Subject(s)
Brain/diagnostic imaging , Microcephaly/etiology , Neuroimaging/methods , Pregnancy Complications, Infectious/virology , Zika Virus Infection/complications , Adult , Autopsy/methods , Brain/pathology , Female , Humans , Magnetic Resonance Imaging/methods , Microcephaly/diagnostic imaging , Microcephaly/pathology , Neuropathology/methods , Pregnancy , Ultrasonography, Prenatal/methods , Zika VirusABSTRACT
Bullous systemic lupus erythematosus (BSLE) is a rare but distinct disease, characterized by vesiculobullous skin eruptions and systemic lupus erythematosus (SLE). It can arise either before or after a diagnosis of SLE has been established. BSLE is characterized by a dermatitis herpetiformis-like histology and an autoimmunity to type VII collagen. It must be differentiated from other autoimmune vesiculobullous diseases such as epidermolysis bullosa acquisita, dermatitis herpetiformis, linear IgA disease, and bullous pemphigoid. A combination of clinical, histological, and immunofluorescence findings are necessary to establish a diagnosis of BSLE. We present a case of BSLE to illustrate and emphasize the need for an integrative diagnostic approach.
Subject(s)
Lupus Erythematosus, Cutaneous/diagnosis , Lupus Erythematosus, Cutaneous/drug therapy , Skin Diseases, Vesiculobullous/diagnosis , Skin Diseases, Vesiculobullous/drug therapy , Adolescent , Adrenal Cortex Hormones/administration & dosage , Diagnosis, Differential , Fluorescent Antibody Technique, Direct , Humans , Immunohistochemistry , Lupus Erythematosus, Cutaneous/complications , Male , Skin Diseases, Vesiculobullous/complicationsABSTRACT
BACKGROUND: The prognostic significance of DNA ploidy and the S-phase fraction (SPF) have been extensively studied in breast cancer, but their clinical utility remains controversial. The type of tumour material can substantially influence flow cytometric DNA measurements. Material obtained by fine needle aspiration (FNA) biopsy is very suitable for flow cytometric DNA analysis because it contains a low proportion of non-tumour cells and less debris than tissue samples. METHODS: The prognostic significance of DNA ploidy and SPF, determined on FNA samples, was analysed in 770 breast cancer patients, diagnosed between 1992 and 1997. DNA ploidy and SPF were determined at the time of diagnosis as part of the diagnostic work-up. The median follow-up was 90 months. Survival analysis included overall cancer specific survival (OS), disease free survival (DFS) and survival after recurrence (SAR). Other variables included in survival analyses were age, histological grade, histological type, lymph node status and tumour size. Disease free interval and the site of recurrence were also included in SAR analysis. RESULTS: DNA ploidy and SPF correlated with tumour type, size, lymph node involvement and, especially, tumour grade. In a univariate analysis, both aneuploidy and high SPF were associated with shorter OS, DFS and SAR, but only SPF retained its independent prognostic significance in multivariate analyses. Independent prognostic variables for OS were node status, histological grade, SPF and tumour size. Node status, histological grade and SPF were independent predictors of DFS, while the site of recurrence, SPF, histological grade, disease free interval and age were independent predictors of SAR. CONCLUSIONS: DNA ploidy and SPF can be efficiently and routinely determined on FNA samples. High SPF is independently associated with a worse clinical outcome of patients with breast cancer. Although SPF and histological grade share prognostic information to some degree, SPF provides additional, less subjective prognostic information. The prognostic value of SPF determined on FNA samples could be even more relevant in neoadjuvant settings and for patients not amenable for surgical treatment, when histological grade cannot be assessed.
Subject(s)
Biopsy, Fine-Needle , Breast Neoplasms/diagnosis , Breast Neoplasms/pathology , S Phase , Breast Neoplasms/genetics , Female , Humans , Middle Aged , Multivariate Analysis , Prognosis , Proportional Hazards Models , Recurrence , Survival AnalysisABSTRACT
Survivin is a member of the inhibitor of apoptosis protein family, which is over-expressed in many human cancers. Our aim was to analyse survivin expression in medulloblastoma, its association with aberrant activation of the WNT (wingless) pathway and to test the prognostic significance of survivin expression. We immuno histochemically analysed survivin expression and localization of beta-catenin, a downstream mediator of the WNT pathway, in 56 cases of medulloblastoma. Survivin was detected in the nuclei of tumour cells in all cases, but the proportion of positive nuclei varied from 0.5 to 31.3%. Survivin expression tended to be higher in medulloblastomas with an aberrant activation of the WNT pathway (nuclear localization of beta-catenin), but did not correlate with histological type, age group or dissemination via cerebrospinal fluid pathways. Survivin expression and dissemination status were two independent negative prognostic variables for the overall survival of patients with medulloblastoma. In conclusion, survivin is up-regulated in medulloblastomas. It is a negative prognostic marker and a potential therapeutic target.
Subject(s)
Biomarkers, Tumor/analysis , Cerebellar Neoplasms/metabolism , Medulloblastoma/metabolism , Microtubule-Associated Proteins/metabolism , Neoplasm Proteins/metabolism , Adolescent , Adult , Cerebellar Neoplasms/mortality , Child , Child, Preschool , Cytoskeletal Proteins/metabolism , Female , Humans , Immunohistochemistry , Inhibitor of Apoptosis Proteins , Male , Medulloblastoma/mortality , Middle Aged , Prognosis , Survival Analysis , Survivin , Trans-Activators/metabolism , Up-Regulation , beta CateninABSTRACT
The aim of the study was to compare the pin-bone interface microstructural characteristics of hydroxyapatite-coated (HAC) and stainless steel Schanz screws after 2, 4 and 6 months of implantation in a sheep model. The microstructure and composition of the hydroxyapatite coating were analyzed using scanning electron microscopy (SEM) and X-ray diffraction (XRD) analysis. Twelve coated and 12 uncoated screws were implanted into both femora of three sheep, each sheep receiving eight screws. Specimens of polished bone with screws were examined with SEM and light microscope for morphometric analyses. The HAC was approx. 40 microm thick, the grain size ranged from 5 to 40 microm, with pores less than 20 microm. The atomic ratio of Ca/P was 1.62. SEM showed that the bone-implant contact was better with HAC than with uncoated implants. The ingrowth of the bone in the HAC was clearly seen. Morphometric analysis showed good bone-implant contact in 65.1 (+/-24.6)% in the HAC and 32.0 (+/-23.3)% in the uncoated group (p<0.001). Although the percentage of good contact increased with time for both groups, it was significantly higher for HAC screws. Our investigation demonstrated a time dependent improvement of implant-bone contact of the HAC compared to standard stainless steel implants in the chosen experimental conditions.
Subject(s)
Bone Screws , Coated Materials, Biocompatible/chemistry , Durapatite/chemistry , Equipment Failure Analysis , Femur/cytology , Femur/surgery , Osseointegration/physiology , Animals , Coated Materials, Biocompatible/analysis , Durapatite/analysis , Female , Femur/diagnostic imaging , Radiography , Sheep , Surface PropertiesABSTRACT
AIMS: To investigate survivin expression in laryngeal squamous cell carcinoma (LSCC), its prognostic significance and relation to p53 status. Survivin is an inhibitor of apoptosis protein that is overexpressed in cancer. It has been implicated in both prevention of apoptosis and cell cycle regulation. It has been suggested that wild-type p53 represses survivin expression. METHODS AND RESULTS: Expression of survivin and p53 was analysed in 68 archival biopsy specimens of LSCC by immunohistochemistry. Survivin was detected in 67 of 68 LSCC cases; the proportion of survivin-positive cells varied from 8.2% to 100%. It was localized in the nucleus and/or cytoplasm of tumour cells. Of LSCC cases, 31.8% were p53+. The number of survivin-positive cells was significantly higher in the p53+ group. A high level of survivin expression and a supraglottic site of the tumour were two independent adverse prognostic factors in LSCC. CONCLUSIONS: Survivin is expressed in a varying proportion of cells in virtually all cases of LSCC. A high level of its expression predicts poor survival. Loss of wild-type p53 is a possible mechanism of survivin up-regulation in LSCC.
Subject(s)
Antigens, Neoplasm/metabolism , Carcinoma, Squamous Cell/metabolism , Laryngeal Neoplasms/metabolism , Microtubule-Associated Proteins/metabolism , Tumor Suppressor Protein p53/metabolism , Biomarkers, Tumor/metabolism , Carcinoma, Squamous Cell/mortality , Carcinoma, Squamous Cell/pathology , Female , Humans , Immunoenzyme Techniques , Inhibitor of Apoptosis Proteins , Laryngeal Neoplasms/mortality , Laryngeal Neoplasms/pathology , Male , Middle Aged , Neoplasm Proteins , Neoplasm Staging , Prognosis , Survival Rate , SurvivinABSTRACT
UNLABELLED: The aim of the study was to determine the proliferative and apoptotic activity of neoplastic and non-neoplastic hepatocytes, to ascertain whether there was a correlation between the histopathological characteristics of hepatocellular carcinoma (HCC) and its proliferative or apoptotic activity. METHODS: One tumour sample and one sample of non-neoplastic liver from 16 patients with HCC were analysed. The proliferative activity was established by immunohistochemical staining against PCNA (proliferating cell nuclear antigen) and Ki-67. Apoptotic activity was determined by morphological and TUNEL methods. Bcl-2 immunoreactivity was analysed. RESULTS: A positive correlation between PCNA and Ki-67 proliferative indexes was found in HCC (p < 0.01). The PCNA index was 0.21% +/- 0.80% (Mean +/- SD) in non-neoplastic liver and 7.41% +/- 8.22% in HCC, while the Ki-67 index was 0.19% +/- 0.26% in non-neoplastic liver and 9.67% +/- 7.70% in HCC. The differences between HCC and non-neoplastic liver were significant (p < 0.05). The PCNA index differed significantly between different HCC grades (p < 0.05). In HCC and non-neoplastic liver samples, apoptotic indexes (AI) assessed morphologically were higher than Al determined by the TUNEL method. Differences in Al (irrespective of the method used) between different HCC grades were not significant. Bcl-2 staining was positive in one non-neoplastic liver sample (6.3%) and in 4 HCC samples (25%). CONCLUSIONS: PCNA and Ki-67 were useful for proliferative activity assessment of hepatocytes. There were no differences in apoptotic activity between HCC and non-neoplastic tissue, so it seems that uncontrolled tumour cell division plays an important role in HCC growth. In the regulation of the apoptotic process in HCC, Bcl-2 could be important.
