Immunohistochemical evaluation of PTEN protein in patients with endometrial intraepithelial neoplasia compared to endometrial adenocarcinoma and proliferative phase endometrium

OBJECTIVE: The aim of this study was to reclassify endometrial hyperplasia cases and examine PTEN protein immunoreactivity compared to cases with endometrial adenocarcinoma and proliferative endometrium. DESIGN: Endometrial samples from 37 women with endometrial hyperplasia with atypia were reclassified as endometrial intraepithelial neoplasia (EIN). Eighteen were complex and 19 were simple endometrial hyperplasia. Twenty-our cases of EIN, ten endometrial adenocarcinoma cases and ten proliferative phase endometrium sections were immunostained for PTEN expression. PTEN expression was documented according to the degree of immunoreactivity as complete loss, partial loss and present. RESULTS: Twenty-four of 37 (64%) women with endometrial hyperplasia were reclassified as EIN. Complete loss of PTEN immunoreactivity was found in only one of the 24 EIN patients (4.2%), partial loss in eight of 24 (33.3%) and present in 15 of 24 (62.5%). There were no difference in PTEN immunoreactivity between EIN, endometrial adenocarcinoma and endometrial proliferation (p = 0.342). PTEN immunoreactivity was partially lost in seven and present in three of the patients with endometrial adenocarcinoma. None of the patients expressed complete loss of PTEN immunoreactivity in this group. CONCLUSION: EIN classification may provide a better and more objective assessment of endometrial hyperplasia cases. PTEN expression showed no differences among the cases of EIN, endometrial carcinoma and proliferative phase endometrium.     

Inhibition of human hepatic and placental xenobiotic monooxygenases by imidazole antimycotics

Three imidazole antimycotic drugs, ketoconazole, clotrimazole and miconazole, were studied to characterize the inhibition of aryl hydrocarbon hydroxylase (AHH), 7-ethoxycoumarin O-deethylase (ECDE) and 7-ethoxyresorufin O-deethylase (ERDE) activities in human liver and placenta in vitro in comparison with liver enzymes from control, phenobarbital (PB) and 3-methylcholanthrene (MC) pretreated rats. All three compounds inhibited rat liver enzymes, although MC pretreatment seemed to lead to a resistance of inhibition relative to PB-treated and control animals. There were large differences in the extent of inhibition of human hepatic and placental activities. Furthermore, while the type of inhibition of the hepatic ERDE was competitive or mixed, that of the placental enzyme cannot be described in ordinary terms of inhibition kinetics. Ketoconazole and clotrimazole were relatively potent inhibitors of maternal cigarette smoking-induced placental ECDE activities (IC50 values from 0.5 microM to 5 microM), whereas much less inhibition of the placental AHH activity was obtained with ketoconazole and miconazole (IC50 values from 50 microM to 500 microM). In most cases, hepatic enzymes were less sensitive to antimycotics than placental activities. This was in contrast with results from rat enzyme studies, in which MC pretreatment seemed to decrease the inhibitory response.     

Association between estrogen receptor β polymorphisms and prostate cancer in a Slovak population

Sex steroid hormones have important roles in the function of the prostate; however, they may also serve as factors in the initiation and progression of carcinogenesis. Estrogens, acting through estrogen receptors, may significantly affect prostate cancer development and progression. The main aim of the present study was to analyze the association between the rs3020449, rs4986938 and rs1256049 polymorphisms in the promoter region of the estrogen receptor β (ESR2) gene and prostate cancer risk in the Slovak population. A total of 510 patients with prostate cancer and 184 healthy men were included in the present study. No association between the rs4986938 and rs1256049 polymorphisms and prostate cancer development and progression was revealed; however, there was a statistically significant association between the rs3020449 GG genotype [odds ratio (OR), 2.35; P=0.002] and the G allele (OR, 1.42; P=0.005) and a higher risk of prostate cancer development. The rs3020449 GG genotype was significantly associated with a higher risk of development of carcinoma with a Gleason score >7 (OR, 2.66; P=0.005), as well as with the development of carcinoma with pT3/pT4 (OR, 2.28; P=0.02). According to the results from the present study, the rs3020449 polymorphism, in the promoter region of ESR2, may be considered to have a role in the development and progression of prostate cancer in the Slovak population.     

Liquid‐based Papanicolaou test (SurePath) interpretations before histologic diagnosis of endometrial hyperplasias and carcinomas

BACKGROUND.

In addition to the reporting of atypical glandular cells (AGC) and adenocarcinoma (ADCA), the 2001 Bethesda System requires the reporting of benign‐appearing endometrial cells in women aged >40 years (BAEMC). In this study, the authors evaluated the contribution of each of these reporting categories to the sensitivity and specificity of a liquid‐based Papanicolaou test for endometrial carcinoma or hyperplasia.

METHODS.

Over the 3‐year study period, in the setting of a large, multihospital health care system, the authors analyzed the results from liquid‐based Papanicolaou tests that were performed within the 6 months that preceded a histologic diagnosis of endometrial carcinoma or hyperplasia and that were reported according to the 2001 Bethesda System.

RESULTS.

Two hundred seventy‐two women had a histologic diagnosis of endometrial hyperplasia (n = 199) or malignancy (n = 73) within 6 months after a Papanicolaou test. In total, 188,594 Papanicolaou tests (91,385 from women aged >40 years) were interpreted during the study period and resulted in 3810 diagnoses of BAEMC, 326 diagnoses of AGC, and 30 diagnoses of ADCA. Only 28 of 73 women (38.4%) with endometrial carcinoma had cytologically AGC or ADCA reported on a previous Papanicolaou test. The reporting of BAEMC increased this sensitivity by only 5.5% (4 additional tests) but decreased the specificity of the Papanicolaou test for endometrial malignancy from 99.8% to 96%. For endometrial hyperplasias, the sensitivity of the Papanicolaou test was even lower (39 of 198 tests; 19.7%), but BAEMC represented the majority of endometrial‐type cells reported (36 of 39 tests).

CONCLUSIONS.

The reporting of BAEMC led to an only marginal increase in sensitivity that had to be weighed against the significant loss in specificity of the Papanicolaou test for endometrial neoplasia. Cancer (Cancer Cytopathol) 2007. © 2007 American Cancer Society.     

The effects of cervical headgear with an expanded inner bow in the permanent dentition

In this study, the effects of cervical headgear (CHG) use on the transverse dimension of the maxillary dental arch were evaluated in patients in the permanent dentition. Thirteen girls and 12 boys (mean age: 13.41 +/- 0.52 years) with a bilateral full cusp Class II molar relationship comprised the study group. Fifteen girls and 10 boys with a Class I normal occlusion comprised the controls. In the treatment group, CHG with an expanded inner bow was used for a mean period of 11.2 +/- 5.6 months. The headgear was used for molar distalization and the force magnitude was 196.1 cN. After CHG treatment, the patients underwent non-extraction fixed orthodontic treatment for 14.1 +/- 2.5 months. During this period, the control group received regular dental check-ups. Dental casts obtained at the beginning (T1) and end (T2) of headgear use and at the end of orthodontic treatment (T3) and posteroanterior cephalograms taken at T1 and T2 were evaluated. A Student's t-test was used for intergroup comparison at T1, T2, and T3 and a Mann-Whitney U-test with a Bonferroni correction for comparison of treatment/observation changes. At T2, intercanine (0.96 +/- 0.56 mm), interpremolar (1.6 +/- 0.55 mm for the first premolar, 1.74 +/- 0.65 mm for the second premolar), and intermolar (2.31 +/- 0.75 mm) widths increased, while the distance between the intersection of the zygomatic process and the maxillary alveolar process on the right (JR) and left (JL) did not change. Fixed orthodontic treatment did not have any effect on any of the measurements. With the intentional expansion of the inner bow of CHG, the amount of maxillary dental arch expansion achieved in the permanent dentition was statistically significant (P < 0.017).     

The interplay between expressed parental anxiety and infant behavioural inhibition predicts infant avoidance in a social referencing paradigm

Background: Anxiety aggregates in families. Environmental factors, such as modelling of anxious behaviours, are assumed to play a causal role in the development of child anxiety. We investigated the predictive value of paternal and maternal anxiety (lifetime anxiety disorders and expressed parental anxiety) on infants’ fear and avoidance during encounters with social and nonsocial novel stimuli in a social referencing (SR) paradigm. Methods: A total of 122 12‐month‐old infants participated in this study separately with their fathers and mothers (parents with lifetime: social anxiety disorders [n = 47], other types of anxiety disorders [n = 33], comorbid social and other types of anxiety disorders [n = 52] and without anxiety disorders [n = 112]). Infants were confronted with a stranger and a mechanical dinosaur as novel stimuli in two SR situations. Infants’ avoidance as well as fear and parents’ expressed anxiety were observed. Infants’ behavioural inhibition (BI) was separately observed in structured tasks. Results: Parental lifetime anxiety disorders did not significantly predict infant fear or avoidance. Expressed parental anxiety interacted with BI to significantly predict infant avoidance, revealing a positive association between expressed parental anxiety and infant avoidance among infants with moderate‐to‐high BI. The association between infant avoidance and expressed parental anxiety was not significantly different for mothers and fathers, pointing to an equally important role of fathers at this young age. Infant fear was significantly predicted by infant BI, but not by expressed parental anxiety. Conclusions: Infants with a temperamental disposition for anxiety (BI) may learn from both paternal and maternal anxious signals and become avoidant towards novelty when their parents express anxiety. This link between expressed parental anxiety and infant avoidance for moderate‐to‐high BI children, that seems to hold across contexts and to be independent of lifetime parental anxiety disorders, may be a mechanism explaining early intergenerational transmission of anxiety.     

Coronary reoperations without the use of cardiopulmonary bypass

BACKGROUND: Reoperations of coronary artery surgery still carry a higher mortality and morbidity rate, compared to primary revascularization procedures. Coronary artery bypass reoperations without the use of cardiopulmonary bypass (CPB) is a potential strategy that has been developed to decrease mortality and morbidity. MATERIALS AND METHODS: Between 1978 and 2000, 113 patients were reoperated for coronary artery revascularization, 32 (28.3%) cases on beating heart without the use of CPB (Group II) and 81 (71.7%) cases under CPB and cardioplegic arrest (Group I). Mean age of Groups I and II were 61.3+/-5 and 57.4+/-7.3 years, respectively. RESULTS: Statistically significant difference was found between the two groups, favoring off pump surgery in the early postoperative findings with respect to low cardiac output, postoperative myocardial infarction and postoperative hospitalization duration until discharge. Operative mortality was not statistically different between groups and these figures for cardiopulmonary and off pump groups were 11/81 (13.5%), 1/32 (3.1%), respectively. CONCLUSION: Reoperations of coronary artery revascularization surgery without the use of CPB is more economic, necessitating less manipulations, free of side effects of CPB, less time consuming surgical procedure compared to reoperations performed under standard techniques. When performed with a refined technique and true indications, off pump coronary reoperations have mortality and morbidity advantages over the surgery performed under CPB, improvements in techniques and instruments off pump strategy must be in the surgeons armamentarium in coronary reoperations.     

Evaluation of carotid intima-media thickness, a marker of subclinical atherosclerosis, in children with cerebral palsy

Background

Respiratory and cardiovascular diseases are the most common causes of death in children with cerebral palsy.

Objective

To evaluate sonographic carotid intima-media thickness, an early marker of atherosclerosis, in children with cerebral palsy and in healthy controls.

Materials and methods

One hundred children with cerebral palsy (65 boys), mean age 6.2 (SD, 2.1) years, and 35 age-matched and sex-matched healthy controls were included. Common carotid artery intima-media thickness was measured sonographically. Differences between patients and controls were evaluated with an independent samples t-test.

Results

Age, sex distribution and levels of serum lipids were comparable between patients and controls. Average, right and left carotid artery intima-media were thicker in patients compared with controls (mean ± SD, 0.61?±?0.13 mm vs 0.40?±?0.03 mm; 0.61?±?0.14 mm vs 0.40?±?0.03 mm; 0.61?±?0.13 mm vs 0.40?±?0.03 mm, respectively; all P?Conclusion Carotid intima-media is sonographically thicker in children with cerebral palsy compared with healthy controls, which may express an increased risk of atherosclerotic diseases.