Tall cell carcinoma of the breast with reversed polarity - a report of three cases with a review of the literature.

Tall cell carcinoma with reverse polarity (TCCRP) is a rare special type of breast epithelial neoplasm presented by columnar cells with opposite nuclear polarity, solid and solid-papillary architecture, and frequent IDH2 gene alterations. Hereby, the authors present three cases of TCCRP in women aged 56, 66 and 67 years with maximum tumour sizes of 29 mm, 10 mm and 8 mm. Tumours showed histomorphological characteristics of TCCRP supported by immunohistochemical profile of tumour cells, in which positive expression of CK7, CK5/6, GCDFP15, mammaglobin, GATA3 and calretinin and negativity of CK14, p63, TTF1, thyroglobulin and neuroendocrine markers were demonstrated. Two tumours were triple negative, and in one tumour, only weak focal ER expression was noted along with PR and HER2 negativity. Pathogenic somatic variants in mutational hotspot region p.R172 in IDH2 gene were detected using NGS technology in all three tumours. Moreover, in two of these tumours, the most common pathogenic variants p.E545A and p.H1047R of PIK3CA were identified. TCCRP represents a rare breast neoplasm of low malignant potential, the incidence of which will probably increase due to the more clearly defined histomorphological, immunohistochemical and molecular-genetic characteristics, which were all responsible for including this entity into the 5th edition of WHO classification breast tumours.

[Operative treatment of acute acromioclavicular joint dislocation with anatomic reconstruction]. / Akut acromioclavicularis ízületi ficamok mutéti kezelése anatómiai rekonstrukcióval.

INTRODUCTION: The authors audited the outcomes of various surgical interventions employed to fix the dislocations of the acromioclavicular joint in their unit. This resulted in changing their method to treat this condition. OBJECTIVE: Finding a technique that results in the best functional stability of the injured joint while preserving its physiological function. METHOD: In this particular area of traumatology, there is still uncertainty of the ideal way to provide the best outcome in terms of stability and function. From the currently known techniques, the authors have chosen the Minimally INvasive Acromioclavicular Joint Reconstruction (MINAR) method to be introduced in their unit. Its advantage is that it provides good stability combined with fast rehabilitation with a minimally invasive intervention. Furthermore, it is safe and easy to learn and master. It is also to be pointed out that it restores not only the stability but also the physiological functionality of the damaged joint. The authors carried out this type of operation first in 2012. They promoted the technique first in Hungary and became a 'reference centre' in the country. The authors will detail the method itself, both its indications and contraindications as well as the stages of the postoperative rehabilitation. RESULTS: The authors scrutinized their results with imaging and 7 years of retrospective analysis with Constant and DASH scores. These were all in support of their choice of the MINAR method. DISCUSSION: The authors concluded results congruent with international studies and recommendations. Additional analysis deducted aspects of the technique that could lead to further improvement in outcomes and highlighted areas for future study. CONCLUSION: In line with the recommendation of the European Shoulder Associates, the author's recommendation is that the MINAR technique should be the first choice of intervention for dislocations of the acromioclavicular joint. Orv Hetil. 2022; 163(50): 1992-1999.

Accurate Non-Disturbance Population Survey Method of Nesting Colonies in the Reedbed with Georeferenced Aerial Imagery.

High altitude aerial surveys have the potential to improve disturbance-free data collection in wildlife research, but previously, bird species were not recognizable in high-altitude orthophotos. This method of aerial surveying is effective and can be repeated frequently due to its low cost; it also has the additional advantage of being able to monitor the status of protected areas. In the case of waterbirds, due to the low vegetation coverage, aerial remote sensing is an exceptionally effective technique for surveying populations and detecting nests. Aerial surveys made at low altitudes can cause serious stress for birds. The method we developed and employed is unlikely to be detected by either ground-based or nesting birds but is far more reliable compared to the low-resolution imaging methods and to the evaluation of non-georeferenced photo series. The modern sensors and photogrammetric procedures enable the use of the present method worldwide; furthermore, the large-scale ortho image-derived information has become obtainable more frequently. Direct georeferencing makes the field geodetic survey unnecessary. Orthophotos with a 0.7 cm spatial resolution allow us to reliably identify even the individuals of smaller species, and by the use of oblique images, they can be tracked from two or four different directions.

Skin wound healing with composite biomembranes loaded by tiopronin or captopril.

Novel wound dressings composed of chitosan (Ch) and hyaluronan (HA) loaded with tiopronin or captopril as antiinflammatory drugs were prepared. Composite biomembranes were examined in skin wounds of ischemic rabbits with the aim to accelerate the process of healing. The results proved that the biomembranes composed of Ch/HA/tiopronin or Ch/HA/captopril facilitated healing of skin wounds compared to untreated animals and animals treated with Ch/HA membranes. These results were confirmed by histology. Cu(II) ions and ascorbate-induced high-molar-mass HA degradation by means of rotational viscometry was performed and the ability of the both drugs to scavenge reactive oxygen species was evaluated. The results showed that captopril as well as tiopronin decreased the rate of HA degradation exclusively at higher concentrations.

Impact of Ergothioneine, Hercynine, and Histidine on Oxidative Degradation of Hyaluronan and Wound Healing.

A high-molecular weight hyaluronan is oxidatively degraded by Cu(II) ions and ascorbate-the so called Weissberger biogenic oxidative system-which is one of the most potent generators of reactive oxygen species, namely •OH radicals. Ergothioneine, hercynine, or histidine were loaded into chitosan/hyaluronan composite membranes to examine their effect on skin wound healing in ischemic rabbits. We also explored the ability of ergothioneine, hercynine, or histidine to inhibit hyaluronan degradation. Rotational viscometry showed that ergothioneine decreased the degree of hyaluronan radical degradation in a dose-dependent manner. While histidine was shown to be potent in scavenging •OH radicals, however, hercynine was ineffective. In vivo results showed that the addition of each investigated agent to chitosan/hyaluronan membranes contributed to a more potent treatment of ischemic skin wounds in rabbits compared to untreated animals and animals treated only with chitosan/hyaluronan membranes.

MitoQ Loaded Chitosan-Hyaluronan Composite Membranes for Wound Healing.

Two self-associating biopolymers, namely chitosan (Ch) and a high-molar-mass hyaluronan (HA), were used to prepare membranes with the aim to protect and to enhance the healing of injured skin. A mitochondrially-targeted antioxidant-MitoQ-was incorporated into the mixture of biopolymers prior to their self-association. These three-component membranes were evaluated in detail utilising surface roughness measurements, contact angle measurements, hemocompatibility, and thrombogenicity analyses. Furthermore, in vivo application of Ch/HA/MitoQ membranes was assessed on injured rabbit and rat skin utilizing histological methods. The results showed that the prepared thrombogenic Ch/HA/MitoQ membranes had higher roughness, which allowed for greater surface area for tissue membrane interaction during the healing processes, and lower cytotoxicity levels than controls. MitoQ-loaded composite membranes displayed superior healing properties in these animal models compared to control membranes.

[Vitamin D and calcium supplementation in elderly patients with hip fracture]. / D-vitamin és kalciumpótlás az idoskori csípotáji törések megelozésében.

Vitamin D plays an important role in maintaining calcium and bone metabolism, a risk factor of osteoporosis, fall and fracture in old age. Reduction in D-vitamin levels associated with compensatory increased level of parathyroid hormone causes significant loss of bone matrix, so substitutions of vitamin D and calcium are very important. Many authors publish their recommended doses used for prevention of hip fracture during the last years. Some authors are satisfied only with vitamin D supplementation while others have better experiences with vitamin D and calcium substitution. On the other hand, some metaanalyses give contradictory results and propose further investigations. It is important to consider the patients' eating habits and lifestyle as well as the risk of cardiovascular and other chronic diseases. Further trials should be done in different age groups in order to examine the effects of different doses of vitamin D without and with calcium to make a final decision. Orv Hetil. 2017; 158(43): 1699-1707.

[Molecular pathology of endometrial carcinoma - a review]. / Molekulová patológia endometriálneho karcinómu - prehlad.

Endometrial carcinoma (EC) is the most common malignancy of the female genital tract in developed countries. According to its histomorphologic characteristics EC is divided into endometroid and serous carcinoma; among less common subtypes there are clear cell, mucinous, neuroendocrine and undifferentiated carcinoma and carcinosarcoma. Endometroid and serous EC were essential for the so-called dual classification of EC (type I and type II), which considered mainly epidemiological, clinical and endocrine characteristics. It was shown that part of the high-grade serous carcinomas (type II) can develop from the endometroid EC by a multiplication of genomic changes and there are also EC, in which both basic types are overlapping. Today it is known that clinical and histological presentation of the EC reflects the genetic and epigenetic alterations affecting mainly PTEN, PIK3CA, KRAS, CTNNB1 and TP53 genes, or leading to microsatellite instability. However, these changes are variably present in both types of EC; therefore dual division of EC has appeared very rigid. The novel classifications should represent an integrated system which also incorporates the results of the gene expression analyses and multiparallel DNA sequencing. Based on these findings EC were divided into four molecular categories: a) POLE/ultra mutated; b) hyper mutated microsatellite instable; c) "copy number low" d) "copy number high" serous-like carcinoma. This division better reflects the biological characteristics of each EC and represents a base for the individual therapy.

Intravascular papillary endothelial hyperplasia of larynx: case report and literature review of all head and neck cases.

Intravascular papillary endothelial hyperplasia (IPEH) is a benign lesion of a vascular origin that is caused by excessive proliferation of endothelial cells in blood vessels or vascular malformations. It is a rare entity that can present in any region of the body, but with particular predilection to the head and neck region and the extremities. We also present the results of the English literature search, which to our knowledge are all the published cases of IPEH in the head and neck region (No=213). IPEH has not been reported to arise from the glottic region previously. We present a first case of IPEH arising from the vocal fold of a 48-year-old male. Histological differential diagnosis of IPEH includes several entities, most importantly angiosarcoma. Presentation and histology are discussed. The main treatment option is a complete surgical resection. Prognosis of IPEH is excellent, with the exception of some intracranial cases.

[Vitamin D supply of patients with hip fracture]. / A csípotáji csonttörést szenvedett betegek D-vitamin-ellátottsága.

INTRODUCTION: Vitamin D deficiency is an important risk factor for fractures. However, there are few data available only on the relationship between serum 25-hydroxyvitamin D levels and recovery after surgery for hip fracture. AIM: The authors investigate the vitamin D supply of patients with hip fractures. METHOD: Between February and September 2013, serum 25-hydroxyvitamin D and parathyroid hormone levels were determined in 203 patients with hip fracture (74.8±11.5 ys; 67 men and 136 women) and in 74 control subjects. RESULTS: Vitamin D deficiency and secondary hyperparathyroidism occurred significantly more frequently in patients with hip fracture than in control subjects (72% vs. 45%, and 33% vs. 17%, respectively). Patients with better condition after surgery showed higher 25-hydroxyvitamin D levels (p<0.001) than those with poor condition. Serum 25-hydroxyvitamin D were lower in the 31 patients who died [median of survival time: 19 (5-52) days] compared to those who survived [22.6 (9.5-45.0) vs. 33.0 (16.5-56.6) nmol/l]. CONCLUSIONS: The association between vitamin-D deficiency and mortality as well as the positive correlation between serum 25-hydroxyvitamin D levels and better postoperative condition confirm the importance of proper vitamin D supply in the prevention and cure of hip fractures, what is more in the increase of the chance of survival.

[The role of vitamin D deficiency in the pathogenesis of falls and fractures]. / A D-vitamin-hiány szerepe az elesések és csonttörések patogenezisében.

The diverse effects of vitamin D in human body became known during the last years. Vitamin D deficiency causes many problems in medical care. Important roles of vitamin D are the regulation of calcium metabolism and the effect on bone metabolism. The authors review literature data on vitamin D deficiency recognized as an important risk factor in the pathogenesis of falls and fractures and they call attention of Hungarian physicians to the importance of vitamin D substitution. Supplementation of vitamin D deficiency is particularly important in the elderly age-group.

Chemical imaging of cardiac cell and tissue by using secondary ion mass spectrometry.

PURPOSE: Identification and localization of biomolecules in cells and tissue samples are important for understanding of subcellular structures and can be helpful in biomedical and pharmaceutical research. PROCEDURES: Isolated cardiac cells and tissue of rats are studied by using time-of-flight secondary ion mass spectrometry. This technique provides chemical composition of cardiac cell membrane and tissue surface in native form. RESULTS: The result is a spatially resolved chemical imaging of cell and tissue surfaces as a lateral distribution of biologically relevant molecules-phospholipids, along with fatty acids, and cholesterol. Phospholipids are represented by phosphatidylcholine and cardiolipin molecules and their fragments. Phosphatidylcholine polar head group at mass of 184.1 u has an origin in the cell membrane, and a two-dimensional distribution of this fragment provides clear chemical contours of the cell. The high-resolution contrast of the cell is observed within its environment represented with Na(+) ions. Images of PO(4)H(-) fragment and fatty acids with 16 or 18 C atoms are determined in cardiac tissue. Distributions of these 16 and 18 C fatty acids are the same within their groups, and interestingly, these two distribution groups are spatially complementary. Contours of phosphatidylcholine and cardiolipin fragments are also complementary, the distributions of 16 C fatty acids and phosphatidylcholine are identical, and the distributions of 18 C fatty acids and cardiolipin are also the same. This complementarity thus supports the chemical compositions of phosphatidylcholine and cardiolipin based on 16 C and 18 C fatty acids, respectively. CONCLUSION: The method provides information not only about cell and tissue morphology, shape, and condition but also about cellular membrane chemical composition and lateral distribution of biologically relevant molecules.

[Treatment of "kissing surface" injury with mosaicplasty]. / "Kissing surface" sérülésének kezelése mozaikplasztikával.

Kissing surface type defects of the cartilage represent a special category in cartilage diseases. They are characteristics for more difficult treatment, more compromises and moderate results. The authors adopted mosaicplasty technique for full thickness cartilage defects. According to their early experiences, this technique can provide capable healing type resurfacement and quick rehabilitation. There is a separate injury on cartilage surface, so called "kissing surface" injury (patellofemoral injury on both surfaces at the same time). The treatment possibility is much more difficult, more compromising and the results are moderate. Mosaicplasty was the choice of treatment by authors. This method provides better results than other methods, mainly because of the high quality and better rehabilitation.

Oxidative stress and electron spin resonance.

The body constantly reacts with oxygen as part of the energy producing processes of cells. Oxidative stress is a dysbalance between the production of free radicals as products of these reactions and antioxidant properties of cells. The factors influencing the production of free radicals are physical agents, chemical agents and biological agents. Free radicals are paramagnetic molecules with short time-period for their detection by electron spin resonance (ESR) spectroscopy. The free radical stabilization can be gained by freezing a solution of an organic radical or bonding to spin trapping agents. The spin trapping agents are diamagnetic compounds which rapidly scavenge transient radicals to form stable paramagnetic spin adducts radicals. Because this secondary radical retains an unpaired electron, it can often be detected by electron spin resonance. From ESR spectra can be obtained structural information and kinetic information, information about the formation and decay of the radicals. To study the process of free radical generation is an important step towards reducing the deteriorating effects of oxidative stress.