Physician's initial impression of elderly breast cancer patients allows appropriate treatment stratification despite lack of quantitative assessment.

The management of older women with breast cancer is often suboptimal based on perceived patient comorbidities. The aim of this study was to evaluate the choice of treatment modality based on clinicians 'gut-feeling' compared to comorbidity scoring indices. A retrospective review of women over 70 presenting with breast cancer was performed. Presenting comorbidities (Charlson Comorbidity Index and Cumulative Illness Rating Scale) and the treatment received was documented. Sixty-six patients were identified. Forty-six had surgery while twenty patients had primary endocrine manipulation. The mean age of patients having surgery was 76.4 in comparison to 84.4 for the endocrine group (p = 0.001). The CCI scores for the surgical group and endocrine group were 6.62 and 9.26 respectively (p = 0.001). The scores for the CIRS were 8.93 and 22.68 (p = 0.001). This study has demonstrated that physician's "gut feelings' are often correct in identifying patients who may benefit from primary hormone therapy.

The application of crystal soaking technique to study the effect of zinc and cresol on insulinotropin crystals grown from a saline solution.

PURPOSE: The purpose of this study is to investigate the effect of zinc and cresol on the structure of insulinotropin crystals. METHODS: Insulinotropin crystals grown from a saline solution were treated with zinc and/or m-cresol using a crystal soaking technique. The effects of these additives on the crystal structure were investigated with powder X-ray diffraction, photomicrography, and differential scanning calorimetry. The molecular interaction between insulinotropin and m-trifluorocresol in solution was also studied by 19F NMR: RESULTS: The data suggest that the original crystals grown from a saline solution have relatively weak lattice forces. After the addition of m-cresol to the suspension of the insulinotropin crystals, the crystals were immediately rendered amorphous. The m-cresol molecules which diffused into the crystals through solvent channels may have disturbed the lattice interactions that maintain the integrity of the crystal. In contrast, the zinc added to the suspension stabilized the crystal lattice so that the subsequent addition of m-cresol did not alter the integrity of the crystals. A marked increase in melting point (206 degrees versus 184 degrees) and heat of fusion (24.6 J/g versus 1.4 J/g) of the crystals was observed after the treatment with zinc. The solubility of the zinc treated crystals in a pH 7.1 phosphate buffered saline was 1/20 of that of the original crystals. CONCLUSION: When the insulinotropin crystals were treated with the additives using a crystal soaking method, the crystals underwent structural changes. Zinc stabilized the crystal lattice, and reduced the solubility of the peptide.

Determination of delta 9-tetrahydrocannabinol in plasma using solid-phase extraction and high-performance liquid chromatography with electrochemical detection.

A method for the determination of nanogram amounts of delta 9-tetrahydrocannabinol (THC) in plasma and serum is described. THC was quantitatively isolated by solid-phase extraction after addition of an aqueous solution of urea and methanol to the sample. The extracts were analysed by high-performance liquid chromatography with electrochemical detection in the oxidizing mode. The detection limit of THC is ca. 100 pg for a signal-to-noise ratio of 3. With this method, levels of 2 ng/ml of THC in plasma can be measured.