Metastatic carcinoid presenting as a breast lesion.

Metastasis to the breast is a rare occurrence, constituting fewer than 2% of all breast tumours. Of all metastatic tumours in the breast, most arise from contralateral breast primaries. Other reported primary solid tumour sites include melanoma; lung, gastric, and renal cancers; and approximately 29 cases of carcinoid tumour.Ambiguous presentations and an absence of carcinoid syndrome features make accurate radiographic and histologic assessment of breast carcinoids challenging. Here, we report the case of a 52-year-old woman who presented with a mammographic abnormality in the left breast. Excisional biopsy revealed histopathology consistent with carcinoid. After an exhaustive work-up, carcinoid within the terminal ileum was ultimately identified, and the woman was diagnosed with metastatic breast carcinoid, an exceedingly rare entity. This paper describes the common mammographic, cytologic, and immunohistochemical features typical of metastatic breast carcinoid tumours, together with their common clinical features, prognosis, and treatment options.

Extraskeletal myxoid chondrosarcoma of the heart and review of current literature.

Extraskeletal myxoid chondrosarcoma (EMS) is a rare oncologic phenomenon characterized by chondroid and neurogenic differentiation in extraskeletal locations. These tumours represent fewer than 2.5% of all soft-tissue sarcomas and are most commonly found in the lower extremities, limb girdles, distal extremities, and trunk. Their presence in cardiac tissue is exceedingly unusual; just a single case of ems metastatic to the heart has been reported, and no cases of primary cardiac EMS are known.Here, we report the case of a 26-year-old man who presented to his physician with a chest wall mass. Further evaluation led to the discovery of a large intracardiac mass with multiple end-organ growths. Complete work-up of this patient included cardiac biopsy, echocardiography, magnetic resonance imaging, positron-emission tomography, computed tomography, and fluorescence in situ hybridization studies for the translocation involving the EWSR1 gene locus (22q12). Results of the foregoing studies confirmed the diagnosis of ems, but the origin of this patient's tumours remains elusive and the contention between a primary cardiac source and cardiac metastasis has yet to be resolved.This article describes the histopathology, immunohistochemistry, and chromosomal aberrations common to ems, together with the common presenting features, natural history, and prognosis.

Metastatic lung adenocarcinoma in a 20-year-old patient.

Lung cancer is rare disease in patients under 25 years of age. It typically occurs in older patients with a history of tobacco use. This case concerns a 20-year-old man with no history of tobacco use who complained of several months of cough and lower back pain and an 11.3-kg weight loss. He was treated for pneumonia after a chest radiograph showed total opacification of the right lung. Computed tomography imaging subsequently revealed a superior right hilar mass and mediastinal lymphadenopathy. Further imaging studies showed diffuse metastatic disease. Mediastinal biopsy showed poorly differentiated epithelioid tumour with desmoplastic stromal reaction, neutrophil infiltration, and squamous differentiation. Tissue immunostaining confirmed a non-small-cell lung cancer. Unfortunately, despite aggressive therapy, the patient's disease progressed, and he died within 9 months. In this paper, we hope to illustrate the unique challenges in diagnosing and treating young patients with metastatic lung cancer.

Primary ovarian malignant lymphoma presenting as ovarian carcinomatosis: a case report and literature review.

INTRODUCTION: Primary ovarian lymphoma may present with a clinical scenario consistent with advanced epithelial ovarian carcinoma. Although ovarian lymphoma is a rare entity, accounting for 0.5% of all non-Hodgkin's lymphoma and 1.5% of all ovarian neoplasms, it should be included in the differential diagnosis of an ovarian mass. CASE: We report a case of a 78-year-old woman who presented with an ovarian neoplasm suggestive of advanced ovarian carcinoma. During diagnostic laparoscopy, biopsies were obtained with frozen section analysis revealing malignant lymphoma. Further histopathologic analysis revealed a diffuse large B-cell lymphoma (DLBCL). The treatment plan was for six cycles of R-CHOP chemotherapy. A drammatic response was noted after only three cycles of R-CHOP. CONCLUSION: Primary ovarian lymphoma presenting as an ovarian tumor is exceedingly rare. Since the prognosis and treatment of lymphoma differs significantly from ovarian carcinoma, a representative tissue sample of the adnexal tumor should be obtained and sent for frozen section analysis to establish the diagnosis. Principal treatment for non-Hodgkin's lymphoma is chemotherapy without surgical cytoreductive efforts.

Long-term consequences of the Alzheimer's caregiver role: a qualitative analysis.

A qualitative analysis was performed on responses of 51 participants to open-ended questions about the experience of being family caregivers for a loved one affected by Alzheimer's disease. Participants had been in the caregiver role for at least eight years. Results indicated a pattern of adapting successfully or unsuccessfully to the caregiver role, experiencing initial caregiver burden, finding relief in social support when available, and long-term distress or long-term positive change. Memories and feelings were strong about individuals and institutions that had been helpful or indifferent many years earlier as the caregivers struggled to cope with their unplanned predicament.

[Hygienic aspects of application of the resolution, "Certification of workplaces according to work conditions"]. / Gigienicheskie aspekty ispol'zovaniia postanovleniia "O provedenii attestatsii rabochikh mest po usloviiam truda".

The authors summarize experience of using "Act on procedure of working environment assessment at workplace". The authors analyze drawbacks of main documents used in assessment of working environment at workplace.

Psychopathology in caregivers of the chronically ill: personality and clinical syndromes.

The purpose of this study was to examine the caregivers of the chronically physically ill across personality and clinical psychopathology dimensions. The MCMI-II inventories of 30 caregivers and 28 matched controls were analyzed. Differences between the two groups were found on the clinical scales of anxiety, somatoform, dysthymia, and major depression. This suggests that differences exist between caregivers and non-caregivers on several clinical syndromes including psychosomatic variables. Professional, paraprofessional, and lay hospice support personnel should be aware of these possibilities, actively assess for them, and be prepared to intervene.

Teacher-ratings and self-ratings of social competency in adolescents with low- and high-depressive symptoms.

A comparison of teacher-ratings and self-ratings of adolescents' social competency was investigated. One hundred five high school students completed the Reynolds Adolescent Depression Scale (RADS; Reynolds, 1987) and were divided according to their scores into three groups: the lowest quartile [low-depressive symptoms (LDS) group (n = 27)], the highest quartile [high-depressive symptoms (HDS) group (n = 28)], and the remainder. Students also rated themselves and were rated by their teachers on a social competency scale. A 2 (High- and Low-Depressive Groups) x 2 (Teacher-Ratings and Self-Ratings) ANOVA was conducted using social competency rating scores as the dependent variable. The two main effects were significant (p < .01). Adolescents with low-depressive symptoms rated themselves and were rated by their teachers as more socially competent than adolescents with high-depressive symptoms; additionally, self-ratings of social competency were higher than teacher-ratings. Results are discussed in the context of an adolescent optimistic bias or a teacher pessimistic bias.

[Perinatal care for the fetus in women exposed to ionizing radiation after the Chernobyl nuclear plant accident]. / Perinatalnaia okhrana ploda u zhenshchin, prozhivaiushchikh v usloviiakh ioniziruiushchego izlucheniia v rezultate avarii na ChAES.

Thorough examination covered 114 pregnant women living in the second zone of radioactive pollution (Novozybkov town in Briansk region). Occurrence of miscarriage, late gestosis, intrauterine hypoxia and hypotrophia of fetus was higher vs. control. Laboratory studies helped to reveal underlying mechanisms of the stated conditions which are caused by compromised immunity and changes in fetoplacental system.

Time-dependent uncoupling between myosin phosphorylation and contractile force induced by Ca(2+)-depletion in smooth muscle.

Phosphorylation of the 20,000-Da myosin light chain is an important regulatory mechanism of smooth muscle contraction. In this study, we investigated the uncoupling between carbachol-activated myosin phosphorylation and isometric stress in Ca(2+)-depleted bovine tracheal smooth muscle at low [Ca2+]. In control tissues, lowering extracellular [CaCl2] from 1.6 to 0.1 mM had insignificant effects on carbachol-activated steady-state isometric stress and myosin phosphorylation. In contrast, in Ca(2+)-depleted tissues, lowering [CaCl2]0 from 1.6 to 0.1 mM significantly reduced steady-state isometric stress without significantly changing steady-state myosin phosphorylation, thus uncoupling contractile force from myosin phosphorylation. Time-course data of myosin phosphorylation and isometric stress revealed that isometric stress and myosin phosphorylation were coupled at the beginning of contractions, but then gradually became uncoupled at steady state. We attempted to stabilize the cell membrane and contractile filaments using high [Mg2+]. However, 25 mM [MgSO4] further reduced steady-state isometric stress development at 0.1 mM [CaCl2]0 without significantly changing steady-state myosin phosphorylation. These results indicated that Ca(2+)-depletion induced a time-dependent cellular process which gradually uncouples contractile force from myosin phosphorylation. Furthermore, steady-state isometric stress appeared to be not limited by myosin phosphorylation, but sensitive to the [Ca2+]/[Mg2+] ratio near the cell membrane.