RESUMEN
Endometrial adenocarcinoma is the leading cause of malignancy of the female genital tract. Prognosis of this tumor, which has implications on patient management, is determined by evaluation of the stage of disease, architectural grade, nuclear grade, myometrial invasion, and peritoneal cytology. These parameters have inherent subjectivity and, therefore, the search for an objective reliable parameter to determine prognosis is required. DNA ploidy is under investigation as an objective and reproducible prognostic parameter. This study will evaluate the role of DNA ploidy and its relationship to the traditional parameters as predictors of prognosis in patients with endometrial carcinoma. Fifty-eight patients were evaluated by two observers for architectural grade according to the International Federation of Gynecology and Obstetrics classification, nuclear grade, and depth of myometrial invasion. DNA ploidy was evaluated using flow cytometer (FACscan, Becton Dickinson, San Jose, CA). Histologic parameters were than compared with DNA ploidy. Survival data were obtained from the tumor registry. Results of patient survival were compared with histologic parameters and DNA ploidy. Higher nuclear grade and aneuploidy correlated with poor survival rate (P <.05). Higher nuclear grade correlated with aneuploidy. The survival of patients with architectural grade 2 (moderately differentiated) endometrial adenocarcinoma is poorer if the tumor is aneuploid as compared with diploid as determined by flow cytometry. In conclusion, aneuploidy and nuclear grade correlates with poor patient survival. The poorer survival rates with aneuploid architectural grade 2 endometrial adenocarcinoma may have an impact on clinical management.
Asunto(s)
Adenocarcinoma/genética , ADN de Neoplasias/análisis , Neoplasias Endometriales/genética , Ploidias , Adenocarcinoma/diagnóstico , Adenocarcinoma/mortalidad , Adulto , Anciano , Anciano de 80 o más Años , Núcleo Celular/patología , Neoplasias Endometriales/diagnóstico , Neoplasias Endometriales/mortalidad , Femenino , Citometría de Flujo , Humanos , Persona de Mediana Edad , Invasividad Neoplásica/diagnóstico , Estadificación de Neoplasias , Pronóstico , Análisis de Supervivencia , Tasa de SupervivenciaRESUMEN
OBJECTIVE: To use standard molecular methods to define the prevalence and metabolic characteristics of Chlamydia trachomatis during infection of fallopian tubes in women with ectopic pregnancies. DESIGN: Polymerase chain reaction (PCR)- and reverse transcription-PCR (RT-PCR)-based assessment of presence of chlamydial DNA and various RNA species in fallopian tube biopsy samples. SETTING: Hospital and molecular genetics laboratory. PATIENTS: Ten women of varying ages, each presenting with ectopic pregnancy. MAIN OUTCOME MEASURE(S): Positive signal in specific chlamydia-directed PCR and RT-PCR assays. RESULT(S): Nucleic acid preparations from 7 of the 10 fallopian tube patient samples were PCR-positive for C. trachomatis DNA. Each of the 7 PCR-positive samples also showed the presence of several transcripts from the bacterium, including primary transcripts from the ribosomal RNA operons. CONCLUSION(S): A higher proportion of ectopic pregnancies than was believed previously may be attributable to infection of the fallopian tubes by C. trachomatis. The presence of various chlamydial RNA molecules suggests that viable, metabolically active bacteria were present in fallopian tubes of the patients studied.
Asunto(s)
Chlamydia trachomatis/crecimiento & desarrollo , Trompas Uterinas/microbiología , Embarazo Ectópico/microbiología , Adulto , Femenino , Células HeLa , Humanos , Reacción en Cadena de la Polimerasa/métodos , Embarazo , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
A sudden and unexpected death, at 26 hours of age, of a term infant with no identifiable risk factors either in the prenatal or in the immediate neonatal period is described. The most remarkable postmortem findings were confined to the lungs, which had many areas of aspirated amniotic fluid, as well as extensive areas of bronchopneumonia. Postmortem cultures of the lung revealed Citrobacter freundii. This case is an atypical presentation of this devastating neonatal infection, both because of the absence of central nervous system involvement and because of the total absence of clinical signs before death.