The cadherin–catenin complex in nasopharyngeal carcinoma

Abnormal Wnt signaling and impaired cell–cell adhesion due to abnormal E-cadherin and b-catenin func tion have been implicated in many cancers, but have not been fully explored in nasopharyngeal carcinoma. The aim of this study was to analyze b-Catenin cellular location and E-cadherin expression levels in nasopharyngeal carcinoma. E-cadherin expression levels were also correlated with clinical data and underlying pathology. b-Catenin and E-cadherin expression were examined in 18 nasopharyn geal carcinoma and 7 non-tumoral inflammatory pharynx tissues using immunohistochemical methods. Patient clin ical data were collected, and histological evaluation was performed by hematoxylin/eosin staining. b-catenin was detected in membrane and cytoplasm in all cases of naso pharyngeal carcinoma, regardless of histological type; in non-tumoral tissues, however, b-catenin was observed only in the membrane. As for E-cadherin expression levels, strong staining was observed in most non-tumoral tissues, but staining was only moderate in nasopharyngeal carci noma tissues. E-cadherin expression was associated with b-catenin localization, study group, metastatic disease, and patient outcomes. Reduced levels of E-cadherin protein observed in nasopharyngeal carinoma may play an important role in invasion and metastasis. Cytoplasmic b-catenin in nasopharyngeal carcinoma may impair cell– cell adhesion, promoting invasive behavior and a metastatic tumor phenotype

Inmunohistochemical Profile of Solid Cell Nest of Thyroid Gland

It is widely held that solid cell nests (SCN) of the thyroid are ultimobranchial body remnants. SCNs are composed of main cells and C cells. It has been suggested that main cells might be pluripotent cells contributing to the histogenesis of C cells and follicular cells, as well as to the formation of certain thyroid tumors. The present study sought to analyze the immunohistochemical profile of SCN and to investigate the potential stem cell role of SCN main cells. Tissue sections from ten cases of nodular hyperplasia (non-tumor goiter) with SCNs were retrieved from the files of the Hospital Infanta Luisa (Seville, Spain). Parathormone (PTH), calcitonin (CT), thyroglobulin (TG), thyroid transcription factor (TTF-1), galectin 3 (GAL3), cytokeratin 19 (CK 19), p63, bcl-2, OCT4, and SALL4 expression were evaluated by immunohistochemistry. Patient clinical data were collected, and tissue sections were stained with hematoxylin–eosin for histological examination. Most cells stained negative for PTH, CT, TG, and TTF-1. Some cells staining positive for TTF-1 and CT required discussion. However, bcl-2, p63, GAL3, and CK 19 protein expression was detected in main cells. OCT4 protein expression was detected in only two cases, and SALL4 expression in none. Positive staining for bcl-2 and p63, and negative staining for PTH, CT, and TG in SCN main cells are both consistent with the widely accepted minimalist definition of stem cells, thus supporting the hypothesis that they may play a stem cell role in the thyroid gland, although further research will be required into stem cell markers. Furthermore, p63 and GAL-3 staining provides a much more sensitive means of detecting SCNs than staining for carcinoembryonic antigen, calcitonin, or other markers; this may help to distinguish SCNs from their mimics

The cadherin–catenin complex in nasopharyngeal carcinoma

Abnormal Wnt signaling and impaired cell–cell adhesion due to abnormal E-cadherin and β-catenin function have been implicated in many cancers, but have not been fully explored in nasopharyngeal carcinoma. The aim of this study was to analyze β-Catenin cellular location and E-cadherin expression levels in nasopharyngeal carcinoma. E-cadherin expression levels were also correlated with clinical data and underlying pathology. β-Catenin and E-cadherin expression were examined in 18 nasopharyngeal carcinoma and 7 non-tumoral inflammatory pharynx tissues using immunohistochemical methods. Patient clinical data were collected, and histological evaluation was performed by hematoxylin/eosin staining. β-catenin was detected in membrane and cytoplasm in all cases of nasopharyngeal carcinoma, regardless of histological type; in non-tumoral tissues, however, β-catenin was observed only in the membrane. As for E-cadherin expression levels, strong staining was observed in most non-tumoral tissues, but staining was only moderate in nasopharyngeal carcinoma tissues. E-cadherin expression was associated with β-catenin localization, study group, metastatic disease, and patient outcomes. Reduced levels of E-cadherin protein observed in nasopharyngeal carinoma may play an important role in invasion and metastasis. Cytoplasmic β-catenin in nasopharyngeal carcinoma may impair cell–cell adhesion, promoting invasive behavior and a metastatic tumor phenotype

Patrones de ploidia y de textura nuclear en el diagnóstico del hiperparatiroidismo primario

El diagnostico histologico del hiperparatiroidismo primario aun continua siendo un tema controvertido. Se revisan 48 glandulas procedentes de 41 pacientes con hiperparatiroidismo primario, con el fin de determinar si existen diferencias subvisuales (cuantificacion del dna y estudio de texturas cromatinicas) que permitan la distincion entre enfermedad de una sola glandula (adenoma) y de varias glandulas (hiperplasia). tambien se pretende determinar si existen diferencias citometricas entre celulas principales y celulas claras. Se utilizo un citometro estatico cas 200 para estudio de cortes histologicos teñidos con dna stain reagent. Los resultados obtenidos indican que no existen variables continuas que permitan distinguir entre enfermedad de una glandula y de varias glandulas. El 55.6% de las glandulas presentaban un patron diploide, el 8.9% periploide, el 6.7% hiperdiploide, el 11.1% poliploide, el 13.6% hipodiploide y el 2.2% aneuploide inclasificable. Una poblacion tetraploide superior al 3% se advirtio en el 39.1% (18) de los casos y fue más frecuente en las lesiones uniglandulares (44.1%) que en las pluriglandulares (27.3%). Las variables discretas que presentaron mayor significacion fueron el patron de crecimiento y la bi o multinucleacion. una clasificacion correcta de celulas claras y de celulas principales se alcanzo en el 61.3%, en las pruebas de validacion cruzada utilizando las variables dbshdt y txndt. Aunque el patron ploide no mostro diferencias significativas la poliploidia, la aneuploidia y la tetraploidia superior al 3% fueron levemente más comunes entre las celulas principales

Concordancia interevaluador en la elección de tratamiento profiláctico para la migraña vestibular y papel de un algoritmo asistido para la elección de dicho tratamiento

Background and objective: Vestibular migraine (VM) is a cause of episodic vestibular syndrome. There are many drugs available for its prophylaxis and currently the choice is mainly made according to the patient's comorbidities. The aim of this article was to measure the agreement of a group of otorhinolaryngologists in the choice of a prophylactic treatment and to evaluate the role of an assisted algorithm in the choice of this prophylaxis. Material and method: The medical records of 10 patients with VM were offered to 10 otolaryngologists who were asked to select for each patient the drug they considered most appropriate among five possible options. The Fleiss’ κ index was calculated among the 10 otolaryngologists alone, recalculating it including the algorithm as the eleventh evaluator, and Cohen's κ index was calculated between each otolaryngologist and the answers of the algorithm. The otolaryngologists were offered the option to change their responses after knowing the responses of the algorithm and then both indexes were calculated again. Results: The Fleiss’ κ index was .302. This index was raised to .343 after introducing the algorithm as an evaluator. After offering the responses proposed by the algorithm, Cohen's κ was improved in 9 of the 10 evaluators, and Fleiss’ κ rose to .711. Conclusions: The agreement between otorhinolaryngologists in choosing prophylaxis for MV can be defined as “fair”. The responses of the algorithm for the choice of prophylaxis were close to the average opinion of the otolaryngologists, raising the agreement between them to “substantial”.Antecedentes y objetivo: La migraña vestibular (MV) es una de las causas de síndrome vestibular episódico. Existen muchos fármacos disponibles para su profilaxis y actualmente su elección se realiza mayoritariamente según las comorbilidades del paciente. El objetivo de este artículo es medir la concordancia de un grupo de otorrinolaringólogos en la elección de profilaxis y evaluar el papel que ejerce sobre esta un algoritmo asistido para la elección de profilaxis. Material y método: Las historias clínicas de 10 pacientes con MV fueron ofrecidas a 10 otorrinolaringólogos, a los que se les pidió que seleccionasen para cada paciente el fármaco que considerasen más adecuado entre 5 opciones posibles. Se calcularon los índices κ de Fleiss entre los 10 otorrinolaringólogos solos y se recalcularon incluyendo al algoritmo como undécimoevaluador, y la κ de Cohen entre cada otorrinolaringólogo y el algoritmo. Se ofreció a los otorrinolaringólogos la opción de cambiar su respuesta tras conocer la respuesta del algoritmo, y ambos índices fueron calculados nuevamente. Resultados: El índice κ de Fleiss fue de 0,302. Dicho índice se elevó a 0,343 tras introducir al algoritmo como evaluador. Tras ofrecer las soluciones propuestas por el algoritmo, se mejoró la κ de Cohen en 9 de los 10 evaluadores y la κ de Fleiss subió a 0,711. Conclusiones: La concordancia entre otorrinolaringólogos para elegir profilaxis para la MV se define como «justa». Las respuestas del algoritmo para la elección de profilaxis se situaron próximas a la opinión media de los otorrinolaringólogos, elevando la concordancia entre ellos a «sustancial»

Incidenza della vertigine parossistica benigna bilaterale e monolaterale in caso di positività alla manovra Dix-Hallpike a destra e sinistra: modello basato sul verso del nistagmo rotatorio

[EN]: Patients presenting with nystagmus indicative of benign paroxysmal positional vertigo (BPPV) during the left and the right Dix-Hallpike manoeuvres (DHMs) are frequently seen in clinical practice. In such cases, BPPV may be unilateral or bilateral. The aim of this study is to describe the incidence of unilateral and bilateral BPPV when both DHMs are positive, taking into account the sense of the torsional component of nystagmus. This is a prospective multicentre study. BPPV patients were classified into three groups: patients with only one positive DHM (control group, CG), patients showing positive bilateral DHM with nystagmus in the same sense in both DHMs (same sense group, SSG) and patients showing positive bilateral DHM with the torsional component of nystagmus beating in opposite senses in each DHM (opposite sense group, OSG). Only one Epley Manoeuvre (EM) was performed on all patients. Based on the ipsilateral result of the EM, the contralateral result of the same EM and the BPPV resolution rate in the control group, a model was developed to predict the incidence of unilateral and bilateral BPPV in the SSG and the OSG. There were 234 patients in the control group, 20 in the SSG and 23 in the OSG. The model estimated that the percentage of unilateral BPPV would be 89.5% in SSG and 38.7% in OSG. Using these findings, we conclude that when both DHMs are positive, BPPV may be unilateral or bilateral. If the torsional components of both nystagmuses beat in the same sense, it is more likely to be unilateral BPPV. If the torsional components beat in opposite senses, both situations can be considered equally likely.[IT]: Frequentemente nella pratica clinica si valutano pazienti che mostrano alle manovre di Dix-Hallpike (DHM), verso destra e verso sinistra, il nistagmo tipico della vertigine posizionale parossistica benigna (BPPV). In questi casi la BPPV può essere unilaterale o bilaterale. Lo scopo del presente studio è quello di descrivere l’incidenza della BPPV unilaterale e bilaterale, quando entrambe le DHM sono positive, considerando il verso della componente torsionale del nistagmo. In questo studio prospettico multicentrico i pazienti sono stati suddivisi in tre gruppi: pazienti con solo una DHM positiva (gruppo di controllo, CG), pazienti con DHM positiva bilateralmente e con nistagmo battente nello stesso verso evocabile in entrambe le manovre (gruppo stesso verso, SSG), pazienti con DHM positiva bilateralmente e con nistagmo avente componente torsionale con verso opposto nelle due manovre (gruppo verso opposto, OSG). La manovra di Epley (EM) è stata condotta su tutti i pazienti. Considerando i risultati ottenuti dalla EM e il tasso di risoluzione della BPPV nel CG, è stato sviluppato un modello predittivo dell’incidenza della BPPV unilaterale e bilaterale negli SSG e OSG. Il CG comprendeva 234 pazienti, 20 erano inclusi invece nel SSG e 23 nell’OSG. Il modello ha stimato che la percentuale di BPPV unilaterale ammonterebbe a 89,5% nel SSG e 38,7% nel OSG. In conclusione, se entrambe le DHM sono positive, la BPPV può essere sia unilaterale che bilaterale. Se la componente torsionale dei nistagmi batte nello stesso verso, è più probabile che la BPPV sia unilaterale; se invece tale componente ha verso opposto alle DHM, le due condizioni possono considerarsi ugualmente probabili