Adenomatous polyposis coli (APC) protein expression in primary and metastatic serous ovarian carcinoma.

The aim of this study was to investigate protein expression of adenomatous polyposis coli (APC) in primary and metastatic serous ovarian carcinoma. The expression of beta-catenin and E-cadherin was additionally analyzed. One hundred and thirteen primary (n = 56) and metastatic (n = 57) lesions were immunohistochemically stained for APC, E-cadherin, and beta-catenin. Staining extent was scored. Possible differences in immunoreactivity in primary and metastatic sites and the association between the proteins analyzed were evaluated statistically. Cytoplasmic immunoreactivity for APC was found in 67/113 (59%) tumors, most often in the majority (> 50%) of cells. E-cadherin was detected in 102/113 (90%) carcinomas, while beta-catenin was expressed in 109/113 (97%) specimens. Nuclear expression of beta-catenin was seen in 3/113 (3%) specimens, all negative for APC. APC and beta-catenin were often coexpressed, but this finding failed to reach statistical significance (p = 0.11). A significant association was seen between E-cadherin and beta-catenin expression (p = 0.001). APC expression was comparable in primary and metastatic tumors (p > 0.05). In conclusion, APC expression is absent in a considerable number of both primary and metastatic ovarian carcinomas, but this finding is only rarely coupled to nuclear accumulation of beta-catenin. These findings support the role for beta-catenin signaling via the Wingless/Wnt pathway in ovarian carcinoma. The mechanism behind the down-regulated expression of APC in serous ovarian carcinoma and its significance has yet to be elucidated.

Surveillance, control and management of infections in intensive care units in Southern Europe, Turkey and Iran--a prospective multicenter point prevalence study.

OBJECTIVE: We aimed to compare the features of intensive care units (ICUs), their antimicrobial resistance patterns, infection control policies, and distribution of infectious diseases from central Europe to Mid-West Asia. METHODS: A cross-sectional point prevalence study was performed in 88 ICUs from 12 countries. Characteristics of ICUs, patient and antibiotic therapy data were collected with a standard form by infectious diseases specialists. RESULTS: Out of 749, 305 patients at least with one infectious disease were assessed and 254 patients were reported to have coexistent medical problems. When primary infectious diseases diagnoses of the patients were evaluated, 69 had community-acquired, 61 had healthcare-associated, and 176 had hospital-acquired infections. Pneumonia was the most frequent ICU infection seen in half of the patients. Distribution of frequent pathogens was as follows: Enteric Gram-negatives (n = 62, 28.8%), Acinetobacter spp. (n = 47, 21.9%), Pseudomonas aeruginosa (n = 29, 13.5%). Multidrug resistance profiles of the infecting microorganisms seem to have a uniform pattern throughout Southern Europe and Turkey. On the other hand, active and device-associated infection surveillance was performed in Turkey more than Iran and Southeastern Europe (p < 0.05). However, designing antibiotic treatment according to culture results was highest in Southeastern Europe (p < 0.05). The most frequently used antibiotics were carbapenems (n = 92, 30.2%), followed by anti-gram positive agents (vancomycin, teicoplanin, linezolid, daptomycin, and tigecycline; n = 79, 25.9%), beta-lactam/beta lactamase inhibitors (n = 78, 25.6%), and extended-spectrum cephalosporins (n = 73, 23.9%). CONCLUSION: ICU features appears to have similar characteristics from the infectious diseases perspective, although variability seems to exist in this large geographical area.

Papillary serous carcinoma of the ovary: an ultrastructural and immunohistochemical study.

Twenty-four patients with ovarian serous papillary carcinoma were enrolled in the present ultrastructural and immunohistochemical study. Immunohistochemistry was used to examine the status of proliferation activity with antibodies against Ki67 and BM28, and the status of EGFR family members with antibodies against EGFR, c-erbB-2, and c-erbB-4. Ultrastructurally, poorly differentiated tumors often revealed solid sheets of tumor cells with variable desmosomes, cell connection complexies, and microvilli. No mature cilia, which are often present in benign and borderline ovarian epithelial tumors, were seen in these 24 carcinomas. However, two poorly differentiated tumors demonstrated oligocilia. In addition, numerous secondary lysosomes and bizzare intracytoplasmic pseudocavities were more often present in the poorly differentiated tumors. Immunohistochemically, strong expressions of BM28 and Ki67 in more than 50% of the tumor cells were found in 12/15 (80%) and 11/15 (73%) of the poorly differentiated tumors, respectively, compared with 3/9 (33%) and 1/9 (11%) of the moderately differentiated tumors, respectively. Higher levels of EGFR and c-erbB-2 expressions were more often observed in the poorly differentiated tumors, compared with that in the moderately differentiated tumors. In conclusion, oligocilium, numerous secondary lysosomes, and bizarre intracytoplasmic inclusions are more often seen in poorly differentiated ovarian serous carcinomas. Poorly differentiated ovarian serous carcinomas express higher levels of Ki67, BM28, EGFR, and c-erbB-2 proteins.