Marginal Mass Research Articles

Preoperative assessment of myometrial and cervical invasion in endometrial carcinoma: Comparison of multi‐section dynamic MR imaging using a three dimensional FLASH technique and T2‐weighted MR imaging

We aimed to show the diagnostic performance of magnetic resonance imaging by comparing T2-weighted images and dynamic 3D MR images in the assessment of myometrial and cervical invasion by endometrial carcinoma. This prospective study included 53 women consecutively diagnosed with endometrial carcinoma. The subjects were evaluated by TSE T2-weighted images and 3D FLASH-VIBE dynamic MR images by two radiologists with a special training in gynecology. Sensitivity, specificity, negative and positive predictive values were calculated for each imaging modality with regard to assessment of myometrial and cervical invasion. The diagnostic accuracy of TSE T2-weighted and dynamic 3D FLASH-VIBE MR imaging for the identification of any myometrial invasion were estimated as 64% and 84%, respectively. In the differentiation of deep myometrial invasion from the superficial invasion, the diagnostic accuracy of TSE T2-weighted and dynamic 3D FLASH-VIBE MR images were 75.5%, and 88.7%, respectively. Additionally, in the determining of deep myometrial invasion the sensitivity, the specificity, PPV, and NPV were 76%, 75%, 50%, and 90.9% on T2-weighted images, respectively; 100%, 85%, 68.4%, and 100% on dynamic 3D MR images, respectively. The diagnostic accuracy of TSE T2-weighted and dynamic 3D FLASH-VIBE MR images for cervical invasion by endometrial carcinoma were 86%, and 92%, respectively. The multiplanar capabilities of MRI are invaluable to evaluate spreading and margins of an endometrial mass, and the 3D dynamic MR techniques offer the advantages of increased coverage and high spatial resolution. Three dimensional dynamic MR imaging may be recommended in the especially postmenopausal cases before performing potentially curative treatments.

The effect of patient age on the internal carotid artery location around the atlas

The aim of this study was to analyze the exact location of the internal carotid artery (ICA) relative to the C-1 lateral mass and describe the effect of age on the tortuosity of the ICA. The authors analyzed 641 patients who had undergone CT angiography to evaluate the location of the ICA in relation to the C-1 lateral mass. Each patient was assigned to 1 of 3 age groups (< 41 years, 41-60 years, and > 60 years of age). The degree of lateral positioning of the ICA was classified into 4 groups: Group 1 (lateral to the C-1 lateral mass), Group 2 (lateral half of the lateral mass), Group 3 (medial half of the lateral mass), or Group 4 (medial to the lateral mass). The anteroposterior relationship of the ICA was classified into Group A (posterior to the anterior tubercle) or Group B (anterior to the anterior tubercle). Distances from the ICA to the midline, anterior tubercle, and anterior cortex of the lateral mass were measured. Distances between the lateral margin of the lateral mass and the longus capitis muscle were also evaluated. The prevalence of the ICA located in front of the lateral mass (Groups 2 and 3) was 47.4% overall. The position of the ICA changes with age due to vessel tortuosity. Only 18.3% of patients in the youngest age group (< 41 years of age) had an ICA in front of the lateral mass (Group 2 or 3 area). However, this percentage increased in the older 2 groups (43.5% in the 41-60 year old group, and 57% in the > 60-year-old age group). The mean distance from the midline to the ICA was 22.6 mm, and the mean distance from the ICA to the C-1 anterior tubercle and the ventral cortex of the lateral mass was 4.7 and 4.5 mm, respectively. Moreover, the ICA is more prone to injury during bicortical C-1 screw placement when the longus capitis muscle is hypotrophic and does not cover the entire ventral surface of the lateral mass. Elderly patients have a higher incidence of a medially located ICA that may contribute to the risk of injury to the ICA during bicortical C-1 screw or C1-2 transarticular screw placement. Although the small number of reported cases of ICA injury does not allow for determination of a direct relationship with specific anatomical characteristics, the presence of unfavorable anatomy does warrant serious consideration during evaluation for C-1 screw placement in elderly patients.

Mesenchymal Stem Cells Prevent Acute Rejection and Prolong Graft Function in Pancreatic Islet Transplantation

Pancreatic islet transplantation is a promising cell-based therapy for type 1 diabetes (insulin-dependent diabetes mellitus), a disease triggered by the immune response against autoantigens of beta-cells. However, the recurrence of immune response after transplantation and the diabetogenic and growth-stunting side effects of immunosuppressants are major challenges to the application of islet transplantation. Mesenchymal stem cells (MSCs) have recently been reported to modulate the immune response in allogeneic transplantation. The ability of MSCs, either syngeneic or allogeneic to recipients, to prevent acute rejection and improve glycemic control was investigated in rats with diabetes given a marginal mass of pancreatic islets through the portal vein. Reduced glucose levels and low-grade rejections were observed up to 15 days after transplantation upon triple-dose administration of MSCs, indicating that MSCs prolong graft function by preventing acute rejection. The efficacy of MSCs was associated with a reduction of pro-inflammatory cytokines and was independent of the administration route. Efficacy was similar for MSCs whether syngeneic or allogeneic to recipients and comparable to that of immunosuppressive therapy. The results show that MSCs modulate the immune response through a down-regulation of pro-inflammatory cytokines, suggesting that MSCs may prevent acute rejection and improve graft function in portal vein pancreatic islet transplantation.

Radiographic Findings in the Diagnosis of Pediatric Ileocolic Intussusception

Several previous studies have evaluated the usefulness of plain abdominal radiographs for the diagnosis of pediatric intussusception, although investigation of the most specific clues to diagnose intussusception has not been studied alone. The 3 most specific findings of intussusception include intraluminal mass or intussusceptum, nonvisualized air-filled cecum, and obscured liver margin or right upper-quadrant mass. In this study, a retrospective review of 73 known cases of intussusception with age- and sex-matched controls was performed. The cases were reviewed by 2 blinded, board-certified pediatric radiologists to aid in the determination of sensitivity and specificity. The sensitivity and specificity of plain radiographs to correctly diagnose ileocolic intussusception in pediatric patients compared with a control population were 77% and 97%, using a 50% or greater receiver operating characteristic curve cutoff.

Multiplanar spinal CT 3D reconstruction and measurement of the lower cervical pedicle

Objective To evaluate the clinical significance of measuring the lower cervical pedicle using multiplanar spinal CT (MSCT) 3D reconstruction. Methods Eight specimens of adult male ver-tebrae were examined by MSCT. The data were sent to Silicon Graphics 02 for 3D reconstruction according to the parameter requirements for lower cervical pedicle fixation, using reconstruction images of volume rendering (VR) and muhiplanar reformation (MPR). Results Statistically significant differences were found be-tween vertebrae in the following lower cervical data, including the pedicle angle relative to transverse plane= 42.02°±7.55°, with the largest at C4 and the smallest at C7; the pedicle angle relative to sagittal plane =76. 30°±12.01°, with the largest at C7 and the smallest at C3; the distance from the entry-peint to the margin of lower joint=11.23 mm±1.78 mm, with the longest at C6 and the shortest at C3; the distance from the entry-point to the outermost margin of lateral mass=2.65mm±1.21mm, with the longest at C7 and the shortest at C4. The distance from the entry-point to the vertebral anterior border=31.42 mm±2.13mm,with little difference between C3 and C7; the height of pedicle cancellous bone=3.69 mm±1.19 mm and the width = 2.67 mm ± 1.15 ram; the height of pedicle cortical bone=8.43 mm ± 1.30 mm and the width =5.54 mm ± 1.26 ram. The longest inside diameter of pedicle was seen at C7 and the shortest at C4. Generally the height of pedicle was larger than the width of pedicle. Conclusion Since 3 D reconstruction images by VR and MPR techniques can be used to measure various data related to the pedicles, they can help the pre-operative planning for transpedicular screw fixation of the lower cervical spine. Key words: Tomngraphy; spiral computed; Imaging; three-dimensional; Cervical vertebrae

Prediction of Marginal Mass Required for Successful Islet Transplantation

ABSTRACTIslet quality assessment methods for predicting diabetes reversal (DR) following transplantation are needed. We investigated two islet parameters, oxygen consumption rate (OCR) and OCR per DNA content, to predict transplantation outcome and explored the impact of islet quality on marginal islet mass for DR. Outcomes in immunosuppressed diabetic mice were evaluated by transplanting mixtures of healthy and purposely damaged rat islets for systematic variation of OCR/DNA over a wide range. The probability of DR increased with increasing transplanted OCR and OCR/DNA. On coordinates of OCR versus OCR/DNA, data fell into regions in which DR occurred in all, some, or none of the animals with a sharp threshold of around 150-nmol/min mg DNA. A model incorporating both parameters predicted transplantation outcome with sensitivity and specificity of 93%% and 94%%, respectively. Marginal mass was not constant, depended on OCR/DNA, and increased from 2,800 to over 100,000 islet equivalents/kg body weight as OCR/DNA decreased. We conclude that measurements of OCR and OCR/DNA are useful for predicting transplantation outcome in this model system, and OCR/DNA can be used to estimate the marginal mass required for reversing diabetes. Because human clinical islet preparations in a previous study had OCR/DNA

The contralateral synchronous breast carcinoma: a comparison of histology, localization, and magnetic resonance imaging characteristics with the primary index cancer

Women with unilateral breast carcinoma reveal an increased risk of suffering from malignancies in the contralateral breast. There is a controversy about the existence of bilateral phenotypic similarities. The aim of this investigation was to compare histologic findings, magnetic resonance imaging (MRI) parameters, and tumor localizations of synchronous bilateral carcinomas. MRI revealed in 42 of 875 women (4.8%) with primary index carcinomas a contralateral malignancy. Twenty-two of the 42 contralateral carcinomas could only be detected by MRI, not by clinical examination, X-ray mammography, or ultrasonography. In 875 patients, MRI therefore identified 22 (2.5%) otherwise occult contralateral cancers. To evaluate bilateral MRI similarities, multiple dynamic and morphologic parameters were evaluated. Of 42 bilateral cancer pairs, histologic tumor type was identical in 54.8% (correlation analysis, P < 0.05). Estrogen receptor status was simultaneously positive or negative in 86.2% (P < 0.01), progesterone receptor status in 79.3% (P < 0.05), expression of human epidermal growth factor receptor 2 in 76.2% (P < 0.05). In 75.8%, initial signal increase, and in 63.6%, postinitial curve types were bilaterally congruent on MRI (P < 0.05). Detected masses showed bilaterally similar T2-signal intensity in 81.8% (P < 0.001). Similar shape and margin of tumor masses and occurrence of non-mass-like enhancement were also frequently observed in both breasts (P < 0.05). The main tumor quadrant was the same in 61.9%, the main localization (retromamillar, central, or dorsal) in 66.7% (P < 0.01). Contralateral carcinomas frequently present similar histologic findings, tumor localizations and MRI characteristics reflecting analogies of tumor neoangiogenesis, histopathologic components, and infiltration in the surrounding stroma. Bilateral synchronous carcinomas may represent on each site distinct, but similar biologic entities, due to analogous influences of tumor developments.

A Case of Primary Chondrosarcoma of the Cricoid Cartilage

Laryngeal chondrosarcoma is a cartilaginous malignant tumor which is rarely encountered in the head and neck. They occur most often in the paranasal sinus, mandibule, and larynx. The cricoid cartilage is the most common site of the laryngeal chondrosarcoma. Complete surgical resection and postoperative radiotherapy are generally recommended. Almost all cases of the laryngeal chondrosarcoma are detected early because of the rapid development of symptoms such as dyspnea, dysphagia and hoarseness, which are caused by the anatomic location. Authors experienced a case of laryngeal chondrosarcoma that originated from the cricoid cartilage in a 67 yearold male without any symptoms. The mass was found on a routine esophagogastroduodenoscopy examination. Hemicricoidectomy with complete excision of tumor was performed via laryngofissure approach. The patient did not undergo radiotherapy, since all margins of the resected mass were tumor-free. There was no evidence of recurrence or metastasis 12 months after surgery. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:378-82 Key WordsZZChondrosarcoma·Larynx·Cricoid cartilage.

Epidermal Inclusion Cyst after Breast Reconstruction with TRAM Flaps

Breast reconstruction with TRAM flaps has becomean increasingly common surgical procedure amongbreast cancer patients who undergo a mastectomy (1).TRAM flap reconstruction involves the transfer of lowerabdominal skin and subcutaneous fat to the chest defectat the mastectomy site (2). In this procedure, the epider-mal inclusion cyst can be developed at the surgical site ifthe de-epithelized portion of buried skin flaps retains theepithelial elements. This epidermal inclusion cyst,which can be mistaken for a recurrent cancer, may leadto a false positive finding on a mammogram.To our knowledge, reports on epidermal inclusioncysts after breast reconstruction surgery have not beenpreviously described in the literature. So, we report ourexperience of an epidermal inclusion cyst in a patientwho underwent a total mastectomy with breast recon-struction and TRAM flaps.Case ReportA 50-year-old woman was admitted to our hospital fora follow-up mammography. She underwent a left totalmastectomy and reconstruction with TRAM flaps fortreatment of the ductal carcinoma in situ, about 6-months prior. The mammography showed findings sug-gesting that the postoperative change and an oval-shaped, circumscribed partially indistinct marginal iso-dense mass at the 2 o’clock position of the left breast(Fig. 1A). The mass was believed to be benign, such asfat necrosis or benign granuloma, so the patient was rec-ommended to receive follow-up mammography 6-months later.The 6 month follow-up showed an increase in the sizeof the previously detected mass at the 2 o’clock positionfrom about 10 mm to 13 mm in diameter (Fig. 1B). Onultrasonography, the lesion was located in the peripher-al portion of reconstructed breast, adjacent to the inci-

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Primary Breast Carcinoma: Association of Mammographic Calcifications with Osteopontin Expression

To evaluate the osteopontin (OPN) protein expression levels in breast carcinomas to determine if they correlate with mammographic appearances such as calcifications. This retrospective study was institutional review board approved. Informed consent was obtained from patients. Clinical history, histopathologic findings, mammographic features, and OPN expression as determined with immunohistochemistry results were evaluated in 141 women with breast cancer. The median age of patients was 53 years (range, 29-82 years). Mammographic features and clinicopathologic characteristics were correlated with tumor OPN expression. chi(2) And Fisher exact tests were used to evaluate the association of OPN expression with mammographic and clinicopathologic features. Calcifications on mammograms (P = .012), spiculated margins of mass on mammograms (P = .02), "triple-negative" (ie, cancer that is estrogen receptor, progesterone receptor, and human epidermal growth factor receptor negative) phenotype (P = .02), and lymph node metastasis (P < .0001) were significantly associated with OPN status. In contrast to OPN-negative tumors, OPN-positive tumors were more likely to have spiculated margins (57.6% vs 9.2%), to be associated with calcifications (54.3% vs 30.6%), to be a triple-negative phenotype (26% vs 8.1%), and to have axillary lymph node metastasis (81.5% vs 38.8%). Most calcifications were of pleomorphic morphology (60.4% vs 11.8%, P = .046). OPN could play a role in the formation of calcifications that often are associated with breast cancer.

Pretransplant Immune Parameters Associate With Islet Allograft Outcome

Extensive and informative immunological assessments of islet transplant recipients have been limited due, in part, to the smaller numbers of patients transplanted compared with solid organ trials. Limitations related to blood volume and the logistical challenges of collecting multiple posttransplant samples for drug levels as well as clinical and metabolic parameters also pose challenges. Several variables affect islet allograft outcome, including allo- and autoimmune responses to transplanted islets, β-cell mass and islet quality, efficacy of the immunosuppressive regimen and its effect on islet function, as well as glycemic control. In fact, much debate has centered on whether or not islet attrition is due to immune-mediated loss, death of overworked cells caused by insufficient mass, and/or diabetogenic effect of various immune intervention agents. In addition, many of these parameters may have differing effects based on the transplanted mass, with marginal mass transplants being more susceptible to immune-mediated or stress-induced loss. Recently, several studies have demonstrated immunological alterations in islet allograft patients. Posttransplant changes in lymphocytes and lymphocyte subsets were reported to be variable depending on the immune suppression used but have not yet been associated with graft status or specific clinical outcomes (1–4). Higher posttransplant cytotoxic T-cell precursor frequency against donor antigens was associated with poorer outcome at 6 months in recipients treated with sirolimus-based maintenance therapy but not tacrolimus–mycophenolate mofetil (5). In one study, cytokine production in allogeneic mixed lymphocyte reactions (MLRs) was skewed toward …

Chemical Shift MRI: Is There any Contribution to Morphologic Evaluation of Solid Breast Masses?

To investigate the contribution of chemical shift magnetic resonance imaging for assessment of the margins of solid breast masses by benefiting from India ink artifact. Eighty-eight masses in 64 patients were evaluated in T1- and T2-weighted images, dynamic contrast and chemical shift studies according to Breast Imaging Reporting and Data System magnetic resonance lexicon. Subtraction images were automatically obtained by chemical shift imaging and dynamic studies. Each sequence was scored using a scale of 1 to 5 according to its ability to demonstrate margins separate from surrounding parenchyma. Breast parenchyma was evaluated as fatty and dense. The results were compared with the histopathologic results. Twenty-eight (31.8%) of the lesions were localized in fatty breast, and the remaining 60 (68.2%) lesions were localized in dense breast. There were 34 (38.6%) benign and 54 (61.4%) malignant masses. In fatty breast, chemical shift subtraction and T1-weighted images were valuable both for the demonstration and differentiation of benign lesions (P < .05). None of the sequence was valuable for both the demonstration and differentiation of malignant lesions in fatty breasts (P > .05). In dense breasts, chemical shift subtraction and dynamic contrast subtraction images were valuable for both the demonstration and differentiation of benign and malignant lesions. Additional to these sequences, T2-weighted images was also valuable for benign lesions (P < .05). Chemical shift subtraction can contribute to routine dynamic contrast subtraction in morphologic analysis particularly for the evaluation of margins of benign lesions in fatty breasts. It can also help in morphologic analysis of masses in dense breast.

Clinical value of computer-aided algorithm on radiologist's diagnosis of masses using breast ultrasound imaging

Objective To propose a novel computer-aided segment algorithm, and retrospectively investigate its effect on radiologist's sensitivity and specificity for discriminating malignant masses from benign masses basing on ultrasound images. Methods Four hundred and sixty-six images of 100 masses obtained by conventional ultrasound were processed by a novel segment algorithm. Radiologists who were blind to the histology results were invited to analyse the original and computerized images respectively. The sensitivity and specificity were calculated by means of a binary outcome using receiver operating characteristic(ROC) analysis. Results By using the segment algorithm, the quantity of the image was obviously improved, especially the margin and calcification of the masses. The diagnostic performance of the radiologists was also improved. The sensitivity rose from 70.32% to 90.52% while the specificity was 74.31%. The area under the ROC curve increased significantly (P<0.01) from 80.8% to 90.5%. Conclusions The proposed segmentation algorithm can improve the diagnosis performance of the radiologists by meliorating the quality of the ultrasound image. Key words: Ultrasonography; Breast diseases; Image processing,computer-assisted

In vivo visualization of transplanted pancreatic islets by MRI: comparison between in vivo, histological and electron microscopy findings

The aim of the work was to compare in vivo MRI visualization of pancreatic islets labeled with clinical-grade superparamagnetic iron oxide (SPIOs) contrast agents with ex vivo examination of liver tissue in an experimental model of marginal mass transplantation in rats. Seven hundred IEq (Islet Equivalent) from Wistar rats, labeled by incubation with Endorem or Resovist, were transplanted into Sprague-Dawley rats through the portal vein. Liver MR images of recipient rats were acquired at different time points (3-42 days) after transplantation. Animals were sacrificed during this period and their livers were excised and prepared for histology and electron microscopy. Hypointense spots originating from iron particles were observed in MR images. The number of separate spots was counted. Three days after transplantation one spot for every three or four transplanted islets was observed. Seven days after transplantation, histological sections showed the presence of iron within pancreatic islets. The time course of MR images showed a decrease in the number of spots, at 42 days, amounting to 65 and 22% of the initial value, for Resovist and Endorem respectively, while no immunopositive endocrine cells were detected in histological slices. The present work shows that pancreatic islets can be labeled using clinically approved SPIO contrast agents and visualized using in vivo MRI with high sensitivity, consistently with findings in the literature. Differently from reports in the literature, our findings indicate that iron particles could last in the liver for long periods, independently of the presence of intact pancreatic islets.

Persistency Model and Its Applications in Choice Modeling

Given a discrete maximization problem with a linear objective function where the coefficients are chosen randomly from a distribution, we would like to evaluate the expected optimal value and the marginal distribution of the optimal solution. We call this the persistency problem for a discrete optimization problem under uncertain objective, and the marginal probability mass function of the optimal solution is named the persistence value. In general, this is a difficult problem to solve, even if the distribution of the objective coefficient is well specified. In this paper, we solve a subclass of this problem when the distribution is assumed to belong to the class of distributions defined by given marginal distributions, or given marginal moment conditions. Under this model, we show that the persistency problem maximizing the expected objective value over the set of distributions can be solved via a concave maximization model. The persistency model solved using this formulation can be used to obtain important qualitative insights to the behavior of stochastic discrete optimization problems. We demonstrate how the approach can be used to obtain insights to problems in discrete choice modeling. Using a set of survey data from a transport choice modeling study, we calibrate the random utility model with choice probabilities obtained from the persistency model. Numerical results suggest that our persistency model is capable of obtaining estimates that perform as well, if not better, than classical methods, such as logit and cross-nested logit models. We can also use the persistency model to obtain choice probability estimates for more complex choice problems. We illustrate this on a stochastic knapsack problem, which is essentially a discrete choice problem under budget constraint.

Marginal mass islet transplantation with autologous mesenchymal stem cells promotes long-term islet allograft survival and sustained normoglycemia

Allogeneic islet transplantation is an option to treat diabetes however there are obstacles that are limiting its clinical use. We have examined whether mesenchymal stem cells (MSC) improve islet graft survival and whether such therapy allows for better graft acceptance with reduced requirement for immunosuppression. In vitro-expanded syngeneic bone marrow-derived MSC were co-transplanted with islets into omental pouch in a rat model of streptozotocin-induced diabetes. Marginal mass syngeneic islet transplantation into the omentum with MSC promoted sustained normoglycemia. Interestingly, allogeneic islets +MSC, but not islets alone, with short-term use of immunosuppression enhanced long-term islet graft survival, insulin expression in the grafts and induced normal serum insulin levels and normoglycemia. T cells from recipients transplanted with allogeneic islets +MSC produced low levels of IFN-γ and TNF-α upon ex-vivo activation, and this transplantation protocol promoted the generation of IL-10-secreting CD4 + T cells. These data encourage further preclinical and eventually, clinical MSC-based islet transplantation to improve the outcome of allogeneic islet transplantation in the treatment of diabetes.

Comparison of Four Pancreatic Islet Implantation Sites

Although the liver is the most common site for pancreatic islet transplantation, it is not optimal. We compared kidney, liver, muscle, and omentum as transplantation sites with regard to operative feasibility, and the efficiency of implantation and glycemic control. Islets from C57BL/6 mice were transplanted into diabetic syngeneic recipients. The mean operative time and mortality were measured to assess feasibility. To assess implantation efficiency, the marginal mass required to cure diabetes and the mean time taken to achieve normoglycemia were measured. A glucose tolerance test was performed to assess glycemic control efficiency. The data are listed in the order of the kidney, liver, muscle, and omentum, respectively. The mean mortality rate was 6.7, 20.0, 7.1, and 12.5%; the mean operative time was 10.2, 27.4, 11.2, and 19.8 min; the marginal islet mass was 100, 600, 600, and 200 islet equivalence units and the mean time to reach euglycemia was 3.0, 15.1, 26.6, and 13.9 days. The glucose kinetics of omental pouch islets was the most similar to controls. Thus, a strategic approach is required for deciding on the best transplantation recipient sites after considering donor sources and islet volume. Alternatives can be chosen based on safety or efficacy.

Porcine Marginal Mass Islet Autografts Resist Metabolic Failure Over Time and Are Enhanced by Early Treatment with Liraglutide

Although insulin independence is maintained in most islet recipients at 1 yr after transplant, extended follow-up has revealed that many patients will eventually require insulin therapy. Previous studies have shown that islet autografts are prone to chronic failure in large animals and humans, suggesting that nonimmunological events contribute to islet graft functional decay. Early intervention with therapies that promote graft stability should provide a measurable benefit over time. In this study, the efficacy of the long-acting glucagon-like peptide-1 analog liraglutide was explored in a porcine marginal mass islet autograft transplant model. Incubation with liraglutide enhanced porcine islet survival and function after prolonged culture. Most vehicle-treated (83%) and liraglutide-treated (80%) animals became insulin independent after islet autotransplantation. Although liraglutide therapy did not improve insulin independence rates or blood glucose levels after transplant, a significant increase in insulin secretion and acute-phase insulin response was observed in treated animals. Surprisingly, no evidence for deterioration of graft function was observed in any of the transplanted animals over more than 18 months of follow-up despite significant weight gain; in fact, an enhanced response to glucose developed over time even in control animals. Histological analysis showed that intraportally transplanted islets remained highly insulin positive, retained alpha-cells, and did not form amyloid deposits. This study demonstrates that marginal mass porcine islet autografts have stable long-term function, even in the presence of an increasing metabolic demand. These results are discrepant with previous large animal studies and suggest that porcine islets may be resistant to metabolic failure.

Risk factors of cardiac diseases in faculty members and educational staff

Background In spite of different studies for identifying risk factors in cardiovascular diseases, mortality rate resulted from them is worrying. It is estimated that by the year 2020, the rate will reach to 75%. At present, such risk factors as urban lifestyle, stress, diabetes, obesity, immobility, smoking, increased lipids, BUN, creatinine, hypertension etc. have been identified and are under investigation. Purpose This cross-sectional study was carried out to determine identified and probably unknown risk factors in the faculty and educational staff of Islamic Azad University in Karaj city. Methods 242 subjects including 81 (33.5%) faculty members and 161 persons (66.5%) from educational staff were randomly selected. A questionnaire in 2 parts and some clinical as well as paraclinical tests were used for data collection. All data were gathered between 8 AM and 12 MD during heavy workload. Results It was revealed that 44% of the faculty and 46% of the staff had marginal body mass index (BMI). In addition, 14% as well as 26% of the subjects had abnormally higher BMI respectively. In both groups, 63% had higher BMI than normal. Waist circumferences of 62% of the faculty and 76% of the staff were 80 cm or more. 65% had normal blood pressure while it was more than 140/80 mm Hg in 22%. However, in 9% of the faculty and 4% of the staff, the pressure was 100/50 mm Hg. 96% and 91% of both groups did not smoke and fell within normal ranges for blood sugar and urine. The amount of urea and creatinine showed a significant difference between the groups (P=0.000, P=0.009). Conclusion Some known risk factors such as blood sugar and lipids were controlled in the groups but some of them have not been identified as risk factors for cardiac diseases, e.g. BMI, waist circumference, urea and creatinine. A significant relationship exists between blood pressure and job stress as well as coping strategies. This denotes that educational authorities and administrators should modify their plans to control stress and risk factors. Keywords: Cardiac risk factors, Stress, Faculty members, Educational staff.