No abstract

Resting skin blood flow (RF) and the venoarteriolar response (VAR = the vasoconstrictor response on standing) have been studied in 100 patients with diabetic neuropathy, in 100 diabetics without neuropathy, and in 100 normal subjects by laser Doppler flowmetry. Capillary filtration was also studied with strain gauge plethysmography. The authors followed up these patients by evaluating their microcirculation again after three years. At the beginning of the study in patients with neuropathy, RF and capillary filtration were increased. The VAR and the microangiopathy index (MI = VAR/RF) were reduced in all diabetics, to a greater extent to those with neuropathy. After three years the authors observed an increase in capillary filtration associated with a further impairment in VAR and MI, suggesting progression of microangiopathy in both groups of diabetics. These results suggest that the postural control of blood flow in the skin of the foot is impaired in diabetic microangiopathy, particularly in neuropathics. Increased skin blood flow and capillary filtration and the impaired venoarteriolar response cause edema and may contribute to the thickening of capillary basement membranes and the progressive evolution of diabetic microangiopathy.

NCT00128180.

Oral poster abstracts S-BOT (p = 0.05). M-BOT had echogenic fluid more than S-BOT, but this difference did not reach statistical significance. Only in 5/11 tumors (45%) a significant blood flow was documented. 11/23 (47%) tumors were correctly triaged for oncology-related surgery procedure based on clinical and sonographic evaluation. Conclusions: Echogenic fluid, multilocularity and a larger diameter is more typical to M-BOT. Papillary projections are more often associated with S-BOT. Correct triage for an oncology-related surgery, based on these factors, seem less successful than expected. Objective: The purpose of this study was to evaluate the intraobserver and interobserver agreement for identifying adnexal malignancy using color flow location in indeterminate masses after a gray-scale transvaginal sonography. Methods: Digitally stored color Doppler sonographic images, from a consecutive series of 130 women with an adnexal mass submitted to surgery after transvaginal sonography were evaluated by 6 different examiners with different degree of experience. Only consecutive cystic mass in which the gray-scale echo architecture was not suggestive of benign histology was included in the study. Solid excrescences or solid portions of the tumor were evaluated for vascular flow with color Doppler sonography. A mass was graded malignant if flow was shown within the excrescences or solid areas (central flow) and benign if there was no flow or only peripheral. Intraobserver and interobserver agreement according with the level of experience were assessed by calculating the kappa index. Results: Of the 130 consecutive cases with indeterminate findings at gray-scale evaluation, definitive histologic diagnoses were as follows: 80 (61.5%) benign and 50 (38.5%) malignant masses. Intraobserver agreement was good or very good for all examiners with different degree of experience (kappa ranging from 0.721 to 0.888). Interobserver agreement was good to moderate for all operators (kappa ranging from 0.478 to 0.714), irrespective of degree of experience. A correct classification was obtained by all assessors in 52% of malignant masses. Only ten masses (7.7%) were incorrectly classified by all the assessors. Conclusions: The use of color Doppler in the evaluation of flow location for the detection of adnexal malignancy seems to be reproducible method even in moderate experienced examiners. OP24.08 OP24.09Transrectal ultrasound in the evaluation of locally advanced cervical cancer after neoadjuvant chemotherapy Objective: We compared accuracy of transrectal ultrasound (TRUS) and magnetic resonance (MRI) in evaluation of locally advanced cervical cancer after neoadjuvant chemotherapy (NACT) in this study. Total 36 women with histologically verified cervical cancer stage IB2, incipient IIB and deep stromal invasion with response to NACT were included in this study. All patients were treated with ifosfamide/cisplatin chemotherapy followed by radical hysterectomy at our department in years [2004][2005][2006][2007][2008]. The histologica...

The prevalence of BRCA1 and BRCA2 mutations among breast cancer patients in Peru has not yet been explored. We enrolled 266 women with breast cancer from a National cancer hospital in Lima, Peru, unselected for age or family history. DNA was screened with a panel of 114 recurrent Hispanic BRCA mutations (HISPANEL). Among the 266 cases, thirteen deleterious mutations were identified (eleven in BRCA1 and two in BRCA2), representing 5% of the total. The average age of breast cancer in the mutation-positive cases was 44 years. BRCA1 185delAG represented seven of the eleven mutations in BRCA1. Other mutations detected in BRCA1 included: two 2080delA, one 943ins10, and one 3878delTA. The BRCA2 3036del4 mutation was seen in two patients. Given the relatively low cost of the HISPANEL test, one should consider offering this test to all Peruvian women with breast or ovarian cancer.