Usporedba preoperativnog i postoperativnog kliničkog stadija i gradusa karcinoma prostate u bolesnika s vrijednostima PSA 2-10 ng/ml

Patients are selected for radical prostatectomy with a disease limited to the organ, satisfying general condition and enough long life expectancy. Postsurgical findings often point out more advanced disease or less differentiated cancer compared to findings upon which an indication for prostatectomy was made, what affects prognosis and points out need for adjuvant treatment. The study is aimed at establishing in what manner the clinical stage and grade of the disease correlate to the definitive histological finding. The investigation was done in 80 patients with histologically proven, clinically organ confirmed prostate cancer, and initial PSA values 2-10 ng/ml, which underwent retro-pubic prostatectomy. Pathohistological analysis of complete resection sample was performed in order to establish spread and differentiation of the tumor. Clinical and pathological stage of the disease, Gleason score and Gleason grade were compared. In 11 patients (14%) extra-prostatic invasion of the disease was found following examination of the obtained slides. After surgery, in a significant number of patients inclusion of both prostate lobes was established, so the number of clinical stage T2b was significantly higher than pT2b (40 compared to 18), and T2c was significantly lower than pT2c (3 compared to 22). The Gleason score was underestimated in 25 (31, 25%) while it was overrated in 2 (2.5%). In more than one-third of patients the bioptical Gleason score was lower than the definitive pathohistologic score of the prostate slide. There is a significant difference between the biopsy and definitive pathohistologic T stage of prostate cancer also in a sense of underestimation. The frequency of established extra-capsular invasion and lymphatic metastasis corresponds to the rates of predictive models (Partin tables). The study did not show extra-capsular invasion in cases of well-differentiated prostate cancer (Gleason score ≤ 6).Za radikalna prostatektomiju selekcioniraju se pacijenti s na organ ograničenom bolešću, zadovoljavajućem općem stanju i dovoljno dugim očekivanim preživljenjem. Postoperativni nalazi često upućuju na veću uznapredovalost ili slabiju diferenciranost karcinoma u odnosu na nalaze na osnovi kojih je postavljana indikacija za kirurški zahvat, što utječe na prognozu i upućuje na potrebu adjuvantnog liječenja. Cilj rada je utvrditi u kojoj mjeri klinički stadij i gradus bolesti odgovaraju definitivnim patohistološkim nalazima kod pacijenata kod kojih je preoperativno postavljena dijagnoza na organ ograničenog karcinoma prostate i učinjena radikalna prostatektomija. Ispitivanje je provedeno kod 80 pacijenata s histološki dokazanim karcinomom prostate, vrijednostima PSA od 2 do 10 ng/ml, klinički na organ ograničenom bolešću, te učinjenom retropubičnom radikalnom prostatektomijom. Napravljena je patohistološka analiza kompletnog reseciranog materijala sa ciljem utvrđivanja uznapredovalosti i diferenciranosti tumora. Uspoređivan je klinički i patohistološki stadij bolesti, te Gleason skor i Gleason gradus karcinoma postavljen na osnovi pregleda bioptičkog materijala s istim pokazateljima diferenciranosti tumora utvrđenim u materijalu dobivenom radikalnom prostatektomijom. Pregledom definitivnog preparata kod 11 pacijenata (14%) utvrđena je ekstraprostatična ekstenzija bolesti. Kod značajnog broja postoperativno je utvrđena zahvaćenost oba lobusa prostate, tako da je u definitivnom preparatu prostate broj kliničkih u odnosu na patološki stadij T2b znatno manji (40 u odnosu na 18), a T2c znatno veći (3 u odnosu na 22). Biopsijski Gleason skor podcijenjen je u odnosu na Gleason skor preparata prostate kod 25 (31.25%) , dok je precijenjen kod 2 (2.5%). Kod više od trećine pacijenata u biopsijskom preparatu Gleason skor niži je u odnosu na definitivni patohistološki Gleason skor preparata prostate. Postoji značajna razlika između biopsijskog i definitivnog patohistološkog T stadija karcinoma prostate također u smislu podcjenjivanja. Učestalost utvrđenog ekstrakapsularnog širenja i limfnih metastaza odgovara stopama prediktivnih modela (Partinove tablice). U provedenom istraživanju ekstrakapsularno širenje nije nađeno kod dobro diferenciranih karcinoma prostate (Gleason skor ≤ 6)

Neurosurgical Options for Glioma

Glioma surgery has been the main component of glioma treatment for decades. The surgical approach changed over time, making it more complex and more challenging. With molecular knowledge and diagnostic improvement, this challenge became maximally safe resection of tumor, which resulted in prolonged overall survival, progression-free period, and a better quality of life. Today, the standard glioma treatment includes maximally safe resection, if feasible, administration of temozolomide, radiotherapy, and chemotherapy. Surgical resection is performed as subtotal resection, gross total resection, and supratotal resection. Subtotal resection is the resection where a part of tumor is left. Gross total resection is a complete removal of the magnetic resonance imaging (MRI) visible tumor tissue. Supratotal resection is performed as gross total resection with excising the MRI visible tumor tissue borders into the unaffected brain tissue. Before we make final decision on which type of resection should be performed, many factors have to be considered. The main question has to be answered: what the actual impact of resection on the progression of glioma is and what the functional risk of resection is

Peritumoral p53 Expression in Oral Carcinoma

p53 is one of the most frequently mutated genes in human tumors including head and neck tumors like oral squamous cell carcinoma. It might be responsible for more than 50% of all relapses in patients with surgically treated oral carcinoma and clean margins. The aim of the present study was to explore p53 protein expression in peritumoral tissue and correlate it with relapse of the disease. The study included 25 patients (17 males and 8 females) with oral squamous cell carcinoma in the period August 2006 till August 2008. For immunohistochemical assay, a monoclonal antibody against p53 protein was applied (clone DO-7, DAKO Glostrup, Denmark). Peritumoral expression of p53 was as follows: 10 out of 25 cases (40%) were negative, 2 cases (8%) showed weak, 5 cases (20%) moderate and 8 cases (32%) strong p53 positivity. No significant correlation between peritumoral expression of p53 protein and patient’s relapse was found. In contrast, we found a trend toward association between intratumoral p53 expression and patient’s relapse (p=0.07). There was also trend toward higher peritumoral p53 expression in females comparing with p53 expression in males (52.9% of males did not have p53 expression while 87.5% females had mild, moderate or high p53 expression, p=0.088). Peritumoral expression of p53 protein is frequently seen in oral squamous cell carcinoma and merits further research

Bacterial aggregation in infected root canal

The aim of this study was to investigate different microbial morphotypes in the root canal infection associated with chronic diffuse periapical lesion. In forty cases of asymptomatic teeth with radiographically diagnosed diffuse periapical lesion we took specimens of infected tissue from the root canals at the beginning of endodontic treatment. Fixation and four different staining methods of the specimens were obtained to provide microscope examination. All examined root canal specimens were heavily infected by bacteria. The most commonly identified were cocci 92 %, small mostly G+ diplococci and large G+cocci in clusters and grapelike groups, bacilli found in 67%, coccobacilli 37%, fungi 17%, and spirochetes in 5%

Bacterial aggregation in infected root canal

The aim of this study was to investigate different microbial morphotypes in the root canal infection associated with chronic diffuse periapical lesion. In forty cases of asymptomatic teeth with radiographically diagnosed diffuse periapical lesion we took specimens of infected tissue from the root canals at the beginning of endodontic treatment. Fixation and four different staining methods of the specimens were obtained to provide microscope examination. All examined root canal specimens were heavily infected by bacteria. The most commonly identified were cocci 92 %, small mostly G+ diplococci and large G+cocci in clusters and grapelike groups, bacilli found in 67%, coccobacilli 37%, fungi 17%, and spirochetes in 5%

Laparoscopic treatment of ovarian dermoid cysts is a safe procedure

Experienced laparoscopic surgeons should consider laparoscopy as an alternative to laparotomy in management of ovarian dermoid cysts in selected cases. The aim of this study was to analyze the safety of laparoscopy in ovarian dermoid cysts treatment and risk of chemical peritonitis. We report 63 cases of patients (mean age of 37) with ovarian dermoid cysts originating from the ovary, treated from 2002 to 2010. Most of the patients underwent cysts removal. In 7 patients salpingo-oophorectomy was performed. We used 15 mm trocars for removing specimens. In patients with dermoid cyst rupture peritoneal cavity was washed out thoroughly with Ringer lactate and drained for 24-48 hours. All the material extracted was sent for a histopathology examination. The diagnosis of mature ovarian dermoid cysts was confirmed in 58 (92.63%) of cases and immature ovarian dermoid cysts in 5 (7.37%) cases. Dermoid cysts were composed of tissue developed from three germinative layers in 31 (49%) patients, from two germinative layers in 25 (40%), and in 7 (11%) patients from one germinative layer. No intra or postoperative complications occurred. No signs or symptoms of chemical peritonitis were observed regardless of cystic spillage or not. We conclude that the risk of chemical peritonitis can be minimized when undertaking laparoscopic removal of ovarian dermoid cysts if the peritoneal cavity is washed out thoroughly from spillage of cyst contents. Drainage of peritoneal cavity should be performed in the patients with the ruptured dermoid cysts

The Role of the Stroma in Carcinogenesis

This systematic review considers the most recent attitudes and news regarding the influence of the stroma on tumor initiation and progression. It is now widely accepted that tumor stroma plays an active role in carcinogenesis. Many different signaling molecules, ligands and signaling pathways recently have been discovered. This review considers the complexity of interactions between malignant cells and its stroma (cross-talk). The recent advances and better understanding of the tumor-stroma interactions will have important impact on the new and combined therapeutic approaches and modalities

Usporedba preoperativnog i postoperativnog kliničkog stadija i gradusa karcinoma prostate u bolesnika s vrijednostima PSA 2-10 ng/ml

Patients are selected for radical prostatectomy with a disease limited to the organ, satisfying general condition and enough long life expectancy. Postsurgical findings often point out more advanced disease or less differentiated cancer compared to findings upon which an indication for prostatectomy was made, what affects prognosis and points out need for adjuvant treatment. The study is aimed at establishing in what manner the clinical stage and grade of the disease correlate to the definitive histological finding. The investigation was done in 80 patients with histologically proven, clinically organ confirmed prostate cancer, and initial PSA values 2-10 ng/ml, which underwent retro-pubic prostatectomy. Pathohistological analysis of complete resection sample was performed in order to establish spread and differentiation of the tumor. Clinical and pathological stage of the disease, Gleason score and Gleason grade were compared. In 11 patients (14%) extra-prostatic invasion of the disease was found following examination of the obtained slides. After surgery, in a significant number of patients inclusion of both prostate lobes was established, so the number of clinical stage T2b was significantly higher than pT2b (40 compared to 18), and T2c was significantly lower than pT2c (3 compared to 22). The Gleason score was underestimated in 25 (31, 25%) while it was overrated in 2 (2.5%). In more than one-third of patients the bioptical Gleason score was lower than the definitive pathohistologic score of the prostate slide. There is a significant difference between the biopsy and definitive pathohistologic T stage of prostate cancer also in a sense of underestimation. The frequency of established extra-capsular invasion and lymphatic metastasis corresponds to the rates of predictive models (Partin tables). The study did not show extra-capsular invasion in cases of well-differentiated prostate cancer (Gleason score ≤ 6).Za radikalna prostatektomiju selekcioniraju se pacijenti s na organ ograničenom bolešću, zadovoljavajućem općem stanju i dovoljno dugim očekivanim preživljenjem. Postoperativni nalazi često upućuju na veću uznapredovalost ili slabiju diferenciranost karcinoma u odnosu na nalaze na osnovi kojih je postavljana indikacija za kirurški zahvat, što utječe na prognozu i upućuje na potrebu adjuvantnog liječenja. Cilj rada je utvrditi u kojoj mjeri klinički stadij i gradus bolesti odgovaraju definitivnim patohistološkim nalazima kod pacijenata kod kojih je preoperativno postavljena dijagnoza na organ ograničenog karcinoma prostate i učinjena radikalna prostatektomija. Ispitivanje je provedeno kod 80 pacijenata s histološki dokazanim karcinomom prostate, vrijednostima PSA od 2 do 10 ng/ml, klinički na organ ograničenom bolešću, te učinjenom retropubičnom radikalnom prostatektomijom. Napravljena je patohistološka analiza kompletnog reseciranog materijala sa ciljem utvrđivanja uznapredovalosti i diferenciranosti tumora. Uspoređivan je klinički i patohistološki stadij bolesti, te Gleason skor i Gleason gradus karcinoma postavljen na osnovi pregleda bioptičkog materijala s istim pokazateljima diferenciranosti tumora utvrđenim u materijalu dobivenom radikalnom prostatektomijom. Pregledom definitivnog preparata kod 11 pacijenata (14%) utvrđena je ekstraprostatična ekstenzija bolesti. Kod značajnog broja postoperativno je utvrđena zahvaćenost oba lobusa prostate, tako da je u definitivnom preparatu prostate broj kliničkih u odnosu na patološki stadij T2b znatno manji (40 u odnosu na 18), a T2c znatno veći (3 u odnosu na 22). Biopsijski Gleason skor podcijenjen je u odnosu na Gleason skor preparata prostate kod 25 (31.25%) , dok je precijenjen kod 2 (2.5%). Kod više od trećine pacijenata u biopsijskom preparatu Gleason skor niži je u odnosu na definitivni patohistološki Gleason skor preparata prostate. Postoji značajna razlika između biopsijskog i definitivnog patohistološkog T stadija karcinoma prostate također u smislu podcjenjivanja. Učestalost utvrđenog ekstrakapsularnog širenja i limfnih metastaza odgovara stopama prediktivnih modela (Partinove tablice). U provedenom istraživanju ekstrakapsularno širenje nije nađeno kod dobro diferenciranih karcinoma prostate (Gleason skor ≤ 6)

The Role of the Stroma in Carcinogenesis

This systematic review considers the most recent attitudes and news regarding the influence of the stroma on tumor initiation and progression. It is now widely accepted that tumor stroma plays an active role in carcinogenesis. Many different signaling molecules, ligands and signaling pathways recently have been discovered. This review considers the complexity of interactions between malignant cells and its stroma (cross-talk). The recent advances and better understanding of the tumor-stroma interactions will have important impact on the new and combined therapeutic approaches and modalities