Morphometric study of primary cutaneous germinal center cell lymphomas

Background. Primary cutaneous germinal center cell lymphomas (PCGCCL) are B-cell neoplasias; most are mixed cell type, composed of small and large cleaved cells and large noncleaved cells (centrocytes and centroblasts). Because of the significant pleomorphism of the cells, which ranged in size from small elements with indented nuclei to larger ones with multilobulated vesiculous nuclei, histopathologic examination of PCGCCL of mixed cell type has the worst degree of histologic interobserver reproducibility. Methods. In this study, the authors determined whether the light microscopic morphologic classification criteria applied in quantifying cleaved and noncleaved cells in these lymphomas are substantiated by morphometric analysis and have good reproducibility in differentiating the various cell subsets. They used an image analyzer (IBAS 2000, Zeiss Kontron, Munich, Germany) to study 17 centroblastic/centrocytic and centroblastic follicular and/or diffuse primary cutaneous lymphomas. Results. The data obtained showed morphometric differences between the follicular and diffuse patterns of neoplastic cells. In follicular neoplasms, the cells tend to be smaller, more cleaved, and more monomorphic than those observed in the diffuse forms. In all the follicular and diffuse cases, the authors observed a unimodal population with a wide peak composed of cells with intermediate morphometric features that cannot be labeled properly. Conclusions. These data underline the considerable overlap of nuclear parameters of lymphocytes between the subtypes of cells in cutaneous mixed small and large cell lymphoma, making the Kiel classification and Working Formulation unsuitable for this kind of neoplasia and supporting revision of classification criteria in cutaneous germinal center cell lymphomas

Arthroscopic second generation autologous chondrocyte implantation at 48 months follow-up

none7openE. Kon; G. Filardo; M. Delcogliano; S. Zaffagnini; C. Montaperto; F. Iacono; M. MarcacciE. Kon; G. Filardo; M. Delcogliano; S. Zaffagnini; C. Montaperto; F. Iacono; M. Marcacc

Development and implementation of a medical record system for the Istituti Clinici di Perfezionamento public network of outpatient specialty clinics in Milano, Italy

The Istituti Clinici di Perfezionamento of Milano (ICP) Hospital, Italy took the charge of managing the network of 22 outpatient specialty clinics of Milano in 2008. Within these clinics 650.000 visits are performed yearly by 255 specialists of 26 different specialties. Until 2008 these clinics have been managed by several different Public Hospitals, there was no unique standard for paper medical records and only a minority of patients encounters were registered electronically. ICP is one Public Hospital of the Lombardia Region, which had developed a Health Information System called SISS. SISS allows all the entitled public health professionals to gain access to individual patient records which contain demographic, clinical and service utilisation data registered with SISS standards. Furthermore, standards for both paper and electronic hospital records have been clearly defined by the Regione Lombardia. In this context ICP started a program for the development and implementation of an outpatient specialty clinics medical record system that took off at the end of 2009. A project team was settled, composed of specialists\u2019 representatives, quality management and organization experts from within the ICP. In six months the group defined: \u2022 The outpatient medical records general structure and format standards \u2022 The structure and content of the medical documentation for 10 main specialties that cover more than 90% the ambulatory visits and more than 75% of the specialists \u2022 The functions needed to integrate patient clinical and administrative management \u2022 The implementation plan of the medical record system, comprehensive of the evaluation of logistic, hardware, medical education and quality control needs within each of the 22 clinics \u2022 The overall medical record system architecture in order to integrate future development with the opportunities offered by the SIS

Adiponectin, resistin and leptin in paediatric chronic renal failure: Correlation with auxological and endocrine profiles

Introduction: Chronic renal failure (CRF) compromises nutrition, growth, puberty, glycometabolic homeostasis, and adipokine secretion (i.e. adiponectin, resistin, and leptin). Adipokines play a role in the clinical outcome, but data in paediatric patients is scant. Aim: To evaluate the link between kidney function, adiponectin, resistin, leptin, hormonal status, nutritional state and late outcome of CRF children. Materials and methods: We studied leptin, adiponectin and resistin levels in 31 CRF patients (19 males, 12 females, aged 12.1 \ub1 4.47 years) managed conservatively, and 30 healthy age- and gender-matched controls. Clinical, auxological, biochemical, hormonal data, glucose and insulin levels were correlated with adipokine levels. Results: Six percent of patients had glycaemia T0\u2032 > 126 mg/dl, 23 % glycaemia T60\u2032 > 126, and 23 % glycaemia T120\u2032 65 140. Glycated haemoglobin (HbA1c) measured during follow-up was in the normal range in all patients (4-5.6 %). Insulinaemia was significantly higher in CRF patients than controls. Homeostatic model of assessment-insulin resistance (HOMA-IR) levels were more elevated in patients (32 % had HOMA-IR > 2.5) than controls. Leptin levels were significantly higher in CRF patients than controls and differed significantly between males and females. Leptin correlated significantly with creatinine, body mass index (BMI), BA, pubertal stage, insulin-like growth factor 1, and HOMA-IR in females. Adiponectin levels were significantly higher in patients than controls, higher in patients with BMI < 85th centile and significantly inversely correlated to BMI, BA, haemoglobin, ferritin, proteins, albumin, and creatininuria. Resistin levels showed a direct correlation with C-reactive protein and an inverse correlation with haemoglobin. Conclusion: Normal resistin levels are an expression of both adequate nutritional state and controlled inflammatory state. Adiponectin could protect against chronic inflammation, atherosclerosis, and cardiovascular diseases. Preventing obesity and ensuring a correct nutritional state are primary goals for physicians following children with CRF. Adipokines could be a useful marker in the follow-up

Arthroscopic mosaicplasty technique for cartilage knee lesions. Magnetic resonance observation of cartilage repair tissue (MOCART) at a minimum 7 years follow-up

none7noneE. Kon; G. Filardo; M. Delcogliano; S. Zaffagnini; C. Montaperto;M. Busacca; M. MarcacciE. Kon; G. Filardo; M. Delcogliano; S. Zaffagnini; C. Montaperto;M. Busacca; M. Marcacc