S-phase fraction and ploidy as predictive markers in primary disease and recurrence of papillary thyroid carcinoma.

OBJECTIVE: To investigate the prognostic influence of DNA ploidy and S-phase fraction (SPF) on disease-free (DFS) and overall survival (OS) of patients with primary disease and loco-regional lymph node recurrence of papillary thyroid carcinoma (PTC). DESIGN: A large prospective study with long-term follow-up (median, 117 months). PATIENTS: Two series of patients with primary PTC (n = 305) and lymph node recurrence metastasis (LNM) (n = 39) were involved in the study. MEASUREMENTS: Patient's age and gender, histological variant, pathological tumour-node-metastasis (pTNM) staging, extrathyroidal extension, vascular and lymphatic invasion and tumour bilateral growth were the clinical and pathological characteristics evaluated. DNA flow cytometry was performed on fresh/frozen surgical tumour samples. Cox regression models were estimated for prognostic analyses. RESULTS: Seventeen (5·6%) primary tumours and five (12·8%) LNMs were aneuploid, while mean SPF was 2·7% and 3·7%, respectively (P = 0·022). High SPF was significantly associated with lymphatic invasion and tall cell and diffuse sclerosing variants. In univariate analysis, all the clinico-pathological variables, but tumour bilateral growth and gender, were significantly correlated with survival. SPF showed borderline significance (P = 0·051) in relation to OS. In multivariate analysis, older age (≥48 years), lymph node spread and high SPF were significantly adverse prognostic factors. Extrathyroidal extension and distant metastasis for OS, as well as tumour size for DFS, were also found as unfavourable prognostic features. In LNM, the Kaplan-Meier curves showed significant differences for older age and DNA aneuploidy (recurrence; P = 0·011). CONCLUSION: The results indicate that SPF and ploidy can provide additional predictive information in patients with PTC.

Follicular phase serum levels of luteinizing hormone do not influence delivery rates in in vitro fertilization cycles down-regulated with a gonadotropin-releasing hormone agonist and stimulated with recombinant follicle-stimulating hormone.

OBJECTIVE: To assess the value of serum LH measurements in early and late follicular phase as predictors of ovarian response and IVF outcome in patients treated with recombinant FSH with GnRH agonist (GnRH-a) pituitary down-regulation. DESIGN: Retrospective cohort analysis. SETTING: Institutional. PATIENT(S): Women undergoing 157 consecutive IVF cycles suppressed with leuprolide acetate (LA) started in the midluteal phase and stimulated with recombinant FSH. Only women <40 years of age and with a basal cycle day 3 serum FSH

Effects of creep feeding and supplemental glutamine or glutamine plus glutamate (Aminogut) on pre- and post-weaning growth performance and intestinal health of piglets.

BACKGROUND: Creep feeding is used to stimulate piglet post-weaning feed consumption. L-Glutamine (GLN) is an important source of fuel for intestinal epithelial cells. The objective of this study was to determine the impact of creep feeding and adding GLN or AminoGut (AG; containing glutamine + glutamate) to pre- and post-weaning diets on pig performance and intestinal health. Litters (N = 120) were allotted to four treatments during 14-21 d of lactation: 1) No creep feed (NC, n = 45); 2) creep fed control diet (CFCD, n = 45); 3) creep fed 1% GLN (CFGLN, n = 15); 4) creep fed .88% AG (CFAG, n = 15). After weaning, the NC and CFCD groups were sub-divided into three groups (n = 15 each), receiving either a control nursery diet (NC-CD, CFCD-CD) or a diet supplemented with either GLN (NC-GLN, CFCD-GLN) or with AG (NC-AG, CFCD-AG). Litters that were creep fed with diets containing GLN or AG also were supplemented with those amino acids in the nursery diets (CFGLN-GLN, CFAG-AG). Glutamine was added at 1% in all three post-weaning diet phases and AG was added at .88% in phase 1 and 2 and at .66% in phase 3. RESULTS: Feed conversion (feed/gain) showed means among treatment means close to significance (P = 0.056) and Tukey's test for pairwise mean comparisons showed that Pigs in the CFGLN-GLN group had the best feed conversion (feed/gain) in the first three-week period post-weaning, exceeding (P = 0.044) controls (CFCD-CD) by 34%. The NC-AG group had (P = 0.02) the greatest feed intake in the last three week of the study, exceeding controls (CFCD-CD) by 12%. CFGLN-GLN, CFCD-GLN and sow reared (SR) pigs had the greatest (P = 0.049) villi height exceeding the CFCD-AG group by 18%, 20% and 19% respectively. The CFAG-AG group had the deepest (P = 0.001) crypts among all treatments. CFGLN-GLN, CFCD-GLN and SR groups had the greatest (P = 0.001) number of cells proliferating (PCNA) exceeding those in the NC-CD group by 43%, 54% and 63% respectively. Sow reared pigs showed the greatest (P = 0.001) intestinal absorption capacity for xylose and mannitol. CONCLUSION: Supplementation of creep feed and nursery diets with GLN and/or AminoGut in the first three week improved feed conversion possibly due to improved intestinal health.

Influence of birth order, birth weight, colostrum and serum immunoglobulin G on neonatal piglet survival.

BACKGROUND: Intake of colostrum after birth is essential to stimulate intestinal growth and function, and to provide systemic immunological protection via absorption of Immunoglobulin G (IgG). The birth order and weight of 745 piglets (from 75 litters) were recorded during a one-week period of farrowing. Only pigs weighing greater than 0.68 kg birth weight were chosen for the trial. Sow colostrum was collected during parturition, and piglets were bled between 48 and 72 hours post-birth. Piglet serum IgG and colostral IgG concentrations were determined by radial immunodiffusion. RESULTS: Sow parity had a significant (P < 0.001) effect on sow colostral IgG concentration, being 5% higher in multiparous females. Sow colostral IgG concentration explained 6% and piglet birth order accounted for another 4% of the variation observed in piglet serum IgG concentration (P < 0.05); however, birth weight had no detectable effect. Piglet serum IgG concentration had both a linear (P < 0.05) and quadratic effect (P < 0.05) on % survival. Piglets with 1,000 mg/dl serum IgG or less (n=24) had a 67% survival; whereas, piglets with IgG concentrations between 2250 to 2500 mg/dl (n=247) had a 91% survival. Birth order had no detectable effect on survival, but birth weight had a positive linear effect (P < 0.05). Piglets weighing 0.9 kg (n = 107) at birth had a 68% survival rate, and those weighing 1.6 kg (n = 158) had an 89% survival. CONCLUSION: We found that the combination of sow colostrum IgG concentration and birth order can account for 10% of the variation of piglet serum IgG concentration and that piglets with less than 1,000 mg/dl IgG serum concentration and weight of 0.9 kg at birth had low survival rate when compared to their larger siblings. The effective management of colostrum uptake in neonatal piglets in the first 24 hrs post-birth may potentially improve survival from birth to weaning.

Carcinoma of the collecting ducts of Bellini and renal medullary carcinoma: clinicopathologic analysis of 52 cases of rare aggressive subtypes of renal cell carcinoma with a focus on their interrelationship.

Carcinoma of the collecting ducts of Bellini and renal medullary carcinoma are rare aggressive neoplasms of putative distal nephron origin. First described in 1949, case reports and review articles constitute a major source of information on collecting duct carcinoma, whereas Davis and colleagues and the pediatric tumor registry have contributed the seminal works on renal medullary carcinoma. Here we present a detailed study of collecting duct carcinoma (n=39) and renal medullary carcinoma (n=13), characterizing these rare neoplasms and analyzing their interrelationship. Both collecting duct carcinoma and renal medullary carcinoma exhibited significant similarities, such as predilection for the right kidney, tumor mass with an epicenter in the renal medulla, and a mean size of 7 cm. Overall, both tumors exhibited a poorly differentiated adenocarcinoma histology with desmoplastic stromal response (100%), inflammatory infiltrate (100%), frequent perinephric extension (collecting duct carcinoma: 97%; renal medullary carcinoma: 83%), lymphovascular invasion (100%), intraluminal mucin (collecting duct carcinoma: 42%; renal medullary carcinoma: 73%), high nuclear grade (97%), overlapping immunoreactivity for Ulex europaeus agglutinin 1 (collecting duct carcinoma: 75%; renal medullary carcinoma:55%), CK7 (collecting duct carcinoma: 44%; renal medullary carcinoma: 71%), and high-molecular weight cytokeratin (collecting duct carcinoma: 26%; renal medullary carcinoma: 29%), and nonimmunoreactivity for Ksp-cadherin. Histologically, collecting duct carcinoma frequently had tubular, tubulopapillary, or irregular glandular architecture, whereas renal medullary carcinoma commonly demonstrated islands of anastomosing tubules and cords forming irregular microcystic spaces. Multiple metastases to the lymph nodes, lung, bone, and liver were observed in both categories at presentation (collecting duct carcinoma: 17%; renal medullary carcinoma: 36%). Only patients with organ-confined small tumors were disease free beyond the median survival time. Differential clinical features between collecting duct carcinoma and renal medullary carcinoma included proclivity for younger male individuals of African ancestry with hemoglobin abnormalities and a shorter median survival of 17 weeks (vs. 44 wk for collecting duct carcinoma) for renal medullary carcinoma. The markedly overlapping clinical features, histology, immunophenotype, metastasis patterns, and uniformly aggressive outcome in collecting duct and renal medullary carcinomas suggest that renal medullary carcinoma is a distinctive clinicopathologic subtype within the entity of collecting duct carcinoma. The extremely poor prognosis and ongoing clinical trials with specific therapeutic protocols argue for their accurate distinction from other renal cell carcinoma subtypes.

Prostaglandin-endoperoxide synthase (PTGS1 and PTGS2) expression and prostaglandin production by normal monkey ovarian surface epithelium.

OBJECTIVE: To determine whether hCG regulates the expression of prostaglandin (PG) synthesis enzymes and the production of PGs by normal monkey ovarian surface epithelium (OSE). DESIGN: Experimental animal study. SETTING: Research laboratory. ANIMAL(S): Adult cynomolgus macaques. INTERVENTION(S): Monkeys received exogenous gonadotropins to stimulate multiple follicular development. Ovarian surface epithelium cells and whole ovaries were obtained before (0 hours) and 36 hours after an ovulatory dose of hCG. MAIN OUTCOME MEASURE(S): Ovarian surface epithelium expression of prostaglandin-endoperoxide synthase 1 (PTGS1) and PTGS2 proteins was determined by immunocytochemistry. Prostaglandin synthesis enzyme messenger RNA (mRNA) levels were determined by RT-PCR. Prostaglandin E2 and PGF2alpha production was assessed by enzyme immunoassays. RESULT(S): Ovarian surface epithelium maintained in long-term culture expressed mRNA and protein for PTGS1 and PTGS2 (n = 6); inhibition of PTGS1, but not PTGS2, reduced PGE2 synthesis (n = 3). Prostaglandin-endoperoxide synthase 1 was present in OSE of ovarian tissue sections obtained 0 (n = 4) and 36 (n = 3) hours after hCG; PTGS2 was not detected. Ovarian surface epithelium collected 0 (n = 3) and 36 (n = 4) hours after hCG expressed mRNAs for PTGS1, PTGS2, and three PGE synthases; the ratio of PTGS2 to PTGS1 increased in response to hCG exposure. CONCLUSION(S): Monkey OSE expresses mRNA for PTGS1, PTGS2, and all PGE synthases and produces PGE2 both before and 36 hours after hCG. Detection of PTGS1, but not PTGS2, protein in OSE in vivo supports the hypothesis that PTGS1 is the enzyme responsible for PGE2 production by primate OSE in vivo.

La dismenorrea como causa de ausentismo y bajo rendimiento laboral / Dismenorrea : cause of absence and low production at work

Se investiga el ausentimo y bajo rendimientos laboral como consecuencia de la dismenorrea entre obreras de una empresa de zona franca y una institución bancaria de la ciudad de Santo Domingo. Se encontró una incidencia de la dismenorrea de un 55.3//. Se encontró que un 13.0//no asiste al trabajo el primer dia de la menstruación, entre tanto otro 21.0//pierde de manera parcial o total una tanda de trabajo. Entre las que acuden a trabajar con dismenorrea, el rendimiento laboral disminuye en el 46.3//de los casos, no se altera en el 38.2//y se incrementa en el 2.4//. Un 72.8//de la población estudiada usa medicamentos para tratar la dismenorrea por la severidad de los síntomas, pero asisten a sus trabajos para poder recibir sus salarios completos

La dismenorrea como causa de ausentismo laboral / Dysmenorrea as a cause of labor absentism

Antecedentes. Comunmentes se piensa que la mitad de la población femenina padece de amenorrea y que esto afecta su rendimiento laboral. Materiales y Métodos. Realizamos un estudio prospectivo entre las empleadas de una institución bancaria y una zona franca en el Distrito Nacional de la República Dominicana, durante el período 1ro de mayo 1996 al 30 de abril 1997, que padecían dismenorrea y que accedieron a contestar un cuestionario sobre esta patología. Resultados De un total de 226 empleadas interrogadas 126 (55.3//) dijeron padecer dismenorrea para un 55.3. De las 125 afectadas, 16 (13.0//), no asistia a su trabajo el primer dia de su menstruación, 26 (21.0//) de ellas pierden de manera parcial o total una tanda de trabajo. entre las que acuden a trabajar el rendimiento laboral disminuye en 58 (46.3//), no se altera en 48 (38.2//) y tres de ellas (2.4//), dijeron que trabajaban mas cuando tenían su menstruación. de las 125, 91 (72.8//) usa medicamentos para tratar su dismenorrea por la severidad de los síntomas, pero asisten a sus trabajos para poder recibir sus salarios completos. Comentario. Este estudio confirma que aproximadamente la mitad de las mujeres padecen dismenorrea y que esto afecta su rendimiento laboral de una u otra forma