Pregnancy-associated breast cancer - Special features in diagnosis and treatment

For obvious psychological reasons it is difficult to associate pregnancy - a life-giving period of our existence with life-threatening malignancies. Symptoms pointing to malignancy are often ignored by both patients and physicians, and this, together with the greater difficulty of diagnostic imaging, probably results in the proven delay in the detection of breast cancers during pregnancy. The diagnosis and treatment of breast cancer are becoming more and more important, as the fulfillment of the desire to have children is increasingly postponed until a later age associated with a higher risk of carcinoma, and improved cure rates of solid tumors no longer exclude subsequent pregnancies. The following article summarizes the special features of the diagnosis and primary therapy of pregnancy-associated breast cancer with particular consideration of cytostatic therapy

Physical Nucleon Properties from Lattice QCD

We demonstrate that the extremely accurate lattice QCD data for the mass of the nucleon recently obtained by CP-PACS, combined with modern chiral extrapolation techniques, leads to a value for the mass of the physical nucleon which has a systematic error of less than one percent.Comment: 4 pages, 2 figure

Magnon Dispersion in the Field-Induced Magnetically Ordered Phase of TlCuCl3

The magnetic properties of the interacting dimer system TlCuCl3 are investigated within a bond-operator formulation. The observed field-induced staggered magnetic order perpendicular to the field is described as a Bose condensation of magnons which are linear combinations of dimer singlet and triplet modes. This technique accounts for the magnetization curve and for the field dependence of the magnon dispersion curves observed by high-field neutron scattering measurements.Comment: 4 pages, 4 figures, REVTeX

Plankton ecology: The past two decades of progress

This is a selected account of recent developments in plankton ecology. The examples have been chosen for their degree of innovation during the past two decades and for their general ecological importance. They range from plankton autecology over interactions between populations to community ecology. The autecology of plankton is represented by the hydromechanics of plankton (the problem of life in a viscous environment) and by the nutritional ecology of phyto- and zooplankton. Population level studies are represented by competition, herbivory (grazing), and zooplankton responses to predation. Community ecology is represented by the debate about bottom- up vs. top-down control of community organization, by the PEG model of seasonal plankton succession, and by the recent discovery of the microbial food web

The Structure of Isothermal, Self-gravitating Gas Spheres for Softened Gravity

A theory for the structure of isothermal, self-gravitating gas spheres in pressure equilibrium in a softened gravitational field is developed. The one parameter spline softening proposed by Hernquist & Katz (1989) is used. We show that the addition of this extra scale parameter implies that the set of equilibrium solutions constitute a one-parameter family, rather than the one and only one isothermal sphere solution for Newtonian gravity. We demonstrate the perhaps somewhat surprising result that for any finite choice of softening length and temperature, it is possible to deposit an arbitrarily large mass of gas in pressure equilibrium and with a non-singular density distribution inside of r_0 for any r_0 > 0. The theoretical predictions of our models are compared with the properties of the small, massive, quasi-isothermal gas clumps which typically form in numerical Tree-SPH simulations of 'passive' galaxy formation of Milky Way sized galaxies. We find reasonable agreement despite the neglect of rotational support in the models. We comment on whether the hydrodynamical resolution in our numerical simulation of galaxy formation is sufficient, and finally we conclude that one should be cautious, when comparing results of numerical simulations involving gravitational softening and hydrodynamical smoothing, with reality.Comment: 22 pages Latex + 12 figure

Pain Management After Outpatient Anterior Cruciate Ligament Reconstruction: A Systematic Review of Randomized Controlled Trials.

BACKGROUND: Effective pain management after anterior cruciate ligament (ACL) reconstruction improves patient satisfaction and function. PURPOSE: To collect and evaluate the available evidence from randomized controlled trials (RCTs) on pain control after ACL reconstruction. STUDY DESIGN: Systematic review. METHODS: A systematic literature review was performed using PubMed, Medline, Google Scholar, UpToDate, Cochrane Reviews, CINAHL, and Scopus following PRISMA guidelines (July 2014). Only RCTs comparing a method of postoperative pain control to another method or placebo were included. RESULTS: A total of 77 RCTs met inclusion criteria: 14 on regional nerve blocks, 21 on intra-articular injections, 4 on intramuscular/intravenous injections, 12 on multimodal regimens, 6 on oral medications, 10 on cryotherapy/compression, 6 on mobilization, and 5 on intraoperative techniques. Single-injection femoral nerve blocks provided superior analgesia to placebo for up to 24 hours postoperatively; however, this also resulted in a quadriceps motor deficit. Indwelling femoral catheters utilized for 2 days postoperatively provided superior analgesia to a single-injection femoral nerve block. Local anesthetic injections at the surgical wound site or intra-articularly provided equivalent analgesia to regional nerve blocks. Continuous-infusion catheters of a local anesthetic provided adequate pain relief but have been shown to cause chondrolysis. Cryotherapy improved analgesia compared to no cryotherapy in 4 trials, while in 4 trials, ice water and water at room temperature provided equivalent analgesic effects. Early weightbearing decreased pain compared to delayed weightbearing. Oral gabapentin given preoperatively and oral zolpidem given for the first week postoperatively each decreased opioid consumption as compared to placebo. Ibuprofen reduced pain compared to acetaminophen. Oral ketorolac reduced pain compared to hydrocodone-acetaminophen. CONCLUSION: Regional nerve blocks and intra-articular injections are both effective forms of analgesia. Cryotherapy-compression appears to be beneficial, provided that intra-articular temperatures are sufficiently decreased. Early mobilization reduces pain symptoms. Gabapentin, zolpidem, ketorolac, and ibuprofen decrease opioid consumption. Despite the vast amount of high-quality evidence on this topic, further research is needed to determine the optimal multimodal approach that can maximize recovery while minimizing pain and opioid consumption. CLINICAL RELEVANCE: These results provide the best available evidence from RCTs on pain control regimens after ACL reconstruction

Three-Quark Potential in SU(3) Lattice QCD

The static three-quark (3Q) potential is measured in the SU(3) lattice QCD with $12^3 \times 24$ and $\beta=5.7$ at the quenched level. From the 3Q Wilson loop, the 3Q ground-state potential $V_{\rm 3Q}$ is extracted using the smearing technique for the ground-state enhancement. With accuracy better than a few %, $V_{\rm 3Q}$ is well described by a sum of a constant, the two-body Coulomb term and the three-body linear confinement term $\sigma_{\rm 3Q} L_{\rm min}$, where $L_{\rm min}$ denotes the minimal length of the color flux tube linking the three quarks. By comparing with the Q-$\bar {\rm Q}$ potential, we find a universal feature of the string tension, $\sigma_{\rm 3Q} \simeq \sigma_{\rm Q \bar Q}$, as well as the one-gluon-exchange result for the Coulomb coefficient, $A_{\rm 3Q} \simeq \frac12 A_{\rm Q \bar Q}$.Comment: 7 pages, 3 figur

A path integral approach to the dynamics of a random chain with rigid constraints

In this work the dynamics of a freely jointed random chain which fluctuates at constant temperature in some viscous medium is studied. The chain is regarded as a system of small particles which perform a brownian motion and are subjected to rigid constraints which forbid the breaking of the chain. For simplicity, all interactions among the particles have been switched off and the number of dimensions has been limited to two. The problem of describing the fluctuations of the chain in the limit in which it becomes a continuous system is solved using a path integral approach, in which the constraints are imposed with the insertion in the path integral of suitable Dirac delta functions. It is shown that the probability distribution of the possible conformations in which the fluctuating chain can be found during its evolution in time coincides with the partition function of a field theory which is a generalization of the nonlinear sigma model in two dimensions. Both the probability distribution and the generating functional of the correlation functions of the positions of the beads are computed explicitly in a semiclassical approximation for a ring-shaped chain.Comment: 36 pages, 2 figures, LaTeX + REVTeX4 + graphicx, minor changes in the text, reference adde

Prognostic relevance of disseminated tumor cells in the bone marrow and biological factors of 265 primary breast carcinomas

Introduction The prognostic significance of disseminated tumor cells in the bone marrow (DTC-BM) of breast cancer patients has been demonstrated in many studies. Yet, it is not clear which of the primary tumors' biological factors predict hematogenous dissemination. We therefore examined `tissue micro arrays' (TMAs) of 265 primary breast carcinomas from patients with known bone marrow ( BM) status for HER2, Topoisomerase IIa ( Top IIa), Ki 67, and p53. Methods BM analysis was performed by cytospin preparation and immunocytochemical staining for cytokeratin (CK). TMAs were examined by immunohistochemistry (IHC) for HER2, Top IIa, Ki 67 and p53, and fluorescence in situ hybridization ( FISH) for HER2. Results HER2 ( 2+/ 3+) was positive in 35/167 (21%) cases ( FISH 24.3%), Top IIa (> 10%) in 87/187 (46%), Ki 67 in 52/ 184 (28%) and p53 (> 5%) in 61/174 cases (34%). Of 265 patients, 68 (25.7%) showed DTC-BM with a median of 2/2 x 106 cells ( 1 to 1,500). None of the examined factors significantly predicted BM positivity. Significant correlation was seen between HER2 IHC and Top IIa ( p = 0.06), Ki 67 ( p = 0.031), and p53 ( p <.001). Top IIa correlated with Ki 67 and p53, and Ki 67 also with p53 ( p = 0.004). After a median follow-up of 60.5 months ( 7 to 255), the presence of DTC-BM showed prognostic relevance for overall survival ( p = 0.03), whereas HER2 ( IHC, p = 0.04; FISH, p = 0.03) and Ki 67 ( p = 0.04) correlated with disease free survival, and HER2 with distant disease free survival ( IHC, p = 0.06; FISH, p = 0.05). Discussion The congruence of the examined factors' expression rates indicates a causal line of suppressor, proliferation, and mitosis markers, and growth factor receptors. Hematogenous tumor cell spread seems to be an independent process. The examination of these factors on DTC-BM is the aim of ongoing research

HQET at order 1/m1/m: II. Spectroscopy in the quenched approximation

Using Heavy Quark Effective Theory with non-perturbatively determined parameters in a quenched lattice calculation, we evaluate the splittings between the ground state and the first two radially excited states of the $B_s$ system at static order. We also determine the splitting between first excited and ground state, and between the $B_s^*$ and $B_s$ ground states to order $1/m_b$. The Generalized Eigenvalue Problem and the use of all-to-all propagators are important ingredients of our approach.Comment: (1+18) pages, 3 figures (4 pdf files); pdflatex; v2: corrections to table 1, results unaffecte