite early diagnosis and treatment. The authors attempt in this study to identify the various features of this serious and uncommon condition, based upon the rare published cases in the world literature.

Iatrogenic arteriovenous fistula: a complication of percutaneous subclavian vein puncture

A case of iatrogenic subclavian arteriovenous fistula is reported. An intracath had been inserted percutaneously into the left subclavian vein to monitor the central venous pressure during aortic valve surgery. On the second postoperative day a thrill and continuous murmur were detected at the left subclavian region. Left subclavian arteriogram and catheterization studies confirmed the diagnosis of subclavian arteriovenous fistula. The lesion was treated surgically with satisfactory results.