The Expression of p21 Marker in Bladder Urethral Tumor and its Association with Histopathologic Characteristicslogic charactristics

Background: In addition to clinical and histologic factors that are able to differentiate between low and high grades of bladder's urethral tumor from each other, there are a number of biomarkers that may be helpful in evaluating the degree, outcome, and prognosis of the tumor. The aim of this study was to investigate the relationship between overexpression of p21 marker and histologic status, prognosis, and recurrence of urethral carcinoma of the bladder. Methods: In this cross-sectional study, the paraffin wax blocks of 356 patients were gathered. Tumor points of the tissue were selected from the main block and mounted on the tissue microarray (TMA) of receptor block. Immunohistochemical staining was performed for the p21 marker. The intensity and extent of staining for this marker were determined by two pathologists using the combined and semi-quantitative method [Histochemical Score (H-Score)]. Results: The expression of p21 marker was significantly different in the high- and low-grade tumors. On the basis of H-Score, and in the high-grade tumor group, this expression was significantly higher than the low-grade (153.85 ± 91.06 versus 130.01 ± 82.20). Using the receiver operating characteristic (ROC) curve analysis, the p21 marker (based on the H-Score) had a high degree of precision in distinguishing high-grade items from the low-grade (ROC = 0.596, P = 0.002). Accordingly, the best cut-off value for the marker in differentiation of two grades was 92.5%, at which, the sensitivity and specificity were 67.7% and 44.7%, respectively. Regarding the results of multivariate logistic regression analysis, in the evaluation of factors related to tumor recurrence, the presence of non-papillary pattern predicted the recurrence (likelihood ratio: 6.363, P = 0.001). Conclusion: By determining the H-Score of p21 marker, the high- and low-grade tumors can be discriminated with an acceptable sensitivity and specificity. The presence of non-papillary pattern has a high predictive value for tumor recurrence

Prediction of hamstring tendon autograft diameter using preoperative measurements with different cut-offs between genders

Abstract Purpose Studies have suggested some predictors for hamstring tendon (HT) autograft diameter based on anthropometric factors and preoperative magnetic resonance imaging (MRI) with variable results. Some authors have attributed the variability to gender differences. This prospective cohort reports the sensitivity and specificity of anthropometric and MRI predictors in males and females separately to determine the difference. Methods Forty-two eligible patients who underwent anterior cruciate ligament reconstruction (ACLR) and MRI in our center were included. ACLR was performed by the senior surgeon using a 4-stranded HT autograft for all patients. A blinded musculoskeletal radiologist measured the cross-sectional area (CSA) of gracilis and semitendinosus tendons using the free-hand region of interest tool for all patients. An orthopaedic resident (PGY4) collected anthropometric factors and measured intraoperative autograft diameter. Results Mean intraoperative autograft diameter was 8.0 mm. Females had a significantly lower autograft diameter (7.4 vs. 8.2, P < 0.001), smaller gracilis (6.9 vs. 7.9, P = 0.003) and semitendinosus CSA (11.5 vs. 12.8, P = 0.014) compared to males. ROC curve analysis resulted different cut-off values with high sensitivity and specificity for semitendinosus and combined CSA regarding gender. Conclusion Based on the results of this study, CSA of either isolated or combined HTs on preoperative axial MRI, height, and weight are the strongest predictors of intraoperative autograft diameter. It is suggested to consider different cut-offs for males and females to have a better clinical guide for surgeons. Level of evidence Level II

Aneurysmal Bone Cyst: An Analysis of 38 Cases and Report of Four Unusual Surface Ones

Aneurysmal bone cyst (ABC) is a benign expansile bone tumor, most commonly involving the medulla of long bones. ABC rarely arises within the cortex or in the subperiosteal region, radiographically mimicking other conditions, in particular surface osteosarcomathat is low-grade in nature and may go secondary ABC changes, and telangiectatic osteosarcoma. Both of these are sometimes mistaken microscopically for primary ABC. We review the characteristics of ABC cases in our center and report four unusualsurface ABCs arising in the subperiosteal or cortical region of long bones, identified among 38 histologically proven ABCs during a four-year period in our center. The surface ABCs occurred at an older agewith a predilection for diaphysis of femur, tibia, and humerus