Prognostic significance of MAPK, Topo IIα and E-cadherin immunoexpression in ovarian serous carcinomas.

Ovarian cancer accounts for only 3% of all cancers in women but is the most lethal gynaecologic malignancy. Low-grade and high-grade ovarian serous carcinomas (OSCs) represent two different diseases with different prognosis, approaches to detection and treatment. We assessed correlation between, MAPK, topoIIα, E-cadherin immunoexpression and clinicopathological features with overall survival (OS) in OSCs. The study included 81 patients undergoing surgery between January 1995 and December 2005.Formalin fixed paraffin embedded tumour sections were reviewed and examined immunohistochemically using antibodies against MAPK, topoIIα and E-cadherin. The clinicopathological features included: age at surgery, stage according to the criteria of the International Federation of Gynecology and Obstetrics (FIGO), tumour grade, residual disease and vascular invasion. Only ten patients (12.3%) were diagnosed in early FIGO stage of disease. According to morphological criteria, 13.6% of tumor samples were low-grade OSCs and 86.4% were high-grade OSCs. On uninominal analysis, residual disease (p<0.001), E-cadherin (p<0.001), vascular invasion (p=0.002), high-grade morphology (p=0.025) and FIGO stage III-IV (p=0.010) were related to significantly shorter OS. We found no significant association between, MAPK and topoIIα expression and OS. Multinominal analysis revealed that only residual disease (p<0.001) and negative E-cadherin immunoexpression were useful independent predictors of unfavourable clinical outcome and shorter OS.

Expression of Ki-67 and p53 in meningiomas.

UNLABELLED: Meningiomas account for about 30% of all primary brain tumors. It is difficult to predict the behaviour of meningiomas, and identification of protein markers responsible for the regulation of cell proliferation can be very helpful. The aim of this study was to evaluate immunohistochemical expression of Ki-67 and p53 in 170 meningiomas.A total number of 170 meningioma samples were classified according to WHO, immunohistochemically stained for Ki-67 and p53 and analysed using light microscope. Of 170 meningiomas analysed, 142 were grade I, 17 grade II and 11 grade III. Female to male ratio was 1.42:1. Statistically significant correlation was found between tumor grade and Ki-67 (p<0.001). There was significant correlation between Ki-67 levels and tumor subtypes (p=0.009). The optimal cut-off value for Ki-67 was 3.195. Tumors with Ki-67 ≤3.195 were 2 cm smaller than tumors with Ki-67 >3.195. Statistically significant correlation was found regarding p53 expression and tumor size (p=0.034). No correlation was established between Ki-67 or p53 and location of the tumor.According to positive correlation between tumor grade and subtype with Ki-67 levels, as well as positive correlation between Ki-67 and p53 with tumor size, indicate that Ki-67 and p53 might have influence on meningioma development and progression. KEYWORDS: meningioma, Ki-67, p53, immunohistochemistry.

Unusual cause of small intestine obstruction in a child: small intestine anisakiasis: report of a case.

INTRODUCTION: Anisakiasis is caused by human infection by the anisakis larvae, a marine nematode found in undercooked or raw fish. Infection with the parasite Anisakis simplex is common in Japan and northern European countries. With the increased popularity of eating sushi and raw fish infection with anisakis is expected to rise. CASE PRESENTATION: We present the case of a 14-year-old boy who had eaten sushi 3 days before the onset of symptoms and had small bowel obstruction caused by enteric anisakiasis. To the best of our knowledge this is the first reported case of intestinal anisakiasis presenting as a bowel obstruction in a child. CONCLUSION: Enteric anisakiasis is very rare, and its diagnosis is usually made after laparotomy. Nevertheless, when signs of acute abdomen develop after the ingestion of raw fish, such as sushi or sashimi, the possibility of enteric anisakiasis should be considered.

Synchronous bilateral infiltrating syringomatous adenoma of the breast.

Infiltrating syringomatous breast adenoma is an uncommon mammary neoplasm composed of angulated glandular structures with a variable amount of epidermoid differentiation which proliferate in a background of dense collagenous stroma. The patient presented with bilateral hardness and oedema of the nipples. Ultrasound and mammography revealed microcalcifications in retromammilary regions of both nipples. Histological examination of the resected specimens showed angulated glands and solid cords, lined by an inner layer of epithelial cells and an outer layer of myoepithelial cells, immersed in desmoplastic stroma. Within the solid cords reminiscent of squamous cells, occasionally aggregated in keratinizing cysts were found. To the best of our knowledge this is the first described case of bilateral infiltrating syringomatous breast adenoma with synchronous presentation. Infiltrating syringomatous adenoma is a rare lesion. A finding of infiltrating syringomatous adenoma in one breast should prompt careful examination of the opposite breast with adequate follow-up.

How to prevent lateral thermal damage to tissue using the harmonic scalpel: experimental study on pig small intestine and abdominal wall.

INTRODUCTION: When using a harmonic scalpel, the lower amount of energy that is transduced to the tissue reduces the chance of lateral thermal damage. METHODS: Pigs (weight: 40 kg) were used as the experimental model. After anesthesia, tissue was coagulated using different application regimens for each group. The width of tissue necrosis was measured from the point of incision by the harmonic scalpel. RESULTS: The pig abdominal tissues suffered mean thermal damage of 0.0825 (output power 3) and 0.2969 mm (output power 5) when used for 5 s; at 10 s these values were 0.3850 and 0.4793 mm, respectively. In a third experimental condition, with 10 s of application broken down into 2 parts of 5 s with a 5-second pause in-between, these values were 0.1876 and 0.2013 mm, respectively. The small intestine tissues suffered mean thermal damage of 0.1302 (output power 3) and 0.1771 mm (output power 5) at a duration of 5 s. After 10 s of application, these values changed to 0.2655 (output power 3) and 0.2983 mm (output power 5). In the third condition (activity for 5 s, pause for 5 s, activity for 5 s), they were 0.2011 and 0.2258 mm, respectively. CONCLUSION: Coagulation necrosis is bigger if the usage is continuous rather than if it is disconnected/reconnected.