Measuring proliferation in breast cancer: practicalities and applications

Various methods are available for the measurement of proliferation rates in tumours, including mitotic counts, estimation of the fraction of cells in S-phase of the cell cycle and immunohistochemistry of proliferation-associated antigens. The evidence, advantages and disadvantages for each of these methods along with other novel approaches is reviewed in relation to breast cancer. The potential clinical applications of proliferative indices are discussed, including their use as prognostic indicators and predictors of response to systemic therapy

The usefulness of lateral internal sphincterotomy combined with hemorrhoidectomy in the treatment of hemorrhoids: a randomized prospective study

The aim of this prospective randomized study was to investigate anorectal manometric findings in hemorrhoid patients and to evaluate the clinical benefits and physiological consequences of additioning a lateral internal sphincterotomy (LIS) to haemorrhoidectomy. Anorectal manometry was preoperatively performed in forty-eight consecutive patients with prolapsed piles; resting and squeeze pressures, sphincter length and rectoanal inhibitory reflex were recorded. Ten healthy volunteers served as controls. Six patients were excluded because no raised and pressures were found. Forty-two patients were randomised: Group 1 (n = 22) patients underwent haemorrhoidectomy plus LIS; Group 2 (n = 20) patients underwent haemorrhoidectomy alone. Postoperative course was carefully evaluated; all patients were questioned about continence and anorectal manometry was repeated twice. Sphincter anomalies were found in 87.5% of patients. Haemorrhoidectomy alone did not affect anal pressures, which returned into the normal ranges after sphincterotomy. Postoperative course was better in LIS group. Anal stricture was seen in four patients without sphincterotomy; no patients with LIS experienced and incontinence. This study shows that high and pressures are very frequent in hemorrhoid patients; they are not due to hypertensive and cushions and might have a pathogenetic role. Anorectal manometry is very useful to identify patients with raised anal pressures; in these cases additioning a lateral internal sphincterotomy to haemorrhoidectomy seems justified; it significantly improves postoperative course and can be safely performed

Construction of age-related reference limits for 24-hour blood pressure pattern.

Blood pressure (BP) is recursively variable during the day-night cycle because of a physiological circadian rhythm. The aim of this study is, therefore, to show how to construct the population reference limits (desms) for BP in its time varying 24-h pattern, starting from a small sample, in order to facilitate their use in a local context. The sample for standardization comprised 427 clinically healthy subjects (211 males and 216 females), ranging in age from 16 to 100 years, attending their routine activities. The procedure begins with the statistical biometry related to the sample, and proceeds with the computation of the BP desms related to (1) the time-qualified discrete values; (2) the parameters of circadian rhythm; (3) the daily pressure load. The pertaining rules are explained step by stop, allowing each one to prepare the proper local desms for BP 24-h pattern. These standards may be useful for validating the individual BP monitoring according to the upper limits of the circadian physiological variability in the diagnostic procedure for identifying hypertensive subjects

Age-related changes in blood pressure twenty-four-hour pattern in normotensive subjects of two populations

OBJECTIVES: This study investigates the systolic (S) and diastolic (D) blood pressure (BP) 24-h pattern in normotensive healthy subjects belonging to two populations characterized respectively by a "non-salt culture" (Italian subjects) and a "salt culture" (Japanese subjects) in their dietary salt intake (4-6 g/day in Italians vs 10-12 g/day in Japanese). The comparison was performed by taking into consideration the within-day variability (WDV) and circadian rhythmicity (CR) of BP with respect to age. MATERIALS AND METHODS: Subjects investigated were 862 normotensive healthy subjects (308 Italians and 554 Japanese), stratified by age from 16 to 75 years, who volunteered for a noninvasive BP monitoring in an ordinary day of their life. The SBP and DBP time series were analyzed via conventional parametric statistics as well as chronobiological procedures. RESULTS: The biometric estimates demonstrate that BP changes in its WDV and CR as a function of age in both populations. Despite the difference in their habitual salt intake, the age-related changes in BP WDV and CR result to be almost comparable at the cross-sectional contrasts, giving origin to age-related trends for SBP and DBP which are significantly parallel. CONCLUSIONS: The comparability of BP WDV and CR in the two populations with a substantial difference in salt intake suggests that the normotensive status in human races is realized despite the difference in their habitual salt intake. This implies the ancestral development of mechanism(s) of adaptation to the possible "sodium luxus consumption". Although the adaptive mechanisms which provide a normotensive regimen under different conditions of sodium intake are almost unexplored, the racial adaptation to dietary salt constitutes, however, the initial condition for the cause-effect nexus between dietary salt intake and hypertension in human populations