Prognostic value of von Willebrand factor, CD34, CD31, and vascular endothelial growth factor expression in women with uterine leiomyosarcomas

BACKGROUND AND OBJECTIVES: To compare uterine leiomyosarcomas (LMS) and leiomyomas (LM) with normal myometrium in terms of microvessel density (MVD), and to correlate this parameter with vascular endothelial growth factor (VEGF) expression and clinical/pathological parameters. METHODS: An immunohistochemical technique, using antibodies against von Willebrand factor (FvW), CD34, CD31, and VEGF, was applied to formalin-fixed paraffin-embedded samples of 32 normal myometria, 32 uterine LM, and 12 LMS. MVD was calculated by a digital image analyzer. RESULTS: Using anti-FvW, mean +/- SD MVD in myometrium, LM, and LMS was 107.0 +/- 53.6, 66.2 +/- 55.4, and 64.4 +/- 44.2, respectively (P = 0.001). MVD was lower in LMS (P = 0.021) and in LM (P = 0.0004) than in normal myometrium. Using anti-CD34, mean +/- SD MVD in myometrium, LM, and LMS was 187.6 +/- 91.2, 106.1 +/- 55.5, and 114.2 +/- 98.8, respectively (P = 0.001). MVD was lower in LMS (P = 0.012) and LM (P = 0.0004) than in normal myometrium. No such differences were found using anti-CD31 and anti-VEGF. No correlation was found between MVD and VEGF expression. In women with uterine LMS, low MVD (assessed with anti-FvW) correlated with recurrence (P = 0.04) and poor overall survival (P = 0.03). CONCLUSIONS: Uterine smooth muscle tumors exhibit a lower MVD than normal myometrium, as assessed using anti-FvW or anti-CD34 antibodies. A reduced MVD, as assessed by FvW staining, has prognostic value in uterine LMS.     

Renal function and outcome of PTRA and stenting for atherosclerotic renal artery stenosis

BACKGROUND: Prior studies of percutaneous transluminal renal artery angioplasty and stenting (PTRAS) for atherosclerotic renal artery stenosis (RAS) have shown that renal function is improved in about 25%, stabilizes in about 40%, but worsens in about 25% of patients. The factors predicting benefit remain controversial. We tested the hypothesis that the baseline glomerular filtration rate (GFR) predicts the changes in GFR and blood pressure (BP) after PTRAS. METHODS: Treated hypertensive patients with positive renal color-coded duplex Doppler velocimetry and clinical criteria were screened by arteriography. Patients (N = 105) were included if they had an RAS >or=70%, a transluminal pressure gradient >or=30 mm Hg and, they had more than 100 days of follow-up. GFR was calculated from the serum creatinine concentration (SCr). Patients were divided by baseline GFR into subgroups with normal to mildly impaired (N = 52) or moderately to severely impaired (N = 53) initial GFR, according to a GFR >or=50 or <50 mL. min-1 respectively. All received PTRAS. RESULTS: For the entire group, after a mean follow-up period of 371 days, there were significant reductions in systolic and diastolic BP (before, 160 +/- 26/91 +/- 12 vs. after, 145 +/- 20/83 +/- 10 mm Hg, respectively; mean +/- SD; P < 0.0001), and a modest increase in the calculated GFR (before, 54 +/- 26 vs. after, 62 +/- 28 mL. min-1; mean +/- SD; P < 0.007). However, in the subgroup of patients with an initially lower GFR there was a significant increase in the calculated GFR (from 33.3 +/- 10 to 54 +/- 24 mL. min-1; mean +/- SD; P < 0.0001) despite no significant change in BP (161 +/- 27/90 +/- 12 vs. 151 +/- 21/86 +/- 12; P = NS). In contrast, in the subgroup with an initially higher GFR, there were significant (P < 0.0001) reductions in systolic BP (from 159 +/- 25 to 138 +/- 16 mm Hg) and diastolic BP (from 91 +/- 11 to 81 +/- 9 mm Hg), but no significant change in the calculated GFR (from 75 +/- 21 to 70.2 +/- 30 mL. min-1; P = NS). The significance of GFR variation in subgroups remained after correction of baseline data to exclude the influence of the expected regression to the mean. CONCLUSIONS: Patients with atherosclerotic RAS fulfilling strict criteria of severity may have significant improvements in BP one year after PTRAS but only modest in GFR. The initial GFR may anticipate whether the benefits in the outcome will be in renal function enhancement (those with an initially depressed GFR) or in hypertension control (those with an initially normal or mildly impaired GFR).     

Systematic review of whole body vibration exercises in the treatment of cerebral palsy: Brief report

Objective: Whole body vibration (WBV) is increasingly being used to improve balance and motor function and reduce the secondary complications associated with cerebral palsy (CP). The purpose of this study was to systematically appraise published research regarding the effects of static and/or dynamic exercise performed on a vibrating platform on gait, strength, spasticity and bone mineral density (BMD) within this population. Methods: Systematic searches of six electronic databases identified five studies that met our inclusion criteria (2 at Level II and 3 at Level III-2). Studies were analysed to determine: (a) participant characteristics; (b) optimal exercise and WBV treatment protocol; (c) effect on gait, strength, spasticity and BMD; and (d) the outcome measures used to evaluate effect. As data was not homogenous a meta-analysis was not possible. Results: Several design limitations were identified and intervention protocols are poorly described. The effects on strength, gait, spasticity and BMD in persons with CP remain inconclusive with weak evidence that WBV may improve selected muscle strength and gait parameters and that prolonged exposure may improve BMD; there is currently no evidence that WBV can reduce spasticity. Conclusions: The evidence for exercise performed on a vibrating platform on mobility, strength, spasticity and BMD in CP remains scant and further larger scale investigations with controlled parameters to better understand the effects of WBV exercises in this population is recommended.     

Association of polymorphisms of the β‐defensin 1 gene with nematode and protozoan infection traits in goat

This study's purpose was to identify polymorphisms (SNP) in the goat β‐defensin 1 gene and to associate these SNPs with traits related to nematodean and protozoan infections in Anglo‐Nubian goats from semiarid region of Brazil. A total of 184 animals were used for DNA extraction, PCR and DNA automatic sequencing. The association analyses included the fixed effects of animal age, bloodline and genotype of the SNP marker in the statistical model. The means of genotypes were compared by the Fisher test (P < 0.05). Twelve polymorphism genotypes were found: two in intron 1, seven in exon 2 and three in 3′ untranslated region. The SNPs of exon 2 were responsible for amino acid substitutions in six genetic codes, and the changes in the 25th and 33rd codes affected the protein function. The SNP 1937 was significantly associated with number of protozoan oocysts, whereas SNP 2001 was associated with degree of anaemia (Famacha©). Polymorphism 2046, in turn, showed a significant association with Famacha© degree and number of protozoan oocysts. SNP 2140 associated with maximum EPG of the animal. Results from this study suggest that the β‐defensin 1 gene can be used as a molecular marker for selection of goats regarding the susceptibility to endoparasites infections.