Activity

lease e-mail journals.permissions@oup.com.OBJECTIVES To review the significance of MDM2 and cyclin D1 expression and loss of p16 expression in malignant and borderline Brenner tumors (BTs) of the ovary. METHODS We describe 2 new cases of ovarian BT, 1 malignant and 1 borderline. We studied MDM2, p16, and cyclin D1 expression by immunohistochemistry in the benign, borderline, and malignant components of these 2 cases and in 5 additional cases of benign BT. We also reviewed and summarized the literature on the clinical, immunohistochemical and molecular characteristics of borderline and malignant BTs (BdBTs and MBTs). RESULTS Nuclear expression of MDM2 was seen only in the MBT. Loss of p16 expression was seen in both BdBT and MBT. Cyclin D1 expression was in proportion to the degree of malignancy. Amplification of MDM2, loss of CDKN2A (p16-encoding gene), and amplification of CCND1 (cyclin D1-encoding gene) were confirmed by commercial next-generation sequencing in the case of MBT. CONCLUSIONS We are the first to report immunohistochemical expression of MDM2 in an MBT. Amplification of MDM2 and loss of p16 expression may have a role in malignant transformation of BT. © American Society for Clinical Pathology, 2020. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.Repeated exposure to insecticides, particularly pyrethroids and organophosphates, has resulted in the development of insecticide resistance in the mosquito Culex pipiens, a primary disease vector. Glutathione S-transferase (GST) is involved in the phase II detoxification of numerous xenobiotics, including insecticides. In this study, a GST gene (CPIJ002678) was amplified, sequenced, and used in comprehensive molecular analyses ending up in development of a rapid assay to distinguish more tolerant individuals from susceptible Culex pipiens using the Restriction Fragment Length Polymorphism (RFLP) technique. Field collected Culex pipiens strains from untreated areas, organophosphates-treated areas and a lab strain reared for many generations, all were used in CDC bottle bioassays to evaluate the susceptibility status of the studied individuals to malathion insecticide. Interestingly, both field sites collected groups showed high levels of resistance at the malathion diagnostic time. Gene amplification, and bidirectional direct sequencing results were analyzed. Compared with the reference genome sequence, the pairwise alignment of the amplified sequences showed 96.6% similarity to the reference sequence in the GenBank database. The confirmed gene sequences were assembled and aligned using various bioinformatic softwares. The assembled contigs were used in NEBcutter V2.0 for constructing restriction maps and checked for the availability of differences (if present) between susceptible and more tolerant strains. Specific molecular RFLP markers were successfully recognized to differentiate the more tolerant from the susceptible Culex pipiens phenotypes. © The Author(s) 2020. Published by Oxford University Press on behalf of Entomological Society of America.All rights reserved. For permissions, please e-mail journals.permissions@oup.com.BACKGROUND Improving appropriate antibiotic use is crucial for combating antibiotic resistance and unnecessary adverse drug reactions. Acute respiratory illness (ARI) commonly causes outpatient visits and accounts for ~41% of antibiotics used in the United States (U.S.). We examined the influence of influenza vaccination on reducing antibiotic prescriptions among outpatients with ARI. Selleckchem PF-05221304 METHODS We enrolled outpatients aged ≥6 months with ARI from 50-60 U.S. clinics during five winters (2013-2018) and tested for influenza with RT-PCR; results were unavailable for clinical decision-making and clinical influenza testing was infrequent. We collected antibiotic prescriptions and diagnosis codes for ARI syndromes. We calculated vaccine effectiveness (VE) by comparing vaccination odds among influenza-positive cases to test-negative controls. We estimated ARI visits and antibiotic prescriptions averted by influenza vaccination using estimates of VE, coverage, and prevalence of antibiotic prescriptions and influenza. RErnals.permissions@oup.com.We aimed to investigate the safety, feasibility, and outcomes of thoracoscopic surgery for recurrent tracheoesophageal fistula (rTEF) after esophageal atresia repair. The medical records and follow-up data of 31 patients who underwent thoracoscopic surgery for rTEF at a single institution were collected and reviewed. In total, 31 patients were enrolled with a median age of 7 months (range 3-30 months) and a median weight of 6,000 g (range 4,000-12,000 g) before reoperation. The median operation time for the entire series was 2.9 hours (range 1.5-7.5 hours), and the median total hospitalization duration after surgery was 19 days (range 11-104 days). One patient died of anastomotic leakage, a second rTEF, severe malnutrition, and thoracic infection; the mortality rate was 3.23% (1/31). Nine patients (9/31, 29.03%) had an uneventful recovery, and the incidences of postoperative anastomotic leakage, anastomotic stricture, and second rTEF were 25.81%, 61.29%, and 9.68%, respectively. After a median follow-up of 12 months (range 3-24 months), 26 survivors resumed full oral feeding, 2 were tube fed, 2 required a combination of methods, and 4 patients experienced severe respiratory complications. In total, 9 patients had pathological gastroesophageal reflux, and 2 patients eventually underwent Nissen fundoplication. Of the 30 survivors with growth chart data, the median weight for age Z-score, height for age Z-score, and weight for height Z-score were – 0.46 (range -5.1 to 2.8), 0.75 (range -2.7 to 4.7), and – 1.14 (range -6.8 to 3.0), respectively. Thoracoscopic surgical repair for rTEF is safe, feasible, and effective with acceptable mortality and morbidity. © The Author(s) 2020. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.OBJECTIVE This study compared the survival outcomes and the incidence of chemotherapy-related adverse events in endometrial cancer patients who received four and six cycles of adjuvant chemotherapy to examine the optimal number of adjuvant chemotherapy cycles. METHODS A total of 112 patients with endometrial cancer with a high risk of recurrence were retrospectively enrolled; 46 patients received four cycles and 66 received six cycles of adjuvant chemotherapy. Between-group differences of overall survival, disease-free survival, hematological and non-hematological toxicities were analyzed. Baseline patient’s background differences were assessed with inverse probability of treatment weighting using propensity score. RESULTS Overall and disease-free survivals between the two groups were not significantly different. Paclitaxel + carboplatin, every 3-4 weeks was the most frequently used chemotherapy regimen in both groups. Patients in the six-cycle chemotherapy group developed neutropenia G4 or febrile neutropenia more frequently than those in the four-cycle group; odds ratio (95% confidence interval) is 4.