BACKGROUND: The ability to accurately predict tumor behavior and patient survival is a problem in managing patients with prostate cancer. Prognostic variables in predicting death from tumor include prostate-specific antigen (PSA) level, histological grade, and clinical stage. Observer subjectivity is inherent in determining grade and stage; thus, criteria that are more objective are needed to identify patients for appropriate treatment. METHODS: The authors correlated flow cytometric nuclear DNA ploidy with Gleason score, PSA level, and recurrence risk in patients who underwent radical retropubic prostatectomy and bilateral pelvic lymphadenectomy between 1987 and 1993 for histopathologic stage B prostate cancer (T2, N0, M0). RESULTS: Of the tumors analyzed, 64% were DNA diploid with a low proliferative fraction, 25% were DNA diploid with a high proliferative fraction, and 11% were DNA aneuploid. DNA aneuploidy was associated with high Gleason grade (7-10). All Gleason grade 10 tumors were DNA aneuploid. Both DNA aneuploidy and high proliferative fraction (S+G2M) were statistically correlated with high Gleason grade and adverse prognosis but not with PSA level or patient age. CONCLUSIONS: A direct relationship is shown between both DNA aneuploidy and a high proliferation index with aggressive biological behavior in stage B prostatic cancer. Objective tumor criteria are needed to choose treatment more selectively for individual patients.

This study sought to identify differences in strategies used for teacher recruitment and retention by successful and non-successful rural high schools. According to data from the 2003-2004 Schools and Staffing Survey (SASS), small towns and rural areas in the central U.S. states did have relatively more difficuly in recruiting teachers than did larger communities. However, when the successful and unsuccessful school districts were compared on the strategies and benefits included in the SASS, the only difference was with signing bonuses, which were offered significantly more often in the unsuccessful group than the successful group. The researchers also interviewed seven principals identified as successful by their state agencies. Their responses revealed minimal reliance on the strategies addressed in the SASS. however, there was some alignment between many of the strategies they did use and the three approaches investigated in previous research: grow-your-own, using federal funding opportunities, and using targeted incentives.

Renal tubular dysgenesis is a rare disease of fetal kidney differentiation, which became a diagnostic entity with less than 30 years of history and with many etiologic-pathogenic variants. Most reported cases were autosomal recessive, but acquired cases, including drug-induced (ACE inhibitor, NSAID) and twin-twin transfusion-induced ones, were also present. Ischemia and reduced renal perfusion seem to be the common denominator in all cases. We report a new case and for the first time linked this entity to diabetic embryopathy. The patient was 5-hour-old premature girl born at 35 weeks of gestation via emergency cesarean section owing to an ultrasound finding of multiple fetal anomalies, oligohydramnios, and, later, fetal distress. The mother was a 22-year-old G1P1 with diet-controlled gestational diabetes but without other significant past or family medical history. External examination noted multiple dysmorphic features and abnormalities: large anterior fontanelle with open sutures; Potter face; prominent epicanthal folds; hypoplastic nasal bridge and small, low set ears; nuchal edema; bilateral clubfeet with overlapping toes; and sacral dimple. Dissection revealed bilateral renomegaly with mild hydronephrosis and features characteristic of renal tubular dysgenesis. The kidneys showed disorganized glomerulogenesis at various stages with no clear demarcation of the cortical vs medullary zones, and no cysts were identified. Most prominently were short and poorly developed proximal convoluted tubules. All tubules were monomorphic, lined by small darkly stained epithelial cells, positive for EMA, and lacking PAS-positive brush border in the apical surfaces. The other key findings included hepatomegaly, bilateral hypoplastic lungs, and hypoplastic left heart syndrome. The accompanying placenta showed placentomegaly, meconium staining, umbilical cord edema, and fetal thrombotic vasculopathy, reflecting gestational diabetes. Cytogenetic studies (FISH, karyotyping, and signature chip microarray) all showed a normal female 46,XX karyotype. We concluded that renal tubular dysgenesis can be part of a diabetic embryopathy spectrum.