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Opioid use among reproductive-age women has greatly increased, resulting in high rates of opioid-exposed pregnancies, which are associated with negative outcomes, such as neonatal abstinence syndrome. Prevention of unintended pregnancy among opioid users is a critical pathway to reducing opioid-exposed pregnancies; however, little is known about pregnancy intention in this group. This article estimates the prevalence of unintended pregnancy among opioid-using women, thereby supporting efforts to develop interventions to reduce unintended pregnancy.A systematic literature search was conducted in PubMed, Web of Science, PsycINFO, and CINAHL, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses framework. Reference lists of articles were searched. Eligibility criteria included reported unintended pregnancy rates within a population of opioid-using women of reproductive age. The search was completed in July 2018 and updated in October 2019.We identified 115 citations, screened 64 titles/abstracts, reviewed 31 full-text articles, and included 12 articles for this review. Rates of unintended pregnancy in opioid users were estimated in two ways, across the lifetime and for a current pregnancy, depending on study samples. Rates for both groups were high, with rates among currently pregnant opioid-using women (85%) compared with 45% among the general population.Unintended pregnancy rates in opioid-using women were strikingly high, indicating a critical need for intervention. Routine inclusion of pregnancy planning in opioid treatment care is indicated. Education regarding contraception and opioid treatment services is essential for nurses in these settings. Family planning and opioid treatment efforts can be optimized by care coordination, with focus on nurse training for screening and patient education.

The article describes the main achievements of the NUMEN project together with an updated and detailed overview of the related R&D activities and theoretical developments. NUMEN proposes an innovative technique to access the nuclear matrix elements entering the expression of the lifetime of the double beta decay by cross section measurements of heavy-ion induced Double Charge Exchange (DCE) reactions. Despite the fact that the two processes, namely neutrinoless double beta decay and DCE reactions, are triggered by the weak and strong interaction respectively, important analogies are suggested. The basic point is the coincidence of the initial and final state many-body wave functions in the two types of processes and the formal similarity of the transition operators. First experimental results obtained at the INFN-LNS laboratory for the 40Ca(18O,18Ne)40Ar reaction at 270MeV give an encouraging indication on the capability of the proposed technique to access relevant quantitative information. The main experimental tools for this project are the K800 Superconducting Cyclotron and MAGNEX spectrometer. The former is used for the acceleration of the required high resolution and low emittance heavy-ion beams and the latter is the large acceptance magnetic spectrometer for the detection of the ejectiles. The use of the high-order trajectory reconstruction technique, implemented in MAGNEX, allows to reach the experimental resolution and sensitivity required for the accurate measurement of the DCE cross sections at forward angles. However, the tiny values of such cross sections and the resolution requirements demand beam intensities much larger than those manageable with the present facility. The on-going upgrade of the INFN-LNS facilities in this perspective is part of the NUMEN project and will be discussed in the article. © 2018, SIF, Springer-Verlag GmbH Germany, part of Springer Nature.

Amazonia is a ‘source’ of biodiversity for other Neotropical ecosystems, but which conditions triggerin situspeciation and emigration is contentious. Three hypotheses for how communities have assembled include (1) a stochastic model wherein chance dispersal events lead to gradual emigration and species accumulation, (2) diversity-dependence wherein successful dispersal events decline through time due to ecological limits, and (3) barrier displacement wherein environmental change facilitates dispersal to other biomes via transient habitat corridors. We sequenced thousands of molecular markers for the Neotropical Tityrinae (Aves) and applied a novel filtering protocol to identify loci with high utility for dated phylogenomics. We used these loci to estimate divergence times and model Tityrinae's evolutionary history. We detected a prominent role for speciation driven by barriers including synchronous speciation across the Andes and found that dispersal increased toward the present. Because diversification was continuous but dispersal was non-random over time, we show that barrier displacement better explains Tityrinae's history than stochasticity or diversity-dependence. We propose that Amazonia is a source of biodiversity because (1) it is a relic of a biome that was once more extensive, (2) environmentally mediated corridors facilitated emigration and (3) constant diversification is attributed to a spatially heterogeneous landscape that is perpetually dynamic through time.

Background and Objectives Serological evaluation of maternal sera for platelet antibodies in suspected fetal/neonatal alloimmune thrombocytopenia (FNAITP) discloses in only ≈ 30% of individuals a platelet-specific antibody. Transfusion-induced alloimmunization against human platelet antigen-15 (HPA-15) has been reported to be about as common as against HPA-5, the second most common platelet antibody. Thus, anti-HPA-15 may also contribute significantly to yet-unclear cases of FNAITP. Materials and Methods In this retrospective analysis, we provide data on maternal platelet antibodies from 309 mothers who delivered an offspring with suspected FNAITP. Results Genotyping maternal and paternal samples (together n = 573) revealed a gene frequency of 0·496 for HPA-15a and a gene frequency of 0·504 for HPA-15b. HPA-15 antibodies were detected in 2% of all samples. Anti-HPA-15a and -15b were detected in two and three samples, respectively. One serum reacted equally with HPA-15a and -15b platelets. The most frequent platelet-specific antibodies were anti-HPA-1a (22%), but anti-HPA-5b (8·4%) were more frequent than anti-HPA-15. In addition, panreactive (5·5%) or autoreactive (5·2%) anti-GPIIb/IIIa or anti-GPIb/IX were detectable in maternal samples. Conclusions These data indicate that HPA-15 alloimmunization needs only to be considered in subjects with suspected FNAITP if no other platelet-specific antibody is detectable. The presence of panreactive or autoreactive antibodies should also be considered in neonatal thrombocytopenia.

Objective: To investigate the effects of low-dose oral hormonal contraception on the immune system during certain phases of the hormonal cycle. Design: Prospective, nonrandomized, controlled study. Setting: Academic research setting. Patient(s): Women with regular menstrual cycle using hormonal oral contraception (OC; Cileste®, 250 μg of norgestimat and 35 μg of ethinylestradiol, or Marvelon®, 150 μg of desogestrel and 30 μg of ethinylestradiol) and women not using hormonal or other forms of contraception. Intervention(s): Peripheral blood lymphocyte subsets were determined by flow cytometry on the first day of menstruation (day 1), in the follicular phase (day 8), midcycle (day 15), and in the luteal phase (day 22). Main Outcome Measure(s): Levels of lymphocyte subpopulations. Result(s): Women using OC had significantly higher levels of CD3+ CD8+ cells throughout their pill cycle compared to controls. Furthermore, women taking Cileste® had lower levels of natural killer (NK) cells during their cycle and also women taking Marvelon® but only from days 8–15. Within the pill cycle of Cileste® we observed an increase in CD20+ and CD20+ CD5+ cells from days 1–8. Conclusion(s): Cytotoxic lymphocytes, which are responsible for first-line immune defense, and B cells, which are involved in autoimmune disorders, are affected by OC.

We measured the cross section and response functions for the quasielastic 16O(e,e'p) reaction for missing energies 25< or =E(m)< or =120 MeV at missing momenta P(m)< or =340 MeV/c. For 25

We have measured the cross section for quasielastic 1p -shell proton knockout in the {sup 16}O( e, e{sup '}p) reaction at {omega}=0.439 GeV and Q{sup 2}=0.8 (GeV/c){sup 2} for missing momentum P{sub miss}{

The deuteron elastic structure function A(Q2) has been extracted in the range 0.7≤Q2≤6.0(GeV/c)2 from cross section measurements of elastic electron-deuteron scattering in coincidence using the Hall A Facility of Jefferson Laboratory. The data are compared to theoretical models, based on the impulse approximation with the inclusion of meson-exchange currents, and to predictions of quark dimensional scaling and perturbative quantum chromodynamics.

Fragestellung: Die Immunreaktion mütterlicher Lymphozyten gegen den Embryo wird für die fetale Wachstumsretardierung mitverantwortlich gemacht. Die Sekretion von plazentarem Isoferritin (PLF) während der Schwangerschaft kann diese Immunreaktion verringern. In dieser multizentrischen Studie soll die Bestimmung von PLF zur Früherkennung einer Wachstumsretardierung untersucht werden. Methodik: Die PLF-Konzentrationen im Serum wurden bei 402 schwangeren Frauen zwischen der 12. und der 16. Schwangerschaftswoche mit Enzym-Immunoassay bestimmt und mit dem Geburtsgewicht, der Perzentile des Geburtsgewichtes und mit dem Gestationsalter verglichen. Ergebnisse: Frauen mit gemäss dem Gestationsalter untergewichtigen Neugeborenen (d.h. auf oder unter der 10. Perzentile des Geburtsgewichtes) wiesen im Vergleich zu Frauen mit normalgewichtigen Kindern (19,9 E/ml, n = 295) signifikant niedrigere (11,4 E/ml, n = 107) Serum-PLF-Konzentrationen auf (p < 0,004). Schlussfolgerung: Die Bestimmung der PLF-Konzentration im Serum während der ersten Hälfte der Schwangerschaft kann ein wichtiger zusätzlicher Parameter sein, um fetale Wachstumsretardierungen frühzeitig zu erkennen.

Regular screening mammographies and increasing knowledge of high-risk groups have resulted in an improvement in the rate of detection of smaller malignant lesions. However, uncertain minimal mammographic features frequently require further costly and often uncomfortable investigation, including repeat radiological controls or surgical procedures, before cancerous lesions can be identified. Placental isoferritin (p43), a protein with immunosuppressive effects, has been detected on the surface of lymphocytes taken from peripheral blood in patients with breast cancer. In this study we evaluated the sensitivity and specificity of the expression of p43-positive lymphocytes as a marker in early stage breast cancer and also investigated its expression on T-cell subpopulations. The presence of p43-positive lymphocytes was investigated using the monoclonal antibody CM-H-9 and flow cytometry in 76 women with controversial, non-palpable mammographic findings who were undergoing surgical biopsy. Patients with early breast cancer (n = 48) had significantly higher p43-positive cell values (median 3.83%, range 0.98–19.4) than patients with benign lumps (n = 28, median 1.43%, range 0.17–3.7) or controls (n = 22, median 1.3%, range 0.4–1.87) (P < 0.0001). At a cut-off level of 2% p43-positive cells a sensitivity of 91.7% and a specificity of 89.3% for detection of breast cancer could be reached. While the median ratio of total CD4+/CD8+ cells was 2.6, a ratio of 1.3 was found for the p43-positive subpopulation (P < 0.001), thus indicating a significant link between p43 and CD8+ cells. The determination of p43-positive lymphocytes in peripheral blood could serve as an additional diagnostic tool in patients with controversial mammographic findings and could also reduce the need for cost-intensive and often uncomfortable management of these patients. © 1999 Cancer Research Campaign

Tumor samples of 240 patients with primary breast cancer were biochemically and immunohistochemically investigated for estrogen receptors (ER) and, in 130 of the samples, for progesterone-receptors (PgR) in order to examine reasons for discordant findings. The biochemical (DCCA) and immunohistochemical assays (ICA) yielded positivity in 71% for ER, and in 44% for PgR. Concordant ER-DCCA and ER-ICA results were obtained in 84%; two thirds of the discordant ER-findings manifested as DCCA-neg/ICA-pos. Concordance in the case of PgR amounted to 72%, and of the discordances 60% were DCCA-neg/ICA-pos. Significant association with postmenopausal status existed only for ER positivity in ICA (p = 0.01), whereas ER-DCCA, PgR-DCCA and PgR-ICA were all more or less independent of the menopausal status. The frequency of discordances was independent of menopausal status. Discordance for ER-assays increased significantly near the respective cut-off point; this was not unequivocally true for PgR-assays. The correlation of tumor types of sparse cellularity, as well as prominent stroma content ('scirrhous carcinoma') with increased frequency of the constellation DCCA-neg/ICA-pos was of borderline significance for PgR (p = 0.06), but not for ER. The percentage of discordant ER-findings, figuring as DCCA-neg/ICA-pos, was statistically significantly increased in locally advanced breast cancer (p = 0.03). Fibrocystic disease in peritumoral breast tissue had no impact on receptor-assay discordance. In any case, the models derived from theoretical thought, laboratory data and singular observations can only in part explain the discordance in steroid receptor values measured with different methods.

Ziel dieser prospektiven Diagnosestudie war es, die Effektivitat des Vaginalultraschalls in der Nachsorge von Brustkrebs-Patientinnen unter Tamoxifentherapie zu uberprufen. Zusatzlich sollten spezifische sonomorphologische Veranderungen des Endometriums unter Tamoxifentherapie aufgezeigt werden. 82 symptomlose, postmenopausale Patientinnen, welche zwischen 20 und 40 mg Tamoxifen durchschnittlich 25 ± 16 Monate genommen hatten, nahmen an einer vaginosonographischen Untersuchung teil. Beurteilt wurde das gesamte innere Genitale mit besonderer Berucksichtigung der Cavumbreite, Homogenitat und Abgrenzbarkeit des Endometriums. In 49 Fallen wurde ein homogenes, gut abgrenzbares Cavumecho 10 mm, or endometrium > 5 showing bizarre struetures not clearly separated from the myometrium was an indication for performing curettage. In 49 patients, ultrasound yielded a normal result. Twelve patients showed homogeneous, well-definable endometrial thickness between 6 and 10 mm. In 21 cases, the endometrium was thickened to more than 10 mm, losing homogeneity and sonographie separability from the underlying tissue. Thus, in 21 of the 82 patients, curettage had to be performed. In 8 cases only, an atrophic endometrium could be found. In a control after curettage, the sonographie appearance of endometrial hyperplasia was unchanged in these 8 patients. In the other 13 patients that showed an enlarged, atypical endometrium, we found 10 cases with endometrial polyps and 3 cases with hyperplasia, one of them atypical. We think that transvaginal ultrasound is a good means to detect and evaluate endometrial alterations induced by tamoxifen treatment of postmenopausal breast cancer patients. With tamoxifen we suggest the cut-off level for enlarged endometrium to be definitely higher than starting at 6 mm. Nevertheless, loss of homogeneity and loss of endometrial separability should immediately lead to further diagnostic procedures. Because of the tamoxifen-specific phenomenon of „pseudoendometrial hyperplasia“, it is very important not to overinterpret ultrasonographic findings in the further follow-up of tamoxifen-treated patients who have already undergone curettage.

The conversion of plasminogen to active plasmin is thought to be a crucial step in the process of extracellular matrix degradation associated with metastatic spread. Activation of plasminogen is initiated by urokinase plasminogen activator (uPA). The binding of uPA to the uPA cell surface receptor (uPA-R) accelerates plasmin generation from plasminogen and localizes uPA activity to the cell surface. We investigated the mRNA-expression of uPA-R in 19 different human breast cancer cell lines. In a competitive reverse transcription polymerase chain reaction (cRT-PCR) we simultaneously co-amplified two different RNA templates bearing the same primer recognition sequences, the cell line RNA and a known amount of an in vitro synthesized uPA-R-RNA internal standard. We analyzed the two PCR products differing 50 bp in size by agarose gel electrophoresis and calculated the initial uPA-R-RNA template concentration from the relative intensities of the bands quantified by video densitometry. We grouped the investigated cell lines according to their in vitro invasiveness according to literature. Cell lines with a high potential of invasiveness showed a higher expression of uPA-R compared to those with a low potential of invasiveness (Student's t-test, p 0.04). In addition to that we compared the uPA-R mRNA levels with uPA-R, uPA, and PAI-1 protein levels in culture supernatants and cell lysates. The obtained results in breast cancer cell lines with different invasiveness and in benign epithelial cell lines revealed the complex cooperation of the urokinase type proteolytic pathway. uPA, uPA-R, and PAI-1 are to be considered as a diagnostic tool rather than assaying a particular molecule alone. Our findings support the hypothesis that the urokinase proteolytic pathway plays a central role in the acquisition of an invasive phenotype and favors its potential use as a prognostic marker in patients with breast cancer.

The secretion of placental isoferritin (PLF) during pregnancy could be responsible for the diminished immunoreaction of maternal lymphocytes against the embryo. In this study, serum levels of PLF in 335 pregnant women were correlated with birth weight, percentile of birth weight, gestational age, and pulsatility index of the uterine artery, as well as with diastolic notching. Women with small-for-gestational age (SGA) infants (birth weight below or equal to the tenth percentile) showed significantly lower PLF levels (11.7 U/ml) compared with women whose newborns were of normal weight (19.4 U/ml) (P < 0.05). In line with this finding, a strong correlation was observed between PLF levels and the percentile of birth weight, pulsatility index of the uterine artery, and the presence of diastolic notching. The strong correlation of low PLF values and SGA newborns suggests that determination of PLF could serve as a marker to identify women at risk of having such babies.

S.R., a 66-year old woman, was referred to our department because of an axillary mass in the right side. The patient had observed an increasing, painless swelling in the right axilla for the last two months. In the region of the right axilla in the middle axillary line an ovoid and solid tumour of 3 cm in diameter, quite well distinguishable, moving against the skin and the surrounding tissue, could be palpated. A subsequent mammography yielded an unsuspicious visualisation of both breasts and the left axilla. In the right axilla a circular solidification was detected, which then turned out on ultrasound examination to be a 2.6-cm diameter axillary lymph node. In the course of the lymph node extirpation of the right axilla two lymph nodes were dissected with histological evidence of metastatic nodes of a solid tumour, most likely in accordance with a breast carcinoma. Several immunohistochemical methods had been applied to determine the origin of the tumour cells and were thus identified as breast cancer cells. To detect primary causative carcinoma, different examinations were performed postoperatively without identifying any cancerous lesions. At least accurate research concerning the history of the patient was required to reexamine the histologic material of an operation of the right breast in 1989. The histological diagnosis of the dissected node of that time had been defined as a benign intracanaliculary papilloma in the right side without evidence of malignancy. The reexamination of the paraffin-embedded material from the operation of the right breast in 1989 revealed a lobular carcinoma of the right breast. The "occult" (undetectable) carcinoma of the breast occurs in less than 1% of all breast carcinomas. Thus it represent a rare clinical event and hence no standardised therapy schemata exist. To confirm the diagnosis of an occult carcinoma of the breast efficient reexamination of histological material from earlier breast operations indicated.

The dose-response effects of exercise training on insulin sensitivity, metabolic risk, and quality of life were examined.Sixty-one healthy, sedentary (VO₂max: 35 ± 5 ml/kg/min), moderately overweight (BMI: 27.9 ± 1.8), young (age: 29 ± 6 years) men were randomized to sedentary living (sedentary control group; n = 18), moderate (moderate dose training group [MOD]: 300 kcal/day, n = 21), or high (high dose training group [HIGH]: 600 kcal/day, n = 22) dose physical exercise for 11 weeks.The return rate for post-intervention testing was 82-94% across groups. Weekly exercise amounted to 2,004 ± 24 and 3,774 ± 68 kcal, respectively, in MOD and HIGH. Cardiorespiratory fitness increased (P0.001) 18 ± 3% in MOD and 17 ± 3% in HIGH, and fat percentage decreased (P0.001) similarly in both exercise groups (MOD: 32 ± 1 to 29 ± 1%; HIGH: 30 ± 1 to 27 ± 1%). Peripheral insulin sensitivity increased (P0.01) (MOD: 28 ± 7%; HIGH: 36 ± 8%) and the homeostasis model assessment of insulin resistance decreased (P0.05) (MOD: -17 ± 7%; HIGH: -18 ± 10%). The number of subjects meeting the criteria of the metabolic syndrome decreased by 78% in MOD (P0.01) and by 80% in HIGH (P0.05). General health assessed by questionnaire increased similarly in MOD (P0.05) and HIGH (P0.01).Only minor additional health benefits were found when exercising ∼3,800 as opposed to ∼2,000 kcal/week in young moderately overweight men. This finding may have important public health implications.

A retrospective nationwide evaluation of primary fallopian tube carcinomas for a period of 10 years (1980-1990) was performed to evaluate the prognostic impact of various factors. Sixty-six cases were investigated for the prognostic influence of estrogen (ER) and progesterone (PgR) status, mitotic activity, degree of nuclear anaplasia, and inflammatory reaction. ER and PgR receptors were detected by immunohistochemistry from paraffin sections. Forty-two percent were PgR-positive and 26% were ER-positive. However, no correlation of steroid receptors with survival could be found. Ninety-two percent of all tumors showed a moderate and high degree of nuclear anaplasia and only 8% showed a low degree of nuclear anaplasia. Thirty-four (52%) samples from all patients revealed low mitotic activity compared to 32 (48%) with an intermediate and high mitotic rate. Twenty-four (37%) tissue samples showed a positive inflammatory reaction which correlated with a significantly better outcome compared with tumors without this feature. This finding was also confirmed in multivariate analysis as an independent prognostic factor.

A retrospective evaluation of 68 Fallopian tube carcinomas (FTC) of a period of ten years (1980-1990) in stage I and II was performed. The aim of this study was to evaluate the prognostic impact of various factors. 68 cases were investigated for the prognostic influence of mitotic activity, degree of nuclear anaplasia and inflammatory reaction. Histological grading (p=0.08), and inflammatory reaction (p=0.003) showed to have a prognostic impact for survival in univariate analysis. Whereas, mitotic activity did not show any statistically significant influence. 47 (69%) tissue samples showed a positive inflammatory reaction which correlated with a significantly better outcome compared with tumors without this feature. However, this influence was proved in multivariate analysis for inflammatory reaction only (p=0.01). Although no data on the influence of the inflammatory reaction on prognosis in FTC has been published up to now, we can state that the determination of this factor can be useful for prognosis in this rare but highly aggressive tumor.

Dilute scintillation mixtures emit isotropic light for both fast and slow particles, but retain the Cherenkov light cone from fast particles. Large volume detectors using photomultipliers to reconstruct relativistic tracks will also be sensitive to slow particles if they are filled with these mixtures. Our data show that 0.03 g/l of b-PBD in mineral oil has a 2.4:1 ratio (in the first 12 ns) of isotropic light to Cherenkov light for positron tracks. The light attenuation length is greater than 15 m for wavelength above 400 nm, and the scintillation decay time is about 2 ns for the fast component. There is also a slow isotropic light component that is larger (relative to the fast component) for protons than for electrons. This effect allows particle identification by a technique similar to pulse shape discrimination. These features will be utilized in LSND, a neutrino detector at LAMPF.

Die Behandlung von Erkrankungen mit komplementaren Methoden ist keine Entdeckung des 20. Jahrhunderts. Grundsatzliche Erkenntnisse zu den menschlichen Korperfunktionen waren schon der Antike bekannt, wenn auch meist bose Damonen oder Ahnen, strafende Gotter, der Einfluss der Gestirne oder einfach der fehlende rechte Glaube als Ursachen fur Epidemien oder Krankheiten angesehen wurden. Zur Vertreibung des Leidens und Wiederherstellung der Gesundheit wurden Heiler, Schamanen, Priester herangezogen, die mit verschiedensten Ritualen zu therapieren versuchten. Meist wurden zusatzlich Pflanzen der Umgebung als Heilmittel eingesetzt. Mit der Etablierung von Zentren fur eine standardisierte medizinische Ausbildung wurde dieses Wissen von empirischen gesammelten Heilwirkungen verschiedenster pflanzlicher, tierischer und mineralischer Arzneimittel gesammelt und gelehrt.

We report a virtual Compton scattering study of the proton at low c.m. energies. We have determined the structure functions P(LL)-P(TT)/epsilon and P(LT), and the electric and magnetic generalized polarizabilities (GPs) alpha(E)(Q2) and beta(M)(Q2) at momentum transfer Q(2)=0.92 and 1.76 GeV2. The electric GP shows a strong falloff with Q2, and its global behavior does not follow a simple dipole form. The magnetic GP shows a rise and then a falloff; this can be interpreted as the dominance of a long-distance diamagnetic pion cloud at low Q2, compensated at higher Q2 by a paramagnetic contribution from piN intermediate states.

We report a virtual Compton scattering study of the proton at low c.m. energies. We have determined the structure functions P(LL)-P(TT)/epsilon and P(LT), and the electric and magnetic generalized polarizabilities (GPs) alpha(E)(Q2) and beta(M)(Q2) at momentum transfer Q(2)=0.92 and 1.76 GeV2. The electric GP shows a strong falloff with Q2, and its global behavior does not follow a simple dipole form. The magnetic GP shows a rise and then a falloff; this can be interpreted as the dominance of a long-distance diamagnetic pion cloud at low Q2, compensated at higher Q2 by a paramagnetic contribution from piN intermediate states.

Staging and surgical as well as post-operative treatment of primary Fallopian tube carcinoma (FTC) followed the lines established for primary ovarian cancer (OC). In a nationwide retrospective analysis we were able to find a distinct difference between these two tumours. A total of 262 patients, 68 with FTC and 194 with OC, in stage I and II were included into this study. A univariate as well as a multivariate analysis for survival was performed, including factors such as age, histological type, grading and surgical and adjuvant treatment. A significantly poorer outcome (P = 0.0002) for FTC patients with a 5-year survival of 50.8% compared with 77.5% for OC patients was observed. This finding was persistent and independent of any investigated factor, in univariate as well as multivariate analyses. Therefore, we feel that a more aggressive therapeutic approach to the treatment of FTC even in early stages can be recommended. On the other hand, the retrospective character of our study has to be taken into account.

The main arteries to the breast are the lateral thoracic artery and to a lesser extent the internal thoracic artery. In this prospective open diagnostic study involving 94 women, we compared the intraindividual differences of Doppler indices in the lateral thoracic (breast-feeding) artery of breasts affected by cancer with those unaffected by disease.Sixty-seven consecutive patients were recruited from an outpatient unit for breast surgery and 27 volunteers were studied who were known to be without any breast disease (controls). In each patient we attempted to obtain Doppler indices from the lateral thoracic artery of both breasts. The difference in Doppler indices in each individual was assessed and statistical analysis was performed to assess whether these differences were significantly altered in women with cancer compared to healthy women.Lateral thoracic arteries could be visualized in 88% of the study population. Significantly lower values for pulsatility and resistance indices and systolic/diastolic ratios were obtained in the lateral thoracic arteries of breasts affected by cancer as compared to the contralateral breasts (1.73 +/- 0.39 vs. 2.05 +/- 0.47, P = 0.003; 0.78 +/- 0.06 vs. 0.84 +/- 0.06, P0.0001; 4.71 +/- 1.24 vs. 6.75 +/- 3.38, P = 0.0008, respectively). Using the intraindividual difference of pulsatility index, resistance index and systolic/diastolic ratio to screen for malignancy, sensitivities for breast cancer of 78%, 85% and 83%, respectively, were achieved. Depending on the cut-off level, specificity reached 94%.The intraindividual difference in Doppler indices in women with breast cancer may be a useful test for the diagnosis of breast lesions.

The first $(\stackrel{\ensuremath{\rightarrow}}{e}{,e}^{\ensuremath{'}}\stackrel{\ensuremath{\rightarrow}}{p})$ polarization transfer measurements on a nucleus heavier than deuterium have been carried out at Jefferson Laboratory. Transverse and longitudinal components of the polarization of protons ejected in the reaction ${}^{16}\mathrm{O}(\stackrel{\ensuremath{\rightarrow}}{e}{,e}^{\ensuremath{'}}\stackrel{\ensuremath{\rightarrow}}{p})$ were measured in quasielastic perpendicular kinematics at a ${Q}^{2}$ of 0.8 $(\mathrm{GeV}{/c)}^{2}.$ The data are in good agreement with state of the art calculations.

We measured the cross section and response functions for the quasielastic 16O(e,e'p) reaction for missing energies 25or =E(m)or =120 MeV at missing momenta P(m)or =340 MeV/c. For 25E(m)50 MeV and P(m) approximately 60 MeV/c, the reaction is dominated by a single 1s(1/2) proton knockout. At larger P(m), the single-particle aspects are increasingly masked by more complicated processes. Calculations which include pion exchange currents, isobar currents, and short-range correlations account for the shape and the transversity, but for only half of the magnitude of the measured cross section.

Maternal immunoreaction against the embryo can be responsible for fetal growth retardation. The secretion of PLF during pregnancy could be reliable for a diminished immunoreaction of maternal lymphocytes against the embryo. The aim of the present study was to elucidate a possible correlation between PLF and fetal growth retardation.In this study, blood samples of 402 pregnant women were obtained between the 12th and 16th weeks of gestation. The serum levels of PLF were compared with birth weight, percentile of birth weight, and gestational age.Women with children whose birth weight was below or equal to the 10th percentile for gestational age showed significantly lower PLF levels (11.4 U/ml, n = 107) as compared with women whose newborns were of normal weight (19.9 U/ml, n = 295; p0.004).Determination of the PLF level could serve to identify women at risk of having growth-retarded babies.

The effectiveness of Indian version to convert fetuses from breech to vertex presentation was evaluated.One hundred and nine pregnant women presenting between 30 and 32 weeks of gestation with singleton breech infants were included in our prospective randomized open study making an interim analysis recruitment to estimate the sample sizes after one year. The spontaneous version rate of fetuses in breech presentation was compared with the version rate in women performing Indian version. Indian version is a maternal positioning exercise that consists of raising the pelvis, abduction of the thighs, and relaxed abdominal breathing. Clinical parameters that could influence the result were assessed.In primiparous women, the version rate was 70% in the Indian version group and 63% in the comparison group. In multiparous women, 89% Indian versions and 87% spontaneous versions were observed. Parity was the only clinical parameter found to be related to outcome.Indian version does not significantly improve the rate of spontaneous version of breech to vertex presentation.

The secretion of placental isoferritin (PLF) during pregnancy could be responsible for the diminished immunoreaction of maternal lymphocytes against the embryo. In this study, serum levels of PLF in 335 pregnant women were correlated with birth weight, percentile of birth weight, gestational age, and pulsatility index of the uterine artery, as well as with diastolic notching. Women with small-for-gestational age (SGA) infants (birth weight below or equal to the tenth percentile) showed significantly lower PLF levels (11.7 U/ml) compared with women whose newborns were of normal weight (19.4 U/ml) (P0.05). In line with this finding, a strong correlation was observed between PLF levels and the percentile of birth weight, pulsatility index of the uterine artery, and the presence of diastolic notching. The strong correlation of low PLF values and SGA newborns suggests that determination of PLF could serve as a marker to identify women at risk of having such babies.

A search for neutrino oscillations of the type nu_bar_mu to nu_bar_e has been conducted at the Los Alamos Meson Physics Facility using nu_bar_mu from muon decay at rest. Evidence for this transition has been reported previously. This paper discusses in detail the experimental setup, detector operation and neutrino source, including aspects relevant to oscillation searches in the muon decay-at-rest and pion decay in flight channels., 27 pages, 26 figures, revtex and psfig, additional information available at http://nu1.lampf.lanl.gov/~lsnd/