2,571 research outputs found
Oncologic outcomes following surgical management of clinical stage II sex cord stromal tumors
Objective
To investigate the clinical history of patients with clinical stage II sex cord stromal tumors who underwent RPLND at our institution.
Methods
Our prospectively maintained testicular cancer database was queried to identify patients who presented with or developed clinical stage II sex cord stromal tumors and underwent RPLND at our institution between 1980 and 2018. Demographic, clinical and pathological characteristics were reviewed. Kaplan-Meier curves were graphed to assess recurrence-free and overall survival.
Results
Fourteen patients were included in the study with a median age of 44.2 years. Four patients presented with clinical stage II disease and 10 patients developed metastatic disease during follow-up of initial clinical stage I disease with a median time to metastasis of 2.7 years (range: 0.4-19.5 years). Of the 10 patients with orchiectomy pathology data available, all patients had at least 1 risk factor on testis pathology (mean: 2.9 risk factors). Nine patients received treatment prior to referral to our institution. All patients recurred post-RPLND at Indiana University. Median recurrence-free survival was 9.8 months. Twelve patients died of disease with a median overall survival of 14.4 months.
Conclusions
Metastatic sex cord stromal tumors are rare and are more resistant to standard treatment modalities than metastatic germ cell tumors. Patients presenting with sex cord stromal tumors should consider prophylactic primary RPLND in the setting of one or more pathological predictor of malignancy
Posttranslational Truncation of E-Cadherin and Significance for Tumour Progression
Stable intraepithelial adhesion complexes are essential for
the maintenance of epithelial integrity. Alterations in these
complexes are key events in the development and progression
of many diseases. One of the major proteins involved in
maintaining epithelial cell-cell adhesion is the cell-adhesion
junction protein E-cadherin, a member of the cadherin family
of transmembrane adhesion proteins. E-cadherin is involved
in many cellular processes including morphogenesis,
adhesion, recognition, communication and oncogenesis. Inactivation
of its adhesive properties is often a key step in
tumour progression and metastasis, leading to its recent description
as a tumour suppressor gene. Mutations of the Ecadherin
gene CDH1 in gastric and mammary cancers have
been well documented and reports of transcriptional repression
during tumour progression are increasing. This review
examines the role of posttranslational truncation of Ecadherin
in cancer cells focusing on implications for tumour
progression. The various proteins involved in the directed
cleavage of E-cadherin and consequences of these truncations
are discussed
Fertilizing No-Till Corn
Results of an experiment conducted in 1968 at Princeton, Kentucky on low phosphate soil showed that surface-applied phosphorus was sufficiently available to no-till corn to produce good yields. This experiment was repeated again in the 1969 growing season with the results well in line with those reported for 1968 in Agronomy Research (Misc. 377) pages 41-43
Meta-analysis and Meta-regression of Cognitive Behavioral Therapy for Psychosis (CBTp) Across Time: The Effectiveness of CBTp has Improved for Delusions
Published research shows small-to-medium effects of Cognitive Behavioral Therapy for Psychosis (CBTp) on reducing psychotic symptoms. Given the on-going development of CBTp interventions, the aim of this systematic review is to examine whether the effectiveness of CBTp has changed across time. MEDLINE, EMBASE, PsycINFO, and CENTRAL were searched for randomized controlled trials examining CBTp interventions targeting positive and/or negative symptoms vs treatment as usual. Four meta-analyses were carried out to examine the effectiveness of CBTp for: positive symptoms; delusions; hallucinations; and negative symptoms. Four meta-regressions examined whether the effectiveness of CBTp changed across time for these groups of symptoms. A total of 28 studies (n = 2698) yielded a pooled g of −0.24 (95% confidence interval [CI] −0.32, −0.16, P < .001) favoring CBTp for positive symptoms, with nonsignificant heterogeneity (Q = 26.87, P = .47; I2 =0%); 13 studies (n = 890) yielded a pooled g of −0.36 (95% CI −0.59, −0.13, P = .002) for delusions, with substantial heterogeneity (Q = 31.99, P = .001; I2 =62%); 16 studies (n = 849) yielded a pooled g of −0.26 (95% CI −0.42, −0.11, P < .001) for hallucinations, with nonsignificant heterogeneity (Q = 18.10, P = .26; I2 =17%); 19 studies (n = 1761) yielded a pooled g of −0.22 (95% CI −0.33, −0.12, P < .001) for negative symptoms, with nonsignificant heterogeneity (Q = 20.32, P = .32, I2 =11%). Meta-regressions indicated a significant effect of year on the effectiveness of CBTp only for delusions (F[1, 11] = 5.99, P = .032; R2 = 0.594); methodological quality did not effect this finding. Findings indicate small-to-medium effects of CBTp for psychotic symptoms, with increasing effectiveness across time for delusions
Intratubular Germ Cell Neoplasms of the Testis and Bilateral Testicular Tumors: Clinical Significance and Management Options
Eosinophils, probiotics, and the microbiome
There is currently substantial interest in the therapeutic
properties of probiotic microorganisms as recent research suggests that oral administration of specific
bacterial strains may reduce inflammation and alter the
nature of endogenous microflora in the gastrointestinal
tract. Eosinophils are multifunctional tissue leukocytes,
prominent among the resident cells of the gastrointestinal mucosa that promote local immunity. Recent studies
with genetically altered mice indicate that eosinophils not
only participate in maintaining gut homeostasis, but that
the absence of eosinophils may have significant impact
on the nature of the endogenous gut microflora and
responses to gut pathogens, notably Clostridium difficile.
Furthermore, in human subjects, there is an intriguing
relationship between eosinophils, allergic inflammation,
and the nature of the lung microflora, notably a distinct
association between eosinophil infiltration and detection
of bacteria of the phylum Actinobacteria. Among topics
for future research, it will be important to determine
whether homeostatic mechanisms involve direct interactions between eosinophils and bacteria or whether
they involve primarily eosinophil-mediated responses to
cytokine signaling in the local microenvironment. Likewise, although is it clear that eosinophils can and do
interact with bacteria in vivo, their ability to discern
between pathogenic and probiotic species in various
settings remains to be explored
The role of education in economic development in Ireland and Spain after EU integration
In this paper I will examine the role of education in determining the progress of economic development in Ireland and Spain after their respective ascensions to the European Union. Some factors to be examined in this study are a comparison of each country’s economic state at the time of EU integration, the rate and shape of progress since EU integration, the general role of education in economic development, and the influence of the European Union on education policy. I will then examine the specific effects of education on economic development in both Ireland and Spain. A theoretical framework provided by Joseph Stiglitz is used as the rationale behind this study, as he explains the purpose of reforming the education system and creating ‘knowledge capital’ in order to prepare for economic change. Finally, some comparisons will be made between the two countries to discern some general trends between education policy and successful economic development
Bilateral Pneumothoraces Following Central Venous Cannulation
We report the occurrence of a bilateral pneumothoraces after unilateral central venous catheterization of the right subclavian vein in a 70-year-old patient. The patient had no history of pulmonary or pleural disease and no history of cardiothoracic surgery. Two days earlier, she had a median laparotomy under general and epidural anaesthesia.
Prior to the procedure, the patient was hemodynamically stable and her transcutaneous oxygen saturation was 97% in room air. We punctured the right pleural space before cannulation of the right subclavian vein. After the procedure, the patient slowly became hemodynamically instable with respiratory distress. A chest radiograph revealed a complete left-side pneumothorax and a mild right-side pneumothorax. The right-side pneumothorax became under tension after left chest tube insertion. The symptoms finally resolved after insertion of a right chest tube. After a diagnostic work-up, we suspect a congenital “Buffalo chests” explaining bilateral pneumothoraces and a secondary tension pneumothorax
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