Objective. To determine the utility of targeted sonography in the evaluation of patients with focal breast pain. Methods. From January 1995 through December 1999, 110 targeted sonographic ...examinations were performed in 99 patients for evaluation of focal breast pain in the absence of an associated palpable mass. The sonographic, mammographic, and clinical findings were reviewed. The hospital pathology database was searched to identify any interval cancers and false‐negative interpretations. Results. No cancer was identified in any of the 110 examinations. Eighty‐five (77.3%) of the examinations had negative findings. Cysts were identified in 15 cases (13.6%), and 3 solid masses (2.7%) were identified. Two of these 3 solid masses had biopsies and were shown to be benign, whereas the third mass was followed for 29 months without change. Most patients were premenopausal, had no family or personal history of breast cancer, and were not taking exogenous hormones. Eighty‐five patients (77%) were referred by primary care physicians. Conclusions. In patients with focal breast pain without an associated palpable mass, sonography may be more useful for patient reassurance than for cancer detection.
General description of the physicochemical consequences of the different sterilization methods on the dextran-coated magnetic nanoparticles. Display omitted
► Caution must be taken when sterilizing ...DMNPs. ► All four treatments did not alter the core size and magnetic behavior. ► All four treatments on DMNPs induced no additional toxic effects. ► Filtration decreased the mean hydrodynamic size and weight percentage of cores. ► Sample size distribution has alterations under autoclaving and ethanol treatment.
Dextran-coated magnetic iron oxide nanoparticles (DMNPs) have attracted significant attention for their many applications in biomedical area such as diagnostic magnetic resonance imaging (MRI), and gene therapy. For biomedical applications, nanoparticles must be sterile, and several terminal sterilization methods can be used. However, very little is known regarding the effect of sterilization methods on the properties of DMNPs. It is crucial to find out whether the DMNPs are affected by the sterilization process. This paper reported the influences on the physicochemical properties of DMNPs from four different methods: autoclaving, sterile filtration, UV irradiation and chemical sterilization with ethanol. In addition, cell viability was also studied. Our results indicate that filter sterilization changes the iron oxide/dextran ratio in DMNPs sample significantly. Besides, the autoclaving and ethanol treatment affected the polydispersity index of DMNPs sample. Thus, caution must be taken when choosing an appropriate method to perform sterilization for DMNPs.
Background: Single-agent doxorubicin has been widely used to treat unresectable hepatocellular carcinoma (HCC), but the response rate is low (<20%) and there is no convincing evidence for improved ...survival. Cisplatin, interferon, doxorubicin, and fluorouracil (PIAF) used in combination, by contrast, has shown promise in a phase II study. We compared doxorubicin to PIAF in patients with unresectable HCC in a phase III trial. Methods: Patients with histologically confirmed unresectable HCC were randomly assigned to receive either doxorubicin or PIAF every 3 weeks, for up to six cycles. The primary endpoint was overall survival, and secondary endpoints were response rate and toxicity. Survival differences were calculated using the Kaplan-Meier method. Treatment groups were compared for differences in the incidence of adverse events using chi-square tests. All statistical tests were two-sided. Results: The median survival of the doxorubicin and PIAF groups was 6.83 months (95% confidence CI = 4.80 to 9.56) and 8.67 months (95% CI = 6.36 to 12.00), respectively (P = 0.83). The hazard ratio for death from any cause in the PIAF compared with the doxorubicin groups was 0.97 (95% CI = 0.71 to 1.32). Eighty-six of the 94 patients receiving doxorubicin and 91 of the 94 receiving PIAF were assessable for response. The overall response rates in the doxorubicin and PIAF groups were 10.5% (95% CI = 3.9% to 16.9%) and 20.9% (95% CI = 12.5% to 29.2%), respectively. Neutropenia, thrombocytopenia, and hypokalemia were statistically significantly more common in patients treated with PIAF than in patients treated with doxorubicin. Conclusion: Although patients on PIAF had a higher overall response rate and better survival than patients on doxorubicin, the differences were not statistically significant. PIAF was also associated with increased treatment-related toxicity. The prognosis of patients with unresectable HCC remains poor.
Routine screening for hepatocellular carcinoma among chronic carriers of hepatitis B virus using a combination of abdominal sonography and serum alpha-fetoprotein levels is widely practiced. Negative ...results on an abdominal sonogram generally indicate the absence of hepatocellular carcinoma despite the elevation of alpha-fetoprotein levels, but the false-negative rate of abdominal sonography has not been established prospectively.
In our screening program, we routinely investigated patients with Lipiodol (iodized oil) CT when they presented with alpha-fetoprotein levels above 20 ng/mL or a focal lesion as depicted on abdominal sonography. Lipiodol CT comprised a hepatic angiogram with injection of Lipiodol selectively in the hepatic arteries, followed by an unenhanced CT scan 10 days later. Positive findings on Lipiodol CT were confirmed histologically by biopsy or surgical resection. We defined false-negative as histologic diagnosis of hepatocellular carcinoma within 3 months of normal findings on screening abdominal sonography.
One hundred three patients with elevated alpha-fetoprotein levels were investigated with Lipiodol CT within 2 months of abdominal sonography. Of these, three of 70 patients with negative abdominal sonography had histologically confirmed hepatocellular carcinoma. Thus, abdominal sonography has a false-negative rate of 4.3%. Lipiodol CT is associated with a significant false-positive rate of 43.7%. The sensitivity, specificity, and positive predictive value of abdominal sonography for early detection of hepatocellular carcinoma among hepatitis B virus carriers with elevated alpha-fetoprotein levels was 85.7%, 81.7%, and 54.5%, respectively.
Negative results on a screening abdominal sonogram among hepatitis B virus carriers with elevated alpha-fetoprotein levels does not rule out the presence of small hepatocellular carcinoma. Routine use of Lipiodol CT as a supplementary screening tool is not recommended.
Realizable one-step RT-PCR assays specific for influenza PB2, PB1 and PA segments are described in this report. The designs of the consensus primers were based on more than five thousands polymerase ...genes derived from avian or mammalian viral strains. All the viral RNA tested in this study could be consistently amplified by the assays. The reaction products were specific and could be used for direct DNA sequencing. These assays might be useful tools to study the sequences of these genes.
To provide a practical action plan for effective infection control of norovirus outbreak in acute paediatric wards.
We report the infection control measures that were implemented to terminate and to ...prevent nosocomial spread of norovirus gastroenteritis in an open-designed paediatric ward.
Nine children, one visitor, and one medical student were affected in a norovirus gastroenteritis outbreak in an acute paediatric ward. Vomiting was the main presenting symptom. The outbreak was rapidly terminated three days after implementation of stringent infection control measures and there was no second wave of attack. These measures included strict contact precautions, prompt isolation and cohorting of symptomatic patients, vigorous environmental cleansing with concentrated disinfectant (hypochlorite solution 1000 ppm), meticulous handling of waste products, and efficient contact tracing of exposed patients, family members, and medical students.
Prompt implementation of stringent infection control measures and contact tracing can rapidly terminate the norovirus outbreak and prevent a second wave of infection. Children with unexplained vomiting and those with contact history of gastroenteritis should be properly triaged, isolated, and investigated for possible infective causes, including norovirus-induced gastroenteritis.
Understanding of the droplet detachment behavior from rough hydrophilic surfaces is important in many biological and industrial applications such as biomedicine, surface coating, and pathogen-laden ...aerosol resuspension. Due to the partial detachment of the droplet on hydrophilic surfaces, leaving behind some droplet residues, the adhesion behavior is extremely complicated. Here we reveal a new adhesion mechanism between a droplet and a rough hydrophilic surface. The adhesion behavior is controlled by a liquid film stuck in the surface microstructure. We establish a model to describe the contributions of liquid film and naked solid peaks, to the work of adhesion and verify the model experimentally. We also find that the normal adhesion force is about 3.35 ± 0.25 times of the lateral adhesion force for different surface roughness, meaning that the separation direction is an important factor affecting adhesion due to the different separation mechanisms. The results of this work shed new insights on the understanding of droplet detachment and adhesion to a rough surface.
•Rough surface attaches larger liquid aerosol than smooth surface, while rough surface holds smaller solid aerosol.•A model is proposed and experimentally verified to reveal adhesion mechanism of a liquid aerosol to a rough surface.•Normal adhesion force is about 3.35±0.25 times of lateral adhesion force, which is independent of surface roughness.
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