Kounis syndrome type I in a victim of cardiopulmonary arrest after hymenoptera sting.

Kounis syndrome is a relatively rare entity in which allergic or hypersensitivity reactions (including anaphylaxis) coexist with acute coronary syndromes. We report a case of Kounis syndrome type I variant in a 51-year-old male, victim of an out-of-hospital cardiac arrest a few minutes after a hymenoptera sting. Ιn-hospital cardiopulmonary resuscitation was provided and return of spontaneous circulation was achieved. The post-resuscitation electrocardiogram revealed ST-segment elevation in leads II, III, aVF, and ST depression in leads V2, V3, and V4. After administration of corticosteroids, antihistamines, nitrates, and a calcium-channel blocker the electrocardiogram rapidly returned to normal. There was no elevation in markers of myocardial necrosis and the coronary angiography revealed normal coronary arteries. According to the clinical course and the laboratory findings the diagnosis of Kounis syndrome type I variant was made. Only a few cases of Kounis syndrome in the setting of cardiopulmonary arrest have been published. We believe that in these cases, the recognition of the main underlying cause that lead to arrest (acute coronary syndrome or severe anaphylactic reaction) plays an important role in the choice of the most appropriate treatment for the patient. .

The value of E-cadherin/beta-catenin expression in imprints of NCSLC: relationship with clinicopathological factors.

Metastasis is specific for malignant tumors and its control is one of the most important problems in the design of therapies for cancer patients. Loss or reduction of E-cadherin expression and/or beta-catenin expression plays a casual role in tumor progression and metastasis and is associated with poor prognosis. The purpose of the study is to investigate the expression of E-cadherin and beta-catenin and their significance as independent prognostic markers in imprints of resected nonsmall cell lung cancer (NSCLC). Imprint smears from 70 patients who underwent surgical lung resection for primary carcinoma were studied. As control group was used imprints of physiological tissues. Histologically 47 (67.1%) of the tumors were squamous cell carcinomas and 23 (32.9%) were adenocarcinomas. Tumors stage was I in 29 (41.4%), II in 13 (18.6%), III in 24 (34.3%) and IV in 4 (5.7%). Positive expression for E-cadherin was observed in 44.29% of malignant smears vs 85.71% for control group (P = 0.011). For beta-catenin, positive expression was observed in 42.86% malignant cases vs 85.71% for control group (P = 0.008). Positive expression of E-cadherin and beta-catenin was observed in moderate and well differentiated tumors (P < 0.0001 for both respectively). Positive E-cadherin and beta-catenin expression was observed in 70.6% and 76.5% of the cases with negative lymphnode metastasis (P < 0.0001 for both respectively). There was no statistically significant association between histological type, tumor stage, pleural invasion, tumor size (P > 0.05 for all) and E-cadherin/beta-catenin expression.Reduced E-cadherin or beta-catenin negative expression relates to dedifferentiation and progression of NSCLC.

DNA ploidy, E-cadherin, beta-catenin expression and their clinicopathologic significance in imprints of non-small cell lung cancer.

OBJECTIVE: To evaluate, in imprints of resected non-small cell lung cancers (NSCLCs), the relationship between DNA ploidy and E-cadherin/beta-catenin expression with classical prognostic factors. STUDY DESIGN: A total of 45 patients (28 squamous cell carcinomas and 17 adenocarcinomas) who underwent surgical treatment for NSCLC were examined with immunocytochemistry for the expression of E-cadherin/ beta-catenin imprint smears, which also were stained using the Thionin Feulgen procedure in order to evaluate DNA ploidy in the same cases. RESULTS: Thirty-two (71.1%) of the tumors were classified as aneuploid. E-cadherin-positive expression was observed in 18 (40%) and p-catenin in 21 (46.7%) of the tumors. We found a significant relationship between DNA ploidy and grade (p= 0.005). E-cadherin and beta-catenin expression correlated with grade (p < 0.0001 for both) and also with nodal status (p = 0.004 and p = 0.017, respectively). The mean DNA index was higher for tumors with negative expression of E-cadherin/beta-catenin (p = 0.045 and p = 0.025, respectively). CONCLUSION: DNA aneuploidy correlates with poor and moderately differentiated tumors. E-cadherin- and beta-catenin-positive expression is in relation to well-differentiated carcinomas and nodal metastasis. The relationship between DNA ploidy and E-cadherin/beta-catenin needs to be further investigated.