Good Health and Wellness: Measuring Impact Through an Indigenous Lens.

In 2014, the Centers for Disease Control and Prevention (CDC) commissioned the Urban Indian Health Institute (UIHI) to coordinate a multifaceted national evaluation plan for Good Health and Wellness in Indian Country (GHWIC), CDC's largest investment in chronic disease prevention for American Indians and Alaska Natives (AI/ANs). GHWIC is a collaborative agreement among UIHI, CDC, tribal organizations, and individual tribes. In collaboration, UIHI and CDC drew upon an indigenous framework, prioritizing strength-based approaches for documenting program activities, to develop a 3-tiered evaluation model. The model incorporated locally tailored metrics, adherence to tribal protocols, and cultural priorities. Ultimately, federal requirements and data collection processes were aligned with tribal strengths and bidirectional learning was promoted. We describe how UIHI worked with tribal recipients, tribal health organizations, Tribal Epidemiology Centers, and CDC to develop and implement the model on the basis of an indigenous framework of mutual trust and respect.

Aberrant lamellar body counts noted on the Beckman Coulter Unicel DxH 800.

BACKGROUND: The lamellar body count (LBC) plays a crucial role in fetal lung maturity testing. Lamellar bodies are often counted in the platelet channel of routine hematology analyzers, resulting in a rapid and inexpensive assay for fetal lung maturity. Recently, significant imprecision was noted during LBC validation on the Beckman Coulter Unicel DxH 800. METHODS: The results of two Beckman Coulter Unicel DxH 800 instruments were compared to those of a Coulter LH 750 and Coulter LH 500. Three pools of amniotic fluid, commercial quality control materials, and proficiency test specimens were analyzed on all four instruments. Fifty patient specimens were also analyzed using the Coulter LH 500 and the Unicel DxH 800. RESULTS: The mean values and precision obtained from commercial quality control materials and proficiency test samples were comparable on all four instruments. However, many erroneously low LBC results were produced from amniotic fluid pools using both DxH 800 instruments. The erroneous values were approximately 50% lower than respective target values, occurred randomly, and affected the low, medium, and high LBC results. Inter-assay precision of the three pools ranged from 24.7 to 39.0 CV% on the DxH 800 instruments. CONCLUSIONS: The source of LBC errors likely involves the exclusion of smaller lamellar bodies from the counts. The DxH 800 combines new data fusion technology and mathematical algorithms to produce increased accuracy and flagging efficiency. Laboratorians should be aware that the improved specificity of the DxH 800 may preclude its use for this laboratory-developed test.

Primary dedifferentiated liposarcoma of the axilla arising in a mixed, well-differentiated and myxoid liposarcoma.

We describe a case of mixed liposarcoma of the axilla presenting as a high grade undifferentiated sarcoma with areas of well-differentiated and myxoid liposarcoma. MRI demonstrated a lobulated, septated intermuscular mass with marked heterogeneous gadolinium enhancement. A small focus of the tumor demonstrated fat suppressed signal more characteristic of well-differentiated liposarcoma. Pathologic analysis following wide local excision revealed a large, high grade sarcomatous component with highly pleomorphic cells with a thin rim of well-differentiated and myxoid liposarcoma on histologic examination. Dedifferentiated liposarcomas arising outside of the retroperitoneum are very rare, as are dedifferentiated liposarcomas arising from a histologically mixed liposarcoma. In this regard, this case illustrates an unusual combination of tumor location and histology which, to our knowledge, has not previously been reported.

The expression level of lysophosphatidylcholine acyltransferase 1 (LPCAT1) correlates to the progression of prostate cancer.

BACKGROUND: Lysophosphatidylcholine acyltransferase 1 (LPCAT1), the enzyme catalyzing the reaction in remodeling of phosphatidylcholine (PC) has been reported to express in prostate. However, its diagnostic and prognostic values remain unclear. METHODS: Immunohistochemistry (IHC) for LPCAT1 was performed on the tissue microarray (TMA) slides containing 251 samples from 148 patients with various prostatic disorders. The association of expression level of LPCAT1 with the progression of prostate cancer was analyzed. RESULTS: LPCAT1 IHC mean score was the highest in metastatic prostate cancer (8.00±1.28), which was significantly higher than that in primary prostate cancer (4.63±3.00, p=9.73E-07), in high grade prostatic intraepithelial neoplasia (HGPIN, 2.72±2.47, p=1.02E-12), and in benign prostate (2.68, p=6.17E-12). The mean score in primary prostate cancer was significantly higher than that in HGPIN (p=4.09E-04) and in benign prostate (p=2.74E-04). There was no significant difference in the mean score between HGPIN and benign prostate (p=0.951). LPCAT1 IHC score also correlated to the tumor grade and stage of prostate cancer. Patients who underwent prostatectomy for prostate cancer and developed biochemical recurrence or clinical metastasis had higher LPCAT1 IHC score than those who underwent prostatectomy for prostate cancer and did not develop biochemical recurrence and clinical metastasis. The association of LPCAT1 with the progression of prostate cancer was independent of patient race and age, PSA level and positivity of surgical resection margins. CONCLUSIONS: LPCAT1 correlates with the progression of prostate cancer and could be a new biomarker in diagnosis, prognosis and studying the pathogenesis of prostate cancer.