Breast imaging findings in haematological malignancies.

OBJECTIVES: The objectives of this article are to review and illustrate the imaging appearances of haematological malignancies in the breast. METHODS: With Institutional Review Board approval, a search of the surgical pathology records from 1st January 2000 to 1st July 2012 was performed for haematological malignancies. RESULTS: Forty-eight cases of haematological malignancies (42 women and 6 men) were identified with imaging available for review: 39 cases of breast lymphoma, 6 cases of chronic lymphocytic leukaemia, 2 cases of acute leukaemia and 1 case of known multiple myeloma. CONCLUSIONS: Breast manifestations of haematological malignancies are rare. They can have a variable appearance at imaging and can mimic primary breast carcinoma. In the setting of suspicious breast imaging findings, pathological diagnosis of haematological malignancy is concordant. Correlation with a clinical history of prior haematological malignancy can be helpful in suggesting the diagnosis and help prevent unnecessary surgical treatment. TEACHING POINTS: • Breast haematological malignancies are rare but the imaging appearances can mimic breast carcinoma. • Breast lymphoma, most often B-cell non-Hodgkin lymphoma, may be primary or due to secondary disease. • At ultrasound, haematological malignancies may present as a heterogeneous or predominantly echogenic mass. • Haematological malignancies show intense activity on PET/CT except myeloma which has low FDG uptake.

Deficiencies of human complement component C4A and C4B and heterozygosity in length variants of RP-C4-CYP21-TNX (RCCX) modules in caucasians. The load of RCCX genetic diversity on major histocompatibility complex-associated disease.

The complement component C4 genes located in the major histocompatibility complex (MHC) class III region exhibit an unusually complex pattern of variations in gene number, gene size, and nucleotide polymorphism. Duplication or deletion of a C4 gene always concurs with its neighboring genes serine/threonine nuclear protein kinase RP, steroid 21-hydroxylase (CYP21), and tenascin (TNX), which together form a genetic unit termed the RCCX module. A detailed molecular genetic analysis of C4A and C4B and RCCX modular arrangements was correlated with immunochemical studies of C4A and C4B protein polymorphism in 150 normal Caucasians. The results show that bimodular RCCX has a frequency of 69%, whereas monomodular and trimodular RCCX structures account for 17.0 and 14.0%, respectively. Three quarters of C4 genes harbor the endogenous retrovirus HERV-K(C4). Partial deficiencies of C4A and C4B, primarily due to gene deletions and homoexpression of C4A proteins, have a combined frequency of 31.6%. This is probably the most common variation of gene dosage and gene size in human genomes. The seven RCCX physical variants create a great repertoire of haplotypes and diploid combinations, and a heterozygosity frequency of 69.4%. This phenomenon promotes the exchange of genetic information among RCCX constituents that is important in homogenizing the structural and functional diversities of C4A and C4B proteins. However, such length variants may cause unequal, interchromosomal crossovers leading to MHC-associated diseases. An analyses of the RCCX structures in 22 salt-losing, congenital adrenal hyperplasia patients revealed a significant increase in the monomodular structure with a long C4 gene linked to the pseudogene CYP21A, and bimodular structures with two CYP21A, which are likely generated by recombinations between heterozygous RCCX length variants.

Reflection: an alternative to nursing models.

The value of models is currently being challenged by some health-care practitioners. Alternative theoretical underpinnings are required on which to base nursing care. Informal processes which support learning from experience should be formalized to advance nursing practice.

Embryonic stem cell-derived glial precursors: a source of myelinating transplants.

Self-renewing, totipotent embryonic stem (ES) cells may provide a virtually unlimited donor source for transplantation. A protocol that permits the in vitro generation of precursors for oligodendrocytes and astrocytes from ES cells was devised. Transplantation in a rat model of a human myelin disease shows that these ES cell-derived precursors interact with host neurons and efficiently myelinate axons in brain and spinal cord. Thus, ES cells can serve as a valuable source of cell type-specific somatic precursors for neural transplantation.

Well-designed and well-administered executive incentive plans do work.

Executive incentive plans in the health-care industry, virtually unheard of a decade ago, are becoming a critical part of the overall integrated management system. These plans are necessary today to drive improved performance and overall success in the increasingly difficult health-care environment. This article describes (1) incentive growth, (2) the components of a successful executive incentive program, (3) how an incentive program drives business strategies, performance, and philosophy, and (4) the overall benefits of a well-designed and well-administered program.

Human resources and trends.

I appreciate the opportunity of addressing you on human resource management, some of the issues and some of the trends that face each of us in our roles as managers. Certainly when it comes to managing others regardless of the country, our objectives are virtually the same. All of us want productive work for the payroll dollar we are spending. We want high quality and we want to train and develop employees to the extent necessary in order for our health care organisation to be successful.

Predictive validities of several clinical color vision tests for aviation signal light gun performance.

Scores on the American Optical Company (AOC) test (1965 edition), Dvorine test, Farnsworth Lantern test, Color Threshold Tester, Farnsworth-Munsell 100-Hue test, Farnsworth Panel D-15 test, and Schmidt-Haensch Anomaloscope were obtained from 137 men with color-defective vision and 128 men with normal color vision. The validity of each of these tests in predicting scores on the aviation signal light gun was assessed by using daytime and nighttime administrations of the light gun as the criteria. Two "best sets" of plates from the AOC and Dvorine tests were selected by calculating a multiple regression equation in a stepwise manner with the nighttime and then the daytime administration of the signal light gun test as the criteria. Based on a graphic presentation of the miss and false alarm rates for each test at various possible cut scores, suggestions were made regarding the use of each test and the selection of optimal pass/fail scores.