Endometrial carcinoma risk among women diagnosed with endometrial hyperplasia: the 34-year experience in a large health plan

Classifying endometrial hyperplasia (EH) according to the severity of glandular crowding (simple hyperplasia (SH) vs complex hyperplasia (CH)) and nuclear atypia (simple atypical hyperplasia (SAH) vs complex atypical hyperplasia (CAH)) should predict subsequent endometrial carcinoma risk, but data on progression are lacking. Our nested case–control study of EH progression included 138 cases, who were diagnosed with EH and then with carcinoma (1970–2003) at least 1 year (median, 6.5 years) later, and 241 controls, who were individually matched on age, date, and follow-up duration and counter-matched on EH classification. After centralised pathology panel and medical record review, we generated rate ratios (RRs) and 95% confidence intervals (CIs), adjusted for treatment and repeat biopsies. With disordered proliferative endometrium (DPEM) as the referent, AH significantly increased carcinoma risk (RR=14, 95% CI, 5–38). Risk was highest 1–5 years after AH (RR=48, 95% CI, 8–294), but remained elevated 5 or more years after AH (RR=3.5, 95% CI, 1.0–9.6). Progression risks for SH (RR=2.0, 95% CI, 0.9–4.5) and CH (RR=2.8, 95% CI, 1.0–7.9) were substantially lower and only slightly higher than the progression risk for DPEM. The higher progression risks for AH could foster management guidelines based on markedly different progression risks for atypical vs non-atypical EH

Human auditory fast and slow omitted stimulus potentials and steady-state responses

Two kinds of omitted stimulus potentials (OSP) are called "fast" and "slow." Fast OSPs, rec entry found with visual stimuli, are here extended to auditory; they occur after omissions or after the end of trains of 1 to > 20 Hz clicks. Slow OSPs, long known, follow trains of 0.3 to 4 Hz. Each has its constant peak latency after the due-time of the first missing stimulus, as though the system is expecting something quite accurately on schedule, They differ in dynamics and slow OSPs require the subject to attend; fast OSPs do not. Steady-state responses (SSR) at a critical click rare of 6-7 Hz sometimes appear to alternate between two forms and OSPs may depend on which they follow. Fast OSPs can occur to the first, second and even the third omissions after the end of a train. Short conditioning periods suffice. Irregular interstimulus intervals do not reduce fast OSPs but attenuate slow OSPs

INTERVAL-SPECIFIC EVENT-RELATED POTENTIALS TO OMITTED STIMULI IN THE ELECTROSENSORY PATHWAY IN ELASMOBRANCHS - AN ELEMENTARY FORM OF EXPECTATION

Multiunit activity and slow local field potentials show Omitted Stimulus Potentials (OSP) in the electrosensory system in rays (Platyrhinoidis triseriata, Urolophus halleri) after a missing stimulus in a 3 to > 20 Hz train of muV pulses in the bath, at levels from the primary medullary nucleus to the telencephalon. A precursor can be seen in the afferent nerve. The OSP follows the due-time of the first omitted stimulus with a, usually, constant main peak latency, 30-50 ms in medullary dorsal nucleus, 60-100 ms in midbrain, 120-190 ms in telencephalon - as though the brain has an expectation specific to the interstimulus interval (ISI). The latency, form and components vary between nerve, medulla, midbrain and forebrain. They include early fast waves, later slow waves and labile induced rhythms. Responsive loci are quite local. Besides ISI, which exerts a strong influence, many factors affect the OSP slightly, including train parameters and intensity, duration and polarity of the single stimulus pulses. Jitter of ISI does not reduce the OSP substantially, if the last interval equals the mean; the mean and the last interval have the main effect on both amplitude and latency

Anodal Transcranial Direct Current Stimulation of the Motor Cortex in Healthy Volunteers

Effects of anodal transcranial direct current stimulation (tDCS) of the motor cortex on heart rate variability (HRV) indices in healthy volunteers were examined. Baseline HRVs of 16 healthy subjects were recorded, and the HRV changes during anodal and sham tDCS stimulation over the vertex were observed. RM-ANOVA showed significant changes in the means of the high-frequency (HF) band, lowfrequency (LF) band, and LF/HF ratio (P < 0.0001, P = 0.012, and P = 0.01, respectively). A significant decrease in the LF/HF ratio was found during tDCS as compared to baseline (P = 0.033); this effect was mainly due to an increase in the HF band during active stimulation (P = 0.002 in active vs. baseline, and P = 0.007 in active vs. sham). A slight statistically insignificant decrease in the LF band and increase in the HF band induced a significance in comparison of the LF/HF ratio during sham stimulation. The increase in the HF HRV component reflects intensification of parasympathetic activity during anodal stimulation of the motor cortex. Possible explanations are activation of the motor cortex or a dominancy of the left hemisphere due to lateralized current flow. According to our results, neuromodulation of the motor cortex can be an adjuvant to maintain the autonomic balance in some neurological diseases