The clinicopathologic and prognostic significance of CD44+/CD24(-/low) and CD44-/CD24+ tumor cells in invasive breast carcinomas

Cells with distinct phenotypes and stem cell-like properties have been reported to exist in breast cancer. The aim of the present study was to investigate the clinicopathologic and prognostic significance of the CD44(+)/CD24(-/low) and CD44(-)/CD24(+) tumor phenotypes' prevalence. Double immunohistochemistry was applied on a series of 155 paraffin-embedded breast tissue specimens to detect CD44 and CD24. Evaluation of the phenotypes was performed by image analysis. The prevalence of CD44(+)/CD24(-/low) and CD44(-)/CD24(+) tumor cells was 58.7% and 82.6%, respectively. The dominance of the CD44(+)/CD24(-/low) tumor cells was inversely associated with lymph node metastasis (P = .019) and tended to inversely associate with the stage of the disease (P = .068). Moreover, the prevalence of CD44(+)/CD24(-/low) was found to exert no significant impact on patients' prognosis although it displayed a tendency toward an increase in disease-free survival (P = .074). On the other hand, the prevalence of CD44(-)/CD24(+) tumor cells was found to have no clinicopathologic significance. However, it was found to exert an unfavorable impact on both relapse-free (P = .009) and overall survival (P = .046) of the patients with breast carcinomas of intermediate differentiation (grade 2). In breast tissue, CD44(+)/CD24(-/low) tumor cells seem to be associated with lack of lymph node metastasis and a tendency toward an increase of the relapse-free survival of the patients. On the contrary, tumor cells with the phenotype CD44(-)/CD24(+) seem to identify patients with worse disease-free and overall survival within the group of intermediate-grade differentiation patients whose prognosis is difficult to assess.     

The protein arginine methyltransferases (PRMTs) PRMT1 and CARM1 as candidate epigenetic drivers in prostate cancer progression

Epigenetic changes are implicated in prostate cancer (PCa) progression and resistance to therapy. Arginine residue methylation is an understudied histone post-translational modification that is increasingly associated with cancer progression and is catalyzed by enzymes called protein arginine methyltransferases (PRMTs). The molecular consequences of aberrant expression of PRMTs in PCa and the relationship between PRMTs and PCa progression are largely unknown. Using immunohistochemistry, we examined the expression of PRMT1 and CARM1, two of the best-studied PRMTs, in 288 patients across the spectrum of PCa and correlated them with markers of androgen receptor (AR) signaling, and milestones of carcinogenesis. Our findings indicate that PRMT1 and CARM1 are upregulated early in PCa progression, and that CARM1 is further upregulated after therapy. In addition, a correlation of CARM1 with AR post-translational modifications was noted in the setting of therapy resistance, highlighting CARM1 as one of the adaptation mechanisms of PCa cells in an androgen-depleted environment. Finally, CARM1 correlated with markers of cell cycle regulation, and both CARM1 and PRMT1 correlated with markers of epithelial-to-mesenchymal transition signaling. Taken together these findings indicate that an epigenetic network drives PCa progression through enhancement of milestone pathways including AR signaling, the cell cycle, and epithelial-to-mesenchymal transition.     

Screening practice and misplaced priorities

Purpose  To estimate cancer screening coverage among a large sample of Greek individuals. Methods  7012 adults from 30 Hellenic areas were surveyed. Tests included: faecal occult blood test, sigmoidoscopy, chest X-ray, urine test, testicular examination, trans-rectal ultrasound, full blood count, skin examination, digital rectal examination, PSA, Pap test, mammography, clinical breast examination (CBE), self breast examination and breast ultrasound. Results  Eighty-eight percent of males and 93% of females declared being interested in cancer screening; 37.8% of men and 37.9% of women had had a medical consultation for screening purpose in the previous 2 years. Less than 2% reported having received screening for colorectal cancer or skin malignancies. Screening for cervical cancer, mammography and CBE was reported by 39.6%, 22.8% and 27.9% of females respectively. Twenty percent of males reported screening for prostate cancer. Conclusion  The actual opportunistic screening approach presents important deficiencies with displaced priorities in test performance and a low proportion of individuals undergoing recommended tests.     

CT in appendicitis

Appendicitis is the most common abdominal emergency occurring in 7%-12% of the population. The aim of this article was to pictorially present the spectrum of appendix and acute appendicitis appearances on computed tomography (CT). The various appearances on CT of the normal appendix are shown as well as the CT criteria for the differentiation of perforated and non-perforated appendicitis.     

Anti-inflammatory effects of ethanolic extract and alkamides-derived from Heliopsis longipes roots

Ethnopharmacological relevance

Heliopsis longipes (A. Gray) Blake (Asteraceae) is a broadly used species in the Mexican, Central and South American Traditional Medicine for its anaesthetic, analgesic, anti-inflammatory and anti-ulcerative properties. The ethanolic extract contains alkamides, mainly affinin (spilanthol). This family of compounds exerts an in vitro inhibitory action on the cyclooxygenase and lipoxygenase enzymes.

Aim of the study

The present study approaches the anti-inflammatory effect of the extract and its main bioactive component affinin and derived isobutyl-decanamide.

Materials and methods

The anti-inflammatory effect was evaluated through the mouse ear oedema test by means of two irritating agents, arachidonic acid (AA) and phorbol myristate acetate (PMA).

Results

Heliopsis longipes, affinin and isobutyl-decanamide displayed a marked anti-inflammatory effect on the AA model with ED₅₀ = 0.8, 1.2 and 0.9 mg/ear, respectively. Nimesulide (1 mg/ear) was used as a reference drug. In PMA model, the extract and two alkamides also showed a dose-dependent anti-inflammatory effect with ED₅₀ = 2.0, 1.3 and 1.1 mg/ear, respectively. Indomethacin (3 mg/ear) was used as reference drug.

Conclusions

These results could represent an important contribution to explain the anti-inflammatory ethnobotanical effects reported for Heliopsis longipes and other species containing affinin (spilanthol). For the first time the topical anti-inflammatory effects of Heliopsis longipes, affinin and isobutyl-decanamide were studied.     

Ovarian insufficiency in congenital lipoid adrenal hyperplasia begins in infancy

The aim of the present study was to investigate ovarian function in a 46,XX female patient with congenital lipoid adrenal hyperplasia (lipoid CAH) during infancy and childhood. We measured serum gonadotropin and estradiol levels regularly from 6 months to 10.9 years of age. Serum FSH levels were clearly elevated during the first 2 years of life; they decreased gradually until the age of 5 years and they then fell into the normal range for a prepubertal female. Serum LH levels were elevated until the age of 2 years and they then fell into the normal range. Serum estradiol levels were always in the normal prepubertal range. Pelvic ultrasonography performed at the age of 9 months and at 9.8 years of age showed normal uterine and ovarian morphology for a prepubertal female. In conclusion, our data suggest that ovarian insufficiency in lipoid CAH begins in infancy.     

A comparison of 40 Hz auditory steady-state response (ASSR) and cortical auditory evoked potential (CAEP) thresholds in awake adult subjects

Evoked potential thresholds using the 40 Hz auditory steady-state response (ASSR) and cortical auditory evoked potential (CAEP) were recorded at 500 Hz and 4000 Hz test frequencies in 36 subjects with normal acuity, and 30 subjects with sensorineural hearing loss. ASSR threshold sensation levels (SLs) were lower in ears with greater degrees of hearing loss, and for the 500 Hz stimulus. Mean SLs (maximum duration of a single recording: 89 seconds) were as follows at 500 Hz and 4000 Hz respectively: normal hearing group, 16.9+/-10.3 dB and 42.4+/-14.4 dB; mild-moderate group, 10.6+/-8.8 dB and 23.8+/-8.1 dB; severe-profound group, 10.0+/-13.2 dB and 21.5+/-18.9 dB. CAEP SLs showed no change with hearing level and CAEP/behavioural differences were similar at each test frequency. Mean SLs for CAEP threshold (single recording duration: 84 seconds) at 500 Hz and 4000 Hz respectively were: normal hearing group, 10.3+/-6.4 dB and 11.5+/-3.8 dB; mild-moderate group, 8.4+/-7.4 dB and 13.2+/-12.4 dB; severe-profound group, 11.0+/-6.6 dB and 15.9+/-16.4 dB. The results of this study suggest that while both 40 Hz ASSR and CAEP can reflect the behavioural audiogram, CAEPs may provide a more reliable estimate of hearing in awake adults.     

Microcatheter Use for Difficult Percutaneous Biliary Procedures

Percutaneous biliary drainage procedures in patients with nondilated ducts are demanding, resulting in lower success rates than in patients with bile duct dilatation. Pertinent clinical settings include patients with iatrogenic bile leaks, diffuse cholangiocarcinomas, and sclerosing cholangitis. We describe a method to facilitate these procedures with the combined use of a 2.7-Fr microcatheter and a 0.018–in. hydrophilic wire.