The Philadelphia Inquirer from Philadelphia, Pennsylvania • Page 50

E4 THE PHILADELPHIA INQUIRER Monday, December 28, 1998 Ask Dr. H. By Mitchell Hecht Patterns of calcium deposits may indicate beginnings of cancer The Epstein-Barr virus causes infectious mononucleosis. You may have heard it described as the kissing disease, and that's because it's usually transmitted from contact with infected saliva from kissing, shared drinking glasses or eating utensils. Actually, the transmission of the virus requires prolonged and repeated contact with infected saliva.

You probably won't get it with just one kiss. Therefore, it's not necessary to quarantine a person with mono. It's not that contagious. It can occur in persons of any age, even infants. Because fever and sore throat are the initial complaints in most people with the virus, it isn't unusual for a physician to initially diagnose mono as a strep throat and start antibiotics.

Often, after a few days of antibiotics (especially amoxicillin), a rash will occur. You might think it's from an allergy to an antibiotic, but it's probably a sign of the viral infection of mono. Sometimes, it fools doctors, too. How do we find out if a person has mono? Well, we can have a blood test done that will show an elevated white-blood-cell count with an in Malignant-appearing microcalcifications are almost always due to breast cancer, and a biopsy must be performed. Sometimes, an alternative to an open-tissue biopsy is a stereotactic core needle biopsy.

It uses a three-dimensional ray to locate the microcalcifications and a computer-guided needle to obtain tissue for biopsy. Another part of all of this is that the evaluation of a breast for early cancer or a suspicious lesion is limited by the technology of mammogram imaging. While the experienced "eye" of a radiologist is invaluable, the objective is to provide the clearest image of the highest resolution. Digital computer mammography may help doctors detect more breast cancers than standard mammography imaged on X-ray film. The digital image can be enhanced or magnified to more closely examine suspicious areas that aren't easily seen on standard X-ray film.

My daughter had mononucleosis. The doctor said to rest that's all. She still gets tired. What can you tell me about this infection? creased number of lymphocytes (cells that fight off viral infections). We can also have a "mono-spot" test, which if positive, will confirm the Epstein-Barr infection.

We can also check for the presence of the Epstein-Barr virus in the blood as well as any antibodies produced in response to it. Is there medicine for it? In most cases, no. For the vast majority of sufferers, there will be an acute phase with muscle aches, fever, chills, headache, nausea, abdominal pain, sore throat, weakness, cough or joint pain lasting one to three weeks, with the infection running its course toward a full recovery over the next four to six weeks. A person with mono needs lots of rest, along with good nutrition, plenty of fluids, warm saltwater gargling, and acetaminophen or ibu-profen to help with the aches and pains. Steroids such as prednisone may sometimes be helpful, but, because of their potential toxicity, are best used only in severe cases.

As for antibiotics, they won't help in a viral infection. In half of all cases, the spleen, an organ under the left ribcage, will be enlarged. Liver enlargement, under the right tions tend to be scattered about randomly, few in number and round. They don't usually need any further work-up. Indeterminate microcalcifications are in a gray zone where they're not clearly suspicious for cancer, but they're not normal either.

Generally, these are evaluated with magnification views (enlargements), This allows the radiologist to define it further as "probably benign" (98 percent chance of not being cancer), "suspicious" (20 to 25 percent chance of being cancer) or "malignant." In some indeterminate cases, the shape and arrangement of the microcalcifications may lead the radiologist to believe that a biopsy isn't necessary. Instead, a follow-up mammogram with close-up views in three to six months will be advised. Then, if there's no interval change, annual mammograms are sufficient. If the microcalcifications are believed to be "suspicious," a breast biopsy is usually advised. While cancer needs to be ruled out, the most common cause for these "suspicious" microcalcifications isn't cancer, it's fibrocystic breast disease.

fab, the feisty and the Question: I have microcalcifications in both breasts. I'm being checked every year with mammograms, but no biopsy has been taken. Are the comparisons of my yearly mammograms sufficient? Answer: Tiny calcium deposits that look like grains of sand may develop within breast tissue. They're seen as small, white specks on a mammogram. We're not sure why they occur, but we do know that they have nothing to do with calcium in food or supplements.

These microcalcifications may be randomly scattered throughout the breast tissue, or they may be clustered. Why worry about them? Some microcalcifications, particularly those in clusters, may be the earliest mammographic sign of cancer of the breast milk duct, known as intraductal carcinoma. Remember, there's not as yet a mass of cancer tissue that can be felt. It's way too early. Almost 90 percent of cases of this early form of breast cancer are associated with microcalcifications.

Here's where it gets tricky: There are three patterns of microcalcifica-l tions, each with a different level of concern: 1 Benign-appearing microcalcifica A salute to ART CAREY from E1 is bright and sassy and attractive not so much because she has the bones of Cindy Crawford or Camer-' on Diaz, but because she glows with fire within. The beauty of a babe is not static but dynamic a mystical, kinetic energy that often eludes the camera. The bottom line: Babes are women who know how to have fun and are fun to be. with (and, not coincidentally, don't mind being called babes). Some PC prigs and sad-sack feminists don't like the term.

Too bad for them. Far from being derogatory or demeaning, babe is actually an honorific one of the highest I can bestow. Does that help? Moving right along, and in keeping with custom, let's spend a few inches looking back at the year. On the scientific front, it was a year when we learned the answer to a long-puzzling question: Why do the French stink? The answer: They think they're still living in the Mid-; die Ages. Specifically, they don't bathe or change their underwear half as often as they should, a recent series of studies and polls has found.

Zut alors! It was also a year when lobbyist Paul Mathison, 39, tried to run from Harrisburg to Philadelphia the equivalent of four marathons. He conked out in Ardmore after ering that "man can function on a 5050 mix of oxygen and carbon monoxide." Delirious, he considered trying to legislate his failure away by lobbying to have the city retroactively annex the suburban burg for one day. (Does this guy have a future in Washington or the fit, the ST VICK.I VALEHIO Inquirer Statf Photographer Vivian Roundtree preaches and practices a gospel of fitness. what?) Wouldn't the world be mighty dull without such wacky folks? Fortunately, we met them aplenty in this space and learned some interesting things to boot. Wasn't it fun meandering with the Liberty Bell Wanderers, body-pumping at the Voorhees playing Ultimate Frisbee with the Philly Peppers, dancing with the divinely feminine Karen Andes, trekking with Donna Storm, "spiritual walking" with Carolyn Kortge, and chasing leaves with Jack Millerick? It was a year when we heard various experts debate the pros and cons of running, then had a chance sm "nUIll 1 ribcage, occurs about 20 percent of the time.

It's very important to avoid any strenuous exercise, lifting or straining, and all contact sports until recovery is complete. Damage or rupture of the swollen spleen resulting in emergency surgery or death has occurred in per-sons with mono. Unless you have a seriously weakened immune system, such as if you're a transplant recipient or a person with end-stage AIDS, you'll never suffer from acute mono again. Sometimes, people feel as though they're having a second bout, when they're actually suffering ill effects from one of several viruses that can provoke similar symptoms. Fatigue, headaches, swollen glands or sore throat can linger months after a bad bout of mono.

Although the Epstein-Barr virus itself can cause fatigue, doctors aren't quite sure if it's a cause of condition known as chronic fatigue syndrome. Mitchell Hecht is a physician specializing in internal medicine. Send questions to him at "Ask Dr. Box 767787, Atlanta, Ga. 30076.

For personal replies, please send a self-addressed stamped envelope. Health Science Calendar Health Here are some free programs offered, this week by area institutions. Blood pressure screening 10 a.m. -noon Wed. Seashore Gardens, 3850 Atlantic Atlantic City.

609-345-5941. Caregiver support group 2-3 p.m. Thu. Cooper Education Center, 1210 Brace Cherry Hill. 609-757-7807 Diabetes support group 1 p.m.

today. Gerontology Center of Kennedy Health Sys- tern, 30 E. Laurel Stratford. 1-800-522- 1965. Mobile mammography.

Breast-cancer screening service. Schedule van for your community, organization or place of business. 609-342- 2531. Walking program. a.m.

Monday to Saturday, 1 a.m. Sunday at Springfield Mall, Baltimore Pike, Springfield 6 a.m.-2 p.m. Monday to Friday at Brookhaven Municipal Building, Cambridge Road, Brookhaven 9 a.m.-3 p.m. Monday to Friday at Watkins Senior Center, Watkins Avenue, Upper Darby. Sponsored by Crozer-Keystone Health Sys- tern ElderMed in conjunction with sites.

610- i 447-6003. Science This program is open to the public, -School break program 9 a.m-5 p.m. today-Wed. Schuylkill Center, 8480 Hagy's Mill Rd Philadelphia. Winter hikes, crafts, stories, games and more.

$22 per day for members; $30 per day for nonmembers. Registration can be for one, two or three days. Limited to 20 children, ages.6-1 1 years old. 215-482-7300. To have your event listed, please mail the information to Maureen M.

Carmen, The Inquirer, Box 8263, Philadelphia 19101, or fax it to 215-854-4795. Information must be received by noon Wednesday for events that will occur the following Monday through Sunday. may think To figure out when to add those leap seconds, astronomers look at a group of hundred's of quasars objects much brighter than stars that lie millions or even billions of light years away. Together these quasars make up what is called the "International Celestial Reference Frame." Using these as a reference point they can measure the Earth's rotational speed to a tiny fraction of a second, he said. If it gets too far behind the standard 86,400 ticks of the atomic clocks, they throw in an extra second.

"Without the leap seconds, eventually you'd look at your watch and see noon but the sun would be setting," said Chester. "Someone had to worry about that, and it might as well be astronomers." T1 8 Columnist: Acel Moore every Tucsdav and Thursday MM BOB WILLIAMS Inquirer Suburban Statf Dominic Appleton came back from a near-fatal accident. Super Bowl MVP Terrell Davis taught us about migraine headaches, and Olympic gold medalist Gail Devers taught us about thyroid disease. We learned about the prostate, exercise and diabetes, safer baseballs, the value of fat, how to figure our body mass index, and much more than we ever wanted to know about the rotator cuff and Art's left shoulder (mirabile dictw. it's Eric Mitchell tutored us in speed training, Macey Watson introduced us to the highs of gymnastics, Pekka Mooar urged us to lift our sagging butts by strapping on ice skates, Al Jacobson showed us there's life after heart surgery, and John Pierra- fun of '98 kos set us straight about sex and sexuality (and its wonderful benefits).

We were inspired by Vivian Roundtree and Gail Chinn-Pratt and their joyous efforts to spread the gospel of fitness and health. We shared the workout wisdom of Lisa Cummins, the Cosmo Girl dentist, and Zonia Klein, the extraordinary ordinary supermarket cashier. We marveled at the determination of anti-cancer crusader Jon Forman; South Jersey cyclist Ed Weirauch; Willow Grove's John Twyman, who lost 300 pounds; and Bucks County's Dominic Appleton, who came back from a bike crash that nearly killed him to finish a half-marathon. And who will ever forget Kim Petraglia and her brave battle against cancer? Even as it was assaulting her brain and chest and throat, she continued to exercise, to build her body and make herself stronger by lifting weights, regarding each day as a bonus and blessing and cherishing it accordingly. "I don't want to be miserable for however long I exist," Kim told me in March.

"I'd rather participate in life than give up and surrender to the disease. By exercising, I'm saying, 'There's still life to be lived. I still have things to do, and if I want to enjoy them, I have to stay strong and Kim died Thanksgiving night. She was 32. Said Richard Gibson, a close friend and her personal trainer: "She put up a hell of a struggle right up to the end." She was some kind of babe.

way every year. That exactly 52-week calendar would work by adding an extra day at the, end of the non-leap years. Such days, said McCarty, would become world holidays. Since 1972, astronomers have also started adding leap seconds every so often, but that's not to keep the calendar in line with the astronomical year, said astronomer Chester. Those seconds help correct for a different problem that comes from changes in the length of the day.

The Earth, he said, is slowing down by a few milliseconds every century, dragged ever so slightly by the attraction of the moon. That might not seem like a serious problem, but in high-precision navigation, a millisecond corresponds to enough error to take a flight or missile off course. And so people now measure time not by the turning of the Earth but by the whizzing of electrons around the nucleus of the atom. There is no timepiece more precise than the atom. Its electrons Mr Vnin twft yjt rtTiM-irtrr nrA iK sorbing little bursts of energy millions of times a second.

Physicists refer to those pulses as oscillations. So in 1972, the second long defined as 186400 of a day became instead instead 9,192,631,770 oscillations of an atom of cesium. "That has become the time reference used for most military and civil purposes," said Chester. "The atomic second is completely independent of the vagaries of the Earth's rotation." To keep the atomic time from getting too far ahead of the Earth, Chester and his colleagues have added about 22 leap seconds to our clocks, since 1972', and another will come at the end of this year. Drawing up an accurate calendar is not as simple as you How Long Is a Year? The exact length of a year has been redefined many times throughout the last 2,000 years, often with great precision.

But in 1582, Pope Gregory XIII ordered 10 days dropped from October to correct errors that had resulted from 1600 years of using Julius Caesar's calendar. MICHAEL MALLY Inquirer Stall Photographer Kim Petraglia sought to build strength to fight cancer. i I to test theory against reality by trotting with the likes of John Timoney, the marathoning commish, and Sister Mary Scullion, who is powered by the Holy Spirit. Let's not forget Joel Perlish, who invited us to join him for his consecutive run (actually, it was 7,007, but who's Remember Cherry Hill's "Sugar Ray" Steinberg, still throwing punches at age 98? And how about Greg "The Carnivore" Ellis, who stays lean and mean by devouring lots of steak; Alan Brackup, the street-fighting plastic surgeon; Jerry Zaslow, the perforated pioneer of high-tech acupuncture; and Joel Weintraub, the Seinfeld of the Physical Elite? wasn't precise enough over the long term. The Earth still went around the sun slightly faster than his calendar.

That wasn't much of a problem for the Romans, but by the 1200s, English Friar Roger Bacon noticed that the calendar was lagging behind the actual seasons by more than a week. He was imprisoned by the church for suggesting anything was wrong with the calendar, which had taken on sacred significance. So the problem went on for another 300 years. By then, the calendar was off by 10 days clearly a concern. The spring etjuinox, which was used to calculate the date of Year Source Length of Year Error (Days, hours, minutes, seconds) Hipparchus 365d 5h 55m 6m 14s 45 B.C.

Julius Caesar 365d 6h 11m 14s 139 Ptolemy 365d 5h 55m 13s 6m27s 499 Arayabhata 365d 8h 36m 30s 2h 47m 44s 882 al-Battani 365d5h48m 24s h22s c. 1100 Omar Kahyyam 365d 5h 49m 12s 26s 1252 Alfonsine Tables 365d 5h 49m 1 6s 30s c. 1440 Ulugh Beg 365d5h49m15s 29s" 1543 Copernicus 365d 5h 49m 29s 43s 1574-75 Ignazio Danti 365d 5h 48m -46s 1582 Gregorian calendar 365d5h48m2Qs -26s Present Atomic Clock 365d 5h 48m 46s None" CALENDAR from E1 than their European contemporaries. Some argue that different timekeeping methods using the moon or stars work as well or better than our current solar one, known as the Gregorian calendar. But David Ewing Duncan, author of the 1998 book Calendar, argues that for centuries the moon seduced people into making inaccurate calendars.

The moon is a tempting timekeeper because it goes through a regular cycle of phases every 29 and a half days, and 12 of these lunar "months" make up 355 days almost a year. In spots around the world, ancient peoples made 355-day calendars. Some, such as the Jewish calendar, added extra months as necessary to keep their holidays from drifting backward through the seasons. Others let holidays drift. The Moslem holy month of Ramadan, which falls around Christmastime this year, actually moves all around the Western calendar.

Cnpsflr opts rrprlit for thp first widespread solar calendar. But he may never have considered imposing this "Julian" calendar on Rome had he not fallen in love with Cleopatra. In Cleopatra's time, Egypt had figured out the approximate length of a year and used a calendar with 365 To Our Readers We welcome your comments and suggestions. Write us at Health and Science, Box 8263, Philadelphia 19101, reach our voicemail at 215-854-2929 Easter, was falling on March 11 instead of its prescribed 21st. Finally, in 1582, Pope Gregory XIII decreed that the calendar should be corrected.

For that year, he ordered the one-time removal of 10 days of October. Then, to prevent the misalignment from beginning all over again, he refined the system of leap years: Instead of one leap year every four, he decreed 97 leap years every 400 years. Century years such as 1700, 1800, and 1900 would not be leap years because they are not divisible by 400. This makes the year 2,000 a leap But this Pope-ordered change only took hold in the Catholic world. It would be more than a century before England and other Protestant countries accepted it as well.

The Gregorian calendar is so accurate that it will not lose even one day over the next 2,900 years, according to astronomer Jeff Chester of the Naval Observatory in Washington. But Snmp ppnnlp wniilrj Qtill lifrp tn see further reform, according to Rck McCarty, a philosophy professor at East Carolina University. The biggest complaint among the would-be reformers, he said, is that the 7-day week doesn't match up with the days of the month. That forces people to throw calendars away every year and buy new ones or dig up old yellowed ones from a few years past. Others prefer a decimal system, though, that failed for the French, who tried a 10-month year and 10-day week after their revolution.

It took just a few years for people to revert to the old system. In the 1930s a movement began in the United States to adopt a "world" calendar in which the 7-day 'week would be forced to line up the same days, adding extra days every few years, since the real year is slightly longer. Caesar, under the advice of his astronomers, adopted the Egyptian calendar and began using the modern trick of adding an extra day every four years leap years to keep the calendar in line with the Earth's revolutions. The extra day comes at the end of February because that was once the 12th month the end of the year. That explains why September, October, November and December are derived from the Latin words for 7, 8, 9 and 10.

But even Caesar's new calendar.