Micropapillary urothelial carcinoma is a high-grade carcinoma in which the prognosis is related to the proportion and location of the MPC. Cases with moderate or extensive MPC are at high risk of being advanced at presentation. Cases with <10% MPC and surface MPC have a high chance of detection at an early stage. The morphology and immunohistochemical profile of the MPC suggest that it is a form of glandular differentiation in urothelial carcinoma.

Objectives To test the hypothesis that birth weight for gestational age and weight gain in early childhood have a long term association with psychological distress in adults. Design Longitudinal study of 1958 birth cohort followed to age 42 years. Setting Population based birth cohort study. Participants 9731 cohort members with valid perinatal, postnatal, and adult data. Main outcome measures Malaise inventory scores measured at ages 23, 33, and 42 years. Generalised estimating equations approach used to analyse repeated measures. Results Psychological distress score was inversely related to birthweight z score and weight gain from birth to the age of 7 years. A unit increase in birthweight z score or childhood weight gain was associated with a mean reduction in psychological distress score of 0.10 (95% confidence interval 0.05 to 0.15) and 0.06 (0.02 to 0.10), respectively. Birth weight and weight gain were also inversely related to the odds of having a high level of psychological distress, with odds ratios being 0.90 (0.85 to 0.95) and 0.93 (0.89 to 0.98), respectively. Conclusions Psychological health in adults is related to fetal growth and growth in early childhood.

The combination of paclitaxel and carboplatin is an active regimen in NPC. Its convenience of administration and good tolerability make it an attractive alternative regimen to consider for patients with metastatic disease.

Although the evidence is not completely consistent, soy intake has been inversely associated with breast cancer risk, and the strongest results have been observed in certain Asian populations. To address this issue and to examine the association between mammographic density and reproductive factors in this population, we conducted a cross-sectional analysis of mammograms and validated food-frequency questionnaires from 380 Chinese women living in Singapore. Percent mammographic density, a biomarker for breast cancer risk, was assessed using a validated computer-assisted method. We used generalized linear models to estimate mean mammographic density by quartiles of soy intake and intake of other dietary factors while adjusting for potential confounders. Percent mammographic density was inversely associated with age, body mass index, parity, breastfeeding, and soy intake. The difference in mammographic density between the highest and lowest quartiles of soy intake was 4-5%; this difference was statistically significant for soy protein and soy isoflavone intake and is similar in magnitude to what has been reported in Western populations when women undergo menopause or commence hormone therapy. We found no evidence that high fiber, fruit, or vegetable intake has protective effects on mammographic density. Our results suggest that the effect of soy intake on percent mammographic density is moderate but possibly of clinical relevance.

This study addresses the contributions of speci®c retinoid receptors during all-trans-retinoic acid (RA)-mediated dierentiation and growth suppression of human embryonal carcinoma cells. The pleiotropic eects of RA are mediated by retinoic acid receptors (RARs) and retinoid X receptors (RXRs), members of the nuclear receptor family of transcription factors. After RA-treatment the multipotent human embryonal carcinoma cell line NTERA-2 clone D1 (NT2/D1) displays limited proliferative potential, reduced tumorigenicity, and morphologic and immunophenotypic neuronal maturation. RARg over-expression in NT2/D1 cells signals mesenchymal NT2/D1 terminal dierentiation while RARa and RARb do not and RARg overcomes retinoid resistance in an NT2/D1 clone (NT2/D1-R1) having deregulated RARg expression. Since RARg transfectants do not display neuronal maturation, this study sought to identify cooperating retinoid receptors engaged in NT2/D1 dierentiation. Through gain of function experiments, this report highlights RXRb as playing an important role along with RARg in signaling dierentiation of NT2/D1 cells. Stable over-expression of RXRb, but not RXRa or RXRg, was found to signal NT2/D1 growth suppression and to induce a non-neuronal morphology and immunophenotype. Notably, co-transfection of RARg and RXRb resulted in marked growth suppression and for the ®rst time, expression of typical neuronal markers of NT2/D1 dierentiation. To clarify the role of RXRb and RARg in this dierentiation program, a modi®ed transient ®broblast growth factor-4 (FGF4) promoter-enhancer reporter assay that re¯ects eective RA-mediated dierentiation of NT2/D1 cells was employed. Transfection of RARg or RXRb in NT2/D1 cells augments transcriptional repression of the FGF4 reporter and RARg and RXRb co-transfection markedly repressed reporter activity, indicating the combined role of these receptors in RA-induced NT2/D1 dierentiation. Taken together, these ®ndings reveal speci®c retinoid receptors must cooperate to signal terminal growth suppression and maturation of NT2/D1 cells. Since the transcriptional repression of FGF4 is coupled to the eective maturation of human embryonal carcinoma cells, the described co-transfection strategy should prove useful to identify genes with positive or negative eects on the dierentiation program of these tumor cells.