Does thyroid-stimulating hormone influence the prognosis of patients with endometrial cancer? A multicentre trial

Background:

Thyroid function has been suggested to interfere with tumour biology and prognosis in different cancers. The present study was performed to investigate the impact of pre-therapeutic serum thyroid-stimulating hormone (TSH) levels on the prognosis of patients with endometrial cancer.

Methods:

Pre-therapeutic serum TSH was investigated in 199 patients with endometrial cancer. After stratification in TSH risk groups, univariate and multivariable survival analyses were performed.

Results:

Elevated TSH was independently associated with poor disease-specific survival in univariate/multivariable survival analyses (P=0.01 and P=0.03, respectively).

Conclusion:

Thyroid-stimulating hormone may serve as a novel and independent prognostic parameter for disease-specific survival in patients with endometrial cancer.

The age of attaining highest body weight correlates with lifespan in a genetically obese mouse model

Obesity has been associated with a higher risk of mortality, whereas caloric restriction reduces the risk. In this study, we examined how body weight development during life affects lifespan in a mouse model for obesity. Therefore, mice of the Berlin Fat Mouse Inbred line were set on either a standard or a high-fat diet (HFD). Median lifespans of standard diet-fed mice were 525 and 539 days for males and female animals, respectively. HFD feeding further decreased lifespan by increasing the risk of mortality. Our data provide evidence that the highest body weight reached in lifetime has only a minor effect on lifespan. More important is the age when the highest body weight is reached, which was positively correlated with lifespan (r=0.77, P<0.0001). Likewise, the daily gain of body weight was negatively correlated with the age of death (r=−0.76, P<0.0001). These data indicate that rapid weight gain in early life followed by rapid weight loss affect lifespan more than the body weight itself. These data suggest that intervention strategies to prevent rapid weight gain are of high impact for a long lifespan.

Early and late onset of voluntary exercise have differential effects on the metabolic syndrome in an obese mouse model

In a mouse model for juvenile obesity, we investigated how the age of onset of voluntary exercise affects factors of the metabolic syndrome. One exercise group had access to running wheels from 3 weeks (representing childhood) and another one from 9 weeks on (early adulthood). Both groups were compared to mice without exercise. The investigations were performed under 2 diets (standard maintenance and high-fat diet). Average daily running activity was independent of diet and exercise. On both diets, mice with exercise from 3 weeks on gained 10 g body weight and 5 g fat mass less than mice without exercise. The highest body weight difference between mice on HFD without exercise and mice on standard maintenance diet with exercise was 24 g. Despite the higher energy expenditure during exercise, young mice did not increase their energy intake adjusted for lean mass, while mice with exercise from 9 weeks had an increased energy intake of 6 kJ per day and therefore could not reduce fat mass on both diets. However, mice with exercise from 9 weeks had better glucose tolerance at 20 weeks than mice with exercise from childhood on. Independently of the age of exercise onset, triglycerides were reduced from 2.4 to 1.7 mmol/l on both diets and insulin levels from 1.5 to 0.3 and 4.5 to 1.8 µg/ml on standard maintenance and high-fat diet, respectively, which represents a considerable improvement. Physical activity seems to have long-lasting effects on body composition and health, but they are different depending on when exercise has begun.

Seasonal variation in expression and localization of testicular transforming growth factors TGF-{beta}1 and TGF-{beta}3 corresponds with spermatogenic activity in roe deer

Adult roe deer males show hormonally controlled seasonal cycles of testicular growth and involution. Mediation of endocrine signals likely requires variable production of testicular growth factors for regulation of testis function. Here we studied the expression pattern of transforming growth factors (TGFs) beta1 and beta3. Total RNA from testis parenchyma was extracted monthly and analysed using quantitative reverse transcriptase PCR. The localization of mRNAs was determined by in situ hybridization, and corresponding proteins were visualized immunohistochemically. Both factors showed different expression levels and different seasonal expression patterns. The TGF-beta1 mRNA content was up to 45 times higher than that of TGF-beta3. Compared with its lowest level in May, TGF-beta1 expression was slightly enhanced during pre-rut (June/July). TGF-beta3 expression increased 5-fold from April to June/July and decreased thereafter to its low in December. This corresponded with changing numbers of spermatocytes and round spermatids, in which both TGF-beta3 mRNA and the protein were mainly localized. The TGF-beta1 mRNA was found in interstitial cells, mainly during the non-breeding season, but also in spermatocytes and spermatids during activated spermatogenesis. The translation product was localized in few spermatogenic cells only. The results suggest that TGF-beta1 and -beta3 are important in regulating seasonal spermatogenesis of roe deer with diverse functions affecting interstitial and spermatogenic cells.

Multi-channel near-infrared spectroscopy detects specific inferior-frontal activation during incongruent Stroop trials

Near-infrared spectroscopy (NIRS) is an optical method, which allows non-invasive in vivo measurements of changes in the concentration of oxygenated (O2Hb) and deoxygenated (HHb) hemoglobin in brain tissue. In the present study we investigated 10 healthy subjects by means of multi-channel NIRS (Optical Topography; ETG-100, Hitachi Medical Co., Japan) during performance of congruent and incongruent trials of the Stroop color word task. With a similar pattern of activation for both congruent and incongruent Stroop trials in the NIRS channels located left superior-frontally, the results for O2Hb and the total amount of hemoglobin (Hb-tot) indicate specific activation for interference trials in inferior-frontal areas of the left hemisphere. This result is in line with several neuroimaging studies (fMRI, PET) that have already investigated the frontal activation related to Stroop interference, which further supports the assumption that multi-channel NIRS is sensitive enough to detect spatially specific activation during the performance of cognitive tasks.

Near-infrared optical topography to assess activation of the parietal cortex during a visuo-spatial task

Multi-channel near-infrared spectroscopy (NIRS) is a relatively new method to investigate the brain activation, based on changes in oxygenated haemoglobin (O2Hb) and deoxygenated haemoglobin (HHb). Recently, it has been shown that NIRS seems to be able to detect even small changes in O2Hb and HHb concentration due to cognitive demands. This study aimed at investigating the changes in O2Hb and HHb concentrations of the parietal cortex during a spatial task, a modified version of the Benton Line Orientation Task [Gur, R. C., Alsop, D., Glahn, D., Petty, R., Swanson, C. L., Maldjian, J. A., et al. (2000). An fMRI study of sex differences in regional activation to a verbal and a spatial task. Brain & Language, 74(2), 157-170.]. Twenty-four subjects were measured with NIRS while they had to estimate the orientation of a given line or to name the colour of the line in the control condition. Both conditions consisted of three activation phases each lasting 30 s, with a 10 s baseline and a 20 s post resting period. For assessing the changes in O2Hb and HHb concentrations, we measured with 24 NIRS channels over the parietal cortex using the NIRS apparatus ETG-100 (Hitachi Medical Ltd.). O2Hb concentration significantly increased during the active phase compared to the baseline for both conditions, but was significantly higher in the active phase for the line orientation condition compared to the colour naming condition bilaterally parieto-occipital. For the HHb concentrations, we only found significant decreases for both conditions but no differences between the conditions. The results of our study underscore the value of multi-channel NIRS for assessing cortical activation during cognitive tasks.

Nah-Infrarot-Spektroskopie in der Psychiatrie

Near-infrared spectroscopy (NIRS) is a noninvasive optical method for in vivo measurement of regional brain tissue oxygenation. Light from the near-infrared spectrum can penetrate the skull and is mainly absorbed by oxyhaemoglobin (O(2)Hb) and desoxyhaemoglobin (HHb). From the amount of reflected near-infrared light in relation to the amount absorbed by brain tissue, regional changes in O(2)Hb and HHb concentrations can be calculated spectrophotometrically. It has been shown that NIRS is not only able to measure massive disturbances in cerebral blood circulation due to serious neurological diseases, but that it also is sensitive enough to assess task-specific patterns of activation in healthy subjects during circumscribed cognitive processes. Preliminary investigations indicate altered regional brain tissue oxygenation in psychiatric patients during cognitive activation tasks. The NIRS outmatches other functional imaging methods in that it has no side effects and is well tolerated by psychiatric patients. Furthermore, it can be applied quickly and easily. Thus, NIRS is a potential screening method in psychiatric settings, provided that robust parameters of reliable diagnostic and/or prognostic value can be developed for individual psychiatric illnesses. However, this will depend on broader application of the method combined with established neurophysiological procedures and functional imaging techniques in psychiatric research.

Far field potentials from the brain stem after transcutaneous vagus nerve stimulation

Recently, the vagus nerve has gained particular interest in neuropsychiatry, as neurodegenerative diseases like Alzheimer's and Parkinson's disease are supposed to affect the brainstem nuclei of the vagus nerve early in their course. In addition, electric stimulation of the vagus nerve has therapeutic effects in otherwise therapy-refractory epilepsies and depressions. So far, no method is available to assess vagus nerve function in this context. On this background and based on the established techniques of early acoustic evoked potentials we investigated if a transcutaneous electric stimulation of the sensory auricular branch of the vagus nerve innervating parts of the outer ear is feasible in healthy subjects using this hypothesis-generated approach. We were able to record a clear, reproducible Vagus Sensory Evoked Potential (VSEP) measured as far field potential probably originating in vagus nuclei in the brainstem. Further studies are needed to test the interindividual stability and test-retest reliability of this new method before potential diagnostic and therapeutic applications might be evaluated.

Seasonal timing of sperm production in roe deer: interrelationship among changes in ejaculate parameters, morphology and function of testis and accessory glands

Roe deer are seasonal breeders with a short rutting season from mid-July to mid-August. The seasonality of reproductive activity in males is associated with cyclic changes between growth and involution of both testes and the accessory sex glands. This study characterizes morphological and functional parameters of these organs prior to, during and after breeding season in live adult roe deer bucks. Size and morphology of the reproductive tract was monitored monthly by transcutaneous (testes, epididymis) and transrectal (accessory glands) ultrasonography. Semen was collected by electroejaculation. Concentration, motility and morphological integrity of spermatozoa as well as the content of proteins and testosterone in semen plasma were evaluated. Proportions of haploid, diploid and tetraploid cells were estimated by flow cytometry in testicular tissue biopsies. Serum testosterone was measured by enzyme immunoassay. Most parts of the male reproductive tract showed distinct circannual changes in size and texture. These changes were most pronounced in the testes, seminal vesicles, and prostate. All reproductive organs were highly developed during the rut only. The volume of ejaculates, total sperm number and percentages of motile and intact spermatozoa also showed a maximum during this period and corresponded with high proportions of haploid cells in the testis. The highest percentages of tetraploid cells were found in the prerutting period. The production of motile and intact spermatozoa correlated with both the protein content of semen plasma and the concentration of testosterone in semen plasma and blood serum. These results suggest the importance of combined actions of the testes and accessory sex glands and the crucial role of testosterone in facilitating the optimal timing of intensified semen production to ensure sufficient numbers of normal spermatozoa in seasonal breeders.

Seasonal timing of sperm production in roe deer: interrelationship among changes in ejaculate parameters, morphology and function of testis and accessory glands

Roe deer are seasonal breeders with a short rutting season from mid-July to mid-August. The seasonality of reproductive activity in males is associated with cyclic changes between growth and involution of both testes and the accessory sex glands. This study characterizes morphological and functional parameters of these organs prior to, during and after breeding season in live adult roe deer bucks. Size and morphology of the reproductive tract was monitored monthly by transcutaneous (testes, epididymis) and transrectal (accessory glands) ultrasonography. Semen was collected by electroejaculation. Concentration, motility and morphological integrity of spermatozoa as well as the content of proteins and testosterone in semen plasma were evaluated. Proportions of haploid, diploid and tetraploid cells were estimated by flow cytometry in testicular tissue biopsies. Serum testosterone was measured by enzyme immunoassay. Most parts of the male reproductive tract showed distinct circannual changes in size and texture. These changes were most pronounced in the testes, seminal vesicles, and prostate. All reproductive organs were highly developed during the rut only. The volume of ejaculates, total sperm number and percentages of motile and intact spermatozoa also showed a maximum during this period and corresponded with high proportions of haploid cells in the testis. The highest percentages of tetraploid cells were found in the prerutting period. The production of motile and intact spermatozoa correlated with both the protein content of semen plasma and the concentration of testosterone in semen plasma and blood serum. These results suggest the importance of combined actions of the testes and accessory sex glands and the crucial role of testosterone in facilitating the optimal timing of intensified semen production to ensure sufficient numbers of normal spermatozoa in seasonal breeders.

[Legal occupational standards and clinical reality]

Permanently rising costs--especially caused by the high proportion of staffing costs (depending on the system)--conflict with a continuous budgetary coverage and the consequent exhaustion of an individual hospital's commercial reserves. The solution to this problem cannot be found by making far-reaching staff cuts, because the liability law alone already presents an insurmountable hurdle in this respect. Furthermore, the pressure on hospitals for rationalization is increased because high legal requirements--such as are given for example by the law regulating working hours--must be implemented in practice. There is a need for new, intelligent solutions in order to satisfy the legal requirements to their full extent. The responsible senior consultants, who will in future hold the function of "health managers" with budgetary responsibility, must be able to fulfill these new duties as well as further ones. It is the legislator's task to create the requisite legal basis--especially in Labour law.

Detection of growth factors in the testis of roe deer (Capreolus capreolus)

Roe deer is a seasonal breeder characterised by a short rutting season in summer. Mature males show synchronised cycles of testicular involution and recrudescence. Therefore, this species is a valuable model to study seasonal regulation of spermatogenesis in ruminants. It is hypothesised that a time-dependent production of testicular growth factors is required to regulate seasonal changes in testis growth and spermatogenesis. To identify potential candidates, total RNA from roe deer testis tissue was extracted at three different seasonal periods (April, August, December), and using RT-PCR the presence of several growth factors (aFGF, bFGF, IGF-I, IGF-II, TGF-alpha, TGF-beta1, TGF-beta3 and two isoforms of VEGF) was detected. Sequencing of the growth factor PCR fragments revealed a high sequence homology between cattle and roe deer. To further explore the expression patterns of the identified growth factors in roe deer their expression levels were standardised using glyceraldehyde-3-phosphate dehydrogenase (GAPDH) gene expression. The study demonstrates the expression of several growth factors in roe deer testis and supports the assumption of their seasonally diverse regulation. These results provide the basis to investigate the role of growth factors in the regulation of circannual changes of testicular activity.

Testicular mitosis, meiosis and apoptosis in mink (Mustela vison) during breeding and non-breeding seasons

Testes of mink were compared between the breeding (March) and non-breeding seasons with the start (November) and cessation (May) of spermatogenic activity. Testicular mass and spermatozoa per gram testis were assessed. Percentages of haploid (1C), diploid (2C) and tetraploid (4C) cells were monitored using DNA flow cytometry and the proportions of somatic and spermatogenetic cells were determined after selective labelling of somatic cells with a vimentin antibody. Apoptosis was examined by cell death detection ELISA, and testosterone concentrations were measured with an enzyme-immunoassay. The significantly higher testis mass during the breeding period coincided with higher numbers of testicular spermatozoa per gram testis and peak of testicular testosterone concentration in comparison with non-breeding periods. The proportions of 1C, 2C and 4C cells showed corresponding strong differences between these periods with the maximum of 1C cells during breeding. The proportions of testicular cells in G2-M phase of mitosis were very low during the period of peak spermatogenesis; they were markedly increased in the time of autumnal resumption in November but were even higher during testis involution in May. However. the meiotic transformation (1C:4C ratio) is maximal in March. The total as well as the relative proportions of spermatogenic and somatic cells differed significantly not only between breeding and non-breeding periods but also between the periods at the start and at the end of active spermatogenesis. The intensity of apoptosis was also seasonally dependent. The highest level in March indicates a stimulated apoptosis even during the breeding period. In conclusion, the production of spermatozoa in mink is intensified by enlargement of gonads as well as enhanced efficiency of spermatogenesis during breeding. In this time, the testosterone concentration and the meiotic transformation show high levels, but the mitotic activity of spermatogenic cells is already significantly diminished and an intensified apoptosis seems to precede the forthcoming testis involution after breeding. The results suggest that the regulation of seasonal testicular activity is characterised by co-ordinated shifts in the relationships between mitosis, meiosis, apoptosis and testosterone production.

Microbial production of specifically ring-13C-labelled 4-hydroxybenzoic acid

When transformed with a recombinant vector carrying the ubiC gene (encoding chorismate pyruvate-lyase, EC 4.1.3.27) the triple mutant (Phe-, Trp-, Tyr-) Klebsiella pneumoniae 62-1 excretes 4-hydroxybenzoic acid instead of chorismic acid. The recombinant strain can be used to produce in high yield specifically ring-labelled 4-hydroxybenzoic acid from isotopically labelled glucose.