Alfa Internexin Expression in a Series of 137 Gliomas and its Correlation with Oligodentroglial Morphology IDH1, P53 SYN and EGFR Expression

Background: Distinguishing glial subtypes based on nuclear and cellular morphology alone is subjective,with significant interobserver variability, even among highly experienced neuropathologists. Genetic subtyping of a given histological phenotype and robust biomarkers has improved the diagnostic and prognostic assessment. Recently, IDH1 (more rarely IDH2) mutations have been found in nearly 40% of gliomas and strongly predict lower grade in histology and better outcomes. Aim: To evaluate if the expression of alpha-internexin (INA) can be used a reliable diagnostic, prognostic and cost-effective marker, a proneural gene-coding neurofilament interacting protein significantly correlated with oligodendroglial phenotype, 1p/19q codeletion as well as higher chemosensitivity and better prognosis to our study population. Material: We studied INA expression in 137gliomasand correlated it with pure oligodendroglial histology, IDH1, p53, EGFR and SYN expression by immunohistochemistry.Results: INA was expressed in 72.2% of grade II oligodendrogliomas (n = 22), 62.5% of grade III oligodendrogliomas (n = 16), 57.2% of grade II oligoastrocytomas (n = 7), 66.7% of grade III oligoastrocytomas (n = 6), 66.7% of glioblastomas with oligodendroglial component (n = 12), 0% of grade I astrocytomas (n = 13), 0% of grade II astrocytomas (n = 4), 0% of grade III astrocytomas (n = 12) and 2.5% of glioblastomas and gliosarcomas (n = 40).INA was expressed by 27(71.1%) of pure oligodendrogliomas(n=38) versus 17(17.2%) of no pureoligodentrogliomas(n=99), Chi-square was p < 10-4; Cramer’s V was 0.517; p <10-4, which show a very strong relationship.INA was expressed by 32(45.1%) of gliomas with IDH1 mutation (n=71) versus 12(18.2%) of gliomas without IDH1 mutation (n=66), Chi-square was p < 0.001; Cramer’s V was 0.288; p < 0.001, which show a very strong relationship. INA was expressed by 26(27.4%) of gliomas with P53 mutation (n=95) versus 18(42.9%) of gliomas without P53 mutation (n=42), Chi-square wasp=0.05 which show they were negatively correlated. INA was expressed by 30(50.0%) of gliomas with SYN expression (n=60) versus 14(18.2%) of gliomas without SYN expression (n=77), Chi-square was p < 10-4; Cramer’s V was 0.338; p < 10-4, which show a very strong relationship. INA was expressed by 12(27.3%) of gliomas with EGFR expression (n = 44) versus 32(34.%) of gliomas without EGFR expression (n=44), Chi-square was p=0.05 which show they were negatively correlated. Conclusion: INA expression is a fast, cheap and reliable diagnostic and prognostic marker, which helps identify patients of different prognostic groups in diffuse gliomas and should be used routinely in the pathologic diagnosis of glial tumours.Keywords: Glial tumours, Alpha-internecine, IDH1, P53, Synaptophysin, EGFR protein

Alfa Internexin Expression in a Series of 137 Gliomas and its Correlation with Oligodentroglial Morphology IDH1, P53 SYN and EGFR Expression

Background: Distinguishing glial subtypes based on nuclear and cellular morphology alone is subjective,with significant interobserver variability, even among highly experienced neuropathologists. Genetic subtyping of a given histological phenotype and robust biomarkers has improved the diagnostic and prognostic assessment. Recently, IDH1 (more rarely IDH2) mutations have been found in nearly 40% of gliomas and strongly predict lower grade in histology and better outcomes. Aim: To evaluate if the expression of alpha-internexin (INA) can be used a reliable diagnostic, prognostic and cost-effective marker, a proneural gene-coding neurofilament interacting protein significantly correlated with oligodendroglial phenotype, 1p/19q codeletion as well as higher chemosensitivity and better prognosis to our study population. Material: We studied INA expression in 137gliomasand correlated it with pure oligodendroglial histology, IDH1, p53, EGFR and SYN expression by immunohistochemistry.Results: INA was expressed in 72.2% of grade II oligodendrogliomas (n = 22), 62.5% of grade III oligodendrogliomas (n = 16), 57.2% of grade II oligoastrocytomas (n = 7), 66.7% of grade III oligoastrocytomas (n = 6), 66.7% of glioblastomas with oligodendroglial component (n = 12), 0% of grade I astrocytomas (n = 13), 0% of grade II astrocytomas (n = 4), 0% of grade III astrocytomas (n = 12) and 2.5% of glioblastomas and gliosarcomas (n = 40).INA was expressed by 27(71.1%) of pure oligodendrogliomas(n=38) versus 17(17.2%) of no pureoligodentrogliomas(n=99), Chi-square was p < 10-4; Cramer’s V was 0.517; p <10-4, which show a very strong relationship.INA was expressed by 32(45.1%) of gliomas with IDH1 mutation (n=71) versus 12(18.2%) of gliomas without IDH1 mutation (n=66), Chi-square was p < 0.001; Cramer’s V was 0.288; p < 0.001, which show a very strong relationship. INA was expressed by 26(27.4%) of gliomas with P53 mutation (n=95) versus 18(42.9%) of gliomas without P53 mutation (n=42), Chi-square wasp=0.05 which show they were negatively correlated. INA was expressed by 30(50.0%) of gliomas with SYN expression (n=60) versus 14(18.2%) of gliomas without SYN expression (n=77), Chi-square was p < 10-4; Cramer’s V was 0.338; p < 10-4, which show a very strong relationship. INA was expressed by 12(27.3%) of gliomas with EGFR expression (n = 44) versus 32(34.%) of gliomas without EGFR expression (n=44), Chi-square was p=0.05 which show they were negatively correlated. Conclusion: INA expression is a fast, cheap and reliable diagnostic and prognostic marker, which helps identify patients of different prognostic groups in diffuse gliomas and should be used routinely in the pathologic diagnosis of glial tumours

Periosteal Lipoma Compressing Peripheral Nerves

Introduction: Lipoma is a common benign, slow-growing soft tissue neoplasm. Periosteal lipomas of the proximal radius causing posterior interosseus nerve (PIN) palsy are the rarest.  Due to specific anatomical relationships, proximal antebrachial lipomas can easily compress PIN. We present a case report and report on the related literature. Material and Methods: A 55-year-old female was admitted complaining of a progressively growing lump in the anterior-lateral antebrachial region near the left elbow. The recent onset of weakness in finger extension was more evident during manual work.  MRI showed a well-defined oval lesion in the dorsal aspect of the proximal radius bone with inter-muscular laying between m. supinator et extensor carpi radialis brevis of 7x5x3 cm in diameter. EMG study confirmed PIN compression syndrome. An en-block extirpation was performed through extensor muscles. PIN and its muscular branches were well preserved. Histological examination confirmed lipoma. The postoperative course was uneventful, and a good recovery was seen within 12 days.  We revised three other similar cases operated for the same Clinical diagnosis by our team.  Pertinent literature was reported.  Discussion: Periosteal radius lipoma related to compression of PIN has rarely been reported in the literature. We say our operative series and the surgical technique. MRI and EMG are the standard diagnostic methods. The intermuscular approach is safe for total tumor removal in experienced hands. Conclusion: Periosteal lipoma compressing PIN is a rare clinical finding. Total removal may be obtained through an intermuscular approach. Intraoperative monitoring can assist in preserving tiny PIN branche

Epidemiological Study of 1368 Cases of Surgical Repair for Traumatic Peripheral Nerve Injury.

Traumatic injury of the peripheral nerves should be treated in specialized centres. This study presents the epidemiological data of 1368 consecutive patients operated for peripheral nerve injuries beside the Service of neurosurgery, Department of Neurosciences, UHC "Mother Theresa", Tirana. In order to obtain the necessary data for this study we revised the clinical records, surgical registers and pre, intra and postoperative photo/video of the cases operated for peripheral nervous system injuries. A data recording program of the surgery cases was built ad hoc, categorizing the cases according to several variables. The data collected from the operated cases were manually inserted to be processed by the program. Results of informatics elaboration of the data were obtained, reviewed and categorized by: age, gender, type of trauma, localization of injury and type of nerve repair. Future studies to be conducted in this field will focus in determining the level of nerve injury, time from the injury to intervention, distance from the site of trauma to the effector organ. The data will build necessary information for data mining, which based on these important factors that influence the result of nerve repair, will be useful for the prediction of the result in new patients harbouring peripheral nerve injury before undergoing surgery

Serum S100B Levels Can Predict Computed Tomography Findings in Paediatric Patients with Mild Head Injury

Introduction. Traumatic brain injuries (TBIs) are very common in paediatric populations, in which they are also a leading cause of death. Computed tomography (CT) overuse in these populations results in ionization radiation exposure, which can lead to lethal malignancies. The aims of this study were to investigate the accuracy of serum S100B levels with respect to the detection of cranial injury in children with mild TBI and to determine whether decisions regarding the performance of CT can be made based on biomarker levels alone. Materials and Methods. This was a single-center prospective cohort study that was carried out from December 2016 to December 2017. A total of 80 children with mild TBI who met the inclusion criteria were included in the study. The patients were between 2 and 16 years of age. We determined S100B protein levels and performed head CTs in all the patients. Results. Patients with cranial injury, as detected by CT, had higher S100B protein levels than those without cranial injury (p<0.0001). We found that patients with cranial injury (head CT+) had higher mean S100B protein levels (0.527 μg L−1, 95% confidence interval (CI) 0.447–0.607 μg L−1) than did patients without cranial injury (head CT−) (0.145 μg L−1, 95% CI 0.138–0.152 μg L−1). Receiver operating characteristic (ROC) curve analysis clearly showed that S100B protein levels differed between patients with and without cranial injury at 3 hours after TBI (AUC = 0.893, 95% CI 0.786–0.987, p=0.0001). Conclusion. Serum S100B levels cannot replace clinical examinations or CT as tools for identifying paediatric patients with mild head injury; however, serum S100B levels can be used to identify low-risk patients to prevent such patients from being exposed to radiation unnecessarily

The 6th Albanian Congress of Trauma and Emergency Surgery

After a three-year quarantine from the deadliest global pandemic of the last century, ASTES is organizing to gather all health professionals in Tirana, The 6th Albanian Congress of Trauma and Emergency Surgery(ACTES 2022) on 11-12 November 2022, with the topic Trauma & Emergency Surgery and not only...with the aim of providing high quality, the best standards, and the best results, for our patients ...ACTES 2022 is the largest event that ASTES (Albanian Society for Trauma and Emergency Surgery) has organized so far with 230 presentations, and 67 foreign lecturers with enviable geography, making it the largest national and wider scientific event.The scientific program is as strong as ever, thanks to the inclusiveness, where all the participants with a mix of foreign and local lecturers, select the best of the moment in medical science, innovation, and observation.The scientific committee has selected all the presentations so that the participants of each medical discipline will have something to learn, discuss, debate, and agree with updated methods, techniques, and protocols.I hope you will join us on Friday morning, and continue the journey of our two-day event together