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Climate change is expected to alter European floods and associated economic losses in various ways. Here we investigate the impact of precipitation change on European average winter and summer financial losses due to flooding under a 1.5 °C warming scenario (reflecting a projected climate in the year 2115 according to RCP2.6)and for a counterfactual current-climate scenario where the climate has evolved without anthropogenic influence (reflecting a climate corresponding to pre-industrial conditions). Climate scenarios were generated with the Community Atmospheric Model (CAM)version 5. For each scenario, we derive a set of weights that when applied to the current climate's precipitation results in a climatology that approximates that of the scenario. We apply the weights to annual losses from a well-calibrated (to the current climate)flood loss model that spans 50,000 years and re-compute the average annual loss to assess the impact of precipitation changes induced by anthropogenic climate change. The method relies on a large stochastic set of physically based flood model simulations and allows quick assessment of potential loss changes due to change in precipitation based on two statistics, namely total precipitation, and total precipitation of very wet days (defined here as the total precipitation of days above the 95th percentile of daily precipitation). We compute the statistics with the raw CAM precipitation and bias-corrected precipitation. Our results show that for both raw and bias-corrected statistics i)average flood loss in Europe generally tend to increase in winter and decrease in summer for the future scenario, and consistent with that change we also show that ii)average flood losses have increased (decreased)for winter (summer)from pre-industrial conditions to the current day. The magnitude of the change varies among scenarios and statistics chosen.

Climate change is expected to alter European floods and associated economic losses in various ways. Here we investigate the impact of precipitation change on European average winter and summer financial losses due to flooding under a 1.5 °C warming scenario (reflecting a projected climate in the year 2115 according to RCP2.6)and for a counterfactual current-climate scenario where the climate has evolved without anthropogenic influence (reflecting a climate corresponding to pre-industrial conditions). Climate scenarios were generated with the Community Atmospheric Model (CAM)version 5. For each scenario, we derive a set of weights that when applied to the current climate's precipitation results in a climatology that approximates that of the scenario. We apply the weights to annual losses from a well-calibrated (to the current climate)flood loss model that spans 50,000 years and re-compute the average annual loss to assess the impact of precipitation changes induced by anthropogenic climate change. The method relies on a large stochastic set of physically based flood model simulations and allows quick assessment of potential loss changes due to change in precipitation based on two statistics, namely total precipitation, and total precipitation of very wet days (defined here as the total precipitation of days above the 95th percentile of daily precipitation). We compute the statistics with the raw CAM precipitation and bias-corrected precipitation. Our results show that for both raw and bias-corrected statistics i)average flood loss in Europe generally tend to increase in winter and decrease in summer for the future scenario, and consistent with that change we also show that ii)average flood losses have increased (decreased)for winter (summer)from pre-industrial conditions to the current day. The magnitude of the change varies among scenarios and statistics chosen.

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Abstract: Objective: Endometrial hyperplasia without cytological atypia is commonly treated with progestins, but other treatment regimes may be available with equivalent efficacy and low side effects. Design: A randomized double-blind, placebo and progesterone-controlled clinical trial to evaluate the effects of genistein aglycone in reducing endometrial hyperplasia. Patients: A group of 56 premenopausal women with non-atypical endometrial hyperplasia were enrolled and received: genistein aglycone (n =19; 54mg/day); norethisterone acetate (n =19; 10mg/day on days 16–25 of the menstrual cycle) or placebo (n =18) for 6 months. Measurements: Hysteroscopy was performed with biopsies and symptomology assessed at baseline, 3 and 6 months of administration. The effect on estrogen (ER) and progesterone receptors (PR) expression in uterine biopsies were assessed after 3 and 6 months. For each treatment follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), sex hormone-binding globulin (SHBG) and progesterone (PG) levels were also evaluated. Results: After 6 months, 42% of genistein aglycone-administered subjects had a significant improvement of symptoms (histologically confirmed in the 29%) compared to 47% of norethisterone acetate subjects (histologically confirmed in the 31%), but only 12% in the placebo group with 19% exhibiting worsening symptoms and increased endometrial thickness. No significant differences were noted for hormone levels for any treatment, but immunohistochemical analysis revealed significantly reduced staining for ER-α and PR and enhanced ER-β1 staining in genistein-administered subjects associated with a complete regression of bleeding. Conclusions: These results suggest that genistein aglycone might be useful for the management of endometrial hyperplasia without atypia in women that cannot be treated with progestin. [ABSTRACT FROM AUTHOR]

Purpose: Testicular torsion is a medical emergency that requires immediate diagnosis and treatment to avoid subsequent testicular injury and infertility. PPARs are a family of nuclear hormone receptors belonging to the steroid receptor superfamily. Three PPAR isotypes (α, β/δ and γ) encoded by separate genes and showing different tissue distribution patterns have been identified. PPARβ/δ is expressed in testis and its role is largely unknown. We tested whether pharmacological activation of PPARβ/δ might protect the testis from ischemia and reperfusion injury. Materials and Methods: Adult male Sprague-Dawley rats were subjected to 1-hour testicular ischemia, followed by 24 hours of reperfusion. Sham testicular ischemia-reperfusion rats served as controls. The animals were randomized to receive immediately after detorsion 1) L-165,041 (4 mg/kg intraperitoneally), a potent agonist of PPARβ/δ, 2) GW9662 (Calbiochem®) (4 mg/kg intraperitoneally), an antagonist of PPAR, 3) L-165,041 (4 mg/kg intraperitoneally) plus GW9662 (4 mg/kg intraperitoneally) concomitantly or 4) vehicle (1 ml/kg 10% dimethyl sulfoxide/NaCl solution). We evaluated testicular extracellular signal regulated kinase, tumor necrosis factor-α and interleukin-6 by Western blot. We also investigated PPARβ/δ activation by Western blot, mRNA expression and organ damage. Results: Testicular ischemia-reperfusion injury caused a significant increase in extracellular signal regulated kinase, tumor necrosis factor-α and interleukin-6 expression in each testis. Furthermore, histological examination revealed marked damage. L-165,041 administration increased the PPARβ/δ message and protein, inhibited extracellular signal regulated kinase, tumor necrosis factor-α and interleukin-6 expression, and decreased histological damage. Concomitant administration of GW9662 reversed the protection exerted by PPARβ/δ agonist. Conclusions: These findings indicate that PPARβ/δ agonists might be an attractive therapeutic candidate for managing testicular torsion. [Copyright &y& Elsevier]

Purpose of Investigation: Retrospective evaluation of hysteroscopic findings in the accurate diagnosis of endometrial carcinoma., Methods: A retrospective monocentric study from January 1995 to December 2004. One hundred and four patients with hysteroscopic aspects evocative of endometrial carcinoma confirmed by endometrial biopsy during diagnostic hysteroscopy, by surgical hysteroscopic resection pieces or by hysterectomy specimen were included., Results: Among the 104 patients, diagnostic hysteroscopy pointed out endometrial features suggestive of endometrial carcinoma in 102 cases. In two women diagnostic hysteroscopy failed to diagnose endometrial malignancy which was identified on pieces of polyps by surgical hysteroscopic resection., Discussion: Polypoid proliferations cerebroid in appearance, with ulceration and necrosis, friable and with irregular vessels, represent endometrial findings highly indicative of malignancy. The diagnosis may be missed in cases of focal neoplasias, within endometrial polyps or in conditions of unsatisfactory endouterine visualization.

Vaginal submucosal nodules were observed in a 67-year-old woman, with ultrasonographic features of an advanced uterine neoplasm. On biopsy, light microscopy suggested that the lesions might be metastatic foci from an extragenital cancer, with a prevalent tubular growth pattern. Parallel immunohistochemical reactions revealed a diffuse, strong CA 19-9 positivity in both the cell membrane and cytoplasm. Subsequently, high serum levels of such tumor marker were also found, and an extragenital cancer was suspected of pancreatic or biliary origin. A mass in the gallbladder fossa was then detected by computed tomography and a primary gallbladder adenocarcinoma was confirmed on ultrasound-guided biopsy.

The aim of this study was to review the histology of the upper pole segment in patients with duplex ectopic ureterocele to verify if a less aggressive surgery is justified in the prenatally diagnosed patients. We reviewed the histology of the upper pole segment of 15 consecutive patients with duplex system ectopic ureterocele treated between 1991 and 1999 at the Paediatric Surgery Unit of University Hospital of Messina. The diagnosis of duplex system ectopic ureterocele was made according to the criteria of the Section on Urology of the American Academy of Paediatrics. The histology specimens were assessed for dysplastic, inflammatory and obstructive changes. All 15 patients with duplex system ectopic ureterocele were surgically treated with heminephro-ureterectomy and the surgical specimens were histologically examined. Nine of the 15 patients were prenatally diagnosed. The histology of the upper pole segment of the 9 prenatally diagnosed showed in all patients segmental renal microcystic dysplasia, chondroid metaplasic islands and an inflammatory tubulo-interstitial nephropathy in 6 patients (66.6%) and in 2 (22.2%) nephroblastomatosis. The histology of six the postnatal postnatally diagnosed patients showed in all patients segmental multicystic renal dysplasia, inflammatory tubulo-interstitial nephropathy and segmental parenchymal scars. The upper pole histology of the patients with duplex ectopic ureterocele diagnosed prenatally did not show any evidence of reversible histological change. Considering the histology and the good outcome of patients treated with upper pole nephroureterectomy a less aggressive surgery with preservation of the upper pole does not seem justified.

Objective: To examine the maturational-delay hypothesis of primary megaureter (PM), i.e. that the condition arises by a segmental maturational delay of the ureteric wall that can resolve spontaneously within the first year of life, using comparative immunocytochemistry of ureters resected from infants and from homologous pre-natal ureters., Materials and Methods: Seventeen distal urinary tracts were obtained from children with PM who were referred for surgery (aged 6 months to 8 years, mean 2.1 years). These were compared with ureteric buds obtained from 11-week-old human and 11- to 38-week-old calf fetuses. The samples were immunostained using a monoclonal antibody specific for transforming growth factor beta (TGF-beta)., Results: The histological appearances of the narrowed ureteric segments from patients under 18 months old were like the fetal ureteric buds at 26-38 weeks of gestation. Positive TGF-beta immunoreactions were detected in the longitudinal muscle layer in the ureter from patients 6-12 months old. Such reactions weakened progressively in those patients older than 1 year, becoming negative in all children older than 3 years. The TGF-beta immunolabelling in resected ureters was closely similar to that in fetal ureters from 20 to 26-week old calves., Conclusions: From these results, PM should be ascribed to a segmental developmental delay of the terminal ureter arising at about 20 weeks of gestation, with a possible pathogenetic involvement of autocrine TGF-beta overexpression.

Some cytochemical and immunocytochemical investigations were carried out on actively growing Yoshida ascites sarcoma cells. These cells displayed an intense granular alpha-naphthylacetate esterase (ANAE) staining while the alpha-naphthylbutyrate esterase (ANBE) reaction was in part fluoride-sensitive and marked particularly in the large-size malignant cells. Acid phosphatase as well as peroxidase activities were not detected. The lack of immunoreactive lysozyme and alpha 1-antitrypsin suggested a poor differentiation of the above-mentioned tumor cells, but fibronectin and S-100 protein where highly expressed, as in tumors arising from the mononuclear phagocyte system.

The effects of subcutaneous daily treatment with thyroxine on cell proliferation, differentiation, polyamines, and gamma-aminobutyric acid metabolism in the rat retina were studied during the first 20 postnatal days. The retinal layers of the treated rats displayed an enhanced cell differentiation which reached its maximum 9-12 days from birth; but this effect stopped very quickly and was finished by the 20th postnatal day. Primarily there was an increase in ornithine decarboxylase activity which was accompanied by an increase in putrescine, spermidine, and spermine levels. S-Adenosylmethionine decarboxylase was induced later than ODC; corresponding with the enhanced synaptogenesis, glutamate decarboxylase increased 15-fold between the fourth and 15th days. Our data are consistent with the hypothesis that thyroxine may exert some of its effects by inducing the enzymes which regulate polyamine metabolism and synaptogenesis.