Thyroid hemiagenesis associated with multinodular goiter and Hashimoto's thyroiditis.

Thyroid hemiagenesis is a rare congenital abnormality in which one of the thyroid lobes is not developed. It can be associated with various thyroid diseases, such as Grave's disease, nodular goiter and thyroid neoplasm, rarely with hyperparathyroidism. We report a case of a 50-year old woman with left thyroid lobe agenesis diagnosed by ultrasonography and scintigraphy. Right thyroidectomy was performed and the histopathological examination showed diffuse hyperplasia, multinodular goiter and Hashimoto's thyroiditis. To our knowledge, this is the first description of multinodular goiter and Hashimoto's thyroiditis in a patient with thyroid hemiagenesis.

Pattern recognition. Classification of therapeutic agents according to pharmacophores.

One of the preprocessing methods used in pattern recognition-factor analysis-is shown to be well suited to the derivation of structure-activity relationships. Applications of the procedure developed are illustrated using sets of compounds which are of accepted therapeutic utility.

Molecular topology and aqueous solubility of aliphatic alcohols.

A physically based method for arriving at topological indexes is described. The derived indexes correlate with molecular surface areas and with the molecular connectivity index. The newly derived index seems to account better for the expected distinctions among primary, secondary, and tertiary alcohol aqueous solubilities. This study suggests that the Del Re method for calculating molecular charges and dipole moments also may be used, without appreciable change, to provide estimates of molecular refraction.

Pattern recognition II: Investigation of structure--activity relationships.

A simple form of pattern recognition is successfully used to classify a set of structurally diverse therapeutic agents. By using only organic structural information, the major pharmacological classes present were correctly identified and the pharmacologically unrelated compounds were separated out. One technique of factor analysis--principal component analysis--is shown to be readily adaptable in preprocessing the data. Simple graphical representation of the results enables their direct interpretation.

Pharmacokinetic model for a primary antibody response.

Antigen distribution and clearance studied in vivo may be viewed as a pharmacokinetic problem complicated by the intervention of the immune response. A model characterizing the clearance of the simple antigen phiX174 from the bloodstream of various experimental animals, as well as the subsequent serum antibody response, was developed. The present model is the simplest of the possible models and no doubt will have to be modified when considering more complex antigens, additional distribution modes, and differences in antibody reactivity. For the primary (IgM) immune response, however, early events in the immunological response can be adequately accounted for in a consistent and quantitative manner.

The surgeon's decision as a prognostic factor in a pool of patients with colorectal cancer coming from different institutions.

Different pathological and predictive factors are used to stratify patients submitted to radical surgery for colorectal carcinoma. In addition to stage and histotype, the surgeon's technique and decisions also appeared to affect the prognosis. The aim of the present study was to evaluate if the extent of lymphadenectomy was associated with a different long-term outcome in a pool of 117 patients. In particular, in patients classified as Dukes' B, some evidences seem to suggest that the staging procedure depends on a correct surgical lymphadenectomy with a higher risk of understaging colorectal carcinomas when the number of removed nodes is limited. Moreover, the promptness in forwarding patients to the chemotherapist seems to influence the disease-free survival.

Haemorheological profile in subjects with nonvalvular atrial fibrillation.

In a group of subjects (n = 35) with nonvalvular atrial fibrillation (AF) subdivided according to the presence (n = 16) or absence (n = 19) of left atrial spontaneous echocontrast (SEC), demonstrated using transthoracic and transesophageal echocardiography, we evaluated the principal haemorheological determinants: whole-blood viscosity, plasma and serum viscosity, haematocrit, whole-blood filtration (VBC) and mean erythrocyte aggregation (MEA). From the obtained data it was evident that in subjects with nonvalvular AF there was an impairment of the haemorheological profile that seemed more evident in AF subjects with SEC, although no significant haemorheological difference was present between AF subjects with and without SEC. These findings need to be underlined considering that this clinical condition is associated to a major thromboembolic risk.

Breast biopsy and guidance for occult lesions.

Biopsy and histological examination is the only way of determining with absolute accuracy whether a lesion is benign or malignant, as well as its exact nature and whether it shows any evidence of precancerous changes. Occult malignant lesions, not clinically detectable, may be found by the study of surrounding tissue in the course of the excision of a benign lesion. However, they are most often found by breast x-rays (mammography or xerography) which are done for: the survey of high-risk asymptomatic women; contralateral breast studies; symptomatic breasts without palpable findings; nipple discharge; large pendulous breasts; and multinodular breasts. Biopsies for occult lesions, based on radiographic findings, are recommended for: suspicious calcifications; stellate-shaped masses; breast masses with ill-defined borders or nodular contours; dominant masses; and areas of increased density or distorted breast architecture. In general, biopsy for these lesions is best done under general anesthesia, as an in-patient and as a two-step type of procedure, i.e., the biopsy should be studied by permanent histologic sections before making a final diagnosis. Preoperative localization can be done by measurements, markers, radio-opaque dye injections or by needle localization which we feel is the preferred technique because it is simple and accurate and allows for removal of only a small amount of tissue with better cosmetic results. The advantages and disadvantages of various types of needle localization are discussed and figures are given for 387 needle localizations in which 148 cancers were found (38.2%). Of these cancers, 54.1% were invasive and 45.9% were noninvasive.(ABSTRACT TRUNCATED AT 250 WORDS)

Breast cancer statistics: use and misuse.

Statistics can be manipulated, by using various methods of reporting, to support almost any type of regime in breast cancer. The basis for statistical calculations include: the definition of the population of patients treated, the time used for starting calculations, the exact nature of the treatment used and any adjuvant therapy, the prognostic parameters utilized, the importance of long-term follow-ups, adequate number of cases, therapy standardization and pathological reporting, methods of evaluating survival such as observed or crude, relative and no evidence of disease, methods of calculating observed survival rates such as absolute, actuarial or life-table and Kaplan Meier or product limit, statistical evaluation for planned improvement with acceptable Type I and Type II errors, and the use of arithmetic and logarithmic scales in plotting statistics. Purveyors of innovative methods for the treatment of breast cancer aimed at preserving part or all of the breast as cosmetic alternatives to mastectomy, by limited operations with and without primary radiotherapy, have a most appealing argument to a woman with breast cancer. To determine if such procedures are justifiable alternatives to selective mastectomies and reconstructions, detailed, long-term statistical data on large numbers of cases must be available and end-results comparisons of various therapeutic modalities must be made on the basis of comparable statistical data.

Phenotypic features and secretory pattern of alveolar macrophages in atopic asthmatic patients.

The aim of this study was to evaluate by cytofluorimetry, the phenotype and the activation of alveolar macrophages (CD14; CD33; CD44; CD54; CD23; HLA-DR) and, by radioimmunoassay, the "in vivo and in vitro" macrophage secretory pattern (IL-1 alpha; IL-1 beta; IL6; IL8; PGE2; PGD-1 alpha; TXB2; LTB4) in atopic patients with mild asthma in intercritical phase and with bronchial hyperreactivity (PD20 FEV1 = 377 +/- 262.8 micrograms). In asthmatic patients we have demonstrated that the number of cells recovered in BALF expressing the phenotypic features (CD14; CD33; HLA-DR; CD23; CD44; CD54) was larger than in control subjects. By analysing the culture medium of unstimulated and LPS-stimulated alveolar macrophages from asthmatic and normals we have demonstrated a greater production of IL-1 beta (p = 0.005) and IL-8 (p = 0.005) in the first group than in one second, as confirmed by a Wilcoxon test. Concerning the secretory pattern in BALF of asthmatic patients we obtained similar results, showing a significant IL-1 beta (p = 0.005) and IL-8 (p = 0.002) increase suggesting a persistent cellular activation. On the contrary we could not show any significant increase of IL-1 alpha (p = 0.31) and IL-6 (p = 0.22). The cellular activation was confirmed by increased levels of different chemical mediators such as TXB2 (p = 0.005); LTB4 (p = 0.004); PGE2 (p = 0.007); PGF-1 alpha (p = 0.008) which were recovered from BALF of asthmatic patients compared to normal subjects. In conclusion alveolar macrophages play an important role in the pathogenesis of asthma because of the presence of cytokines and mediators in BALF and in the supernatant of alveolar macrophage cultures.