Myofibroblastoma of the breast.

INTRODUCTION: Myofibroblastoma is a rare benign mesenchymal tumour arising from the stromal elements of the breast tissue. Histopathological variants such as classic, cellular, collagenous / fibrous, lipomatous, infiltrative, myxoid and epithelioid have been identified. Most myofibroblastomas are immunoreactive for CD34, actin, CD10 and desmin, usually express oestrogen receptor (ER), progesterone receptor (PR) and variably express androgen receptor (AR). CASE REPORT: We report a case of myofibroblastoma in an octogenarian male presenting with painless solitary breast lump. Mammography (digital tomosynthesis) and ultrasound showed a well-circumscribed hyperdense mass and hypoechoic, solid, oval mass with peripheral vascularity respectively. Patient underwent wide local excision. DISCUSSION: Diverse characteristics of myofibroblastoma on imaging necessitates histopathological analysis for an accurate diagnosis. Myofibroblastoma are often confused with fibroadenomas due to the benign imaging characteristics and with malignant neoplasia due to their wide morphological spectrum. Surgical excision is considered curative.

Gender differences in coping skills of parents with hearing-impaired children.

OBJECTIVE: To assess differences between the coping strategies of the mothers and fathers with hearing-impaired children. METHODOLOGY: A cross-sectional study was conducted looking at parents of children with moderate to profound hearing impairment. The parents with more than one child with a hearing impairment, the parents of children with additional disabilities and syndromes, single parents, and parents with their own hearing impairments were excluded from the study. A Brief COPE Scale questionnaire translated into Malay was used to assess the coping strategies. The questionnaire includes 28 items and was rated using a four-point Likert scale. Independent t-testing was used to compare the coping strategies of mothers and fathers. Simple linear regression was used to determine the association between age and coping strategies. RESULTS: There were 72 participants. The number of mothers and fathers was equal. Religion, active coping and acceptance were the highest three scores in the domains, while substance use and behavioural disengagement were least used in both groups. The domains of religion, seeking emotional support and seeking instrumental support scored significantly higher in mothers than in fathers (p < 0.05). There was a significant difference between the two groups in terms of problem-focused strategies (p = 0.016) but not in terms of emotional-focused strategies (p = 0.134). There were significant negative linear correlations between age and seeking emotional support, humour and instrumental support ( p < 0.05). CONCLUSION: There were gender differences in the coping strategies among parents with hearing-impaired children. These are important factors that should be considered when counselling and establishing support groups for the parents of these children.

Screening of dental staff nurses for noise induced hearing loss.

PROBLEMS/OBJECTIVES: The effect of noise on employees of dental clinics is debatable. The purposes of this study were to determine the intensity and frequency components of dental instruments used by dental staff nurses and the prevalence of noise induced hearing loss. METHODOLOGY: We performed a comparative, cross sectional study on a group of dental staff nurses. Participants underwent ear examination followed by pure tone audiometry. Pure tone audiometry was performed at least 48 hours after the participants were free from noise exposure. Noise induced hearing loss was defined as failed definitive threshold at a frequency of 4000 Hz greater than 20 dB. The intensity level, noise spectrum, and frequency of hand piece, saliva suction, and scaler were recorded during the dental procedure. RESULTS: A total of 65 dental staff nurses were included. The mean intensity of hand pieces, scalers, and saliva suctions were 88.7 (SD2.2), 87.1 (SD2.6), and 77.4 (SD6.3) dBA while their most prominent frequencies were 3880, 7997, and 3513 Hz, respectively. Three of the subjects had slightly more than 20 dB hearing loss at 4 kHz on audiogram; all were affected unilaterally. These three individuals worked as dental nurses for 11, 13, and 21 years, respectively. Therefore, the prevalence of noise induced hearing loss was 5.0% (95% CI: -1.0%, 10.0%). CONCLUSIONS: Dental staff nurses might have an increased risk of noise induced hearing loss, depending upon individual factors influencing susceptibility and duration of noise exposure.

Chemistry and conformation of vitamin D molecules.

1 alpha,25-Dihydroxyvitamin D3 (1,25) is a structurally unique steroid hormone because it not only possesses the complete 25-hydroxycholesterol side chain, but most notably, it possesses a seco-B triene structure (it lacks a B-ring and is usually depicted in a non-steroidal, extended conformation). In contrast, the classical steroid hormones possess a truncated side chain (progesterone, cortisol, and aldosterone) or no side chain (estradiol and testosterone) and they all possess the fully intact ABCD steroid rings. These structural differences render the seco-B-steroid 1,25 considerably more conformationally flexible. Since 1,25 is now known to target a myriad of tissues where specific interactions occur to produce an array of biological responses, it is of interest to determine whether different topologies of 1,25 (resulting from different conformational orientations of 1,25) are necessary to interact effectively at the different target sites. The array of biological responses include both non-genomic and genomic effects and there is considerable promise for the efficacy of 1,25 analogs as chemotherapeutic agents in a variety of human disease states. For the non-genomic calcium transport response of transcaltachia, the finding that two 6-s-cis locked analogs, 1 alpha,25-dihydroxyprevitamin D3 (pre-1,25) and 1 alpha,25-dihydroxylumisterol3 (1,25-Lumi), are equipotent to 1,25, points strongly to the involvement of the 6-s-cis conformer of 1,25 as the biologically active conformer. Since there is a continuum of easily interconvertible 6,7-single bond conformers of the seco-B ring available to 1,25, conformational minima (either local or global) may have little to do with the manner in which 1,25 is bound to receptor. For the genomic calcium transport response, and for other genomic (or non-genomic) effects, there is no clear evidence whether the steroidal (s-cis) or non-steroidal (s-trans) conformer of 1,25 is involved. In order to address this matter further, efforts are underway to evaluate other conformationally locked analogs of 1,25 which might mimic either the planar 6-s-trans-1,25 or some intermediate conformer between it and the planar-6-s-cis form.

Ligand specificity of the genetic variants of human alpha1-acid glycoprotein: generation of a three-dimensional quantitative structure-activity relationship model for drug binding to the A variant.

Human alpha1-acid glycoprotein (AAG) is a mixture of at least two genetic variants: the A variant and the F1 and/or S variant or variants, which are encoded by two different genes. In a continuation of previous studies indicating specific drug transport roles for each AAG variant according to its separate genetic origin, this work was designed to (1) determine the affinities of the two main gene products of AAG (i.e., the A variant and a mixture of the F1 and S variants) for 35 chemically diverse drugs and (2) to obtain meaningful 3D-QSARs for each binding site. Affinities were obtained by displacement experiments, leading to qualitative indications about binding site characteristics. In particular, drugs binding selectively to the A variant displayed some common structural features, but this was not seen for the F1*S variants. Three-dimensional QSAR analyses using the CoMFA method yielded a steric model for binding to the A variant, from which a simplified haptophoric model was derived. In contrast, no statistically sound model was found for the F1*S variants, possibly due (among other reasons) to an insufficient number of high affinity ligands in the set.