Primary Foci Research Articles

Tackling Controversial Topics: Developing Thematic Text Sets for Elementary Social Studies

Increased integration of the social studies into language arts instructional time in elementary schools, has led to a common practice of covering social studies content through use of children’s literature. Though the two content areas are covered in tandem, the primary foci are the language arts objectives. The authors suggest teaching with themed text sets, developed using carefully selected social studies topics and inquiries, not only addresses English Language Arts standards but also allows for authentic and meaningful social studies instruction. A four-step process for developing themed text sets is presented. These are: 1) identify the big idea to be explored, 2) recognize the multiple perspectives needed for a more complete story, 3) locate qualifying texts, and 4) select texts to be included. Each step is demonstrated with three controversial topics in the elementary social studies curriculum: family (Kindergarten-1), civil rights (grades 2-3), and slavery (grades 4-5) and resources are provided for locating texts. The authors illustrate the importance of developing text sets that include multiple perspectives, particularly those lesser-known stories of historical events or themes, to serve as windows or mirrors for children in developing historical content knowledge.

The diagnostic value of tumor markers in bronchoalveolar lavage fluid for the peripheral pulmonary carcinoma.

To investigate the value of Ubiquitin specific peptidase 8 (USP8), Chitinase 3-like 1 (YKL40), Heat shock protein 90a (HSP90α), glutathione S-transferase P1 (GSTP1), carcinoembryonic antigen (CEA), neuron specific enolase (NSE) and cytokeratin fragment antiogen 21-1 (CYFRA21-1) in bronchoalveolar lavage fluid (BALF) and serum for diagnosis in patients with peripheral lung cancer. The concentration of these markers were measured in 50 patients with peripheral lung cancer and 50 patients with benign lung diseases by using enzyme-linked immuno sorbent assay methods. There were significant differences between the peripheral lung cancer group and the benign lung disease group (P < 0.05) in the BALF of USP8, YKL40, HSP90α, CEA, NSE and CYFRA21-1. There were significant differences between the peripheral lung cancer group and the benign lung disease group (P < 0.05) in the serum of HSP90α and CEA. There were no differences in others. There were no correlation between the concentration of all markers and age, histological type, TNM stage (I-IV). There was a weak correlation between the primary foci diameters and the concentration of YKL40 in BALF. (Pearson's correlation: 0.203, P = 0.048) The diagnostic efficiencies of USP8, YKL40, HSP90α were superior to CYFRA21-1 and NSE, being lower CEA. Detection of tumor markers in BALF was superior to serum specimens. The measurement of USP8, HSP90α and YKL40 in BALF had more clinical value for the diagnosis of peripheral pulmonary carcinoma.

Pregnancy Following Cervical Tuberculosis

Incidence of urogenital tuberculosis is a raising concern worldwide specially in developing countries, in most cases, primary foci may not be identified either due to ignorance of the individual or her family may remain unaware about the seriousness or consequences. In this case a multiparous reproductive aged woman presented with repeated episode of post coital bleeding. Most of the attending Physician confused with hormonal disturbance and treated with hormone and others for months in outreach area. Once upon a time however she was referred to Gynae OPD and after inspection of cervix she was advised for inpatient admission for Examination Under Anaesthesia (EUA) and biopsy. Histopathology report revealed chronic granulomatous lesion of the cervix and ultimately she was diagnosed as a case of tubercular ulcer of the cervix. After successful treatment by antitubercular medication as per schedule, she was conceived and gave birth to a healthy term baby. Pregnancy following cervical Tuberculosis (TB) is a rare incidence and probably not reported in literature. JCMCTA 2015 ; 26 (1) : 55-58

Remote spatiotemporally controlled and biologically selective permeabilization of blood-brain barrier

The blood–brain barrier (BBB), comprised of brain endothelial cells with tight junctions (TJ) between them, regulates the extravasation of molecules and cells into and out of the central nervous system (CNS). Overcoming the difficulty of delivering therapeutic agents to specific regions of the brain presents a major challenge to treatment of a broad range of brain disorders. Current strategies for BBB opening are invasive, not specific, and lack precise control over the site and timing of BBB opening, which may limit their clinical translation. In the present report, we describe a novel approach based on a combination of stem cell delivery, heat-inducible gene expression and mild heating with high-intensity focused ultrasound (HIFU) under MRI guidance to remotely permeabilize BBB. The permeabilization of the BBB will be controlled with, and limited to where selected pro-inflammatory factors will be secreted secondary to HIFU activation, which is in the vicinity of the engineered stem cells and consequently both the primary and secondary disease foci. This therapeutic platform thus represents a non-invasive way for BBB opening with unprecedented spatiotemporal precision, and if properly and specifically modified, can be clinically translated to facilitate delivery of different diagnostic and therapeutic agents which can have great impact in treatment of various disease processes in the central nervous system.

Hepatocellular carcinoma presenting as thoracic spinal canal metastasis with no clinical primary foci: A report of a rare case and review of the literature.

Hepatocellular carcinoma (HCC) is the third most common malignant tumor worldwide and has a poor survival rate. The poor prognosis can be attributed to several of the characteristics of HCC, such as fast infiltrating growth, early-stage metastasis, high-grade malignancy and poor therapeutic efficacy. The current study presents a case of HCC that was metastatic to the spinal canal with an unknown primary site and discusses the diagnostic probabilities. The patient was a 48-year-old female who presented with chest paraesthesis of the back and numbness of the right lower limb. Computed tomography (CT) and magnetic resonance imaging indicated a possible lipomyoma in the thoracic spinal canal. Surgery was performed to remove the mass and the post-operative pathological diagnosis indicated a moderately-differentiated HCC. Subsequent abdominal CT scans and B-mode ultrasound failed to localize the primary foci in the liver and the tumor markers were normal. The patient had no history of chronic liver disease in the past. The patient refused any further examinations after surgery and was discharged from hospital. A post-operative follow-up 1.5 years later found that the patient was healthy and that the level of discomfort had been significantly reduced following the surgery. HCC presenting as thoracic spinal canal metastasis with an unknown primary site is extremely rare. The present study additionally reports the results of a literature review and provides a rational deduction for the unknown primary foci of HCC.

Abstract 3883: Clonal evolution of a lethal prostate cancer: Integrated whole genome analysis case study

Abstract Prostate cancer (PC) is prevalent in both indolent and lethal forms. Although many PC patients diagnosed today have organ-confined disease curable by prostatectomy or radiation therapy, 20-30% of PCs will relapse to lethal disease within 5-years of treatment. Relatively little attention has been paid to distinguishing the molecular characteristics of proven lethal metastatic PC from non-lethal cancers. A better understanding of the origins and evolution of lethal cancers should allow screening and treatment to be better tailored to the needs of each patient. To this end, we performed an integrative molecular profiling of a lethal PC from one patient (A21). High-coverage whole genome sequence, transcriptome sequence, and methylation analysis was performed on 9 anatomically separate metastases obtained by autopsy, and targeted sequencing was performed in multiple cancerous and noncancerous foci within the radical prostatectomy specimen removed 5 years prior to death. Molecular results were analyzed in relation to detailed clinical data. Integrated whole genome sequence analysis revealed convergent evolution of AR gene amplification events, and inception of p.L702H mutation in the AR present only in liver metastases. In addition, the analysis showed parallel increases in AR regulated transcripts in the liver metastases, suggesting a dominant effect by the mutation. Mutation of PI3/PI4 kinase member PIK3CG was found in all metastases but in no primary tumor foci studied. The study demonstrated the power of an integrated approach to interrogate clonal evolution of cancer suggesting that such studies are valuable on the individual level and could lead the way towards personalized treatment. In the individual studied, cessation of corticosteroid treatment and/or therapeutic manipulation of PI3K/AKT/mTOR activity theoretically could have provided a personalized benefit. These findings suggest that similar integrated analysis in large cohorts of patients with metastatic cancer could accelerate progress in establishing effective personalized cancer medicine. Citation Format: Heini M.L. Kallio, Matti Annala, Kati Kivinummi, Gunilla Högnäs, Gunes Gundem, David C. Wedge, Peter Van Loo, Holger Heyn, Michael R. Emmert-Buck, William B. Isaacs, Manel Esteller, Ultan McDermott, Matti Nykter, Tapio Visakorpi, G. Steven Bova. Clonal evolution of a lethal prostate cancer: Integrated whole genome analysis case study. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3883. doi:10.1158/1538-7445.AM2015-3883

Discordance of Histologic Grade Between Primary and Metastatic Neuroendocrine Carcinomas.

The prognosis and management of neuroendocrine carcinoma are largely driven by histologic grade as assessed by mitotic activity. The authors reviewed their institutional experience to determine whether the histologic grade of neuroendocrine carcinoma can differ between primary and metastatic tumors. This study examined patients who underwent operative resection of both primary and metastatic foci of neuroendocrine carcinoma. Resected tumors were independently reviewed and categorized as low, intermediate, or high grade as determined by mitotic count. The authors identified 20 patients with metastatic neuroendocrine carcinoma treated at their institution between 1997 and 2013 for whom complete pathologic review of primary and metastatic tumors was possible. Primary lesions were found in the small intestine (n = 12), pancreas (n = 7), ampulla (n = 1), stomach (n = 1), and rectum (n = 1). The timing of hepatic metastasis was synchronous in 15 cases and metachronous in 5 cases. The histologic grade was concordant between primary and metastatic tumors in 9 cases and discordant in 11 cases. Among the discordant cases, 7 had a higher metastatic grade than primary grade, and 4 had a lower metastatic grade than primary grade. Metachronous presentation was associated with a higher likelihood of grade discordance (p = 0.03). The histologic grade of all metachronous metastases differed from that of the primary tumors. There is a high prevalence of histologic grade discordance between primary and metastatic foci of neuroendocrine carcinoma, particularly among patients with a metachronous metastatic presentation. Given the importance of histologic grade in disease prognostication and treatment planning, this finding may be informative for the management of patients with metastatic neuroendocrine carcinoma.

The Multiplicity of Cellular Infection Changes Depending on the Route of Cell Infection in a Plant Virus.

The multiplicity of cellular infection (MOI) is the number of virus genomes of a given virus species that infect individual cells. This parameter chiefly impacts the severity of within-host population bottlenecks as well as the intensity of genetic exchange, competition, and complementation among viral genotypes. Only a few formal estimations of the MOI currently are available, and most theoretical reports have considered this parameter as constant within the infected host. Nevertheless, the colonization of a multicellular host is a complex process during which the MOI may dramatically change in different organs and at different stages of the infection. We have used both qualitative and quantitative approaches to analyze the MOI during the colonization of turnip plants by Turnip mosaic virus. Remarkably, different MOIs were observed at two phases of the systemic infection of a leaf. The MOI was very low in primary infections from virus circulating within the vasculature, generally leading to primary foci founded by a single genome. Each lineage then moved from cell to cell at a very high MOI. Despite this elevated MOI during cell-to-cell progression, coinfection of cells by lineages originating in different primary foci is severely limited by the rapid onset of a mechanism inhibiting secondary infection. Thus, our results unveil an intriguing colonization pattern where individual viral genomes initiate distinct lineages within a leaf. Kin genomes then massively coinfect cells, but coinfection by two distinct lineages is strictly limited. The MOI is the size of the viral population colonizing cells and defines major phenomena in virus evolution, like the intensity of genetic exchange and the size of within-host population bottlenecks. However, few studies have quantified the MOI, and most consider this parameter as constant during infection. Our results reveal that the MOI can depend largely on the route of cell infection in a systemically infected leaf. The MOI is usually one genome per cell when cells are infected from virus particles moving long distances in the vasculature, whereas it is much higher during subsequent cell-to-cell movement in mesophyll. However, a fast-acting superinfection exclusion prevents cell coinfection by merging populations originating from different primary foci within a leaf. This complex colonization pattern results in a situation where within-cell interactions are occurring almost exclusively among kin and explains the common but uncharacterized phenomenon of genotype spatial segregation in infected plants.

Skin Cancers as Contraindication to Organ Transplantation

The period of preparing patients for organ transplantation is a suitable time for dermatologic screening and examination that guarantee early diagnosis and easier treatment of precancerous states and skin cancers. In most cases, diagnosis of skin cancer in the pretransplantation period is not a contraindication to transplantation. Knowledge of risk factors and etiopathogenesis of skin cancers after transplantation make it easier to point out patients with increased risk of skin carcinogenesis. Patients with skin phototype I–III (Fitzpatrick classification) and with high cumulative doses of ultraviolet radiation have an increased risk of skin cancers. Patients who had skin cancers in the past should be carefully examined, and the skin cancer histopathology should be analyzed in detail. These examinations have to be done from the clinical, surgical, and histopathologic aspects. It helps dermatologists to estimate the risk and predict the patient's health after a possible organ transplantation. Basal cell carcinoma and squamous cell carcinoma that are present before transplantation indicate the possibility of similar cancer occurrence after transplantation; however, they are not a contraindication to transplantation after treatment of the primary foci. The waiting period to transplantation in the case of melanoma in situ takes 2 years, but in more serious forms of melanoma this time is prolonged to ≥5–10 years. Different skin cancers have a 3-year asymptomatic period to renewed indication for transplantation.

Expression of TYMS in lymph node metastasis from low-grade glioma.

The aim of the present study was to investigate the expression of thymidylate synthase (TYMS) in the primary foci and metastatic lymph nodes of low-grade glioma, and to analyze the function of TYMS in the lymph node metastases from low-grade glioma. The study included 93 cases of surgically resected and pathologically confirmed low-grade glioma, form patients treated at Huaihe Hospital of Henan University (Kaifeng, China). The following clinical data was obtained from each patient: Gender, age, subjective symptoms (dizziness, headache, a feeling of pressure in the head, etc.), site of disease, tumor type, pathological stage, degree of differentiation and lymph node involvement. The surgically resected gliomas and dissected cervical lymph nodes were immunohistochemically stained, and DNA was extracted from the tumor and lymph node tissues samples for polymerase chain reaction sequencing and amplification. The expression of TYMS in the primary foci and metastatic lymph nodes of low-grade glioma was examined. Additionally, the association between pathological features and the postoperative survival rate of the patients was analyzed. The primary lesions of all 93 cases exhibited positive TYMS expression and 43/157 (27.39%) lymph nodes exhibited positive TYMS expression. Factors that significantly influenced the postoperative survival rate of the patients, included the metastasis of the cervical lymph nodes (P<0.01), the number of dissected cervical lymph nodes (P<0.01) and the degree of differentiation (P<0.05). The metastasis of the cervical lymph nodes was the only independent risk factor affecting postoperative disease-free survival. The risk of recurrence in patients with metastasis of the cervical lymph nodes was 6.3-fold higher than in those without metastasis (P<0.01). Thus, the results of the present study provide a theoretical basis for accurately predicting the prognosis of patients with low-grade malignant brain glioma, reducing the conjecture involved in selecting postoperative treatment strategies and improving therapeutic efficacy.

Patients with pelvic serous cancer have more side population (SP) cells and aldehyde dehydrogenase positive (ALDH+) cells in ascites than in primary foci

Objective To investigate the relationship between pelvic serous cancer stemlike cells(CSC)and peritoneal metastasis. Methods Primary pelvic serous cancer tissues and ascites were obtained from 17 female patients without preoperative chemotherapy from July 2011 to July 2013.Side population(SP)cells and aldehyde dehydrogenase positive(ALDH+)cells were tested by Hoechst33342 staining and ALDH staining respectively to observe their expression difference and their relationship with pelvic metastasis. Results Among the detectable specimen,73.3%(11/15)were detected SP cells positive(percentage of SP cells0.15%),and 100%(10/10)ALDH+cells in either primary foci or ascites.Comparing the cells percentage from different sites in the same patients,73.3%(11/15)of the patients showed higher SP cells in ascites than those in primary tumors(P=0.01),whereas 90%(9/10)of the patiens showed higher ALDH+cells in ascites than those in primary tumors(P=003).Furthermore,patients with both SP positive and more ALDH+cells in ascites showed more metastatic sites than those with only SP positive or ALDH+cells(P0.05),however,they had little difference in metaststic rate(P0.05). Conclusions Higher percentage of SP cells and ALDH+cells in ascites indicates that pelvic serous CSC are related with peritoneal metastasis and disease progression.

Breast MRI in detecting primary malignancy of patients presenting with axillary metastases and negative X-ray mammography

Objective To evaluate the role of breast MRI in detecting the primary malignancy in patients presenting solely with axillary lymph node metastases. Methods Thirty-three patients with axillary lynph node metastases but negative findings on either physical examination or mammography underwent breast MRI to identify occult breast carcinoma. MRI of the breast was assessed according to BI-RADS criteria. The pathologic diagnosis was made according to the standard criteria by the WHO Classification of Tumor. Results Among 33 patients presenting solely with axillary metastases, 30 patients underwent modified radical mastectomy. Primary breast carcinoma was proven in 17 patients. MRI detected lesions in 16 patients, including 10 masses and 6 non-mass lesions. Size of the masses ranged from 0. 5 to 2. 6 cm (mean 1.5 cm). Six lesions were smaller than 1.5 cm in size. Non-mass lesions showed ductal enhancement in 4 cases and segmental enhancement in 2 cases. One patient with tumor detected by histopathology showed no abnormal enhancement on MRI. No tumor was found at mastectomy in the other 13 womeu, and negative MR findings were revealed in 9. Four cases with suspicious enhancement on MRI had no corresponding primary foci on pathology. Three patients didn't undergo surgical procedure. The sensitivity, specificity, and accuracy of MRI in the diagnosis of the primary malignancy were 94. 1%,69. 2%, and 83.3%, respectively. Conclusions Small size of mass and ductal or segmental enhancement of non-mass lesion were common MR features of occult malignancy. MRI showed high sensitivity and accuracy in diagnosing occult breast carcinoma. Breast MRI should be taken in search of occult malignancy in patients with axillary metastases. Key words: Breast neoplasms; Neoplasm metastasis; Lymph nodes; Magnetic resonance imaging

Abstract P2-18-04: Differential prognosis of pulmonary lumpectomy in patients with a history of curative breast cancer

Abstract Objective: Treatment of patients with a history of breast cancer who are diagnosed as newly found solid pulmonary nodule is still controversial. Our study is to find out whether the pulmonary nodule represents a primary cancer, metastasis, or benign lesion secondary to breast cancer can be differentially prognostic. Methods: A total of 165 consecutive patients who underwent surgery or biopsy for pulmonary nodules between 2007 and 2013 after curative operation for breast cancer were reviewed. The postoperative survival rate was analyzed and the difference in survival rate was assessed between groups of pulmonary nodules representing a primary cancer, metastasis, and benign lesion. Results: Among these 165 patients, median age was 59 and mean follow-up was 51 months (range from 5 to 398). The pathologic diagnoses of pulmonary nodules were pulmonary metastases of breast cancer in 71 patients (43%), primary lung cancer in 59 (35.8%), and other diagnoses in 35 (21.2%) (hyperplasia in 11; pneumonia in 9; granuloma in 6; sclerosing hemangioma and pulmonary fibrosis in 4 each). In those who were diagnosed as malignant pulmonary tumor, about one half (56.4%) were secondary malignant and the rest were metastatic. There was no statistically difference in median age or disease free interval between operation date of breast surgery and pulmonary surgery or biopsy among these groups. However, those who were diagnosed as primary malignant or benign lesion had significantly higher incidence of isolated pulmonary nodule shown on their CT scan results (P=0.036). The incidence of positive lymph node involvement and negative ER/PR status was significantly higher in metastatic breast cancer patients (63.8% and 70.6%, respectively). Among patients with metastatic pulmonary nodules, rates of discordance between primary breast tumor and metastasis foci were 20.3%, 23.7% and 14.7% for ER, PR and HER2, respectively, which changed a lot the regimen used for treatment of metastatic breast cancer. Both the 5-year and 10-year disease-free survival from the initial mastectomy were significantly shorter in metastatic breast cancer patients (72.9%, 35.3%) when compared with patients with primary pulmonary cancer (82.9%, 53.8%) or pulmonary benign lesions (91.6%, 67.8%). Prognostic factors in metastatic breast cancer patients were a disease-free interval of &amp;gt;60 months with 10-year survival of 48.3% (P&amp;lt;0.05), solitary lung metastasis is associated with a survival rate of 78.9% after 5 years and of 48.7% after 5 and 10 years, and this is statistically significant compared to multiple metastases. Conclusions: We think that pulmonary lumpectomy is the best option in selected cases of solitary or multiple pulmonary nodules from breast cancer, which can be useful for differential diagnosis, predicting prognosis and deciding the drug treatment strategy in some cases. Citation Format: Zhebin Liu, Yihua Sun, Fangjing Ma, Hong Ling, Keda Yu, Guangyu Liu, Genhong Di, Zhen Hu, Canmin Chen, Yifeng Hou, Jiong Wu, Zhenzhou Shen, Zhimin Shao. Differential prognosis of pulmonary lumpectomy in patients with a history of curative breast cancer [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-18-04.

Initial Evaluation of [(18)F]DCFPyL for Prostate-Specific Membrane Antigen (PSMA)-Targeted PET Imaging of Prostate Cancer.

Prostate-specific membrane antigen (PSMA) is a recognized target for imaging prostate cancer. Here we present initial safety, biodistribution, and radiation dosimetry results with [(18)F]DCFPyL, a second-generation fluorine-18-labeled small-molecule PSMA inhibitor, in patients with prostate cancer. Biodistribution was evaluated using sequential positron-emission tomography (PET) scans in nine patients with prostate cancer. Time-activity curves from the most avid tumor foci were determined. The radiation dose to selected organs was estimated using OLINDA/EXM. No major radiotracer-specific adverse events were observed. Physiologic accumulation was observed in known sites of PSMA expression. Accumulation in putative sites of prostate cancer was observed (SUVmax up to >100, and tumor-to-blood ratios up to >50). The effective radiation dose from [(18)F]DCFPyL was 0.0139mGy/MBq or 5mGy (0.5rem) from an injected dose of 370MBq (10mCi). [(18)F]DCFPyL is safe with biodistribution as expected, and its accumulation is high in presumed primary and metastatic foci. The radiation dose from [(18)F]DCFPyL is similar to that from other PET radiotracers.

Reply to a. Molfino et Al.

We thank Molfino et al for their thoughtful comments regarding our article. Anorexia is a burdensome symptom for patients with cancer, and is significantly associated with survival. Anorexia is associated with systemic inflammatory response in cancer. Therefore, loss of appetite was chosen as a secondary outcome in our trial assessing the effects of methylprednisolone for cancer pain. Our trial showed a significant improvement of appetite loss, which coincides with the findings of Yennurajalingam et al. They also found a significant improvement in anorexia using the Functional Assessment of Anorexia/Cachexia Therapy subscale of 4.89 points on day 15 (P .013) in favor of the dexamethasone group as compared with the placebo group. As Molfino et al correctly point out, appetite is only one part of the symptom complex causing anorexia and reduced food intake. In addition to appetite, changes in taste and GI motility are important, together with secondary factors caused by the disease itself or the treatment, such as stomatitis, diarrhea, and constipation. Furthermore, food intake is an important item to measure separately, as it shows only a weak association with loss of appetite. Consequently, it is recommended to assess all these symptoms as well as food intake in cancer cachexia trials. Different assessment tools have been proposed to assess the anorexia symptom, including the Functional Assessment of Anorexia/ Cachexia Therapy, which rates the intensity of anorexia and cachexia and the related symptoms on a verbal rating scale 0 to 4. The abridged Patient-Generated Subjective Global Assessment assesses the symptoms on a yes or no basis together with nutritional and functional levels. Finally, loss of appetite can be quantitatively evaluated by a numeric rating scale like the Edmonton Symptom Assessment System, and the European Association for Palliative Care minimum data set, or health-related quality-of-life tools like the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30). Loss of appetite can be measured by the EORTC QLQ-C30 in a reliable way. Indeed, the EORTC group is currently developing a lack of appetite item bank for computer-adaptive testing as a further development of this single item. Due to the risk of adverse effects in prolonged use, it is generally agreed that corticosteroids should be used to treat anorexia in the end-of-life setting. In patients with short life expectancy, the primary foci are symptom control and quality of life. Therefore, patientreported outcomes are recommended at this stage of disease, and only a minor improvement in appetite may be important to the patients. The risk of adverse effects from the use of high-dose corticosteroids is substantial. This needs to be assessed and may counterbalance the positive effects on appetite. Ornulf Paulsen Telemark Hospital Trust, Skien; Norwegian University of Science and Technology, Trondheim, Norway

Chemopreventive effects of rosmarinic acid on rat colon carcinogenesis.

Rosmarinic acid (RA) is a polyphenolic compound that shows a number of interesting biological activities, such as antiapoptotic, antifibrotic, antioxidant, hepatoprotective, antineurodegenerative, and anti-inflammatory properties. The aim of this study was to investigate the ability of RA to prevent 1,2-dimethylhydrazine (DMH)-induced primary DNA damage and aberrant crypt foci (ACF) in Wistar rat colon. The animals were treated by gavage with doses of 4, 8, and 16 mg/kg body weight/day. Next, the animals received a single subcutaneous injection of 40 mg/kg DMH and were killed 4 h later for the evaluation of DNA damage using the comet assay. In addition, two doses of 40 mg/kg DMH were administered weekly for 2 weeks and the animals were killed 2 weeks after the last injection for the evaluation of ACF formation in rat colon. The results showed that RA exerted no genotoxic/carcinogenic effects. Treatment with different doses of RA combined with DMH led to a significant reduction in the extent of DNA damage and in the frequency of ACF compared with animals treated with DMH alone. These findings suggest that RA reduces DNA damage and suppresses the formation of ACF.

Diagnostic Imaging Efficacy In Metastases From Unknown Primary Site--Own Material.

Cancer of Unknown Primary Origin (CUPO) is defined by the presence of metastatic lesions, diagnosed by means of cytological or pathological evaluation, for which no primary site can be detected during a thorough examination. The clinical investigation, directed at locating the site of the neoplastic lesion, is determined by the results of laboratory tests, imaging procedures, and pathological examinations. It is also essential to conduct a complete medical history and thorough physical examination. The detection of the primary site allowed to introduce specific therapy, which can offer clinical benefits, considering a favorable prognosis. The aim of the study was to assess the range of diagnostic procedures performed in patients with CUPO and efficacy in identifying the primary lesion. Retrospective analysis comprised a group of 29 patients with CUPO, operated between January, 2002 and December, 2011, at the Department of Surgical Oncology, Medical University in Łódź. The study group comprised 16 male and 13 female patients; median age at presentation was 58.3 years (ranging between 30-79 years). Detailed diagnostic management depending on the location of metastatic lesions and their histological type was performed in 20 of the 29 study patients (69%). Considering the remaining 9 (31%) patients detailed diagnostics was not performed, due to the patients' poor general condition. In 55% (11/20) of patients subject to detailed diagnostics, the primary neoplastic lesion was determined. Considering the study group, most patients with cancer of unknown primary origin were characterized by a favorable prognosis, which justified thorough diagnostics, in order to establish the primary neoplastic lesion. The introduction of diagnostic examinations enabled to identify the primary site of the tumor in more than 50% of patients. With the development of imaging methods one can expect improvement of unsatisfactory results, considering the detection of primary neoplastic foci.

Forearm intramuscular tuberculosis of flexor digitorum profundus: a case report

Tuberculosis is one of the most commonly occurring infectious disorders in the developing countries like India, which literally can affect any organ and system. Primary tuberculous myositis is used to describe the clinical situation in which the most prominent lesion in the course of haematogenous tuberculosis involves the muscle and not the fact that the infection occurred primarily in the muscle. Tubercular pyomyositis is the least frequent extra spinal musculoskeletal tuberculosis reported in literature. We came across a 15 year old female without any known primary pulmonary or lymphoid foci who presented with a swelling and pain over right forearm since 3 months. After running all the radiological investigations and nerve conduction studies and taking under consideration the various differentials of the swelling, finally the swelling was excised and histopathology of the excised specimen was performed which suggested that the swelling was due to primary tuberculosis of the muscle and the underlying subcutaneous tissue and after that patient received anti tuberculosis regimen for 9 months and no recurrence of the disease was noted till date. This rare case is presented with review of literature.

Identification of Malting Quality QTLs in Advanced Generation Breeding Germplasm

Malting quality has been one of the primary foci in barley (Hordeum vulgare L.) breeding programs but has been difficult for breeders to manipulate due to the quantitative nature of the traits involved and the cost of trait measurement. To assist in breeding for malt quality traits, identifying the genomic regions that affect these traits is essential. Two populations were used to conduct genome-wide association studies in order to elucidate the alleles responsible for variation in malting traits. The first population, composed of 367 lines genotyped with 3,072 single-nucleotide polymorphism (SNP) markers, was a representative sample of the entire germplasm of the Montana State University barley breeding program, including feed, food, and malt lines. The second population, with 650 lines genotyped with 384 SNPs, consisted of 11 biparental families whose parents were cultivars and elite experimental lines developed strictly for malting purposes. Lines were phenotyped at the United States Department of Agriculture–Agricultural Research Service Cereal Crops Research Unit in Madison, WI. Mixed linear models were applied to the data using a Q+K approach in order to identify single marker–trait associations accounting for population structure and relatedness among lines. Fifty-four significant marker–trait associations were found. The results of this work give a comprehensive overview of the salient regions of the barley genome affecting malting traits that vary within a modern malting barley breeding program.

Dismantling and rebuilding bureaucracies: reinventing wheels on rebranded hubs.

Dismantling and rebuilding bureaucracies: reinventing wheels on rebranded hubs.