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Aim Paired boxed gene 1 (PAX1) has previously been reported to be a methylation-silenced gene in cases of cervical and ovarian cancers. We evaluated the expression of PAX1 in normal endometrium, endometrial hyperplasia and endometrial carcinoma (EC), and investigated the prognostic value of PAX1 expression in patients with EC. Methods We conducted a hospital-based retrospective review of PAX1 distribution immunohistochemically in 201 samples of endometrium from biopsy or hysterectomy. PAX1 immunoreactivity was classified into low and high score groups based upon the extent and intensity of staining. Results There was intense intranuclear staining for PAX1 in premalignant endometrial lesions. A high PAX1 score was observed in a high percentage of samples of normal endometrium (93.3%), in endometrial hyperplasia without atypia (97.2%) and in endometrial atypical hyperplasia (87.5%), but this level was found in only one-third of the EC samples (30.1%). The PAX1 protein score was significantly higher in samples of premalignant endometrial lesions compared with those of EC (P < 0.001). Importantly, a higher PAX1 score in EC cases was correlated with good overall survival, with a hazard ratio of 0.22 for death (95% confidence interval, 0.05–0.96). Conclusions PAX1 protein expression is a potential histopathology biomarker for the differential diagnosis of malignant and premalignant endometrial lesions. PAX1 is also a potential prognostic marker in cases of EC.

Aim and objectives. The aim of this study was to test the psychometric properties of the Chinese version of the Bipolar Spectrum Diagnostic Scale (C-BSDS) in a Chinese population to serve as an aid to clinical diagnosis of bipolar disorders. Background. Bipolar spectrum disorders are often misdiagnosed because of the wide range of symptoms seen in patients. The consequences of delayed diagnoses or misdiagnoses can be devastating. Design. A cross-sectional research design. Method. Two hundred patients with affective disorders from a psychiatric outpatient clinic in Taiwan were enrolled. Internal consistency reliability and two-week test–retest reliability were performed to evaluate the reliability of the C-BSDS. Expert content validity and factor analysis were used for testing construct validity. To evaluate sensitivity and specificity, the Chinese version of the Mini International Neuropsychiatric Interview (MINI) was used as the gold standard for diagnosis. Results. The internal consistency coefficient measured by intra-class correlation (ICC) was 0·81, the test–retest reliability coefficient was 0·85 and the expert validity was 0·85. For construct validity, ‘irritable and hyper-energetic factors’ and ‘depressed and lack of energy factors’ were extracted by factor analysis. These two factors reflected the structure of the original scale and accounted for 33·27% of the variance. The optimal cut-off was 12, which yielded a sensitivity of 74 and a specificity of 0·97 for detecting bipolar disorder and for bipolar II disorder these were 0·79 and 0·68, respectively. Conclusions. The C-BSDS showed good reliability and validity, and the results were consistent with the English version of the BSDS. Therefore, the C-BSDS is an effective tool for evaluation of a Chinese population. Relevance to clinical practice. The BSDS can further increase the detection rate of bipolar disorders, especially bipolar II disorder, with satisfactory sensitivity and specificity. It can effectively assist with clinical screening of patients for bipolar spectrum disorders.

A 31-year-old Indonesian female was diagnosed with adenocarcinoma of the cervix (FIGO stage Ib1). She underwent laparoscopy-assisted radical hysterectomy with pelvic lymph node dissection. Postoper...

Objective Women with atypical hyperplasia (AH) are often found to have endometrial carcinoma (EC) at hysterectomy. The purpose of this study was to evaluate whether the hypermethylation of specific genes found by methylomic approaches to the study of gynecologic cancers is a biomarker for EC in women with AH. Methods We evaluated the methylation of AJAP1 , HS3ST2 , SOX1 , and PTGDR from 61 AH patients undergoing hysterectomy. Endometrial biopsy samples were analyzed by bisulfite conversion and quantitative methylation-specific polymerase chain reaction. A methylation index was used to predict the presence of cancer. To confirm the silencing effects of DNA methylation, immunohistochemical analysis of AJAP1, HS3ST2, and SOX1 was performed using tissue microarray. Results Fourteen (23%) patients had EC at hysterectomy. AJAP1 , HS3ST2 , and SOX1 were highly methylated in the EC patients' biopsy samples (p≤0.023). AJAP1, HS3ST2, and SOX1 protein expression was significantly higher in patients with AH only (p≤0.038). The predictive value of AJAP1 , HS3ST2 , and SOX1 methylation for EC was 0.81, 0.72, and 0.70, respectively. Combined testing of both AJAP1 and HS3ST2 methylation had a positive predictive value of 56%, methylation of any one of AJAP1 , SOX1 , or HS3ST2 had a 100% negative predictive value. Conclusions Hypermethylation of AJAP1 , HS3ST2 , and SOX1 is predictive of EC in AH patients. Testing for methylation of these genes in endometrial biopsy samples may be a hysterectomy-sparing diagnostic tool. Validation of these new genes as biomarkers for AH screening in a larger population-based study is warranted.

Objective Serous tumors can occur on the surface of the ovaries and—rarely—as primary tumors on the peritoneal surface. However, the origin of extraovarian serous tumors is unknown. An unusual case of a serous tumor is presented here. Case report A 34-year-old nulligravid woman presented for evaluation of her primary infertility, with acute abdominal pain. At laparoscopy, a paratubal cyst, independent of the ovaries, was found to be associated with bilateral hydrosalpinges. The final pathology diagnosis was of a benign paratubal serous cystadenoma. Conclusion We present an unusual case of a paratubal serous cystadenoma with bilateral hydrosalpinges in an infertile woman, which was resected laparoscopically..

Objectives To examine the effects of reminiscence therapy on psychological well-being, depression, and loneliness among institutionalized elderly people. Methods In an experimental study design, 92 institutionalized elderly people aged 65 years and over were recruited and randomly assigned to two groups. Those participants in the experimental group received reminiscence therapy eight times during 2 months to examine the effects of this therapy on their psychological well-being. Results After providing the reminiscence therapy to the elderly in the experimental group, a significant positive short-term effect (3 months follow-up) on depression, psychological well-being, and loneliness, as compared to those in the comparison group was found. Conclusions Reminiscence therapy in this study sample improved socialization, induced feelings of accomplishment in participants, and assisted to ameliorate depression.

Objective This study was aimed at evaluating whether a Life Review Group Program (LRGP) improved the self-esteem and life satisfaction in the elderly. Methods This randomized, controlled trial consisted of 75 elderly males from a Veterans' Home in Northern Taiwan, 36 of whom were in the experimental group and 39 of whom were in the control group. The subjects in the experimental group participated in an 8-week LRGP. Data were collected before and after the LRGP and again 1 month after the end of the program. Results The study subjects had a mean age of 78.13 years. The generalized estimating equation was used to compare alterations in the self-esteem and life satisfaction of the elderly before and after the intervention. The alterations in self-esteem and life satisfaction in the experimental group after the LRGP were significantly improved compared to the control group. One month after the LRGP was completed, the self-esteem and life satisfaction of the experimental group continued to improve when compared with pre-intervention levels. Conclusions Based on these results, the LRGP can potentially improve the self-affirmation, confidence, and self-esteem of the elderly and promote short-term life satisfaction. The results of this study provide a model for clinical evidence-based therapy, serving as a reference for related studies and evaluation of health-promoting programs, as well as improving the health and quality of care of the elderly. Copyright © 2007 John Wiley & Sons, Ltd.