CT evaluation of myometrium invasion in endometrial carcinoma

Myometrium invasion (M) is one of the principal prognostic factors in the early clinical stages of endometrial carcinoma and can be evaluated presurgically only by CT, although with conflicting results. We compared CT of 65 patients with early clinical stage endometrial carcinomas with the corresponding anatomopathological findings. Myometrial infiltration of the same degree may present different CT images. Therefore, we identified five fundamental CT patterns, each of which corresponded to one of the three degrees of myometrium infiltration (M1, M2, M3). Furthermore, we defined the infiltration index as the ratio of minimum free myometrium to maximum free myometrium. Overall diagnostic accuracy was 76%; however, for clinical purposes CT provided adequate guidelines for therapeutic decisions in 93% of the cases. These criteria proved to be less reliable in elderly women with atrophic myometria, especially when the neoplasia was polypoid in shape.

Milk protein intake in the term infant. I. Metabolic responses and effects on growth

Thirty healthy term infants were studied during the three first months of life. The infants were divided into three feeding groups consisting of 10 infants in each. The feeding regimens were: human milk by breast feeding, a formula (F-I) containing 1.2 g/100 ml of protein and a control formula (F-II) containing 1.6 g protein/100 ml. Both formulas were whey predominant and isocaloric. Protein intake was significantly higher with formula F-II when compared to the human milk group and to formula F-I. No significant differences with respect to weight, length and head circumference were found among the groups, but the rate of growth between 2 to 12 weeks was higher in the control formula (F-II) group. Serum albumin concentrations were normal and similar in all feeding groups. Blood urea nitrogen and urine total nitrogen concentration was significantly lower in the low protein formula I group when compared to the control formula II. After the fourth week of life the low protein formula infants had similar blood urea nitrogen and urine nitrogen concentrations as those of the breast-fed infants. The results indicate that current formulas in use provide excessive protein intakes after the first months of life.

Milk protein intake in the term infant. II. Effects on plasma amino acid concentrations

The response of plasma amino acids to two bovine protein formulas with different protein content (1.6 and 1.2 g/100 ml containing 60% whey proteins and 40% caseins) was measured in term infants. These two groups of infants were compared with a group of infants that were breast-fed; all infants were fed ad libitum. Concentrations of threonine, valine and total branched chain amino acids reflected the amount of protein provided. Thus, the concentrations were higher in the higher protein formula infants from the second week of the study. In the low protein formula infants these amino acids were lower but differed from the infants on breast milk at eight and twelve weeks. Concentration of taurine was lower in the formula fed infants than they were in breast-fed infants at the end of the study. The valine/glycine ratio in the low protein formula group was lower than in the breast-fed group for the first four weeks of the study. After this time it was equal to that of the breast-fed group. These differences in plasma amino acid concentrations give further evidence that formulas now in common use for term infants provide a protein intake in excess of protein requirements after the first months of life.

[Advantages and limitations of combined assays of 4 serum markers in various types of malignant neoplasms]

CEA, TPA, GICA and Ferritin were assayed in 700 cancer patients (230 assays in 181 breast cancers, 75 in 57 lung cancers, 114 in 70 cervico-facial neoplasms, 131 in 95 uterovaginal tumours, 444 in 225 colorectal tumours, 106 in 72 gastric cancers). Groups were divided into stages and the results of all possible associations were assessed. Only the most significant are reported. Among combinations of 2 markers the combined assay of CEA and TPA offers the best response as diagnostic potential (expressed as percentage positivity) in all neoplasm groups as well as a good correlation with the evolution of the disease.

Type X collagen synthesis during in vitro development of chick embryo tibial chondrocytes

In the developing chick embryo tibia type X collagen is synthesized by chondrocytes from regions of hypertrophy and not by chondrocytes from other regions (Capasso, O., G. Tajana, and R. Cancedda, 1984, Mol. Cell. Biol. 4:1163-1168; Schmid, T. M., and T. F. Linsenmayer, 1985, Dev. Biol. 107:375-381). To investigate further the relationship between differentiation of endochondral chondrocytes and type X collagen synthesis we have developed a novel culture system for chondrocytes from 29-31-stage chick embryo tibiae. At the beginning of the culture these chondrocytes are small and synthesize type II and not type X collagen, but when grown on agarose-coated dishes they further differentiate into hypertrophic chondrocytes that synthesize type X collagen. The synthesis of type X collagen has been monitored in cultured cells by analysis of labeled collagens and in vitro translation of mRNAs. When the freshly dissociated chondrocytes are plated in anchorage-permissive dishes, most of the cells attach and dedifferentiate, as revealed by their fibroblastic morphology. Dedifferentiated chondrocytes, after several passages, can still reexpress the differentiated phenotype and continue their development to hypertrophic, type X collagen-synthesizing chondrocytes. Hypertrophic chondrocytes, when plated in anchorage permissive dishes, attach, maintaining the differentiated phenotype, and continue the synthesis of type X collagen.

[Lung cancers synchronous and metachronous with primary malignant neoplasms in other sites]

A series of 19 cases are reported in which, with the exception of one case, two primary malignant tumours developed at different times, one of which in the lung. Some details of this occurrence are discussed in relation to similar findings in the international literature. The average interval between the two tumours was found to be 7.5 years. In eight cases, all male, the lung tumour arose in subjects who had already been subjected to radical treatment for a laryngeal tumour. A lung carcinoma appeared in four women who had been subjected to radiation therapy following mastectomy. This sequence of events was considered a coincidence and not radioinduced in view of the fact that a total of 1061 similarly treated patients were observed over the same period. Finally it is suggested that certain histobiochemical factors induced by the lung tumour may somehow become pathogenically transformed to simulate a new primary malignant tumour.

[Malignant tumors preceding or following breast cancer]

Using the records of the Cancer Clinic of Biella Hospital that date back more than 25 years, a retrospective survey was conducted into 65 patients suffering from two primary malignant neoplasms one of which affected the breast. Graphs and tables illustrate; the frequency, location, histological type, staging, the age of the patient and the date of the onset of the first neoplasia, any previous family history of cancer, the interval between the two neoplasias and the type of treatment given during this interval. Particular attention is paid to cases in which both neoplasias were breast tumours, and brief remarks on certain aspects of such cases are presented.

Constraints of intensive care units and follow-up studies in prematures

This paper reviews the main known causes of deafness in newborns at risk. Some of them, like infections, anoxia, prematurity, etc. can be classified as 'clinical factors'. Others, like the ototoxicity of some antibiotics and the noise of the life-supporting equipment, are described in the paragraph on the 'constraints of intensive care'. Finally, the possible potentiating effect that some of the above mentioned factors may have on each other is mentioned in the paragraph entitled 'combined effects'. The need of accurate follow-up studies of neonatal intensive care unit (NICU) babies treated in different ways is stressed in the last paragraph.

Relationship between protein and energy in the feeding of preterm infants during the first month of life

Energy and protein quantity and quality in the diet are factors regulating the rate of growth in the preterm infant. In the present study twenty infants 31-36 weeks of gestational age were fed with identical test formulas which varied only in the content of energy. One formula (F-81) contained 3.1 g protein (60 bovine whey: 40 bovine caseins) and 81 kcal per dl. The second formula (F-94) contained the same amount of protein but 94 kcal per dl. At an intake of 150 ml/kg/d the infants received 4.6 g protein/kg/d and either 121 or 141 kcal/kg/d. The infants on F-94 had a significantly higher rate of weight gain, but growth of length and head circumference was equal in the two groups. Significant differences were found in the plasma concentrations of glutamine and alanine between the two feeding groups. The other plasma amino acids were not statistically different in the two groups of infants. Urine excretion of threonine, serine, glycine, alanine, histidine, tyrosine, glutamine and cystathionine was significantly increased in the high caloric, F-94-group. The results indicate that increasing the caloric intake above 120 kcal/kg/d in preterm infants on a relatively high protein intake does not increase linear growth but does produce increased weight gain. The biochemical results provide indirect evidence that this weight increase is the result of increased fat accretion.

[Correlation of the DNCB skin test and CEA assay in the prognosis of malignant neoplasms]

130 neoplastic patients were subjected to DNCB skin tests and radioimmunological CEA measurements during antiblastic and/or radiation treatment. The prognostic reliability of the two techniques was examined as was the connection between DNCB response and CEA plasma levels. Results obtained confirm the link between development of the neoplasia and immunological factors in the host organism in 73% of the cases. The connection between CEA measurement and DNCB test was noted in only 56%. Finally CEA measurements of haematic levels alone corresponded to the clinical development of the condition in 71% of the cases examined.

Essential fatty acid status in premature newborns fed by nasoduodenal technique

The fatty acid composition of plasma phospholipids and the triene (20:3, n=9) to tetraene (20:4, n=6) ratio in the same lipid fraction have been determined, as indices of the essential fatty acid status, in a group of 22 healthy premature newborns fed by the nasoduodenal technique. Determinations have been carried out on the first and fifth day of life for all 22 newborns, and also on the tenth and 30th day of life for 12 of them. The normal plasma levels of essential fatty acids obtained indicate a satisfactory utilization of dietary essential fatty acids under these unusual nutritional conditions.

Growth and metabolic and hormonal profiles during transpyloric and nasogastric feeding in preterm infants

The effect of transpyloric and nasogastric feeding on the blood concentration of glucose, lactate, pyruvate, glycerol, hydroxybutyrate, acetoacetate, alanine, insulin, pancreatic and total glucagon was determined in 20 preterm infants. The babies were studied on the last day of transpyloric feeding and the first and fifth days of ensuing nasogastric feeding. In 9 infants hourly measurements of hormones and metabolites were made at 1000, 1100, 1200, 1300 and 1400 hours. The blood concentrations of glucose, alanine, pancreatic and total glucagon were stable, the concentration of the other metabolites and insulin, less so. No significant difference in mean metabolite or hormone concentration was noted by time of day or type of feeding. Measurements made on the fifth day of nasogastric feeding showed no significant differences from those at the time of changeover. The infants were clinically well and growing normally at the time of study, but had low plasma insulin and high plasma glucagon concentrations. We conclude (i) the site of presentation of milk in the gastrointestinal tract has no effect on the circulating concentration of selected metabolites and hormones in the preterm infants, (ii) the preterm infant grows at a normal rate with a plasma insulin/glucagon ratio that in the adult would be expected to favour catabolism.