Percutaneous ultrasound guided implantation of VX2 for creation of a rabbit hepatic tumor model.

Creation of a VX2 tumor model has traditionally required a laparotomy and surgical implantation of tumor fragments. Open surgical procedures are invasive and require long procedure times and recovery that can result in post-operative morbidity and mortality. The purpose of this study is to report the results of a percutaneous ultrasound guided method for creation of a VX2 model in rabbit livers. A total of 27 New Zealand white rabbits underwent a percutaneous ultrasound guided approach, where a VX2 tumor fragment was implanted in the liver. Magnetic resonance imaging was used to assess for tumor growth and necropsy was performed to determine rates of tract seeding and metastatic disease. Ultrasound guided tumor implantation was successful in all 27 rabbits. One rabbit died 2 days following the implantation procedure. Two rabbits had no tumors seen on follow-up imaging. Therefore, tumor development was seen in 24/26 (92%) rabbits. During the follow-up period, tract seeding was seen in 8% of rabbits and 38% had extra-hepatic metastatic disease. Therefore, percutaneous ultrasound guided tumor implantation safely provides reliable tumor growth for establishing hepatic VX2 tumors in a rabbit model with decreased rates of tract seeding, compared to previously reported methods

Tumor preparation.

<p>(A) Hind limb tumors were placed in a sterile petri dish and sliced into small tumor fragments (3-4mm³). (B) A 17 gauge coaxial introducer has a hollow core (white arrow), with two inner stylets, sharp (black arrow head) and blunt (white arrow head).</p

Histology.

<p>H&E staining was performed confirming tumors within the liver.</p

Ultrasound guided implantation.

<p>(A) Using ultrasound guidance, a 17 gauge coaxial introducer (arrow) is advanced into the liver. The sharp inner stylet is removed and a small tumor fragment (3-4mm³) is placed in the hub of the introducer and pushed with the blunt stylet. (B) Post implantation US image reveals a small focus of hyperechogenicity (arrow) representing the tumor fragment and air.</p

MRI and Gross Pathology.

<p>(A) Axial T2 weighted MRI image demonstrates two T2 hyperintense lesions in the left hepatic lobe (arrow heads). (B) Explanted gross specimen reveals tumors corresponding to the lesions seen on MRI (arrow heads).</p

Mean tumor growth rates.

<p>Mean tumor growth rates.</p

Ovarian Aging and Hormone Replacement Therapy: Hormonal Levels, Symptoms, and Attitudes of African-American and White Women

OBJECTIVES: To characterize reproductive hormone levels, symptoms, and attitudes related to menopause among healthy, menstruating white and African-American women aged 44 to 49 years. DESIGN: Pilot study; cross-sectional survey. SETTING: Community-based convenience sample of women in the Philadelphia metropolitan area. PARTICIPANTS: Thirty-three African-American and 35 white women. MEASUREMENTS: The survey instrument collected demographic data, medical and reproductive history, health practices and behaviors. It included previously validated function, depression, and quality-of-life instruments, and a Menopause Attitude Scale that included two factors, attitudes toward the menopause and attitudes toward medical therapy. Anthropometric measurements were taken at enrollment, and reproductive hormones and daily symptom logs were followed over two menstrual cycles. MAIN RESULTS: The two groups were comparable in mean age (African-American 46.2 years, white 46.9 years). Serum levels of estradiol, follicle-stimulating hormone, dihydroepiandrosterone-sulfate, and progesterone were comparable. Symptoms were similar in type and frequency. However, the African-American women had significantly more positive attitudes toward menopause, were more likely to rely on family for information about menopause, and were less likely to have been recommended hormone replacement therapy by their physicians. A majority of women in each group expressed satisfaction with the care they had received. CONCLUSIONS: Perimenopausal African-American and white women have different expectations of menopause and the role of medical care in menopause. This bears directly on women’s acceptance of hormone replacement therapy. Conclusions are limited by the small sample size and convenience nature of the study population: further work with larger samples is needed to confirm these apparent differences