The optimal number of lymph nodes examined in stage II colorectal cancer and its impact of on outcomes

Background: Lymph node status is the most important prognostic factor for colorectal cancer. The number of lymph nodes that should be histologically examined has been controversial. The aims of this study were to assess the impact of the number of lymph nodes examined on survival of patients with stage II colorectal cancer and to determine the optimal number of lymph nodes that should be examined.Methods: The study included 664 patients who underwent resection for stage II colorectal cancer. The clinical and histopathologic data of the patients were prospectively collected and analyzed.Results: The median number of lymph nodes examined was 12 (range: 1 to 58). The 5-year disease free survival rate was significantly higher for patients with 12 or more lymph nodes examined compared to those with less than 12 lymph nodes examined. The significant difference in 5-year disease free survival persisted if the dividing number increased progressively from 12 to 23. However, the difference in survival was most significant (lowest p value and highest hazard ratio) for the number 21. The 5-year disease free survival of patients with 21 or more lymph nodes examined was 80% whereas that of patients with less than 21 lymph nodes examined was 60% (p = 0.001, hazard ratio 2.08). Multivariate analysis showed that 21 or more lymph nodes examined was a factor that independently influenced survival. The 5-year disease free survival also increased progressively with the number of lymph node examined up to the number 21. After the number 21, the survival rate did not increase further. It was likely that 21 was the optimal number, at and above which the chance of lymph node metastasis was minimal.Conclusions: The number of lymph nodes examined in colorectal cancer specimen significantly influences survival. It is recommended that at least 21 lymph nodes should be examined for accurate diagnosis of stage II colorectal cancer. © 2010 Choi et al; licensee BioMed Central Ltd.published_or_final_versio

Nuclear Progesterone Receptors Are Up-Regulated by Estrogens in Neurons and Radial Glial Progenitors in the Brain of Zebrafish

In rodents, there is increasing evidence that nuclear progesterone receptors are transiently expressed in many regions of the developing brain, notably outside the hypothalamus. This suggests that progesterone and/or its metabolites could be involved in functions not related to reproduction, particularly in neurodevelopment. In this context, the adult fish brain is of particular interest, as it exhibits constant growth and high neurogenic activity that is supported by radial glia progenitors. However, although synthesis of neuroprogestagens has been documented recently in the brain of zebrafish, information on the presence of progesterone receptors is very limited. In zebrafish, a single nuclear progesterone receptor (pgr) has been cloned and characterized. Here, we demonstrate that this pgr is widely distributed in all regions of the zebrafish brain. Interestingly, we show that Pgr is strongly expressed in radial glial cells and more weakly in neurons. Finally, we present evidence, based on quantitative PCR and immunohistochemistry, that nuclear progesterone receptor mRNA and proteins are upregulated by estrogens in the brain of adult zebrafish. These data document for the first time the finding that radial glial cells are preferential targets for peripheral progestagens and/or neuroprogestagens. Given the crucial roles of radial glial cells in adult neurogenesis, the potential effects of progestagens on their activity and the fate of daughter cells require thorough investigation

Influência do estado nutricional no risco para transtornos alimentares em estudantes de nutrição

Avaliar a relação entre a alteração do comportamento alimentar, associado à insatisfação com a imagem corporal, e o estado nutricional de universitárias de Nutrição. Realizou-se um estudo transversal com 175 universitárias do Curso de Nutrição (ENUT/UFOP). Foram aplicados os questionários Eating Attitudes Test-26 (EAT-26) e o Body Shape Questionare (BSQ) e realizadas medidas antropométricas. 21,7% das estudantes apresentaram alto risco para transtornos alimentares e 13,7% apresentaram insatisfação com a imagem corporal. A maioria das estudantes com BSQ e EAT-26 positivos estava eutrófica. As estudantes com excesso de peso, aumento do percentual de gordura corporal (% GC) e do perímetro da cintura (PC) apresentaram risco 5 a 9 vezes maiores de alteração do comportamento alimentar. Houve associação positiva entre os parâmetros antropométricos com a pontuação dos questionários EAT-26 e BSQ. Futuras nutricionistas com excesso de peso apresentaram maior risco de estarem insatisfeitas com a sua imagem corporal e de desenvolverem transtornos alimentares. A utilização de outros parâmetros antropométricos, além do IMC, pode ser útil na triagem de indivíduos suscetíveis ao surgimento de preocupações excessivas com o peso corporal e a alimentação.The scope of this paper was to evaluate the relationship between changes in eating behavior associated with dissatisfaction with body image, and the nutritional status of female university students of nutrition. A cross-sectional study was conducted among 175 female students of nutrition (ENUT/UFOP). The Eating Attitudes Test-26 (EAT-26) and Body Shape Questionnaire (BSQ) were applied and anthropometric measurements were taken. 21.7% of the students were found to be high risk in terms of eating disorders, and 13.7% declared dissatisfaction with their body image. The majority of students with positive results in the BSQ and EAT-26 tests were eutrophic. The students who were overweight, with elevated body fat percentage (% BF) and waist circumference (WC) had a 5-9 times greater risk of change in eating habits. There was a positive association between the anthropometric parameters with high scores in the EAT-26 and BSQ questionnaires. The future dietitians who are overweight, with increased body fat and waist circumference were more likely to be dissatisfied with their body image and develop eating disorders. The use of other anthropometric parameters, in addition to BMI, may prove useful in screening individuals susceptible to the emergence of excessive concerns with weight and diet

Global Chronic Total Occlusion Crossing Algorithm

The authors developed a global chronic total occlusion crossing algorithm following 10 steps: 1) dual angiography; 2) careful angiographic review focusing on proximal cap morphology, occlusion segment, distal vessel quality, and collateral circulation; 3) approaching proximal cap ambiguity using intravascular ultrasound, retrograde, and move-the-cap techniques; 4) approaching poor distal vessel quality using the retrograde approach and bifurcation at the distal cap by use of a dual-lumen catheter and intravascular ultrasound; 5) feasibility of retrograde crossing through grafts and septal and epicardial collateral vessels; 6) antegrade wiring strategies; 7) retrograde approach; 8) changing strategy when failing to achieve progress; 9) considering performing an investment procedure if crossing attempts fail; and 10) stopping when reaching high radiation or contrast dose or in case of long procedural time, occurrence of a serious complication, operator and patient fatigue, or lack of expertise or equipment. This algorithm can improve outcomes and expand discussion, research, and collaboration.info:eu-repo/semantics/publishedVersio

Biostratigraphy and paleoecology of an unusual palynological record from the Aquidauana Formation, Late Pennsylvanian of Paraná Basin

The Aquidauana Formation is a Permo-Carboniferous sedimentary unit, widely stratigraphicaly distributed in the northwestern and northern portions of the Paraná Basin. However, little paleontological data is available from this formation, preventing accurate biostratigraphic and paleoecological interpretations. An abundant, diversified and well preserved assemblage of palynomorphs was recognized from sampling conducted in an outcrop section in Cipolândia District of Aquidauana Municipality, state of Mato Grosso do Sul, Brazil. A total of 35 indigenous palynomorph taxa was recognized, comprising 6 species of spores (related to 5 genera), 28 species of pollen grains (14 genera) and 1 species of chlorophycean algae. Monosaccate pollen grains are exceptionally dominant, representing 90.38% of the association, particularly constituted by species of the genera Cannanoropollis (30.41% of the total assemblage), Potonieisporites (28.14%) and Plicatipollenites (19.52%). This quantitative overrepresentation is not usual from Gondwana deposits, revealing a particular plant dominance of Cordaitales in the terrestrial flora. These results are interpreted as an upland ecology characterized by plants with a moisture-independent reproduction strategy, under a glacial climate influence. Certain species of pollen allow assignment of this assemblage to the Crucisaccites monoletus Zone (Late Pennsylvanian), which had been recognized only in the middle portion of the Itararé Group at the northeastern margin of the basin