In vitro human growth hormone increases human chorionic gonadotropin and progesterone secretion by human placenta at term: evidence of a modulatory role by opioids

We examined the in vitro effect of human growth hormone (hGH) on hormone placental production and the modulation by opioids of this function. Small placental fragments from 12 term placentas were incubated at 37 degrees C in a 95% air and 5% CO2 atmosphere for 4 h with various concentrations of hGH (1-1000 ng/ml) or naloxone (3-500 ng/ml). Both hGH and naloxone increased the concentrations of human chorionic gonadotropin (hCG) and progesterone in the media. The effect of the hGH was dose-dependent and statistically significant at 10 ng/ml, while naloxone was able to increase hCG and progesterone production only at the highest doses (250-500 ng/ml). The concomitant treatment with ineffective doses of naloxone and hGH was able to enhance hCG and progesterone secretion reaching levels similar to those obtained with the highest doses of hGH alone. High naloxone concentrations significantly decreased both hCG and progesterone secretion induced by high doses of hGH. This study confirms the relevance of growth hormone in sustaining placental endocrine activities and indicates an effect of opioids in modulating these function

Chemokines mRNA expression in relation to the Macrophage Migration Inhibitory Factor (MIF) mRNA and Vascular Endothelial Growth Factor (VEGF) mRNA expression in the microenvironment of endometrial cancer tissue and normal endometrium: A pilot study

Tumor microenvironment inflammatory cells play a major role in cancer progression. Among these, the Tumor Associated Macrophages (TAMs) infiltration depends on the kind of chemokine, cytokines and growth factors secreted by the tumor cells and by the stroma in response to the cancer invasion.TAMs have been found to promote anti-tumor response in early stages and to stimulate neovascularization and metastases in advanced disease. In the microenvironment chemo-attractants of many human cancers, MIF and VEGF correlate with an increased TAMs recruitment. In addition, MIF enhances tumor cells metastases by modulating the immune responses and by promoting the angiogenesis related to VEGF. On the contrary the inhibition of MIF can lead to cell cycle arrest and apoptosis. Some chemokines (e.g. CXCL12, CXCL11, CXCL8) and their receptors, thanks to their ability to modulate migration and proliferation, are involved in the angiogenetic process.In this study we compared the expression of MIF mRNA with VEGF mRNA expression and with mRNA expression of other chemokines related to neo-angiogenesis, such as CXCL12, CXCL11, CXCL8 and CXCR4, in human endometrial cancer tissue (EC) and normal endometrium (NE).Fresh samples of EC tissue and NE were extracted from 15 patients with FIGO stage I-III undergoing primary surgery. Some of the tissue was sent for histology and part of it was treated with RNA later and stored at -80. °C.Four patients dropped out. A significant up-regulation of MIF mRNA in EC tissue versus NE samples ( P=. 0.01) was observed in all 11 patients. The MIF mRNA over-expression was coincident with a VEGF mRNA overexpression in 54% of patients ( P=. NS). MIF mRNA was inversely related to CXCL12 mRNA expression ( P=. 0.01).MIF over-expression was significantly related to low grading G1-2 ( P=. 0.01), endometrial type I ( P=. 0.05), no lymphovascular spaces invasion ( P=. 0.01) and 3. years DFS ( P=. 0.01).As reported in previous studies on patients with breast cancer, our data suggest that the up-regulation of MIF in patients with endometrial cancer might be related to the inhibition of distant and lymphatic spread. © 2013

Early feeding compared with nasogastric decompression after major oncologic gynecologic surgery: a randomized study

To evaluate the feasibility, safety, and tolerance of early feeding in patients undergoing surgery for gynecologic malignancies. METHODS: Patients were stratified according to operative time and type of tumor and were randomized into two arms: A) early oral feeding and B) nasogastric decompression followed by feeding at the first passage of flatus. Variables assessed included nausea, vomiting, time to first passage of flatus and stool, time elapsed before adequate tolerance of a regular diet, postoperative stay, and complications. RESULTS: Sixty-one patients were randomized into each arm. The types of tumor, the surgical procedures performed, and the operative times were similar in both groups. Early oral feeding in patients in arm A was associated with a significantly faster resolution of postoperative ileus (P < .01), with a more rapid return to a regular diet (P < .01), with an earlier first passage of stool (P < .01), and with a shorter postoperative stay (P < .05) than patients in arm B. Rates of nausea and vomiting were similar in both arms. Hindered deglutition and nasal soreness caused by the nasogastric tube were observed in 88% of patients in arm B. Insertion of a nasogastric tube was necessary in six patients in arm A (10%), and three of these had postoperative complications. Thus, early feeding was feasible in 95% of patients and did not seem to be related to preoperative chemotherapy, tumor type, or lymphadenectomy. CONCLUSION: Early feeding is feasible and well tolerated and is associated with reduced postoperative discomfort and a more rapid recovery in patients undergoing major surgery for gynecologic malignancies

Diagnostic flow-chart to identify bowel involvement in patients with stage IIIC-IV ovarian cancer: Can laparoscopy improve the accuracy of CT scan?

Objective: This study investigates the diagnostic power of CT scan combined with exploratory laparoscopy (EXL) at identifying large bowel involvement in patients with stage IIIC-IV primary Epithelial Ovarian Cancer (EOC) by comparing with the macroscopic surgical findings at laparotomy. Methods: All patients with FIGO Stage IIIC-IV EOC who had Visceral Peritoneal Debulking (VPD) were included in the study. Results of CT scan, EXL and laparotomy (LPT) with regards to the bowel involvement were prospectively recorded in an ad hoc study form. Setting LPT findings as the gold standard, positive and negative predictive value (PPV/NPV), sensitivity, specificity and accuracy of CT and EXL were calculated. In addition, the diagnostic power of the combination CT scan + EXL was investigated. Results: Ninety-four out of 177 patients (53.2%) had a bowel resection during VPD. CT-scan alone had sensitivity, specificity, PPV, NPV and accuracy of 56.7%, 72.4%, 70.8%, 58.5% and 63.8% respectively. EXL alone 84.4%, 93.8%, 93.8%, 84.3%, 88.8%. CT combined with EXL detected bowel involvement with a sensitivity, specificity, PPV, NPV and accuracy of 87.5%, 70.4%, 77.8%, 82.6% and 79.6% and respectively. The combined tests showed a statistically significant improvement vs. CT scan alone (p < 0001) in sensitivity, NPV and accuracy, with non-significant difference in specificity and PPV. Conclusions: CT-scan alone shows a limited diagnostic power at detecting large bowel involvement in patients with stage IIIC-IV EOC. The combination of CT scan with EXL increases the diagnostic power and enables to appropriately plan the bowel resection and consent the patients

CUTANEOUS SIDE-EFFECTS OF ANTIBLASTIC CHEMOTHERAPY: AN EMERGING PROBLEM

Synopsis Locai cutaneous complications following chemotherapeutic agents administration are generally due to accidental extravasation of drugs, while systemic toxicity may be caused by: i) a direct toxic effect, ii) hypersensitivity reactions and iii) dissemination of inflammatory response mediators by necrotic cells. Alopecia is the most common cutaneous systemic effect of antiblastic chemotherapy. Other lesions are maculo-papular eruptions, cutaneous plaques, bullae, hyperpigmentation, folliculitis and nail dystrophy (e.g. red and brown transverse lines, Mees&apos; strips, Beau-Reil lines and onycholisis). Dermatological side effects rarely represent the dose-limiting toxicity of antiblastic drugs. Nevertheless, some of these agents, even when used at standard dose, may cause severe cutaneous side effects requiring treatment modification. With the introduction into clinical practice of new drugs and innovative treatment st:rategies and the implementation of effective hematological support, the toxic profile of chemotherapy has changed with non-hematological side-effects being the most common dose-limiting toxicity. In particular, dermatologica! toxicity involves the patient body image, with a peculiar influence on the patient&apos;s quality of life. Therefore, cutaneous side-effects increasingly involve the oncology clinical practice and require a multidisciplinary team for an adequate treatment. Controlled clinica! trials are worthwhile to explore effective means of prevention and therapy. Riassunto La tossicità cutanea da terapia antiblastica può manifestarsi a livello locale e sistemico. Le complicanze cutanee locali sono dovute a stravaso accidentale del farmaco antiblastico mentre la tossicità sistemica può essere causata da: I ) un effetto tossico diretto, 2) una reazione di ipersensibilità e 3) una liberazione dei mediatori della risposta infiammatoria da parte delle cellule necrotiche. L&apos;alopecia è l&apos;effetto sistemico cutaneo più comune causato dalla terapia antiblastica. Altre lesioni comprendono eruzioni maculo-papulari, placche e bolle cutanee, aree di iperpigrnentazione, follicolite e distrofia ungueale (linee marroni e rosse trasversali, linee di Mees, linee di Beau-Reil e onicolisi). La tossicità dermatologica raramente rappresenta un fattore dose-limitante della chemioterapia. Tuttavia alcun i agenti antiblastici, anche se a dosi standard, possono causare effetti collaterali, a carico 165 Cutoneous s1de-effects of ont1blost1c chemotheropy: on emerging problem della cute e degli annessi, tali da richiedere una modificazione del trattamento. Con l&apos;introduzione, nella pratica clinica, di nuovi farmaci e strategie di trattamento e con l&apos;utilizzo del supporto ematologico il profilo tossico della chemioterapia è cambiato e gli effetti collaterali non ematologici sono diventati la causa più comune di riduzione della dose. In particolare la tossicità dennatologica, coinvolgendo l&apos;immagine della paziente, esercita una particolare influenza sulla sua qualità di vita. Perciò gli effetti cutanei da chemioterapia antiblastica diventeranno di interesse crescente per il medico oncologo richiedendo un approccio multidisciplinare per un trattamento adeguato. Studi clinici controllati dovranno verificare l&apos;effettivo significato di eventuali terapie preventive. 166 S Mancuso. S Greggi. R G1annice. P A Margant1. M G Salerno. A De 01!ect1s and G Scambi

Neo-adjuvant chemotherapy does not increase the rate of complete resection and does not significantly reduce the morbidity of Visceral-Peritoneal Debulking (VPD) in patients with stage IIIC-IV ovarian cancer

Objective To measure the efficacy and the safety of Visceral-Peritoneal Debulking (VPD) in patients with stage IIIC-IV ovarian cancer and to compare the outcomes before and after chemotherapy. Methods Between 2008 and 2013, 200 consecutive patients were offered VPD for stage IIIC/IV ovarian cancer. Exclusion criteria were: metastases in the lungs or 3 liver segments at CT review and/or disease on small bowel serosa or encasing the porta hepatis at explorative laparoscopy. The endpoints were efficacy (rate of complete resection, CR) and safety (morbidity and mortality). The results were compared between patients in group 1 (upfront surgery) and group 2 (during or after chemotherapy). Results Ninety-eight patients were in group 1 and 102 in group 2. Twenty out of 200 patients (10%) did not have VPD, 180 out of 200 patients (90%) had VPD and CR: 90.8% in group 1, 89.8% in group 2. The mortality (1%) and intra-operative complication rate (3.3%) were similar. Post-operative complications rate was 34.8% in group 1 vs. 30.7% in group 2 (P = 0.669). The difference in grade III (15.7% vs. 5.5%, P = 0.053) and grade IIIb complications (13.4% vs. 4.4%, P = 0.062) approached statistical significance. All other outcomes were not significantly different in the 2 groups. Conclusion VPD achieved CR in 90% of the patients. Neo-adjuvant chemotherapy did not increase the rate of CR and did not significantly decrease the morbidity or the complexity of the surgery

Automated Detection and Cropping of Hyphae in Microscopic Images of Various Fungi

Fusarium oxysporum f. sp. cubense is a soil-borne fungi that has become a major threat to the current banana industry. The presence of this fungi can destroy entire plantations if not detected and stopped early enough. The purpose of this study is to create a Convolutional Neural Network (CNN) that can detect hyphae in microscopic images. By detecting hyphae, the presence of fungi in the soil can be confirmed. To create a model that can detect hyphae, a dataset of various microscopic images of fungi was sorted into hyphae images and non-hyphae images (labeled as others). Four subsequent datasets were created from this, namely: (1) bright field, (2) dark field, (3) fluorescent, and (4) all microscopy techniques. Pretrained ResNet34 and ResNet152 models were used for each of the datasets and the use of heatmaps on these models was done to analyze how the models looked for hyphae. The ResNet34 model achieved accuracies of 86.38% for bright field, 87.31% for dark field, 88.37% for fluorescent, and 87.60% for all microscopy techniques. The ResNet152 model achieved accuracies of 87.97% for bright field, 86.79% for dark field, 89.37% for fluorescent, and 87.69% for all microscopy techniques. Additionally, to improve the accuracy even further, automated cropping using edge detection and contour detection was done on the datasets to create cropped photos of hyphae. This resulted in average test accuracies of 87.17% for bright field, 86.90% for dark field, 91.22% for fluorescent, and 89.99% for all microscopy techniques. Generally, fluorescent consistently performed the best, but the heatmaps generated from each model show that hyphae can also be detected using the other microscopy techniques. This study can act as a steppingstone for future studies involving the classification of fungi through hyphae and other features

Transfer Learning in Ensemble Convolutional Neural Networks Toward the Detection of Microscopic Fusarium Oxysporum

The Panama disease; also known as the Fusarium wilt; is a deadly disease known to affect banana plants all over the world. Caused by a fungal pathogen known as Fusarium oxysporum f. sp. cubense (Foc); the disease has been a constant threat to banana producers considering that it cannot be eradicated once it has infected the soil. A new strain that emerged in 1989 called Tropical Race 4 (TR4) is now threatening the Cavendish cultivar; the most popular banana variety being grown today. Furthermore; symptoms of the disease are not visible until late stages of the infection. While there are methods that accurately determine the presence of Foc in a soil sample; these are costly and inaccessible to most banana producers. Thus; we propose the use of convolutional neural networks in the automatic detection of Foc TR4 in soil samples with the use of microscopy. This study utilized a dataset containing microscopy images of various fungal species captured using three distinct microscopy techniques: brightfield; darkfield; and fluorescent. Transfer learning has shown to make significant improvements to the performance of the models in classifying microscopic fungi. The best performing individual model was trained exclusively on brightfield images and has achieved an accuracy score of 93.92% while the best ensemble model was able to achieve an accuracy of 97.55%. Furthermore; tests on a subset meant to simulate realistic appearances of Foc have shown that the final model is viable for actual field use