The ultrasonic surgical aspirator (USA) is a new surgical instrument that allows precise and selective tissue dissection. Ultrasonic cell destruction is combined with continuous irrigation causing a ...cloud of fine droplets, which sometimes contains viable tumor cells, hanging above the operative field. We present a patient who developed massive recurrent vulvar carcinoma in the subcutaneous tissue in the proximity of the incisions of the vulva and both groins 3.5 months after a USA-assisted radical vulvectomy and inguinal lymphadenectomy. The atypical pattern of recurrence in the entire operative field suggests that tumor cells might have been spread by the irrigation fluid of the USA. Further investigation is needed to assess the risk of tumor dissemination with USA before the instrument can be used safely in patients with early cancer.
When the immunoblotting technique is used as a diagnostic tool, the reproducibility of the results is a major problem. When purified radiolabelled proteins were applied onto SDS gels, the recovery of ...radioactivity on the blot after electrophoresis, blotting and incubation ranged from 10 to 65%, depending on the protein. Although the addition of SDS was subsequently shown to improve protein transfer from gel to blot, it is not recommended because immunological recognition of proteins is diminished after this transfer step. We suggest that during the incubation of protein blots detergents are necessary not only to diminish non-specific background, but also to renature proteins. However, since these detergents also elute protein from nitrocellulose and other blotting matrices, they are in part responsible for the lack of reproducibility in immunoblotting results.
An analysis of the data collected in 1997 and 1998 with the DELPHI detector at e
+e
− collision energies close to 183 and 189 GeV was performed in order to extract the hadronic and leptonic ...fermion-pair cross-sections, as well as the leptonic forward–backward asymmetries and angular distributions. The data are used to put limit on contact interactions between fermions, the exchange of R-parity violating SUSY sneutrinos, Z′ bosons and the existence of gravity in extra dimensions.
Background: Predicting clinical outcomes after cardiac resynchronisation therapy (CRT) remains a challenge. Although QRS duration is crucial as an indication for CRT, it is a poor predictor of ...clinical outcomes. Objectives: To determine whether the direction of ventricular activation, measured using the ratio of the temporospatial isochrone to QRS duration (TSIQRSd) on vectorcardiography (VCG) predicts clinical outcomes after CRT. Methods: In this retrospective study, TSIQRSd, QRS area, QRS duration (QRSd) and QRS morphology (LBBB), derived from pre-implantation ECGs, were assessed in relation to the primary endpoint of cardiac mortality after CRT. Results: In patients (n=720, age 72.8 ± 11.8 years, 71.3% male) undergoing CRT over 7.7 years (median follow-up period of 3.7 interquartile range 2.3–5.1 years), TSIQRSd <92% predicted cardiac mortality (adjusted hazard ratio aHR: 2.21, 95% CI 1.54–3.17; p<0.001), independent of known confounders. When considered together with QRSd, LBBB and QRS area, TSIQRSd <92% was the only predictor of cardiac mortality (aHR: 2.22, 95% CI 1.55–3.18; c-statistics: 0.59, 0.57, 0.63 and 0.68, respectively). A TSIQRSd < 92% predicted cardiac mortality in the strata of QRSd (< or ≥150 ms) and QRS morphology (LBBB or non-LBBB) (all p<0.0001). Both TSIQRSd <92% and a QRS area <102 ms also predicted total mortality or heart failure hospitalisation, and total mortality or major adverse cardiac events (all p<0.001) Conclusions: Vectorcardiographic TSIQRSd is superior to QRS area, QRSd and QRS morphology in predicting cardiac mortality after CRT. These findings support the use of pre-implantation VCG in predicting clinical outcomes after CRT. Image Omitted
Background: Some studies have shown that pre-implantation QRS area (QRSarea) predicts clinical outcomes after cardiac resynchronisation therapy (CRT). Objective: To determine whether ...post-implantation changes in QRSarea predicts clinical outcomes after CRT. Methods: In this retrospective study, QRSarea, derived from pre- and post-implantation vectorcardiography (VCG), were assessed in relation to the primary endpoint of cardiac mortality after CRT. Other endpoints included total mortality, total mortality or heart failure (HF) hospitalisation and total mortality or major adverse cardiac events (MACE). Results: In patients (n=380, age 72.0 ± 12.4 years, 68.7% male) undergoing CRT over 7.7 years (median follow-up: 3.8 years interquartile range 2.3–5.3), pre-implantation QRSarea ≥ 102 µVs predicted cardiac mortality (HR: 0.36; p < 0.001) as well as total mortality (0.58; p=0.001), total mortality or HF hospitalisation (HR: 0.53) and total mortality or MACE (HR: 0.52) (both p < 0.001). The association of QRSarea with cardiac mortality was independent of known confounders, including QRS duration (QRSd) and morphology (p<0.001). After CRT, a reduction in QRSarea ≥ 45 µVs or any reduction in QRSd predicted cardiac mortality (area under curve: 0.74 and 0.72, respectively; p = 0.425 for comparison). Concomitant reductions in QRSarea and QRSd were the best predictor of cardiac mortality (HR: 0.12; p <0.001 for interaction). Conclusion: Pre-implantation QRSarea, derived from VCG, was superior to QRSd and LBBB in predicting cardiac mortality after CRT. A post-implant reduction in both QRSarea and QRSd was associated with the best outcomes. Image Omitted
A first measurement of the average polarisation Pτ of tau leptons produced in e+e− annihilation at energies significantly above the Z resonance is presented. The polarisation is determined from the ...kinematic spectra of tau hadronic decays. The measured value Pτ=−0.164±0.125 is consistent with the Standard Model prediction for the mean LEP energy of 197 GeV.
Flow cytometry is a high-precision technique for rapid analysis and sorting of cells and particles. In theory, it can be used to measure any cell constituent, provided that a fluorescent tracer is ...available that reacts specifically and stoichiometrically with that constituent. The technique provides statistical accuracy, reproducibility, and sensitivity and allows simultaneous measurement of several constituents on a cell-to-cell basis. The main drawback of flow cytometry is the lack of visual control and structural information in solid tissues. Careful sample preparation, quality control of all staining and instrumentation procedures, and the use of immunohistologic or cytologic controls are essential for high-quality flow cytometric analysis. The technique has been used successfully for simultaneous measurement of DNA and tumor-associated antigens, oncogene products, proliferation markers, and markers for multidrug resistance in cultured cell lines and in cell suspensions prepared from solid tumors and cervical smears. Flow cytometry has the potential to play an important role in the study of carcinogenesis. With an appropriate panel of monoclonal antibodies, the technique can be used for screening, "biochemical" diagnosis of neoplasia, and rapid drug, hormone, and radiotherapy sensitivity tests.
Objective: We sought to investigate whether angiogenesis can predict the risk of recurrence of cervical intraepithelial neoplasia after treatment.
Study Design: Microvessel density was studied in 75 ...patients with grade 3 cervical intraepithelial neoplasia and in 20 patients with microinvasive squamous carcinoma (International Federation of Gynecology and Obstetrics stage IA1) of the uterine cervix by staining representative tissue sections with the specific endothelial marker anti-CD31. The microvessel density was determined with a digital image analyzer. The results were correlated with clinical and histopathologic data.
Results: The mean vessel density was 264 per field (range, 86-674 per field) in grade 3 cervical intraepithelial neoplasia and 378 per field (range, 161-848 per field;
P = .001) in microinvasive squamous carcinoma. Thirteen patients with grade 3 cervical intraepithelial neoplasia had recurrent cervical intraepithelial neoplasia (microvessel density, recurrent vs nonrecurrent; not significant). Multiple regression analysis in the noninvasive group confirmed that the mean vessel density (
P = .121) had no prognostic value. Furthermore, it showed that the age at diagnosis (
P = .011), menopausal status (
P = .052), and treatment modality (
P = .022) proved to be independent prognostic factors for recurrence.
Conclusions: During the progression from noninvasive to microinvasive cervical carcinoma, the microvessel density increases significantly. However, the vessel density does not predict recurrence of noninvasive lesions. (Am J Obstet Gynecol 1999;181:554-9.)
The quark model does not exclude states composed of more than three quarks, like pentaquark systems. Controversial evidence for such states has been published in the last years, in particular: for a ...strange pentaquark
Θ
(
1540
)
+
; for a double-strange state, the
Ξ
(
1862
)
−
−
, subsequently called
Φ
(
1860
)
−
−
; and for a charmed state, the
Θ
c
(
3100
)
0
. If confirmed, a full pentaquark family might exist; such pentaquark states could be produced in
e
+
e
−
annihilations near the Z energy. In this Letter a search for pentaquarks is described using the DELPHI detector at LEP, characterized by powerful particle identification sub-systems crucial in the separation of the signal from the background for these states. At 95% CL, upper limits are set on the production rates
〈
N
〉
of such particles and their charge-conjugate state per Z decay:
〈
N
Θ
+
〉
×
Br
(
Θ
+
→
p
K
S
0
)
<
5.1
×
10
−4
,
〈
N
Θ
+
+
〉
<
1.6
×
10
−3
,
〈
N
Φ
(
1860
)
−
−
〉
×
Br
(
Φ
(
1860
)
−
−
→
Ξ
−
π
−
)
<
2.9
×
10
−4
,
〈
N
Θ
c
(
3100
)
0
〉
×
Br
(
Θ
c
(
3100
)
0
→
D
∗
+
p
¯
)
<
8.8
×
10
−4
.
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