Determinants of outcome in elderly patients with positive sentinel lymph nodes.

Background: Older women are less likely to receive standard of care treatment for breast cancer.

Methods: We examined variables that affected the outcome of elderly patients ≥70 years old among 1,470 patients with invasive cancer with positive sentinel lymph nodes (SLNs).

Results: Elderly patients were less likely to undergo mastectomy, completion axillary node dissection (ALND), adjuvant chemotherapy, and radiotherapy (RT) following breast-conserving therapy (BCT) compared with patients <70 years old.

Cisplatin and PI3kinase inhibition decrease invasion and migration of human ovarian carcinoma cells and regulate matrix-metalloproteinase expression.

Targeting of the PI3K (phosphoinositide3-kinase)/Akt/mTOR pathway in human ovarian cancer cells is a promising novel therapeutic strategy. We investigated the effects of cisplatin and the PI3K inhibitor LY294002 on invasion, migration and the expression of essential matrix metalloproteinases (MMPs) in ovarian cancer cells. SKOV3, OVCAR5 and IGROV1 human ovarian cancer cell lines were treated with cisplatin, LY294002 and a combination of both drugs.

Polyglutamine toxicity induces rod photoreceptor division, morphological transformation or death in spinocerebellar ataxia 7 mouse retina.

In neurodegenerative disorders caused by polyglutamine (polyQ) expansion, polyQ toxicity is thought to trigger a linear cascade of successive degenerative events leading to neuronal death. To understand how neurons cope with polyQ toxicity, we studied a Spinocerebellar ataxia 7 (SCA7) mouse which expresses polyQ-expanded ATXN7 only in rod photoreceptors. We show that in response to polyQ toxicity, SCA7 rods go through a range of radically different cell fates, including apoptotic and non-apoptotic cell death, cell migration, morphological transformation into a round cell or, most remarkably, cell division.

Curved stylet core biopsy results in larger cores.

Objective: The purpose of this study was to compare the size of biopsy cores obtained using a biopsy needle before and after manual curving of its inner stylet.

Materials And Methods: A total of 40 open renal biopsies were randomly performed on two ex vivo beef kidneys using four different semiautomated cutting needles. Two 18-gauge and two 20-gauge needles were used; one needle of each gauge had its inner stylet manually curved.

Including information about co-morbidity in estimates of disease burden: results from the World Health Organization World Mental Health Surveys.

Background: The methodology commonly used to estimate disease burden, featuring ratings of severity of individual conditions, has been criticized for ignoring co-morbidity. A methodology that addresses this problem is proposed and illustrated here with data from the World Health Organization World Mental Health Surveys. Although the analysis is based on self-reports about one's own conditions in a community survey, the logic applies equally well to analysis of hypothetical vignettes describing co-morbid condition profiles.

Management of the aging upper eyelid in the asian patient.

Successful management of the aging upper eyelid region in the Asian patient requires a unique skill set and clinical experience. The surgeon must exhibit a thorough understanding of the unique anatomy of the Asian eyelid and its variations and of the cultural expectations of the patient and must possess a unique set of surgical skills such as de novo creation of the supratarsal crease as well as complementary procedures such as fat transfer used for volume augmentation of the periorbital region. The modern approach outlined here summarizes the key elements necessary to restore the youthful appearance of the upper eyelid region in a natural and ethnically consistent fashion.

Pathogen host switching in commercial trade with management recommendations.

Global wildlife trade exacerbates the spread of nonindigenous species. Pathogens also move with hosts through trade and often are released into naïve populations with unpredictable outcomes. Amphibians are moved commercially for pets, food, bait, and biomedicine, and are an excellent model for studying how wildlife trade relates to pathogen pollution.

Ovarian cancer: the duplicity of CA125 measurement.

Since it was first described in 1981, CA125 has held an important role in monitoring patients with ovarian cancer. CA125 is elevated in 80% of patients with epithelial ovarian cancer at initial diagnosis and correlates well with response to therapy. CA125 monitoring is used for the follow up of patients with epithelial ovarian cancer, and elevations in CA125 measurements often antedate any signs, symptoms or radiographic evidence of disease by several months.

Vascular endothelial growth factor and its relationship to the prognosis and treatment of breast, ovarian, and cervical cancer.

Tumor neovascularization is a complex process that plays a crucial role in the development of many different types of cancer. Vascular endothelial growth factor (VEGF) is a potent mitogen that is involved with mitogenesis, angiogenesis, endothelial survival, and the induction of hematopoiesis. By increasing vascular permeability in endothelial cells, it helps tumors recruit wound-healing proteins fibrin and fibrinogen from the plasma, suggesting that tumor formation is a process of abnormal wound healing dependent on the ability to generate a blood supply.

Chemical peels for darker skin types.

This article focuses on chemical peels for darker skin types. All races comprise a range of Fitzpatrick skin color types: light skin types in African Americans, Asians, Middle Easterners, and Latinos and dark skin types in whites. With the focus on Fitzgerald skin types IV to VI, this article discusses chemical peels, providing current information on types of peels, detailed techniques, preoperative and postoperative care, complications, hazards, and nuances of management.

Supratarsal crease creation in the Asian upper eyelid.

Supratarsal crease fixation in the Asian patient can provide a more open-eyed, awake look without compromising their ethnic appearance. A conservative supratarsal crease height and conservative to no removal of postseptal fat help to ensure this natural-appearing result. With the full-incision method, consistently excellent results have been achieved with durable crease fixation despite a prolonged recovery time.

Evaluating the drug use "gateway" theory using cross-national data: consistency and associations of the order of initiation of drug use among participants in the WHO World Mental Health Surveys.

Background: It is unclear whether the normative sequence of drug use initiation, beginning with tobacco and alcohol, progressing to cannabis and then other illicit drugs, is due to causal effects of specific earlier drug use promoting progression, or to influences of other variables such as drug availability and attitudes. One way to investigate this is to see whether risk of later drug use in the sequence, conditional on use of drugs earlier in the sequence, changes according to time-space variation in use prevalence. We compared patterns and order of initiation of alcohol, tobacco, cannabis, and other illicit drug use across 17 countries with a wide range of drug use prevalence.

Extramedullary duodenal plasmacytoma presenting with gastric outlet obstruction and painless jaundice.

Malignant plasma cells in multiple myeloma are predominantly confined to the medullary space of the skeletal system, therefore the disease course will be dominated by signs and symptoms related to bone marrow infiltration and destructive bone lesions with their consequences as well as abnormal protein production. Visceral extramedullary plasmacytoma involving the gastrointestinal system and particularly the duodenum is a rare manifestation of the disease. We report a case of duodenal extramedullary plasmacytoma presenting with gastric outlet obstruction and painless jaundice, in a patient treated for multiple myeloma.

Osteoblastoma of the frontal sinuses presenting with headache and blurred vision: case report and review of the literature.

Osteoblastoma is a rare benign bone tumor that usually arises in the vertebral column and long bones of young adults. Craniofacial involvement is extremely rare. To date, osteoblastoma of the frontal sinus has not been reported in the English literature.

Percutaneous transrenal retrieval of fractured nephrostomy tube under fluoroscopic guidance.

Percutaneous nephrostomy is a safe procedure, performed routinely by interventional radiologists, and has a low complication rate. We report an unusual case of a fractured nephrostomy tube, retained within the kidney, having its fractured end trapped within the healed retroperitoneal tract. The catheter was retrieved by snaring it, using a percutaneous access to the collecting system.

Giant urethral stone presenting as a scrotal mass: Case report.

Primary urethral stones are a rare form of urolithiasis accounting for less than 0.3% of urinary stones. We are reporting a case of a giant primary urethral stone that developed in the penile urethra resulting from a post-surgical complication of urethral stricture.

Age differences in the prevalence and co-morbidity of DSM-IV major depressive episodes: results from the WHO World Mental Health Survey Initiative.

Background: Although depression appears to decrease in late life, this could be due to misattribution of depressive symptoms to physical disorders that increase in late life.

Methods: We investigated this issue by studying age differences in co-morbidity of DSM-IV major depressive episodes (MDE) with chronic physical conditions in the WHO World Mental Health (WMH) surveys, a series of community epidemiological surveys of respondents in 10 developed countries (n=52,485) and 8 developing countries (n=37,265). MDE and other mental disorders were assessed with the Composite International Diagnostic Interview (CIDI).

Predictors of completion axillary lymph node dissection in patients with immunohistochemical metastases to the sentinel lymph node in breast cancer.

Background: Axillary lymph node dissection (ALND) in patients with immunohistochemistry (IHC)-determined metastases to the sentinel lymph node (SLN) is controversial. The goal of this study was to examine factors associated with ALND in IHC-only patients.

Methods: Retrospective review of an institutional SLN database from July 1997 to July 2003 was performed.

Gender and the relationship between marital status and first onset of mood, anxiety and substance use disorders.

Background: Prior research on whether marriage is equally beneficial to the mental health of men and women is inconsistent due to methodological variation. This study addresses some prior methodological limitations and investigates gender differences in the association of first marriage and being previously married, with subsequent first onset of a range of mental disorders.

Method: Cross-sectional household surveys in 15 countries from the WHO World Mental Health survey initiative (n=34493), with structured diagnostic assessment of mental disorders using the Composite International Diagnostic Interview 3.

Sulfonic acid functionalized crystal-like mesoporous benzene-silica as a remarkable water-tolerant catalyst.

Here we report that sulfonated crystal-like benzene-silica is much more robust and active than conventionally used periodic mesoporous silica for catalyzing aqueous organic reactions.

Short-scar purse-string facelift.

Despite the variety of novel facial rejuvenation technologies available today, the reference standard for correction of the senescent jaw line and neck remains rhytidectomy. This article describes the purse-string facelift, a vertical facelift that moves away from traditional techniques that use a horizontal vector of subcutaneous muscle-aponeurotic system repositioning. The vertical facelift can counterbalance the effects of gravity and natural facial aging and can reposition the facial soft tissues into a more youthful position more directly and correctly.

Imaging of gastrointestinal stromal tumors before and after imatinib mesylate therapy.

Gastrointestinal stromal tumors (GISTs) account for the majority of gastrointestinal mesenchymal tumors. Recent advances in treatment using the molecular targeting agent imatinib mesylate have shown startling response rates and variegated imaging findings. We present the various imaging appearances of GIST on computed tomography (CT) and magnetic resonance imaging (MRI), both before and after treatment.

DSM-IV personality disorders in the WHO World Mental Health Surveys.

Background: Little is known about the cross-national population prevalence or correlates of personality disorders.

Aims: To estimate prevalence and correlates of DSM-IV personality disorder clusters in the World Health Organization World Mental Health (WMH) Surveys.

Method: International Personality Disorder Examination (IPDE) screening questions in 13 countries (n = 21 162) were calibrated to masked IPDE clinical diagnoses.

Extreme drug resistance assay results do not influence survival in women with epithelial ovarian cancer.

Objectives: Extreme drug resistance (EDR) assays have been used to identify chemotherapy regimens that are least likely to be of clinical benefit in the treatment of epithelial ovarian cancer (EOC). We sought to examine the impact of EDR assay-guided therapy on the outcome of patients with EOC in the primary and recurrent settings.

Methods: We conducted a retrospective review of demographic, pathologic, EDR assay and clinical outcome data from 377 patients with EOC who had an assay sent at the time of their primary or subsequent cytoreductive surgeries.