Histological Properties of Adipose Tissue as an Autologous Tissue Filler Harvested from Different Donor Areas and Impact of Centrifugation.

Background: As a burgeoning technique in reconstructive and aesthetic surgery, lipofilling's success is hindered by the unpredictability of graft integrity and quality. This study addresses the critical need to enhance consistency and reproducibility by exploring the clinical utility of adipose tissue from specific body areas, considering the influence of patient-specific factors and mechanical processing on fat graft integrity and morphology. Methods: In a prospective, randomized, single-blind study, 52 patients undergoing surgical reconstruction due to significant deformities were enrolled. Lipoaspiration from four areas was performed. Adipose tissue was compared using five parameters of tissue damage and 10 parameters of graft integrity, assessed immediately postcollection and after centrifugation. The study aimed to evaluate the structural integrity and clinical applicability of adipocytes. Results: Morphological assessment revealed no significant differences in adipose tissue quality across donor sites, suggesting consistent graft quality regardless of the harvesting location. Centrifugation induced more morphological damage than noncentrifuged samples, but the overall graft integrity was maintained due to increased cell density. Higher graft acceptance parameters were noted in noncentrifuged samples compared with centrifuged ones. Conclusions: Despite centrifugation-induced morphological changes, adipose tissue integrity remains relatively unaffected, supporting a flexible approach to donor site selection. The consistent quality of adipose tissue underscores the potential for autologous fat transplantation across various clinical scenarios. Optimizing graft processing techniques is crucial for enhancing the predictability and efficacy of lipofilling.

Hedgehog Signaling Pathway Proteins in Prognosis of Pancreatic Ductal Adenocarcinoma and Its Differentiation From Chronic Pancreatitis.

OBJECTIVES: The Hedgehog signaling pathway (Hh) probably plays a role in development and progression of pancreatic ductal adenocarcinoma (PDAC). METHODS: In our study, 114 patients (83 with PDAC and 31 with chronic pancreatitis [CP]) after pancreatic surgery were enrolled. The immunoexpression of Sonic hedgehog (Shh), Smoothened (Smo), and Glioblastoma transcription factor 1 (Gli1) and Ki-67 were detected in tissue specimens. RESULTS: Mean (standard deviation) immunoexpression of all Hh pathway molecules was significantly higher in PDAC than in CP patients: Shh, 2.24 (0.57) versus 1.17 (0.25) (P < 0.01); Smo, 2.62 (0.34) versus 1.21 (0.23) (P < 0.01); and Gli1, 1.74 (0.74) versus 1.15 (0.72) (P < 0.01). Patients with a lower expression level (z score <0) of Shh and Ki-67 have longer overall survival when compared with z score >0 (15.97 vs 8.53 months [P = 0.0087] and 15.20 vs 5.53 months [P = 0.0004], respectively). In addition, Shh sensitivity in PDAC detection was 84.3%; specificity, 93.5%; positive predictive value, 97.2%; and negative predictive value, 69%. CONCLUSIONS: Our results suggest the prognostic role of the Hh pathway in PDAC and a role in the differential diagnosis with CP.

Alpha Smooth Muscle Actin (αSMA) Immunohistochemistry Use in the Differentiation of Pancreatic Cancer from Chronic Pancreatitis.

AIM: Fibrosis is observed both in pancreatic cancer (PDAC) and chronic pancreatitis (CP). The main cells involved in fibrosis are pancreatic stellate cells (PSCs), which activate alpha smooth muscle actin (αSMA), which is considered to be the best-known fibrosis marker. The aim of the study was to evaluate the expression of the αSMA in patients with PDAC and CP as the possible differentiation marker. METHODS: We enrolled 114 patients undergoing pancreatic resection: 83 with PDAC and 31 with CP. Normal fragments of resected specimen from 21 patients represented the control tissue. The immunoexpressions of αSMA were detected in tissue specimens with immunohistochemistry (Abcam antibodies, GB). RESULTS: Mean cytoplasmatic expression of αSMA protein in PDAC stromal cells was significantly higher compared to CP: 2.42 ± 0.37 vs 1.95 ± 0.45 (p < 0.01) and control group 0.61 ± 0.45 (p < 0.01). Strong immunoexpression of the αSMA protein was found in the vast majority (80.7%) of patients with PDAC, in about half (58%) of patients with CP, and not at all in healthy tissue. The expression of αSMA of different intensity was found in all patients with PDAC and CP, while in healthy tissue was minimal or absent. In PDAC patients, αSMA expression was significantly higher in tumors of diameter higher than 3 cm compared to smaller ones (p = 0.017). CONCLUSIONS: Presented findings confirm the significant role of fibrosis in both PDAC and CP; however, they do not confirm the role of αSMA as a marker of differentiation.

Clinical significance of miRNA-21, -103, -129, -150 in serous ovarian cancer.

PURPOSE: We aimed to compare expression levels of miRNA-21, -103, -129, -150 in primary tumour tissues and its omental metastases from patients operated for advanced ovarian serous cancer. Expression levels of selected miRNAs were correlated with clinicopathological features, including chemosensitivity and survival. METHODS: We performed total RNA extraction from archival formalin-fixed paraffin-embedded tissue samples of primary serous ovarian cancer and omental metastases. The study included 48 patients with advanced ovarian cancer. The reference group consisted of 48 normal ovarian tissue samples. We performed cDNA synthesis, real time polymerase chain reaction and assessed relative expression of selected miRNAs. RESULTS: Samples derived from serous ovarian cancer were characterized by higher expression levels of miRNA-150 in comparison to omental metastases (p = 0.045). Furthermore, we observed that shorter progression free-survival was associated with lower levels of miRNA-150 in metastatic tissues. We did not find similar relationships for other miRNAs. CONCLUSIONS: MiRNA-150 may potentially serve as a prognostic factor in advanced ovarian cancer. However, further studies are required to clearly confirm such hypothesis.

Association of microRNA-200c expression levels with clinicopathological factors and prognosis in endometrioid endometrial cancer.

INTRODUCTION: MicroRNAs (miRNAs) are regulators of gene expression, which play an important role in many critical cellular processes including apoptosis, proliferation and cell differentiation. Aberrant miRNA expression has been reported in a variety of human malignancies. Therefore, miRNAs may be potentially used as cancer biomarkers. miRNA-200c, which is a member of the miRNA-200 family, might play an essential role in tumor progression. The purpose of this study was to evaluate the prognostic and clinical significance of miRNA-200c in women with endometrioid endometrial cancer. MATERIAL AND METHODS: Total RNA extraction from 90 archival formalin-fixed paraffin-embedded tissue samples of endometri-oid endometrial cancer and 10 normal endometrium samples was performed. After cDNA synthesis, real-time polymerase chain reaction was conducted and relative expression of miRNA-200c was assessed. Then, miRNA-200c expression levels were evaluated with regard to clinicopathological characteristics. RESULTS: The expression levels of miRNA-200c were significantly increased in endometrioid endometrial cancer samples. Expression of miRNA-200c maintained at significantly higher levels in the early stage endometrioid endometrial cancer compared with more advanced stages. In the Kaplan-Meier analysis, lower levels of miRNA-200c expression were associated with inferior survival. CONCLUSIONS: Expression levels of miRNA-200c might be associated with clinicopathological factors and survival in endometrioid endometrial cancer.

Expression of miR-146a in patients with ovarian cancer and its clinical significance.

The aim of the present retrospective study was to compare microRNA (miR)-146a expression levels in primary tumors and omental metastases of 48 patients, who had undergone surgery for advanced ovarian serous cancer. Possible correlations between miR-146a expression level and clinicopathological features were investigated, including chemosensitivity and survival. miR-146a was evaluated in formalin-fixed, paraffin-embedded samples. miR-146a expression level in primary tumors was demonstrated to be increased in comparison with normal ovary tissues (P=0.02) and metastases (P=0.01). A negative correlation was demonstrated between miR-146a expression in primary tumors and serum levels of cancer antigen 125 (R=-0.37; P=0.03) and Risk of Malignancy Algorithm index (R=-0.79; P=0.0007). Overall survival positively correlated with miR-146a expression in primary tumor tissue samples (R=0.38; P=0.01). Probability of survival was decreased in patients with low miR-146a expression levels in primary tumor tissues (hazard ratio=0.21; P=0.003). Lower levels of miR-146a in primary tumor tissue samples were correlated with a shorter progression-free survival (P=0.04) and platinum-resistance of metastases (P=0.006). In conclusion, miR-146a may be a prognostic marker for serous ovarian cancer.

Prognostic and Clinical Significance of miRNA-205 in Endometrioid Endometrial Cancer.

Endometrial cancer is one of the most common malignancies of the reproductive female tract, with endometrioid endometrial cancer being the most frequent type. Despite the relatively favourable prognosis in cases of endometrial cancer, there is a necessity to evaluate clinical and prognostic utility of new molecular markers. MiRNAs are small, non-coding RNA molecules that take part in RNA silencing and post-transcriptional regulation of gene expression. Altered expression of miRNAs may be associated with cancer initiation, progression and metastatic capabilities. MiRNA-205 seems to be one of the key regulators of gene expression in endometrial cancer. In this study, we investigated clinical and prognostic role of miRNA-205 in endometrioid endometrial cancer. After total RNA extraction from 100 archival formalin-fixed paraffin-embedded tissues, real-time quantitative RT-PCR was used to define miRNA-205 expression levels. The aim of the study was to evaluate miRNA-205 expression levels in regard to patients' clinical and histopathological features, such as: survival rate, recurrence rate, staging, myometrial invasion, grading and lymph nodes involvement. Higher levels of miRNA-205 expression were observed in tumours with less than half of myometrial invasion and non-advanced cancers. Kaplan-Maier analysis revealed that higher levels of miRNA-205 were associated with better overall survival (p = 0,034). These results indicate potential clinical utility of miRNA-205 as a prognostic marker.

Increased TGF-ß: a drawback of tracheal occlusion in human and experimental congenital diaphragmatic hernia?

Survivors of severe congenital diaphragmatic hernia (CDH) present significant respiratory morbidity despite lung growth induced by fetal tracheal occlusion (TO). We hypothesized that the underlying mechanisms would involve changes in lung extracellular matrix and dysregulated transforming growth factor (TGF)-ß pathway, a key player in lung development and repair. Pulmonary expression of TGF-ß signaling components, downstream effectors, and extracellular matrix targets were evaluated in CDH neonates who died between birth and the first few weeks of life after prenatal conservative management or TO, and in rabbit pups that were prenatally randomized for surgical CDH and TO vs. sham operation. Before tissue harvesting, lung tissue mechanics in rabbits was measured using the constant-phase model during the first 30 min of life. Human CDH and control fetal lungs were also collected from midterm onwards. Human and experimental CDH did not affect TGF-ß/Smad2/3 expression and activity. In human and rabbit CDH lungs, TO upregulated TGF-ß transcripts. Analysis of downstream pathways indicated increased Rho-associated kinases to the detriment of Smad2/3 activation. After TO, subtle accumulation of collagen and α-smooth muscle actin within alveolar walls was detected in rabbit pups and human CDH lungs with short-term mechanical ventilation. Despite TO-induced lung growth, mediocre lung tissue mechanics in the rabbit model was associated with increased transcription of extracellular matrix components. These results suggest that prenatal TO increases TGF-ß/Rho kinase pathway, myofibroblast differentiation, and matrix deposition in neonatal rabbit and human CDH lungs. Whether this might influence postnatal development of sustainably ventilated lungs remains to be determined.

[The role of miRNA in endometrial cancer in the context of miRNA 205]. / Rola miRNA w raku endometrium--ze szczególnym uwzglednieniem miRNA 205.

MiRNAs are small, non-coding molecules of ribonucleic acids of approximately 22 bp length, which serve as regulators of gene expression and protein translation due to interference with messenger RNA (mRNA). MiRNAs, which take part in the regulation of cell cycle and apoptosis, may be associated with carcinogenesis. Aberrant expression of miRNAs in endometrial cancer might contribute to the endometrial cancer initiation or progression, as well as metastasis formation, and may influence cancer invasiveness. Specific-miRNAs expressed in endometrial cancer tissues may serve as diagnostic markers of the disease, prognostic biomarkers, or play an important part in oncological therapy We aimed to describe the role of miRNAs in endometrial cancer with special consideration of miRNA 205.

Leiomyomatosis peritonealis disseminata of unusual course with malignant transformation: case report.

Leiomyomatosis peritonealis disseminata is a very rare, benign entity of unknown pathogenesis, characterized by the presence of multiple subperitoneal or peritoneal smooth muscle nodules throughout the peritoneal surface. Mostly the course is asymptomatic and it is found incidentally during laparotomy, laparoscopy or cesarean section. Non-specific symptoms such as abdominal pain, vaginal bleeding, abdominal mass or gastrointestinal signs are described. Rare cases of malignant transformation have been reported. We present a case of disseminated peritoneal leiomyomatosis with an unusual course and transformation to endometrial sarcoma in a 26-year-old previously healthy woman, where the appearance of peritoneal nodules was preceded by multiple incidents of fast fibroid growth and delivery of myomatous growth into the cervical canal.

Ossifying fibroma-cementoma of jaw. Differences in histopathological nomenclature.

Ossifying fibroma (cementoma) is a tumor of mesenchymal origin which represents about 1% of odontogenic tumors. It is commonly found in patients under 25, more often so in women. As its growth is slow and painless, it is usually accidentally detected by dental radiological examination. The aim of our study was to present the histopathological dilemma concerning the naming of a rare odontogenic tumor of the jaw. The authors present a rare jaw tumor, a benign ossifying fibroma, in the maxilla of a 12-year-old girl treated surgically, and they discuss the difficulty in making a definitive histopathological diagnosis. The clinical and histological criteria for identifying this type of tumor are still uncertain, as the most common sites, that is the tooth-bearing areas of the mandible, are very rare in the maxilla. The differentiation from the central fibro-osseous lesions in the maxilla bones is discussed. The final diagnosis of ossifying fibroma was based on the WHO classification. A literature search reveals a fundamental flaw in defining a unified classification for this type of change. As there is no clear diagnostic criterion, few repeatable diagnoses can be found. Although individual researchers tend to use their own means of classification in their routine work, the WHO classification should be applied.

Different distribution of c-kit positive interstitial cells of Cajal-like in children's urinary bladders.

We describe the presence of c-kit positive interstitial cells of Cajal-like (ICCs-like) in the walls of the urinary bladders of children. An immunohistochemical study of specimens, obtained at autopsy from either the trigonum (Group A) or the corpus (Group B), was performed using antibodies against c-kit (CD 117). Histological morphometry of the immunoexpression of c-kit positive ICCs-like was performed by means of image analysis system. The c-kit positive ICCs-like were identified by their morphology and counted in the vesical muscle layer in ten adjacent high power fields, each of 0.0479 mm(2). The areas of the epithelial and subepithelial layers containing c-kit positive mast cells (rounded body with no dendritic processes) were neglected. The results were expressed as the number of ICCs-like cells per mm(2). Differences between groups were tested using unpaired Student's t-test preceded by evaluation of normality and Levene's test. Results were considered statistically significant if p 〈 0.05. In Group A, the mean number of ICCs-like cells was statistically significantly higher (41.5 cells/mm(2)) than in Group B (30.4 cells/mm(2)), p 〈 0.05. ICCs-like cells were found within the smooth muscle layer of the urinary bladder. There was a different distribution of these cells in particular parts of the bladder, which was probably due to the different roles of the trigonum and the corpus in the bladders of children.

Benign multicystic peritoneal mesothelioma (BMPM) - case report and review of the literature.

Benign multicystic peritoneal mesothelioma (BMPM), also known as multilocular peritoneal inclusion cyst, is a rare tumour that occurs mainly in women at their reproductive age. The aetiology and pathogenesis are controversial. It originates from any abdominal peritoneal or pleural surface. The biological behaviour of BMPM is usually clinically benign. Here we present a case report of BMPM from our department with a review of the literature.

Multiple congenital epuli (congenital granular cell tumours) in the newborn: a case report and review of literature.

Congenital epulis of newborn is very rare benign intraoral entity of uncertain ethiology. Histologically the lesion is similar to the granular cell tumour of an adult but immunohistochemical stainings prove their different origin. Treatment involves surgical excision, recurrences are rare.

Clinical challenges in the management of a prenatally diagnosed cloacal malformation.

Cloacal dysgenesis sequence is a severe malformation of the primitive cloaca and is characterized by a phallus-like structure, smooth perineum and the absence of genitourinary and anal orifices. It is usually accompanied by oligohydramnios, kidney dysplasia, and pulmonary hypoplasia. We present a case of a 29-year-old woman who was referred at 26 weeks of gestation due to an enlarged fetal abdominal circumference. Investigations revealed the presence of fetal ascites, intrapelvic cysts, calcified meconium, severe oligohydramnios and a 46XX karyotype. Fetal abdominal parecentesis performed on several occasions failed to reduce intra-abdominal pressure. To our knowledge this case represents the first variation of cloacal dysgenesis sequence to contain three dysmorphic structures along with the common findings of this anomaly.

Segmental congenital defect of the intestinal musculature.

Congenital defect of the small intestine muscular layer is rare cause of spontaneous bowel perforation or obstruction in premature infants. Etiology is still unknown. The authors report one case of segmental absence of small bowel muscular layer in preterm born infant. Some ideas concerning the pathogenesis of this entity and review of the literature is presented.

Massive fetal intracranial teratoma with hydrocephalus detected at 33 weeks of gestation.

Fetal intracranial teratomas are rare neoplasms that can be readily detected via USG and MRI. While early discovery of such a condition may be helpful, the prognosis remains poor. We present a case of a massive intracranial teratoma and hydrocephalus initially detected via USG at 33 weeks of gestation.