Diandric triploid partial mole versus digynic nonmolar triploidy: is morphological assessment sufficient for the diagnostic distinction?

AIMS: Diagnostic separation of diandric triploid gestation, i.e. partial mole from digynic triploid gestation, is clinically relevant, as the former may progress to postmolar gestational trophoblastic neoplasia. The aim of the study was to investigate if the combination of abnormal histology combined with ploidy analysis-based triploidy is sufficient to accurately diagnose partial mole. METHODS AND RESULTS: A genotype-phenotype correlation study was undertaken to reappraise histological parameters among 20 diandric triploid gestations and 22 digynic triploid gestations of comparable patient age, gestational weeks, and clinical presentations. Two villous populations, irregular villous contours, pseudoinclusions, and syncytiotrophoblast knuckles, were common in both groups. Villous size ≥2.5 mm, cistern formation, trophoblastic hyperplasia, and syncytiotrophoblast lacunae were significantly more common in the partial hydatidiform mole. Cistern formation had the highest positive predictive value (PPV) (93%) and highest specificity (96%) for diandric triploid gestation, although the sensitivity was 70%. Cistern formation combined with villous size ≥2.5 mm or trophoblast hyperplasia or syncytiotrophoblast lacunae had 100% specificity and PPV, but a marginal sensitivity of 60%-65%. A moderate interobserver agreement (Kappa = 0.57, Gwet's AC1 = 0.59) was achieved among four observers who assigned diagnosis of diandric triploid gestation or digynic triploidy solely based on histology. CONCLUSIONS: None of histological parameters are unique to either diandric triploid gestation or digynic triploid gestation. Cistern formation is the most powerful discriminator, with 93% PPV and 70% sensitivity for diandric triploid gestation. While cistern formation combined with either trophoblastic hyperplasia or villous size ≥2.5 mm or syncytiotrophoblast lacunae has 100% PPV and specificity for diandric triploid gestation, the sensitivity is only 60% to 65%. Therefore, in the presence of triploidy, histological assessment is unable to precisely classify 35% to 40% of diandric triploid gestations or partial moles.

Novel FOXL2 Mutation in an Ovarian Adult Granulosa Cell Tumor: Report of a Case With Diagnostic and Clinicopathologic Implications.

Adult granulosa cell tumor, the most common malignant ovarian sex cord-stromal tumor, harbors the characteristic mutation c.402C>G (p.C134W) in the FOXL2 gene in ~90% to 95% of cases. To date, no other variants of FOXL2 mutations have been identified in these tumors. Here we report the first case of an adult granulosa cell tumor with a novel FOXL2 point mutation c.398C>T (p.A133V) presenting in a 64-year-old postmenopausal woman. The patient underwent total hysterectomy and bilateral salpingo-oophorectomy for atypical endometrial hyperplasia and gross examination revealed an incidental 3.2 cm right ovarian mass with a solid, bright yellow, homogeneous cut surface. Microscopically, ~30% of the tumor showed a nested growth pattern composed of uniform tumor cells with oval nuclei and a moderate amount of pale cytoplasm, while the remaining areas consisted of a bland storiform fibromatous stroma. Reticulin stain demonstrated loss of the individual pericellular network within the nested areas, while the pericellular staining pattern was retained in the background stromal component. FOXL2 sequencing analysis was performed in both components and revealed a c.398C>T (p.A133V) mutation in the nested component, whereas wild-type FOXL2 sequence was identified in the fibromatous stroma. Sections from the uterus showed a low-grade endometrioid endometrial adenocarcinoma with superficial myometrial invasion. The patient underwent adjuvant vaginal cuff brachytherapy for the endometrial carcinoma and is alive and well at 8 months follow-up. This case illustrates that new FOXL2 mutations may be detected in ovarian sex cord-stromal tumors with increasing use of routine molecular testing, adding to the complexity of the pathologic diagnosis. In the right morphologic and clinical context, a FOXL2 mutation-even if it is different from the dominant hotspot mutation c.402C>G (p.C134W)-can support the diagnosis of adult granulosa cell tumor.

Relationships between work-family conflict and family structure in the lives of working mothers in Hungary - a pilot study.

BACKGROUND: The family, as the basic socialization environment, is a complex dynamic system that - as a whole and through its subsystems - is in relationships with other social systems (Bagdy in Family socialization and personality disorders. Nemzeti Tankönyvkiadó, Budapest, 2002; Lakatos et al. in Mentálhigiéné és Pszichoszomatika 21(1):56-85, 2020). The system with which the family system has long-term relationships is the work system/environment. Creating and maintaining a work-life balance has become a central issue in our societies, as they are two of the most organising forces, and reconciling them is a very difficult task due to the demands and expectations coming from both directions, often simultaneously (Makra et al. in Magyar Pszichológiai Szemle 67(3):491-518, 2012). This kind of "double burden" primarily affects women, but their increasing role in the labour market is not necessarily followed by an equal sharing of work within family life (Engler et al. in Work-life balance in women's careers. In: Tardos K, Paksi V, Fábri Gy (eds) Scientific careers in the early 21st century. Belvedere Meridionale, Szeged, pp 114-126, 2021). We hypothesise that involvement in work negatively correlates with work-life balance, making it more difficult to integrate into the family. It was expected that the relationship between the number of children and mothers' professional involvement would be negative. A positive correlation was expected between the age of the youngest child and the mothers' work involvement. On the other hand, a family united by cohesion and resilience leads to higher job satisfaction. METHODS: For the present analysis, we analysed the relationships between work-family conflict and family structure in working mothers with children in a sample of 273 participants. The self-reported questionnaire included demographic data and 2 standard questionnaires: the Work-Family Conflict Questionnaire and the Olson-Family Test (FACES-IV.). The study was conducted in Hungary. RESULTS: No significant relationship was found between work involvement and work-family conflict. A negative relationship was observed between work involvement and family involvement. Similiarily, no significant relationship was found between the number of children, the age of the youngest child and work involvement, contrary to expectations. The findings indicate a positive relationship between good family cohesion, flexibility and job satisfaction. CONCLUSION: Striking a work-family balance is a challenging process for families with young children, especially working mothers. A mutually negative relationship between work and family involvement has been shown. The importance of a well-functioning family, with adequate cohesion and flexibility, is reflected in family and job satisfaction. The relationship between work-to-family conflict and job involvement is moderated significantly only when family flexibility is low. The results from the present pilot study indicate important relationships between variables and point to further research directions worth investigating in a larger sample in the future.

Hypersensitive quantification of major astringency markers in food and wine by substoichiometric quenching of silicon-rhodamine conjugates.

Tannins are chemically diverse polyphenols in plant-derived products that not only show diverse biological activities but also play a crucial role in determining the sensory attributes of food and beverages. Therefore, their accurate and cost-effective quantification is essential. Here, we identified a novel fluorescence quenching mechanism of different synthetic rhodamine fluorophores, with a high selectivity towards tannic acid (TA) and catechin-3-gallate (C3G) compared to a structurally diverse panel of tannins and polyphenols. Specific chemical conjugates of silicon-rhodamine with alkyl linkers attached to bulky apolar moieties had a limit of detection near 500 pM and a linear range spanning 5-100 nM for TA. We validated the assay on 18 distinct red wine samples, which showed high linearity (R2 = 0.92) with methylcellulose precipitation with no interference from anthocyanins. In conclusion, a novel assay was developed and validated that allows the sensitive and selective quantification of major astringency markers abundant in food and beverages.

The prognostic value of stem cell markers in triple-negative breast cancer.

Among the many consecutive theories of cancer, the stem cell theory is currently the most accepted one. Cancer stem cells are located in small niches with specific environment, renew themselves and are believed to be responsible for many recurrences. They can be highlighted with stem cell markers, but often these markers also label tumor cells, and this may represent a phenotypical change associated with prognosis. In this study, we attempted to match tumor outcomes with the expression of the following stem cell markers: ALDH1, AnnexinA1, CD44, CD117, CD166, Nanog and oct-4. Tissue microarray blocks from triple-negative breast cancers were immunostained for the listed markers, and their expression by the majority of tumor cells (diffuse positivity) was correlated with prognosis. Of the 106 tumors investigated, diffuse positivity was seen in 7 (ALDH1), 33 (AnnexinA1), 53 (CD44), 44 (CD117 membranous only), 49 (CD117), 72 (CD166), 19 (Nanog), and 11 (oct-4) cases. With a median follow-up of 83 months, ALDH1 and CD117 expression was associated with DFS, whereas CD44, CD117 and CD166 were associated with OS estimates, based on Kaplan-Meier analyses. In the multivariate Cox proportional hazard models (including the examined markers and clinicopathological data which had a statistical impact in the univariate analysis), the pN category and the lack of ALDH1 expression were independent prognosticators for DFS, and the pN category and diffuse CD44 staining were independent prognosticators for OS. In the multivariate analysis including all of the examined clinicopathological data and markers, only CD117 showed a statistical impact on OS. We failed to demonstrate a prognostic impact for most stem cell markers tested in triple-negative breast cancer, but lack of ALDH1 staining and CD44 expression appears as of prognostic value, requiring further examination in independent studies.

Characterization of Indoor Molds after Ajka Red Mud Spill, Hungary.

A red mud suspension of ~700,000 m3 was accidentally released from the alumina plant in Ajka, Hungary, on the 4th of October 2010, flooding several buildings in the nearby towns. As there is no information in the literature on the effects of red mud on indoor mold growth, we conducted studies to answer the following question: does the heavy metal content of red mud inhibit fungal colonization in flooded houses? In order to gain knowledge on fungal spectra colonizing surfaces soaked with red mud and on the ability of fungi to grow on them, swabs, tape lifts, and air samples were collected from three case study buildings. A total of 43 fungal taxa were detected. The dominant species were Penicillium spp. on plaster/brick walls, but Aspergillus series Versicolores, Cladosporium, Acremonium, and Scopulariopsis spp. were also present. The level of airborne penicillia was high in all indoor samples. Selected fungal strains were subcultured on 2% MEA with 10-1 and 10-4 dilutions of red mud. The growth rate of most of the strains was not significantly reduced by red mud on the artificial media. The consequences of similar industrial flooding on indoor molds are also discussed in this paper.