[Endometrial carcinoma--what are the protocols for?]. / Karcinom tela materice--cemu sluze protokoli?

INTRODUCTION: Endometrial cancer accounts for 10% of all malignant diseases affecting women in Western Europe. Women suffering from colonic, breast and ovarian cancer are at higher risk for developing endometrial carcinoma, which points to the fact that some women have a genetic predisposition for developing endometrial cancer. Precancerous conditions, adenomatous hyperplasias, are rarely diagnosed in our institutions. Treatment of endometrial cancer is individual, but surgeons are required to follow some treatment protocols. The aim of this study was to analyze how well treatment protocols are known and used MATERIAL AND METHODS: This study analyzed parameters of treatment of patients with endometrial cancer treated in two institutions treating oncologic patients in Novi Sad during a ten-year period (1991-2000). Results were obtained from patient records, specialist reports, surgery reports and history of disease. RESULTS: The investigation included 450 patients undergoing surgery for endometrial cancer. The average age was 62.5 years. Most patients underwent surgery in stage one (69.1%), two (14.57%), three (9.38%), zero (3.95%) and stage four (2.96%). Surgeries were performed by 16 surgeons, but none of them performed a standard treatment protocol completely. During the last 10 years 10% of patients did not undergo postoperative radiotherapy, due to outworn facilities and follow up of these patients by control of tumor markers was particularly important. DISCUSSION: The stage distribution of cancers is corresponding to that stated in literature. In regard to surgical approach and using treatment protocols, our surgeons stand behind their foreign colleagues. According to treatment standards of oncologic patients in developed countries, only specialised gynecologists and surgeons oncologists can perform operative treatment of oncologic patients. In regard to criteria in the leading countries of the world, 18 surgical gynecologists oncologists (23 the maximum) are sufficient for the territory of Serbia. CONCLUSION: Inadequate primary surgical treatment significantly increases the cost of therapy by late reoperations or additional postoperative treatment and has a negative effect on survival. In order to group patients and provide a well-educated staff with full work-time and adequate facilities, two (maximum three) institutions are sufficient at the territory of Vojvodina.

Functional interactions between Hsp90 and the co-chaperones Cns1 and Cpr7 in Saccharomyces cerevisiae.

Hsp90 complexes contain a class of co-chaperones characterized by a tetratricopeptide repeat (TPR) domain, which mediates binding to a carboxyl-terminal EEVD region in Hsp90. Among Hsp90 TPR co-chaperones in Saccharomyces cerevisiae, only Cns1 is essential. The amino terminus of Cns1, which harbors the TPR domain, is sufficient for viability when overexpressed. In a screen for temperature-sensitive alleles of CNS1, we identified mutations resulting in substitutions of conserved residues in the TPR domain. Mutations in CNS1 disrupt in vitro and in vivo interaction with Hsp90 and reduce Hsp90 function, indicating that Cns1 is a bona fide co-chaperone. Genetic interactions between CNS1 and another Hsp90 co-chaperone, CPR7, suggest that the two co-chaperones share an essential role in the cell. Although both the TPR and the isomerase domains of the cyclophilin Cpr7 are required for viability of cns1 mutant cells, this requirement does not depend on the catalytic function of the isomerase domain. Instead, hydrophilic residues on the surface of this domain appear to be important for the common Cns1.Cpr7 function. Although both co-chaperones interact with Hsp90 primarily through the carboxyl terminus (EEVD), Cns1 and Cpr7 are mostly found in complexes distinct from Hsp90. EEVD is required for normal growth in cns1 mutant cells, demonstrating for the first time in vivo requirement for this conserved region of Hsp90. Overall, our findings reveal a considerable degree of complexity in the interactions not only between Hsp90 and its co-chaperones, but also among the co-chaperones themselves.