Recurrence of tuberculosis after hip replacement 58 years after primary infection.

The paper presents the case of a 73-year-old patient with a history of tuberculosis of the hip in childhood who received an Exeter total hip prosthesis. Tuberculosis recurred 58 years after primary infection and 9 years after THA. The authors analyzed the available literature, which described only a few case reports, because Mycobacterium tuberculosis infections of a joint implant after THA are extremely rare. They are frequently the result of local reactivation of the pathogen or, less commonly, an overlooked diagnosis of tuberculosis at the time of endoprosthesis implantation. Proper diagnostic work-up of infection is particularly difficult because synovial fluid cultures are usually negative. In addition, a coexisting Staphylococcus aureus infection may obscure the clinical presentation. In post-THA patients, complete anti-TB treatment is recommended. Particular caution should be observed in patients from regions with high TB morbidity or with a history of pulmonary and operated joint tuberculosis.

[The histopathological evaluation of the local tolerance of alendronate containing medicines]. / Ocena histopathologiczna tolerancji miejscowej preparatów zawierajacych alendronian.

INTRODUCTION: In order to be effective, treatment for osteoporosis must be long-term. Unfortunately, according to clinical trials and clinical practice the most frequent cause of patient resignation from the treatment is adverse reactions to the medications. In the case of bisphosphonates they are most frequently connected with irritant impact of the drug on gastrointestinal mucosa. The aim of our study was to answer the question whether alendronate tablets coated with a thin neutral layer may protect gastrointestinal mucosa from the irritant effects of the active substance. MATERIAL AND METHODS: Three types of tablets were administered into the cheek pouches of 18 Syrian hamsters (divided into 3 experimental groups: I, II, III) i.e. regular alendronate tablets, coated alendronate tablets and placebo. The tablets were applied for 4 minutes a day on 4 consecutive days. 24 hours after the last application, the animals were sacrificed and segments of buccal tissue were taken for histopathological examination. Oral tissue reaction was assessed using the microscopic examination grading system developed by ISO. The following adverse changes of the tissue were recorded: epithelial lesions, leucocyte infiltration, vascular congestion and oedema. Later the irritation index was calculated. RESULTS: The irritation index was 11.0 (moderately irritant), 0.0 and 0.0 (none-irritant), in each group respectively. CONCLUSION: It appears that the administration of the coated alendronate tablets reduces the frequency and intensity of the local adverse events from the gastrointestinal tract.

[Adenomatoid tumors of the testis and epididymis]. / Guzy adenomatoidalne jadra i najadrza.

The authors report 8 adenomatoid tumors treated in the Urology Department of the Medical Academy of Warsaw by organ sparing surgery during 1985-2003. Microscopic and immuno-histochemic investigations confirmed their benign character and histiogenesis. Follow-up of 6 treated patients, over 5-15 years did not reveal recurrence of the neoplasm. Two patients were treated this year and are under medical observation.

P27(Kip1) and Ki-67 expression analysis in transitional cell carcinoma of the bladder.

P27(Kip1) protein is a cell cycle inhibitor which blocks the transition of cells from G1 to S phase, while Ki-67 is the most specific marker of proliferative activity. Both proteins are independent predictors of clinical outcome in various neoplasms. The aim of the study was to assess the prognostic value of p27(Kip1) and Ki-67 expression in urothelial bladder tumours. P27(Kip1) and Ki-67 expressions were evaluated immunohistochemically in archival samples of 45 superficial and 26 invasive transitional cell carcinomas obtained by a transurethral resection. In the patients with superficial tumours, disease-free survival (DFS) was positively influenced by good histological differentiation as well as by concurrent high p27(Kip1) and low Ki-67 expression. Multivariate analysis has confirmed that tumour grade and p27(Kip1)/Ki-67 status were independent predictors of DFS ( p=0.028 and p=0.029, respectively). P27(Kip1) or Ki-67 expressions did not influence overall survival. We conclude that a variable combined of p27(Kip1) and Ki-67 expressions is a better predictor of DFS in superficial bladder tumours than either protein alone.

Low expression of DNA polymerase beta in human testicular germ cell tumours--impact on foetal gonocytic origin theory.

Different models of pathogenesis of adult testicular germ cell tumours (TGCTs) are presented. Analysis of telomeric length and DNA polymerase beta expression suggests that seminoma and nonseminoma, two main histological types of TGCTs, derive independently from transformed foetal primordial cells.