MR rectum imaging with ultra sound gel as instrumental contrast media in tubulovillous adenoma Bacground. Colorectal polyps are frequent and can be found in 10% of adults, most common in elderly with prevalence of 20% in age group of 60. Over 90% cases of cancer are being developed from benign adenomas. Colorectal cancer (CRC) is a significantly large cause of death right after bronchial cancer in males, and breast cancer in women. Therefore, a standpoint was adopted that the removal of polyps as precursor will prevent the development of colorectal area cancer. Polyps can occur as peduncular or sessile. Adenomas are grouped in three subtypes based on histological criteria: tubular, tubulovillous and villous. Villous adenomas are larger than others and show a higher level of dysplasia. The prevalence of adenomas increases with the patient's age. Having in mind that the risk of malign adenoma transformation is 10 years average, and that small lesions have no clinical potential to turn into cancer, their removal would lead to unnecessary complications and additional costs. CRC risk grows both with the size and the number of adenomas. In patients who refuse polypectomy, we can expect cancer development in average of 5 years 4% and in 10 years 14%. Case report. We present a patient with a years long history of rectal polyp. She has refused any treatment of polyp removal up so far. Due to stool problems, mostly constipation, occasional bleeding and falling out feeling, she has decided to remove the polyp. The polyp has been detected through colonoscopy and described as very risky for polypectomy due to its suspected malign appearance. We did rectum MR on 1.5T Siemens, so that the patient came with clean lumen into which we applied ultra sound gel with huge 60 ml syringe (no needle) simply and pain free with three fillings (total 180 ml of gel). We have concluded that the polyp was of uneven outline and stretched partially along the inner rectum wall without extra rectal infiltration into mesorectal area. After that, we performed endoscopic polypectomy according to peace meal method resection up to real muscular layer after adrenalin undermining. Pathohistological finding which was done in HE technique showed tubulovillous adenoma. Conclusions. Rectal MR is a new, very reliable method of contemporary radiological imaging that gives better characterization of polyp tissue and of other tumours. It is currently the best imaging modality enabling very accurate evaluation and topographic ratio of tumour growth within the rectum wall and outside the wall, especially compared to mesorectal fascia. In addition, it is a very comfortable procedure without radiation. The application of ultra sound gel as intra luminal rectal contrast agent can distend the lumen and make an excellent contrast of lumen against the rectum wall and thus can better show polyps and tumours.

Epidermolytic hyperkeratosis (EHK) or bullous congenital ichthyosiform erythroderma is a rare autosomal dominant disorder characterized by an early onset, with erythroderma and bullous lesions, leading to severe generalized hyperkeratosis in adulthood. Mutations have been found in keratin 1 and keratin 10 genes. The clinical manifestations of EHK present striking heterogeneity and at least six clinical phenotypes have been identified. We report on a case of EHK in a 12-year-old girl with erythroderma, erosions and blisters on the entire body surface at birth and generalized hyperkeratosis but without severe palm and sole involvement in the later stage. On the basis of clinical and histopathologic findings, the diagnosis of EHK type NPS-3 was made.

This systematic review considers the most recent attitudes and news regarding the influence of the stroma on tumor initiation and progression. It is now widely accepted that tumor stroma plays an active role in carcinogenesis. Many different signaling molecules, ligands and signaling pathways recently have been discovered. This review considers the complexity of interactions between malignant cells and its stroma (cross-talk). The recent advances and better understanding of the tumor-stroma interactions will have important impact on the new and combined therapeutic approaches and modalities.

The aim of this study was to investigate different microbial morphotypes in the root canal infection associated with chronic diffuse periapical lesion. In forty cases of asymptomatic teeth with radiographically diagnosed diffuse periapical lesion we took specimens of infected tissue from the root canals at the beginning of endodontic treatment. Fixation and four different staining methods of the specimens were obtained to provide microscope examination. All examined root canal specimens were heavily infected by bacteria. The most commonly identified were cocci 92 %, small mostly G+ diplococci and large G+cocci in clusters and grapelike groups, bacilli found in 67%, coccobacilli 37%, fungi 17%, and spirochetes in 5%.

Bcl-2, the protein product of the Bcl-2 gene, is a member of the Bcl-2 family of proteins that play a crucial role in a complex mechanism of apoptosis. It was recently proposed that bcl-2 could inhibit cancer progression. In this study, we evaluated the expression patterns of Bcl-2, estrogen receptors (ER), progesterone receptors (PR) in 71 primary invasive breast carcinomas and their association with other clinicopathological parameters. Samples from 71 patients with invasive breast cancer with follow-up ranging from 4-103 months (median 57 months) were included in the study. Forty-six patients (66%) obtained a complete response, while 5 (9%) were considered non-responders during the follow up period of 103 months. Eighteen (25%) patients died, 15 (21%) from primary disease and 3 (4%) from other disease. In unvaried analysis, tumor size (<2 cm), lymph node (<4 lymph nodes), hormonal status and Bcl-2 expression are correlated with longer overall (OS) and relapse-free survival (RFS). Patients with 4 or more positive axillary lymph nodes had significantly shorter OS (p=0.01) and RFS (p=0.009). Higher expression of Bcl-2 was associated with longer OS (p=0.02) and RFS (p=0.03), and this result were independent of axillary lymph nodes and tumor size in Cox multivariate analysis.