Angiogenesis, proliferation, and apoptosis in anal high-grade squamous intraepithelial lesions.

PURPOSE: Management of anal high-grade squamous intraepithelial lesions is controversial. Anal and cervical high-grade squamous intraepithelial lesions are similar in that they occur in transitional squamous epithelium, are associated with human papilloma virus infection, and have increased incidence in the immunocompromised population. Ablation of cervical high-grade squamous intraepithelial lesions is preferred, but similar ablation or excision of anal high-grade squamous intraepithelial lesions may compromise bowel control; thus, there is a need to define the malignant potential of anal high-grade squamous intraepithelial lesions. METHODS: We analyzed 50 paraffin sections of normal anoderm, anal low-grade squamous intraepithelial lesions, high-grade squamous intraepithelial lesions, and anal squamous-cell carcinoma. Microvessels were detected immunohistochemically with von Willebrand factor and counted manually along the epithelial-stromal junction. Proliferation and apoptosis were determined in the epithelial cells with MIB-1 antibody immunostaining and the terminal deoxynucleotidyl transferase-mediated digoxigenin-11-dUTP nick end labeling, respectively. RESULTS: Microvascular density was significantly greater in anal high-grade squamous intraepithelial lesions (mean, 0.50 vessels/cm) vs. normal anoderm (mean, 0.21 vessels/cm; P = 0.0017, Mann-Whitney U test). The proliferative percentages were greater in low-grade squamous intraepithelial lesions, high-grade squamous intraepithelial lesions, and squamous-cell carcinoma (mean, 20.4, 21.8, and 23.6 percent) vs. normal anoderm (mean, 14.4 percent), although not significantly (P = 0.06, Kruskal-Wallis statistic). Although the mean proliferative proportions were similar in low-grade squamous intraepithelial lesions and high-grade squamous intraepithelial lesions, the apoptotic proportion was lower for high-grade squamous intraepithelial lesions than low-grade squamous intraepithelial lesions (10.13 vs. 19.96 percent, respectively; P = NS, Mann-Whitney U test). CONCLUSIONS: Angiogenesis, increased proliferation, and decreased apoptosis occur in anal high-grade squamous intraepithelial lesions as they do in the cervix before the development of malignancy. These biologic markers support the importance of anal high-grade squamous intraepithelial lesions as a potential premalignant lesion warranting surgical intervention.

The model of place utility revisited.

"The purpose of this paper...is twofold: first, to specify a way of calculating place utility so that potential migrants could move to the place where overall place utility is maximized; and second, which is more important, to reveal how decision-makers in the real world, who are acting within 'bounded rationalities'...,make their decisions on where to migrate. This study is supported by an empirical survey of recent Chinese immigrants to Edmonton [Canada].... The findings reveal that when people evaluate different places, they do not necessarily look for the one that generates the highest overall value or utility across all properties.... The study further indicates that the assumption underlying most microeconomic models (that maximizing utility or benefit is the ultimate rule for choosing one location out of several) has not been verified." (SUMMARY IN FRE AND SPA)

Governments' perceptions and policies of population redistribution in East and South East Asia.

"This paper is based on the results of the Third Inquiry among Governments on Population and Development carried out in 1977 by the UN Secretariat. It reports on perceptions and policies concerning international migrations, spatial distribution of the national population, internal migration and settlement patterns in fourteen South East and East Asian countries. "It appears that nearly all countries under consideration were concerned with the spatial distribution of population both as a factor related to problems caused by excessive natural increase and as a problem on its own right. The majority of countries were prepared to pursue policies affecting basic trends in internal migration. Most governments declared their willingness to alter patterns of rural or both rural and urban settlement. Only two countries were interested in increasing emigration; the remaining ones were satisfied with the existing levels of international migration."