Tumor characteristics and metabolic quantification in carcinoma breast: An institutional experience.

BACKGROUND: In India, carcinoma breast is the most common cancer among urban women population and second most common cancer after carcinoma cervix in rural areas. One in 22 women in India develops carcinoma of the breast in their lifetime. Fluorine-18-fluoro-2-deoxy-D-glucose (18F-FDG) uptake in breast cancer usually indicates the degree of tumor metabolism and hence can predict its behavior and prognosis. On the other hand, the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER-2) or neu state of breast cancer is a biomarker that provides important prognostic information in addition to predicting response to therapy. AIMS: The main objective of this study is to assess whether a correlation exists between 18F-FDG uptake in untreated cases of breast cancer, their receptor status (ER, PR, and HER-2 or neu), tumor histology, and tumor size. SUBJECTS AND METHODS: Sixty consecutive female patients, with biopsy-proven primary breast cancer, were enrolled in this prospective study for whom 18F-FDG positron emission tomography-computed tomography scan was done in the Department of Nuclear Medicine. Results obtained were analyzed using appropriate statistical tests (t-test and Pearson Chi-square tests), and interpretation was made with 95% confidence level. RESULTS: In our series, a positive correlation between tumor size, high tumor grade, and standardized uptake value (SUV) was found. Tumors with positive receptor status for estrogen, progesterone, and HER-2/neu receptors had statistically insignificant lower maximum SUV (SUVmax) values than their negative counterparts. Triple-negative breast tumors (ER-, PR-, and no overexpression of HER-2/neu) are currently a subject of major interest because of their aggressiveness, poor prognosis, and lack of targeted therapy. Based on receptor status when the SUVmaxof the group with triple-negative receptor status (ER-/PR-/HER-2/neu-) was compared to rest of the patient group, it was seen that patients with negative receptor status had significantly higher mean SUVmaxvalues. CONCLUSIONS: We have inferred that in patients with breast cancer, various biological parameters such as tumor size, grade, histology, and hormonal receptor status have different impact on tumor metabolic activity.

A study of twenty-three cases of postvasectomy sterility operated for recanalization.

Twenty-three patients with postvasectomy sterility underwent recanalization by means of various techniques. In most of the cases, the commonest reason for requesting recanalization was death of a male child and re-marriage. The majority of patients were farmers with a low economic status, and all were Hindus by caste. The interval between vasectomy and recanalization ranged from 3 to 48 weeks. The patients were aged between 22 and 40 years. Nine cases were successfully operated on (confirmed by presence of spermatozoa in postoperative semen analysis): out of ten operated on bilaterally by the end-to-end method with splint, five were cured (one pregnancy resulted). Both of the patients operated on by the double method (splinted end-to-end and side-to-side) were cured. One was operated on each side. One patient operated on unilaterally by the microsurgical technique was also cured, but another operated on by the telescopic method on one side and vasoepididymostomy on the other was lost to follow-up. 4-0 monofilament nylon was used in all splinted recanalizations, whereas in the one successful case treated by the bilateral end-to-end method, 5-0 chronic catgut was used as intravasal stent. The suture material used in all cases to approximate the vasal walls was 6-0 arterial silk under ophthalmic loupe magnification; seromuscular 3-4 interrupted sutures were used in 22 cases; in the one case operated on by the microsurgical method, 8-0 nylon was used.

Survey of Cryptococcus neoformans in the respiratory tract of patients with bronchopulmonary disorders and in the air.

Cryptococcus neoformans was cultured from 9 (1%) of 835 clinical specimens examined from the respiratory tract of patients. These isolations came from 3 (0.4%) of the760 patients; 8 isolates were from sputum and one from urine. The fungus was not demonstrable in the air at a selected site during a 2-year study although other species of Cryptococcus, namely, C. albidus, C. ater, C. flavus, C. laurentii, C. magnus, C. terreus and C. uniguttulatus were isolated. The three C. neoformans positive patients were males, with pulmonary tuberculosis as the primary disease and history of repeated exposure to pigeon excreta in two. None of these patients manifested any overt signs and symptoms specificially attributable to cryptococcosis, nor did they receive any antifungal therapy. Repeated isolations of C. neoformans from sputum, a positive urine culture and demonstration of cryptococcal antibodies in a serum specimen, followed by negative cultures and serology, suggested that patient 1 had spontaneously recovered from an episode of benign, minimal pulmonary cryptococcosis. Patients 2 and 3 probably carried the fungus as a transient resident of the respiratory tract. The results suggest that C. neoformans is of uncommon occurrence in the respiratory tract of patients with bronchopulmonary disorders and that the isolation of the fungus from this site may not necessarily imply an etiologic relationship.

A modified method for testing inositol assimilation by Cryptococcus species.

The proposed method for rapid testing of inositol assimilation incorporates shake cultures in an indicator-based broth containing inositol (1%), yeast nitrogen base (0.067%), bromocresol purple, and a heavy inoculum. Of 153 yeast isolates investigated, inositol assimilation was shown with the modified method, as also by the Adams-Cooper procedure, in all the 123 isolates, representing 11 species of Cryptococcus. The results were negative by both the methods in the remaining 30 isolates belonging to Candida, Rhodotorula, Torulopsis, Pichia, Saccharomyces, and Sporobolomyces. The modified method was found to be significantly more effective than the Adams-Cooper procedure; the results could be read within 36 h by the former as against 336 h by the latter method. The superiority of the modified method to the Adams-Cooper procedure is attributed to increased aeration in shake cultures, a heavier inoculum, and reduced concentration of yeast nitrogen base.

Acute effect of ascorbic acid on fibrinolytic activity.

The acute effect of 1 g oral ascorbic acid on serum fibrinolytic activity was studied in 40 adult males. In Group I (healthy adults) administration of ascorbic acid raised the serum level by about 71%, while the fibrinolytic activity increased to a peak of 137% at 6 h. In patients with CAD (Group II) an essentially similar increase in FA was observed. In Group III, simultaneous administration of ascorbic acid with 100 g fat effectively prevented a fall in fibrinolytic activity and actually raised it by 64% above the fasting level.

Evaluation of a simplified Guizotia abyssinica seed medium for differentiation of Cryptococcus neoformans.

A simplified Guizotia abyssinica seed medium, eliminating glucose, creatinine, and phosphate, was evaluated for the isolation and presumptive identification of Cryptococcus neoformans. Of 80 isolates of C. neoformans tested, 69 (86%) developed the characteristic brown pigment within 12 h on this medium as against only 5 isolates (6%) on the complete medium. In primary cultures of experimentally seeded specimens of sputum, bronchial aspirate, soil, and pigeon excreta, C. neoformans was recognizable within 3 to 5 days on the modified medium in contrast to the 3 to 8 days required on the complete medium. The results demonstrated that the simplified G. abyssinica seed agar, with or without diphenyl, is superior to the complete medium for the rapid development of the brown pigment by C. neoformans.

A rapid pigmentation test for identification of Cryptococcus neoformans.

A rapid pigmentation test for identification of Cryptococcus neoformans is described. The method is based on the formation of a characteristic, mouse-grey to violaceous-black pigment when shake cultures of C. neoformans in a phosphate-buffered, l-DOPA - ferric citrate medium are incubated at 37 C for one hour.

Occurrence and significance of Cryptococcus neoformans in the oropharynx and on the skin of a healthy human population.

Cryptococcus neoformans was cultured on one occasion from the oropharyngeal washings in 1 of 820 and from the interdigital areas of the feet in 6 of 723 healthy persons. Among the positive persons were two school children, two laboratory workers, one gardener, one plumber, and one printing press worker. Repeat cultures were negative in all seven positive persons; serological tests for cryptococcal antigen/antibody were negative in three. The results demonstrate that C. neoformans may occur as a transient inhabitant of the oropharynx or skin of healthy people.

Aspergillosis in imported penguins.

An outbreak of aspergillosis in imported penguins caused by Aspergillus fumigatus is described. The birds probably acquired the infection from the country of origin or during their transportation. Predisposing circumstances are discussed.

Rapid method for detection of urea hydrolysis by yeasts.

A method is described for the rapid detection of urea hydrolysis by yeasts, using the Berthelot color reaction. The results could be determined within 30 to 50 min with this method, compared with 8 to 72 h usually required with Christensen urea agar.