Analysis of pleural fluid in idiopathic spontaneous pneumothorax; correlation of eosinophil percentage with the duration of air in the pleural space

AbstractPleural fluid analysis was performed in patients with idiopathic spontaneous pneumothorax. The objective of the study was to define the cell differentiation, and part of the cytokine profile, in relation to the duration of pneumothorax.In the 23 consecutive patients (19 men, mean age 34·2 years, 17 smokers), pleural fluid was obtained immediately after chest tube drainage (n=6), or during thoracoscopy (n=17). Cytospins were carried out, and supernatant analysis of the different cytokines was performed using sandwich ELISA. All concentrations were corrected for dilution.The duration of the pneumothorax was correlated with the rise in eosinophil percentage (r=0·81, P<0·00001) in pleural fluid. RANTES, platelet-activating factor (PAF), and monocyte chemotactic protein-1 (MCP-1) were detectable but no relationship with eosinophils or duration of the pneumothorax was found. Granulocyte-macrophage colony stimulating factor (GM-CSF) and interluekin-8 (IL-8) were not detectable. Interleukin-5 (IL-5) concentration correlated with the eosinophil concentration (r=0·84, P=0·037) and the eosinophil percentage (r=0·68, P=0·005) in the pleural fluid.Idiopathic spontaneous pneumothorax causes a time-related rise in the eosinophil percentage in the pleural space, which correlates with the level of IL-5

Trends in treatment, incidence and survival of hypopharynx cancer: a 20-year population-based study in the Netherlands

Hypopharynx cancer has the worst prognosis of all head and neck squamous cell cancers. Since the 1990s, a treatment shift has appeared from a total laryngectomy towards organ preservation therapies. Large randomized trials evaluating treatment strategies for hypopharynx cancer, however, remain scarce, and frequently this malignancy is evaluated together with larynx cancer. Therefore, our aim was to determine trends in incidence, treatment and survival of hypopharynx cancer. We performed a population-based cohort study including all patients diagnosed with T1-T4 hypopharynx cancer between 1991 and 2010 in the Netherlands. Patients were recorded by the national cancer registry database and verified by a national pathology database. 2999 patients were identified. The incidence increased significantly with 4.1% per year until 1997 and decreased non-significantly afterwards. For women, the incidence increased with 1.7% per year during the entire study period. Total laryngectomy as primary treatment significantly decreased, whereas radiotherapy and chemoradiation increased. The 5-year overall survival significantly increased from 28% in 1991-2000 to 34% in 2001-2010. Overall survival for T3 was equal for total laryngectomy and (chemo)radiotherapy, but for T4-patients the survival was significantly better after primary total laryngectomy (+/- adjuvant radiotherapy). This large population-based study demonstrates a shift in treatment preference towards organ preservation therapies. The 5-year overall survival increased significantly in the second decade. The assumed equivalence of organ preservation and laryngectomy may require reconsideration for T4 diseas

Electronic transport and vibrational modes in the smallest molecular bridge: H2 in Pt nanocontacts

We present a state-of-the-art first-principles analysis of electronic transport in a Pt nanocontact in the presence of H2 which has been recently reported by Smit et al. in Nature 419, 906 (2002). Our results indicate that at the last stages of the breaking of the Pt nanocontact two basic forms of bridge involving H can appear. Our claim is, in contrast to Smit et al.'s, that the main conductance histogram peak at G approx 2e^2/h is not due to molecular H2, but to a complex Pt2H2 where the H2 molecule dissociates. A first-principles vibrational analysis that compares favorably with the experimental one also supports our claim .Comment: 5 pages, 3 figure

The time has come for quantitative protein mass spectrometry tests that target unmet clinical needs

Protein mass spectrometry (MS) is an enabling technology that is ideally suited for precision diagnostics. In contrast to immunoassays with indirect readouts, MS quantifications are multiplexed and include identification of proteoforms in a direct manner. Although widely used for routine measurements of drugs and metabolites, the number of clinical MS-based protein applications is limited. In this paper, we share our experience and aim to take away the concerns that have kept laboratory medicine from implementing quantitative protein MS. To ensure added value of new medical tests and guarantee accurate test results, five key elements of test evaluation have been established by a working group within the European Federation for Clinical Chemistry and Laboratory Medicine. Moreover, it is emphasized to identify dinical gaps in the contemporary clinical pathways before test development is started. We demonstrate that quantitative protein MS tests that provide an additional layer of dinical information have robust performance and meet long-term desirable analytical performance specifications as exemplified by our own experience. Yet, the adoption of quantitative protein MS tests into medical laboratories is seriously hampered due to its complexity, lack of robotization and high initial investment costs. Successful and widespread implementation in medical laboratories requires uptake and automation of this next generation protein technology by the In-Vitro Diagnostics industry. Also, training curricula of lab workers and lab specialists should include education on enabling technologies for transitioning to precision medicine by quantitative protein MS tests.Afdeling Klinische Chemie en Laboratoriumgeneeskunde (AKCL

Properties of the Fixed Point Lattice Dirac Operator in the Schwinger Model

We present a numerical study of the properties of the Fixed Point lattice Dirac operator in the Schwinger model. We verify the theoretical bounds on the spectrum, the existence of exact zero modes with definite chirality, and the Index Theorem. We show by explicit computation that it is possible to find an accurate approximation to the Fixed Point Dirac operator containing only very local couplings.Comment: 38 pages, LaTeX, 3 figures, uses style [epsfig], a few comments and relevant references adde

Management of soft tissue sarcomas in extremities: variation in treatment recommendations and surveillance according to specialty and continent

Background This study aimed to provide an insight into clinical decision-making and surveillance strategy of sarcoma specialists for patients with primary soft tissue sarcoma of the extremities (eSTS). The secondary aim was to quantify the role of patient- and tumor-specific factors in the perioperative management. Methods Members of sarcoma societies were sent a Web-based 21-item survey about eSTS management. The survey concerned only primary resectable high-grade eSTS in adults. Results The study enrolled 396 respondents. The majority of the surgical specialists thought the evidence for perioperative chemotherapy (CTX) for high-grade eSTS was insufficient. Radiotherapy (RTX) was less frequently offered in Asia than in North America and Europe. The specialties and continents also differed regarding the importance of patient and tumor characteristics influencing RTX and CTX recommendation. For surveillance after initial treatment outpatient visits, chest computed tomography (CT) scans, and magnetic resonance images of the extremity were the methods primarily used. The specialists in North America preferred chest CT scan over chest x-ray, whereas those in Asia and Europe had no clear preference. Discussion Specialty and continent are important factors contributing to the variation in clinical practice, treatment recommendations, and surveillance of patients with primary resectable high-grade eSTS.Biological, physical and clinical aspects of cancer treatment with ionising radiatio