Evaluation of the proliferation markers Ki-67/MIB-1, mitosin, survivin, pHH3, and DNA topoisomerase II alpha in human anaplastic astrocytomas - an immunohistochemical study

Background Histological malignancy grading of astrocytomas can be challenging despite criteria given by the World Health Organisation (WHO). Grading is fundamental for optimal prognostication and treatment, and additional biomarkers are needed to support the histopathological diagnosis. Estimation of proliferative activity has gained much enthusiasm, and the present study was designed to evaluate and compare novel immunohistochemical proliferative markers in human anaplastic astrocytomas. Methods Proliferative activity was determined in twenty-seven cases with antibodies reactive against the Ki-67 antigen, mitosin, survivin, pHH3, and DNA topoisomerase IIα, and they were mutually compared as well as related to mitotic activity. Results The markers correlated well with each other, but poorly with mitoses, probably because of small and squeezed tumour samples, in which identification of mitoses can be difficult. Positive association to overall survival was observed as well. Conclusions Our data show that these markers may assist significantly in the evaluation of proliferative activity in anaplastic astrocytomas and even have prognostic value

The challenges of describing rehabilitation services: A discussion paper

Objectives: To apply the Classi cation of Service Or- ganization in Rehabilitation (ICSO-R) classi cation of services to different target groups, include the user perspective, identify missing categories, and propose standardized descriptors for the categories from a Norwegian perspective. Design: Expert-based consensus conferences with user involvement. Subjects: Health professionals, stakeholders and users. Methods: Participants were divided into 5 panels, which applied the ICSO-R to describe the habilitation and rehabilitation services provided to children with cerebral palsy and people with Huntington’s disease, acquired brain injuries (traumatic brain injuries and stroke) and painful musculoskeletal conditions. Ba- sed on the Problem/Population, Intervention, Com- parison, Outcome (PICO) framework, the services were described according to the ICSO-R. Missing ca- tegories were identi ed. Results: The ICSO-R was found to be feasible and applicable for describing a variety of services pro- vided to different target groups in Norway, but the user perspective was lacking, categories were missing, and a need for standardized description of the categories was identi ed. Conclusion: The present work supports the need to produce an updated version of the ICSO-R and to en- courage national and international discussion of the framework. The ICSO-R has the potential to become a tool for the standardized assessment of rehabilita- tion services. For such purposes, more standardized descriptions of subcategories are necessary