Histiocytosis x: Recurrent isolated mandibular lesion (case report)

Histiocytosis X usually affects children and adolescents. In our case, a 54-year-old woman was admitted to hospital for evaluating and treatment of an isolated, painless swelling of the left side of the mandible. Orthopanthomogram showed a cystic formation located on the left side of the mandibular body. Radiographs of the scull and body showed no pathologic changes. Laboratory findings did not reveal any abnormality. Surgical enucleation of the mandibular cystic lesion was performed and histopathological analysis confirmed the presence of histiocytosis X. One year after the first operation a relapse formation was found and surgically removed. Resection of the left side of the mandibular body was performed immediately followed by reconstruction of the mandibular defect with free osseos graft taken from the iliac crest. All follow-ups in the period of three years after the second operation showed no sign of relapse

Biocompatibility of a new nanomaterial based on calcium silicate implanted in subcutaneous connective tissue of rats

The aim of the study was to investigate rat connective tissue response to a new calcium silicate system 7, 15, 30 and 60 days after implantation. Twenty Wistar albino male rats received two tubes half-filled with a new calcium silicate system (NCSS) or MTA in subcutaneous tissue. The empty half of the tubes served as controls. Five animals were sacrificed after 7, 15, 30 and 60 days and samples of the subcutaneous tissue around implanted material were submitted to histological analysis. The intensity of inflammation was evaluated based on the number of inflammatory cells present. Statistical analysis was performed using one way ANOVA and Holm Sidak's multiple comparison tests. Mild to moderate inflammatory reaction was observed after 7, 15 and 30 days around a NCSS while mild inflammatory reaction was detected after 60 days of implantation. In the MTA group, mild to moderate inflammatory reaction was found after 7 and 15 days while mild inflammatory reaction was present after 30 and 60 days. There was no statistically significant difference in the intensity of inflammatory reactions between the tested materials and control groups in any experimental period (ANOVA p>0.05). Regarding the intensity of inflammatory reactions at different experimental periods, a statistically significant difference was observed between 7 and 30 days, 7 and 60 days and 15 to 60 days for both materials. For the controls, a statistically significant difference was found between 7 and 60 days and 15 and 60 days of the experiment (Holm Sidak < p 0.001). Subcutaneous tissue of rats showed good tolerance to a new calcium silicate system. Inflammatory reaction was similar to that caused by MTA. [Projekat Ministarstva nauke Republike Srbije, br. 172026

Polycystic kidney disease--autopsy review from the period 1987-2007

INTRODUCTION: Polycystic kidney disease is an inherited kidney disease that affects both kidneys and it is characterized by diffuse replacement of renal parenchyma by thousands of microcysts. In time, renal insufficiency develops. There are two forms of PKD: ADPKD, which is detected in adults (children are rarely affected), and ARPK, which is detected in neonates (later presentations do occur, but rarely). OBJECTIVE: The aim of this study was to analyse frequency of polycystic kidney disease, clinical data and morphological characteristics. METHOD: At the Institute of Pathology, School of Medicine, Belgrade, there were detected 33 cases of ADPKD and 20 cases of ARPKD between 1987 and 2007. RESULTS: There were no differences between incidence of ADPKD in males and females. Average age of patients with ADPKD was 52 years. In 20 (66.7%) cases of ADPKD there were neither extrarenal cysts nor extrarenal manifestations detected. In other 13 cases, we detected extrarenal cysts: hepatic cysts in 8 cases, pancreatic cysts in 5 cases. In two cases, hepatic cysts were associated with intracranial (arachnoid cysts) and extracranial aneurysms. The most frequent cause of death in patients with ADPKD was end-stage disease. ARPKD affects more often male children compared to female. 70% of children with ARPKD were male. The mean age of patients with ARPKD was 1 month. 5 patients (40%) had hepatic fibrosis. The most frequent cause of death was respiratory insufficiency (75%). In 25% of patients, the cause of death was sepsis and renal insufficiency. CONCLUSION: Morphological and clinical manifestations of the analysed cases of both types of PKD are fairly consistent with literature data. Better knowing of aethiopathogenesis of PKD will facilitate early diagnosis, based on clinical and morphological characteristics and better management of the disease

The significance of Goodpasture antigen in hereditary nephritis

INTRODUCTION: Two types of hereditary nephritis, nonprogressive and progressive, clinically present as asymptomatic haematuria, sometimes combined with proteinuria. At the onset, in both types, light microscopic changes are minimal, immunofluorescence findings are negative, and diagnosis can be made only upon electron microscopic findings that are considered to be specific. OBJECTIVE: The aim of this study was to determine the significance of Goodpasture antigen detection in diagnosis of progressive and nonprogressive hereditary nephritis in its early phase. METHOD: Analysis of renal biopsy specimens was done in patients with hereditary nephritis that were followed from 1990 to 2005. Progression of renal disease was examined in 14 patients with Alport's syndrome, 10 patients with thin basement membrane disease, and 6 patients with unclassified hereditary nephritis diagnosed. For all these cases, indirect immunofluorescence study with serum from a patient with high titer of Goodpasture autoantibodies that recognize the antigenic determinants in human glomerular and tubular basement membrane was performed. RESULTS: In 11 out of 14 cases diagnosed as Alport's syndrome, there was negative staining with Goodpasture serum, and in 3 additional cases with Alport's syndrome, expression of Goodpasture antigen in glomerular basement membrane and thin basement membrane was highly reduced. In all 10 patients with thin basement membrane disease, immunofluorescence showed intensive, bright linear staining with Goodpasture serum along glomerular and tubular basement membrane. In 2 out of 6 patients with unclassified hereditary nephritis, Goodpasture antigen expression was very strong, in one patient it was very reduced, and in 3 patients it was negative. CONCLUSION: The results of our study show that Goodpasture antigen detection plays a very important role in differential diagnosis of progressive and nonpregressive hereditary nephritis, particularly in early phases of the disease

The effect of antioxidant status on overall survival in renal cell carcinoma

Introduction The oxidative stress contributes to all three phases of carcinogenesis and represents a concomitant condition in renal cell carcinoma (RCC). RCC is the most common type of neoplasm of the kidney, and despite numerous studies the set of predictive and prognostic markers of survival are still unknown. The aim of our study was to examine the relation between antioxidant (AO) status and overall survival (OS) in RCC patients. Material and methods Our study included 95 patients with RCC, who underwent radical nephrectomy. We analysed the prognostic role of antioxidant enzymes (superoxide dismutase, catalase, glutathione peroxidase, glutathione S-transferase, glutathione reductase, glutathione, and malondialde-hyde) and other clinicopathological factors (size, grade, stage, and histological subtype) on the OS of RCC patients. Results The 5-year OS was 54.6%. The survival analysis related to AO parameters showed no significant difference in survival of RCC patients. The concentration of malondialdehyde, an indicator of lipid peroxidation, also had no significant effect on the survival rate of RCC pa-tients. Univariate and multivariate analysis confirmed the significance of clinicopathological parameters (size, p < 0.001; Fuhrman grade, p = 0.001, and stage, p < 0.001) for patients’ survival. Conclusions In our cohort of patients, different antioxidant parameters were not found to be predictors for OS of patients with RCC, who underwent radical nephrectomy

The effect of antioxidant status on overall survival in renal cell carcinoma

Introduction The oxidative stress contributes to all three phases of carcinogenesis and represents a concomitant condition in renal cell carcinoma (RCC). RCC is the most common type of neoplasm of the kidney, and despite numerous studies the set of predictive and prognostic markers of survival are still unknown. The aim of our study was to examine the relation between antioxidant (AO) status and overall survival (OS) in RCC patients. Material and methods Our study included 95 patients with RCC, who underwent radical nephrectomy. We analysed the prognostic role of antioxidant enzymes (superoxide dismutase, catalase, glutathione peroxidase, glutathione S-transferase, glutathione reductase, glutathione, and malondialde-hyde) and other clinicopathological factors (size, grade, stage, and histological subtype) on the OS of RCC patients. Results The 5-year OS was 54.6%. The survival analysis related to AO parameters showed no significant difference in survival of RCC patients. The concentration of malondialdehyde, an indicator of lipid peroxidation, also had no significant effect on the survival rate of RCC pa-tients. Univariate and multivariate analysis confirmed the significance of clinicopathological parameters (size, p < 0.001; Fuhrman grade, p = 0.001, and stage, p < 0.001) for patients’ survival. Conclusions In our cohort of patients, different antioxidant parameters were not found to be predictors for OS of patients with RCC, who underwent radical nephrectomy

Iga nephropathy: clinical-morphologic correlation

IgA nephropathy is glomerular disease caracterized by the presencemorphologic changes as wella as the prognosis is in correlation with of IgA dominant or codominant imunoglobuline deposits in glomer-the amount of proteinuria. The prognosis is better in children. ular mesangium which can be demostrated by immunofluorescence. Clinical manifestations of IgA nephropathy in the majority of cases is hematuria which can be macro or mikroskopic, isolated or combined with proteinuria, which can be of nephrotic range. The prognosis o the disease is better if presented with haematuria. Intensity of????

Adhesion molecules in Wilms tumor (part II) : beta-catenin expression and significance

Beta-catenin is a glicoprotein which has an important role in cell-cell adhesion, as well as in cell signal transmition, in u regulation of gen expression and in interaction with axin and APC (adenomatous poliposis coli). Its oncogenic role in several types of carcinomas in human population is well known. It is very likely that b-catenin as an protooncogen plays an importante role in genesis of Wilms tumor. It is well known that in 15% Wilms tumors there are b-catenin mutations, which indicates that there is a disorder in Wnt signal paththat plays an important role in Wilms tumor genesis. The aim of our study was to investigate b-catenin expression in Wilms tumor, to compaire it with the expression in normal renal tissue as well as to see if there is a positive correlation between b-catenin expression in Wilms tumor with tumor stage, histologic type and/ or prognostic group

Prognostic value of survivin expression in Wilms tumor

Purpose: To determine survivin expression patterns in Wilms tumor (WT) and compare it with the expression in normal renal tissue. Also, to analyse cytoplasmic and nuclear survivin expression in relation to histological type, prognostic group and tumor stage. Methods: Immunohistochemical expression of survivin was analysed in 59 cases of primary WT and in 10 normal kidney specimens, taken from the same patients, but distant from the tumor. Results: 51 out of 59 cases of WT (86.44%) showed decreased cytoplasmic survivin expression and 4 out of 59 cases of WT (6.78%) showed nuclear overexpression of survivin. There was statistically significant difference in the frequency of decreased cytoplasmic expression of survivin in individual components of WT (p=0.005). Decreased cytoplasmic expression of survivin in epithelial, blastemal and stromal component was found significantly more often in low stage WT compared to high stage WT (Fisher exact test, p=0.0002, p=0.002, p=0.002, respectively). There was no statistically significant difference in the frequency of survivin nuclear overexpression between different stages of WT (Fisher exact test, p=0.564), histological types (Fisher exact test, p=0.915), or between different prognostic groups (Fisher exact test, p=1). Conclusion: Decreased survivin cytoplasmic expression or nuclear overexpression may be related to favorable prognosis of WT

Immunohistochemical expression of protein p16 in Wilms' tumor

Proliferative disorders including tumors are recognized as diseases of the cell cycle in which the crucial role belongs to the cyclin-dependent kinase family. The aim of this study was to investigate the expression of protein p16 in the normal kidney, and in Wilms tumor by immunohistochemistry to correlate the obtained results with tumor stage, histological type and prognostic group. We have investigated 28 cases of Wilms tumor, two Wilms tumor metastases in the lungs and one case of normal renal tissue. Protein p16 was over expressed in 20 cases of Wilms tumor. Expression of p16 was less frequent in stages III/IV/V than in stages I/III, showing no statistically significant correlation (p > 0.05). Intermediate risk groups of Wilms tumor showed more frequent p16 expression in comparison with high risk cases, showing no statistical significance (p > 0.05). Protein p16 expression was detected in all histologic types of Wilms tumor with the highest expression in the predominantly blastemal type (50%). There was a statistically significant difference between p16 expression in this and its expression in other histological types (p lt 0.05). The correlation between p16 expression and the predominantly blastemal histological type was statistically significant and showed that in such cases tumor cells can proliferate even in the presence of p16