Immunohistochemical expression and prognostic significance of VEGF-C in well-differentiated thyroid cancer.

CONTEXT: Neoangiogenesis and lymphangio-genesis are essential for the growth of tumor and progression of malignancy. OBJECTIVE: The study examined the significance of VEGF-C expression in comparison to classical prognostic factors in differentiated thyroid carcinoma (DTC), as well as an independent prognostic marker in DTC. DESIGN: The study included 81 patients with DTC allocated in two groups according to the type of cancer (follicular versus papillary) and then compared to expression of VEGF-C and clinicopathological features. METHODS: Expression of VEGF-C was identified with anti-VEGF-C antibody using tris-EDTA buffer Antigen Retrieval Protocol. Each specimen was scored with a semi-quantitative score system (H-score). RESULTS: The analysis of T staging system showed a linear correlation between the size of a tumor, expression of VEGF-C and recurrence of a disease, with a statistical significance (p < 0.0001). There was a clear and significant correlation between VEGF-C expression and T stage in patients with papillary carcinoma (p = 0.0294). Analysis of invasion of a surgical margin demonstrated significant positivity in patients with papillary thyroid cancers who expressed VEGF-C (p = 0.0207) indicating the worse prognosis of a disease. Also a statistically significant correlation was between VEGF-C and extrathyroid extension, indicating the worse prognosis (p = 0.0133) in papillary cancers. The level of VEGF-C expression was statistically significant in patients with papillary thyroid cancer (p = 0.039). CONCLUSIONS: This study undoubtedly demonstrates that VEGF-C expression is an evident negative prognostic factor in patients with papillary thyroid carcinoma, along with the classic prognostic factors, such as a larger tumor size, tumor margin involvement, extrathyroid extension, i.e. local aggressiveness.

The first case of Li-Fraumeni syndrome in Bosnia and Herzegovina: case report.

Li-Fraumeni syndrome (LFS) is a very rare autosomal dominant and highly penetrant cancer syndrome characterized by early-onset primary tumours, including soft tissue and bone sarcoma, breast cancer, leukemia, brain tumours and adrenocortical carcinoma. Here we report the first evidence-based case of LFS in Bosnia and Herzegovina and the whole Balkan region. A ten year-old girl developed multiple primary tumours (rhabdomyosarcoma) during a period of eight years, as well as fibroadenoma of the breast. Sequential analysis revealed a germ line mutation of TP53 in exon 8, a common mutation in patients with LFS, in both the patient and her mother.

Prognostic significance of PU.1 in follicular lymphoma.

Very few prognostic factors are known in follicular lymphoma (FL), a common malignancy of germinal centre (GC) B-cells. The Follicular Lymphoma International Prognostic Index (FLIPI) thus far appears to be the most important predictor of clinical outcome. This study explores the predictive power of the degree of GC differentiation for outcome in FL. Samples from 73 patients with FL were evaluated by immunohistochemistry for expression of GC markers. Strong PU.1, CD20, and CD75 expression were significantly associated with longer progression-free survival (PFS) and overall survival (OS). Results for PFS were independent of the International Prognostic Index or the Italian Lymphoma Intergroup prognostic index for CD75 and PU.1, but only PU.1 expression was independent of FLIPI for PFS and OS. Oct-2 was weakly expressed overall, but more strongly in higher grades of FL; it had a trend for negative linear association with PU.1 and strong positive linear association with CD27, which possibly reflects its role in terminal B-cell differentiation. We show that the level of GC differentiation, as determined by the levels of PU.1, CD75, CD20, Bcl-6, and CD10 expression, has an association with outcome in patients with FL. While this is determined qualitatively in most studies of diffuse large B-cell lymphoma, in FL there is a quantitative positive association between a high level of expression of GC antigens and longer OS and PFS even when data are stratified by the FLIPI score.

[Telemedicine with respect to telepathology in Bosnia-Herzegovina]. / Telemedicina sa osvrtom na telepatologiju u BiH.

Telemedicine is rather new activity covering various approaches in order to fulfill the main task which can be expressed in more comprehensive words such as "remote medicine" or "medicine on distance". One of definitions of the telemedicine given by the European Commission for Telemedicine says that "telemedicine is fast access to distributed medical expert knowledge using telemedicine and information technologies regardless of actual location of a patient or relevant information". The first connection has been established with Zagreb, Croatia in September by means of PHAROS. In October 1996 the Institute of Pathology with the Radiology and Ophthalmology Clinic of University hospital of Sarajevo has joined the experimental project "SHARED" (a telemedicine initiative to support remote health care structure, proposed by the San Raffaele International Biomedical Science Park with Stato Maggiore della diffesa and European Space Agency). Due to problems in infrastructure and lack of experts, small country like, Bosnia and Herzegovina (B&H) sees telemedicine as a future in its health care organizing.

Benefits of using telemedicine and first results in Bosnia and Herzegovina.

In October 1996 the Institute of Pathology with the Radiology and Ophthalmology Clinic of the university hospital of Sarajevo joined the experimental telemedicine project SHARED. Two months after the project began, dermatology, paediatrics and haematology were also included. During the first phase we had 40 teleconsultations that showed us the benefits of using telemedicine. Our opinions and the opinions of the pathologist in Milan were similar for most of the biopsies (78%). The total time required for the consultation for the first 40 cases was 372 min, or 9.3 min each, on average. The longest consultation time was 25 min. The largest number of images was 44 per case, the smallest four. Because of problems of infrastructure and lack of experts, telemedicine will be important to a small country like Bosnia and Herzegovina.

[Morphometric characteristics of Leydig cells after total irradiation of rats treated with melatonin]. / Morfometrijske karakteristike Leydigovih stanica totalno ozracenih stakora tretiranih melatoninom.

The aim of the study was to determine the effects of exogenous melatonin on Leydig cells in irradiation stress. Nuclear and cytoplasm surface of Leydig cells in sham pinealectomized and pinealectomized adult Wistar rats was determined after their total irradiation with 8 Gy of gama rays produced by 60 Co and with previously performed 14 days treatment by injecting of melatonin solution in a daily dose of 0.2 mg. Rats testes were histologically prepared 17 days after irradiation. Total melatonin administration significantly decreased surface of Leydig cells including both decrease of their nuclear and cytoplasm surface in irradiated sham pinealectomized and pinealectomized rats. The results suggested about direct effects of exogenous melatonin on Leydig cells in irradiation stress.

[Telemedicine with emphasis on telepathology--its beginnings and future prospects in Bosnia-Herzegovina]. / Telemedicina sa osvrtom na telepatologiju--njen pocetak i vizija buducnosti u BiH.

Telemedicine is a rather new activity which covers various approaches in order to fulfill the main task which can be expressed in a more comprehensive way such as "remote medicine" or "medicine on distance". The first telemedical relation has been established with Zagreb, Croatia in November 1996 by means of PHAROS. One month later the Institute of Pathology together with the Radiology and Ophthalmology Clinic of University Hospital of Sarajevo joined the experimental project "SHARED" (a telemedicine initiative to support remote health care structure, proposed by the San Raffaele International, Biomedical Science Park with Stato Maggiore della diffesa and European Space Agency). During the first phase, which started in July 1996, we had 40 consultations that showed us the first results and advantages of using this system. After that we had 31 consultations more. Due to problems in the infrastructure and lack of experts, small country like Bosnia and Herzegovina (B&H) sees telemedicine as a future in its health care organising.

[Telepathology and present experience based on use of the SHARED telecommunication project]. / Telepatologija i dosadasnje iskustvo bazirano na koristenju telekomunikacionog projekta "SHARED".

Telemedicine is rather new activity covering various approaches in order to fulfill the main task which can be expressed in more comprehensive words such as "remote medicine" or "medicine on distance". One of definitions of telemedicine given by the European Commission for Telemedicine says that "telemedicine is fast access to distributed medical expert knowledge using telemedicine and information technologies regardless of actual location of a patient or relevant information". The first connection has been established with Zagreb, Croatia in September by means of PHAROS. In October 1996 the Institute of Pathology with the Radiology and Ophthalmology Clinics of University hospital of Sarajevo has joined the experimental project "SHARED" (a telemedicine initiative to support remote health care structure, proposed by the San Raffaele International Biomedical Science Park with Stato Maggiore della diffesa and European Space Agency). Due to problems in infrastructure and lack of experts, small country like Bosnia and Herzegovina (BiH) sees telemedicine as future in its health care organizing.