Does retention of the ovaries improve long-term survival after hysterectomy? A gynecological oncological perspective.

Ovarian cancer is, in most cases, a lethal disease as it is virtually impossible to diagnose at an early stage and almost impossible to treat successfully when detected at an advanced stage. In postmenopausal women, there is no prevention for ovarian cancer but oophorectomy. Therefore, from the gynecological oncological perspective, where benign gynecological pathology requires surgery in postmenopausal women, oophorectomy should be the preferred option.     

Biological and physical properties of autogenous vascularized fibular grafts in dogs

The biological and biomechanical properties of normal fibulae, fibulae that had had a sham operation, and both vascularized and non-vascularized autogenous grafts were studied in dogs at three months after the operation. The study was designed to quantify and correlate changes in these properties in orthotopic, stably fixed, weight-bearing grafts and to provide a baseline for additional studies of allografts. The grafts were eight centimeters long and internally fixed. The mechanical properties of the grafts were studied by torsional testing. Metabolic turnover of the grafts was evaluated by preoperative labeling of the dogs with 3H-tetracycline for resorption of bone mineral and with 3H-proline for turnover of collagen. Cortical bone area and porosity were measured. Postoperative formation of bone was evaluated by sequential labeling with fluorochrome. The vascularized grafts resembled the fibulae that had had a sham operation and those that had not had an operation with regard to the total number of osteons and the remodeling process, as measured both morphometrically and metabolically. The vascularized grafts were stronger and stiffer than the non-vascularized grafts and were not different from the bones that had had a sham operation. In contrast, the non-vascularized grafts were smaller, weaker, less stiff, and more porotic, had fewer osteons, and demonstrated increased turnover and resorption compared with the vascularized grafts, the bones that had had a sham operation, and the bones that had not been operated on.     

Modifications of the hydrophilicity of heterocyclic methacrylate copolymers for protein release

A series of copolymers comprising ethyl methacrylate (EM) and tetrahydrofurfuryl methacrylate (THFMA) gelled with either THFMA monomer or hydroxyethyl methacrylate (HEMA) monomer have been developed. In this paper, we examine the water uptake characteristics of the polymer systems and address the possibility of increasing the hydrophilicity of the systems by changing the ratios of the copolymers. We have investigated whether protein release from the polymers is related to the composition of the polymer systems. More protein was released from the polymers gelled with the more hydrophilic monomer (HEMA) than with THFMA. This was consistent with the calculated diffusion coefficients, which were 10 times greater for the polymers gelled with HEMA than those gelled with THFMA. Interestingly, the water uptake and protein release profiles were not dependent on the ratio of EM and THFMA in the copolymers. This is probably due to the conflicting roles of THFMA in the copolymer; it is both the more hydrophilic component as well as a cross-linking agent. In addition, it would appear that the structural and surface topography of these polymers had more significant effects on protein release than copolymer composition.     

Torsional loads in the early postoperative period following total hip replacement

Torques generated in one subject during the early postoperative period were measured with a telemeterized total hip component. The patient was examined during gait, stair ascent, rising from a chair, and single-limb stance. The torques were plotted against both the resultant joint contact force and the force component directed along the stem axis. During gait, the maximum torque was 35 Nm, recorded at a walking velocity of 1.7 m/sec. The peak torques during stair ascent and during rising from a seated position were found to be 23 and 15 Nm, respectively. The maximum value for torque measured in this study was 37 Nm during one attempt at single-limb stance. Comparison of plots for torque versus stem-axis component for the four activities shows that the torque increased more rapidly for chair exits than for gait up to resultant contact force values of as much as 1,000 N. For stair ascent, the same was true to values of 1,400 N. Within any given activity, the relationship between stem torque and resultant or stem-axis force showed considerable variability. These results indicate that experiments evaluating the stability of femoral components in total hip arthroplasty should incorporate a component directed along the stem axis, as well as a component normal to the plane of the prosthesis. The results also suggest that theoretical stress analysis models should consider the broad variability in the orientation of the joint force at the hip.     

Effects of oropharyngeal/buccal insulin on glucose levels in alloxan-induced diabetic rabbits: clinical implications

The effect of oropharyngeal administration of insulin lente (BP, USP) on alloxan-induced diabetic rabbits was investigated. In mild cases of hyperglycaemia (below 500 mg/dl), a buccal dose of 100 IU was able to produce significant reduction in blood glucose levels over seven hours, as compared with diabetic animals during the same period. As much as 60% reduction in glucose level from the starting level could be achieved. However, at very high levels of hyperglycaemia (above 500 mg/dl), this regimen failed to produce normoglycaemia although it rendered the animal tolerant to high levels of glucose. This mode of administration of insulin did not produce hypoglycaemia in any of the animals: the blood levels in the mildly diabetic animals were reduced to normoglycaemia without progressing into the hypoglycaemic state. The administration of insulin to normoglycaemic rabbits by this route did not produce any reduction in glucose levels. This preliminary report suggests that a noninvasive oropharyngeal route may be an alternative for the clinical management of insulin and non-insulin dependent diabetes mellitus in man.     

乳腺管状小叶癌

乳腺管状小叶癌（Tubulolobular carcinoma，TLC）最初是被作为小叶癌的管状变型。作者总结了27例TLC的组织学、免疫表型和临床特征，并与纯小管癌和经典型小叶癌进行了比较。此组患者年龄43-79岁（中位年龄60岁）。1例双侧乳腺受累，5例病变为多灶性。肿瘤直径0．5-2．5cm，色灰褐，质硬。组织学观察：TLC的肿瘤细胞形成管状和条索状两种结构模式并相互混杂，且两者比例相当（统称为管状小叶模式）。     

Germline mutations of the CDKN2 gene in UK melanoma families

Germline mutations in CDKN2 on chromosome 9p21, which codes for the cyclin D kinase inhibitor p16, and more rarely, mutations in the gene coding for CDK4, the protein to which p16 binds, underlie susceptibility in some melanoma families. We have sequenced all exons of CDKN2 and analysed the CDK4 gene for mutations in 27 UK families showing evidence of predisposition to melanoma. Five different germline mutations in CDKN2 were found in six families. Three of the mutations (Met53Ile, Arg24Pro and 23ins24) have been reported previously. We have identified two novel CDKN2 mutations (88delG and Ala118Thr) which are likely to be associated with the development of melanoma, because of their co-segregation with the disease and their likely functional effect on the CDKN2 protein. In binding assays the protein expressed from the previously described mutation, Met53Ile, did not bind to CDK4/CDK6, confirming its role as a causal mutation in the development of melanoma. Ala118Thr appeared to be functional in this assay. Arg24Pro appeared to bind to CDK6, but not to CDK4. No mutations were detected in exon 2 of CDK4, suggesting that causal mutations in this gene are uncommon. The penetrance of these mutant CDKN2 genes is not yet established, nor is the risk of non-melanoma cancer to gene carriers.      

High Prevalence of Low Birth Weight Babies Born to Pregnant Women Referred to a District Hospital in Rural Zambia

Maternal and Child Health Journal - Low birthweight (LBW) is a significant public health problem in sub-Saharan Africa and LBW in rural Zambia is high. Our study explored the prevalence of LBW for...