A retrospective analysis was performed in order to evaluate prognostic factors and treatment-rela... more A retrospective analysis was performed in order to evaluate prognostic factors and treatment-related outcome in patients with uterine papillary serous carcinoma (UPSC). Between 1989 and 2003 forty-five patients with UPSC were treated at the McGill University Health Centre (MUHC), and therefore were included in the analysis. Age, race, history, tumor stage and grade, invasion and metastasis, treatment and outcome for each patient were evaluated. According to FIGO classification, Stage I, II, III, and IV tumors were identified in 36%, 9%, 44%, and 11% of the patients, respectively. At the time of analysis, 37.8% of patients (17/45) were dead due to disease, with a mean survival of 22 months (SD +/- 7.5 months). Cause-specific survival for the entire group was 69%, 66%, and 58% at 2, 3, and 5 years, respectively. With respect to disease stage, 5-year cause-specific survival for stage I, II, III, and IV was 100%, 75%, 43%, and 0%, respectively. Univariate analysis comparing cause-specif...
Arbuscular mycorrhizal (AM) fungi are important plant mutualists that can connect roots of neighb... more Arbuscular mycorrhizal (AM) fungi are important plant mutualists that can connect roots of neighboring plants to form common mycelial networks. A recent study demonstrated that these networks can act as conduits for aphid-induced signals between plants, activating chemical defenses in uninfested neighboring plants so that they become unattractive to aphids but attractive to their enemies (parasitoids). The benefit to the neighboring plants will increase if the signal speed is rapid, enabling them to respond before aphids attack. Here, we determine the speed of aphid-induced signal transfer between plants infested with aphids ("donor") and neighboring aphid-free plants that were either connected or unconnected to the donor via a common mycelial network. Induced changes in plant volatiles from neighbors connected to donors started within 24 h of aphid infestation of donors. This demonstrates a rapid signal, implying potential benefit to plants receiving the signal, and raises intriguing ecological and evolutionary questions.
Arbuscular mycorrhizal (AM) fungi, important plant mutualists, provide plants with nutrients such... more Arbuscular mycorrhizal (AM) fungi, important plant mutualists, provide plants with nutrients such as phosphorus (P) in return for carbon. AM fungi also enhance the attractiveness of plants to aphids via effects on emissions of plant volatiles used in aphid host location. We tested whether increased P uptake by plants is the mechanism through which AM fungi alter the volatile profile of plants and aphid behavioural responses by manipulating the availability of P and AM fungi to broad beans (Vicia faba L.) in a multi-factorial design. If AM fungi affect plant volatiles only via increased P acquisition, we predicted that the emission of volatiles and the attractiveness of mycorrhizal beans to aphids would be similar to those of non-mycorrhizal beans supplied with additional P. AM fungi and P addition increased leaf P concentrations by 40 and 24%, respectively. The production of naphthalene was less in mycorrhizal plants, regardless of P addition. By contrast, production of (S)-linalool...
BACKGROUND: We report a novel fertility preservation strategy that may be useful for young breast... more BACKGROUND: We report a novel fertility preservation strategy that may be useful for young breast cancer patients who present with time constraints or concerns about the effect of ovarian stimulation.
Objective: This pilot study aimed to provide supportive evidence for the acceptability and useful... more Objective: This pilot study aimed to provide supportive evidence for the acceptability and usefulness of the Meaning-Making intervention (MMi) in patients newly diagnosed with Stage III or IV ovarian cancer, and to provide estimates of parameters needed to design a full-scale study.
Proceedings of the Royal Society B: Biological Sciences, 2012
Mothers can non-genetically influence offspring phenotype in response to environmental conditions... more Mothers can non-genetically influence offspring phenotype in response to environmental conditions, including mate attractiveness. If such 'maternal effects' influence the offspring's reproduction and F2 generation, there is a mechanism for non-genetic trans-generational effects on phenotype, including epigenetic phenomena, with implications for evolution and population dynamics. We demonstrate in the zebra finch Taeniopygia guttata such non-genetic effects on offspring fecundity and the size of early stage F2 (eggs) in response to experimentally manipulated father's attractiveness. Our experimental design allowed us to deduce that the mechanism for this non-genetic paternal effect was via maternal investment in eggs. This affected female offspring size and, consequently, fecundity and F2 (egg) size. This demonstrates that female perception of mate attractiveness can have non-genetic, trans-generational fitness consequences and this may have important implications for the evolution of sexually selected traits and population dynamics.
Lyme borreliosis (LB) is the most common arthropod-borne disease of humans in the Northern hemisp... more Lyme borreliosis (LB) is the most common arthropod-borne disease of humans in the Northern hemisphere. In Europe, the causative agent, Borrelia burgdorferi sensu lato complex, is principally vectored by Ixodes ricinus ticks. The aim of this study was to identify environmental factors influencing questing I. ricinus nymph abundance and B. burgdorferi s.l. infection in questing nymphs using a large-scale survey across Scotland. Ticks, host dung and vegetation were surveyed at 25 woodland sites, and climatic variables from a Geographical Information System (GIS) were extracted for each site. A total of 2397 10 m 2 transect surveys were conducted and 13 250 I. ricinus nymphs counted. Questing nymphs were assayed for B. burgdorferi s.l. and the average infection prevalence was 5·6% (range 0·8-13·9%). More questing nymphs and higher incidence of B. burgdorferi s.l. infection were found in areas with higher deer abundance and in mixed/deciduous compared to coniferous forests, as well as weaker correlations with season, altitude, rainfall and ground vegetation. No correlation was found between nymph abundance and infection prevalence within the ranges encountered. An understanding of the environmental conditions associated with tick abundance and pathogen prevalence may be used to reduce risk of exposure and to predict future pathogen prevalence and distributions under environmental changes.
The Trivers-Willard hypothesis predicts sex biases in parental investment according to parental c... more The Trivers-Willard hypothesis predicts sex biases in parental investment according to parental condition. In addition, parents may need to sex bias their investment if there is an asymmetry between the sexes in offspring fitness under different conditions. For studying maternal differential investment, egg resources are ideal subjects because they are self contained and allocated unequivocally by the female. Recent studies show that yolk androgens can be beneficial to offspring, so here we test for sex-biased investment with maternal investment of yolk testosterone (T) in zebra finch (Taeniopygia guttata) eggs. From the Trivers-Willard hypothesis, we predicted females to invest more in male eggs in optimum circumstances (e.g. good-condition mother, early-laid egg), and more in female eggs under suboptimal conditions (e.g. poor-condition mother, late-laid egg). This latter prediction is also because in this species there is a female nestling disadvantage in poor conditions and we expected mothers to help compensate for this in female eggs. Indeed, we found more yolk T in female than male eggs. Moreover, in accordance with our predictions, yolk T in male eggs increased with maternal quality relative to female eggs, and decreased with laying order relative to female eggs. This supports our predictions for the different needs and value of male and female offspring in zebra finches. Our results support the idea that females may use yolk androgens as a tool to adaptively manipulate the inequalities between different nestlings.
1. Ecological count data typically exhibit complexities such as overdispersion and zero-inflation... more 1. Ecological count data typically exhibit complexities such as overdispersion and zero-inflation, and are often weakly associated with a relatively large number of correlated covariates. The use of an appropriate statistical model for inference is therefore essential. A common selection criteria for choosing between nested models is the likelihood ratio test (LRT). Widely used alternatives to the LRT are based on information-theoretic metrics such as the Akaike Information Criterion. 2. It is widely believed that the LRT can only be used to compare the performance of nested models -i.e. in situations where one model is a special case of another. There are many situations in which it is important to compare non-nested models, so, if true, this would be a substantial drawback of using LRTs for model comparison. In reality, however, it is actually possible to use the LRT for comparing both nested and non-nested models. This fact is well-established in the statistical literature, but not widely used in ecological studies. 3. The main obstacle to the use of the LRT with non-nested models has, until relatively recently, been the fact that it is difficult to explicitly write down a formula for the distribution of the LRT statistic under the null hypothesis that one of the models is true. With modern computing power it is possible to overcome this difficulty by using a simulation-based approach. 4. To demonstrate the practical application of the LRT to both nested and non-nested model comparisons, a case study involving data on questing tick (Ixodes ricinus) abundance is presented. These data contain complexities typical in ecological analyses, such as zero-inflation and overdispersion, for which comparison between models of differing structure -e.g. non-nested models -is of particular importance. 5. Choosing between competing statistical models is an essential part of any applied ecological analysis. The LRT is a standard statistical test for comparing nested models. By use of simulation the LRT can also be used in an analogous fashion to compare non-nested models, thereby providing a unified approach for model comparison within the null hypothesis testing paradigm. A simple practical guide is provided in how to apply this approach to the key models required in the analyses of count data.
The objective of this study was to provide evidence that the transformation of DHEA into both and... more The objective of this study was to provide evidence that the transformation of DHEA into both androgens and/or estrogens locally in cells of the three layers of the vagina (epithelium, lamina propria, and muscularis) would have effects of greater impact, including effects on sexual function, than only effects on superficial epithelial cells as achieved with estrogens. This prospective, randomized, double-blind, and placebo-controlled phase III clinical trial has evaluated the effect of daily local intravaginal application of Prasterone (dehydroepiandrosterone; DHEA) for 12 weeks on the domains of sexual dysfunction, namely, desire/interest, arousal, orgasm, and pain at sexual activity, in 216 postmenopausal women with moderate to severe symptoms of vaginal atrophy. A time- and dose-dependent improvement of the four domains of sexual function was observed. At the 12-week time interval, the 1.0% DHEA dose led, compared with placebo, to 49% (P = 0.0061) and 23% (P = 0.0257) improvements of the desire domains in the Menopause Specific Quality of Life and Abbreviated Sex Function questionnaires, respectively. Compared with placebo, the Abbreviated Sex Function arousal/sensation domain was improved by 68% (P = 0.006), the arousal/lubrication domain by 39% (P = 0.0014), orgasm by 75% (P = 0.047), and dryness during intercourse by 57% (P = 0.0001). By a local action in the vagina, DHEA applied daily at doses at which serum steroids remain well within normal postmenopausal values exerts relatively potent beneficial effects on all four aspects of sexual dysfunction. Such data indicate that combined androgenic/estrogenic stimulation in the three layers of the vagina exerts important beneficial effects on sexual function in women without systemic action on the brain and other extravaginal tissues.
Objective: Because the secretion of dehydroepiandrosterone (DHEA), the exclusive source of sex st... more Objective: Because the secretion of dehydroepiandrosterone (DHEA), the exclusive source of sex steroids in postmenopausal women, is already decreased by 60% and continues to decline at the time of menopause, the objective of this study was to examine the effect of intravaginal DHEA on the symptoms and signs of vaginal atrophy.
Methods: This study is a prospective one that 100 diabetic women with ages 15-49 years who referr... more Methods: This study is a prospective one that 100 diabetic women with ages 15-49 years who referred to the diabetes clinic were included. The random Sampling method is used and a questionnaire was used for gathering information and data was analyzed by chi-square test and descriptive statistics. Results: Our finding showed that method of contraceptive in 25% of women was oral, 22% tubal legation, 17% withdrawal, 4% condom and vasectomy, 3% IUD and DMPA, 9% Norplant and 27% not used of any contraceptive methods. Conclusions: Patterns of contraceptive use are not suitable among diabetic women in Ardabil city and education must be given for them about appropriate contraceptive methods.
Carcinosarcomas, a malignancy consisting of squamous cell carcinoma with sarcomatous features, ar... more Carcinosarcomas, a malignancy consisting of squamous cell carcinoma with sarcomatous features, are extremely rare and aggressive tumor of the vulva. Including this case, there are 17 cases reported in the literature. Risk factors for this entity are poorly understood. We describe the case of a rapidly growing primary vulvar carcinosarcoma developing in an 84-year-old woman. The patient had previously received pelvic radiation for a squamous carcinoma of the anal canal. The excised vulvar tumor showed a superficial squamous carcinomatous element, associated vulvar intraepithelial neoplasia, and a transition into deeper sarcomatous component. By immunohistochemistry, the carcinomatous component was positive for keratins and negative for vimentin and smooth muscle actin, whereas the sarcomatous component was negative for keratins and positive for vimentin and smooth muscle actin. The patient was treated with hemivulvectomy with sentinel lymph node dissection followed by limited postoperative chemotherapy. The FIGO stage of the vulvar cancer was stage IB (T1 N0 M0), but even with this low stage, the patient had recurrence 17 months after treatment and died of her disease 8 months later. We compared age and stage at presentation, treatment, disease-free survival, and overall survival of our case to other reported vulvar carcinosarcomas. Vulvar carcinosarcomas are poorly characterized aggressive tumors with poor outcome. This is the first case reported that points to previous radiation exposure as a possible etiologic agent for this lesion.
Background: NLRP7 is responsible for recurrent hydatidiform moles, but its functional role is unk... more Background: NLRP7 is responsible for recurrent hydatidiform moles, but its functional role is unknown. Results: NLRP7 mutations impair IL-1 and TNF secretion but do not affect IL-1 processing. NLRP7 co-localizes with the microtubule organizing center, and mutations impair cytokine trafficking. Conclusion: Patients with NLRP7 mutations have abnormal tolerance to aberrant pregnancies. Significance: We unravel a new mechanism for reproductive wastage.
A retrospective analysis was performed in order to evaluate prognostic factors and treatment-rela... more A retrospective analysis was performed in order to evaluate prognostic factors and treatment-related outcome in patients with uterine papillary serous carcinoma (UPSC). Between 1989 and 2003 forty-five patients with UPSC were treated at the McGill University Health Centre (MUHC), and therefore were included in the analysis. Age, race, history, tumor stage and grade, invasion and metastasis, treatment and outcome for each patient were evaluated. According to FIGO classification, Stage I, II, III, and IV tumors were identified in 36%, 9%, 44%, and 11% of the patients, respectively. At the time of analysis, 37.8% of patients (17/45) were dead due to disease, with a mean survival of 22 months (SD +/- 7.5 months). Cause-specific survival for the entire group was 69%, 66%, and 58% at 2, 3, and 5 years, respectively. With respect to disease stage, 5-year cause-specific survival for stage I, II, III, and IV was 100%, 75%, 43%, and 0%, respectively. Univariate analysis comparing cause-specif...
Arbuscular mycorrhizal (AM) fungi are important plant mutualists that can connect roots of neighb... more Arbuscular mycorrhizal (AM) fungi are important plant mutualists that can connect roots of neighboring plants to form common mycelial networks. A recent study demonstrated that these networks can act as conduits for aphid-induced signals between plants, activating chemical defenses in uninfested neighboring plants so that they become unattractive to aphids but attractive to their enemies (parasitoids). The benefit to the neighboring plants will increase if the signal speed is rapid, enabling them to respond before aphids attack. Here, we determine the speed of aphid-induced signal transfer between plants infested with aphids ("donor") and neighboring aphid-free plants that were either connected or unconnected to the donor via a common mycelial network. Induced changes in plant volatiles from neighbors connected to donors started within 24 h of aphid infestation of donors. This demonstrates a rapid signal, implying potential benefit to plants receiving the signal, and raises intriguing ecological and evolutionary questions.
Arbuscular mycorrhizal (AM) fungi, important plant mutualists, provide plants with nutrients such... more Arbuscular mycorrhizal (AM) fungi, important plant mutualists, provide plants with nutrients such as phosphorus (P) in return for carbon. AM fungi also enhance the attractiveness of plants to aphids via effects on emissions of plant volatiles used in aphid host location. We tested whether increased P uptake by plants is the mechanism through which AM fungi alter the volatile profile of plants and aphid behavioural responses by manipulating the availability of P and AM fungi to broad beans (Vicia faba L.) in a multi-factorial design. If AM fungi affect plant volatiles only via increased P acquisition, we predicted that the emission of volatiles and the attractiveness of mycorrhizal beans to aphids would be similar to those of non-mycorrhizal beans supplied with additional P. AM fungi and P addition increased leaf P concentrations by 40 and 24%, respectively. The production of naphthalene was less in mycorrhizal plants, regardless of P addition. By contrast, production of (S)-linalool...
BACKGROUND: We report a novel fertility preservation strategy that may be useful for young breast... more BACKGROUND: We report a novel fertility preservation strategy that may be useful for young breast cancer patients who present with time constraints or concerns about the effect of ovarian stimulation.
Objective: This pilot study aimed to provide supportive evidence for the acceptability and useful... more Objective: This pilot study aimed to provide supportive evidence for the acceptability and usefulness of the Meaning-Making intervention (MMi) in patients newly diagnosed with Stage III or IV ovarian cancer, and to provide estimates of parameters needed to design a full-scale study.
Proceedings of the Royal Society B: Biological Sciences, 2012
Mothers can non-genetically influence offspring phenotype in response to environmental conditions... more Mothers can non-genetically influence offspring phenotype in response to environmental conditions, including mate attractiveness. If such 'maternal effects' influence the offspring's reproduction and F2 generation, there is a mechanism for non-genetic trans-generational effects on phenotype, including epigenetic phenomena, with implications for evolution and population dynamics. We demonstrate in the zebra finch Taeniopygia guttata such non-genetic effects on offspring fecundity and the size of early stage F2 (eggs) in response to experimentally manipulated father's attractiveness. Our experimental design allowed us to deduce that the mechanism for this non-genetic paternal effect was via maternal investment in eggs. This affected female offspring size and, consequently, fecundity and F2 (egg) size. This demonstrates that female perception of mate attractiveness can have non-genetic, trans-generational fitness consequences and this may have important implications for the evolution of sexually selected traits and population dynamics.
Lyme borreliosis (LB) is the most common arthropod-borne disease of humans in the Northern hemisp... more Lyme borreliosis (LB) is the most common arthropod-borne disease of humans in the Northern hemisphere. In Europe, the causative agent, Borrelia burgdorferi sensu lato complex, is principally vectored by Ixodes ricinus ticks. The aim of this study was to identify environmental factors influencing questing I. ricinus nymph abundance and B. burgdorferi s.l. infection in questing nymphs using a large-scale survey across Scotland. Ticks, host dung and vegetation were surveyed at 25 woodland sites, and climatic variables from a Geographical Information System (GIS) were extracted for each site. A total of 2397 10 m 2 transect surveys were conducted and 13 250 I. ricinus nymphs counted. Questing nymphs were assayed for B. burgdorferi s.l. and the average infection prevalence was 5·6% (range 0·8-13·9%). More questing nymphs and higher incidence of B. burgdorferi s.l. infection were found in areas with higher deer abundance and in mixed/deciduous compared to coniferous forests, as well as weaker correlations with season, altitude, rainfall and ground vegetation. No correlation was found between nymph abundance and infection prevalence within the ranges encountered. An understanding of the environmental conditions associated with tick abundance and pathogen prevalence may be used to reduce risk of exposure and to predict future pathogen prevalence and distributions under environmental changes.
The Trivers-Willard hypothesis predicts sex biases in parental investment according to parental c... more The Trivers-Willard hypothesis predicts sex biases in parental investment according to parental condition. In addition, parents may need to sex bias their investment if there is an asymmetry between the sexes in offspring fitness under different conditions. For studying maternal differential investment, egg resources are ideal subjects because they are self contained and allocated unequivocally by the female. Recent studies show that yolk androgens can be beneficial to offspring, so here we test for sex-biased investment with maternal investment of yolk testosterone (T) in zebra finch (Taeniopygia guttata) eggs. From the Trivers-Willard hypothesis, we predicted females to invest more in male eggs in optimum circumstances (e.g. good-condition mother, early-laid egg), and more in female eggs under suboptimal conditions (e.g. poor-condition mother, late-laid egg). This latter prediction is also because in this species there is a female nestling disadvantage in poor conditions and we expected mothers to help compensate for this in female eggs. Indeed, we found more yolk T in female than male eggs. Moreover, in accordance with our predictions, yolk T in male eggs increased with maternal quality relative to female eggs, and decreased with laying order relative to female eggs. This supports our predictions for the different needs and value of male and female offspring in zebra finches. Our results support the idea that females may use yolk androgens as a tool to adaptively manipulate the inequalities between different nestlings.
1. Ecological count data typically exhibit complexities such as overdispersion and zero-inflation... more 1. Ecological count data typically exhibit complexities such as overdispersion and zero-inflation, and are often weakly associated with a relatively large number of correlated covariates. The use of an appropriate statistical model for inference is therefore essential. A common selection criteria for choosing between nested models is the likelihood ratio test (LRT). Widely used alternatives to the LRT are based on information-theoretic metrics such as the Akaike Information Criterion. 2. It is widely believed that the LRT can only be used to compare the performance of nested models -i.e. in situations where one model is a special case of another. There are many situations in which it is important to compare non-nested models, so, if true, this would be a substantial drawback of using LRTs for model comparison. In reality, however, it is actually possible to use the LRT for comparing both nested and non-nested models. This fact is well-established in the statistical literature, but not widely used in ecological studies. 3. The main obstacle to the use of the LRT with non-nested models has, until relatively recently, been the fact that it is difficult to explicitly write down a formula for the distribution of the LRT statistic under the null hypothesis that one of the models is true. With modern computing power it is possible to overcome this difficulty by using a simulation-based approach. 4. To demonstrate the practical application of the LRT to both nested and non-nested model comparisons, a case study involving data on questing tick (Ixodes ricinus) abundance is presented. These data contain complexities typical in ecological analyses, such as zero-inflation and overdispersion, for which comparison between models of differing structure -e.g. non-nested models -is of particular importance. 5. Choosing between competing statistical models is an essential part of any applied ecological analysis. The LRT is a standard statistical test for comparing nested models. By use of simulation the LRT can also be used in an analogous fashion to compare non-nested models, thereby providing a unified approach for model comparison within the null hypothesis testing paradigm. A simple practical guide is provided in how to apply this approach to the key models required in the analyses of count data.
The objective of this study was to provide evidence that the transformation of DHEA into both and... more The objective of this study was to provide evidence that the transformation of DHEA into both androgens and/or estrogens locally in cells of the three layers of the vagina (epithelium, lamina propria, and muscularis) would have effects of greater impact, including effects on sexual function, than only effects on superficial epithelial cells as achieved with estrogens. This prospective, randomized, double-blind, and placebo-controlled phase III clinical trial has evaluated the effect of daily local intravaginal application of Prasterone (dehydroepiandrosterone; DHEA) for 12 weeks on the domains of sexual dysfunction, namely, desire/interest, arousal, orgasm, and pain at sexual activity, in 216 postmenopausal women with moderate to severe symptoms of vaginal atrophy. A time- and dose-dependent improvement of the four domains of sexual function was observed. At the 12-week time interval, the 1.0% DHEA dose led, compared with placebo, to 49% (P = 0.0061) and 23% (P = 0.0257) improvements of the desire domains in the Menopause Specific Quality of Life and Abbreviated Sex Function questionnaires, respectively. Compared with placebo, the Abbreviated Sex Function arousal/sensation domain was improved by 68% (P = 0.006), the arousal/lubrication domain by 39% (P = 0.0014), orgasm by 75% (P = 0.047), and dryness during intercourse by 57% (P = 0.0001). By a local action in the vagina, DHEA applied daily at doses at which serum steroids remain well within normal postmenopausal values exerts relatively potent beneficial effects on all four aspects of sexual dysfunction. Such data indicate that combined androgenic/estrogenic stimulation in the three layers of the vagina exerts important beneficial effects on sexual function in women without systemic action on the brain and other extravaginal tissues.
Objective: Because the secretion of dehydroepiandrosterone (DHEA), the exclusive source of sex st... more Objective: Because the secretion of dehydroepiandrosterone (DHEA), the exclusive source of sex steroids in postmenopausal women, is already decreased by 60% and continues to decline at the time of menopause, the objective of this study was to examine the effect of intravaginal DHEA on the symptoms and signs of vaginal atrophy.
Methods: This study is a prospective one that 100 diabetic women with ages 15-49 years who referr... more Methods: This study is a prospective one that 100 diabetic women with ages 15-49 years who referred to the diabetes clinic were included. The random Sampling method is used and a questionnaire was used for gathering information and data was analyzed by chi-square test and descriptive statistics. Results: Our finding showed that method of contraceptive in 25% of women was oral, 22% tubal legation, 17% withdrawal, 4% condom and vasectomy, 3% IUD and DMPA, 9% Norplant and 27% not used of any contraceptive methods. Conclusions: Patterns of contraceptive use are not suitable among diabetic women in Ardabil city and education must be given for them about appropriate contraceptive methods.
Carcinosarcomas, a malignancy consisting of squamous cell carcinoma with sarcomatous features, ar... more Carcinosarcomas, a malignancy consisting of squamous cell carcinoma with sarcomatous features, are extremely rare and aggressive tumor of the vulva. Including this case, there are 17 cases reported in the literature. Risk factors for this entity are poorly understood. We describe the case of a rapidly growing primary vulvar carcinosarcoma developing in an 84-year-old woman. The patient had previously received pelvic radiation for a squamous carcinoma of the anal canal. The excised vulvar tumor showed a superficial squamous carcinomatous element, associated vulvar intraepithelial neoplasia, and a transition into deeper sarcomatous component. By immunohistochemistry, the carcinomatous component was positive for keratins and negative for vimentin and smooth muscle actin, whereas the sarcomatous component was negative for keratins and positive for vimentin and smooth muscle actin. The patient was treated with hemivulvectomy with sentinel lymph node dissection followed by limited postoperative chemotherapy. The FIGO stage of the vulvar cancer was stage IB (T1 N0 M0), but even with this low stage, the patient had recurrence 17 months after treatment and died of her disease 8 months later. We compared age and stage at presentation, treatment, disease-free survival, and overall survival of our case to other reported vulvar carcinosarcomas. Vulvar carcinosarcomas are poorly characterized aggressive tumors with poor outcome. This is the first case reported that points to previous radiation exposure as a possible etiologic agent for this lesion.
Background: NLRP7 is responsible for recurrent hydatidiform moles, but its functional role is unk... more Background: NLRP7 is responsible for recurrent hydatidiform moles, but its functional role is unknown. Results: NLRP7 mutations impair IL-1 and TNF secretion but do not affect IL-1 processing. NLRP7 co-localizes with the microtubule organizing center, and mutations impair cytokine trafficking. Conclusion: Patients with NLRP7 mutations have abnormal tolerance to aberrant pregnancies. Significance: We unravel a new mechanism for reproductive wastage.
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Papers by Lucy Gilbert