The functional immunological consequences of thymic regeneration after castration were studied in adult male C57Bl/6 mice. Phenotypic profiles of thymocytes present in the enlarged thymuses of castrate animals demonstrated a significant decrease in the proportion of thymocytes positive for the suppressor/cytotoxic phenotype (CD4-CD8+; P = 0.005). Thymic enlargement in castrate animals was accompanied by increased capacity of thymocytes to incorporate thymidine in response to Concanavalin A in vitro. Spleens from castrate mice also were enlarged, and in vitro generation of functional suppressor cells by splenocytes from castrate animals was decreased. Testosterone replacement resulted in thymic regression, with a shift toward expression of mature thymocyte phenotypes, a decrease in the double-positive phenotype (CD4+CD8+), and a relative predominance of the CD4-CD8+ suppressor/cytotoxic phenotype over the CD4+CD8- helper phenotype. Unstimulated thymidine incorporation by thymocytes from androgen-treated animals was decreased compared to controls (P = 0.050). Spleen size was not altered by androgen administration. These findings suggest that in the adult animal, changes in androgen status effect alterations in thymocyte phenotypic profiles and thymocyte function, with removal of androgens shifting the T cell balance toward the CD4 helper subset and administration of androgens changing the balance toward CD8 suppressor/cytotoxic T cell predominance.

Background Human papillomavirus (HPV) testing as primary cervical cancer screening has not been studied in Caribbean women. We tested vaginal self-collection versus physician cervical sampling in a population of Haitian women. Methods Participants were screened for high-risk HPV with self-performed vaginal and clinician-collected cervical samples using Hybrid Capture 2 assays (Qiagen, Gaithersburg, Maryland). Women positive by either method then underwent colposcopy with biopsy of all visible lesions. Sensitivity and positive predictive value were calculated for each sample method compared to biopsy results, with kappa statistics performed for agreement. McNemar’s tests were performed for differences in sensitivity at ≥ cervical intraepithelial neoplasia (CIN)-I and ≥ CIN-II. Results Of 1845 women screened, 446 (24.3%) were HPV-positive by either method, including 105 (5.7%) only by vaginal swab and 53 (2.9%) only by cervical swab. Vaginal and cervical samples were 91.4% concordant (κ= 0.73 [95% CI: 0.69 – 0.77], p < 0.001). Overall, 133 HPV-positive women (29.9%) had CIN-I, while 32 (7.2%) had ≥ CIN-II. The sensitivity of vaginal swabs was similar to cervical swabs for detecting ≥ CIN-I (89.1% vs 87.9%, respectively, p=0.75) lesions and ≥ CIN-II disease (87.5% vs 96.9%, p=0.18). Eighteen of 19 cases of CIN-III and invasive cancer were found by both methods. Conclusions HPV screening via self-collected vaginal swabs or physician-collected cervical swabs are feasible options in this Haitian population. The agreement between cervical and vaginal samples was high, suggesting vaginal sample-only algorithms for screening could be effective for improving screening rates in this under-screened population.

The risk of isolated local recurrence in patients with T3pN0 breast cancer and negative margins is moderately low and similar to T2pN0 patients. These results suggest that routine use of postoperative chest wall and nodal irradiation in all T3pN0 patients may not be required.

Telomerase activity level was associated with the proliferative index of invasive breast cancers, but its measurement in samples from this group of nonmetastatic breast cancer patients did not predict survival.

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Introduction: Homeotic (HOX) gene products are now known to be functionally associated with breast cancer biogenesis. Recent evidence has indicated that HOXA5 regulates both p53 and progesterone receptor expression levels in breast cancer cells. In addition, HOXA5 has been shown to interact and regulate the activity of another protein referred to as Twist. As homeotic genes play a pivotal role in development, we sought to decipher the expression pattern in both normal breast tissues and in breast carcinomas. Methods: RT-PCR and immunohistochemistry were performed, to assay the levels of HOXA5 expression, on a panel of normal breast tissue and its corresponding primary breast tumors. Results and Conclusions: We show that HOXA5 expression was maintained at stable levels at different reproductive stages of a woman's life, except during lactation. This evidence indicates that HOXA5 may play a role in maintaining the differentiated state within the breast epithelium. However, nearly 70% of all breast carcinomas had decreased HOXA5 protein levels as compared to normal breast tissues. In addition, we demonstrate that HOXA5 protein expression levels in breast carcinomas inversely co-relates with Epidermal Growth Factor Receptor (EGFR) expression. Furthermore, we found that the survival rate amongst the different low levels of HOXA5 expressing breast tumors was not significant, indicative of an early tumorigenesis process in the absence of innate levels of HOXA5 in normal breast cells.

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Surgical management of cervical carcinoma by radical hysterectomy has been proven a highly effective method in treating early-stage disease. The purpose of this study was to evaluate the efficacy and safety of radical hysterectomy for the treatment of early-stage (I-IIA) cervical carcinoma at our institution. A retrospective analysis of data on 40 patients with cervical cancer undergoing radical hysterectomy over an 8-year period (1994-2002) was performed. The mean age of the patients was 41.5 years. The most common histology was squamous cell carcinoma (67.5%). Adenocarcinoma comprised 17.5% of cases and adenosquamous cancers 15% of cases. The mean blood loss was 442 mL. The average operating time was 3 hours and 36 minutes. The average duration of hospital stay was 6 days. Metastatic carcinoma to the regional lymph nodes was found in 15% of the cases. Overall survival was 92.5%. There were no operative mortalities or fistulae. With proper patient selection and excellent operative technique, survival rates of well over 90%, with minimal complication can be obtained (J GYNECOL SURG 19:129)