The 2 paired arteries—the posterior communicating arteries (PCoAs) and the precommunicating parts of the posterior cerebral arteries—form the so-called posterior segment of the cerebral arterial ...circle on the base of the brain. A number of (ab)normal morphologic features were described in the literature (e.g., unusual kinking, or extreme elongations, hypoplasia, duplications, fenestrations, the infundibular widening, or aplasia of the PCoA in the prenatal and/or postnatal periods). The aim of this study was to analyze an incidence of various fenestrations and duplications of the PCoA, and describe their general features and their association with other vascular abnormalities.
The research was performed on the brains of 200 human fetuses and 377 adult cadavers of both genders and different ages using microdissection and macrodissection methods.
There were 0.34% cases with PCoA fenestrations and 3.12% cases with various PCoA duplications. Their morphologic features were described and compared with the similar PCoA abnormalities recorded in the scientific literature. There was no association between the PCoA and either duplication or aneurysm in adult cases.
After thorough examination, the fenestrations and duplications of the PCoA are distinguished as 2 special forms of vascular abnormalities, and the PCoA duplications are characterized as partial and total. Furthermore, whereas the low incidence of a fenestration of the PCoA suggests it to be a sufficiently rare phenomenon, the duplications of the PCoA trunk are fairly frequent, especially concerning its terminal segment.
In 19th century the death-rate of newborns was 25% and it was in direct correlation with breastfeeding. Mortality connected with breastfeeding and formula nutrition today is not regarded as a current ...issue in developed Western counties, and they are rather treated as reflection of expanded morbidity and cost benefit. Breastfeeding advantages are projected in nutritive, immune, developmental, psychological, social and economical aspects. Breastfeeding promotion should involve professionals from different areas. The basic aim of the current research is to examine the way in which the implementation of Baby Friendly programme influences both breastfeeding as the only nourishing method, and the use of formula nutrition and substitution after third and sixth month of a newborn‘s life. The observed group consisted of 216 newborns who were exposed to Baby Friendly programme after birth in maternity hospitals, and the same number of newborns who were not exposed to the program. The results point to significantly more frequent breastfeeding as the only nourishing method, and less often use of formula nutrition and substitution in the group of newborns exposed to Baby Friendly programme, even after three and six months of life when compared to the control group. All around the world, during the last century, breastfeeding rates were declining, and only in the last decade, the application of BFHI and its ten steps of successful breastfeeding brought positive results worldwide. This initiative has been accepted by around 20,000 medical centres, which present about a third of all world institutions. The study doubtlessly confirms that the implementation of Baby Friendly programme raises breastfeeding rates. The implementation of Baby Friendly programme is of utmost necessity wherever possible, since the advantages of breastfeeding are enormous and precious for the health of future generations.
We presented an extremely severe case of tuberous sclerosis complex (TSC) in a female patient with recurring, life-threatening bleeding complications related to renal angiomyolipomas. Massive ...intratumoral hemorrhage required surgical removal of both angiomyolipomatous kidneys and kidney transplantation. During the follow-up period, the patient developed severe metrorrhagia that eventually led to hysterectomy and salpingo-oophorectomy. Bleeding from the operative sites caused the loss of the first kidney transplant received from the mother, and immediate hemorrhagic shock led to the loss of the second, cadaveric kidney allograft. The third kidney transplant had a successful outcome. Pathological analysis of all tissue specimens showed TSC-associated lesions and deformed blood vessels in the surgically removed organs. Molecular genetic analysis of TSC1 and TSC2 in the DNA of peripheral leukocytes identified a novel TSC2 c.3599G>C (p.R1200P) variant. Functional assessment confirmed the likely pathogenicity of the TSC2 c.3599G>C (p.R1200P) variant. To the best of our knowledge, this is the first report of the c.3599G>C (p.R1200P) variant in exon 29 of the TSC2 gene related to a severe clinical course and multiple kidney transplants in a patient with TSC.
Introduction/Objective. Serbia has been burdened with one of the highest cervical cancer incidence and mortality rates in Europe. The objective of the study was to estimate the prevalence and factors ...associated with compliance to cervical cancer screening among women in the general population. Methods. The study used the data from 2013 National Health Survey of the population of Serbia. Logistic regression analysis was further used to examine demographic and socio-economic factors which affect the disparities in cervical cancer screening practices among the female population. Results. Every third woman (35.4%) has never done a Pap test in her lifetime. The highest percentage of respondents did their Pap tests after they were recommended by doctors (52.3%); 45% of women did it on their own initiative, and only 2.7% did it after they had been summoned to participate in an organized screening by their doctor. The multivariate logistic regression analysis revealed that the most important factors in women who had never undergone Pap tests were the following: age (being within the youngest or the oldest age group), rural residence and low level of education, poor socio-economic status, and marital status (have never married). Conclusion. Further strategies and interventions for improving cervical cancer incidence and mortality rates should be focused on socially and economically endangered population groups in order to reduce disparities in cervical cancer screening more effectively.
nema
Summary
Objective
The aim of the present study was to correlate the level of tumor-infiltrating immune cells with bladder cancer size and T category in patients with solitary low-grade non-muscle ...invasive bladder cancer (NMIBC).
Patients and methods
Between 1996 and 2006, 115 patients with solitary low-grade NMIBC after transurethral resection of the bladder without adjuvant therapy were retrospectively identified from the institutional database. Tumor specimens were retrieved and tissue microarrays were constructed. Immunhistochemical staining for tumor-infiltrating immune cells with anti-CD3, CD4, CD8, CD20, CD56, CD68, and granzyme B (Gr B) was performed.
Results
Immune cells were predominantly observed within the cancer stroma. Statistically significant higher levels of CD56 cells in small tumors and CD68 cells in T1 tumors (
p
= 0.0310, 0.0151, respectively) were established.
Conclusion
The current study propose a possible correlation of CD56+ and CD68+ cells with bladder cancer size and stage in patients with solitary low-grade NMIBC.
Prostate cancer is one of the most important men's health issues in developed countries. For patients with prostate cancer a preoperative staging of the disease must be made. Involvement of lymph ...nodes could be assessed using imaging methods (CT or/and MRI), however, newer methods also exist (PET/CT, PSMA PET/CT). For some patients during radical prostatectomy a pelvic lymphadenectomy is recommended. Pelvic lymphadenectomy is indicated in intermediate- and high-risk group patients and with increased probability of lymph node invasion. The most used prediction tools for preoperative assessment of lymph nodes are Briganti and MSKCC nomograms and Partin tables. Pelvic lymphadenectomy can include different lymph nodes group, but extended lymphadenectomy is the recommended procedure. In 1-20% of patients, the lymph node invasion is present. Pelvic lymphadenectomy is primarily a diagnostic and staging method, and in minority of patients with positive lymph nodes it can be a curative method, too. In other patients with positive lymph nodes adjuvant therapy (radiotherapy and androgen deprivation therapy) can be beneficial.
The aim of this study was to evaluate the expression of matrix metalloproteinase 2 (MMP-2) and matrix metalloproteinase 9 (MMP-9) in prostate cancer in the main tumor mass and tumor cells at the ...positive margin as well as the influence of these biomarkers on the biochemical recurrence of the disease in prostatectomy patients. Tissue microarrays of 120 archival prostate carcinoma samples were immunohistochemically evaluated for MMP-2 and MMP-9 expression and compared with clinicopathological parameters. Tumors with positive surgical margins showed significantly higher overall expression of MMP-9 versus tumors with negative resection margins P = 0.0121 . MMP-9 expression was significantly elevated in tumors from patients who had biochemical recurrence P = 0.0207 . In the group of patients with negative margins, MMP-9 expression above the cut-off value was significantly associated with recurrence P = 0.0065 . Multivariate analysis indicated that MMP-9 is a good predictor of biochemical recurrence (odds ratio = 10.29; P = 0.0052 ). Expression of MMP-2 in tumor cells was significantly higher at the positive margins than in the main tumor mass P = 0.0301 . The present results highlight the potential value of MMP-2 and MMP-9 expression for predicting the behavior of prostate tumors after prostatectomy with both positive and negative surgical margins.
Background
The posterior cerebral artery (PCA), as a paired terminal branch of the basilar artery, runs through four segments (P1 to P4) to the inferior and medial surfaces of the occipital and a ...part of the temporal lobes. There are many PCA variants in its course. The literature data indicated that a fenestration of the PCA was very rare and that its clinical significance is unknown. The purpose of this investigation was to present the frequency, location, and some morphological features of PCA fenestration in the prenatal and postnatal period.
Method
Using brain bases of 468 (200 fetal and 268 adult) cadavers, we applied macroscopic and microscopic investigation.
Results
We found four (0.85 %) cases of PCA fenestrations—two at the left and right P1 segment of fetuses, respectively, then one adult at the left P2 segment, as well as one adult at one right PCA of the two existing arteries. There were associated multiple vascular abnormalities in one adult case. We did not find any case of PCA aneurysm originating from fenestration, as well as from PCA without fenestration.
Conclusion
The frequency, segment, and side location, as well as the size and shape of PCA fenestrations in specimens of our population did not significantly differ from the same in other populations. PCA fenestrations in our adult specimens were not the bases of aneurysms.
Abstract
Background
The role of angiogenesis in the pathogenesis of renal cell carcinoma is well recognized, however, the influence of tumor cells in this activity has not yet been fully clarified. ...The aim of this study was to analyze the expression of hypoxia inducible factor-1α (HIF-1α), a regulatory factor of angiogenic switch, in comparison to vascular endothelial growth factor A and C (VEGF-A and VEGF-C), recognized to be involved in blood and lymph vessel neoangiogenesis, with potential association in the prognosis of patients with renal cell carcinoma.
Methods
Ninety-four patients with diagnosis of clear cell renal cell carcinomas (CCRCC), all clinicopathological characteristics and overall survival were unrolled in this study. Immunohistochemicaly VEGF-A, VEGF-C, HIF-1α and Ki67 were detected on tumor cells and the staining was performed on tissue microarrays (TMA). The staining was evaluated as a percentage of cytoplasmic or nuclear positive tumor cells.
Results
Variable expression of all three proteins was confirmed. Both angiogenic factors demonstrated perimembranous or diffuse cytoplasmic staining, with diffuse pattern positively associated (p < 0.001). Nuclear HIF-1α expression (nHIF-1α) showed inverse correlation with diffuse cytoplasmic VEGF-A (p = 0.002) and VEGF-C (p = 0.053), while cytoplasmic HIF-1α expression (cHIF-1α) showed positive correlation with diffuse staining of both angiogenic factors (p < 0.001; p < 0.001, respectively). In comparison to clinicopathological characteristics, a higher nuclear grade (p = 0.006; p < 0.001, respectively), larger tumor size (p = 0.009; p = 0.015, respectively), higher stage (p = 0.023; p = 0.027, respectively) and shorter survival (p = 0.018; p = 0.024, respectively) were associated with overexpression of cHIF-1α and diffuse cytoplasmic VEGF-A expression. In contrary, overexpression of nHIF-1α was associated with better diagnostic parameters i.e. lower nuclear grade (p = 0.006), smaller tumor size (p = 0.057), and longer survival (p = 0.005).
Conclusion
Overexpression of VEGF-A and cHIF-1α in tumor cells highlights a more aggressive subtype of CCRCC that might have some clinical implications. The significance of nHIF-1α expression associated with better differentiated tumors should be further elucidated.
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