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Background:. Nipple-sparing mastectomy (NSM) preserves the natural nipple–areola complex and entire native breast skin, with the goal of better cosmetic outcomes in breast reconstruction. In bilateral TE/implant-based reconstruction requiring unilateral postmastectomy radiotherapy (PMRT), progressive radiation-induced fibrosis can lead to increasing nipple asymmetry with cosmetic dissatisfaction. Thus, PMRT may ultimately negate the intended positive cosmetic value of NSM compared with skin-sparing mastectomy (SSM). This study compares (1) surgical complications, (2) patient satisfaction, and (3) aesthetic outcomes between NSM versus SSM in bilateral implant-based reconstruction with unilateral PMRT. Methods:. This retrospective matched cohort study included consecutive NSM patients with bilateral TE/implant breast reconstruction + unilateral PMRT matched 1:2 to SSM group. Patients completed PMRT and TE exchange to implants. Demographics, oncologic stage, comorbidities, and complications were collected. Patient satisfaction was evaluated by BREAST-Q. Aesthetic outcomes were assessed by blinded reviewers with a five-point Likert scale. Results:. Among 58 patients who underwent bilateral TE/implant reconstruction with unilateral PMRT, 17 NSM patients were matched to 41 SSM patients by age, body mass index, and comorbidities. No significant differences existed in overall surgical complications and individual BREAST-Q questionnaire scores between cohorts. However, aesthetic outcomes scores were higher in SSM compared with NSM. Conclusions:. Although NSM is generally associated with superior cosmetic outcomes compared with SSM, it has far less impact in bilateral implant-based breast reconstruction with unilateral PMRT due to the negative postradiotherapy effect on nipple symmetry.

Aims: To assess the potential value of chromosome in situ hybridisation (CISH), Ki-67, and telomerase immunocytochemistry in liquid based cervical cytology to help detect carcinoma cells and precursors., Method: Sixty ThinPrep processed cervical cytology samples were studied: 23 cases within the normal limit, 13 low grade squamous intraepithelial lesions (LSILs), 10 high grade squamous intraepithelial lesions (HSILs), six squamous cell carcinomas, three endocervical adenocarcinomas, two cervical adenosquamous cell carcinomas, and three endometrial adenocarcinomas. CISH was performed with DNA probes specific for the pericentromeric regions of chromosome 11 and 16. Hybridisation signals were visualised with the streptavidin-biotin peroxidase technique. The monoclonal MIB1 and polyclonal TRT-H231 antibodies were used to detect Ki-67 and telomerase immunoreactivity, respectively., Results: Non-specific background staining was almost absent in CISH slides. Normal squamous and glandular cells showed a diploid chromosomal pattern. A relative gain in chromosomes 11 and 16 (aneusomy) was seen in HSIL and the carcinomas (p<0.0001). In MIB1 stained smears, normal cells and koilocytes showed inconspicuous immunoreactivity, whereas strongly immunoreactive nuclei were found in cancer cells and HSIL (p<0.0001). Not only carcinoma and HSIL cells, but also some normal cells, showed cytoplasmic staining for telomerase., Conclusions: These preliminary results indicate that ThinPrep processed cervical smears are suitable for CISH and immunocytochemical studies. The neoplastic squamous and glandular cells were easily identified based on nuclear aneusomy and strong Ki-67 immuoreactivity in the context of abnormal nuclear morphology. This is the first study to apply CISH in cervical cytology using an immunoenzymatic approach.

Objective: To assess the expression of messenger RNA (mRNA) for estrogen receptors alpha and beta in the vaginal walls and uterosacral ligaments of premenopausal and postmenopausal women., Design: In vitro experiment., Setting: Academic research environment., Patient(s): Sixteen consecutively seen women who underwent hysterectomy., Intervention(s): Samples of anterior vaginal walls and uterosacral ligaments were obtained during hysterectomy., Main Outcome Measure(s): Reverse transcriptase-polymerase chain reaction analysis for estrogen receptor mRNA., Result(s): Messenger RNA transcripts for estrogen receptor alpha were present in all samples of vaginal walls (16/16) and uterosacral ligaments (16/16). Estrogen receptor beta mRNA was detected in all samples of vaginal walls from premenopausal women (12/12) but in none of those from postmenopausal women (0/4). Estrogen receptor beta mRNA was found in most samples of uterosacral ligaments from premenopausal women (10/12) and in some of those from postmenopausal women (2/4)., Conclusion(s): Estrogen receptors alpha and beta were expressed in the vaginal walls and uterosacral ligaments of premenopausal and postmenopausal women. Estrogen receptor beta was absent from the vaginal walls of postmenopausal women.

Objective: Immature mammalian oocytes cultured in vitro undergo inadequate cytoplasmic maturation and hence have a limited potential for fertilization. Our primary objective was to determine if the addition of epidermal growth factor (EGF) to the in vitro culture system would have a positive effect on oocyte cytoplasmic maturation., Design: We studied the effect of different EGF concentrations on both denuded and cumulus-enclosed mouse oocytes cultured in vitro., Main Outcome Measures: The percentage of oocytes undergoing germinal vesicle breakdown (GVBD) and polar body one formation over time as a function of EGF concentration was determined., Results: A dose-related positive effect of EGF on both GVBD and polar body one formation over time was observed for mouse oocytes. As well, a similar effect of EGF was seen on immature human oocytes that had not been stimulated with exogenous gonadotropins., Conclusions: The use of EGF may allow for the performance of successful in vitro fertilization procedures using immature human oocytes retrieved during unstimulated cycles.

CAMA-1 cells, isolated from malignant pleural effusion, are grown in long-term cultures as monolayers. The rate of growth is dependent upon fetal bovine serum and estradiol. These cells also exhibit a dose response to added 17 beta-estradiol with respect to the incorporation of radiolabeled thymidine into cells. The uptake is increased at low levels of estradiol and decreased at pharmacological levels of estradiol. The uptake of uridine and leucine is also stimulated by estradiol in a dose-related manner. Induction of precursor uptake is not observable until cells have been exposed to estradiol for approximately 10 hr or longer. Cells plated for different periods in steroid-stripped serum remain sensitive to estrogenic stimulation and show similar lag time in response. Estrogenic effect is not noticeable in the absence of serum. Addition of prolactin can partially restore estrogenic stimulation of thymidine uptake in serum-free medium. Like other estrogen target tissues, these cells contain cytoplasmic and nuclear estrogen receptors. These results demonstrate that the CAMA-1 cell line is estrogen dependent and that these cells may provide a promising model for the in vitro investigation of the mode of estrogen action in human breast cancer.

Hormonal influences on dimethylbenz(a)anthracene-induced tumor growth were investigated in detail by endocrine ablation and replacement of hormones. The majority of tumors regressed following ablation and most of them were reactivated by subsequent administrations of estrogen (0.1 to 5 mug) or prolactin (2 mg). Increasing numbers of tumors, however, were not stimulated by prolactin when administration was delayed, and a basal level of estradiol (0.01 mug) in addition to prolactin was required for reactivation of tumors. Nafoxidine hydrochloride, a competitor of estrogen at the receptor sites, arrested growth of a large portion of dimethylbenz(a)anthracene-induced tumors in intact animals but failed to retard growth of prolactin-stimulated tumors. On withdrawal of prolactin-nafoxidine, rapid regression of tumor occurred and readministration of prolactin failed to activate most of the tumors for as long as 28 days. Our results give good supporting evidence that estrogen plays a primary role in tumor growth. The interactions of prolactin and estrogen at tumor sites are necessary for regulatory events related to tumor growth.

The cytoplasmic content of estrogen and progesterone receptors (ERc and PRc) was measured in the rat uterine and mammary tissues during the period from late pregnancy through lactation. Uterine ERc and PRc, which sedimented at the 8S and 4S regions, respectively, of a 5-20% sucrose gradient, showed similar rise and decline patterns before and after parturition. Following a decline from the 15th day (114 +/- 13.7 fmol/mg protein) to the 20th day of pregnancy (57.7 +/- 10.2 fmol/mg protein), ERc levels increased almost 2.5-fold at the time of parturition. A decrease to the predelivery level by 24 h post-delivery was followed by a steady increase to 270.6 +/- 46 fmol/mg protein by 15 days of lactation. Uterine PRc levels also showed a peak similar to that of ERc at the time of parturition (24.3 +/- 1.1 fmol/mg protein). The level of ERc in mammary gland 6 h postpartum was the lowest (1.5 +/- 0.3 fmol/mg protein) and during the first 10 days of lactation ERc levels were maintained at about 10 fmol per mg of cytosol protein. Results herein suggest that levels of these steroid receptors may be hormonally regulated and that the uterus and mammary gland may have a different sensitivity to these regulatory control mechanisms. The physiological significance in the variation of these receptors in conjunction with the onset of parturition is discussed.

The phospholipids from subcellular fractions of human intracranial tumors were examined. For comparison, microsomes were isolated from a fetal human brain and from the gray matter of adult human brains. The subcellular membranes of tumors had a higher protein-to-phospholipid ratio than the normal brain membranes. The microsomes from tumors had a lower proportion of diacylglycerophosphorylethanolamine and higher proportions of alkenylacylglycerophosphorylcholine and sphingomyelin (plus diacylglycerophosphorylinositol) than microsomes from the gray matter. Also, the ratios of alkenylacylglycerophosphorylethanolamine to diacylglycerophosphorylethanolamine were higher in the tumors than in the normal controls. The acyl groups of ethanolamine phosphoglycerides in tumor microsomes had relatively more 18:1, 18:2, and 20:4(n - 6) and less 18:0, 22:4(n - 6), and 22:6(n - 3) than the adult brain gray matter. Except for the increase in 18:2, acyl group changes in choline phosphoglycerides between tumors and controls were not as extensive as in the ethanolamine phosphoglycerides. The characteristic features of phospholipids and their constituent acyl groups of tumors were often present in all the subcellular fractions. Although the acyl group profiles of the tumor phosphoglycerides were in closer resemblance to the fetal brain than to the adult brain, other differences were observed. Results indicate that neoplastic brain cells are unique in their cellular composition, and consequently they deviate from the normal neurons and glials in metabolism and functions.

Cytosolic progesterone receptors (PRcs) from the reproductive tract of the female turkey were analyzed by high-performance liquid chromatography using a diethylaminoethyl (DEAE) ion-exchange column. PRcs from oviduct tissue of laying, incubating, photorefractory and short-day turkey hens were compared. In general, three types of PRcs were identified: Receptor I, a partially displaceable species that was eluted at a 0.13 M salt concentration; and Receptors II and III, which were two specific binding species eluting at 0.23 M and 0.26 M, respectively. In the subdivided tissue from the laying hen oviduct, Receptor I was the major PRc species of the isthmus and Receptor III was the only receptor present in the uterus. The infundibulum and magnum each contained a small amount of Receptor II and a substantial amount of Receptor III. The whole oviduct of incubating hens contained a greater proportion of Receptor I than Receptor II or III, and these last two receptor types were present in equal quantity. The whole oviduct of the short-day hens had an equal distribution of the three receptor types. In the presence of sodium molybdate, an inhibitor of phosphatase and protease, only one sharp Receptor II species was seen in the magnum and uterus of the laying hen oviduct and in the whole oviducts of incubating and short-day hens. The transformation of Receptor II to Receptor III in the absence of sodium molybdate was facilitated by the aging of cytosol at 0-4 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS)

Two sublines, CAMA-1R and CAMA-1N, were derived from the original CAMA-1 cells after continuous passages in our laboratory. 1R cells were supplemented in culture with estradiol and retained the properties of the original cell line, whereas 1N cells, not supplemented with estradiol, had a partial loss of estrogenic responsiveness. The doubling times for 1R and 1N cells were 2 and 2.4, respectively. These two sublines showed different effects on thymidine uptake after estradiol stimulation. Cells of 1R had a 2-fold greater thymidine incorporation than did the control without estradiol. In contrast, no difference of thymidine uptake was demonstrated in cells of 1N in the presence or absence of estradiol. Both cell lines contained cytoplasmic progesterone receptors with a Kd of 0.56 nM and a sedimentation coefficient of 6 to 7S on a 5 to 20% sucrose gradient. The progesterone receptor level in 1N was about 8-fold higher than in 1R cells. Both sublines exhibited a dose-dependent increase in progesterone receptor levels in response to estradiol with the maximal stimulation (8-fold increase) reached by using 5 nmol of estradiol. The rate of increase for estradiol-induced progesterone receptor appears to be the same for both sublines; a liner increase was demonstrated between Days 3 and 7 following plating. Our results show that estrogen regulation of thymidine uptake and progesterone receptor induction may be mediated through two separate mechanisms. Thus, following a chronically deficient supply of estradiol to 1N cells, there is apparent loss of responsiveness to estradiol-induced thymidine uptake, but the ability of these cells to respond to estradiol induction of progesterone receptor was retained.

The ability of L-dopa to arrest pain can be used to predict objective response of skeletal disease to endocrine ablation or additive therapy. In the present study, 43 patients with painful skeletal metastases were evaluated for the relief of pain by L-dopa, given 250 mg to 500 mg orally every 4 hours for 4 days. Sixteen of the 25 responders to L-dopa had objective response to either previous or later hormonal therapy while all the 18 non-responders did not benefit from endocrine ablation. The results of L-dopa responses also correlated well to the presence of absence of cytoplasmic ER in tumor. These results demonstrate that both tests (L-dopa and ER) are reliable indicators, one complimenting the other, in prognosticating response to endocrine therapy and should be used prior to hormone treatment. Alternative therapy should be considered for patients who are non-responders to the L-dopa test and/or whose tumors contain negligible ER. The long term therapeutic value of L-Dopa, however, is limited.