Paget bone disease involving young adults in 3 generations of a Korean family

Pancreatic cancer is an aggressive disease with a dismal prognosis. It has long been regarded as one of the most difficult cancers to accurately diagnose and stage preoperatively. The purpose of this review is to provide an update of the state-of-the-art for early detection, diagnosis, and staging of pancreatic cancer. These methods include spiral CT scans, magnetic resonance imaging, positron emission tomography (PET) imaging, laparoscopy, endoscopic ultrasound, CA 19-9 serology, fine needle aspiration cytology, ERCP brush cytology, and screening for p53 and ras oncogenes. These advanced techniques should help us to detect pancreatic cancers in high-risk populations at a curative stage and to decrease pancreaticoduodenectomies for benign disease which could otherwise be treated with less morbid procedures. In addition, these tests will help reliably diagnose pancreatic cancer preoperatively.     

A phase I/II trial of transurethral surgery combined with concurrent cisplatin, 5-fluorouracil and twice daily radiation followed by selective bladder preservation in operable patients with muscle invading bladder cancer

PURPOSE: We describe a protocol designed to evaluate the use of twice daily radiation used together with cisplatin and 5 fluorouracil (5-FU) in the treatment of operable transitional cell carcinoma of the bladder with potential bladder preservation. MATERIALS AND METHODS: A total of 18 consecutive patients with T2-T4a bladder tumors underwent as complete a transurethral resection as possible, which was visibly complete in 14 cases. They then received twice daily radiation and infusion cisplatin and 5-FU during an induction phase. No therapy was given for 3 weeks, following which patients were reevaluated cystoscopically. Cases of clinical complete response by biopsy and cytology were consolidated with further chemotherapy/radiation using the same chemotherapeutic agents and radiation schedule. Patients who had incomplete responses were advised to undergo an immediate radical cystectomy. Of the 18 patients 15 subsequently received 3 cycles of adjuvant chemotherapy, consisting of methotrexate, cisplatin and vinblastine. Median followup for the entire group is 32 months. RESULTS: Of the 18 patients 14 had no detectable tumor after induction therapy. Of the 4 patients with persistent tumor 2 underwent radical cystectomy and 2 refused cystectomy, 1 of whom was treated with partial cystectomy and the other with consolidation chemotherapy/radiation. The actuarial overall survival at 3 years was 83%. The chance of a patient being alive at 3 years with a native bladder was 78%. No patient required cystectomy for hematuria or bladder shrinkage. Three patients in whom superficial tumors developed were treated successfully with bacillus Calmette-Guerin. Small bowel obstruction in 1 case was corrected surgically. CONCLUSIONS: This pilot study demonstrates a high rate of response to this combined chemotherapy/radiation regimen in conjunction with a visibly complete transurethral resection. Reevaluation after a short induction phase allows for the early selection of patients with persistent disease for radical cystectomy.     

Innate immunity, cytokines, and pulmonary host defense

Effective host defense against bacterial infection is dependent on the activation and recruitment of phagocytic cells. The initiation, maintenance, and resolution of this inflammatory response in the setting of bacterial pneumonia is dependent on the expression of cytokines. As the complexities of the host-pathogen interaction are further dissected and unraveled, immunologic manipulation of cytokine expression will likely become an important adjuvant therapy in the treatment of serious lung infections.     

The keyboard blues: Modern technology and the rights and risks of people at work

Health and safety at work is a moral imperative, but the debates emphasise only the economic and legal sides. Drawing on case material from working with VDUs and other forms of modern technology it is shown that loss of control over their immediate work processes can be stressful and potentially harmful to responsible operators. Autonomy and freedom in work process control enhances the power that workers have to protect their health. It is suggested that unquestioned divisive and dualistic practices at workplaces are a potent and unnecessary reason for this problem.A human being can only survive in the Age of Machinery if the ethical norms of life are held sacred. This Shamanist protest at the destructive power of evil, as expressed in theCurse Upon Iron, stands forth prominently in a society in moral crisis.     

Sequencing of RAPD fragments amplified from the genome of the prokaryote Prochlorococcus marinus (prochlorophyta)

DNA fingerprint patterns from the chlorophyll a and b containing prokaryote Prochlorococcus marinus were generated with the RAPD technique using two primers derived from repetitive sequence motifs, [(GATA)4 and M13] and a random primer (OPB-10]. Five RAPD fragments were reamplified, cloned and sequenced. The clones M13/1300 and OPB-10/1100 contained open reading frames, whereas the (GATA)4 fragments were interrupted by stop codons in all frames indicating their noncoding function and possessed a high AT score of 63% and 71%, respectively. With the two (GATA)4 clones and the M13/300 clone strain-specific signals were obtained in a Southern blot analysis of various Prochlorococcus strains. Clones M13/1300 and OPB-10/1100, containing the ORFs, produced RFLPs between the strains analyzed. All RAPD fragments are represented as single copy in the genome of Prochlorococcus.     

Effects of removal of weight-bearing function on contractility and myosin isoform composition in single human skeletal muscle cells

The purpose of this study was to investigate the effects of a 6-week period without weight bearing, achieved by bed rest, on the contractile behaviour, myosin isoform expression and myofibrillar protein content of single human muscle fibres. Percutaneous biopsied specimens of the quadriceps muscle were taken from three healthy male volunteers before and at the end of the experimental period. Maximum force normalised to cross-sectional area (specific tension), maximum velocity of unloaded shortening (V0), and myosin heavy chain (MyHC) and light chain (MyLC) isoform composition were measured in single membrane-permeabilised muscle cells obtained from these specimens. At the end of the experimental period, specific tension was reduced (P < 0.001) by 40% and there was a parallel decline in myofibrillar protein content per muscle cell volume. V0 did not change significantly in response to bed rest when data from all muscle cells were pooled. In two of the subjects, however, V0 decreased (P < 0.01-0.001) in muscle cells expressing the beta/slow (type I) MyHC isoform, but there was no change in fibres expressing type IIA or a combination of type IIA and IIB MyHCs. The slowing in type I MyHC fibres was associated with a change in the isoform composition of the regulatory MyLC.