P16 alterations increase the metastatic potential of endometrial carcinoma

ObjectiveThe aim of this study was to investigate the role of p16 in tumorigenesis of endometrial carcinoma (EC).MethodsExpression of p16 protein was analyzed using immunohistochemistry. The methylation status of p16 promoter region was determined by methylation-specific PCR. Deletion analysis of the p16 gene was performed by PCR-analyses.ResultsAberrant protein expression of p16 was observed in 18 of 46 (39.2%) ECs and correlated significantly with p16 alterations, including gene deletions in 26 of 46 (56.5%) ECs and promoter hypermethylation in 8 of 46 (17.4%) ECs (p < 0.001). A significant increase in the frequency of p16 alterations from early stage (I–II) to advanced stage (III–IV) ECs was observed (p = 0.002). There was no significant correlation between p16 protein expression and the clinico-pathological features of EC. The development of metastases correlated significantly with the frequency of p16 alterations: p16 alterations were detected in 14 of 15 (93.3%) PTs with metastases and in only 18 of 31 (58.1%) PTs without metastases (p = 0.018). The genetic comparison of 15 primary ECs and their paired metastases revealed that in most of the cases the deleted region of p16 gene remains the same or becomes larger during the progression from primary tumor to its corresponding metastases.ConclusionOur results suggest that p16 alterations and particularly p16 gene deletions in ECs are associated with increased incidence of metastases.     

FT-IR spectrophotometric analysis of dehydroepiandrosterone and its pharmaceutical formulation

A Fourier transform infrared (FT-IR) spectrometric method was developed for the rapid, direct measurement of dehydropeiandrosterone. Conventional KBr spectra and KBr + 2.0 mg microcrystalline cellulose (MCC) spectra were compared for best determination of active substance in drug formulation. Two chemometric approaches, partial least-squares (PLS) and principal component regression (PCR+) methods were used in data processing. The best results were obtained with PCR+ method.     

Risk factors for colorectal cancer: an epidemiologic descriptive study of a series of 333 patients

AIM: The purpose of the research was to evaluate several risk factors for colonic neoplasia and to institute a specialized colorectal cancer (CRC) registry in the 3rd Medical and Surgical Clinics Cluj-Napoca. MATERIAL AND METHODS: The study comprised 333 patients,155 women, mean age 61.32 +/- 12.42 years and 178 men, mean age 64.31 +/- 10.39 years, admitted to the 3rd Medical Clinic and 3rd Surgical Clinic Cluj-Napoca and diagnosed with CRC between January 2001 - September 2003. The diagnosis was made on the basis of clinical, endoscopical and histopathological findings. Age, geographical patterns, tumor location, family history, personal history and several lifestyle factors: dietary habits (intake of fat and red meat), long term smoking (more than 20 years), heavy alcohol consumption were analyzed. Evaluation was made using family history and epidemiologic lifestyle questionnaires. RESULTS: CRC occurred more frequently in the 7th decade. There was a strong correlation between age and CRC development. In the 5th decade, females developed CRC more frequently than males. The median age for developing right-sided tumors was significantly higher in males. Patients living in an urban area were dominant (69%). Family history was present in 1/3 of females and 1/4 of males. Personal history of colon polyps was more common in men, particularly among smokers for more than 20 years and among those with an excessive intake of fat. The cholecystectomized women had an increased frequency of sigmoidian tumors. All the patient's information was included in a specialized colon cancer registry. CONCLUSION: High fat intake and cigarette smoking favour colon polyp development. CRC development and location of the tumor are associated with an older age (in men) and personal history of cholecystectomy (in women). Inheritance was significant in our study group.     

True aneurysms of the pancreaticoduodenal artery: successful non-operative management

BACKGROUND: True aneurysms of the pancreaticoduodenal arteries (PDA) are rare, often ruptured, and treated by operation with a high level of mortality. We review our experience since 1994 and that of the literature in the past 20 years to provide management guidelines for this uncommon clinical entity. About 100 cases of PDA aneurysms are described in the literature, most of them as case report. METHODS: Nine patients were admitted to our institution between 1994 and 2004 for true aneurysm of the PDA. They were analyzed with regard to the clinical presentation, radiologic findings, management, and outcome. RESULTS: Seven patients presented for sudden abdominal pain from retroperitoneal hemorrhage. In 2 patients PDA aneurysm was an incidental finding. Abdominal ultrasonography, computed tomographic scan, and visceral angiography was carried out in all cases. Aneurysms ranged from 4 to 30 mm (median, 16.5) in size. Celiac axis stenosis or occlusion was identified in 3 patients. One patient required emergent laparotomy for intra-abdominal rupture of a retro peritoneal hematoma. Therapeutic embolization was successful in all 9 patients. All except 1 are alive with no evidence of recurrence of the true PDA aneurysm with a mean follow-up of 59 months. CONCLUSIONS: The authors recommend definitive treatment of all true aneurysms PDA because of their high risk of rupture. Ruptured PDA aneurysms suspected on CT-scan requires emergent visceral angiography and selective embolization as definitive treatment.     

Mental status, functioning, and stress in chronic schizophrenic patients in communicity care.

The author studied the interactions between functioning, stress, and psychological deficit, variables considered essential to the schizophrenic patient's adjustment in the community. The results indicate that comprehensive measurement of functioning and stress correlates significantly with mental status. A breakdown by the components of functioning and stress revealed further areas of interaction between these variables. An important finding was that anxiety contributed maximally to the prediction of stress and depression to that of functioning. These data seem relevant to the schizophrenic patient's degree of social adjustment in the community.     

Hemorrhagic fever with renal syndrome

Based on the observation of 11 patients (10 males and 1 female), the occurrence of hemorrhagic fever with renal syndrome in two new geographic areas of Romania is reported. Two patients died within several hours after admission. The other nine recovered gradually. In four patients hemodialysis was necessary. A complete recovery of renal functions one year after onset could be proved in four patients. The clinical, laboratory, morphopathological (necroptic and bioptic), epidemiologic and evolutive characteristics of the disease, especially the main features supporting the diagmosis of hemorrhagic fever with renal syndrome, are discussed.     

Syndrome of depression and depigmentation after administration of combined estrogen-progestagens

A case is presented of a 38-year old woman who, when treated for alternating amenorrhea and menorrhagia with Lyndiol (.l5 mg mestranol and 5 mg lynestrenol, combined) became anxious and depressed and developed depigmentation and alopecia of her left eyebrow. She showed several symptoms of luteal insufficiency: menstrual disorders, spontaneous abortions, menometrorrhagia, and hyperplastic endometrium, a fter progestagen treatment. During a 6 month course of Lydiol she became severely depressed with short attention span, loss of memory, fatique, frigidity, obsessions and phobic behavior. Treatment with Antideprein (Tofranil) and Napoton (Librium) were not effective, but stopping Lyndiol improved the depression, frigidity, and partially improved the obsessive-phobic behavior. The disscussion centered on the role of monoamines in the depressions associated with oral contraceptives.