Periacinar clefting and p63 immunostaining in prostatic intraepithelial neoplasia and prostatic carcinoma

The aim of the present study was to correlate the presence and extent of retraction clefting and the expression of p63 in neoplastic glands and glands with prostatic intraepithelial neoplasia (PIN) in needle core biopsies. We analyzed needle core biopsies from 28 patients with PIN and 41 patients with adenocarcinoma. Neoplastic glands and those with PIN were analyzed on high power field (400x) and classified in three groups according to the extent of clefting. Immunohistochemical staining was performed following Microwave Streptavidin ImmunoPeroxidase (MSIP) protocol on DAKO TechMate Horizon automated immunostainer. Periacinar retraction clefting was significantly more prominent in prostatic carcinoma compared to PIN (p<0.0001) and nonneoplastic glands (p<0.0001). There was no difference between normal glands and PIN regarding clefting (p=0.8064). p63 was positive around the whole circumference in 12 out of 28 cases with PIN, and discontinuously positive in remaining 16 PIN cases suggesting initial disruption of the basal cell layer. p63 immunostaining was also positive in all nonneoplastic glands, and negative in all carcinomas. We conclude that retraction clefting was associated with cancer and lack of basal cells, but not with PIN. The relationship between clefting and p63 immunostaining in prostatic cancer should be further analyzed

Different types of atrophy in the prostate with and without adenocarcinoma

OBJECTIVES: The purpose of this study was to evaluate, according to a classification proposed by a working group, the extent and type of atrophy lesions in radical prostatectomy specimens obtained from patients with prostatic carcinoma and benign prostatic hyperplasia (BPH), and to compare the prevalence and types of atrophy between two investigated groups. ----- METHODS: Histologic analysis of 1096 slides from 50 patients with carcinoma and 277 slides from 31 patients with BPH was performed to evaluate, according to the new prostatic atrophy classification, the number of foci and type of atrophic lesions. ----- RESULTS: Age, Gleason grade, and TNM showed no significant correlation with the number of proliferative atrophy (PA) and proliferative inflammatory atrophy (PIA) foci (p>0.05). PIA was significantly more frequent in prostates with carcinoma (1.63 vs 1.27 atrophic lesions per slide) (p<0.001), whereas PA displayed an increased frequency in BPH (2.28 vs 0.76 atrophic lesions per slide) (p<0.001). ----- CONCLUSIONS: We confirmed that PA and PIA are common findings in prostates with and without carcinoma, but the question of whether inflammation produces tissue damage and PA or whether some other insult induces the tissue damage and atrophy directly, with inflammation occurring secondarily, is still unresolved

Az akut myocardialis infarctus főbb hazai ellátási jellemzői 2005–2009 között a EuroHOPE kutatás eredményei alapján | Main characteristics of the care of acute myocardial infarction in Hungary between 2005–2009, based on the results of the EuroHOPE research

Absztrakt Bevezetés: A EuroHOPE kutatás az ellátás elemzésének standardizált módszereit fejlesztette ki. Célkitűzés: A szerzők célul tűzték ki a hazai akut myocardialis infarctus ellátásának elemzését és a közreműködő országok adataival való összevetését. Módszer: A korai és kései invazív kardiológiai beavatkozások alkalmazását, a gyógyszerek kiváltását és a halálozást elemezték. Az eredményeket finn, norvég, olasz, skót és svéd adatokkal vetették össze. Eredmények: Nemzetközileg is kedvező eredmény, hogy az időszak végére a betegek közel fele részesült korai intervencióban, 90% körüli volt a statinok, az angiotenzinkonvertálóenzim-gátlók és angiotenzinreceptor-blokkolók kiváltása. Nem magyarázhatóan csökkent a béta-blokkolók alkalmazása. A halálozás javult, de a többi országénál lényegesen kedvezőtlenebb volt. Az egyéves halálozás a korai intervenciós csoportban másfélszerese, a késeiben több mint kétszerese volt az utána következő legrosszabb értéknek. Következtetések: Javasolt az okok vizsgálata a teljes követési időszakban a szakmai tevékenységre és a működési gyakorlatra, illetve a betegek szerepére vonatkozóan. Szükséges a trendek követése és az ST- és nem ST-elevációs myocardialis infarctus kórformák elkülönítő kódolása a mélyebb elemzések elősegítésére. Orv. Hetil., 2016, 157(41), 1626–1634. | Abstract Introduction: The EuroHOPE research developed the standardised methodology of the analysis of the healthcare process. Aim: The aims of the authors were to analyze the care of acute myocardial infarction in Hungary and to compare the results to those of the partner countries. Method: The authors analyzed the application of early and late invasive interventions, medication purchase, and mortality. The results were compared to Finnish, Norwegian, Italian, Scottish and Swedish data. Results: By the end of the observed period, approximately half of the patients received early treatment, which is an internationally acceptable result. Purchase of statins, angiotensin converting enzyme inhibitors, and angiotensin receptor blockers was around 90%, but the application of beta-blockers has decreased for unknown reason. The mortality rate has improved, but it was still significantly worse than that in the partnering countries. One year mortality in the early intervention group was 1.5 times higher, and in the late intervention group was 2 times higher than the second worst results. Conclusions: The causal analysis concerning the professional activities, operational practices, and the role of the patients in the observed period is highly recommended. For more detailed analysis it is necessary to follow the trends and to separate the diagnoses of ST- elevation and non-ST-elevation acute myocardial infarction. Orv. Hetil., 2016, 157(41), 1626–1634

Utjecaj morfološkog tipa stanica na ekspresiju bcl-2, Ki-67 i p-53 u uvealnim melanomima

Uveal melanomas are known to be less aggressive malignant tumors compared with melanoma of other localizations but the same morphological characteristics. We hypothesized that immunohistochemical determination of expression of the known proliferation markers bcl-2 and ki-67, and p-53 as a suppressor gene marker, could better explain the biological behavior of uveal melanoma vs. melanoma of other localizations. Thirty cases of primary uveal melanoma of two levels of invasion were tested retrospectively for the presence of bcl-2, Ki-67 and p-53 proteins with the indirect peroxidase-antiperoxidase immunoenzyme method and three step ABC/AP method. The intensity of reaction was assessed by semiquantiative method.Usprkos morfološkoj građi sličnoj drugim melanomima, poznato je da uvealni melanomi imaju daleko bolju prognozu od melanoma drugih lokalizacija. Upravo stoga pretpostavili smo da bi određivanje ekspresije bcl-2, Ki-67 kao poznatih čimbenika proliferacije, te p-53 proteina u stanicama uvealnih melanoma moglo protumačiti ovakvo biološko ponašanje uvealnih melanoma. U tu svrhu ispitano je retrogradno 30 primarnih uvealnih melanoma stadija pT2 i pT3 na prisutnost bcl-2, Ki-67 i p-53 proteina indirektnom metodom peroksidaze-anti-peroksidaze i trofaznom metodom ABC/AP. Stupanj reaktivnosti određen je semikvantitativnom metodom