Association between lifestyle factors and thyroid function in young euthyroid adults

Purpose:The present work examines the associations of dietary habits,sedentarism,physical activity(PA)levels and sleep habits,with thyroid function in young euthyroid adults.Methods:A total of 105 young euthyroid adults participated in this cross-sectional study.Thyroid function was determined in fasting conditions(>6 h).Dietary habits were measured by a food frequency questionnaire and three non-consecutive 24 h recalls,and different dietary intake and patterns were then estimated.The time spent in sedentary,PA levels and sleep habits were objectively measured using a wrist-worn accelerometer.Results:Energy and carbohydrate intake were positively associated with thyroid stimulating hormone(TSH)(β=0.222;R^(2)=0.102;P=0.022 andβ=0.425;R^(2)=0.129;P=0.007,respectively)whereas fat intake was negatively associated with TSH(β=-0.428;R^(2)=0.137;P=0.004).Energy intake was also positively associated with free triiodothyronine(β=0.277;R^(2)=0.137;P=0.004).Further,adherence to the Mediterranean diet was negatively related to TSH and free thyroxine(FT4)(β=-0.221;R^(2)=0.113;P=0.020 andβ=-0.268;R^(2)=0.071;P=0.007,respectively).Vigorous-intensity and overall PA were negatively associated with FT4(β=-0.227;R^(2)=0.052;P=0.022 andβ=-0.204;R^(2)=0.042;P=0.041,respectively).In contrast,no associations were found between sleep parameters and thyroid function.Conclusions:Lifestyle factors such as dietary intake and PA levels seems to be related to thyroid function even in young euthyroid adults.

Associations between rehabilitants’ functional limitations and conclusions made by a multidisciplinary team during vocational rehabilitation evaluation: Turku ICF Study

Purpose: To investigate associations between functional limitations experienced by rehabilitants and multidisciplinary team’s recommendations during vocational rehabilitation evaluation. Methods: The descriptions of functional limitations were retrospectively identified for 32 patients with chronic musculoskeletal disorders. Vocational rehabilitation evaluation was conducted by a multidisciplinary team in an outpatient clinic of a university hospital. The descriptions were converted to ICF second-level categories. Square contingency coefficient Phi (φ) was calculated to describe the associations between ICF-categories appearing ≥10 times in the study sample and the recommendations given by a professional team. Results: In the study sample, 84 different ICF second-level categories were identified (average 18 codes/subject, range 9 - 25). Of them, 18 categories were observed for at least in 10 rehabilitants. Three statistically significant correlations were observed between these 18 categories and recommendations given by a rehabilitation team. Of them, positive association of moderate strength was found between joint mobility and muscle power functions and recommendation for retirement. Difficulties in walking showed weak negative correlation with recommendation for vocational rehabilitation. Conclusions: During vocational rehabilitation evaluation, the final recommendations given by rehabilitation professionals were only weakly correlated with functional limitations experienced by rehabilitants.

Implementation Research on the Effects and Results of a National Health Promotion Project

The purpose of this study was to describe the implementation of the Finnish government’s 2017-2018 key project titled “Effective lifestyle counselling for social and health care cross-functionally” (VESOTE) in primary health care organizations in Southwest Finland. The study also aimed to illustrate the project’s impacts on nursing practices in primary health care organizations in terms of lifestyle counselling. Data were collected from all of the primary health care organizations in Southwest Finland by using a questionnaire. The data were analyzed qualitatively and by using descriptive statistics. The participants considered the VESOTE project important in terms of its contents. However, only individual measures of the project were adopted into practice. Organizations require tools to monitor the implementation of a new operating model. This should be taken into account when launching national projects.

Increased proliferation activity measured by immunoreactive Ki67 is associated with survival improvement in rectal/recto sigmoid cancer

AIM: To assess the expression of Ki67 as prognosticator in rectal/recto sigmoid cancer.METHODS: Samples from 146 patients with rectal and recto sigmoid cancer were studied for expression of Ki67 and its prognostic significance in comparison with clinicopathological predictors of survival. Formalin-fixed, paraffin-embedded tissues from 6 (4.1%) patients with T1, 26 (17.8%) with T2, 94 (64.4%) with T3, and 20 (13.7%) with T4 tumors were studied. Ki67 expression was determined immunohistochemically. Samples were divided according to mean value into high (＞40%) and low (≤40%) expression. Areas of extensive proliferation (＞50%) were defined as 'hot spot' areas. RESULTS: Hot spot areas were present in samples regardless of histopathological grade. Lower TNM and Dukes stage and higher expression of Ki67 and presence of Ki67 hot spot areas in histopathological samples were associated with better survival, whereas no association was observed with histopathological grade (P = 0.78). In Cox multivariate regression analysis, significant prognostic factors were Dukes stage (P＜0.001), presence of lymph node metastases (P = 0.015), age (P = 0.035) andpresence of Ki67 hot spot areas (P = 0.044). CONCLUSION: Proliferative activity as measured by Ki67 in rectal cancer is associated with survival improvement compared with patients with low Ki67. Areas of prognostically significant increased proliferation were found independently of histopathological tumor grade.

Specific probiotics alleviate allergic rhinitis during the birch pollen season

AIM:To investigate whether birch pollen allergy symptoms are linked with gut microbiota changes and whether probiotics have an effect on these.METHODS:Forty seven children with confirmed birch pollen allergy were randomized to receive either a probiotic combination of Lactobacillus acidophilus (L.acidophilus) NCFMTM (ATCC 700396) and Bifidobacterium lactis (B.lactis) Bl-04 (ATCC SD5219) or placebo in a double-blind manner for 4 mo,starting prior to onset of the birch pollen season.Symptoms were recorded in a diary.Blood samples were taken for analysis of cytokines and eosinophils.Fecal samples were analysed for microbiota components,calprotectin and IgA.Nasal swabs were taken for analysis of eosinophils.RESULTS:The pollen season induced a reduction in Bifidobacterium,Clostridium and Bacteroides which could not be prevented by the probiotic intervention.During the intervention,significantly higher numbers of B.lactis 11.2×107 ± 4.2×107 vs 0.1×107 ± 0.1×107 bacteria/g feces (P<0.0001) and L.acidophilus NCFMTM 3.5×106 ± 1.3×106 vs 0.2×106 ± 0.1×106 bacteria/g feces (P<0.0001) were observed in the probiotic group compared to the placebo group.During May,there was a tendency for fewer subjects,(76.2% vs 95.2%,P=0.078) to report runny nose,while during June,fewer subjects,11.1% vs 33.3%,reported nasal blocking in the probiotics group (P =0.101).Concomitantly,fewer subjects in the probiotic group had infiltration of eosinophils in the nasal mucosa compared to the placebo group,57.1% vs 95% (P=0.013).Eye symptoms tended to be slightly more frequent in the probiotic group,12.5 d [interquartile range (IQR) 6-18] vs 7.5 d (IQR 0-11.5) (P=0.066) during May.Fecal IgA was increased in the placebo group during the pollen season;this increase was prevented by the probiotics (P=0.028).CONCLUSION:Birch pollen allergy was shown to be associated with changes in fecal microbiota composition.The specific combination of probiotics used was shown to prevent the pollen-induced infiltration of eosinophils into the nasal mucosa,and indicated a trend for reduced nasal symptoms.

Lack of CD44 variant 6 expression in rectal cancer invasive front associates with early recurrence

AIM: To investigate the prognostic value of CD44 variant 6 (CD44v6), a membranous adhesion molecule, in rectal cancer. METHODS: Altogether, 210 rectal cancer samples from 214 patients treated with short-course radiotherapy (RT, n = 90), long-course (chemo) RT (n = 53) or surgery alone (n = 71) were studied with immunohistochemistry for CD44v6. The extent and intensity of membranous and cytoplasmic CD44v6 staining, and the intratumoral membranous staining pattern, were analyzed.RESULTS: Membranous CD44v6 expression was seen in 84% and cytoplasmic expression in 81% of the cases. In 59% of the tumors with membranous CD44v6 expression, the staining pattern in the invasive front was determined as "front-positive" and in 41% as "front-negative". The latter pattern was associated with narrower circumferential margin (P = 0.01), infiltrative growth pattern (P < 0.001), and shorter disease-free survival in univariate survival analysis (P = 0.022) when compared to the "front-positive" tumors. CONCLUSION: The lack of membranous CD44v6 in the rectal cancer invasive front could be used as a method to identify patients at increased risk for recurrent disease.

Qualitative and quantitative analyses of the bifidobacterial microbiota in the colonic mucosa of patients with colorectal cancer, diverticulitis and inflammatory bowel disease

AIM: To characterize the bifidobacterial microbiota of the colonic mucosa in patients with colon cancer, inflammatory bowel disease or diverticulitis. METHODS: A sample of the distal colonic mucosa was taken during surgery from a total of 34 patients, twenty-one with diagnosed colorectal cancer, nine with diverticulitis and four with inflammatory bowel disease, requiring surgery for their condition. Bacterial DNA was extracted from the resected mucosal samples and bifidobacterial mucosa-associated microbiota was qualitatively and quantitatively determined by means of qualitative and quantitative PCR. RESULTS: Bifidobacteria were found in 100% of the samples from patients with diverticulitis or IBD and a 76% of those suffering colon cancer. The species B. longum and B. bifidum were the most widely found, followed by B. animalis, B. catenulatum and B. adolescentis. B. breve, B. dentium and B. angulatum were not detected in any sample. A significantly higher occurrence of B. longum was observed in patients with diverticulitis than in those with colon cancer or IBD (100%, 62% and 75%, respectively, P < 0.05). Similar results were obtained for B. animalis (56%, 0% and 25%, P < 0.05), while B. adolescentis was only found in the mucosa from patients with colon cancer (5 out of 21, 24%). At the quantitative level, patients with colon cancer or IBD showed lower counts of total Bifidobacterium (4.94 and 5.91 vs 6.96 log Cells/sample, respectively, P < 0.05) and of the species B. longum (4.05 and 4.79 vs 6.76, P < 0.05) than those with diverticulitis. CONCLUSION: Aberrancies in mucosa associated microbiota are present in different intestinal diseases. This may indicate a role of the microbiota in the pathogenesis of these diseases.

E-cadherin expression pattern in primary colorectal carcinomas and their metastases reflects disease outcome

瞄准：调查在颜色在转移的进程期间发生在 E-cadherin 表示的变化表面的癌症。方法：E-cadherin 表示被免疫组织化学检测，表示的二个索引是计算的它反映了表示和地点(膜和细胞质) 的水平。Univariate 并且多，变量幸存分析被用来作为两个的预言者估计这二个 E-cadherin 索引的价值没有疾病(DFS ) 并且疾病特定(决策支持系统) 幸存。结果：E-cadherin 膜索引(MI ) ，然而并非细胞质的索引(CI ) ，比他们的转移在原发性瘤是显著地更高的(P = 0.0001 ) 。而且，原发性瘤 MI 和 CI 在开发了随后的转移的病人之中是更高的(P = 0.022 并且 P = 0.007，分别地) 。有趣地，两个索引在与另外的解剖地点相比的肝转移是更高的(MI， P = 0.034 并且 CI， P = 0.022 ) 。原发性瘤的 CI 是 DFS 的一个重要预言者(P = 0.042， univariate 分析) ，与在 CI 和 DFS 之间的强壮的反的关联(P = 0.006，多变量分析) 。最后，原发性瘤的 MI 证明了是决策支持系统的一个重要独立预言者，与与更有利的结果被联系的更高的索引(P = 0.016 ) 。结论：在颜色的 E-cadherin 表示和分发的检查表面的肿瘤能在预言是极其珍贵的疾病复发。E-cadherin 的异常细胞质的表示能预言疾病复发为病人和临床医生显然是很重要的，并且显著地有关病人的治疗和管理影响决定的观察。

Nuclear β-catenin expression as a prognostic factor in advanced colorectal carcinoma

AIM: To investigate the changing pattern of β-catenin expression and its prognostic value in advanced colorectal cancer (CRC). METHODS: Archival tumor samples were analyzed for β-catenin using immunohistochemistry (IHC) in 95 patients with advanced CRC. RESULTS: Membranous β-catenin expression was found in the normal colorectal epithelium. Almost 100% of CRC cases showed membranous and cytoplasmic expression,and 55 (58%) cases showed nuclear expression. In univariate (Kaplan-Meier) survival analysis,only the nuclear index (NI) was a signifi cant predictor of disease-free survival (DFS) (P = 0.023; n = 35),with a NI above the median associated with longer DFS (34.2 mo) than those with a NI below the median (15.5 mo) (P = 0.045,ANOVA). The other indices were not significant predictors of DFS,and none of the three tested indices (for membranous,cytoplasmic,or nuclear expression) predicted disease-specific survival (DSS). However,when dichotomized as positive or negative nuclear expression,the former was a signifi cant predictor of more favorable DFS (P = 0.041) and DSS (P = 0.046). CONCLUSION: Nuclear β-catenin expression provides additional information in predicting patient outcome in advanced CRC.

同相位和反相位MR成像快速评价非酒精性脂肪肝的脂肪含量

目的 以^1H-MRS作为参考标准，评价同相位和反相位MR成像在估测非酒精性脂肪肝（NAFLD）病人的肝脏脂肪含量（LFC）中的价值。方法 所有受检者均签署知情同意书，当地伦理委员会也同意开展此项前瞻性研究计划。共有33例NAFLD高风险的2型糖尿病病人[男性23例，女性10例；平均年龄（62．8±8．3）岁，范围48～77岁]接受了1．5T MRI的肝脏^1H-MRS检查及同相位和反相位MRI检查。

Quality of life following laparoscopic Nissen fundoplication: Assessing short-term and long-term outcomes

AIM: To investigate the quality of life following lapa-roscopic Nissen fundoplication by assessing short-term and long-term outcomes. METHODS: From 1992 to 2005, 249 patients under-went laparoscopic Nissen fundoplication. Short-term outcome data including symptom response, side effects of surgery, endoscopy, and patient's perception of over-all success were collected prospectively. Long-term out-comes were investigated retrospectively in patients witha median follow-up of 10 years by assessment of reflux symptoms, side effects of surgery, durability of antire-flux surgery, need for additional treatment, patient's perception of success, and quality of life. Antireflux sur-gery was considered a failure based on the following criteria: moderate to severe heartburn or regurgitation; moderate to severe dysphagia reported in combination with heartburn or regurgitation; regular proton pump inhibitor medication use; endoscopic evidence of erosive esophagitis Savary-Miller grade 1-4; pathological 24-h pH monitoring; or necessity to undergo an additional surgery. The main outcome measures were short-and long-term cure rates and quality of life, with patient sat-isfaction as a secondary outcome measure. RESULTS: Conversion from laparoscopy to open sur-gery was necessary in 2.4% of patients. Mortality was zero and the 30-d morbidity was 7.6% (95%CI: 4.7%-11.7%). The median postoperative hospital stay was 2 d [interquartile range (IQR) 2-3 d]. Two hundred and forty-seven patients were interviewed for short-term analysis following endoscopy. Gastro-esophageal reflux disease was cured in 98.4% (95%CI: 95.9%-99.6%) of patients three months after surgery. New-onset dysphagia was encountered postoperatively in 13 patients (6.7%); 95% reported that the outcome was better after antireflux surgery than with preopera-tive medical treatment. One hundred and thirty-nine patients with a median follow-up of 10.2 years (IQR 7.2-11.6 years) were available for a long-term evalu-ation. Cumulative long-term cure rates were 87.7% (81.0%-92.2%) at 5 years and 72.9% (64.0%-79.9%) at 10 years. Gastrointestinal symptom rating scores and RAND-36 quality of life scores of patients with treatment success were similar to those of the general population but significantly lower in those with failed antireflux surgery. Of the patients available for long-term follow-up, 83% rated their operation a success. CONCLUSION: For the long-term, our results indicate decreasing effectiveness of laparoscopic antirefluxsurgery, although most of the patients seem to have an overall quality of life similar to that of the general population.

Squamous cell carcinoma of the skin: Emerging need for novel biomarkers

The incidence of non-melanoma skin cancers(NMSC)is rising worldwide resulting in demand for clinically useful prognostic biomarkers for these malignant tumors,especially for invasive and metastatic cutaneous squamous cell carcinoma(cSCC).Important risk factors for the development and progression of cSCC include ultraviolet radiation,chronic skin ulcers and immunosuppression.Due to the role of cumulative long-term sun exposure,cSCC is usually a disease of the elderly,but the incidence is also growing in younger individuals due to increased recreational exposure to sunlight.Although clinical diagnosis of cSCC is usually easy and treatment with surgical excision curable,it is responsible for the majority of NMSC related deaths.Clinicians treating skin cancer patients are aware that certain cSCCs grow rapidly and metastasize,but the underlying molecular mechanisms responsible for the aggressive progression of a subpopulation of cSCCs remain incompletely understood.Recently,new molecular markers for progresprogression of cSCC have been identified.

Toremifene in the treatment of breast cancer

Although more widespread screening and routine adjuvant therapy has improved the outcome for breast cancer patients in recent years, there remains considerable scope for improving the efficacy, safety and tolerability of adjuvant therapy in the early stage disease and the treatment of advanced disease. Toremifene is a selective estrogen receptor modifier(SERM) that has been widely used for decades in hormone receptor positive breast cancer both in early and late stage disease. Its efficacy has been well established in nine prospective randomized phase Ⅲ trials compared to tamoxifen involving more than 5500 patients, as well as in several large uncontrolled and non-randomized studies. Although most studies show therapeutic equivalence between the two SERMs, some show an advantage for toremifene. Several meta-analyses have also confirmed that the efficacy of toremifene is at least as good as that of tamoxifen. In terms of safety and tolerability toremifene is broadly similar to tamoxifen although there is some evidence that toremifene is less likely to cause uterine neoplasms, serious vascular events andit has a more positive effect on serum lipids than does tamoxifen. Toremifene is therefore effective and safe in the treatment of breast cancer. It provides not only a useful therapeutic alternative to tamoxifen, but may bring specific benefits.

Expression of thymidylate synthase and glutathione-stransferase π in patients with esophageal squamous cell carcinoma

AIM:To investigate the expression of thymidylate synthase(TS)and glutathione-s-transferaseπ(GST-π) in esophageal squamous cell carcinoma and their association with the clinicopathologic characteristics. METHODS:Immunohistochemical methods were used to detect the expression of TS and GST-πin surgically resected formalin-fixed,paraffin-embedded esophageal squamous cell carcinoma(ESCC)tissue sections from 102 patients(median age,58 years)and in 28 normal esophageal mucosa(NEM)samples.The relationship between TS and GST-πexpression and clinicopathologic factors was examined. RESULTS:The expression of TS and GST-πwas not statistically significantly associated with age of the patients,tumor size,lymph node metastasis,depth of invasion or tumor stage.TS staining was positive in 17.86%of normal esophageal mucosa and in 42.16% of ESCC samples(P<0.05).The expression level of TSwas not only significantly lower in well-differentiated (21.88%)than in poorly-differentiated carcinomas (51.43%,P<0.05),but was also significantly higher in samples from male patients(46.51%)than from female patients(18.75%,P<0.05).GST-πwas positively stained in 78.57%of normal esophageal mucosa and in 53.92%of ESCC samples(P<0.05).The expression level of GST-πwas also significantly higher in welldifferentiated carcinomas(65.63%)than in poorlydifferentiated carcinomas(35.00%,P<0.05). CONCLUSION:The expression of TS and of GST-πmay be used as molecular markers for the characterization of ESCC.Poorly-differentiated cells showed increased expression of TS and reduced expression of GST-π.

Towards a comprehensive understanding of p75 neurotrophin receptor functions and interactions in the brain

The role of neurotrophins in neuronal plasticity has recently become a strong focus in neuroregeneration research field to elucidate the biological mechanisms by which these molecules modulate synapses,modify the response to injury,and alter the adaptation response.Intriguingly,the prior studies highlight the role of p75 neurotrophin receptor(p75^(NTR))in various injuries and diseases such as central nervous system injuries,Alzheimer's disease and amyotrophic lateral sclerosis.More comprehensive elucidation of the mechanisms,and therapies targeting these molecular signaling networks may allow for neuronal tissue regeneration following an injury.Due to a diverse role of the p75^(NTR)in biology,the body of evidence comprising its biological role is diffusely spread out over numerous fields.This review condenses the main evidence of p75^(NTR)for clinical applications and presents new findings from published literature how data mining approach combined with bioinformatic analyses can be utilized to gain new hypotheses in a molecular and network level.

Relationship between COX-2 and cell cycle-regulatory proteins in patients with esophageal squamous cell carcinoma

AIM: To investigate the correlation between cyclooxygenase-2 (COX-2) and cell cycle-regulatory proteins in patients with esophageal squamous cell carcinoma (ESCC). METHODS: One hundred and two surgically obtained specimens of ESCC were randomly collected. All specimens were obtained from patients who had not received chemoor radiotherapy prior to surgical resection.Twenty-eight specimens of normal squamous epithelium served as controls. The expression of COX-2, Ki-67, cyclin A and p27 was examined by immunohistochemistry. The Pearson test was used to analyze the relationship between groups. RESULTS: The protein level of COX-2, Ki-67 and cyclin A was significantly higher in ESCC than in normal squamous epithelium (74.7±61.2 vs 30.2 ± 43.4, 64.0 ± 51.6 vs 11.6 ± 2.3, 44.2 ± 32.2 vs 11.7 ± 5.0, respectively, all P<0.01). In contrast, the protein level of p27 was signifi cantly lower in ESCC than in normal squamous epithelium (182.0 ±69.0 vs 266.4±28.0, P<0.01). In ESCC, COX-2 expression was correlated with T stage, the score of T1-T2 stage was lower than that of T3-T4 stage (55.0±42.3 vs 83.0 ± 66.5, P<0.05), and Ki-67, cyclin A and p27 expressions were correlated with the tumor differentiation (43.8±31.7 vs 98.4± 84.8, 32.0 ± 19.0 vs 54.1 ±53.7,206.2±61.5 vs 123.5±68.3, respectively, all P<0.01). COX-2 expression was positively correlated to Ki-67, cyclin A and negatively correlated to p27 expression in ESCC (r=0.270, 0.233 and-0.311, respectively, all P<0.05).CONCLUSION: The expression of COX-2 is correlated with tumor cell invasion and is closely related to the cell proliferation in patients with ESCC.

Bcl-2 expression significantly correlates with thymidylate synthase expression in colorectal cancer patients

AIM: To examine the expression of thymidylate synthase (TS) and oncoprotein Bcl-2 in advanced colorectal cancer (CRC) patients,and to determine their mutual relationship,association to therapeutic response and impact on disease outcome.METHODS: Tumor samples from 67 patients with CRC,who were treated at advanced stage with either irinotecan alone or in combination with 5-fluorouracil/ leucovorin,were analyzed for expression of TS and Bcl-2 using immunohistochemistry.RESULTS: A significant linear correlation between lower expression levels of Bcl-2 and lower levels of TS expression was found (P = 0.033).Patients with high levels of both TS and Bcl-2 expression had a significantly longer disease-free survival (DFS) (42.6 mo vs 5.4 mo,n = 25) than those with low TS/Bcl-2 index (P = 0.001).Tumors with low levels of both TS and Bcl-2 were associated with a longer survival with metastasis (WMS) interval in the whole patients group (n = 67,P = 0.035).TS/Bcl-2 index was not significantly related to disease-specific survival.CONCLUSION: The present data suggest that CRC patients with low TS/Bcl-2 demonstrate a significantly shorter DFS and longer WMS.

Cyclooxygenase-2 expression as a predictor of outcome in colorectal carcinoma

AIM:To correlate cyclooxygenase-2(COX-2)expression profile with clinical and pathological variables to assess their prognostic/predictive value in colorectal carcinoma(CRC).METHODS:Archival tumor samples were analyzed using immunohistochemistry for COX-2 expression in 94 patients with CRC.Patients were diagnosed and treatedat the Departments of Surgery and Oncology,King Abdulaziz University Hospital,Saudi Arabia.RESULTS:Fifty-six percent of the tumors showed positive cytoplasmic COX-2 expression,whereas 44%of cases were completely COX-2-negative.There were no significant correlations between COX-2 expression and sex,age,grade or tumor location.However,COX-2 expression revealed a significant correlation with tumor stage(P=0.01)and distant metastasis(P=0.02),and a borderline association with lymph node involvement(P =0.07).Tumors with high COX-2 expression showed a higher recurrence rate than tumors with no expression(P<0.009).In univariate Kaplan-Meier survival analysis,there was a significant(P=0.026)difference in disease-free survival between COX-2-positive and negative tumors in favor of the latter.COX-2 expression did not significantly predict disease-specific survival,which was much shorter for COX-2-positive tumors.In multivariate(COX)models,COX-2 did not appear among the independent predictors of disease-free survival or disease-specific survival.CONCLUSION:COX-2 expression seems to provide useful prognostic information in CRC,while predicting the patients at high risk for recurrent disease.

Development of alexithymic personality features

The purpose of this paper is to review the current literature regarding the development of alexithymic personality features. Modern brain imaging technologies provide interesting data on the associations of alexithymia with different aberrations in brain function related to emotion regulation; however, the development of these deviations is poorly understood. A notable amount of research covers the relation of alexithymia to differentenvironmental factors. Many of these associations, for example, with low socio-economic status and general psychopathology in childhood, are well established. However, the retrospective and cross-sectional designs commonly used in these studies, as well as the use of self-report measures, hinder the ability to firmly establish causality. Certain individual developmental factors, such as lagging speech development and congenital cardiac malformations in childhood, have been associated with the development of alexithymia. Regarding the stability of alexithymia, a systematic review of the literature was conducted for this paper. In addition to being characterized as a personality feature in the general population, alexithymia also clearly has a state-like dimension that results in increases and decreases in alexithymic features in conjunction with mental disorder symptoms. An essential question is whether the alexithymic features in adulthood are, in fact, infantile features of a restricted ability to identify and describe emotions that simply persist in individuals through adolescence to adulthood. To firmly establish the roots of alexithymia development, longitudinal studies, particularly in younger populations, are needed. Furthermore, multifaceted study settings are encouraged.

Up-regulation of α-catenin is associated with increased lymph node involvement in colorectal cancer

AIM: To investigate the changing pattern of α-catenin expression and its relationship to clinical and pathological features of colorectal cancer (CRC) patients. METHODS: Archival tumor samples were analyzed using immunohistochemistry (IHC) for α-catenin in 91 patients with advanced CRC. RESULTS: The values of α-catenin membrane index (MI) and cytoplasmic index (CI) were significantly related to the depth of tumor invasion (P = 0.027, P = 0.020, respectively), high indices being associated with increased depth of the primary tumor invasion (T3 and T4). Similarly, patients with high α-catenin expression had a signifi cantly increased risk of lymph node metastasis (32/39 vs 37/52 for MI and 37/45 vs 32/46 for CI) (P = 0.001, P = 0.0001, respectively, for LNN status). An altered expression (i.e., cytoplasmic pattern) was also related (P = 0.047) to the response to chemotherapy; patients with low CI were more responsive (CR: 7/46) than patients with high CI values (CR: 0/45). There was a marginal effect on survival in patients time with metastases (SWM) (P = 0.087); patients with low CI showing slightly longerSWM, but no such effect on disease free survival (DFS) or disease specifi c survival (DSS). As to co-expression with another member of the adhesion complex (β-catenin), high α-catenin/β-catenin MI index was of marginal signifi cance in predicting longer DSS (P = 0.063, log-rank). CONCLUSION: The results implicate that high α-catenin expression is intimately involved in the key regulatory mechanisms leading to invasive phenotype, lymph node metastases, and progressive disease in CRC.