Validation of the Greek translation of the Dundee Ready Education Environment Measure (DREEM).

CONTEXT: The educational environment makes an important contribution to student learning. The DREEM questionnaire is a validated tool assessing the environment. OBJECTIVES: To translate and validate the DREEM into Greek. METHODS: Forward translations from English were produced by three independent Greek translators and then back translations by five independent bilingual translators. The Greek DREEM.v0 that was produced was administered to 831 undergraduate students from six Greek medical schools. Cronbach's alpha and test-retest correlation were used to evaluate reliability and factor analysis was used to assess validity. Questions that increased alpha if deleted and/or sorted unexpectedly in factor analysis were further checked through two focus groups. FINDINGS: Questionnaires were returned by 487 respondents (59%), who were representative of all surveyed students by gender but not by year of study or medical school. The instrument's overall alpha was 0.90, and for the learning, teachers, academic, atmosphere and social subscales the alphas were 0.79 (expected 0.69), 0.78 (0.67), 0.69 (0.60), 0.68 (0.69), 0.48 (0.57), respectively. In a subset of the whole sample, test and retest alphas were both 0.90, and mean item scores highly correlated (p<0.001). Factor analysis produced meaningful subscales but not always matching the original ones. Focus group evaluation revealed possible misunderstanding for questions 17, 25, 29 and 38, which were revised in the DREEM.Gr.v1. The group mean overall scale score was 107.7 (SD 20.2), with significant differences across medical schools (p<0.001). CONCLUSION: Alphas and test-retest correlation suggest the Greek translated and validated DREEM scale is a reliable tool for assessing the medical education environment and for informing policy. Factor analysis and focus group input suggest it is a valid tool. Reasonable school differences suggest the instrument's sensitivity.

Immunohistochemical detection of cathepsin D in low grade breast invasive cancer.

BACKGROUND: Cathepsin D (CatD) can facilitate the invasive behaviour of breast cancer cells and thus plays a key role in the mechanism of invasion and metastasis. MATERIALS AND METHOD: The expression of the protease CatD was evaluated using an immunohistochemical technique with a polyclonal antibody on paraffin-embedded tissue from 80 women treated for invasive ductal mammary carcinoma not otherwise specified (NOS). RESULTS: Thirty seven tumours (46%) showed prominent staining of cells in the tumour. Neoplastic cell staining for CatD correlated with axillary nodal involvement (p < 0.05), high oestrogen receptor positivity status (p < 0.01) and low or moderate tumour grade (p < 0.05). Stromal cell (primarily histiocyte) CatD immunostaining was frequently noticed and was proportional to the degree of the intratumoural inflammatory infiltrate. CONCLUSIONS: Cat D detection in neoplastic cells is likely to be involved in the invasive capability of well differentiated breast cancer cells, but it may simultaneously reflect the functional integrity of the oestrogen response pathway, commonly observed in well-differentiated tumours.

Prognostic significance of p53 and c-erbB-2 immunohistochemical evaluation in colorectal adenocarcinoma.

Mutant p53 tumour suppressor gene and c-erbB-2 proto-oncogene are involved in human carcinogenesis, and their protein product detection in human malignancies might influence the evolution of many neoplasms. Our aim was to estimate their association with histopathological and clinical parameters of prognostic value in colorectal cancer. An immunohistochemical assay was undertaken in formalin-fixed sections from tissue specimens of 60 colorectal carcinomas. Nuclear p53 expression was detected in 46.6%, while membranic c-erbB-2 positivity was noticed in 35% of the examined cases. P53 positivity rate significantly correlated with poor differentiation (p < 0.001), high mitotic activity (p < 0.0001), tumour stage (p < 0.001) and 5-year overall survival period (p < 0.01). C-erbB-2 positivity incidence significantly correlated with advanced Dukes' stage (p < 0.001) and high mitotic activity (p < 0.05). Significant association between p53 and c-erbB-2 immunostaining was observed (p < 0.05) and p53/c-erbB-2 co-expression was related to poor differentiation (p < 0.001), high mitotic activity (p < 0.001), advanced Dukes' stage (p < 0.001), tumour aneuploidy (p < 0.05) and worse overall survival (p < 0.05). P53 and c-erbB-2 immunohistochemical detection in combination with known prognostic indicators may be a useful future tool in determining colorectal cancer prognosis and subsequently in deciding on optimal postoperative treatments.