Left atrium diameter (LAD) is a very simple and easy parameter to obtain by echocardiography. It is influenced by systolic and diastolic ventricular dysfunction and by the coexistence of mitral ...regurgitation. We evaluated LAD as a predictor of prognosis (2 year mortality) in a heart failure (HF) population admitted to an outpatient HF unit. We compared LAD (mm/m2) with other echocardiographic parameters (left ventricular ejection fraction, left ventricular end-diastolic and end-systolic diameters mm/m2, mitral regurgitation, degree of diastolic dysfunction and pulmonary artery pressure).
We studied 368 patients (73% men; mean age standard deviation: 65.2 11 years; 60% of ischemic etiology). The mean left ventricular ejection fraction by echocardiography was 32.3% (13.1%). The majority of patients were in NYHA (New York Heart Association) class II (48%) or III (43%).
Two years mortality was 20.6%. In the univariate analysis LAD (p < 0.001), left ventricular end-diastolic diameter (p < 0.001), left ventricular end-systolic diameter (p = 0.003), the degree of mitral regurgitation (p = 0.002) and the pattern of diastolic dysfunction (p = 0.004) showed a significant relationship with 2 years mortality, but not left ventricular ejection fraction and pulmonary pressure. In the echocardiographic multivariate analysis, only LAD remained significantly associated with mortality. In the multivariate analysis including important clinical parameters such as age, sex, etiology, time lapsed since symptoms onset, NYHA functional class, and the presence of diabetes, hypertension and atrial fibrillation, LAD remained as independent predictor of 2 years mortality. Patients with LAD less than 25 mm/m2 have a 10.9% mortality, whereas those with LAD equal or greater than 25 mm/m2 have a 30.1% mortality (p < 0.001).
LAD was a good predictor of 2 years mortality, better than other echocardiographic parameters in patients of our outpatient HF unit and was independent of strong clinical parameters.
Cryptorchidism is a frequent male sexual disorder in mammals, which affects the histology of the tunica propria, interstitial tissue, blood vessels, seminiferous epithelium and testis functioning. In ...this paper, proliferation and apoptosis were examined in the seminiferous epithelium of both testes from unaffected boars and from boars suffering unilateral and bilateral cryptorchidism. In germ cells, proliferation was studied using the immunohistochemical PCNA technique, and apoptosis was analysed by in situ TUNEL labelling. An index was obtained for the proliferation and apoptosis observed in seminiferous tubules. In abdominal testes the epithelium contained few spermatogonia and Sertoli cells. In the testes of unaffected boars, numerous spermatogonia proliferated, whereas in cryptorchid testes such proliferation was lower and the proliferation/apoptosis ratio diminished. In the unaffected group, the TUNEL-positive germ cells were spermatogonia and spermatocytes in different phases of meiosis. In abdominal testes, the TUNEL-positive germ cells were spermatogonia alone. The apoptosis index of both abdominal and scrotal testes was similar. In conclusion, spontaneous cryptorchid testes showed a lower rate of spermatogonia proliferation in the seminiferous epithelium.
Renal cell carcinoma (RCC) is a kidney neoplasm that accounts for 85% of cases and has complex genetic pathways that affect its development and progression. RCC metastasis can occur in 20%-50% of ...patients and usually affects distant organs. Gastric metastases (GM) from RCC are rare and present as polyp-like growths in the submucosal layer, accounting for 0.2%-0.7% of cases. This case report describes an 84-year-old female with Furhman grade II ccRCC who presented with an atherothrombotic ischemic stroke and gastrointestinal bleeding nine years post-radical nephrectomy. Gastroscopy revealed a 12mm pseudopedicled gastric lesion with ulceration and bleeding, diagnosed as metastatic ccRCC. The discussion focuses on the rarity, diagnostic challenges, and prognostic elements of gastric metastasis from RCC. The median survival after detecting digestive metastasis varies widely, and the mechanisms include direct invasion and dissemination through lymphatic, transcelomic, or hematogenous routes. Prognostic markers encompass patient history, symptoms, time since RCC diagnosis, overall health, and genetic factors. Surgical removal of gastric lesions and targeted therapy are treatment options that can improve survival. This case report highlights the need for further research to enhance diagnostic and treatment strategies for this rare aspect of RCC pathophysiology.
In a recent paper Ariño et al., Plant Mol Biol 21: 475-485 (1993) we reported the amplification of a DNA fragment (AP-2) from the genome of Arabidopsis thaliana encoding an amino acid sequence ...corresponding to a Ser/Thr protein phosphatase distantly related to type 2A protein phosphatases. In this paper we report the use of the AP-2 fragment to isolate several cDNA clones from a leaf cDNA library. Two of these (EP124 and EP129) largely overlap and contain the AP-2 sequence, whereas a third clone (EP128) is different although very related in sequence (86% of identity). Clones EP124/EP129 and EP128 were found to encode two highly related polypeptides (93% identity) of 305 residues, showing a very high identity (83%) to the catalytic subunit of protein phosphatase X (PPX) from rabbit. Therefore, they have been named PPX-1 (EP124/EP129) and PPX-2 (EP128). Southern blot analysis of genomic DNA indicates that only these two genes encoding phosphatases closely related to PPX are present in the genome of A. thaliana. Both PPX-1 and PPX-2 are expressed at very low levels in A. thaliana flowers, leaves, stems and roots. The expression levels of four previously identified type 2A phosphatases are higher than those of PPX genes. PP2A-1 appears to be the major mRNA species detected in all the tissues analyzed.
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