Expression of PAX2 and PAX8 in Wilms Tumor: A Tissue Microarray-based Immunohistochemical Study.

BACKGROUND & OBJECTIVE: There is currently inadequate information about the expression of immunohistochemical markers in pediatric tumors. Paired box genes 2 and 8 (PAX2 and PAX8) genes have an essential role in kidney organogenesis. This study aimed to investigate the IHC expression of PAX2 and PAX8 in Wilms tumor. Such study would be helpful in diagnosis and possibly in differentiation of this tumor from other mimics, especially in those of poorly differentiated type in small needle biopsy specimens. METHODS: We performed a cross-sectional study on 45 Wilms tumor cases referred to Bahrami pediatric hospital between 2005 and 2015. Demographic data were collected from medical documents. Sections from related paraffin blocks were provided by the tissue microarray method, and immunohistochemical (IHC) staining was done for PAX8 and PAX2. RESULTS: The mean tumor size was 9.98±4.95 cm. Favorable histology was seen in 84.4% of samples. PAX2 was expressed in 41 cases (91.1%), and PAX8 in 37 patients (82.2%). PAX2 and PAX8 expression was mostly seen in both blastemal and epithelial components (77.8% and 66.6%), respectively. Tumors with favorable and unfavorable histology did not significantly differ in PAX2 and PAX8 expression (P=0.637). We found a statically significant relationship between PAX8 expression and tumor size (P=0.033). CONCLUSION: PAX2 and PAX8 markers might helpful in diagnosis of Wilms tumor and may differentiate it from other histologically similar kidney tumors. PAX8 expression may be associated with larger tumor size. Tumors with favorable and unfavorable histology may not be different in PAX2 and PAX8 expression.

Mature Cystic Teratoma of Spinal Cord in a 16-Year-Old Male: A Case Report.

Teratoma is a type of multipotential cell tumor, which includes a mixture of two or three germinal layers of ectodermis, endodermis, and mesodermis. Although neonatal sacrococcygeal teratoma has been frequently reported, its occurrence in older age is not common. In this study, we report a rare case of spinal intradural mature cystic teratoma in a 16-year-old male, emphasizing on considering this unusual condition in differential diagnosis of spinal cord cystic tumors.

Bacteria Producing Extended Spectrum ß-lactamases (ESBLs) in Hospitalized Patients: Prevalence, Antimicrobial Resistance Pattern and its Main Determinants.

BACKGROUND AND OBJECTIVE: There is a growing concern regarding the lack of new antibiotics, especially for multidrug- resistant bacteria that produce Extended Spectrum ß-Lactamases (ESBLs). The present study aims to assess the preva- lence of bacteria producing ESBLs, their antimicrobial resistance pattern, and its main determinants among hospitalized patients. METHODS: The study population included 383 consecutive patients with a definitive diagnosis of urinary tract infection (UTI). All eligible subjects for the study had a positive culture for gram-negative microorganisms in urine specimens. ESBL producing isolates were characterized phenotypically for ESBL production using the double disc synergy test. RESULTS: In total, 383 specimens were assessed, among which 212 (55.4%) were related to bacteria producing ESBLs (ESBL+). Of those with ESBL + infections, 65.5% were sourced from catheters (as hospital-associated UTIs), and 35.5% were categorized as community-associated UTIs. In the group consisting of bacteria producing ESBLs, the high- est sensitivity was observed with Imipenem (72.2%), while the highest resistance was revealed with ceftriaxone (100%). CONCLUSION: We have shown that our community faces a high prevalence of bacteria producing ESBLs, mostly sourced from the catheterization of hospitalized patients. The highest bacterial sensitivity was observed with Imipenem, nitrofu- rantoin, and amikacin, while the highest resistance was found with ceftriaxone and cotrimoxazole, suggesting the inef- fectiveness of using the two latter antibiotics for eradicating these bacterial infections. On the other hand, a history of urinary catheterization and previous hospitalization were two main determinants of their presence, a finding which em- phasizes the importance of avoiding catheterization and hospitalization of patients with UTIs without proper indications.

Serum protein electrophoresis pattern in patients living with HIV: frequency of possible abnormalities in Iranian patients.

BACKGROUND AND OBJECTIVES: This prospective case-control study was conducted to evaluate abnormal serum protein electrophoresis (SPEP) patterns in patients living with human immunodeficiency virus (HIV) and its relation with disease severity markers and anti-retroviral treatment status. MATERIALS AND METHODS: Thirty-seven HIV-positive patients and 24 healthy individuals were evaluated in the course of this study. The healthy HIV-negative individuals were selected as control group. Pregnant women, patients with malignancies, children, hepatitis B- and/or C-positive patients, those with a history of an autoimmune disease, or previous corticosteroid administration were excluded. SPEP-which detects serum levels of albumin, total protein, gammaglobulin-, CD4+ T-cell counts, viral load, and antiretroviral treatment status were assessed. Data were analyzed by SPSS™ software. RESULTS: Twelve patients (32 percent) demonstrated polyclonal gammopathy on SPEP, while only 1 (4 percent) healthy individual had the same pattern (P-value = 0.007). No statistically significant connection between SPEP patterns and antiretroviral treatment status was observed (P-value > 0.05). Interestingly no statistically significant relationship between CD4+ T-cell counts and polyclonal gammopathy was discerned. No statistically significant difference was observed between the two groups with regards to serum albumin and total protein levels. The serum albumin to total protein percentage, serum gamma globulin to total protein percentage, and serum albumin to globulin ratio was compared between the groups and a statistically significant difference was observed. CONCLUSION: Polyclonal gammopathy on SPEP is common among HIV-infected patients. Moreover, the SPEP patterns cannot be used as an indication of a patient's negative or positive response to treatment.

A Rare Case of Serous Papillary Ovarian Epithelial Type Carcinoma in Testis: A Rare Testicular Neoplasm.

Ovarian epithelial type carcinomas of testis are an extremely rare group of tumors, a few cases of which having been reported. We present the case of a 67-year-old man, presented with testicular mass and inflation, who underwent radical orchiectomy and pathological and immunohistochemical assessments revealed serous papillary carcinoma of ovarian epithelial type tumor of testis.

Adrenal Collision Tumor Composed of Pheochromocytoma and Diffuse Large B-Cell Lymphoma: A Case Report.

Adrenal involvement in the course of malignant lymphoma occurs in about 4% of patients, but primary adrenal lymphoma (PAL) is extremely rare. To the best of our knowledge, only one case study reported the combination of PAL with pheochromocytoma. In the current study, we present the second case who was a 63-year-old man admitted to our hospital with hematuria and abdominal discomfort. Ultrasound imaging indicated the presence of a lesion, 5×4×3 cm in size, in the upper pole of his right kidney. Histopathologic study confirmed a collision tumor composed of pheochromocytoma and diffuse large B-cell lymphoma (DLBCL).