Endometrial stromal sarcoma: a population-based analysis

To determine independent prognostic factors for the survival of patients with endometrial stromal sarcoma (ESS), data were abstracted from the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute from 1988 to 2003. Kaplan-Meier and Cox proportional hazards models were used for analyses. Of 831 women diagnosed with ESS, the median age was 52 years (range: 17-96 years). In total, 59.9% had stage I, 5.1% stage II, 14.9% stage III, and 20.1% had stage IV disease. Overall, 13.0, 36.1, and 34.7% presented with grades 1, 2, and 3, respectively. Patients with stage I-II vs III-IV disease had 5 years DSS of 89.3% vs 50.3% (P<0.001) and those with grades 1, 2, and 3 cancers had survivals of 91.4, 95.4, and 42.1% (P<0.001). In multivariate analysis, older patients, black race, advanced stage, higher grade, lack of primary surgery, and nodal metastasis were independent prognostic factors for poorer survival. In younger women (<50 years) with stage I-II disease, ovarian-sparing procedures did not adversely impact survival (91.9 vs 96.2%; P=0.1). Age, race, primary surgery, stage, and grade are important prognostic factors for ESS. Excellent survival in patients with grade 1 and 2 disease of all stages supports the concept that these tumors are significantly different from grade 3 tumors. Ovarian-sparing surgeries may be considered in younger patients with early-stage disease.     

Ischemic rat brain extracts induce human marrow stromal cell growth factor production

Intravenous administration of human bone marrow stromal cells (hMSCs) after middle cerebral artery occlusion (MCAo) in rats provides functional benefit. We tested the hypothesis that these functional benefits are derived in part from hMSC production of growth and trophic factors. Quantitative sandwich enzyme‐linked immunosorbent assay (ELISA) of hMSCs cultured with normal and MCAo brain extracts were performed. hMSCs cultured in supernatant derived from ischemic brain extracts increased production of brain‐derived neurotrophic factor (BDNF), nerve growth factor (NGF), vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF). These neurotrophins and angiogenic growth factors increased in a post‐ischemia time‐dependent manner. The hMSC capacity to increase expression of growth and trophic factors may be the key to the benefit provided by transplanted hMSCs in the ischemic brain.     

Experience with stromal tumors and germ-cell tumors of the ovary

Abstract. Thirty patients with tumors of the ovarian stroma (28 granulosa cell tumors, two androblastomas) and 12 women with germ-cell tumors (nine dysgerminomas, two teratomas, one endodermal sinus tumor) were treated at the Department of Obstetrics and Gynecology of the University in Graz between 1972 and 1989. Of the 28 patients with granulosa-cell tumors, 24 (86%) had stage I disease, 27 were primarily treated by surgery, and seven (25%) developed a recurrence (three stage I, three stage III and one stage IV). There were three recurrences in the peritoneal cavity and two in the paraaortic nodes; six of the seven patients died of recurrent disease.
Four of nine patients with stage I dysgerminomas developed recurrences, two of which were located in the para-aortic nodes. Three patients with recurrence after stage Ia disease are currently alive without evidence of disease; one patient with stage Ib disease died 11 months after a paraaortic recurrence.
Wider use of cytostatic combinations and careful surgical staging, including lymphadenectomy, may improve the survival of patients with stromal or germ-cell tumors.     

损伤脑组织诱导骨髓基质细胞向神经元方向分化

目的　探讨损伤脑组织对骨髓基质细胞分化的诱导作用。方法　分离培养SD大鼠骨髓基质细胞 ,以损伤脑组织匀浆诱导骨髓基质细胞分化 ,相差显微镜及免疫细胞化学染色检测诱导结果。结果　诱导后 ,骨髓基质细胞出现分化 ,细胞形态改变 ,胞体呈锥形 ,突起交织成网 ,免疫细胞化学染色表达NSE和tubulin β,分化率达到 30 2 %± 4 0 9%。 结论　损伤脑组织匀浆可诱导骨髓基质细胞向神经细胞分化 ,骨髓基质细胞有可能用于神经系统损伤修复     

Induction of osteocalcin gene expressionin vitro by progesterone

Summary The effect of progesterone on osteocalcin gene expression was investigated in order to understand how progesterone acts on osteoblastin vitro. For this purpose, fetal rat calvanal osteoblasts were cultured in the medium containing 10⁻⁹ M -10⁻⁶ M progesterone respectively for two weeks while the cells progressing differentiation. Northern blot analysis showed that progesterone increased the level of osteocalcin mRNA in a dose-dependent manner. Among those doses of progesterone employed in this study, only 10⁻⁶ M hormone caused a significant induction of osteocalcin gene expression (2. 3 fold, F<0. 01). Our results demonstrated for the first time that the osteocalcin gene expression is regulated by progesterone. In addition, the results obtained from our study provides a good evi dence for the direct effect of progesterone on osteoblastin vitro.     

Human marrow stromal cells in culture: Changes induced by T-Lymphocytes

Summary Suspension cultures of human bone marrow mononuclear cells form colonies of fibroblastoid cells which expand to form confluent monolayers. These fibroblastoid cells are thought to represent elements of the bone marrow stroma. Fibroblastoid cells failed to proliferate when the cultures were initiated and maintained in the presence of 50% (v/v) of medium conditioned by phytohaemagglutinin (PHA)-stimulated blood mononuclear cells or supernatant media from one-way mixed lymphocyte reactions (MLR). Under these conditions, the cultures contained a pleomorphic population of macrophage-like cells. Some of the characteristics of the fibroblastoid and macrophage-like cells have been compared and a separate origin of the two cell types has been demonstrated. Further experiments indicated that T lymphocytes were the source of the factor(s) in the conditioned media which was responsible for the growth of the macrophage-like cells at the expense of the fibroblastoid cells and suggested that activation of the T cells was neccessary for them to exert their effect. The results support the idea that T lymphocytes can influence the haemopoietic microenvironment of the bone marrow.Supported by a grant from the Medical Research Council     

Sclerosing stromal tumours of the ovary

Sclerosing stromal tumours of the ovary have recently been described as a histologically and clinically distinct subgroup within the thecoma-fibroma spectrum of benign ovarian sex cord stromal tumours. Reported cases occurred predominantly in young women and only occasional tumours showed evidence of hormonal activity. The present series of five cases expands the spectra of both histological patterns and clinical presentations and suggests that the entity of sclerosing stromal tumours may not be as clearly circumscribed as has been previously reported.     

Bleeding from foveolar hyperplasia developing on a gastrointestinal stromal tumor of the stomach

A 52‐year‐old Japanese woman who presented with gastrointestinal (GI) bleeding underwent a proximal gastrectomy for a gastrointestinal stromal tumor (GIST) with a foveolar hyperplasia at the apex of the tumor, 4.5 cm in size, located in the upper body of the stomach. Although GIST are often asymptomatic and are found only incidentally, clinical symptoms such as bleeding, abdominal pain, or obstruction, occasionally lead to a premorbid diagnosis. When submucosal tumors present GI bleeding, the source of the bleeding usually is an ulceration of the mucosa over the tumor. However, in the present study, it was thought that the bleeding originated from the region of foveolar hyperplasia.     

Stages in the evolution of squamous cell carcinoma of the uterine cervix: a critique of the concepts of "dysplasia" and "cancer"

A clinically detectable, frankly invasive, squamous cell carcinoma of the uterine cervix evolves through a series of step-like stages, at any one of which, except the last, its progress can be arrested. These stages are intraepithelial neoplasia, early stromal invasion, microcarcinoma and, eventually and irreversibly, invasive squamous cell carcinoma. Crucial to this concept of a series of plateaus in tumour development is the recognition that "dysplasia" is a differentiated intraepithelial neoplasm and the discarding of the term "cancer" in favour of the less emotionally loaded expression "neoplastic process".