Relationship between human mammaglobin mRNA expression in breast cancer tissue and clinico-pathologic features of the tumors.

Human mammaglobin (hMAM) has recently been recognized as a breast associated glycoprotein. Although the biological role of hMAM is unknown, it has been previously reported that hMAM gene expression is a marker of low biological and clinical aggressiveness of breast cancer (BC). In this study, 148 cases of BC tissues were investigated for hMAM mRNA expression by reverse transcriptase-polymerase chain reaction (RT-PCR). In order to evaluate its prognostic value, hMAM was correlated with age of patients, type and size of tumor, nodal stage, histologic grade, c-erbB-2 over expression, Ki67 labelling index, estrogen receptor (ER) status and progesterone receptor (PGR) status. Fisher's exact test was used to examine the association between different parameters and hMAM. hMAM was expressed in 138/148 (93%) of BC tissues examined. Among the 10 hMAM negative cases, 8 were invasive ductal carcinomas (microscopically higher G3 grade) and 2 infiltrating lobular carcinomas. We found a significant association (p = 0.020) between absence of hMAM mRNA and G3 histologic grade but not with any other prognostic parameters studied. The present study indicates that lack of hMAM expression is restricted to the BC with G3 grading. Further studies are needed to clarify the biological basis and the clinical significance of our results.

Perfluorocarbons attenuate oxidative lung damage.

The aim of this study was to investigate the effect of tidal liquid ventilation (TLV) compared to conventional mechanical ventilation (CMV) on oxidative lung damage in the setting of acute respiratory distress syndrome (ARDS). After repeated lung lavages, 10 minipigs were treated with CMV or TLV for 4 hr before the animals were sacrificed. Samples for blood gas analysis and bronchial aspirate samples were withdrawn before the induction of lung injury, and at 10 min, 2 hr, and 4 hr after the beginning of ventilatory support. To assess lung oxidative damage, total hydroperoxide (TH) and advanced oxidation protein product (AOPP) concentrations were measured in bronchial aspirate samples. After 2 and 4 hr of ventilatory support, partial oxygen tension (PaO(2)) and base excess (BE) were significantly higher in the TLV group than in the CMV group, while PaCO(2) was slightly higher, but with no statistical significance. In the CMV group, the AOPP level was significantly higher at 4 hr than at baseline. TH and AOPP bronchial aspirate concentrations were higher in the CMV group than in the TLV group at 2 and 4 hr of ventilation. We conclude that animals treated with TLV showed lower oxidative lung damage compared to animals treated with CMV.

Intravenous leiomyoma with cardiac involvement.

We report a case of intravenous leiomyomatosis (IVL) in a 44-year-old woman, presenting with cardiothoracic clinical manifestations. Such a rare neoplastic condition most often arises from the uterine veins. At times it may reach the right cavities of the heart and it must be considered in the differential diagnosis with a cardiac myxoma or a thrombus.

Laparoscopic decapsulation of a large epidermoid splenic cyst in a child using the UltraCision LaparoSonic Coagulating Shears.

Splenic cysts are rare in pediatric surgery. Congenital epidermoid cysts are exceptional representing only 2.5% of all splenic cysts in childhood. Nowadays, considering the short- and long-term complications of splenectomy in children, the management of epidermoid cyst consists of partial splenectomy or decapsulation of the cystic wall. To our knowledge, the case reported in this article describes the first successful laparoscopic decapsulation of an epidermoid splenic cyst in an 10-year-old child using the UltraCision LaparoSonic Coagulating Shears (LCS). Follow-up at six months confirms no recurrence. Laparoscopic splenic decapsulation provides minimal access and small surgical trauma for treating the cyst while preserving splenic function. The use of UltraCision LCS makes the laparoscopy safely, expeditiously, with minimal blood loss and short hospital stay.

[Approach to the study of vasculitides: general aspects and classification]. / Approccio allo studio delle vasculiti: generalità e inquadramento.

Since etiology and pathogenesis of most systemic and/or isolated vasculitides are unknown, any attempt to make a rational classification of these entities is far from being perfect. Vasculitis may be a primary disease or it may be associated with connective tissue diseases, infectious diseases, neoplasms, drug assumption, allograft rejection and so on. As secondary vasculitides constitute the majority of cases, diagnosis of primary vasculitis is made by exclusion. At the present time, the 1993 Chapel Hill Consensus Conference on Nomenclature of Primary Vasculitides provides a useful guide to clinician and pathologist for evaluating a patient with an idiopathic form of vasculitis. This classification is based on the predominant size of vessels affected and describes the main clinico-pathologic features of the various clearly defined types of systemic vasculitis. Though it suffers from omissions and contradictions, in routine practice it is of great help to distinguish diseases in this intriguing chapter of pathology.

Risk management for physician assistants.

Until recently, physicians traditionally assumed malpractice liability for those to whom they delegated responsibility. Evolution of malpractice law during the past years has seen dependent practitioners held accountable to a standard of care expected to be provided by peers. Physician assistants are no longer protected from liability or suit. The most common action of liability is professional negligence; other actions include breach of contract, battery, informed consent, defamation of character, and invasion of privacy. Accurate diagnoses, good interpersonal skills, and proper documentation of the medical record at all times are the clinician's most effective tools in avoiding a malpractice lawsuit.