Motivation for giving birth after breast cancer.

Background: Breast cancer at a young age threatens the natural developmental tasks that characterize this phase in life including parenthood. The dilemma of whether to give birth arises due to the potential medical, psychological and social implications of pregnancy, birth and child rearing after breast cancer. The purpose of this study was to investigate the positive and negative motivations toward childbirth of breast cancer survivors and their husbands.

The association of chronic atrial fibrillation with right atrial dilatation and left ventricular dysfunction in the elderly.

Background: Left atrial dilatation is often considered as one of the important causes for atrial fibrillation. In this study we sought to examine the relationship between right atrial dilatation and left ventricular function in patients with atrial fibrillation, and the association with the documented duration of the dysrrhythmia.

Material/methods: 56 consecutive patients with atrial fibrillation were investigated by means of clinical history, electrocardiography and echocardiography.

Neural tube defects.

Defects of development of the neural tube can result in a number of seemingly different malformations. Understanding the abnormal embryology helps one understand the malformations and their surgical treatments. The clinical presentations and the follow-up of these patients require attention to various end organs besides the nervous system.

Multicenter evaluation of a new, automated enzyme-linked immunoassay for detection of human immunodeficiency virus-specific antibodies and antigen.

A collaborative multicenter study was conducted to evaluate the sensitivity, specificity, and precision of a three-step, fully automated, qualitative microparticle-based enzyme-linked immunoassay (AxSYM HIV Ag/Ab Combo; Abbott Laboratories), designed to simultaneously detect (i). antibodies against human immunodeficiency virus type 1 (HIV-1) and/or type 2 (HIV-2) and (ii). HIV p24 antigen.

[Congenital cervical spondylolisthesis].

Cervical spondylolysis with spondylolisthesis is a complex abnormality involving the posterior elements of the cervical vertebra, and anterolisthesis of the same vertebra. Cervical spondylolysis is defined as a corticated cleft between the superior and inferior articular facets of the articular "pillar", the cervical equivalent of the pars intraarticularis in the lumbar spine. The typical radiological features of this condition are as follows: 1.

A function for the mitochondrial chaperonin Hsp60 in the structure and transmission of mitochondrial DNA nucleoids in Saccharomyces cerevisiae.

The yeast mitochondrial chaperonin Hsp60 has previously been implicated in mitochondrial DNA (mtDNA) transactions: it is found in mtDNA nucleoids associated with single-stranded DNA; it binds preferentially to the template strand of active mtDNA ori sequences in vitro; and wild-type (rho+) mtDNA is unstable in hsp60 temperature-sensitive (ts) mutants grown at the permissive temperature. Here we show that the mtDNA instability is caused by a defect in mtDNA transmission to daughter cells. Using high resolution, fluorescence deconvolution microscopy, we observe a striking alteration in the morphology of mtDNA nucleoids in rho+ cells of an hsp60-ts mutant that suggests a defect in nucleoid division.

Vibrio vulnificus infection of the lower limb after fish spine injuries.

Five patients with soft tissue infection of the lower extremity caused by Vibrio vulnificus after penetrating injuries by fish spines are described. Despite previously reported dismal rates of morbidity and mortality associated with Vibrio septicemia, early measures including wide-spectrum intravenous antibiotics and surgical excision of devitalized tissues resulted in complete resolution in all cases. Although penetrating injury is the common route of infection, indirect seeding may occur by the contamination of open wounds or injury to a limb previously submerged in contaminated water.

Delayed breast cellulitis following breast conserving operation.

A complication of breast conservation, which has been increasingly reported in the literature, is 'delayed cellulitis' in the treated breast. This is to be distinguished from wound infection in the breast following lumpectomy. This study reports 16 cases diagnosed with delayed cellulitis following breast conserving surgery, unresponsive to antibiotic therapy.

[Hormone replacement therapy in breast cancer survivors: the Israeli Society for Clinical Oncology and Radiotherapy policy letter].

The Israeli Society for Clinical Oncology and Radiotherapy requested that experts in breast cancer therapy assess the Society's policy regarding the use of hormone replacement therapy (HRT) in breast cancer survivors. The following recommendations are based on updated literature, which is limited since it summarizes only retrospective data. There is currently no evidence of an increased risk of breast cancer recurrence, death attributable to cancer, or overall mortality among breast cancer survivors who use HRT.

Mycoplasma hominis and Ureaplasma species brain abscess in a neonate.

We report an infant with a mixed Mycoplasma and Ureaplasma brain abscess who was successfully treated with intravenous doxycycline and erythromycin. Therapeutic concentrations of doxycycline were demonstrated in cerebrospinal fluid. This report is evidence of the potential for Mycoplasma and Ureaplasma to produce focal central nervous system infection, as well as meningitis, in neonates and that use of doxycycline can be efficacious in the therapy of such infections.

Outcome analysis of initial neonatal shunts: does the valve make a difference?

Objective: Ventriculoperitoneal shunts have one of the highest complication rates of all neurosurgical procedures. The purpose of this study was to identify factors associated with malfunction of shunts placed in infants with neonatal hydrocephalus, with the goal of maximizing long-term shunt survival.

Methods: We performed a retrospective chart review of 200 consecutive patients less than 1 year old who underwent primary intracranial shunt placement for hydrocephalus by one of two experienced pediatric neurosurgeons at a single institution.

Bone density and amenorrhea in ballet dancers are related to a decreased resting metabolic rate and lower leptin levels.

Osteopenia, which is correlated with amenorrhea and poor nutritional habits, has been well documented in elite ballet dancers. Estrogen replacement therapy and recovery from amenorrhea have not been associated with normalization of bone density. Thus, the osteopenia may be related to changes brought about by chronic dieting or other factors, such as a hypometabolic state induced by poor nutrition.

Male breast carcinoma in Israel: higher incident but possibly prognosis in Ashkenazi Jews.

Background: Little information is available regarding male breast carcinoma. However, cumulative data have suggested a propensity for the disease among Ashkenazi Jews. Because Ashkenazi Jews comprise one of the major ethnic groups in Israel, the authors conducted a local study to shed more light on the features of this rare disease.

Cleland's ligaments: an anatomic study.

The anatomy and function of Cleland's ligaments--thought by the authors to require clarification because of the conflicting anatomic descriptions in the literature--are reviewed. A statistical representation of the structure of these ligamentous bundles was derived from the study of 16 fixed human cadaveric digits and five fresh cadaveric digits, all from different patients. The results demonstrate a large variation in anatomy.

Purification and characterization of a human pancreatic adenocarcinoma mucin.

Pancreatic mucins consist of core proteins that are decorated with carbohydrate structures. Previous studies have identified at least two physically distinct populations of mucins produced by a pancreatic adenocarcinoma cell line (HPAF); one is the MUC1 core protein, which includes an oligosaccharide structure identified by a monoclonal antibody (MAb) recognizing the DU-PAN-2 epitope. In this study, we purified and characterized a second mucin fraction, which also shows reactivity with the DU-PAN-2 antibody, but which has an amino acid composition that is not consistent with the MUC1 core protein.

Chest radiograph interpretation skills of anesthesiologists.

Objective: To assess the skills of anesthesiologists in the interpretation of chest radiographs.

Design: Randomized evaluation conducted among anesthesiologists and radiologists.

Setting: Postgraduate Assembly of the New York State Society of Anesthesiologists in 1999, and the Department of Radiology, New York University Medical Center.

An unusual cystic appearance of disseminated low-grade gliomas.

We report five cases of pediatric disseminated low-grade gliomas of the brainstem or spinal cord that exhibited an unusual, cystic pattern. Leptomeningeal disease was present in three of these at diagnosis, and was detected shortly afterwards in the other two. Four patients are alive up to 5 years later, following minimal to no intervention, while one is dead.

Evaluating pediatric brain tumor cellularity with diffusion-tensor imaging.

Objective: MR imaging of central nervous system (CNS) malignancies falls short of a definitive evaluation. Tissue diagnosis remains the gold standard. Diffusion-tensor MR imaging measures the apparent diffusion coefficient and diffusion anisotropy of water in tissue.

Prospective study of recovery following neonatal brachial plexus injury.

The prognosis for recovery from brachial plexus injury sustained at or before birth is generally favorable. However, roughly 10% of these infants remain profoundly weak and later exhibit functional disability in the affected arm. Early identification of these at-risk infants would be helpful in selecting patients for surgical management.

Large cell/anaplastic medulloblastomas and medullomyoblastomas: clinicopathological and genetic features.

Object: Medulloblastoma is the most common malignant central nervous system neoplasm found in children. A distinct variant designated large cell/anaplastic (LC/A) medulloblastoma is characterized by frequent dissemination of cerebrospinal fluid (CSF) at presentation and a more aggressive clinical course. The authors report on their examination of the clinicopathological and genetic features of seven such cases encountered at their institution.