Scott Crowell (parrotskirt55)

Serous borderline tumor outside of the peritoneal cavity is rare.•Involvement of cardiophrenic lymph nodes with serous borderline tumor can occur.•Preoperative imaging may aid surgical planning even in serous borderline tumor cases.•Sequencing can help confirm a diagnosis of serous borderline tumor at distant sites.To evaluate BRCA1/2 immunohistochemistry (IHC) as a screening test for germline BRCA1/2 in epithelial ovarian cancer (EOC), tumor tissue from 105 EOC patients who had germline BRCA mutations, including 9 BRCA1 mutations, 6 BRCA2 mutations and 90 no BRCA mutations, were studied. Paraffin-embedded tissue blocks were stained for BRCA1 and BRCA2. Tumors were indicated as a loss of BRCA expression when neoplastic nuclear stained less than 10%. Loss of BRCA1 and/or BRCA2 expression was found in 36 patients (34.3%). BRCA1 IHC loss was found in 21 patients (20%) while 24 patients (22.9%) had BRCA2 IHC loss. There were no significant differences in patient characteristics between both groups. Loss of BRCA1 expression had 66.7% sensitivity, 84.3% specificity, 28.6% positive predictive value (PPV), and 96.4% negative predictive value (NPV) for detection of germline BRCA1 mutation. Meanwhile, loss of BRCA2 expression had 50% sensitivity, 78.8% specificity, 12.5% PPV, and 96.3% NPV for detection of germline BRCA2 mutation. There was no significant difference in survival outcomes between both groups. Based on high NPV, BRCA IHC may be useful to exclude patients without BRCA dysfunction if IHC showed intact expression. Only patients with BRCA IHC loss should be offered further genetic testing.Background Laboratories performing clinical high-throughput sequencing for oncology and germline testing are increasingly migrating their data storage to cloud-based solutions. Cloud-based storage has several advantages, such as low per-GB prices, scalability, and minimal fixed costs; however, while these solutions tout ostensibly simple usage-based pricing plans, practical cost analysis of cloud storage for NGS data storage is not straightforward. Methods We developed an easy-to-use tool designed specifically for cost and usage estimation for laboratories performing clinical NGS testing (https//ngscosts.info). Our tool enables quick exploration of dozens of storage options across three major cloud providers, and provides complex cost and usage forecasts over 1-20 year timeframes. Parameters include current test volumes, growth rate, data compression, data retention policies, and case re-access rates. Outputs include an easy-to-visualize chart of total data stored, yearly and lifetime costs, and a "cost per test" estimate. Results Two factors were found to markedly decrease the average cost per test 1) reducing total file size, including through the use of compression, 2) rapid transfer to "cold" or archival storage. In contrast, re-access of data from archival storage tiers was not found to dramatically increase the cost of storage per test. Conclusions Steady declines in cloud storage pricing, as well as new options for storage and retrieval, make storing clinical NGS data on the cloud economical and friendly to laboratory workflows. Our web-based tool makes it possible to explore and compare cloud storage solutions and provide forecasts specifically for clinical NGS laboratories.Background To provide normal knee function, a total knee arthroplasty (TKA) implant with an anatomic surface shape and an adequate sagittal position has been developed. However, it is unclear how this modern implant influences knee joint kinetics and muscle activation during a gait. Therefore, we evaluated this modern TKA prosthesis and compared it with a conventional TKA prosthesis for gait analysis in terms of kinetics and muscle activation. Methods Subjects were patients (>60 years of age) with knee osteoarthritis who had undergone unilateral TKA. Twelve patients received the modern TKA prosthesis (group modern), and the other 12 patients received a convent