Low ERCC1 expression is associated with prolonged survival in patients with bladder cancer receiving platinum-based neoadjuvant chemotherapy

PurposeExcision repair cross-complementation group 1 enzyme (ERCC1) plays a key role in the removal of platinum induced DNA adducts and cisplatin resistance. Prognostic role of ERCC1 expression in the neoadjuvant setting in bladder cancer has not been reported before. We evaluated the prognostic role of ERCC1 expression in bladder cancer receiving platinum-based neoadjuvant chemotherapy.Materials and methodsThirty-eight patients with muscle invasive bladder cancer who received neoadjuvant platinum-based chemotherapy were included. Clinical and histopathologic parameters along with immunohistochemical ERCC1 staining were examined and correlated with response rates and survival.ResultsPathologic complete response rates were similar between patients with low and high ERCC1 expression. Median disease-free survival (DFS) was 9.3 vs. 20.5 months (P = 0.186) and median overall survival (OS) was 9.3 vs. 26.7 months (P = 0.058) in patients with high ERCC1 expression compared with those with low expression, respectively. In multivariate Cox regression analysis: pathological complete response (pCR) after chemotherapy (hazard ratio (HR) 0.1, 95% CI 0.012–0.842, P = 0.034) and high ERCC1 expression (HR 3.7, 95% CI 1.2–11.2, P = 0.019) were significantly associated with DFS. Patient age (>60 vs. ≤60 years) (HR 3.4, 95% CI 1.2–9.4, P = 0.018), the presence of pCR (HR 0.11, 95% CI 0.014–0.981, P = 0.048) and high ERCC expression (HR 6.1, 95 CI 1.9–19.9, P = 0.002) were significantly associated with OS.ConclusionsOur results showed that high ERCC1 expression was independently associated with shorter disease-free and overall survival in patients with bladder cancer who received neoadjuvant platinum-based chemotherapy. ERCC1 may represent a potential predictive marker for platinum-based treatment in bladder cancer.     

The effect of the Tscherne injury pattern on the outcome of operatively treated Lisfranc fracture dislocations

BackgroundLisfranc fracture dislocations cause severe tarso-metatarsal malalignment. The research question of this study was to evaluate the severity of the soft tissue injury on the final clinical outcome and compare that with the effect of various determinants on the disability in daily living activities after open reduction and internal fixation of a Lisfranc injury.MethodsThis study consisted of a retrospective analysis of patients with Lisfranc fracture dislocations who were treated by open reduction and internal fixation beween 2004 and 2009. Evaluation focused mainly on the severity of the soft tissue injury, age, fracture classification, time to operation, posttraumatic osteoarthritis, and the results were compared with American Foot and Ankle Society (AOFAS) scores, and Foot and Ankle Disability Index (FADI). Eight patients had Tscherne Grade 1, 13 had Grade 2, and 11 had Grade 3 soft tissue injuries. Myerson classification revealed 11 type A, 8 type B and 13 type C fractures. Six patients’ operations were delayed beyond 8 h.ResultsOf the 38 patients treated in the study period, 32 patients (11 female, 21 male; <30 y-old: 14, >30 y-old: 18) were available for complete follow-up (average, 55.5 months). The comparison of treatment results revealed that those patients with high grade soft tissue injuries had lower AOFAS and FADI scores (43.8 ± 15.9, 53.7 ± 9.4, respectively) when compared to Tscherne Grade 1 injuries (82.8 ± 6.1, 109 ± 13.9, respectively) (p < 0.001). The overall negative impact of the severity of soft tissue injury on functional outcomes had similar significance with regard to post-traumatic osteoarthritis, and fracture type. There was also a statistically significant difference between outcome measures and post-reduction quality (p = 0.002). Patient age (p = 0.9) and delayed surgery (p = 0.5) had no statistically significant effect on the final outcome.ConclusionsSatisfactory results can be achieved with open reduction for Lisfranc injuries. However, despite this treatment, both the severity of the soft tissue injury and non-anatomic reduction are negative prognostic factors in the treatment of Lisfranc fracture dislocations.     

The effect of collagen,Interleukin-l α and glicosaminoglycan on the neovascularization of central nervous system

Abstract

Neovascularization, the development of a new microvasculature, has an important role in physiological and pathological processes. The vascular changes in the brain can be easily detected because the proliferation of endothelial cells in its vascular structure is quite small, and so constitutes a good model for neovascularization studies. In the present investigation, to induce intracerebral neovascularization, we implanted collagen, Interleukin-l alpha (IL-lα) and glicosaminoglycan into the brain ofpigs, in order to test the hypothesis that IL-l α, collagen and glicosaminoglycan play a pivotal. role in the process of neovascularization. Both pure collagen and collagen combined with IL-l a induced neovascularization according to light-electron microscopic findings and values of enzymes' activities. In particular, collagen combined with IL-lα synergically affected the increase of neovascularization. However, glicosarrinoglycan did not affect it significantly. Although the results of this study provided us with some interesting data indicating the beneficial effects of collagen combined with IL-1α on neovascularization, further studies should be done to study the short term effect of these biochemical substances. [Neural Res 1998; 20: 513-525]     

Reliability of four different computerized cephalometric analysis programs

The aim of this investigation was to compare the traditional method of manual cephalometric tracing with four different computerized tracing programs, where the lateral cephalograms were scanned at 300 dpi and digitized onscreen. Thirty randomly selected cephalometric radiographs were used in this study. Four programs Dolphin Imaging, Vistadent, Nemoceph, and Quick Ceph were evaluated. Three dental, 11 skeletal, and 1 soft tissue parameters were measured that consisted of 5 linear and 10 angular measurements. Statistical analysis was carried out using multivariate analysis of variance and Box's and Levene's tests. No statistically significant difference was found between manual tracing and the computerized tracing programs. The measurements obtained with the cephalometric analysis programs used in the study were reliable.     

Leptomeningeal dissemination and vertebral bone involvement in a child with pilocytic astrocytoma

In low‐grade glioma, metastasis is rarely seen. Few cases of leptomeningeal dissemination have been reported in children. Vertebral bone metastasis has not been reported so far. Herein is described the case of a pediatric patient with the diagnosis of pilocytic astrocytoma, and leptomeningeal dissemination detected at the time of diagnosis, who then received radiotherapy and chemotherapy upon development of vertebral bone metastasis during treatment.     

Concurrent pericardial diverticulum and unilocular thymic cyst lined with ciliated respiratory epithelium: a rare case report

Thymic cysts are divided into two groups as unilocular and multilocular cysts. Cystic wall is generally lined with squamous, transitional, cuboidal, or columnar epithelium. Unilocular cysts that are lined with ciliated respiratory epithelium are extremely rare, and there are only two reports in the literature. In this paper, we present a case, which had concurrent unilocular thymic cyst lined with ciliated respiratory epithelium and pericardial diverticulum.     

Immunohistochemical expression of PTEN in normal, hyperplastic and malignant endometrium and its correlation with hormone receptors, bcl-2, bax, and apoptotic index

PTEN is a tumor suppressor gene that is frequently mutated in type I endometrioid endometrial carcinomas (EECs), and is involved in the control of cell proliferation, differentiation, and apoptosis. In this study, we aimed to assess the relationship between PTEN expression and estrogen, progesterone receptors (PRs), other apoptosis-related proteins, such as bcl-2 and bax, and apoptotic index (AI) in EEC, its precursor lesion hyperplasia, and cyclical endometrium. We also evaluated the relationship between PTEN expression and clinicopathologic parameters. PTEN, estrogen receptor (ER), PR, and bcl-2 and bax expressions were evaluated immunohistochemically, and AI was evaluated in hematoxylin and eosin (HE)-stained slides in 23 cyclical and 37 hyperplastic endometria and in 35 EECs. PTEN expression was higher in cyclical endometrium than in the carcinomas (p<0.05). The PTEN expression level was significantly higher in non-atypical hyperplasias than in EEC, but there were no differences between atypical complex hyperplasia (ACH) and EEC and between hyperplasias. In the carcinomas, there was a negative correlation between grade and PTEN expression (r=-0.338, p=0.047). In conclusion, we presume that PTEN is involved in the early phases of endometrial tumorigenesis, and it can be speculated that decreased PTEN expression with loss of differentiation in carcinoma can contribute to the emergence of tumors with a more aggressive phenotype.