Prognostic value of EZH2, paxillin expression and DNA ploidy of breast adenocarcinoma: correlation to pathologic predictors.

PURPOSE: The objective of this study was to examine the association of EZH2 and paxillin expression and DNA ploidy status with pathological parameters of breast cancer, aiming to correlate tumor phenotype with its malignant behavior. METHODS: EZH2 and paxillin expression and DNA ploidy were evaluated in imprint smear samples obtained from 105 breast tumors after surgical removal. RESULTS: Increased expression of paxillin was associated with p53 expression (p=0.005), Ki-67 expression (p=0.018) and EZH2 expression (p<0.0001). EZH2 expression correlated with estrogen receptor (ER) and progesterone receptor (PR) status (p=0.01 and p=0.035, respectively), and expression of p53 and Ki-67 (p=0.007 and p<0.0001, respectively). Aneuploid tumors were significantly correlated with poor differentiation (p=0.000), stage of disease (p=0.000), size of the primary tumor (p=0.015), presence of nodal metastasis (p=0.001), ER status (p=0.008), cerbB2 status (p=0.012), and expression of Ki-67 (p=0.001) and EGFR (p=0.018). Multivariate analysis of ploidy results using paxillin and EZH2 expression as dependent variables revealed that aneuploid tumors were associated with disease stage and grade of differentiation, cerbB2 expression and EZH2 expression. CONCLUSION: Our results show that aneuploid tumors, EZH2 expression and paxillin expression correlate with more aggressive phenotype of breast cancer.

Vein patch angioplasty with non-penetrating titanium clips. Comparison to standard suture technique.

Our purpose was to compare the Vascular Closure Staples (VCS) clips to a standard suture technique for vein patch angioplasty in a porcine model. Six female pigs underwent vein patch angioplasty of the common iliac arteries with either VCS clips or continuous suturing. The reconstructed vessels were evaluated macroscopically, angiographically and histologically after two months by re-operation. There was a non significant trend towards shorter reconstruction (6.5 +/- 1.8 min. for clips vs. 8.5 +/- 1.7 min. for sutures, p = 0.15) and clamp times when clips were used (8.4 +/- 1.5 min. vs. 10.1 +/- 1.3 min., p = 0.15). At re-operation all vessels were found patent without significant histological differences regarding the intimal reaction. VCS clips are a reliable alternative to sutures for vein patch angioplasty.

Study comparing sutures and nonpenetrating titanium clips for arteriotomy closure after embolectomy.

BACKGROUND: The vascular closure staple (VCS) clip applier system is an alternative to suture for closing arteriotomies and performing vascular anastomoses. This study was designed to evaluate the possible advantages of its use in closing arteriotomies after embolectomy. METHODS: In this study, 26 patients with upper or lower extremity embolism underwent embolectomy, and the arteriotomy was closed using either VCS clips (group A) or sutures (group B). RESULTS: The time required for arteriotomy closure with clips (11.2 +/- 2.7s) was considerably shorter than the time required with sutures (241.2 +/- 48.7s; p < 0.0001), resulting also in shorter clamp times (380.8 +/- 127.3s vs 612.7 +/- 112.6 s; p < 0.0001). No hemodynamically significant stenoses or pseudoaneurysms were detected at the arteriotomy sites in any of the patients up to 1 year after embolectomy. CONCLUSIONS: The VCS clip applier system, a quick and easy method for closing arteriotomies, is as safe as sutures in terms of narrowing of the artery and formation of pseudoaneurysm.

New views on treatment of aromatase inhibitors induced arthralgia.

BACKGROUND: Aromatase Inhibitor (AI) induced arthralgia is one of the most frequent side effects in breast cancer hormonal therapy, which may become severe in some cases affecting patients' quality of life. The purpose of this study is to investigate alternative treatment of arthralgia, as current treatment options may often prove to be inadequate. MATERIAL-METHODS: According to Morales et al, AI-associated arthralgia syndrome is characterized by tenosynovial changes in MRI, including fluid in tendon sheaths and joints. Initially, furosemide (20 mg per two days) was prescribed by our team, in order to minimize peripheral edema in women receiving aromatase inhibitors. The data collected demonstrated that 16 out of 18 patients had benefited from the addition of a diuretic agent in their adjuvant AI treatment as far as AI induced arthralgia is concerned as well. In this retrospective study, data from 288 women receiving an AI for non-metastatic breast cancer are analyzed in order to define whether chronic diuretic therapy could affect the impact of arthralgia on those patients. RESULTS: 42/288 Patients were receiving chronic diuretic therapy for heart disease or hypertension (Group A), while 246/288 patients had never received any diuretic medication (Group B). At 43.03 months of mean follow up, in Group A arthralgia was developed in 3/42 patients (6.97%) as opposed to 39/246 patients in Group B (15.85%) -p value: 0.01. Other parameters that could affect the impact of arthralgia in both Groups are also analyzed and taken under consideration. CONCLUSION: Despite the low number of patients and the retrospective nature of the study, there was a clear trend to a lower incidence of arthralgia in patients receiving chronic diuretic therapy. We believe that based on this hypothesis generating study further research should be done to assess the value of diuretic agents in the treatment of AI-associated arthralgia.