Association of angiotensin-converting enzyme gene I/D polymorphism with change in left ventricular mass in response to physical training

PURPOSE: To determine the radiologic characteristics of cystic dystrophy of the duodenal wall. MATERIALS AND METHODS: Ten patients with cystic dystrophy of the duodenal wall and chronic pancreatitis underwent ultrasonography (US) (n = 10), computed tomography (CT) (n = 10), endoscopic US (n = 5), and endoscopic retrograde cholangiopancreatography (ERCP) (n = 9). Cystic dystrophy of the duodenal wall was classified as either cystic or solid. The imaging findings were retrospectively analyzed and compared with findings at pancreatoduodenectomy (n = 10). RESULTS: The more frequent cystic type (n = 7) of cystic dystrophy of the duodenal wall was characterized by the presence of easily recognizable cystic lesions (diameter, more than 1 cm), located within the thickened wall of the second portion of the duodenum. The solid type (n = 3) of cystic dystrophy of the duodenal wall demonstrated fibrous thickening of the duodenal wall within which small cysts (diameter, less than 1 cm) were present. The intraduodenal cysts were usually elongated or bilobate with a thick wall. The thickening of the duodenal wall appeared as a solid layer between the duodenal lumen and the pancreas, hypoechoic at US, isoattenuating at unenhanced CT, and hypoattenuating in the early phase (after initiation of infusion of contrast material) and isoattenuating in the late phase (after completion of infusion) at contrast material-enhanced CT. Findings at retrospective analysis of CT and endoscopic US images were characteristic. CONCLUSION: Imaging modalities, notably CT and endoscopic US, helped establish the diagnosis of cystic dystrophy of the duodenal wall.     

Aesthetic outcome of breast implant removal in 85 consecutive patients

As we began to see increasing numbers of women concerned about their gel-filled breast implants, we became aware that we could not advise them with any degree of confidence what they might expect in terms of aesthetic result after implant removal. We decided to review the records and outcomes over a 2-year period of a number of patients who underwent implant removal. Eighty-five consecutive patients were reviewed, 69 of whom had undergone cosmetic augmentation and 16 of whom had breast reconstruction with silicone gel implant(s). Thirty-nine of the 69 cosmetic augmentation patients had removal of implants alone, and 27 had removal accompanied by mastopexy. Three had reaugmentation with saline-filled implants; one had replacement with saline-filled implants. Fifteen of the 16 reconstruction patients underwent autogenous tissue transfer. Preoperative and postoperative photographs of all patients were mixed randomly and rated by two independent raters in four aesthetic categories on a five-point scoring system. Repeatability was measured several weeks later, when each rater scored randomly selected photographs from this patient pool. The patients also performed their own outcome evaluations by means of questionnaire. We discovered that cosmetic augmentation patients who undergo implant removal only often suffer adverse aesthetic results. The postremoval appearance of many cosmetic augmentation patients actually will be improved over their preoperative appearance when mastopexy is performed in conjunction with implant removal. The study demonstrated that patients with certain body types could expect a particular outcome; i.e., women with asthenic builds and older patients with lax, striated breast skin generally had unsatisfactory aesthetic outcomes with implant removal only. Patients selected for autogenous breast reconstruction had favorable results, with extended latissimus dorsi and TRAM flaps yielding equally good outcomes. The study allows us to offer patients an optimistic view of postoperative results following breast implant removal. We have begun to advise selected patients that implant removal accompanied by mastopexy provides a more pleasing aesthetic outcome than implant removal alone.     

The "pedrada" ("coup-de-fouet") syndrome. A possibility to be considered in acute leg pain

The authors report the case of a woman admitted to hospital for minor trauma of the left hip and who presented major ST segment elevation on the second day suggesting an acute anterior wall myocardial infarction at the same time as a cerebrovascular accident. Complementary investigations and follow-up excluded the diagnosis of myocardial infarction with normalisation of the ECG on the 5th day. ECG changes during cerebrovascular accidents may be very variable ranging from extrasystoles to ST elevation mimicking myocardial infarction. They carry a poor prognosis with an increased risk of sudden death necessitating continuous ECG monitoring until the ECG reverts to normal. The cardiac involvement is not ischaemic but due to disease of the insular cortex of the brain which induces myocytolysis (centered around the intra-cardiac nerve endings) due to the sudden liberation of catecholamines. These lesions may be treated by propranolol or phentolamine.     

Hemoptysis caused by pulmonary arterial aneurysm, disclosing Beh?et disease. Apropos of 2 cases]

MCF7 and ZR75-1 breast cancer cells grow as adherent monolayers in tissue culture. Treatment with the serum serine protease plasmin causes them to detach and to grow as floating multicellular spheroids. Two plasmin activators, urokinase plasminogen activator and streptokinase, induce the same growth pattern changes in the presence of plasminogen. Serum contains also plasminogen activator inhibitors. Aged serum, deficient in plasminogen activator inhibitors, converts spontaneously monolayer breast cancer cells into multicellular spheroids which readily revert to monolayer growth after addition of fresh serum. Urokinase blocks the reversion. The formation of multicellular spheroids does not affect the proliferative rate of breast tumor cells but endows tumor cells with increased resistance to the chemotherapeutic drugs, doxorubicin and paclitaxel.     

Has risk associated with smoking increased? Results from the Copenhagen Center for Prospective Population Studies

BACKGROUND: Two recent much cited publications have raised the concern that risk associated with cigarette smoking has so far been underestimated. In this study we wish to determine whether excess all-cause mortality associated with smoking has increased during the last 20-30 years in a study population representative of the general Danish population and whether any such changes relate to changes in smoking behaviour. METHODS: Pooled data from three prospective population studies conducted in Copenhagen with detailed information on smoking habits. A total of 31,194 subjects, 17,669 males and 13,525 females, initially examined between 1964 and 1992 with examinations repeated at intervals from 1-10 years, were followed until 1995 for all-cause mortality. Relative mortality risk in smokers versus never-smokers was calculated within periods of five calendar years and compared throughout the study period. RESULTS: Male smokers' exposure did not change during the study period whereas female smokers' exposure to tobacco increased in terms of age at smoking onset, quantity smoked and depth of inhalation. During follow-up 5744 males and 2900 females died. In males, death rate ratios (comparing continuous smokers with never-smokers) did not change in the study period. In females, ratios increased from 1964-1978 to 1979-1994 by a factor of 1.3 (95% confidence interval 1.0-1.8). CONCLUSIONS: In agreement with the observed changes in smoking habits, excess mortality in male smokers did not increase whereas excess mortality in female smokers increased slightly.     

Detection of cytomegalovirus in semen from a population of men seeking infertility evaluation

This paper presents the results of in vivo measurements on a worker from a fuel reprocessing plant who was involved in an actinide intake. The results revealed that false indications of an actinide lung burden could arise from a contaminant present elsewhere in the chest region. Consequently, it is important that lung monitoring programs for occupational workers handling actinides are conducted with this caution in mind and that due consideration is given even in cases of minor cuts/wounds in order to rule out substantial overestimation of internal radiation doses.     

Lack of carcinogenicity of medium-viscosity liquid paraffin given in the diet to F344 rats

The carcinogenicity of medium-viscosity liquid paraffin was examined in Fischer 344 rats. Groups of 50 males and 50 females were given the material at dietary doses of 0 (control), 2.5 or 5% for 104 wk. Slight increases in food consumption and body weight were observed in both sexes of the 5% group. However, no significant differences between the control and treated groups were noted with regard to clinical signs, mortality and haematology findings. A variety of tumours developed in all groups, including the control group, but all the neoplastic lesions were histologically similar to those known to occur spontaneously in F344 rats, and no statistically significant increase in the incidence of any tumour type was found for either sex in the treated groups. Granulomatous inflammation in the mesenteric lymph nodes, considered to be a reaction to paraffin absorption, was observed with similar incidence and severity in both sexes of the 2.5 and 5% groups. Thus, it is concluded that under the present experimental conditions, the high dose, about 2000-200,000 times higher than the current temporary acceptable daily intake, does not have any carcinogenic potential in F344 rats. Furthermore, granulomatous inflammation observed in mesenteric lymph nodes were not associated with any development of neoplastic lesions.     

Algorithm for cosine transform of Toeplitz matrices

An algorithm for calculating the 2D cosine transform of a Toeplitz matrix is presented. The algorithm is based on the application of 1D cosine transforms. More specifically, four 1D cosine transforms of size N are needed to obtain the transform of a Toeplitz matrix of size N×N. This is an improvement over previously published algorithms. The algorithm is also simple and regular