Sample records for clinical immunohistochemical method

  1. High density of peritumoral lymphatic vessels is a potential prognostic marker of endometrial carcinoma: a clinical immunohistochemical method study

    Meng Xiao-yu


    Full Text Available Abstract Background The lymphatic system is a major route for cancer cell dissemination and also a potential target for antitumor therapy. To investigate whether increased lymphatic vessel density (LVD is a prognostic factor for nodal metastasis and survival, we studied peritumoral LVD (P-LVD and intratumoral LVD (I-LVD in samples from 102 patients with endometrial carcinoma; Methods Endometrial carcinoma tissues were analyzed for lymphatic vessels by immunohistochemical staining with an antibody against LYVE-1. Univariate analysis was performed with Kaplan-Meier life-table curves to estimate survival, and was compared using the log rank test. Prognostic models used multivariate Cox regression analysis for multivariate analyses of survival; Results Our study showed that P-LVD, but not I-LVD, was significantly correlated with lymph vascular space invasion (LVSI, lymph node metastasis, tumor stage, and CD44 expression in endometrial carcinoma. Moreover, P-LVD was an independent prognostic factor for progression-free survival and overall survival of endometrial carcinoma; Conclusions P-LVD may serve as a prognostic factor for endometrial carcinoma. The peritumoral lymphatics might play an important role in lymphatic vessel metastasis.

  2. Immunohistochemical assessment of oestrogen and progesterone receptors: correlations with the DCC method and clinical outcome in primary breast cancer patients

    Grabau, D A; Thorpe, S M; Knoop, A; Vach, W; Schrøder, H D; Blichert-Toft, M; Al-Suliman, N N; Graversen, H P; Rose, C


    patients, receptor positive cases fared better than negative cases in all situations. Investigation of the prognostic power revealed that classification based on IHA allowed better discrimination of patients than classification based on the DCC method. The reason for this difference might be because...

  3. Ductal adenocarcinoma of the prostate: immunohistochemical findings and clinical significance

    Sha JJ


    Full Text Available Jianjun Sha,1,2 Juanjie Bo,1 Jiahua Pan,1 Lianhua Zhang,1 Hanqing Xuan,1 Wei Chen,1 Dong Li,1 Zhaoliang Wang,1 Dongming Liu,1 Yiran Huang1,2 1Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 2School of Biomedical Engineering, Shanghai Jiaotong University, Shanghai, People's Republic of China Introduction: To investigate the clinical features, diagnosis, treatment, and prognosis of ductal adenocarcinoma of the prostate. Methods: The clinicopathological and immunohistochemical data of seven patients with ductal adenocarcinoma of the prostate were retrospectively analyzed. All patients underwent physical examination, magnetic resonance imaging (MRI, bone scan, cystoscopy, and computed tomography (CT scan. The level of prostate-specific antigen (PSA before and after surgery was assessed. Different prostate cancer markers were used for immunohistochemical staining. Results: The mean age of the seven patients diagnosed with prostatic ductal adenocarcinoma in this study was 76.2 years (range 57–88. Five patients presented with intermittent and painless gross hematuria, one patient with progressive dysuria, and one patient with elevated serum PSA on routine health examination. The level of PSA before surgery ranged from 1.3 to 45.0 ng/mL. Immunohistochemical staining results of the prostatic ductal adenocarcinoma confirmed positivity for PSA, prostatic acid phosphatase, androgen receptor, and alpha-methyacyl co-enzyme A (CoA-reductase markers. Two of the patients underwent bilateral orchiectomy combined with anti-androgen therapy, three underwent transurethral resection of prostate, one received radical prostatectomy, and one received medical castration therapy. The clinical outcomes of all patients were satisfactory, based on follow-up data. The symptoms of hematuria and dysuria were ameliorated well, and the postoperative PSA level decreased below 4.0 ng/mL. Recurrence or metastasis of disease was

  4. Congenital myopathies: clinical and immunohistochemical study.

    Thaha, Fazil; Gayathri, N; Nalini, A


    Congenital myopathies (CMs), a group of relatively non-progressive disorders presents with weakness and hypotonia of varying severity, morphologically recognized by specific structural abnormalities within the myofiber. This report presents the clinical and Histopathological features of 40 patients with CMs. Centronuclear myopathy was the commonest (40%) followed by congenital fiber type disproportion (37.5%). Other less common CMs included: myotubular myopathy (5%), nemaline myopathy (5%), central core disease (5%), multicore disease (2.5%) and congenital myopathy with tubular aggregate (5%). Immunolabeling to desmin corresponded to morphological changes within the myofibers while vimentin was negative in all the patients. There is no combined role of these proteins in the disease process. PMID:22234203

  5. Histochemical, lectinhistochemical and immunohistochemical methods in embryological heart researches

    Mashtalir M.A.


    Full Text Available The purpose of the study was to summarize our results of histochemical, lectinhistochemical and immunohistochemical methods for embryonic heart research on chick, mouse and rat as well as human embryo. The alcyan blue staining after Stidman proved useful in identifying populations of neural crest cells within the mesenchymal structures of the heart. McManus staining revealed areas of the extracellular matrix in parts of heart which undergo active transformation. Lectins WGA, STA, RCA, which intensively stained vascular endothelium and endocardium, were also the labels for dying cells. VAA revealed apoptotic cells only, SNA - endocardium, endothelium, mesenchyme cells of the large vessels, PFA - endothe-lium, endocardium. PSA, LCA showed cone-shaped pattern in the wall of pulmonary trunk and aorta of human embryo dur-ing 8-11 weeks. WGA staining was heteromorphic in endothelium of embryonic human heart at 8-12 weeks. The more in-tense reaction was typical in endothelium covering the ventricular and atria walls, as well as the endocardium above trabecu-lae and papillary muscles of the ventricles. WGA staining in endothelium was practically absent in the area of chordae tendi-neae during this period. We suggest that the value of immunohistochemical and lectinhistochemical methods in identifying the endothelium and apoptotic cells is comparable.

  6. Ductal adenocarcinoma of the prostate: immunohistochemical findings and clinical significance

    Sha JJ; Bo JJ; Pan JH; Zhang LH; Xuan HQ; Chen W; Li D; Wang ZL; Liu DM; Huang YR


    Jianjun Sha,1,2 Juanjie Bo,1 Jiahua Pan,1 Lianhua Zhang,1 Hanqing Xuan,1 Wei Chen,1 Dong Li,1 Zhaoliang Wang,1 Dongming Liu,1 Yiran Huang1,2 1Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 2School of Biomedical Engineering, Shanghai Jiaotong University, Shanghai, People's Republic of China Introduction: To investigate the clinical features, diagnosis, treatment, and prognosis of ductal adenocarcinoma of the prostate. Methods: The clinico...

  7. Histological, Immunohistochemical and clinical study of HEPATIC immune response in CHRONIC hepatitis C

    Aboushady MA, Algyoushy AF, Elbaz TZ, Saleh SA and Ewees IE


    Full Text Available The factors that determine persistence or clearance of hepatitis C virus (HCV infection are poorly understood. Information in this area may lead to better understanding of the immune response against HCV infection. Such understanding can support the goal of development of a broad based cellular and humoral immune response to HCV which may be important for eradication of infection. In the present study, needle biopsy specimens from hepatitis C virus infected patients were prepared for histological, histopathological and immunohistochemical studies. Patient history, full clinical examination and biochemical investigations were recorded. Primary and secondary lymphoid follicles were evident in ABOUT 50% of the biopsies. Because CD4(+ T- helper (T-h lymphocytes provide help for humoral immunity, these cells were demonstrated in the liver biopsies by immunohistochemical methods. Positive fluorescence representing CD3(+/CD4(+ T-h was vigorous in liver residing lymph follicles. To test the possibility of T-h proliferation due to autoimmune reaction, the serum of patients was tested for the presence of antimitochondrial, antismooth muscle and antinuclear antibodies by immunohistochemical method. Analysis of the results eliminated the autoimmune response leaving the possibility of antiviral response. Histological examination indicated bile duct injury in areas occupied by secondary follicles. This may indicate that viral core proteins, with antigenic properties that elucidate immune response, may reach the portal area, in which the follicles are formed, via the bile canaliculi to the bile duct where antigen antibody complex is phagocytosed leading to bile duct injury. Unlike the case of patients who did not show follicles in their liver biopsy, those showing secondary follicles did not show liver cirrhosis or high grade fibrosis suggesting immune protection. Moreover, the incidence of secondary follicles in females was higher than males suggesting sex

  8. Clinical and immunohistochemical characterization of thymic lymphosarcoma in a heifer.

    Alexander, A N; Constable, P D; Meier, W A; French, R A; Morin, D E; Lowry, J E; Hoffman, W E


    A 2-year-old Holstein heifer with a swollen brisket, jugular vein distention, muffled heart sounds, tachycardia, and free gas bloat was examined. Thymic lymphosarcoma was suspected based on a negative agar gel immunodiffusion test for bovine leukemia virus, presence of atypical lymphocytes in pleural fluid, and detection of a mass in the thoracic inlet. Right-sided cardiac catheterization was performed, and markedly increased jugular venous pressures (41 mm Hg) with a pressure gradient of 29 mm Hg immediately cranial to the heart indicated constriction of the cranial vena cava. Immunohistochemical staining of formalin fixed, paraffin-embedded tissue sections of the tumor using a rabbit antihuman T cell, CD3 polyclonal antibody confirmed that the neoplastic lymphocytes were of thymic origin. PMID:8819055

  9. Pigmented ameloblastic fibro-odontoma: clinical, histological, and immunohistochemical profile.

    Martínez Martínez, Marisol; Romero, Celeste Sánchez; Piña, Alicia Rumayor; Palma Guzmán, José Mario; de Almeida, Oslei Paes


    Ameloblastic fibro-odontoma (AFO) is a slow-growing, expansive, benign odontogenic tumor, composed of ameloblastic epithelium embedded in an ectomesenchymal stroma resembling dental papilla, containing hard dental tissue in variable degrees of maturation, including enamel, dentin, and sometimes cementum. AFO typically affects the posterior mandible, causing bony expansion. We report a case of pigmented AFO in a 5-year-old boy, comprising clinical and histological features illustrated by immunohistochemistry using a large panel of antibodies, polarized light microscopy and scanning electron microscopy. PMID:25339415

  10. Enzyme catalysis enhanced dark-field imaging as a novel immunohistochemical method

    Fan, Lin; Tian, Yanyan; Yin, Rong; Lou, Doudou; Zhang, Xizhi; Wang, Meng; Ma, Ming; Luo, Shouhua; Li, Suyi; Gu, Ning; Zhang, Yu


    Conventional immunohistochemistry is limited to subjective judgment based on human experience and thus it is clinically required to develop a quantitative immunohistochemical detection. 3,3'-Diaminobenzidin (DAB) aggregates, a type of staining product formed by conventional immunohistochemistry, were found to have a special optical property of dark-field imaging for the first time, and the mechanism was explored. On this basis, a novel immunohistochemical method based on dark-field imaging for detecting HER2 overexpressed in breast cancer was established, and the quantitative analysis standard and relevant software for measuring the scattering intensity was developed. In order to achieve a more sensitive detection, the HRP (horseradish peroxidase)-labeled secondary antibodies conjugated gold nanoparticles were constructed as nanoprobes to load more HRP enzymes, resulting in an enhanced DAB deposition as a dark-field label. Simultaneously, gold nanoparticles also act as a synergistically enhanced agent due to their mimicry of enzyme catalysis and dark-field scattering properties.Conventional immunohistochemistry is limited to subjective judgment based on human experience and thus it is clinically required to develop a quantitative immunohistochemical detection. 3,3'-Diaminobenzidin (DAB) aggregates, a type of staining product formed by conventional immunohistochemistry, were found to have a special optical property of dark-field imaging for the first time, and the mechanism was explored. On this basis, a novel immunohistochemical method based on dark-field imaging for detecting HER2 overexpressed in breast cancer was established, and the quantitative analysis standard and relevant software for measuring the scattering intensity was developed. In order to achieve a more sensitive detection, the HRP (horseradish peroxidase)-labeled secondary antibodies conjugated gold nanoparticles were constructed as nanoprobes to load more HRP enzymes, resulting in an enhanced DAB

  11. A clinicopathological and immunohistochemical study of clinically non-functioning pituitary adenomas: A single institutional experience

    Rishi Arvind


    Full Text Available Background : Non-functioning pituitary adenomas (NFPA are characterized by the lack of clinical syndrome as compared to functioning adenomas (FA but not all functioning adenomas have clinical effects. Their exact incidence varies in different series. Materials and Methods : This study was undertaken to analyze the hormonal profile of NFPA at the immunohistochemical level in the Indian population and to see if any differences exist from the earlier studies. Their biological aggressiveness was also studied by MIB-1 labeling index (MIB-! LI and Epidermal Growth Factor Receptor (EGFR expression. These parameters along with their clinical behavior were correlated with radiological features of invasiveness and size. Results : Of the 151 pituitary adenomas diagnosed during a period of one and half years, 77 (51% were NFPA with a male predominance. There was increase in the incidence of NFPA with increase in age. Immunopositivity for various hormones was observed in 64 (83% cases, either singly or in various combinations. On the basis of immunohistochemistry, NFPA were classified into three subtypes; gonadotroph adenomas, silent adenomas, and null cell adenomas. Gonadotroph adenomas were the commonest subtype. In general, NFPA showed low MIB-1LI but invasive NFPA had LI on the higher side, however, this difference was not significant. We observed EGFR positivity in two cases only; therefore the tumorigenesis mechanism may be different in NFPA. Conclusion : Although non-functional at the clinical level immunohistochemistry showed reactivity for various hormones. If a battery of immunostains including seven hormones is studied, a significant number of cases are shifted to the functional group.

  12. Epidermolytic ichthyosis in a dog: clinical, histopathological, immunohistochemical and ultrastructural findings.

    Mecklenburg, L; Hetzel, U; Ueberschär, S


    Epidermolytic hyperkeratosis (EH) in man is a complex of congenital, ichthyosiform skin diseases characterized clinically by blistering and hyperkeratosis. These clinical signs are the result of a collapse of the cytoskeleton, seen ultrastructurally as tonofilament clumping and cytolysis within terminally differentiating epidermal cells. In man, specific mutations in keratin 1, 2e, 9 or 10 underlie the various types of EH. This report describes the clinical, histopathological, immunohistochemical and ultrastructural findings in a 6-month-old dog with severe multifocal hyperkeratosis. The morphological changes were comparable with those of EH in man, indicating that this disease, presumably with a similar underlying pathogenetic mechanism, also occurs in the dog. PMID:10805985

  13. Immunohistochemical/histochemical double staining method in the study of the columnar metaplasia of the oesophagus

    D. Cabibi


    Full Text Available Intestinal metaplasia in Barrett’s oesophagus (BO represents an important risk factor for oesophageal adenocarcinoma. Instead, few and controversial data are reported about the progression risk of columnar-lined oesophagus without intestinal metaplasia (CLO, posing an issue about its clinical management. The aim was to evaluate if some immunophenotypic changes were present in CLO independently of the presence of the goblet cells. We studied a series of oesophageal biopsies from patients with endoscopic finding of columnar metaplasia, by performing some immunohistochemical stainings (CK7, p53, AuroraA combined with histochemistry (Alcian-blue and Alcian/PAS, with the aim of simultaneously assess the histochemical features in cells that shows an aberrant expression of such antigens. We evidenced a cytoplasmic expression of CK7 and a nuclear expression of Aurora A and p53,  both in goblet cells of BO and in non-goblet cells of CLO, some of which showing mild dysplasia. These findings suggest that some immunophenotypic changes are present in CLO and they can precede the appearance of the goblet cells or can be present independently of them, confirming the conception of BO as the condition characterized by any extention of columnar epithelium. This is the first study in which a combined immunohistochemical/histochemical method has been applied to Barrett pathology.

  14. Epidemiological, clinical and immunohistochemical aspects of canine lymphoma in the region of Porto Alegre, Brazil

    Elisa B. Neuwald


    Full Text Available This paper describes the epidemiological, clinical and immunohistochemical characteristics of canine lymphomas diagnosed in the region of Porto Alegre, Brazil. Thirty dogs were enrolled in the study; most of them were male (60%, mixed-breed (23% and middle-aged or older. The majority (87% of affected dogs showed the multicentric form. The B-cell phenotype was most frequently detected (62%; 37% of the animals were in clinical stage IV, and 83% were classified as sub-stage "b". Lymphadenopathy was observed in 67% of the cases, and dyspnea, prostration, decreased appetite and vomiting were the most common clinical signs encountered. Anemia was a frequently encountered laboratory alteration (57%, as were leukocytosis (40%, thrombocytopenia (33%, lymphopenia (30%, hyperglobulinemia (20% and hypercalcemia (13%. The results of this study indicate that the clinical features of dogs with lymphoma in the region of Porto Alegre are similar to those observed worldwide.

  15. Effect of oral lactulose on clinical and immunohistochemical parameters in patients with inflammatory bowel disease: a pilot study

    Manns Michael P


    Full Text Available Abstract Background The prebiotic potential of lactulose is well established and preclinical studies demonstrated a protective effect of lactulose in murine models of colitis. The aim of the present study was to investigate the clinical and histological efficacy of lactulose in patients with inflammatory bowel disease (IBD, for which probiotic therapy yielded promising results. Methods Patients were treated with standard medication alone or combined with 10 g lactulose daily as adjuvant therapy for 4 months. Clinical efficacy of treatment was assessed using clinical activity indices, a quality of life index (IBDQ, endoscopic scores, defecation frequency and monitoring corticosteroid medication. Orsomucoid, alpha1-antitrypsin and other laboratory parameters were determined. In addition, in some participants colonic biopsies were analyzed with haematoxylin-eosin staining or with antibodies against HLA-DR, CD68, IgA and CD3, and evaluated systematically. All measurements were performed both at enrolment and at the end of the trial. Results 14 patients presenting ulcerative colitis (UC and 17 patients presenting Crohn's disease (CD, most of them in a clinically active state, were enrolled in this pilot study. After 4 month no significant improvement of clinical activity index, endoscopic score or immunohistochemical parameters was observed in CD or UC patients receiving lactulose in comparison to the control group. However, significant improvement of quality of life was observed in UC patients receiving lactulose compared to the control group (p = 0.04. Conclusion The findings of the present pilot study indicate that oral lactulose has no beneficial effects in IBD patients in particular with regard to clinical activity, endoscopic score or immunohistochemical parameters. The importance of the beneficial effect of lactulose in UC patients regarding the quality of life needs further evaluation in larger controlled clinical trials. Trial registration

  16. Oncocytic carcinoma of parotid gland: a case report with clinical, immunohistochemical and ultrastructural features

    Giordano Giovanna


    Full Text Available Abstract Background Oncocytic carcinoma is an extremely rare neoplasm of the salivary glands. We report a case of oncocytic carcinoma arising in a parotid gland in a 66-year-old female. Method An excisional biopsy of the parotid tumor was performed. The specimen was submitted for histology and after fixation in formalin solution and inclusion in paraffin, 3–5 μm sections were stained with hematoxylin and eosin for conventional evaluation and Periodic acid Schiff stain. Immunohistochemical studies were performed using antibodies against mitochondrial antigen, keratin, S-100, alpha-actin, vimentin, alpha-1-antichymotrypsin as well as an ultrastructural analysis was performed. Results Frozen sections revealed an infiltrative growth pattern and the diagnosis of a malignant epithelial lesion was made. Permanent sections stained with haematoxylin and eosin revealed a neoplasm that had replaced a wide area of the parotid gland and had invaded subcutaneous adipose tissue. Perineural invasion was evident, but vascular invasion was not found. Neoplastic elements were large, round or polyhedral cells and were arranged in solid sheets, islands and cords. The cytoplasm was abundant, eosinophilic and finely granular. The nuclei were large and located centrally or peripherally. The nucleoli were distinct and large. Periodic acid Schiff stain demonstrated a granular cytoplasm. Immunohistochemistry demonstrated mithochondrial antigen, keratin, and chymotrypsin immunoreactivity in the neoplastic cells. Ultrastructural analysis revealed numerous mitochondria packed into the cytoplasm of the neoplastic cells. Thus, the final diagnosis was that of oncocytic carcinoma of parotid gland. Conclusion This neoplasm shows clinical, microscopical, histological and ultrastructural features of oncocytic carcinoma and this must be considered in the differential diagnosis of other proliferations in the parotid gland with abundant granular cytoplasm and metastatic oncocytic

  17. Peculiarities of diagnostics and clinical course of different immunohistochemical subtypes of breast cancer

    El Khazhzh M.Kh.


    Full Text Available Modern global guidelines in oncology consider treatment of various forms of breast cancer according to molecular tumor subtype. Steroid receptors, epidermal growth factor receptors, p53, Ki67 proliferative activity index and others are the key indicators of aggressiveness of malignant breast tumors. The material for this study was the retrospective study of the standard set of breast cancer immuno¬histochemical markers (estrogen receptors, progesterone, epidermal growth factor type 2 in 8171 patients. 4 groups of patients - luminal A, luminal B, triple negative and HER2-neu positive subtypes of tumors were identified according to immunohistochemical status. We analyzed overall survival without relapse in 491 patients with breast cancer, clinical data and data of immunohistochemical studies were matched. Based on the investigation it was determined that in the early stages of the disease (1-2 luminal A subtype of cancer is often diagnosed. In the late stages the most common subtype is HER2-neu positive breast cancer. Herewith, patients with luminal A subtype of cancer have the best performance of the overall survival (OS (32,91±2,33 months, and the worst results were found in patients with HER2 - neu positive breast cancer (22,58±1,28 months. The data obtained determine HER2 - neu positive subtype as the most aggressive type of breast cancer, and the luminal A subtype – as the least aggressive one.

  18. Clinical Usefulness of Immunohistochemical Staining of p57kip2 for the Differential Diagnosis of Complete Mole

    Shigeru Sasaki; Yasushi Sasaki; Toshiaki Kunimura; Akihiko Sekizawa; Yoshihiro Kojima; Koichi Iino


    Objective. Can polymer-based immunohistochemical staining of p57kip2 replace DNA analysis as an inexpensive means of differentiating complete mole from partial mole or hydropic abortion? Methods and Materials. Original paraffin-embedded tissue blocks from 14 equivocal cases were turned over to our laboratory and examined by immunohistochemical staining of p57kip2. Results. Four of the 14 cases showed clearly negative nuclear staining in cytotrophoblasts and villous stromal cells: these result...

  19. Clinical significance of NOTCH1 and NOTCH2 expression in gastric carcinomas: an immunohistochemical study

    Lukas eBauer


    Full Text Available Background: Notch signaling can exert oncogenic or tumor suppressive functions and can contribute to chemotherapy resistance in cancer. In this study, we aimed to clarify the clinicopathological significance and the prognostic and predictive value of NOTCH1 and NOTCH2 expression in gastric carcinoma (GC. Methods: NOTCH1 and NOTCH2 expression was determined immunohistochemically in 142 primarily resected GCs using tissue microarrays and in 84 pretherapeutic biopsies from patients treated by neoadjuvant chemotherapy. The results were correlated with survival, response to therapy and clinico-pathological features.Results: Primarily resected patients with NOTCH1-negative tumors demonstrated worse survival. High NOTCH1 expression was associated with early-stage tumors and with significantly increased survival in this subgroup.Higher NOTCH2 expression was associated with early-stage and intestinal-type tumors and with better survival in the subgroup of intestinal-type tumors.In pretherapeutic biopsies, higher NOTCH1 and NOTCH2 expression was more frequent in nonresponding patients, but these differences were statistically not significant. Conclusion: Our findings suggested that, in particular NOTCH1 expression indicated good prognosis in GC. The close relationship of high NOTCH1 and NOTCH2 expression with early tumor stages may indicate a tumor-suppressive role of Notch signaling in GC. The role of NOTCH1 and NOTCH2 in neoadjuvantly treated GC is limited.

  20. Adult urinary bladder tumors with rabdomyosarcomatous differentiation: Clinical, pathological and immunohistochemical studies

    Zhang Paul J; Bing Zhanyong


    Abstract Adult rhabdomyosarcoma (RMS) in the urinary bladder is rare, and is the subject of case reports and small series. It consists of sheets of small round blue cells with high nuclear cytoplasmic ratio, brisk mitosis and apoptosis. In this study, we reported one case of pure rhabdomyosarcoma and two cases of urothelial carcinomas with extensive rhabdomyosarcomatous differentiation. In addition, their immunohistochemical profile was compared to that of small cell carcinoma of the bladder....

  1. Adult urinary bladder tumors with rabdomyosarcomatous differentiation: Clinical, pathological and immunohistochemical studies

    Zhang Paul J


    Full Text Available Abstract Adult rhabdomyosarcoma (RMS in the urinary bladder is rare, and is the subject of case reports and small series. It consists of sheets of small round blue cells with high nuclear cytoplasmic ratio, brisk mitosis and apoptosis. In this study, we reported one case of pure rhabdomyosarcoma and two cases of urothelial carcinomas with extensive rhabdomyosarcomatous differentiation. In addition, their immunohistochemical profile was compared to that of small cell carcinoma of the bladder. Our study showed that sufficient sampling was critical for the diagnosis of urothelial carcinoma with extensive rhabdomyosarcomatous differentiation. As adult RMS in the bladder and urothelial carcinoma with rhabdomyosarcomatous differentiation shared morphological features with small cell carcinoma of the bladder, appropriate immunohistochemical stains were necessary in the differential diagnosis. We showed both rhabdomyosarcoma and rhabdomyosarcomatous areas of the urothelial carcinoma were positive for myogenin, negative for cytokeratin and chromogranin stains. In contrast, small cell carcinoma was positive for cytokeratin, and 7 out of 9 cases were also positive for chromogranin. Both rhabdomyosarcoma and small cell carcinoma could be positive for synaptophysin, a potential pitfall to avoid. In addition, all of the tumors with rhabdomyosarcomatous differentiation were negative for FKHR rearrangement.

  2. Value of Immunohistochemical Methods in Detecting EML4-ALK Fusion Mutations: 
A Meta-analysis

    Chang LIU


    Full Text Available Background and objective The fusion between echinoderm microtubule-associated protein 4 (EML4 and anaplastic lymphatic tumor kinase (ALK rearrangement is present in approximately 5% of non-small cell lung cancer (NSCLC patients. It has been regarded as another new target gene after epidermal growth factor receptor (EGFR and K-ras. Figures showed that the disease control rate could reach up to 80% in NSCLC patients with EML4-ALK fusion gene after treated with ALK inhibitors. Thus, exploring an accurate and rapid detecting method is the key in screening NSCLC patients with EML4-ALK expressions. The aim of this study is to analyze the specificity and sensitivity of IHC in detecting EML4-ALK fusion mutations. To evaluate the accuracy and clinical value of this method, and then provide basis for individual molecular therapy of NSCLC patients. Methods Using Pubmed database to search all documents required. The deadline of retrieval was February 25, 2015. Then further screening the articles according to the inclusion and exclusion criteria. Using diagnostic test meta-analysis methods to analyze the sensitivity and specificity of the immunohistochemistry (IHC method compared with fluorescence in situ hybridization (FISH method. Results Eleven literatures were added into the meta analysis, there were 3,234 of total cases. The diagnositic odds ratio (DOR was 1,135.00 (95%CI: 337.10-3,821.46; the area under curve (AUC of summary receiver operating characteristic curve (SROC curve was 0.992,3 (SEAUC=0.003,2, the Q* was 0.964,4 (SEQ*=0.008,7. Conclusion Immunohistochemical detection of EML4-ALK fusion gene mutation with specific antibody is feasible. It has high sensitivity and specificity. IHC can be a simple and rapid way in screening EML4-ALK fusion gene mutation and exhibits important clinical values.

  3. A clinically motivated 2-fold framework for quantifying and classifying immunohistochemically stained specimens.

    Hall, Bonnie; Chen, Wenjin; Reiss, Michael; Foran, David J


    Motivated by the current limitations of automated quantitative image analysis in discriminating among intracellular immunohistochemical (IHC) staining patterns, this paper presents a two-fold approach for IHC characterization that utilizes both the protein stain information and the surrounding tissue architecture. Through the use of a color unmixing algorithm, stained tissue sections are automatically decomposed into the IHC stain, which visualizes the target protein, and the counterstain which provides an objective indication of the underlying histologic architecture. Feature measures are subsequently extracted from both staining planes. In order to characterize the IHC expression pattern, this approach exploits the use of a non-traditional feature based on textons. Novel biologically motivated filter banks are introduced in order to derive texture signatures for different IHC staining patterns. Systematic experiments using this approach were used to classify breast cancer tissue microarrays which had been previously prepared using immuno-targeted nuclear, cytoplasmic, and membrane stains. PMID:18044580

  4. High Frequency Radio Waves — an Innovative Approach to the Correction of Age-Related Skin Changes: Clinical and Immunohistochemical Research

    V.D. Trufanov


    Full Text Available The aim of investigation was to evaluate the efficiency of high frequency radio wave exposure (4.0 MHz for the correction of age-related changes of facial skin by studying aspects of its regeneration, on the basis of morphological and immunohistochemical characteristics. Materials and Methods. The study consisted of two parts. The clinical part included an analysis of the results of high frequency radio wave facial rejuvenation (4.0 MHz (5 procedures: on days 1, 30, 60, and months 6, 12. Immunohistochemical investigation was performed on repeated punch-biopsy specimens of the skin behind the ear, before the exposure, and at 30, 60, 180 and 360 days after a single exposure. Collagen of types 1 and 3, elastin, Ki-67, CD34, SMA, ММР2 and ТIMP1 were identified. Results. It was found that the most evident morphological changes after high frequency radio wave exposure occurred in the deeper dermis layers and in the adjacent adipose tissue. Such remodeling of the extracellular matrix of the dermis causes an expansion of the deep dermis layers with the accumulation of collagen of types 1 and 3 with a greater proportional increase in favor of type 1. The key anti-ageing factor of radio wave exposure is considered to be the activation of neoangiogenesis in the dermis, which occurs gradually, reaching its maximum by month 12 after a single exposure.

  5. Application of automated morphometric method of estimation of expression of immunohistochemical markers in diagnostics of prostate and bladder cancer

    Popkov V.M.


    Full Text Available The diagnostic significance of molecular markers was evaluated by immunohistochemical research of surgical and biopsy material of 106 patients with diseases of bladder and 57 patients with diseases of prostate. They received treatment at Scientific Research Institute of Fundamental and Clinical Uronephrology with monoclonal antibodies: Ki-67, PCNA, p63 (markers of proliferative activity, p53 (suppressor of tumor growth, Bcl-2, Bax (markers of apoptosis, EGFR (receptor of epidermal growth factors, PSA, PSMA, AMACR (prostate-specific antigens and cytokeratin profile. The morphometric research was conducted on the basis of automated analysis system of digital images Ariol SL50 (Genetix

  6. Immunohistochemical profile of laryngeal cancers with different clinical course and efficiency of treatment.

    Shponka I.S.; Gritsenko P.A.; Kovtunenko A.V.


    The cancer of larynx is one of the most significant medical problems because of its high prevalence, high mortality and low survival rate. The retrospective analysis of specimens of 187 patients suffering from laryngeal squamous cell carcinoma of stage III-IV was performed. The purpose of our study was to substantiate the appropriateness of assessment of immunomorphological profile in estimation of biological behaviour of laryngeal cancer for prediction its clinical course and choice of opt...

  7. Improved double immunohistochemical staining method for cryostat and paraffin wax sections, combining alkaline phosphatase anti-alkaline phosphatase and indirect immunofluorescence

    Tao, Q.; Srivastava, G; Loke, S L; Chan, E. Y.; Ho, F C


    Aims - To develop an immunohistochemical staining method for cryostat and paraffin wax sections so that two different antigens in the same section of tissues could be detected by combining immunoenzyme and immunofluorescence techniques. Methods - This double immunohistochemical staining method combines alkaline phosphatase-anti-alkaline phosphatase (APAAP) using New Fuchsin as a chromogen and indirect immunofluorescence. Results - APAAP staining for one antigen of this double immunohistochemi...

  8. Morphological and immunohistochemical identification of epithelial-to-mesenchymal transition in clinical prostate cancer.

    Kolijn, Kimberley; Verhoef, Esther I; van Leenders, Geert J L H


    Epithelial-to-mesenchymal transition (EMT) is a process known to be associated with aggressive tumor behavior, metastasis and treatment resistance. It is characterized by coincidental upregulation of mesenchymal markers such as vimentin, fibronectin and N-cadherin concurrent with E-cadherin downregulation. Studies on EMT are generally performed in cell lines and mouse models, while the histopathological and phenotypical properties in clinical prostate cancer (PCa) are still unclear. The objective of this study was to identify EMT in PCa patients. We demonstrated that N-cadherin, vimentin and fibronectin were generally not co-expressed in corresponding tumor regions. Immunofluorescent double stainings confirmed that co-expression of mesenchymal markers was uncommon, as we found no prostate cancer cells that co-expressed N-cadherin with fibronectin and only rare (<1%) cells that co-expressed N-cadherin with vimentin. Downregulation of E-cadherin was demonstrated in all N-cadherin positive tumor cells, but not in vimentin or fibronectin positive tumor cells. We further analyzed N-cadherin expression in morphologically distinct PCa growth patterns in a radical prostatectomy cohort (n = 77) and found that N-cadherin is preferentially expressed in ill-defined Gleason grade 4 PCa. In conclusion, we demonstrate that N-cadherin is the most reliable marker for EMT in clinical PCa and is preferentially expressed in ill-defined Gleason grade 4 growth pattern. PMID:26041890

  9. Sunitinib in urothelial cancer: clinical, pharmacokinetic, and immunohistochemical study of predictors of response.

    Gallagher, David J


    BACKGROUND: Sunitinib has activity in patients with metastatic urothelial cancer (UC), but most patients do not respond. OBJECTIVE: To identify predictors of response to sunitinib. DESIGN, SETTING, AND PARTICIPANTS: Seventy-seven patients with advanced UC received sunitinib on one of two schedules at a single institution. Blood pressure (BP), immunohistochemistry (IHC), and pharmacokinetic (PK) results were correlated with response to sunitinib. MEASUREMENTS: BP was assessed on day 1 and 28 of each cycle and on day 14 of cycle 1. IHC was performed on 55 samples from 38 cases using mammalian target of rapamycin and hypoxia-inducible factor (HIF) pathway marker antibodies. Blood samples for PK analysis were collected from 15 patients at three time points. Response was assessed using Response Evaluation Criteria in Solid Tumors criteria. RESULTS AND LIMITATIONS: Sunitinib-induced hypertension predicted improved response when hypertension was categorized as a discrete (p = 0.02) or continuous variable (p = 0.005 [systolic BP] and p = 0.007 [diastolic BP]). The odds ratio of response was 12.5 (95% confidence interval, 1.95-246.8) for grade 3\\/4 hypertension compared with grade 0. Response was associated with low HIF-1alpha expression in primary (p = 0.07) tissue. A nonstatistically significant trend was seen for an association between greater drug concentration and best response. A correlation between expression markers within the same pathways was identified, phosphorylated-4EBP1 and phosphorylated-S6 (p = 6.5 x 10(-9)), and vascular endothelial growth factor receptor 2 and HIF-1alpha (p = 0.008). Results are limited by small numbers. CONCLUSIONS: Clinical and molecular biomarkers of response to sunitinib may have clinical relevance and require prospective validation. There is an urgent need for predictive biomarkers to guide the management of UC.

  10. Expression of sodium-lodide symporter (NlS) in thyroid nodules: comparison of RT-PCR and immunohistochemical staining methods

    Bae, Sang Kyun [College of Medicine, InJe Univ., Busan (Korea, Republic of); Lee, Kang Dae; Chang, Hee Kyung [College of Medicine, Kosin Univ., Busan (Korea, Republic of)


    The sodium-iodide symporter (NlS) expression is an important factor in determining the sensitivity of radioiodine therapy in well-differentiated thyroid cancers. Several previous studies for the expression of NlS in thyroid tissues show diverse results. To investigate whether there is difference between methods in determining the expression of NIS in thyroid tissues of patients with thyroid nodules, we measured the expression of NIS using two different methods (RT-PCR and immunohistochemical staining) and compared the results. We measured the expression of NIS by reverse transcriptase-polymerase chain reaction (RT-PCR) and also by immunohistochemical staining using anti-NIS antibody in thyroid cancers and other benign thyroid diseases. We compared the results of each method. We included 19 papillary carcinomas, 1 follicular carcinoma, 1 medullary carcinoma, 4 adenomas and 7 nodular hyperplasias. By RT-PCR analysis, 10 of 19 papillary carcinomas expressed NIS, but 1 follicular cancer didn't express NlS. By immunohistochemical staining, 15 of 19 papillary carcinomas express NlS, but 1 follicular cancer didn't express NIS. There was a significant correlation between the semiquantitative results of RT-PCR and immunohistochemical staining of NIS expression. (p<0.01) Our data demonstrated that the expression of NIS in thyroid cancers and other benign diseases investigated by RT-PCR and immunohistochemical staining correlated well each other. However, by immunohistochemical staining, more NIS expression was found.

  11. Evaluation of two sets of immunohistochemical and Western blot confirmatory methods in the detection of typical and atypical BSE cases

    Greenlee Justin J


    Full Text Available Abstract Background Three distinct forms of bovine spongiform encephalopathy (BSE, defined as classical (C-, low (L- or high (H- type, have been detected through ongoing active and passive surveillance systems for the disease. The aim of the present study was to compare the ability of two sets of immunohistochemical (IHC and Western blot (WB BSE confirmatory protocols to detect C- and atypical (L- and H-type BSE forms. Obex samples from cases of United States and Italian C-type BSE, a U.S. H-type and an Italian L-type BSE case were tested in parallel using the two IHC sets and WB methods. Results The two IHC techniques proved equivalent in identifying and differentiating between C-type, L-type and H-type BSE. The IHC protocols appeared consistent in the identification of PrPSc distribution and deposition patterns in relation to the BSE type examined. Both IHC methods evidenced three distinct PrPSc phenotypes for each type of BSE: prevailing granular and linear tracts pattern in the C-type; intraglial and intraneuronal deposits in the H-type; plaques in the L-type. Also, the two techniques gave comparable results for PrPSc staining intensity on the C- and L-type BSE samples, whereas a higher amount of intraglial and intraneuronal PrPSc deposition on the H-type BSE case was revealed by the method based on a stronger demasking step. Both WB methods were consistent in identifying classical and atypical BSE forms and in differentiating the specific PrPSc molecular weight and glycoform ratios of each form. Conclusions The study showed that the IHC and WB BSE confirmatory methods were equally able to recognize C-, L- and H-type BSE forms and to discriminate between their different immunohistochemical and molecular phenotypes. Of note is that for the first time one of the two sets of BSE confirmatory protocols proved effective in identifying the L-type BSE form. This finding helps to validate the suitability of the BSE confirmatory tests for BSE

  12. Crisis of the clinical method

    Miguel Moreno Rodríguez


    This is an opinion paper. The author identifies an universal crisis of the clinical method, with dangerous consequences in the practice of medicine. Among its main causes, there are discussed: a deterioration in the doctor-patient relationship, the undervaluation of clinics, the overvaluation of technology, and the indifference for general medicine. A call for attention is made for the restoration of clinical method values and to permanent seed its principles in all medical students and young...

  13. Clinical significance of gelsolin-like actin-capping protein expression in oral carcinogenesis: an immunohistochemical study of premalignant and malignant lesions of the oral cavity

    Gelsolin-like actin-capping protein (CapG) is a ubiquitous gelsolin-family actin-modulating protein involved in cell signalling, receptor-mediated membrane ruffling, phagocytosis, and motility. CapG has generated great interest due to its oncogenic function in the control of cell migration or invasion in a variety of cancer cells. We previously applied proteomic methods to characterize differentially expressed proteins in oral squamous-cell carcinoma (OSCC) cells and detected significantly high expression levels of CapG in OSCC-derived cell lines compared to human normal oral keratinocytes. In the current study, to further determine the potential involvement of CapG in OSCC, we evaluated the status of CapG protein and mRNA expression in human oral premalignant lesions (OPLs) and primary OSCCs and correlated the results with clinicopathologic variables. Matched normal and tumour tissue sections of 79 human primary OSCCs and 28 OPLs were analyzed for CapG expression by immunohistochemistry (IHC). Correlations between CapG-immunohistochemical staining scores of OSCCs and clinicopathologic features were evaluated by Fisher's exact test. Real-time quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) was used to estimate CapG expression at the mRNA level. In IHC, substantial up-regulation of CapG protein was observed in primary OSCCs (52%) and OPLs (64%), whereas corresponding normal tissues showed consistently weak or absent immunoreactivity of CapG. qRT-PCR data were consistent with the protein expression status. Moreover, CapG expression was correlated with the TNM stage grading of OSCCs. Our finding of frequent dysregulated expression of CapG in premalignant and malignant lesions together with an association with an advanced clinical disease stage suggests that CapG could contribute to cancer development and progression and that CapG may have potential as a biomarker and a therapeutic target for OSCC

  14. An attempt to use immunohistochemical methods for semi-quantitative determination of surfactant in bronchial secretion after hyperbaric exposures

    Piotr Siermontowski


    Full Text Available Background The most significant index of pulmonary oxygen toxicity is a decrease in vital capacity (VC dependent on the duration of exposure and partial pressure of oxygen. The only method to measure this decrease is spirometry performed directly after exposure. Objective The aim of the study was to check whether the extent of lung damage could be assessed by quantitative determination of pulmonary surfactant in bronchial secretion. Design Sputum samples were collected before, during and after hyperbaric air or oxygen exposures; histological preparations were prepared and stained immunohistochemically to visualize surfactant. Amongst 781 samples collected, only 209 contained sputum and only 126 were included in the study. In this group, only 64 preparations could be paired for comparison. Results The semi-quantitative method used and statistical findings have not demonstrated any significance. Conclusions The method suggested for assessing the extent of lung damage has been found unsuitable for practical use due to difficulties in obtaining the proper material; moreover, the study findings do not allow to draw conclusions concerning its effectiveness.

  15. Recurrent Johanson-Blizzard syndrome in a triplet pregnancy complicated by urethral obstruction sequence: a clinical, molecular, and immunohistochemical approach.

    Schoner, Katharina; Fritz, Barbara; Huelskamp, Georg; Louwen, Frank; Zenker, Martin; Moll, Roland; Rehder, Helga


    We report on a triplet pregnancy of consanguineous parents with one fetus being affected by recurrent Johanson-Blizzard syndrome (JBS). At autopsy in the 35th gestational week, the affected triplet presented with an especially severe and lethal manifestation of the disorder as compared to his elder affected brother and to cases in the literature, thus exemplifying great interfamilial and intrafamilial phenotypic variability. Arhinencephaly and cystic renal dysplasia associated with urethral obstruction sequence were features not described previously in the literature. In addition to the lack of exocrine acini as the characteristic feature of JBS, the pancreas revealed a resorptive inflammatory reaction with infiltration by eosinophilic granulocytes that focally dispersed onto islets of Langerhans, thus favoring a progressive destructive rather than primary dysplastic process and possibly explaining the occurrence of diabetes mellitus in later life. JBS maps to chromosome 15q15-q21.1 and is associated with mutations in the UBR1 gene. Testing the fetus and the affected sibling revealed a homozygous truncating mutation in UBR1. The resulting absence of the UBR1 protein was confirmed by Western blot. Immunohistochemical staining using a commercial anti-UBR1 antibody demonstrated staining, presumably artifactual. This finding suggests that, until an appropriately validated antibody has been identified, this modality should not be utilized for diagnosis or confirmation of this disorder. PMID:21711208

  16. 垂体微腺瘤的临床内分泌与病理免疫组化类型相关性研究%Micro pituitary adenomas clinical endocrine correlation with pathologic types of immunohistochemical study



    目的:对垂体微腺瘤的临床症状体征、内分泌与病理免疫组化类型相关性进行探讨。方法选取2010年1月至2012年12月在本院确诊的垂体微腺瘤患者84例,对其进行内分泌、影像学和病理检查,分析检查结果之间的关系。结果患者出现内分泌症状76例(90.47%),免疫组化阳性组内分泌症状发生率[92.59%(75/81)]较免疫组化阴性组[33.33%(1/3)]高,差异具有显著性(χ2=5.92,P<0.05),表明内分泌症状与免疫组化结果相符。血清泌乳素(PRL)阳性组血清PRL增高及闭经、溢乳或月经失调发生率高于PRL阴性组;生长激素(GH)阳性组血清GH增高及巨人症或肢端肥大发生率高于GH阴性组。结论垂体微腺瘤患者的临床表现、内分泌结果与病理免疫组化类型相关,可用来提高垂体微腺瘤的诊断率与治疗率。%Objective To explore the relationship between the clinical symptoms and endocrine of micro pituitary adenomas and pathological immunohistochemical type. Method We had Choosed 84 patients with micro pituitary adenomas from January 2010 to December 2012 in our hospital, then checked the endocrine, imaging and pathological of them, and analysis the relationship between the test results. Result There were 76 cases (90.47%) had endocrine symptoms in all patients, the immunohistochemical positive endocrine symptoms rate was 92.59%(75/81) , this rate was higher than the immunohistochemical negative group which rate was 33.33%(1/3), the difference was statistically signiifcant (χ2=5.92, P<0.05), this indicated that the endocrine symptoms consistent with immunohistochemical results. The increased serum PRL and amenorrhea, spilled milk or incidence of menstrual disorder rate of serum prolactin (PRL) positive group were higher than that of PRL negative groups; increased serum GH and gigantism or acromegaly fertilizer rates of growth hormone (GH) positive group were higher than GH

  17. Clinicopathological spectrum of 19 adenosarcomas of female genital tract, including uncommon clinical associations and immunohistochemical profile, reviewed at a single institution

    Bharat Rekhi


    Full Text Available Background: Adenosarcomas of the female genital tract have been rarely documented as case series from our continent. Materials and Methods: Over a seven-year period, 19 adenosarcomas were critically reviewed. Results: Nineteen tumors occurred in the age range of 21-65 years (mean: 43, in the endometrium (8, endometrium and cervix (4, cervix (4, and ovary (3. Four cases displayed coexisting leiomyomas; two, adenomyosis; two on background endometriosis; and one in post-treated cervix carcinoma. Histopathologically, the tumors were low grade (10; 52.6% and high grade (9; 47.3%, the latter with sarcomatous overgrowth (SO (7/9 cases. Dedifferentiation (8, 42.1% and conspicuous decidualization (2 were noted. Immunohistochemically, the tumors focally expressed CD10 (4/6, smooth muscle actin (SMA (3/8, desmin (8/11; diffuse vimentin (7/7, and estrogen receptor/progesterone receptor (ER/PR (2/4. Ki-67 (6 cases varied 5-20%. Seventeen patients underwent surgery and four received adjuvant treatment (3/4 high-grade tumors. Five tumors recurred (4 high-grade tumors with SO and one metastasized. Among 11 patients, five were alive with disease (AWD (mean: 29.4 months and six, free of disease (FOD (mean: 15 months, the latter mostly with low-grade type tumors (83.3% cases. Conclusions: Diverse clinicopathological spectrum was noted within adenosarcomas. Low-grade tumors were less aggressive than high-grade ones, with SO. Immunohistochemically, lower CD10 and ER/PR positivity was noted in high-grade tumors. Surgery formed the mainstay of treatment. Adjuvant treatment was offered in high-grade subtypes, including in tumors with SO.

  18. An immunohistochemical, clinical and electroneuromyographic correlative study of the neural markers in the neuritic form of leprosy

    S.L.G. Antunes


    Full Text Available The nerve biopsies of 11 patients with pure neuritic leprosy were submitted to routine diagnostic procedures and immunoperoxidase staining with antibodies against axonal (neurofilament, nerve growth factor receptor (NGFr, and protein gene product (PGP 9.5 and Schwann cell (myelin basic protein, S-100 protein, and NGFr markers. Two pairs of non-adjacent histological cross-sections of the peripheral nerve were removed for quantification. All the fascicles of the nerve were examined with a 10X-ocular and 40X-objective lens. The immunohistochemistry results were compared to the results of semithin section analysis and clinical and electroneuromyographic data. Neurofilament staining was reduced in 100% of the neuritic biopsies. NGFr positivity was also reduced in 81.8%, PGP staining in 100% of the affected nerves, S100 positivity in 90.9%, and myelin basic protein immunoreactivity in 90.9%. Hypoesthesia was associated with decreased NGFr (81.8% and PGP staining (90.9%. Reduced potential amplitudes (electroneuromyographic data were found to be associated with reduced PGP 9.5 (63.6% and nerve fiber neurofilament staining (45.4% by immunohistochemistry and with loss of myelinated fibers (100% by semithin section analysis. On the other hand, the small fibers (immunoreactive dots seen amid inflammatory cells continued to be present even after 40% of the larger myelinated fibers had disappeared. The present study shows an in-depth view of the destructive effects of leprosy upon the expression of neural markers and the integrity of nerve fiber. The association of these structural changes with the clinical and electroneuromyographic manifestations of leprosy peripheral neuropathy was also discussed.

  19. Phenotypic and immunohistochemical characterization of sarcoglycanopathies

    Ana F. B. Ferreira


    Full Text Available INTRODUCTION: Limb-girdle muscular dystrophy presents with heterogeneous clinical and molecular features. The primary characteristic of this disorder is proximal muscular weakness with variable age of onset, speed of progression, and intensity of symptoms. Sarcoglycanopathies, which are a subgroup of the limb-girdle muscular dystrophies, are caused by mutations in sarcoglycan genes. Mutations in these genes cause secondary deficiencies in other proteins, due to the instability of the dystrophin-glycoprotein complex. Therefore, determining the etiology of a given sarcoglycanopathy requires costly and occasionally inaccessible molecular methods. OBJECTIVE: The aim of this study was to identify phenotypic differences among limb-girdle muscular dystrophy patients who were grouped according to the immunohistochemical phenotypes for the four sarcoglycans. METHODS: To identify phenotypic differences among patients with different types of sarcoglycanopathies, a questionnaire was used and the muscle strength and range of motion of nine joints in 45 patients recruited from the Department of Neurology - HC-FMUSP (Clinics Hospital of the Faculty of Medicine of the University of São Paulo were evaluated. The findings obtained from these analyses were compared with the results of the immunohistochemical findings. RESULTS: The patients were divided into the following groups based on the immunohistochemical findings: a-sarcoglycanopathies (16 patients, b-sarcoglycanopathies (1 patient, y-sarcoglycanopathies (5 patients, and nonsarcoglycanopathies (23 patients. The muscle strength analysis revealed significant differences for both upper and lower limb muscles, particularly the shoulder and hip muscles, as expected. No pattern of joint contractures was found among the four groups analyzed, even within the same family. However, a high frequency of tiptoe gait was observed in patients with a-sarcoglycanopathies, while calf pseudo-hypertrophy was most common in

  20. An Evaluation of clinical, serologic, anatomopathologic and immunohistochemical findings for fifteen patients with mucosal leishmaniasis before and after treatment

    Valdir S. AMATO


    Full Text Available Treatment of mucosal leishmaniasis (ML can be controlled by clinical examination and by serologic titers by the indirect immunofluorescence serologic reaction (IISR. We studied the correlation between the presence of antigen in tissue determined by immunohistochemistry, the IISR titers and the anatomopathologic findings in fifteen patients with ML before and after healing of the lesions as determined by otorhinolaryngologic evaluation, and evaluated these parameters to determine which of them could be useful during follow-up. Tissue antigens became negative in four patients (group A after treatment, with a statistically significant reduction or negativity of IISR titers (pO controle de tratamento da leishmaniose mucosa (LM pode ser realizado pelo exame clínico e o acompanhamento dos títulos sorológicos da reação de imunofluorescência indireta (RIFI. Estudamos a correlação entre a presença de antígeno no tecido através da reação de imuno-histoquímica, os títulos da reação de imunofluorescência indireta e os achados anatomopatológicos, em quinze pacientes com LM, antes e após as lesões estarem cicatrizadas pela avaliação otorrinolaringológica, e avaliamos qual destes parâmetros pode ter utilidade no seguimento. Após a terapêutica houve negativação do antígeno tecidual em quatro doentes (grupo A, sendo a redução ou negativação dos títulos da RIFI estatisticamente significante (p<0.05, o que não ocorreu nos doentes, em que houve permanência do antígeno posteriormente ao tratamento (grupo B, sugerindo que o acompanhamento sorológico deva ser realizado conjuntamente com a pesquisa do antígeno tecidual, associação que não conhecemos ter sido utilizada anteriormente em outro estudo. A negativação do antígeno tecidual e o comportamento dos títulos da RIFI nos doentes do grupo A, provavelmente indicam menor possibilidade de recidiva. Ao exame anatomo-patológico, o processo inflamatório persistiu após a

  1. Immunohistochemical study of perivascular epithelioid cell neoplasms



    Objective To study the clinicopathologic features,immunophenotype and genetic changes of perivascular epithelioid cell neoplasms (PEComa) .Methods A total of 25 cases of PEComa located in various anatomic sites were selected for immunohistochemical staining (SP or

  2. Detection of EGFR and COX-2 Expression by Immunohistochemical Method on a Tissue Microarray Section in Lung Cancer and Biological Significance

    Xinyun WANG


    Full Text Available Background and objective Epidermal growth factor receptor (EGFR and cyclooxygenase-2 (COX-2, which can regulate growth, invasion and metastasis of tumor through relevant signaling pathway, have been detected in a variety of solid tumors. The aim of this study is to investigate the biological significance of EGFR and COX-2 expression in lung cancer and the relationship between them. Methods The expression of EGFR and COX-2 was detected in 89 primary lung cancer tissues, 12 premaliganant lesions, 12 lymph node metastases, and 10 normal lung tissues as the control by immunohistochemical method on a tissue microarray section. Results EGFR protein was detectable in 59.6%, 41.7%, and 66.7% of primary lung cancer tissues, premalignant lesions and lymph node metastases, respectively; COX-2 protein was detectable in 52.8%, 41.7%, and 66.7% of primary lung cancer tissues, premalignant lesions and lymph node metastases, respectively, which were significantly higher than those of the control (P 0.05. COX-2 expression was related to gross type (P < 0.05. A highly positive correlation was observed between EGFR and COX-2 expression (P < 0.01. Conclusion Overexpression of EGFR and COX-2 may play an important role in the tumorgenesis, progression and malignancy of lung cancer. Detection of EGFR and COX-2 expression might be helpful to diagnosis and prognosis of lung cancer.

  3. The clinical method: death and resurrection

    Fidel Ilizástiguir Dupuy


    Full Text Available Considerations on the pertinence and prevalence of the clinical method defined as the process of diagnosis in the practice of human medicine is presented. Epistemologic considerations on the scientific nature of the clinical method, the medical taxonomy and the ‘’main types’’ of differential diagnoses are commented. The process of diagnosis is analyzed from the perspective of logical processes, particularly from the hypothetic deductive method. Activation, refining and evaluation of hypothesis are emphasized as mechanisms of the diagnosis process. Some considerations on the impact of computing technology and its contributions to the clinical method being both benefited or not, are stated. Finally, the pertinence of a transformation of the clinical method due to the emergence of a more expansive and extensive medical paradigm is evaluated. This new paradigm will be hermeneuticaly based on the significance and understanding of the diagnosis, being men the central axis and medicine a humane science and a practice.

  4. Brief Psychotherapy Methods in Clinical Research.

    Koss, Mary P.; And Others


    After a concise overview of the technical characteristics that define brief psychotherapy, the current use and misuse of these methods in clinical research on the outcome and process of treatment is examined. Suggests that brief psychotherapy methods possess unique technical advantages to the researcher. (Author/BL)

  5. Perfil imuno-histoquímico e variáveis clinicopatológicas no câncer de mama Immunohistochemical profile and clinical-pathological variables in breast cancer

    Jane Rocha Duarte Cintra


    Full Text Available OBJETIVO: Descrever as principais características em mulheres com câncer de mama, de acordo com o perfil imuno-histoquímico. MÉTODOS: A população foi composta a partir de coorte hospitalar formada por mulheres com diagnóstico de câncer de mama efetuado entre 2003 e 2005 (n = 601 e atendidas em centro de referência em assistência oncológica de Juiz de Fora-MG. Foram selecionadas apenas 397 mulheres que possuíam imunohistoquímica completa. Para definição dos grupos segundo perfil imuno-histoquímico, optou-se por classificação baseada na avaliação dos receptores de estrógeno e de progesterona, índice de proliferação celular Ki67 e superexpressão de HER2. De acordo com os diferentes fenótipos, foram definidos cinco subtipos: luminal A, luminal B-HER2 negativo, luminal B-HER2 positivo, triplo negativo e HER2 superexpresso. RESULTADOS: A maioria dos pacientes tinha pele branca (80,7% e era pós-menopausada (64,9%, com idade média de 57,4 anos (±13,5. Ao diagnóstico, 57,5% delas tinha tumor de tamanho > 2,0 cm, e 41,7% exibiam comprometimento linfonodal. Os subtipos mais frequentes foram luminal B-HER2 negativo (41,8% e triplo negativo (24,2%. No subtipo luminal A, 72,1% das pacientes eram pós-menopausadas, enquanto que os maiores percentuais na pré-menopausa foram observados nos subtipos luminal B-HER2 positivo e triplo negativo (45,2% e 44,2%, respectivamente. Verificou-se maior frequência de tumores > 2,0 cm e com linfonodos comprometidos nos subtipos triplo negativo e HER2 positivo. CONCLUSÃO: Esta pesquisa possibilitou avaliar a distribuição das principais características clinicopatológicas e relacionadas aos serviços de saúde em coorte de mulheres brasileiras com câncer de mama, segundo os subtipos tumorais imuno-histoquímicos.OBJECTIVE: To describe the main characteristics of women with breast cancer, according to the immunohistochemical profile. METHODS: The population comprised a hospital cohort

  6. Clinical Epidemiology, Evidence Based Medicine and Good Clinical Practice Guidelines vs. Clinical Method?

    Luis Alberto Corona Martínez; Mercedes Fonseca Hernández


    Evidence Based Medicine, as a trend or approach to the medical practice nowadays, and the use of Good Clinical Practice Guidelines in the assistance activities are core elements that contribute to improve the professional practice and the decision making process in diagnosis and therapy; but they do not substitute the professional method for patients assistance: the clinical method. The purpose of this article is to analyze the role of clinical epidemiology, evidence based medicine and good c...

  7. From the scientific method to the clinical method: theoretical considerations

    Roberto Hernández Hernández


    Full Text Available The scientific method is a general method composed of several stages necessary for the development of any scientific research. It is the focus to approach reality and to study natural phenomenon, reality itself and thoughts in order to find their essence and interrelationships. The clinical method is the particular application of the scientific method and in the present economic conditions its use is crucial because of the advantages that it reports from this point of view, as well as for the wellbeing of the patient.

  8. The Sherlock Holmes method in clinical practice.

    Sopeña, B


    This article lists the integral elements of the Sherlock Holmes method, which is based on the intelligent collection of information through detailed observation, careful listening and thorough examination. The information thus obtained is analyzed to develop the main and alternative hypotheses, which are shaped during the deductive process until the key leading to the solution is revealed. The Holmes investigative method applied to clinical practice highlights the advisability of having physicians reason through and seek out the causes of the disease with the data obtained from acute observation, a detailed review of the medical history and careful physical examination. PMID:24457141

  9. Immunohistochemical expression of IDH1 in gliomas: A tissue microarray-based approach

    Varuna Sipayya


    Conclusion : Monoclonal antibody to IDH1 (R132 is a useful and less-labor-intensive method to detect mutations in gliomas. IDH1 is a useful immunohistochemical marker to differentiate reactive gliosis from low-grade astrocytoma, has potential as an independent prognostic marker and also helps in distinguishing primary from secondary GBM. Its sensitivity and specificity need to be assessed by simultaneous sequencing and its validation on clinically annotated samples.

  10. Features of immunohistochemical diagnostic of melanocytic tumours

    Shpon’ka I.S.


    Full Text Available Background. The malignant melanomas are the most important group of skin cancers. Although less common than the familiar basal and squamous cell tumours of the skin, they are much more frequently fatal, due to their intrinsic tendency to lymphatic and haematogenic metastasis. Objective. The article is devoted to parsing cases melanocytic tumours that were established through immunohistochemical study. Methods. In the study analyzed 236 patient material (150 women and 86 men aged 28 to 77 years during 2010-2013 turned out to clarify the histological diagnosis of skin tumors or metastases to lymph nodes (rare at other sites. The primary monoclonal antibodies used Сytokeratin, Рan Ab1 (clone AE1/AE3, S100 (clone 4C4.9, Ki-67 (clone SP6, Vimentin (clone V9, Melanoma gp100 (clone HMB-45. Results. Naevus proliferation rate showed a statistically significant difference with respect to proliferation rate of malignant melanomas (p<0,05. All samples (100% showed positive expression of high-intensity staining (+++ or moderate (++ intensity on the marker S100; 98,30% of samples (232 of 236 showed positive expression of marker HMB-45 at least in terms of tumor cells with intensity color from the high (+++ to weak (+ and 83.89% of the samples (198 of 236 were negative (– Сytokeratin, Рan Ab1 (other 38 cases showed weakly positive expression (+/– of tumor cells. Conclusions. 1. In the differential diagnosis of melanoma and naevus, we must bear in mind the uniformity immunophenotype of these tumors and consider only the cytological features of the tumor, changes in the structure of the epidermis and dermis (contour, symmetry, depth, inflammatory infiltration and proliferation rate. 2. Patients whose lymph nodes were the first clinical signs of cancer are always in need for additional immunohistochemical studies to avoid diagnostic errors. 3. The most common phenotype of melanocytic tumours responsible Сytokeratin, Рan–, Vimintin+, S100+, HMB-45

  11. Clinicopathological and immunohistochemical features of pilomyxoid astrocytoma:a report of six cases

    Zixuan Yang; Fei Yan; Li Meng; Qilin Ao; Pengcheng Zhu


    Objective:The aim of this study was to study the clinicopathological and immunohistochemical features of pilo-myxoid astrocytoma (PMA). Methods:The clinical and pathologic features in six cases of PMA were analyzed. Immunohisto-chemical staining for glial fibril ary acidic protein (GFAP), synaptophysin (Syn), Chromogranin A (CgA), cytokeratin (AE1/AE3), epithelial membrane antigen (EMA) and Ki67 was performed on paraf in-embedded sections. Results:Among the six cases, five occurred in female patients, one was male, the age at diagnosis ranged from 2 to 15 years. Four cases were located in the hypothalamic area and optic pathway, one case in the third ventricle, and one case in left parietal lobe. On imaging, PMAs often appears as wel-circumscribed mass. Microscopically, the tumor was composed of monomorphous bipolar (piloid) cells setting in a prominent myxoid background with an angiocentric radiating growth pattern in some areas. PMA lacked biphasic pattern, Rosenthal fibers and eosinophilic granular bodies which were usual y typical in a classic pilocytic astrocytoma (PA). Immunohistochemcal study showed that the tumor cel s were dif usely positive for GFAP. Syn positive staining was observed in one case. The Ki67 labeling index measured less than 5%. Conclusion:PMA is a distinct aggressive variant of pilocytic astrocytoma with special histological and immunohistochemical features. It is typically a rare tumor of early childhood. Im-munohistochemical staining for GFAP and Syn is helpful in dif erential diagnosis.

  12. Tyrosine kinase inhibitor sunitinib therapy is effective in the treatment of bone metastasis from cancer of unknown primary: Identification of clinical and immunohistochemical biomarkers predicting survival.

    Ma, Yifei; Zhou, Wang; He, Shaohui; Xu, Wei; Xiao, Jianru


    Bone metastasis from cancer of unknown primary (BMCUP) brings poor survival prognosis and its management remains controversial. Sunitinib (SUTENT) proved effective in many sorts of solid tumors but has never been applied for patients with occult primary cancers, and there is no study to identify sensitive or resistant biomarkers for sunitinib therapy in CUP patients. An analysis was carried out to investigate the efficacy of sunitinib by multivariate survival analysis of 286 patients with BMCUP. We further carried out multivariate analysis to identify histological and clinical biomarkers that could predict sensitivity or resistance for sunitinib therapy. Of the 286 patients included from January 2011 to March 2016, sunitinib therapy proved effective to prolong survival in patients with BMCUP. Sensitive and resistant biomarkers were identified in histological specimen of patients receiving sunitinib therapy. Clinical factors were also identified that predict poor survival prognosis for sunitinib therapy. Sunitinib therapy proved effective to prolong survival in patients with BMCUP. Sensitive markers for sunitinib therapy include KDR positivity and early-developed treatment-induced hypertension. Resistance factors for sunitinib include VEGF positivity, CAIX positivity and squamous cell carcinoma pathology type. Prolonged symptom time and severe weight loss before therapy seemed to be associated with poor survival prognosis for sunitinib therapy. PMID:27164264

  13. Differentiation in cutaneous adnexal tumors: Immunohistochemical study

    Figen BARUT


    Full Text Available Cutaneous adnexal neoplasms are rare tumors that display differentiation in different ways. The aim of this study is, to present embryonic developmental properties and to determine the way of differentiation of adnexal neoplasms by evaluating the immunohistochemical expression of various markers.Forty-seven cases with adnexal tumors enrolled in this study. Histopathologic groups of these 47 cases were: 15 (32% hair follicle tumors, 11 (23.4% sebaceous tumors, 8 (17% apocrine tumors, and 13 (27.6% eccrine tumors. CK5-6, CK6, CK7, CK8, CK10, CK19, GCDFP-15, carcinoembryonic antigen, epithelial membrane antigen and S100 protein expressions were examined by immunohistochemical methods.As a result of this immunohistochemical study it was concluded that the expression of CK5-6 and CK8 carries more importance than other markers in determining certain types of differentiation of hair follicle tumors. It was also determined that, epithelial membrane antigen expression is important for the diagnosis of sebaceous tumors and the markers like CK8, CK10 and carcinoembryonic antigen may aid for the same purpose as well. It was found that, GCDFP-15 as well as CK5-6 expressions are significant for apocrine tumors, and carcinoembryonic antigen reaction as well as CK8 positivity will aid in determining differentiation of eccrine tumors. The presence of similar CK6 expression in all kinds of adnexal tumors has demonstrated that this marker is useless in differential diagnosis.

  14. Do clinical, histological or immunohistochemical primary tumour characteristics translate into different {sup 18}F-FDG PET/CT volumetric and heterogeneity features in stage II/III breast cancer?

    Groheux, David; Martineau, Antoine; Merlet, Pascal [Saint-Louis Hospital, Department of Nuclear Medicine, Paris (France); Majdoub, Mohamed; Hatt, Mathieu; Visvikis, Dimitris [INSERM, UMR 1101 LaTIM, Brest (France); Tixier, Florent; Le Rest, Catherine Cheze [Miletrie Hospital, DACTIM, Department of Nuclear Medicine, Poitiers (France); Espie, Marc [Saint-Louis Hospital, Breast Diseases Unit and Department of Medical Oncology, Paris (France); Roquancourt, Anne de [Saint-Louis Hospital, Department of Pathology, Paris (France); Hindie, Elif [University of Bordeaux, Department of Nuclear Medicine, CHU Bordeaux, Bordeaux (France)


    The aim of this retrospective study was to determine if some features of baseline {sup 18}F-FDG PET images, including volume and heterogeneity, reflect clinical, histological or immunohistochemical characteristics in patients with stage II or III breast cancer (BC). Included in the present retrospective analysis were 171 prospectively recruited patients with stage II/III BC treated consecutively at Saint-Louis hospital. Primary tumour volumes were semiautomatically delineated on pretreatment {sup 18}F-FDG PET images. The parameters extracted included SUV{sub max}, SUV{sub mean}, metabolically active tumour volume (MATV), total lesion glycolysis (TLG) and heterogeneity quantified using the area under the curve of the cumulative histogram and textural features. Associations between clinical/histopathological characteristics and {sup 18}F-FDG PET features were assessed using one-way analysis of variance. Areas under the ROC curves (AUC) were used to quantify the discriminative power of the features significantly associated with clinical/histopathological characteristics. T3 tumours (>5 cm) exhibited higher textural heterogeneity in {sup 18}F-FDG uptake than T2 tumours (AUC <0.75), whereas there were no significant differences in SUV{sub max} and SUV{sub mean}. Invasive ductal carcinoma showed higher SUV{sub max} values than invasive lobular carcinoma (p = 0.008) but MATV, TLG and textural features were not discriminative. Grade 3 tumours had higher FDG uptake (AUC 0.779 for SUV{sub max} and 0.694 for TLG), and exhibited slightly higher regional heterogeneity (AUC 0.624). Hormone receptor-negative tumours had higher SUV values than oestrogen receptor-positive (ER-positive) and progesterone receptor-positive tumours, while heterogeneity patterns showed only low-level variation according to hormone receptor expression. HER-2 status was not associated with any of the image features. Finally, SUV{sub max}, SUV{sub mean} and TLG significantly differed among the three

  15. Do clinical, histological or immunohistochemical primary tumour characteristics translate into different 18F-FDG PET/CT volumetric and heterogeneity features in stage II/III breast cancer?

    The aim of this retrospective study was to determine if some features of baseline 18F-FDG PET images, including volume and heterogeneity, reflect clinical, histological or immunohistochemical characteristics in patients with stage II or III breast cancer (BC). Included in the present retrospective analysis were 171 prospectively recruited patients with stage II/III BC treated consecutively at Saint-Louis hospital. Primary tumour volumes were semiautomatically delineated on pretreatment 18F-FDG PET images. The parameters extracted included SUVmax, SUVmean, metabolically active tumour volume (MATV), total lesion glycolysis (TLG) and heterogeneity quantified using the area under the curve of the cumulative histogram and textural features. Associations between clinical/histopathological characteristics and 18F-FDG PET features were assessed using one-way analysis of variance. Areas under the ROC curves (AUC) were used to quantify the discriminative power of the features significantly associated with clinical/histopathological characteristics. T3 tumours (>5 cm) exhibited higher textural heterogeneity in 18F-FDG uptake than T2 tumours (AUC <0.75), whereas there were no significant differences in SUVmax and SUVmean. Invasive ductal carcinoma showed higher SUVmax values than invasive lobular carcinoma (p = 0.008) but MATV, TLG and textural features were not discriminative. Grade 3 tumours had higher FDG uptake (AUC 0.779 for SUVmax and 0.694 for TLG), and exhibited slightly higher regional heterogeneity (AUC 0.624). Hormone receptor-negative tumours had higher SUV values than oestrogen receptor-positive (ER-positive) and progesterone receptor-positive tumours, while heterogeneity patterns showed only low-level variation according to hormone receptor expression. HER-2 status was not associated with any of the image features. Finally, SUVmax, SUVmean and TLG significantly differed among the three phenotype subgroups (HER2-positive, triple-negative and ER-positive/HER2

  16. Tissue Microarrays in Non-Small Cell Lung Cancer: Reliability of Immunohistochemically-Determined Biomarkers

    Pøhl, Mette; Olsen, Karen Ege; Holst, René;


    BACKGROUND: The reliability of immunohistochemically-determined biomarkers using tissue microarrays (TMAs) of clinical specimens has long been open to question. Heterogeneity related to tumor biology might compromise determination of accurate biomarker expression in tumors, especially in small core...... biopsies. We evaluated the reliability of immunohistochemical staining scoring in small core biopsies using 11 biomarkers in non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS: Four 1-mm tumor cores from 178 NSCLCs, 2 representing peripheral areas close to the border of normal lung tissue and 2...... representing central areas, were examined. The biomarkers analyzed included p63, p40, cytokeratin 1/5/10/14, cytokeratin 7, thyroid transcription factor-1, napsin A, cyclin-D1, p53, Ki-67, integrin beta-1, and thymidylate synthase. RESULTS: Using a random intercept logistic regression model...

  17. Experimental lamellar keratoplasty in rabbits using microfibrilar cellulose membrane: clinical, morphological and immunohistochemical findings Ceratoplastia lamelar experimental em coelhos usando membrana microfibrilar de celulose: achados clínicos, morfológicos e imunoistoquímicos

    Luciana Riacciardi Macedo


    Full Text Available The clinical, histopathological and immunohistochemical features of the cornea were investigated in adult male New Zealand rabbits submitted to lamellar keratoplasty with microfibrillar cellulose membrane. Thirty animals were divided into five groups (n=6 and evaluated up to 60 days after surgery. Clinical examination revealed moderate manifestations of edema, blepharospasm and photophobia on the second day, which became mild or disappeared after the seventh day. This period was characterized clinically by repair of the corneal defect. Histopathological analysis showed the presence of a thin layer of squamous cells covering the damaged area as early as 7th day, accompanied by a mild infiltrate of polymorphonuclear cells. Blood vessels were observed in the epithelium after the 15th day, which had regressed by day 48. Ki67 antibody labeling showed an increase of proliferating cells in the epithelium by the 15th day and in the stroma by day 30. Remodeling and epithelial adhesion were observed during this period. Microfibrillar cellulose membrane (Bionext® used for lamellar keratoplasty was found to yield good results considering the good integration of the implant.Avaliaram-se aspectos clínicos, histopatógicos e imunoistoquímicos da córnes de coelhos da raça Nova Zelândia adultos e machos em ceratoplastias lamelares com membrana de celulose microfibrilar. Trinta animais distribuídos em cinco grupos (n=6 foram estudados por até 60 dias de pós-operatório. A avaliação clínica revelou manifestações moderadas de edema, blefaroespasmo e fotofobia ao segundo dia, evoluindo para formas discretas ou ausentes a partir do sétimo dia, período em que se observou, clinicamente, reparo do defeito corneal. A histopatologia revelou uma fina camada de células escamosas, recobrindo a área lesada já aos sete dias, com discreto infiltrado de células polimorfonucleares. Observaram-se vasos no epitélio a partir do 15o dia, com regressão ao 48o dia

  18. Method for evaluating performance of clinical pharmacists.

    Schumock, G T; Leister, K A; Edwards, D; Wareham, P S; Burkhart, V D


    A performance-evaluation process that satisfies Joint Commission on Accreditation of Healthcare Organizations criteria and state policies is described. A three-part, criteria-based, weighted performance-evaluation tool specific for clinical pharmacists was designed for use in two institutions affiliated with the University of Washington. The three parts are self-appraisal and goal setting, peer evaluation, and supervisory evaluation. Objective criteria within each section were weighted to reflect the relative importance of that characteristic to the job that the clinical pharmacist performs. The performance score for each criterion is multiplied by the weighted value to produce an outcome score. The peer evaluation and self-appraisal/goal-setting parts of the evaluation are completed before the formal performance-evaluation interview. The supervisory evaluation is completed during the interview. For this evaluation, supervisors use both the standard university employee performance evaluation form and a set of specific criteria applicable to the clinical pharmacists in these institutions. The first performance evaluations done under this new system were conducted in May 1989. Pharmacists believed that the new system was more objective and allowed more interchange between the manager and the pharmacist. The peer-evaluation part of the system was seen as extremely constructive. This three-part, criteria-based system for evaluation of the job performance of clinical pharmacists could easily be adopted by other pharmacy departments. PMID:2301420

  19. A clinicopathologic and immunohistochemical study of gastrointestinal stromal tumors based on 122 cases

    Shanglong Liu; Zifang Song; Wei Li; Xiaowei Liu; Chen Zhang; Qichang Zheng


    Objective:The aim of the study was to review the clinical records of 122 patients with gastrointestinal stromal tumors(GISTs)and analyze their clinicopathologic and immunohistochemical characteristics.Methods:The medic records of 122 patients with GISTs during the periods from January 2002 to May 2010 were reviewed.All tumors were confirmed by histological and immunohistochemical analyses.Results:The tumors occurred in 59 males and 63 females,ranging from 25to 77 years.Of all cases,46 cases originated from stomach,42 from small intestine,17 from colon and rectum and 9 from retroperitoneal cavity and 4 cases from extra-gastrointestinal site.Liver was the most common organ that tumors metastases involved.Immunohistochemically,there were 114 tumors being positive for CD117 while 8 tumors negative for it.The frequencies of CD34 positive were higher in the stomach and rectum(89.1% and 86.7% respectively)than in the small intestine(64.3%,P < 0.05).Higher expression of SMA was in the tumors located in small intestine(54.8%)while the expressions of SMA in the gastric and rectal tumors were relatively low(21.7% and 20.0% respectively,P < 0.05).Conclusion:Gastrointestinal stromal tumors can occur in the gastrointestinal tract as well as in the extra-gastrointestinal sites.The frequencies of CD34 and SMA expression vary significantly with different locations.

  20. Angiomyolipoma of the kidney: Clinico pathological and immunohistochemical study

    Overview: Although angiomyolipoma (AML) is a relatively rare entity, it is the most common benign mesenchymal neoplasm of the kidney. The aim of this study: To highlight the clinicopathological characteristics of AML and to assess the role of Human Melanoma Black-45 (HMB-45), Melan-A, smooth muscle actin (SMA), S-100 and cytokeratin in its diagnosis. Materials and methods: The study included 15 cases of AML. Clinical and radiological data were retrieved from the archival files and all cases were subjected to a histopathological evaluation as well as immunohistochemical staining for HMB-45, Melan-A, SMA, S-100, and cytokeratin. Results: AML was more common in females (female:male = 4:1), the mean age was 53.9 ± 6.45 years. 60% of patients were symptomatic while the remaining 40% were asymptomatic. A statistically significant relationship was found between size of the tumor and the presence of the symptoms (P = 0.02). Patients with tumor size less than 4 cm were asymptomatic, while those with tumor size larger than 4 cm had different symptoms. Thirteen cases were classic AML, while 2 cases were epithelioid AML. Classic AML demonstrated admixture of fatty tissue, thick-walled blood vessels, and smooth muscle, while epithelioid AML was composed mainly of epithelioid cells and contained no fat. HMB-45 was positive in all cases of AML (100%), Melan-A was positive in 13/15 (87%) while SMA was positive in 11/15 (73%) of AML with variable staining intensity. All cases of AML were negative for S-100 and cytokeratin. Conclusion: AMLs have characteristic clinicopathological and immunohistochemical features and their recognition is crucial for proper diagnosis and treatment

  1. Approach to early-onset colorectal cancer:Clinicopathological,familial,molecular and immunohistochemical characteristics

    Jose; Perea; Edurne; Alvaro; Yolanda; Rodríguez; Cristina; Gravalos; Eva; Sánchez-Tomé; Barbara; Rivera; Francisco; Colina; Pablo; Carbonell; Rogelio; González-Sarmiento; Manuel; Hidalgo; Miguel; Urioste


    AIM:To characterize clinicopathological and familial features of early-onset colorectal cancer(CRC) and compare features of tumors with and without microsatellite instability(MSI).METHODS:Forty-five patients with CRC aged 45 or younger were included in the study.Clinical information,a three-generation family history,and tumor samples were obtained.MSI status was analyzed and mismatch repair genes were examined in the MSI families.Tumors were included in a tissue microarray and an immunohistochemical study w...

  2. Hypotony Maculopathy: Clinical Presentation and Therapeutic Methods

    Thomas, Merina; Vajaranant, Thasarat S.; Aref, Ahmad A.


    Introduction Hypotony maculopathy is ocular hypotony complicated by papilledema and/or folding of the retina and choroid in the posterior pole. Our objective was to examine the current literature regarding hypotony maculopathy and treatment methods. Methods A systematic review of the English-language literature was conducted by performing a broad search of PubMed from 1972 through 2015 using the keywords hypotony maculopathy and hypotony. Additional articles were identified from bibliographie...

  3. Immunohistochemical detection of VHS virus in paraffin-embedded specimens of rainbow trout (Oncorhynchus mykiss); The influence of primary antibody, fixative, and antigen unmasking on method sensitivity

    Evensen, O.; Olesen, Niels Jørgen


    The influence of the primary antibody, the fixative, and the antigen unmasking technique on the method sensitivity of immunohistochemistry as a method for the identification of viral hemorrhagic septicemia (VHS) virus in paraffin-embedded specimens of naturally infected rainbow trout (Oncorhynchus...

  4. Clinical experimental stress studies: methods and assessment.

    Bali, Anjana; Jaggi, Amteshwar Singh


    Stress is a state of threatened homeostasis during which a variety of adaptive processes are activated to produce physiological and behavioral changes. Stress induction methods are pivotal for understanding these physiological or pathophysiological changes in the body in response to stress. Furthermore, these methods are also important for the development of novel pharmacological agents for stress management. The well-described methods to induce stress in humans include the cold pressor test, Trier Social Stress Test, Montreal Imaging Stress Task, Maastricht Acute Stress Test, CO2 challenge test, Stroop test, Paced Auditory Serial Addition Task, noise stress, and Mannheim Multicomponent Stress Test. Stress assessment in humans is done by measuring biochemical markers such as cortisol, cortisol awakening response, dexamethasone suppression test, salivary α-amylase, plasma/urinary norepinephrine, norepinephrine spillover rate, and interleukins. Physiological and behavioral changes such as galvanic skin response, heart rate variability, pupil size, and muscle and/or skin sympathetic nerve activity (microneurography) and cardiovascular parameters such as heart rate, blood pressure, and self-reported anxiety are also monitored to assess stress response. This present review describes these commonly employed methods to induce stress in humans along with stress assessment methods. PMID:26020552

  5. Immunohistochemical detection of VHS virus in paraffin-embedded specimens of rainbow trout (Oncorhynchus mykiss); The influence of primary antibody, fixative, and antigen unmasking on method sensitivity

    Evensen, O.; Olesen, Niels Jørgen


    The influence of the primary antibody, the fixative, and the antigen unmasking technique on the method sensitivity of immunohistochemistry as a method for the identification of viral hemorrhagic septicemia (VHS) virus in paraffin-embedded specimens of naturally infected rainbow trout (Oncorhynchus...... performed on parallel specimens, and the virus titer (TCID50/ml) was determined. Purified nucleocapsid protein (N-protein) of the virus was incorporated in an artificial antigen substrate (polymerized bovine serum albumin), fixed as described above, and embedded in paraffin wax. Microwave unmasking was......, there was a significantly higher epidemiologic sensitivity (the proportion of virus positive samples that tested positive by immunohistochemistry) using ethanol and Bouin's fluid compared with formalin and PLP (P...

  6. Legal clinic gender sensitive method for law students

    Petrušić Nevena


    Full Text Available In this paper, the authors discuss models of integrating gender issues, gender perspective and some gender aspects into the university education. In that context, the authors particularly focus on the concept of clinical legal education in legal clinics offering a specific practical model of teaching gender studies. Legal clinics provide for an innovative approach to gender education of prospective legal professional. The teaching method used in these legal clinics is aimed at raising students' awareness of gender issues and common gender-related biases. In the recent period, the Legal Clinic at the Law Faculty in Niš has achieved excellent results in the Clinical legal education program on the women's rights protection, which clearly proves that legal clinics have good prospects in general legal education.

  7. A simplified method for the clinical study of protein turnover

    The determination of turnover rate of serum albumin, or of other serum proteins, may be interesting for clinical purposes because the turnover rates may be changed as one of the consequences of renal, hepatic or gastro-intestinal diseases. Until now, is was not possible to use turnover methods routinely in the clinic, because daily sampling is too tedious for patients and hospital employees. A simplified method of sampling was introduced. This method was then evaluated in order to determine whether or not the results would be significant enough for clinical purposes. 1 tab

  8. The Role of Epstein-Barr Virus LMP-1 Immunohistochemical Staining in Childhood Hodgkin Lymphoma

    Hikmet Gulsah Tanyildiz


    Full Text Available Background: There are a few published studies about prognostic markers of Epstein-B virus (EBV related to outcomes in pediatric Hodgkin Lymphoma (HL. Objectives: We aimed to investigate the prognostic value and effect of EBV on survival by using biopsy materials in children and adolescents diagnosed with HL. Patients and Methods: EBV LMP-1 expression was examined using immunohistochemical methods in 58 tumor samples. Clinical features, overall survival (OS and failure free survival time (FFS were compared between EBV LMP-1 positive and negative patients. Results: In 20 (35% patients tumors were LMP-1 positive. When compared with patients above 10 years old, EBV LMP-1 was often positive in patients under 10 years old (30% vs. 70%, P = 0.02. In our most cases having B symptoms and advanced stage, EBV positiveness in Hodgkin Reed-Stenberg cells (H-RS was not a significant determinant for survival (P = 0.78. Half of the past clinical trials in childhood HL reported longer survival rates in EBV LMP-1 positive patients. In some trials similar to our results there was no significant relationship between EBV and prognosis. Conclusions: The reason of diminished EBV positiviness may be related to technical methods such as not using immunohistochemical and in situ hybridization for EBER antigen but in laboratory conditions painting of control tissues with EBV impair this probability. In addition, cases enrolled to our study were living in Istanbul where social and economical factors are improved rather than generally.

  9. Kinetics methods for clinical epidemiology problems.

    Corlan, Alexandru Dan; Ross, John


    Calculating the probability of each possible outcome for a patient at any time in the future is currently possible only in the simplest cases: short-term prediction in acute diseases of otherwise healthy persons. This problem is to some extent analogous to predicting the concentrations of species in a reactor when knowing initial concentrations and after examining reaction rates at the individual molecule level. The existing theoretical framework behind predicting contagion and the immediate outcome of acute diseases in previously healthy individuals is largely analogous to deterministic kinetics of chemical systems consisting of one or a few reactions. We show that current statistical models commonly used in chronic disease epidemiology correspond to simple stochastic treatment of single reaction systems. The general problem corresponds to stochastic kinetics of complex reaction systems. We attempt to formulate epidemiologic problems related to chronic diseases in chemical kinetics terms. We review methods that may be adapted for use in epidemiology. We show that some reactions cannot fit into the mass-action law paradigm and solutions to these systems would frequently exhibit an antiportfolio effect. We provide a complete example application of stochastic kinetics modeling for a deductive meta-analysis of two papers on atrial fibrillation incidence, prevalence, and mortality. PMID:26578757

  10. Immunohistochemical staining of avian influenza virus in tissues

    Immunohistochemical methods are commonly used for studying the pathogenesis of avian influenza (AI) virus by allowing the identification of sites of replication of the virus in infected tissues and the correlation with the histopathological changes observed. In this chapter, the materials and metho...

  11. Histological and immunohistochemical studies on primary intracranial canine histiocytic sarcomas

    THONGTHARB, Atigan; Uchida, Kazuyuki; CHAMBERS, James Kenn; KAGAWA, Yumiko; Nakayama, Hiroyuki


    Histiocytic sarcoma is a progressive and fatal malignant neoplasm that mainly occurs in middle- to old-aged dogs. This study describes clinicopathological, histological and immunohistochemical characteristics of intracranial histiocytic sarcomas in 23 dogs. Magnetic resonance imaging and/or computed tomography of the brains revealed that the tumors mainly located in the cerebrum, particularly the frontal lobe. Seizure was a predominant clinical sign in most of the cases. Histologically, the t...

  12. Clinicopathologic and immunohistochemical profile of ovarian metastases from colorectal carcinoma


    Metastasis of colorectal adenocarcinoma of the ovary is not an uncommon occurrence and ovarian metastases from colorectal carcinoma frequently mimic endometrioid and mucinous primary ovarian carcinoma. The clinical and pathologic features of metastatic colorectal adenocarcinoma involving the ovary is reviewed with particular focus on the diagnostic challenge of distinguishing these secondary ovarian tumors from primary ovarian neoplasm. Immunohistochemical stains that may be useful in the dif...

  13. A formal method to resolve temporal mismatches in clinical databases.

    Das, A K; Musen, M. A.


    Overcoming data heterogeneity is essential to the transfer of decision-support programs to legacy databases and to the integration of data in clinical repositories. Prior methods have focused primarily on problems of differences in terminology and patient identifiers, and have not addressed formally the problem of temporal data heterogeneity, even though time is a necessary element in storing, manipulating, and reasoning about clinical data. In this paper, we present a method to resolve tempo...

  14. Nurse educators’ perceptions of OSCE as a clinical evaluation method

    MM Chabeli


    Full Text Available The South African Qualifications Authority, and the South African Nursing Council are in pursuit of quality nursing education to enable the learners to practise as independent and autonomous practitioners. The educational programme should focus on the facilitation of critical and reflective thinking skills that will help the learner to make rational decisions and solve problems. A way of achieving this level of functioning is the use of assessment and evaluation methods that measure the learners’ clinical competence holistically. This article is focused on the perceptions of twenty nurse educators, purposively selected from three Nursing Colleges affiliated to a university in Gauteng, regarding the use of OSCE (Objective Structured Clinical Examination as a clinical evaluation method within a qualitative and descriptive research strategy. Three focus group interviews were conducted in different sessions. A descriptive content analysis was used. Trustworthiness was ensured by using Lincoln and Guba’s model (1985. The results revealed both positive and negative aspects of OSCE as a clinical evaluation method with regard to: administrative aspects; evaluators; learners; procedures/instruments and evaluation. The conclusion drawn from the related findings is that OSCE does not measure the learners’ clinical competence holistically. It is therefore recommended that the identified negative perception be taken as challenges faced by nurse educators and that the positive aspects be strengthened. One way of meeting these recommendations is the use of varied alternative methods for clinical assessment and evaluation that focus on the holistic measurement of the learners’ clinical competence.

  15. LERM (Logical Elements Rule Method): A method for assessing and formalizing clinical rules for decision support

    S. Medlock; D. Opondo; S. Eslami; M. Askari; P. Wierenga; S.E. de Rooij; A. Abu-Hanna


    Purpose: The aim of this study was to create a step-by-step method for transforming clinical rules for use in decision support, and to validate this method for usability and reliability. Methods: A sample set of clinical rules was identified from the relevant literature. Using an iterative approach

  16. The early evolution of Jean Piaget's clinical method.

    Mayer, Susan Jean


    This article analyzes the early evolution of Jean Piaget's renowned "clinical method" in order to investigate the method's strikingly original and generative character. Throughout his 1st decade in the field, Piaget frequently discussed and justified the many different approaches to data collection he used. Analysis of his methodological progression during this period reveals that Piaget's determination to access the genuine convictions of children eventually led him to combine 3 distinct traditions in which he had been trained-naturalistic observation, psychometrics, and the psychiatric clinical examination. It was in this amalgam, first evident in his 4th text, that Piaget discovered the clinical dynamic that would drive the classic experiments for which he is most well known. PMID:17152748

  17. Langerhans cells in lichen planus and lichenoid mucositis an immunohistochemical study

    M Devi


    Full Text Available Aim: The aim of this study is to identify and evaluate Langerhans cell (LC in lichen planus (LP, lichenoid mucositis (LM and normal mucosa (NM using CD1a monoclonal antibody immunohistochemically. Materials and Methods: A total of 15 cases of oral lichen planus and 15 cases of LM were selected based on clinical examination and confirmed by histopathological analysis. The biopsies from the 10 patients were taken from normal buccal mucosa as control. Paraffin blocks of tissue were made, which are used for routine hematoxylin and eosin staining and immunohistochemical staining using biotin streptavidin methods (CD1a monoclonal antibody. Analysis of CD1a expression was performed by evaluating the labeling index (LI for each slide. Results: The mean CD1a LI for LP was significantly higher than that of LM and NM in the basal and supra basal layer. The mean CD1a positive cells in the connective tissues for LP were higher than that of LM and NM. Conclusion: This study clearly demonstrates a statistically significant increase in number of LC in LP than in LM, indicating the possible different immunopathogenic mechanisms.

  18. Cytohistopathological and immunohistochemical correlation of soft tissue tumors

    J. Chandralekha


    Full Text Available Background: Fine needle aspiration cytology has become an established tool in the diagnostic armamentarium of many clinical practices. The initial diagnosis of many mass lesions, both superficial and deep-seated, can often be readily and safely assessed by fine needle aspiration cytology. In our study, we assessed 361 cases of soft tissue tumors by fine needle aspiration cytology during a period of three years. We tried to follow up as many cases as possible to obtain corresponding excision biopsies for histopathological examination. Immunohistochemical studies were also performed on biopsy sections in some cases for confirmation of diagnoses. Aims and objectives: 1 To study the age, sex and site-wise distribution of soft tissue tumors. 2 To assess the utility of fine needle aspiration cytology in diagnosing various types of soft tissue tumors. 3 To assess the sensitivity, specificity, positive and negative predictive values, and overall histological correlation percentage of fine needle aspiration cytology in diagnosing soft tissue tumors. Methods: Aspirations were carried out using a 22 gauge disposable needle and a 10c.c disposable syringe for suction. Wet-fixed smears were stained with hematoxylin and eosin and pap stain. Dry-fixed smears were stained with May-Grunwald Giemsa stain. Periodic Acid Schiff stain was used in some cases of extraskeletal Ewing's sarcoma. Corresponding biopsy sections were stained with hematoxylin and eosin. Immunohistochemical stains were also used in some of the cases for confirmation of diagnosis. Results: Of the 361 cases recorded in our study, 320 patients could be successfully followed up and excision biopsies were obtained. The remaining 41 patients were excluded from the study due to inability to obtain biopsy. Of the 320 cases, 200 were diagnosed as benign soft tissue tumors, while 120 were diagnosed as malignant on cytological examination. The median age of occurrence of benign soft tissue tumors was 34

  19. Celloidin mounting (embedding without infiltration) - a new, simple and reliable method for producing serial sections of high thickness through complete human brains and its application to stereological and immunohistochemical investigations.

    Heinsen, H; Arzberger, T; Schmitz, C


    Celloidin mounting (embedding without infiltration) of the human central nervous system (CNS) proved to be superior to gelatin embedding for the production of serial sections ranging in thickness from 220 to 500 microm. After gallocyanin-staining, a comprehensive neuroanatomical as well as neuropathological survey of the human brain is possible, including diagnosis of Alzheimer's disease. Details of a fractionator analysis of the total striatal neuron number are described and the possible quantitative analysis of parallel immunohistochemically stained sections is discussed. PMID:11074343

  20. Immunohistochemical localisation of advanced glycation end products in pulmonary fibrosis.

    Matsuse, T.; Ohga, E.; Teramoto, S.; Fukayama, M; Nagai, R.; Horiuchi, S; Ouchi, Y.


    AIM: To investigate the presence and distribution of advanced glycation end products (AGE) in pulmonary fibrosis. METHODS: Lung tissue samples obtained from seven necropsy cases with idiopathic pulmonary fibrosis and seven with normal pulmonary parenchyma were examined immunohistochemically with a monoclonal antibody specific for AGE: 6D12. We also tested three cases with diffuse alveolar damage. RESULTS: All the specimens from cases with pulmonary fibrosis and diffuse alveolar damage showed ...

  1. A microRNA isolation method from clinical samples

    Zununi Vahed, Sepideh; Barzegari, Abolfazl; Rahbar Saadat, Yalda; Mohammadi, Somayeh; Samadi, Nasser


    Introduction: microRNAs (miRNAs) are considered to be novel molecular biomakers that could be exploited in the diagnosis and treatment of different diseases. The present study aimed to develop an efficient miRNA isolation method from different clinical specimens. Methods: Total RNAs were isolated by Trizol reagent followed by precipitation of the large RNAs with potassium acetate (KCH3COOH), polyethylene glycol (PEG) 4000 and 6000, and lithium chloride (LiCl). Then, small RNAs were enriched and recovered from the supernatants by applying a combination of LiCl and ethanol. The efficiency of the method was evaluated through the quality, quantity, and integrity of the recovered RNAs using the A260/280 absorbance ratio, reverse transcription PCR (RT-PCR), and quantitative real-time PCR (q-PCR). Results: Comparison of different RNA isolation methods based on the precipitation of DNA and large RNAs, high miRNA recovery and PCR efficiency revealed that applying potassium acetate with final precipitation of small RNAs using 2.5 M LiCl plus ethanol can provide high yield and quality small RNAs that can be exploited for clinical purposes. Conclusion: The current isolation method can be applied for most clinical samples including cells, formalin-fixed and paraffin-embedded (FFPE) tissues and even body fluids with a wide applicability in molecular biology investigations.

  2. Immunohistochemical expression of CD44s in renal cell carcinoma lacks independent prognostic significance

    Walter Henriques da Costa


    Full Text Available PURPOSE: To analyze the immunohistochemical expression of the standard isoform of CD44 (CD44s adhesion molecule in clear cell renal cell carcinoma (CCRCC and its impact on clinical outcomes. MATERIALS AND METHODS: Ninety-nine consecutive patients treated surgically for RCC between 1992 and 2009 were selected. A single pathologist reviewed all cases to effect a uniform reclassification and determine the most representative tumor areas for construction of a tissue microarray. The same pathologist, who was blinded to the outcome of the cases, semi-quantitatively scored the staining intensity of CD44s in all specimens. The counting was done using the H-Score algorithm. RESULTS: Of the 99 immunostained RCC specimens, 57(57.7% showed low expression, and 42(42.4% showed high expression levels of CD44s. The expression of CD44s was directly associated with tumor size (p = 0.03, clinical stage (p = 0.02 and Fuhrman grade (p = 0.02. Disease specific survival (DSS rates for patients whose specimens expressed low and high levels of CD44s was 88.1% and 67.5%, respectively (p = 0.009. Progression free survival (PFS rates in patients with low and high expression of CD44s were 78.8% and 61.7%, respectively (p = 0.05. Classical features such as the presence of metastasis and clinical stage remained isolated predictors of survival. CONCLUSIONS: Immunohistochemical expression of CD44s was associated with important clinical variables such as stage and Fuhrman grade. However, it was not an independent predictor of survival. Therefore, we believe it has a limited role as a prognostic marker in patients with CCRCC.

  3. Pathological, Ultrastructural and Immunohistochemical Observations of Adenoma of Retinal Pigment Epithelium

    Ping Zhang; Guanguang Feng; Tao Yue; Jianxian Lin; Yuzhen Yi; Youjian Pang


    Purpose: To Study the clinical, pathological, ultrastructural and immunohistchemicalcharacters of adenoma of the retinal pigment epithelium in order to offer evidence todiagnose this tumor.Methods: Routine paraffin slices HE stain, histochemistry PAS and VG stain,transmission electron microscopy, and immunohistochemistry for S-100 and vimentinwith LSAB method were used.Results: The tumor cells were oval and cuboidal in shape. Part of the tumor had atubular arrangement. Around the sheets of tumors cells there was a large amount ofuniform red stick-like substances. The above matter represented positive in PAS stain.Most of the above matter was yellow, while less of the matter showed red in VG stain.Transmission electron microscopy showed that there were tight junctions between tumorcells. Immunohistochemistry showed positive for S-100, negative for vimentin.Conclusions: The ultrastructural and immunohistochemical characters of the adenoma ofretinal pigment epithelium are consistent with the retinal pigment epithelium.

  4. A simplified immunohistochemical classification of skeletal muscle fibres in mouse

    M. Kammoun


    Full Text Available The classification of muscle fibres is of particular interest for the study of the skeletal muscle properties in a wide range of scientific fields, especially animal phenotyping. It is therefore important to define a reliable method for classifying fibre types. The aim of this study was to establish a simplified method for the immunohistochemical classification of fibres in mouse. To carry it out, we first tested a combination of several anti myosin heavy chain (MyHC antibodies in order to choose a minimum number of antibodies to implement a semi-automatic classification. Then, we compared the classification of fibres to the MyHC electrophoretic pattern on the same samples. Only two anti MyHC antibodies on serial sections with the fluorescent labeling of the Laminin were necessary to classify properly fibre types in Tibialis Anterior and Soleus mouse muscles in normal physiological conditions. This classification was virtually identical to the classification realized by the electrophoretic separation of MyHC. This immunohistochemical classification can be applied to the total area of Tibialis Anterior and Soleus mouse muscles. Thus, we provide here a useful, simple and time-efficient method for immunohistochemical classification of fibres, applicable for research in mouse

  5. Platelet function testing: methods of assessment and clinical utility.

    Mylotte, Darren


    Platelets play a central role in the regulation of both thrombosis and haemostasis yet tests of platelet function have, until recently, been exclusively used in the diagnosis and management of bleeding disorders. Recent advances have demonstrated the clinical utility of platelet function testing in patients with cardiovascular disease. The ex vivo measurement of response to antiplatelet therapies (aspirin and clopidogrel), by an ever-increasing array of platelet function tests, is with some assays, predictive of adverse clinical events and thus, represents an emerging area of interest for both the clinician and basic scientist. This review article will describe the advantages and disadvantages of the currently available methods of measuring platelet function and discuss both the limitations and emerging data supporting the role of platelet function studies in clinical practice.

  6. Platelet function testing: methods of assessment and clinical utility.

    Mylotte, Darren


    Platelets play a central role in the regulation of both thrombosis and haemostasis yet tests of platelet function have, until recently, been exclusively used in the diagnosis and management of bleeding disorders. Recent advances have demonstrated the clinical utility of platelet function testing in patients with cardiovascular disease. The ex vivo measurement of response to antiplatelet therapies (aspirin and clopidogrel), by an ever-increasing array of platelet function tests, is with some assays, predictive of adverse clinical events and thus, represents an emerging area of interest for both the clinician and basic scientist. This review article will describe the advantages and disadvantages of the currently available methods of measuring platelet function and discuss both the limitations and emerging data supporting the role of platelet function studies in clinical practice.

  7. Automated patient and medication payment method for clinical trials

    Yawn BP


    Full Text Available Barbara P Yawn,1 Suzanne Madison,1 Susan Bertram,1 Wilson D Pace,2 Anne Fuhlbrigge,3 Elliot Israel,3 Dawn Littlefield,1 Margary Kurland,1 Michael E Wechsler41Olmsted Medical Center, Department of Research, Rochester, MN, 2UCDHSC, Department of Family Medicine, University of Colorado Health Science Centre, Aurora, CO, 3Brigham and Women's Hospital, Pulmonary and Critical Care Division, Boston, MA, 4National Jewish Medical Center, Division of Pulmonology, Denver, CO, USABackground: Published reports and studies related to patient compensation for clinical trials focus primarily on the ethical issues related to appropriate amounts to reimburse for patient's time and risk burden. Little has been published regarding the method of payment for patient participation. As clinical trials move into widely dispersed community practices and more complex designs, the method of payment also becomes more complex. Here we review the decision process and payment method selected for a primary care-based randomized clinical trial of asthma management in Black Americans.Methods: The method selected is a credit card system designed specifically for clinical trials that allows both fixed and variable real-time payments. We operationalized the study design by providing each patient with two cards, one for reimbursement for study visits and one for payment of medication costs directly to the pharmacies.Results: Of the 1015 patients enrolled, only two refused use of the ClinCard, requesting cash payments for visits and only rarely a weekend or fill-in pharmacist refused to use the card system for payment directly to the pharmacy. Overall, the system has been well accepted by patients and local study teams. The ClinCard administrative system facilitates the fiscal accounting and medication adherence record-keeping by the central teams. Monthly fees are modest, and all 12 study institutional review boards approved use of the system without concern for patient


    李春研; 王军


    Lidui (厉兑 ST 45) is the Jing (井 Well) point of the Stomach Meridian of Foot-Yangming. It's effective to reduce the heat from the stomach or the Stomach Meridian. The Stomach Meridian is abundant with qi and blood, and is in charge of hemopathy. So, in clinic, we often apply Lidui (ST 45) point bleeding method to the treatment of many kinds of diseases and get good therapeutic effects. Following are 3 typical cases.

  9. Clasificación en subtipos moleculares de tumores de mama de pequeños animales mediante métodos inmunohistoquímicos Classification in molecular subtypes of breast tumors of small animals through immunohistochemical methods

    Mª V. Ortega García


    Full Text Available Antecedentes y Objetivos: Aplicar un panel de anticuerpos (anti -receptor de progesterona, -receptor de estrógenos, -receptor del factor de crecimiento epidérmico humano 2 y -citoqueratina 14 utilizando métodos inmunohistoquímicos en tumores mamarios de pequeños animales para analizar su clasificación en subtipos moleculares y su asociación con la invasión, el grado y el tipo histológico de las neoplasias. Material y Métodos: Muestras de tumores mamarios malignos, 10 de la especie canina y 3 de la felina. Control positivo interno: glándula mamaria no tumoral adyacente a las neoplasias. Resultados: El 23% (3/13 de los tumores fueron del subtipo luminal B, el 23% (3/13 fueron HER2 positivos, el 46% (6/13 fueron basales y el 7,6% (1/13 no se pudieron clasificar porque no expresaron ninguno de los marcadores tumorales analizados. Ningún caso fue del subtipo luminal A. Los 6 tumores basales fueron de grado II o III y presentaban o infiltración de solo el estroma o también invasión vascular. Dos tercios de los tumores HER2 positivos presentaban infiltración del estroma y 1/2 tumores resultó ser de grado II. Los tumores luminal B, 2/3 fueron de grado II o III. Todos los controles internos fueron positivos. No se encontraron diferencias significativas en la distribución de los subtipos moleculares entre los diferentes grupos de las variables invasión (p-valor=0,26, ni grado de malignidad (p-valor=0,42. Sí hubo diferencias en el límite de la significación estadística en la distribución de los subtipos moleculares entre los diferentes grupos de la variable tipo histológico (p=0,08. Conclusiones: La aplicación del panel de anticuerpos ha permitido descubrir 4 (luminal B, HER2, basal y sin clasificar de los 5 subtipos moleculares posibles.Antecedents and objectives: to apply an antibodies panel (anti-progesterone receptor -estrogen receptor, -human epidermal growth factor receptor 2 and cytokeratin 14 using immunohistochemical

  10. False Immunohistochemical Results for Herpesviridae and Other Clusters of Differentiation Due To Biotin Intranuclear Inclusions in the Gestational Endometrium

    Francesco Rivasi


    Conclusions. Immunohistochemical investigations of the gestational endometrium (particularly in pregnancies near to term may yield false results for several herpes viruses, as well as for other immunohistochemical reactions obtained using the ABC method without prior biotin inactivation. [J Interdiscipl Histopathol 2014; 2(1.000: 32-37

  11. DJ-1 and androgen receptor immunohistochemical expression in prostatic carcinoma: A possible role in carcinogenesis

    Background and Aim: Androgen plays a fundamental role in the growth and differentiation of prostate. Androgen receptor (AR) expression may represent a potential marker of prognosis in prostate cancer. However, there have been variable results regarding its ability to predict clinical progression. Despite the oncogenic properties of DJ-1, its significance in prostate cancer development and progression is not well understood. This research shed some light on the possible role of immunohistochemical expression of DJ-1 in clinically localized prostatic carcinoma in relation to the established role of AR and other clinico pathologic parameters. Materials and Methods: The immunohistochemical expression of AR and DJ-1 was evaluated in 129 samples including benign hyperplasia (n = 60) and prostatic carcinoma (n = 69). Results: The mean value of AR immunostaining was significantly higher in prostatic carcinomas than in benign hyperplasia (P = 0.001). A significant inverse correlation was found between AR immunostaining and the grade of prostatic carcinomas. A significantly higher median DJ-1 score was found in prostatic carcinoma than in benign hyperplasia (P = 0.0001). There was a significant direct correlation between AR and DJ-1 score (P = 0.0001). AR is more sensitive in predicting prostatic carcinoma than DJ-1 but DJ-1 is more specific than AR. Conclusion: AR nuclear expression was consistently present in benign and adenocarcinoma epithelium. But, there may be limited clinical use for AR expression in localized carcinoma due to its constant heterogeneity. DJ-1 with its oncogenic properties, specificity for prostatic carcinoma and homogenous expression gives an ideal complementary role to AR in the detection and treatment of prostatic carcinomas.

  12. A Retrospective Immunohistochemical and Clinicopathological Study of Small Cell Carcinomas of the Urinary Tract

    Cheng-Keng Chuang


    Full Text Available Background: To investigate the immunohistochemical and clinicopathological behaviorsof primary urinary tract small cell carcinomas (SCCs.Methods: A retrospective study of 10 cases of urinary tract SCC (7 men and 3 women,average age, 54; range, 35-78 years at Chang Gung Memorial Hospital isreported. Among these cases, 3 tumors arose from the kidney, 2 from therenal pelvis, 2 from the ureter, and 3 from the bladder. Clinical and follow-updata were obtained. Histological and immunohistochemical studies with antibodiesto neuroendocrine (NE markers were conducted.Results: The most prominent common feature of the 10 SCCs was their cellhistopathology: small to medium-sized round to spindle-shaped cells withscanty cytoplasm, hyperchromatic nuclei, and inconspicuous nucleoli.Immunostaining revealed positive neuron-specific enolase (NSE reactivityin 10 of 10 tumors, but there was focal and weak staining for chromogranin-A (CgA in 4 of 10 tumors. The 7 patients with vimentin-positive SCCs alldeveloped metastatic lesions, and 5 of them expired within 1 year.Conclusions: SCCs of the urinary tract system share similar histopathological features andNE markers with their pulmonary counterpart. NSE was expressed moreconsistently than CgA in these tumors. However, the preferential expressionof NSE and intensity of immunostaining of these 2 NE markers did not predictthe clinical outcome of these patients. The presence of both SCC andtransitional cell carcinoma or SCC alone did not foretell the clinical outcomeeither. Patients with the presence of vimentin in the tumor tissues appeared tohave poorer prognoses with early metastasis and mortality.


    朱雪琼; 石一复; 陈晓端; 吴裕中


    Objective: To evaluate the diagnostic implications of immunohistochemical markers in uterine smooth muscle tumors. Methods: Formalin-fixed paraffin-embedded tissue blocks were selected from 17 uterine leiomyosarcomas, 40 uterine unusual leiomyomas and 25 uterine usual leiomyomas. Utilizing immunohistochemical techniques with antigen retrieval, serial sections of each tumor for immunoreactivity with myogenic markers, ovarian steroid receptors, CD44v3, proliferating cell nuclear antigen and mast cells were assessed. Results: Although the myogenic markers and CD44v3 showed less frequent positivity in uterine leiomyosarcomas than those in unusual leiomyomas, they were not reliable markers for differentiating leiomyosarcoma from leiomyoma. Uterine leiomyosarcoma tended to have lower ovarian steroid receptors immunoreactivity rates than leiomyoma. Leiomyoma tended to have a higher quantity of intratumoral mast cells than leiomyosarcoma, while the expression of proliferating cell nuclear antigen was lower in them. Conclusion: Because the estimation of mitotic count was subject to significant variation, the immunohistochemical expression of ovarian steroid receptors, mast cells and proliferating cell nuclear antigen seemed to be helpful for the discrimination of unusual leiomyoma from leiomyosarcoma.

  14. Immunohistochemical expression of interleukin 8 in skin biopsies from patients with inflammatory acne vulgaris

    El Maged Rabee A


    Full Text Available Abstract Background This study was conducted to evaluate the immunohistochemical (IHC expression of interleukin 8 (IL-8 in skin biopsies of inflammatory acne vulgaris (IAV in an attempt to understand the disease pathogenesis. Materials and methods A total of 58 biopsies, 29 from lesional IAV and 29 normal non lesional sites were immunostained for IL-8. The intensity of staining was evaluated in the epidermis and dermis and was scored as mild, moderate and severe. The expression was correlated with the clinical grade, disease course and histological changes. Results IL-8 immunoreactivity was expressed in lesional IAV compared to non lesional skin biopsies (p Conclusion We were able to demonstrate altered immunoreactivity of IL-8 in IAV compared to normal skin. Targeted therapy to block IL-8 production may hold promise in limiting the deleterious effects of IL-8-mediated inflammatory response and angiogenesis.

  15. Histotripsy methods in mechanical disintegration of tissue: towards clinical applications.

    Khokhlova, Vera A; Fowlkes, J Brian; Roberts, William W; Schade, George R; Xu, Zhen; Khokhlova, Tatiana D; Hall, Timothy L; Maxwell, Adam D; Wang, Yak-Nam; Cain, Charles A


    In high intensity focused ultrasound (HIFU) therapy, an ultrasound beam is focused within the body to locally affect the targeted site without damaging intervening tissues. The most common HIFU regime is thermal ablation. Recently there has been increasing interest in generating purely mechanical lesions in tissue (histotripsy). This paper provides an overview of several studies on the development of histotripsy methods toward clinical applications. Two histotripsy approaches and examples of their applications are presented. In one approach, sequences of high-amplitude, short (microsecond-long), focused ultrasound pulses periodically produce dense, energetic bubble clouds that mechanically disintegrate tissue. In an alternative approach, longer (millisecond-long) pulses with shock fronts generate boiling bubbles and the interaction of shock fronts with the resulting vapour cavity causes tissue disintegration. Recent preclinical studies on histotripsy are reviewed for treating benign prostatic hyperplasia (BPH), liver and kidney tumours, kidney stone fragmentation, enhancing anti-tumour immune response, and tissue decellularisation for regenerative medicine applications. Potential clinical advantages of the histotripsy methods are discussed. Histotripsy methods can be used to mechanically ablate a wide variety of tissues, whilst selectivity sparing structures such as large vessels. Both ultrasound and MR imaging can be used for targeting and monitoring the treatment in real time. Although the two approaches utilise different mechanisms for tissue disintegration, both have many of the same advantages and offer a promising alternative method of non-invasive surgery. PMID:25707817

  16. Methods and clinical applications in nuclear cardiology: a position statement

    Nuclear cardiological procedures have paved the way for non-invasive diagnostics of various partial functions of the heart. Many of these functions cannot be visualised for diagnosis by any other method (e.g. innervation). These techniques supplement morphological diagnosis with regard to treatment planning and monitoring. Furthermore, they possess considerable prognostic relevance, an increasingly important issue in clinical medicine today, not least in view of the cost-benefit ratio. Our current understanding shows that effective, targeted nuclear cardiology diagnosis - in particular for high-risk patients - can contribute toward cost savings while improving the quality of diagnostic and therapeutic measures. In the future, nuclear cardiology will have to withstand mounting competition from other imaging techniques (magnetic resonance imaging, electron beam tomography, multislice computed tomography). The continuing development of these methods increasingly enables measurement of functional aspects of the heart. Nuclear radiology methods will probably develop in the direction of molecular imaging. (orig.)

  17. Compass: A hybrid method for clinical and biobank data mining

    Krysiak-Baltyn, Konrad; Petersen, Thomas Nordahl; Audouze, Karine Marie Laure;


    Association Mining in order to find association rules. We demonstrate that this procedure has a number of advantages compared to traditional Association Mining; it allows for handling numerical variables without a priori binning and is able to generate variable groups which act as “hotspots” for statistically...... significant associations. We showcase the method on infertility-related data from Danish military conscripts. The clinical data we analyzed contained both categorical type questionnaire data and continuous variables generated from biological measurements, including missing values. From this data set, we...


    Eduard Crauciuc


    Full Text Available Aim of this study was to establish a significant way to the prognosis improvement in trophoblastic pathologyin patients with hydatidiform mole. Objective. A mole is a particularity of embryonic development where a pregnancyoccurs paradoxically without an embryo (the mole pregnancy and develops only its placental tissue. It is important todemonstrate that the clinical diagnostic should always be completed by a histo-pathological diagnostic and also by thedescription of the natural history of the disease until the time of diagnostic. Material and method. The cases included inthe study (n=45 were hospitalized in ”Elena Doamna” Clinical Hospital Iaşi, in the period of time between 2008 and2013, and diagnosed with hydatidiform mole. The study was a retrospective one, case-control type. Starting from thealready diagnosed illness and following the clinical and paraclinical parameters outlined in literature, the objective of thestudy was to establish the main risk factors that trigger the molar pregnancy. Results. The epidemiological characteristicsshow the following main risk factors for a molar pregnancy: age over 30, urban area, tobacco and alcohol consumption.The mean values of βHCG decreased significantly after the hydatidiform mole was removed, from 26,624 to 9,859mUI/ml (p<0.05.Conclusions. Every woman with a history of hydatidiform mole has an increased risk of developingcarcinoma. After the complete or partial removal of the hydatidiform mole, it is necessary to monitor the values of βHCGtwice a month until they stabilize.

  19. Immunohistochemical diagnosis of fusariosis with monoclonal antibodies

    Jensen, H.E.; Aalbæk, B.; Jungersen, Gregers; Hartvig, T.; Moser, C.; Rozell, B.L.; Blennow, O.

    establishing an accurate diagnosis. Although molecular techniques (e.g. in situ hybridization and PCR) have been explored for diagnostic use, the development of specific monoclonal antibodies (Mabs) for immunohistochemical identification of Fusarium spp. will extend the availability of diagnostic options for...

  20. Clinical value of isotope methods in adrenal morphology investigations

    In the years 1976-1980 in 105 patients 124 adrenal scintigrams were obtained, including 50 in patients with primary hyperaldosteronism syndrome, 27 with Cushings syndrome, 8 after bilateral total adrenalectomy, 4 with adrenal virilizing tumours, 6 with phaeochromocytoma, 10 with normal adrenal function. The results of scintigraphy were compared with those of arteriography, phlebography, computer tomography and postoperative findings. The clinical value of scintigraphy was found to be greatest in cases of adrenocortical disease. In cases of phaeochromocytoma isotope angioscintigraphy is a useful method for localizing the tumour since it makes possible demonstration of the vascular bed of the tumour. A close correlation was demonstrated between the results of scintigraphy and those of computer tomography. In the group of 27 patients treated surgically for adrenocortical disease in 87% of cases an agreement was found between the results of scintigraphy and the result of the operation. For different adrenocortical diseases this per cent was: 77% for Cushings syndrome, 91% for primary hyperaldosteronism, 100% for adrenal virilizing tumours. The study showed that adrenal scintigraphy is a very valuable diagnostic method of high clinical usefulness in adrenocortical diseases. (author)

  1. Papillary squamotransitional cell carcinoma of the uterine cervix: A histomorphological and immunohistochemical study of nine cases

    Mani Anand


    Full Text Available Background: Papillary squamotransitional cell carcinoma (PSCC is a distinctive subcategory of squamous cell carcinoma of the uterine cervix. It has a propensity for local recurrence and late metastasis. Histologically, it can be misinterpreted as transitional cell carcinoma, or other papillary lesions of the cervix including squamous papilloma, verrucous carcinoma or cervical intraepithelial neoplasia grade 3 with papillary configuration. Materials and Methods: Nine cases of PSCC of the uterine cervix were diagnosed on a cervical biopsy specimen on routine hematoxylin and eosin (H and E stained sections. Their clinic-morphological features were analyzed. The cases were further evaluated immunohistochemically by cytokeratin 7 (CK7, cytokeratin 20 (CK20, p53 and Ki-67. Results: The patients ranged in age from 35 years to 75 years; with abnormal uterine bleeding being the most common clinical presentation. All the cases showed papillary architecture with fibrovascular cores lined by multilayered atypical epithelium. Three cell types were observed: Clear, intermediate and basaloid. Stromal invasion was seen in five cases, whereas in the remaining four cases, the biopsy specimen was too superficial to definitely assess invasion. Immunohistochemically, eight cases were CK7 + /CK20 - and one case was CK7 - /CK20 - . All nine cases showed nuclear accumulation of mutant p53. Moderate and high proliferative activity was observed in two and seven cases, respectively. Five of patients for whom follow-up information was available underwent radical hysterectomy and two of them were disease free 18 months following treatment. Conclusion: PSCC of the uterine cervix are a clinicomorphologically distinct group of cervical lesions that display a morphologic spectrum. They are potentially aggressive malignant tumors that should be distinguished from transitional cell carcinoma and other papillary lesions of the uterine cervix.

  2. Immunohistochemical analysis of Hodgkin's disease using microwave heating.

    Charalambous, C.; Singh, N.; Isaacson, P G


    AIMS--To assess the effect of microwave heating on immunohistochemical staining of CD15 and CD30 antigens in Hodgkin's disease tissue samples. METHODS--Formalin fixed, paraffin wax embedded sections from 20 cases of Hodgkin's disease (six mixed cellularity, 14 nodular sclerosis) were immunostained for CD15, using two antibodies (DAKO-M1 and Leu-M1) and for CD30 using the antibody Ber-H2. The staining was carried out by conventional techniques which included pretreatment of sections with tryps...

  3. Immunohistochemical Expression of p16 in Pleomorphic Salivary Adenoma

    Hanouneh, Salah; Darwish, Shorouk; Baroudi, Kusai; Sakka, Salah; Tarakji, Bassel


    Objective: This study aimed to characterize alteration in the immunohistochemical expression of p16 in normal tissue of the salivary gland surrounding pleomorphic adenoma, and the tumor cells of pleomorphic adenomas.Material and Method: A selected series of 120 cases of pleomorphic adenomas were examined.Results: The results showed that p16 expression in non tumor duct cells was strong positive nuclear staining in 98 (81.6%) cases out of 120, while there were 20 (16.6%) with moderate staining...

  4. Mechanomyographic Parameter Extraction Methods: An Appraisal for Clinical Applications

    Morufu Olusola Ibitoye


    Full Text Available The research conducted in the last three decades has collectively demonstrated that the skeletal muscle performance can be alternatively assessed by mechanomyographic signal (MMG parameters. Indices of muscle performance, not limited to force, power, work, endurance and the related physiological processes underlying muscle activities during contraction have been evaluated in the light of the signal features. As a non-stationary signal that reflects several distinctive patterns of muscle actions, the illustrations obtained from the literature support the reliability of MMG in the analysis of muscles under voluntary and stimulus evoked contractions. An appraisal of the standard practice including the measurement theories of the methods used to extract parameters of the signal is vital to the application of the signal during experimental and clinical practices, especially in areas where electromyograms are contraindicated or have limited application. As we highlight the underpinning technical guidelines and domains where each method is well-suited, the limitations of the methods are also presented to position the state of the art in MMG parameters extraction, thus providing the theoretical framework for improvement on the current practices to widen the opportunity for new insights and discoveries. Since the signal modality has not been widely deployed due partly to the limited information extractable from the signals when compared with other classical techniques used to assess muscle performance, this survey is particularly relevant to the projected future of MMG applications in the realm of musculoskeletal assessments and in the real time detection of muscle activity.


    Diego Michelon DE CARLI


    Full Text Available Background Worldwide, gastric cancer is the fourth cancer in incidence and the second most common cause of cancer death. Gastric cancer is asymptomatic in the early stages and very often diagnosed at advanced stages, determining a dismal prognosis. Expression of the HER2 gene has been identified in about 20% of gastric cancer cases, and its hyper-expression is associated with poor prognosis. Objective To investigate HER2 immunohistochemical expression in gastric adenocarcinoma and its relationship to the histological type and anatomic location. Methods A cross-sectional retrospective study analyzed the immunohistochemical expression of HER2 in a sample of 48 specimens of gastric cancer. Immunohistochemical analysis were performed using avidin-biotin-peroxidase method with C-erb B2 (clone EP1045Y, as a primary antibody (Biocare Medical, USA. Standardized gastric adenocarcinoma‘s HER2 expression criteria has been used in the analysis of samples. Results There were seven cases with reactivity for HER2. Five were of intestinal-type while two cases were of mixed-type in which the expression occurred in the intestinal component. It was identified a significant association of HER2 expression in the intestinal subtype of gastric adenocarcinoma (P=0.003. Regarding the anatomical site, HER2 was positive in only one (16.6% of the six proximal cases and six (14.28% of the 42 distal cases (P=0.88. Conclusion HER2 immunoexpression was identified in 14.6% of the samples, and the expression was significantly associated to Lauren’s intestinal subtype.

  6. Clinical simulation as an evaluation method in health informatics

    Jensen, Sanne


    work practice including other technology and organizational structure. Clinical simulation is ideal for proactive evaluation of new technology for clinical work practice. Clinical simulations involve real end-users as they simulate the use of technology in realistic environments performing realistic...... tasks. Clinical simulation study assesses effects on clinical workflow and enables identification and evaluation of patient safety hazards before implementation at a hospital. Clinical simulation also offers an opportunity to create a space in which healthcare professionals working in different...... locations or sectors can meet and exchange knowledge about work practices and requirement needs. This contribution will discuss benefits and challenges of using clinical simulation, and will describe how clinical simulation fits into classical usability studies, how patient safety may benefit by use of...

  7. Immunohistochemical detection of estrogen receptors in canine mammary tumors

    Elena Atanaskova Petrov


    Full Text Available Mammary tumors are among the most common neoplasms in intact female dogs.They have a complex morphology, usually affecting middle age and older bitches. Almost 50% of the mammary tumors in dogs are malignant neoplasms. Prognosis is based on several factors: stage, age, tumor size, metastasis, histopathology, ovariectomy status and hormone-receptor activity. Immunohistochemical (IHC measurement has become increasingly an important diagnostic and prognostic parameter, with the development of monoclonal antibodies against nuclear estrogen and progestin receptors. The aim of this study was to detect the presence of ER receptors in malignant canine mammary tumors and to identify their association with the clinical course of the tumor. Mammary tumor samples have been obtained by mastectomy from dogs presented at our clinic. Detailed clinical examination, CBC and basic serum biochemical profile were performed in all patients. Surgery was the only treatment. Histopathological examination and immunohistochemical detection of estrogen α receptors (ERα was performed on 8 formalin-fixed, paraffin-embedded tissue samples, using the PT LINK immunoperoxidase technique. Histopathological examination of the mammary tumor samples (n=11 revealed tubular adenocarcinoma (n=6,54.5% and ductal adenocarcinoma (n=3, 27.3%, one patient with benign adenoma and one with mastitis. Patients with positive ER tumors are alive, without remission, while 3 of the patients that were ER negative died due to lung metastases. According to our results, it can be concluded that the appearance and development of canine mammary tumors is highly connected with ovarian steroid hormones and that immunostaining of the tumors may be used as a good prognostic parameter in these patients.

  8. Adrenal lymphangioma: clinicopathologic and immunohistochemical characteristics of a rare lesion.

    Ellis, Carla L; Banerjee, Priya; Carney, Erin; Sharma, Rajni; Netto, George J


    Adrenal lymphangiomas, also known as cystic adrenal lymphangiomas, are rare, benign vascular lesions that usually remain asymptomatic throughout life. Although previously adrenal lymphangioma lesions were primarily found at autopsy, they are currently detected during imaging work-up for unrelated causes and are likely to imitate other adrenocortical or adrenal medullary neoplasms. We aimed to retrospectively review all adrenal lymphangioma cases at our hospital and further document their lymphatic origin by immunohistochemical staining. A search of surgical pathology records (1984-2008) was conducted. All hematoxylin and eosin sections were retrieved from archives and reviewed by 2 pathologists in the study. Clinical information was gathered from electronic medical records. Representative paraffin-embedded sections from each case were selected for immunohistochemical analysis using monoclonal antibodies D2-40 and AE1/AE3. A total of 9 adrenal lymphangioma cases were identified (6 women and 3 men). All 9 patients were adults at time of diagnosis with a mean age of 42 years (range, 28-56 years). There were 7 white patients, 1 African American patient, and 1 Asian patient. The average size of an adrenal lymphangioma lesion was 4.9 cm (range, 2.0-13.5 cm). Adrenal lymphangioma was twice more frequently located on the right side (6 right-sided and 3 left-sided). Clinically, 4 (44%) of the 9 lesions presented with abdominal, flank, or back pain. One lymphangioma was found during work-up for labile hypertension. The remaining 4 lesions (44%) were asymptomatic and incidentally found during imaging studies for unrelated causes. Surgical removal was achieved by total adrenalectomy in 8 of the 9 lesions and by partial adrenalectomy in the remaining case. No evidence of recurrence or development of a contralateral lesion was encountered in any of the patients. Histologically, our adrenal lymphangiomas showed a typical multicystic architecture with dilated spaces lined by

  9. General Practitioners’ responses to global climate change - lessons from clinical experience and the clinical method

    Blashki Grant


    Full Text Available Abstract Background Climate change is a global public health problem that will require complex thinking if meaningful and effective solutions are to be achieved. In this conceptual paper we argue that GPs have much to bring to the issue of climate change from their wide-ranging clinical experience and from the principles underpinning their clinical methods. This experience and thinking calls forth particular contributions GPs can and should make to debate and action. Discussion We contend that the privileged experience and GP way of thinking can make valuable contributions when applied to climate change solutions. These include a lifetime of experience, reflection and epistemological application to first doing no harm, managing uncertainty, the ability to make necessary decisions while possessing incomplete information, an appreciation of complex adaptive systems, maintenance of homeostasis, vigilance for unintended consequences, and an appreciation of the importance of transdisciplinarity and interprofessionalism. Summary General practitioners have a long history of public health advocacy and in the case of climate change may bring a way of approaching complex human problems that could be applied to the dilemmas of climate change.

  10. Morphologic Findings in Progressive Familial Intrahepatic Cholestasis 2 (PFIC2): Correlation With Genetic and Immunohistochemical Studies

    Evason, Kimberley; Bove, Kevin E.; Finegold, Milton J; Knisely, A. S.; Rhee, Sue; Rosenthal, Philip; Miethke, Alexander G.; Karpen, Saul J; Ferrell, Linda D; Kim, Grace E.


    Progressive familial intrahepatic cholestasis, type 2 (PFIC2), characterized by cholestasis in infancy that may progress to cirrhosis, is caused by mutation in ABCB11, which encodes bile salt export pump (BSEP). We correlated histopathologic, immunohistochemical, and ultrastructural features in PFIC2 with specific mutations and clinical course. Twelve patients with clinical PFIC2 and ABCB11 mutations were identified, and 22 liver biopsy and explant specimens were assessed. All had hepatocellu...

  11. Estudo comparativo entre vitiligo, nevo halo e lúpus eritematoso vitiligóide por meio de métodos imunológicos, histológicos e imuno-histoquímicos Comparative study of vitiligo, halo nevus, and vitiligoid variant of lupus erythematosus by immunological, histological, and immunohistochemical methods

    Luiz Gonzaga C. Souza Filho


    Full Text Available FUNDAMENTOS: O estudo compara o vitiligo, o nevo halo (NH e lúpus eritematoso vitiligóide (LEV do ponto de vista imunológico, histológico e histoquímico. OBJETIVOS: Avaliar diferenças imuno-histoquímicas entre essas doenças e investigar se a despigmentação do LEV deve-se à destruição pós-inflamatória ou à agressão imunológica aos melanócitos. MÉTODOS: Foram avaliados 20 pacientes com vitiligo, 17 com vitiligo e NH, cinco com NH isolado e 15 com LEV. Detecção de anticorpos: IF direta e indireta com células névicas e de melanoma. Citotoxicidade: atividade NK contra células de melanoma. Estudo anátomo-histoquímico: exame histológico com hematoxilina e eosina, Fontana-Masson, Dopa e Dopa mais prata (D+P e exame histoquímico com proteína S-100. RESULTADOS: Doentes com vitiligo, NH e LEV apresentaram anticorpos antimelanócitos. Tanto no vitiligo e NH, como no LEV, demonstrou-se a presença de fatores de risco favorecedores da citotoxicidade celular. A coloração com D+P foi superior às colorações tradicionais e à proteína S-100 na detecção de melanócitos e melanina nas lesões de vitiligo, NH e LEV. CONCLUSÕES: Demonstrou-se a existência de anticorpos antimelanócitos no vitiligo e NH. É possível que a despigmentação no LEV se deva a fenômenos imunológicos semelhantes aos do vitiligo e NH. A detecção de melanócitos nas lesões de vitiligo sugere mais inibição funcional do que destruição dessas células.BACKGROUND: There are no records of comparative studies on the immunological, histological and immunohistochemical aspects of vitiligo, halo nevus and vitiligoid variant of lupus erythematosus in the literature. The studies available present only descriptive clinical data on leucoderma that accompanies lupus erythematosus in its diverse clinical forms. OBJECTIVES: 1- To evaluate the immunohistochemical differences between vitiligo, halo nevus and vitiligoid variant of lupus erythematosus; 2- To

  12. [Methodical approaches to usage of complex anthropometric methods in clinical practice].

    Bukavneva, N S; Pozdniakov, A L; Nikitiuk, D B


    The new methodical approach of complex anthropometric study in clinical practice has been proposed for evaluation of nutritional state, dyagnostics and effectiveness of dietotherapy of patients with alimentary-depended pathology. The technique of body's voluminous size measurements, adipose folds measurements by means of caliper, extremities diameter measurements has been described, which would allow to receive more precise data during patients examinations. Formulas which allow to calculate the amount of bone, muscular and adipose mass been provided. PMID:18219935

  13. A histological and immunohistochemical study of tissue reactions to solid poly(ortho ester) in rabbits.

    Ekholm, M; Helander, P; Hietanen, J; Lindqvist, C; Salo, A; Kellomäki, M; Suuronen, R


    In many cases only the temporary presence of a biomaterial is needed in tissue support, augmentation or replacement. In such cases biodegradable materials are better alternatives than biostable ones. At present, biodegradable polymers are widely used in the field of maxillofacial surgery as sutures, fracture fixation devices and as absorbable membranes. The most often used polymers are aliphatic polyesters, such as polyglycolic acid (PGA) and polylactic acid (PLA). Poly(ortho ester) is a surface eroding polymer, which has been under development since 1970, but is used mostly in drug delivery systems in semisolid form. The aim of this study was to evaluate the tissue reactions of solid poly(ortho ester) (POE), histologically and immunohistochemically. Resorption times and the effect of 2 different sterilization methods (gamma radiation and ethylene oxide) upon resorption were also evaluated. Material was implanted into the tibia and subcutaneously into the mandibular ramus area of 24 rabbits. Follow-up times were 1-10, 14 and 24 weeks. Histological studies showed that POE induces a moderate inflammation in soft tissue and in bone. At 24 week follow-up, inflammation was mild in soft tissue and moderate in bone. In immunohistochemical studies, no highly fluorescent layer of tenascin or fibronectin was found adjacent to the implant. Resorption of gamma-sterilized rods was faster than ethylene oxide-sterilized rods. The total resorption time was more than 24 weeks in both groups. Clinically the healing was uneventful and the implants the well tolerated by the living tissue. This encourages these authors to continue studies with this interesting new material to search for the ideal material for bone filling and fracture fixation. PMID:16540288

  14. An introduction to clinical microeconomic analysis: purposes and analytic methods.

    Weintraub, W S; Mauldin, P D; Becker, E R


    The recent concern with health care economics has fostered the development of a new discipline that is generally called clinical microeconomics. This is a discipline in which microeconomic methods are used to study the economics of specific medical therapies. It is possible to perform stand alone cost analyses, but more profound insight into the medical decision making process may be accomplished by combining cost studies with measures of outcome. This is most often accomplished with cost-effectiveness or cost-utility studies. In cost-effectiveness studies there is one measure of outcome, often death. In cost-utility studies there are multiple measures of outcome, which must be grouped together to give an overall picture of outcome or utility. There are theoretical limitations to the determination of utility that must be accepted to perform this type of analysis. A summary statement of outcome is quality adjusted life years (QALYs), which is utility time socially discounted survival. Discounting is used because people value a year of future life less than a year of present life. Costs are made up of in-hospital direct, professional, follow-up direct, and follow-up indirect costs. Direct costs are for medical services. Indirect costs reflect opportunity costs such as lost time at work. Cost estimates are often based on marginal costs, or the cost for one additional procedure of the same type. Finally an overall statistic may be generated as cost per unit increase in effectiveness, such as dollars per QALY.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10151059

  15. Immunohistochemical Correlation of Matrix Metalloproteinase-2 and Tissue Inhibitors of Metalloproteinase-2 in Tobacco Associated Epithelial Dysplasia

    Dipshikha Bajracharya


    Full Text Available Aim. To study the immunohistochemical expression of matrix metalloproteinase and tissue inhibitors of matrix metalloproteinase-2 in different histological grades of tobacco associated epithelial dysplasia and correlate the association between these proteases. Potentially malignant oral disorders (PMODs progressing to oral cancer are related to the severity of epithelial dysplasia. Methods. A retrospective immunohistochemical study was carried out on 30 clinically and histologically proven cases of leukoplakia with dysplasia and 10 cases of normal buccal mucosa using anti-MMP-2 and anti-TIMP-2 monoclonal antibodies. Results. Mann Whitney U test, for comparing the expression of both MMP-2 and TIMP-2 in normal mucosa with dysplasia, was highly significant (P<0.001. Kruskal-Wallis test to compare the median score of MMP-2 and TIMP-2 in different grades of dysplasia showed statistical significance (P<0.001, and a Spearman’s correlation between MMP-2 and TIMP-2 through different grades of dysplasia and cells observed showed positive correlation. Conclusion. Concomitant increase in the expression of both MMP-2 and TIMP-2 suggested that the activation of MMP-2 is dependent on TIMP-2 acting as a cofactor. Changes in TIMP-2 levels are considered important because they directly affect the level of MMP-2 activity.

  16. Radiolabelled Autologous Cells: Methods and Standardization for Clinical Use

    This publication serves as a useful resource for nuclear medicine physicians, radiologists, radiopharmacists, pharmacologists and other researchers engaged with radiolabelling of autologous products for clinical application. It provides practical guidelines towards clinical work with radiolabelled autologous products and aims to streamline the variety of strategies that have evolved, for example, in the handling of radiolabelled red and white blood cells. The publication highlights the importance of the quality of radiolabelling services, provides advice on safety issues, and also addresses the use of other radiolabelled autologous products and their translation into the clinical environment

  17. An immunohistochemical study of the sciatic nerve in a rat knee immobilization model

    Yoshida, Shinya; Matsuzaki, Taro; Hoso, Masahiro


    [Purpose] This study was performed to immunohistochemically evaluate changes in the periphery of the sciatic nerve in a rat model of knee immobilization, and to assess the effects of range of motion exercise. [Subjects and Methods] Twenty-one male rats were divided randomly into three groups: control (C), immobilized (I), and exercise (E group). Rats in the I and E groups had the right knee joint immobilized for 2 weeks. In the E group, range of motion exercise was also performed. After the experimental period, the periphery of the sciatic nerve was immunohistochemically observed. [Results] Immunohistochemical staining revealed that the myelin sheath and the perineurium in all groups were laminin positive. In the C and E groups, all rats showed normal staining. In contrast, 4 rats in the I group exhibited weak labeling. [Conclusion] Our results suggest that immobilization alters the perineurium at a molecular level and the range of motion exercise is essential for maintaining the environment of the perineurium.

  18. Human vomeronasal epithelium development: An immunohistochemical overview.

    Dénes, Lóránd; Pap, Zsuzsanna; Szántó, Annamária; Gergely, István; Pop, Tudor Sorin


    The vomeronasal organ (VNO) is the receptor structure of the vomeronasal system (VNS) in vertebrates. It is found bilaterally in the submucosa of the inferior part of the nasal septum. There are ongoing controversies regarding the functionality of this organ in humans. In this study we propose the immunohistochemical evaluation of changes in components of the human vomeronasal epithelium during foetal development. We used 45 foetuses of different age, which were included in three age groups. After VNO identification immunohistochemical reactions were performed using primary antibodies against the following: neuron specific enolase, calretinin, neurofilament, chromogranin, synaptophysin, cytokeratin 7, pan-cytokeratin and S100 protein. Digital slides were obtained and following colorimetric segmentation, surface area measurements were performed. The VNO was found in less than half of the studied specimens (42.2%). Neuron specific enolase and calretinin immunoexpression showed a decreasing trend with foetal age, while the other neural/neuroendocrine markers were negative in all specimens. Cytokeratin 7 expression increased with age, while Pan-Ctk had no significant variations. S100 protein immunoexpression also decreased around the VNO. The results of the present work uphold the theory of regression of the neuroepithelium that is present during initial stages of foetal development. PMID:26132837

  19. Bcl-2 expression is altered with ovarian tumor progression: an immunohistochemical evaluation

    Anderson Nicole S


    Full Text Available Abstract Background Ovarian cancer is the most lethal gynecologic malignancy. The ovarian tumor microenvironment is comprised of tumor cells, surrounding stroma, and circulating lymphocytes, an important component of the immune response, in tumors. Previous reports have shown that the anti-apoptotic protein Bcl-2 is overexpressed in many solid neoplasms, including ovarian cancers, and contributes to neoplastic transformation and drug-resistant disease, resulting in poor clinical outcome. Likewise, studies indicate improved clinical outcome with increased presence of lymphocytes. Therefore, we sought to examine Bcl-2 expression in normal, benign, and cancerous ovarian tissues to determine the potential relationship between epithelial and stromal Bcl-2 expression in conjunction with the presence of lymphocytes for epithelial ovarian tumor progression. Methods Ovarian tissue sections were classified as normal (n = 2, benign (n = 17 or cancerous (n = 28 and immunohistochemically stained for Bcl-2. Bcl-2 expression was assessed according to cellular localization, extent, and intensity of staining. The number of lymphocyte nests as well as the number of lymphocytes within these nests was counted. Results While Bcl-2 staining remained cytoplasmic, both percent and intensity of epithelial and stromal Bcl-2 staining decreased with tumor progression. Further, the number of lymphocyte nests dramatically increased with tumor progression. Conclusion The data suggest alterations in Bcl-2 expression and lymphocyte infiltration correlate with epithelial ovarian cancer progression. Consequently, Bcl-2 expression and lymphocyte status may be important for prognostic outcome or useful targets for therapeutic intervention.

  20. Immunohistochemical Studies on Galectin Expression in Colectomised Patients with Ulcerative Colitis

    Mattias Block


    Full Text Available Introduction. The aetiology and pathogenesis of ulcerative colitis (UC are essentially unknown. Galectins are carbohydrate-binding lectins involved in a large number of physiological and pathophysiological processes. Little is known about the role of galectins in human UC. In this immunohistochemical exploratory study, both epithelial and inflammatory cell galectin expression were studied in patients with a thoroughly documented clinical history and were correlated with inflammatory activity. Material and Methods. Surgical whole intestinal wall colon specimens from UC patients (n=22 and controls (n=10 were studied. Clinical history, pharmacological treatment, and modified Mayo-score were recorded. Tissue inflammation was graded, and sections were stained with antibodies recognizing galectin-1, galectin-2, galectin-3, and galectin-4. Results. Galectin-1 was undetectable in normal and UC colonic epithelium, while galectin-2, galectin-3, and galectin-4 were strongly expressed. A tendency towards diminished epithelial expression with increased inflammatory grade for galectin-2, galectin-3, and galectin-4 was also found. In the inflammatory cells, a strong expression of galectin-2 and a weak expression of galectin-3 were seen. No clear-cut correlation between epithelial galectin expression and severity of the disease was found. Conclusion. Galectin expression in patients with UC seems to be more dependent on disease focality and individual variation than on degree of tissue inflammation.

  1. Caries assessment: establishing mathematical link of clinical and benchtop method

    Amaechi, Bennett T.


    It is well established that the development of new technologies for early detection and quantitative monitoring of dental caries at its early stage could provide health and economic benefits ranging from timely preventive interventions to reduction of the time required for clinical trials of anti-caries agents. However, the new technologies currently used in clinical setting cannot assess and monitor caries using the actual mineral concentration within the lesion, while a laboratory-based microcomputed tomography (MCT) has been shown to possess this capability. Thus we envision the establishment of mathematical equations relating the measurements of each of the clinical technologies to that of MCT will enable the mineral concentration of lesions detected and assessed in clinical practice to be extrapolated from the equation, and this will facilitate preventitive care in dentistry to lower treatment cost. We utilize MCT and the two prominent clinical caries assessment devices (Quantitative Light-induced Fluorescence [QLF] and Diagnodent) to longitudinally monitor the development of caries in a continuous flow mixed-organisms biofilm model (artificial mouth), and then used the collected data to establish mathematical equation relating the measurements of each of the clinical technologies to that of MCT. A linear correlation was observed between the measurements of MicroCT and that of QLF and Diagnodent. Thus mineral density in a carious lesion detected and measured using QLF or Diagnodent can be extrapolated using the developed equation. This highlights the usefulness of MCT for monitoring the progress of an early caries being treated with therapeutic agents in clinical practice or trials.

  2. Localization of West Nile Virus in monkey brain: double staining antigens immunohistochemically of neurons, neuroglia cells and West Nile Virus

    He, Xianli; Ren, Junping; Xu, Fangling; Ferguson, Monique R; Li, Guangyu


    West Nile virus (WNV) can cause encephalitis or meningitis that affects brain tissue, which can also lead to permanent neurological damage that can be fatal. To our knowledge, no consistent double immunohistochemical staining of neurons, neuroglia cells, and WNV has yet been reported. To establish a method for performing double-label immunohistochemical detection of neurons, neuroglia cells and WNV, examining the pathological characteristics of WNV-infected neurons, neuroglia cells, and inves...

  3. Merkel cell carcinoma with an unusual immunohistochemical profile

    L. Pilloni


    Full Text Available The clinical and morphological picture of Merkel cell carcinoma (MCC may be rather challenging; therefore, the immunohistochemical profile plays a relevant role in confirming the microscopic diagnosis. A panel of antibodies including cytokeratins 20, 7 and epithelial membrane antigen, and neuronspecific enolase is used in confirming the morphological diagnosis of MCC. The majority of MCCs express CK20 and are CK7-negative. Herein, we present a case of primary cutaneous neuroendocrine carcinoma with an atypical immunohistochemical pattern. A 83-years old woman presented with a painless plaque, red to violaceous in colour, located in the leg. The skin tumor was excided, formalin-fixed and paraffinembedded. Tissue sections were immunostained with a panel of antibodies routinely utilized in complex primary skin tumors for evidencing epithelial and neuroendocrine differentiation of tumor cells. The neuroendocrine differentiation of tumor cells was evidenced by their immunoreactivity for synaptophysin, chromograninA and neuron-specific enolase. Tumor cells also showed diffuse cytoplasmic staining for CK7. No immunoreactivity was detected for CK20 and thyroid transcription factor-1. Our data, together with previous rare reports of CK20-/CK7+ MCCs, lay stress on the importance of routinely utilizing a panel of antibodies in the differential diagnosis of complex primary carcinomas of the skin and may have important implications in expanding the differential diagnosis of skin tumors. In particular, caution should be taken in excluding the diagnosis of MCC only on the basis of the absence of reactivity of tumor cells for CK20, favouring the wrong diagnosis of less aggressive skin tumors.

  4. Quantitative comparison of immunohistochemical staining measured by digital image analysis versus pathologist visual scoring

    Rizzardi Anthony E


    Full Text Available Abstract Immunohistochemical (IHC assays performed on formalin-fixed paraffin-embedded (FFPE tissue sections traditionally have been semi-quantified by pathologist visual scoring of staining. IHC is useful for validating biomarkers discovered through genomics methods as large clinical repositories of FFPE specimens support the construction of tissue microarrays (TMAs for high throughput studies. Due to the ubiquitous availability of IHC techniques in clinical laboratories, validated IHC biomarkers may be translated readily into clinical use. However, the method of pathologist semi-quantification is costly, inherently subjective, and produces ordinal rather than continuous variable data. Computer-aided analysis of digitized whole slide images may overcome these limitations. Using TMAs representing 215 ovarian serous carcinoma specimens stained for S100A1, we assessed the degree to which data obtained using computer-aided methods correlated with data obtained by pathologist visual scoring. To evaluate computer-aided image classification, IHC staining within pathologist annotated and software-classified areas of carcinoma were compared for each case. Two metrics for IHC staining were used: the percentage of carcinoma with S100A1 staining (%Pos, and the product of the staining intensity (optical density [OD] of staining multiplied by the percentage of carcinoma with S100A1 staining (OD*%Pos. A comparison of the IHC staining data obtained from manual annotations and software-derived annotations showed strong agreement, indicating that software efficiently classifies carcinomatous areas within IHC slide images. Comparisons of IHC intensity data derived using pixel analysis software versus pathologist visual scoring demonstrated high Spearman correlations of 0.88 for %Pos (p  Virtual slides The virtual slide(s for this article can be found here:

  5. Immunohistochemical study of the expression of cell cycle regulating proteins at different stages of bladder cancer

    Primdahl, Hanne; Maase, Hans von der; Sørensen, Flemming B.; Wolf, Hans; Ørntoft, Torben Falck


    PURPOSE: The cell cycle is known to be deregulated in cancer. We therefore analyzed the expression of the cell cycle related proteins p21, p27, p16, Rb, and L-myc by immunohistochemical staining of bladder tumors. METHODS: The tissue material consisted of bladder tumors from three groups of...

  6. Immunohistochemical expression of platelet-derived growth factor receptors in ovarian cancer patients with long-term follow-up

    Madsen, Christine Vestergaard; Dahl Steffensen, Karina; Waldstrøm, Marianne; Jakobsen, Anders


    seen more often in serous adenocarcinomas than in nonserous adenocarcinomas. No clear correlation between PDGFR expression and longterm overall survival or clinical parameters was found. Conclusions. PDGFR-α and PDGFR-β were expressed in a subset of ovarian carcinomas but did not show significant...... relation to histopathological parameters and long-term overall survival. Methods. The immunohistochemical expression of PDGFR-α and PDGFR-β was investigated in tumor and stromal cells in 170 patients with histologically verified epithelial ovarian cancer. Results. Almost half of the tumor specimens showed...... high expression of PDGFR-α and PDGFR-β in tumor cells (43% and 41%) and in stromal compartments (32% and 44%). There was a significant association between high expression of PDGFR-α and high expression of PDGFR-β in both tumor and stromal cells. Coexpression of PDGFR-α and PDGFR-β in stromal cells was...

  7. Methods to improve the efficiency of confirmatory clinical trials

    Boessen, R.


    The development of new drugs is increasingly costly and ineffective. Most time and money is accounted for by late-stage clinical trials that aim to confirm the safety and efficacy of the investigated drug. To assure the continued arrival of new and affordable therapies, it is therefore essential to

  8.  Immunohistochemical Expression of ki-67 and p53 in Colorectal Adenomas: A Clinicopathological Study

    Hussam Hasson Ali


    Full Text Available  Objectives: To evaluate the significance of P53 and Ki-67 expression as immunohistochemical markers in early detection of premalignant changes in different types of colorectal adenomas. Also, to correlate immunohistochemical expression of the two markers with different clinicopathological parameters including; age, and sex of the patient, type, site, size and grade of dysplasia of colorectal adenomas.Methods: Forty-seven polypectomy specimens of colorectal adenomas were retrieved from the archival materials of the Gastrointestinal and Hepatic Diseases Teaching Hospital in Baghdad from 2009 - 2010. Four µm section specimens were stained by immunohistochemical technique with Ki-67 and P53 tumor markers. P-values <0.05 were considered statistically significant.Results: Immunohistochemical expressions of Ki-67 and P53 had a significant correlation with the size and grade of dysplasia in colorectal adenomas. However, there was no significant correlation among the immunohistochemical expression of Ki-67 and P53 with the age and gender of the patient, and the type and site of colorectal adenomas. There was no significant correlation between Ki-67 and P53 expressions in colorectal adenomas. Villous adenomas of colorectum showed a significant correlation with the grade of dysplasia, while there was no significant correlation between size and site of colorectal adenoma with the grade of dysplasia.Conclusion: High grade dysplasia with significant positive immunohistochemical markers of Ki-67 and P53 could be valuable parameters for selecting from the total colorectal adenoma population, those most deserving of close surveillance in follow-up cancer prevention programs. It is closely linked with increasing age particularly in patients with a large size adenoma of villous component in their histology.

  9. Scrub typhus hepatitis confirmed by immunohistochemical staining

    Jong-Hoon Chung; Sung-Chul Lim; Na-Ra Yun; Sung-Heui Shin; Choon-Mee Kim; Dong-Min Kim


    Scrub typhus is an acute febrile disease caused by Orientia tsutsugamushi (O.tsutsugamushi).We report herein the case of a woman who presented with fever and elevated serum levels of liver enzymes and who was definitively diagnosed with scrub typhus by histopathological examination of liver biopsy specimens,serological tests and nested polymerase chain reaction.Immunohistochemical staining using a monoclonal anti-O.tsutsugamushi antibody showed focally scattered positive immunoreactions in the cytoplasm of some hepatocytes.This case suggests that scrub typhus hepatitis causes mild focal inflammation due to direct liver damage without causing piecemeal necrosis or interface hepatitis.Thus,scrub typhus hepatitis differs from acute viral hepatitis secondary to liver damage due to host immune responses,which causes severe Iobular disarray with diffuse hepatocytic degeneration,necrosis and apoptosis as well as findings indicative of hepatic cholestasis,such as hepatic bile plugs or brown pigmentation of hepatocytes.

  10. Synthetic–schematic representation of the model of clinical diagnostic-therapeutic method

    Luis Alberto Corona Martínez


    The use of a systemic approach in the theoretical analysis of the clinical method has allowed the elaboration of an schematic and synthetic representation of the new model of clinical diagnostic- therapeutic method developed from the conception of the medical assistance as a taking decisions process. The identification of the main components of the clinical method system, as well as of the interrelations established among these, facilitate the understanding of the medical attention process, a...

  11. Peritoneal Malignant Mesothelioma with Epithelioid Type, Demonstrating High Serum and Ascitic KL-6 Levels: Immunohistochemical Analyses

    Saifun Nahar; Manabu Nakamoto; Akira Hokama; Chiharu Kobashigawa; Masatoshi Kaida; Tetsu Kinjo; Tetsuo Hirata; Nagisa Kinjo; Masanao Saio; Naoki Yoshimi; Yuji Ohtsuki; Jiro Fujita


    We report a case of KL-6 producing peritoneal malignant mesothelioma. A 56-year-old woman was referred to our hospital on November 2005 with severe abdominal distention. Peritoneal malignant mesothelioma with epithelioid type was diagnosed by clinical symptoms, laboratory investigations, imaging studies, and immunohistochemical examination of known tumor markers. In addition, high serum and ascitic KL-6 levels were observed and the immunostaining of the tumor for KL-6 was evident. We thus con...

  12. Immunohistochemical Studies on Galectin Expression in Colectomised Patients with Ulcerative Colitis

    Mattias Block; Johan Mölne; Hakon Leffler; Lars Börjesson; Breimer, Michael E


    Introduction. The aetiology and pathogenesis of ulcerative colitis (UC) are essentially unknown. Galectins are carbohydrate-binding lectins involved in a large number of physiological and pathophysiological processes. Little is known about the role of galectins in human UC. In this immunohistochemical exploratory study, both epithelial and inflammatory cell galectin expression were studied in patients with a thoroughly documented clinical history and were correlated with inflammatory activity...

  13. Immunohistochemical studies of the periodontal membrane in primary teeth

    Bille, Marie-Louise Bastholm; Nolting, Dorrit; Kjær, Inger


    Objectives. To describe the periodontal membrane of human primary teeth immunohistochemically, while focusing on the epithelial layer of Malassez, fibers, and peripheral nerves, and to compare the findings with those of a previous study of human permanent teeth. Material and methods. Nineteen human...... primary teeth extracted in late childhood in connection with treatment were fixed, decalcified, dehydrated, and embedded in paraffin. Paraffin sections were stained with wide spectrum screening (WSS), Vimentin, and NeuN in order to mark the epithelial layer of Malassez, fibers, and peripheral nerves...... could be identical to those in regions with no resorption. Conclusion. In regions without resorption, spatial organization of the periodontal membrane of primary teeth was similar to that of permanent teeth, although the number and distribution of epithelial cells and fibers differed. In regions with...

  14. Distribution and prognostic value of histopathologic data and immunohistochemical markers in gastrointestinal stromal tumours (GISTs): an analysis of the EORTC phase III trial of treatment of metastatic GISTs with imatinib mesylate

    Sciot, R.; biec-Rychter, M.; Daugaard, S.;


    RATIONALE: The 62005 EORTC phase III trial, comparing two doses of imatinib in patients with advanced GIST, reported a median progression-free survival of 25 months with a trend towards dose dependency for progression-free survival. The current analysis of that study aimed to assess whether...... histological/immunohistochemical parameters correlate with clinical response to imatinib. PATIENTS AND METHODS: Pre-treatment samples of GISTs from 546 patients enroled in phase III study were analysed for immunohistochemical characteristics, correlations with clinicopathological data, with survival and with...... GIST in terms of immunophenotypic expression, but indicate that these parameters have no impact on the outcome of the patients under imatinib treatment Udgivelsesdato: 2008/9...

  15. Bibliography of clinical research in malaysia: methods and brief results.

    Teng, C L; Zuhanariah, M N; Ng, C S; Goh, C C


    This article describes the methodology of this bibliography. A search was conducted on the following: (1) bibliographic databases (PubMed, Scopus, and other databases) using search terms that maximize the retrieval of Malaysian publications; (2) Individual journal search of Malaysian healthrelated journals; (3) A targeted search of Google and Google Scholar; (4) Searching of Malaysian institutional repositories; (5) Searching of Ministry of Health and Clinical Research Centre website. The publication years were limited to 2000- 2013. The citations were imported or manually entered into bibliographic software Refworks. After removing duplicates, and correcting data entry errors, PubMed's Medical Subject Headings (MeSH terms) were added. Clinical research is coded using the definition "patient-oriented-research or research conducted with human subjects (or on material of human origin) for which the investigator directly interacts with the human subjects at some point during the study." A bibliography of citations [n=2056] that fit the criteria of clinical research in Malaysia in selected topics within five domains was generated: Cancers [589], Cardiovascular diseases [432], Infections [795], Injuries [142], and Mental Health [582]. This is done by retrieving citations with the appropriate MESH terms, as follow: For cancers (Breast Neoplasms; Colorectal Neoplasms; Uterine Cervical Neoplasms), for cardiovascular diseases (Coronary Disease; Hypertension; Stroke), for infections (Dengue; Enterovirus Infections, HIV Infections; Malaria; Nipah Virus; Tuberculosis), for injuries (Accidents, Occupational; Accidents, Traffic; Child Abuse; Occupational Injuries), for mental health (Depression; Depressive Disorder; Depressive Disorder, Major; Drug Users; Psychotic Disorders; Suicide; Suicide, Attempted; Suicidal Ideation; Substance- Related Disorders). PMID:25417946

  16. Activity and immunohistochemical localization of porphobilinogen deaminase in rat tissues

    Jørgensen, P E; Erlandsen, E J; Poulsen, Steen Seier;


    the activity and the immunohistochemical localization of PBGD in the following tissues of wistar female rats: brain, heart, submandibular gland, liver, kidney, pancreas, ovary, stomach, duodenum, jejunum, ileum, colon and musculature. The PBGD activity varied considerably among the tissues. It was highest...... in the intestine. Especially, the immunohistochemical reaction in nerve cells is notable considering the nervous dysfunction in AIP....

  17. The clinical method and the scientific method El método clínico y el método científico.

    José Arteaga Herrera; José A Fernández Sacasas


    This paper is the chapter dedicated to the scientific method and the clinical method in the authors’ Handbook “Teaching of Clinics”. Philosophycal principles of the scientific method and its stages are presented as well as the clinical method as a scientific one and its stages. A relationship between the clinical method and the medical record is established, the role of technology in the clinical method is stated and the most frequent mistakes when applying it in clinical practice are provide...

  18. Body composition : methods of measurement, normative values and clinical use

    Genton Graf, Laurence


    Measurement of body composition is an important part of nutritional assessment. The low FFM associated with malnutrition has been associated with numerous infectious and noninfectious complications, increasing length of stay, morbidity and mortality. DXA and TBK are reference method for determination of FFM and BCM, but, as these methods are expensive and require extensive technique of the operator, we have focused especially on BIA, an easy, quick, safe and reliable bedside method to measure...

  19. Reporting and Methods in Clinical Prediction Research: A Systematic Review

    Bouwmeester, W; Zuithoff, NP; Mallett, S.; Geerlings, MI; Vergouwe, Y.; Steyerberg, EW; Altman, DG; Moons, KG


    Editors' Summary Background There are often times in our lives when we would like to be able to predict the future. Is the stock market going to go up, for example, or will it rain tomorrow? Being able predict future health is also important, both to patients and to physicians, and there is an increasing body of published clinical “prediction research.” Diagnostic prediction research investigates the ability of variables or test results to predict the presence or absence of a specific diagnos...

  20. Computerized methods for the clinical interpretation of myocardial scintigrams

    Itti, R.; Benjelloun, L.; Benjelloun, H.; Rosenberg, S.; Laudet, M.


    Computer processing of medical images is mainly used in order to improve the image quality or to derive some quantitative data from the study. Clinical interpretation of the pictures is usually based on criteria which depend on the experience of the observer, who decides to establish a relationship between the results of the study and the clinical situation of the patient. Computerized classification techniques may overcome the operator variability and optimize the criteria which affect pictures to normal or various pathological classes. In order to test the ability of factorial discriminant analysis to interpret thallium-201 myocardial scintigrams, 207 studies (at rest = 95, after stress + redistribution = 50, after dipyridamole + redistribution = 62) performed in patients undergoing coronary angiography have been first evaluated using various criteria of increasing severity, according to a regional tracer uptake model with 10 territories. The receiver operating characteristics (ROC) curves demonstrated, that sensitivity and specificity varied in opposite directions, a high sensitivity (89% to 100%) being only achieved when accepting a lack of specificity (33% to 57%). Discriminant analysis, on the contrary, provided for each type of scintigraphic protocol a single optimal combination of sensitivity (74% to 87%) and specificity (92% to 100%).

  1. Morphological and immunohistochemical characterisation of seminomas in Norwegian dogs

    Thorvaldsen Tor


    Full Text Available Abstract Background Seminomas in the dog have traditionally been assumed to resemble human spermatocytic seminomas, based on their low malignancy and high occurrence in old individuals. However, recently published studies indicate that canine seminomas can be classified as classical and spermatocytic seminomas in a similar way as in man, and that classical seminomas comprise a substantial proportion of seminomas in the dog. These two factors both contribute to increasing the potential of canine seminoma as a relevant model for human testicular cancer. The aim of the present study was to characterise seminoma in Norwegian dogs using morphology and immunohistochemistry, and determine whether these tumours are comparable with human classical seminoma. Methods By applying diagnostic criteria from human pathology, 45 seminomas from the Norwegian Canine Cancer Register were examined histologically with hematoxylin and eosin (HE and periodic acid-Schiff (PAS stains. All sections were stained immunohistochemically with antibodies against human placental alkaline phosphatase (PLAP and the transmembrane receptor c-KIT. Results Although two of the seminomas showed immunohistochemical staining characteristics indicative of classical seminoma (PLAP+/c-KIT+, all 45 examined seminomas were morphologically consistent with spermatocytic seminoma. Conclusions The value of canine seminoma as a model for SE in man remains unclear. Among the 45 investigated tumours from Norwegian dogs, none were classified as classical seminoma based on morphological criteria consistent with human seminomas. Regional or breed differences in the occurrence of classical seminoma in the dog, as well as the lack of uniform diagnostic criteria, might explain the discrepancy between the findings in the current study and the results presented by other authors.

  2. An Enzymatic Clinical Chemistry Laboratory Experiment Incorporating an Introduction to Mathematical Method Comparison Techniques

    Duxbury, Mark


    An enzymatic laboratory experiment based on the analysis of serum is described that is suitable for students of clinical chemistry. The experiment incorporates an introduction to mathematical method-comparison techniques in which three different clinical glucose analysis methods are compared using linear regression and Bland-Altman difference…

  3. Evaluation of immunohistochemical expression of P-glycoprotein in neoplasms of the mammary gland in bitches.

    Badowska-Kozakiewicz, A M; Malicka, E


    The aim of the study was to investigate the P-glycoprotein expression in correlation with other neoplasm traits such as: histological type, the differentiation grade, proliferative activity, expression of the cyclooxygenase-2. Material for the investigation comprised 50 tumours of the mammary gland collected from bitches during surgical procedures performed in Warsaw Veterinary Clinics and Small Animal Clinic of the Department of Clinical Sciences, Faculty of Veterinary Medicine, Warsaw University of Life Sciences - SGGW. All together 8 adenomas, 22 complex carcinomas, 15 simple carcinomas and 5 solid carcinomas. In case of cancers, the degree of histological malignancy was established: 1st degree of histological malignancy--18 neoplasms, 2nd degree of histological malignancy--14 neoplasms and 3rd degree of histological malignancy--10 neoplasms. Evaluations were conducted with histopathological and immunohistochemical methods using suitable antibodies. Proliferative activity was highly dependent on type of the neoplasm and the degree of histological malignancy. The highest value of the mitotic index was characteristic for solid and simple cancers and neoplasms with the highest degree of histological malignancy. Results of expression of the nuclear antigen Ki-67 were similar. Expression of P-glycoprotein was revealed in all types of neoplasms. The expression of P-glycoprotein was identified in cytoplasm and cell membranes of neoplastic cells. Positive expression of P-gp was observed in 76% of cancers. Complex carcinomas were the biggest group among the cancer types which demonstrated positive reaction of P-gp. High expression of P-gp was also established in cancers with the highest degree of malignancy. In bitches aged 9 through 12 years, the cancers featuring a positive reaction of P-gp constituted the most numerous group (63.2%); on the other hand, this cancer type barely appeared in the oldest bitches (10.5%). PMID:20731191



    Objective: To study the potential role of cellular macrophageolony-stimulating factor (cM-CSF) and cellular macrophage colony-stimulating factor receptor (cM-CSF-R) with breast cancer and hepatoma and search the way for clinical application. Methods: Frozen surgical specimens from 48 breast cancer patients, including 29 cases of histological grade II and 19 eases of grade III, and 16 hepatoma patients were investigated by Avidin Biotin Complex (ABC) immunohistochemical assay with anti-M-CSF monoclonal antibody (Mab) and anti-M-CSF-R Mab. Pathohistological examination was performed as well. Results: cM-CSF and cM-CSF-R were detected in tested specimens. The expression levels of cM-CSF and cM-CSF-R in grade III group were higher than in grade II group and more higher than control group hyperplasia of breast. Hepatoma tissues also showed higher expression level of cM-CSF and cM-CSF-R than normal adult and fetal liver. Conclusion: Breast cancer and hepatoma tissues presented higher expression levels of cM-CSF and cM-CSF-R than control and expression level might be related with tumor's process.

  5. Detection of colorectal carcinomas by intraoperative RIS in addition to preoperative RIS: Surgical and immunohistochemical findings

    The immunoscintigraphic detection of tumour foci 99mTc located close to the collimator hole were measured with absolute sensitvity of 100 cps=2.5 kBq 99mTc. The unfavourably high background activity affected both the in vitro and in vivo analysis: SPET results had been considered positive in 8 of 15 cases. In vitro tumour/non-tumour (t/nt) ratios >2.0 were found in 4 cases. In vivo IOSM resulted in t/nt ratios >2.0 in only 3 patients. In most cases, there was no coincidence of elevated t/nt ratios from the different methods. A correlation was derived between positive immunoscintimetric in vitro findings and immunohistochemically proven interstitial localization of CEA in tumor cells. In conclusion, the measurement technique of IOSM seems adequate, but clinical success will depend on a more specific enrichment of MoA in tumour tissue. Future in vivo studies should be performed mainly in cases with a positive immunohistochemistry (interstitial CEA localization) result for the primary tumour. (orig.)

  6. Immunohistochemical molecular markers as predictors of curability of endoscopically resected submucosal colorectal cancer


    AIM: To clarify the usefulness of immunohistochemical molecular markers in predicting lymph node metastasis of submucosal colorectal cancer.METHODS: We examined microvessel density, lymphatic vessel density, the Ki-67 labeling index, expression of MUC1 and Matrix metalloproteinase-7 (MMP-7) in tumor cells, and expression of cathepsin D in stromal cells at the invasive front by immunostaining of samples resected from 214 patients with submucosal colorectal cancer.Pathologic features were assessed on hematoxylin-eosinstained samples. We evaluated the relations between clinicopathologic/immunohistochemical features and lymph node metastasis.RESULTS: Lesions of the superficial type, with an unfavorable histologic grade, budding, lymphatic involvement, high microvessel density (≥ 40), high lymphatic vessel density (≥ 9), high Ki-67 labeling index (≥ 42), and positivity of MUC1, cathepsin D, and MMP-7 showed a significantly high incidence of lymph node metastasis. Multivariate analysis revealed that high microvessel density, unfavorable histologic grade,cathepsin D positivity, high lymphatic vessel density,superficial type, budding, and MUC1 positivity were independent risk factors for lymph node metastasis.A combined examination with four independent immunohistochemical markers (microvessel density,cathepsin D, lymphatic vessel density, and MUC1)revealed that all lesions that were negative for all markers or positive for only one marker were negative for lymph node metastasis.CONCLUSION: Analysis of a combination of immunohistochemical molecular markers in endoscopically resected specimens of submucosal colorectal cancer allows prediction of curability regardless of the pathologic features visible of hematoxylin-eosin-stained sections.

  7. [Auto-analysis of immunohistochemical findings for breast cancer using specified software and virtual microscopy].

    Tanaka, Miho; Kuraoka, Kazuya; Sakane, Junichi; Kodama, Yoko; Nishimura, Toshinao; Tanaka, Masazumi; Tatsushima, Junji; Saitou, Akihisa; Taniyama, Kiyomi


    Currently, the therapeutic strategy for a breast cancer patient is designed according to their histopathological, immunohistochemical and molecular findings. These findings are obtained through the collected efforts of many individual pathologists or medical technologists (MTs) and are, thus, limited by intra-observer error and potentially subjective decision making. Twenty five breast cancer specimens collected between November 2009 and February 2010 were examined for immunohistochemical expressions of estrogen receptor (ER), progesterone receptor (PgR), HER2, Ki-67, Topoisomerase II alpha (Topo IIalpha). Fifty one cancer specimens collected November 2009 and June 2010 were examined for human epidermal growth factor 2 (HER2). Immunohistochemical staining was performed using auto-stainers (Ventana) and the results were stored digitally after examination by virtual microscopy (Hamamatsu Photonics). Data analysis was performed with the Genie/Aperio software package on a desk-top computer. For all the antibodies used expect for HER2, concordant results were obtained in 100% of 24 ER positive cases. Ki-67 index (r=0.96) and Topo IIalpha index (r=0.95) also showed a significant correlation (p<0.001). For HER2, all four specimens with Hercep-score 2 by ocular observation but auto-analysis score 1 revealed no HER2 gene amplification. Well-organized auto-analysis is more likely to result in an objective observation and to provide a means by which to standardize the methods for immunohistochemical detection of breast cancer. PMID:22568082

  8. Ductular proliferation in liver tissues with severe chronic hepatitis B: An immunohistochemical study

    Yao-Kai Chen; Xu-Xia Zhao; Jun-Gang Li; Song Lang; Yu-Ming Wang


    AIM: To clarify the pathogenesis of ductular proliferation and its possible association with oval cell activation and hepatocyte regeneration.METHODS: Immunohistochemical staining and image analysis of the ductular structures in the liver tissues from 11 patients with severe chronic hepatitis B and 2healthy individuals were performed. The liver specimens were sectioned serially, and then cytokeratin 8 (CK8),CK19, OV6, proliferating cell nuclear antigens (PCNA),glutathione-S-transferase (GST), o-fetal protein (AFP)and albumin were stained immunohistochemically.RESULTS: Typical and atypical types of ductular proliferation were observed in the portal tracts of the liver tissues in all 11 patients. The proliferating ductular cells were positive for CK8, CK19, OV6 and PCNA staining.Some atypical ductular cells displayed the morphological and immunohistochemical characteristics of hepatic oval cells. Some small hepatocyte-like cells were between hepatic oval cells and mature hepatocytes morphometrically and immunohistochemically.CONCLUSION: The proliferating ductules in the liver of patients with severe chronic liver disease may have different origins. Some atypical ductular cells are actually activated hepatic oval cells. Atypical ductular proliferation is related to hepatocyte regeneration and small hepatocyte-like cells may be intermediate transient cells between hepatic oval cells and mature hepatocytes.

  9. The assessment of irritation using clinical methods and questionnaires

    Kjærgaard, Søren K.; Hogdson, M.


    , inflammation, and hyperemia. Methods for detecting nasal mucosa irritation include measuring swelling of the nasal mucosa, peak airflows through the nose, acoustic rhinometry, and rhinostereometry, which measures thickness of the anterior nasal turbinate. Questionnaires are useful for defining a set of...

  10. Interleaved Carbon Minibeams: An Experimental Radiosurgery Method With Clinical Potential

    Dilmanian, F. Avraham, E-mail: [Medical Department, Brookhaven National Laboratory, Upton, NY (United States); Department of Radiation Oncology, Stony Brook University Medical Center, NY (United States); Department of Neurology, Stony Brook University Medical Center, NY (United States); Rusek, Adam [NASA Space Radiation Laboratory, Brookhaven National Laboratory, Upton, NY (United States); Fois, Giovanna R. [Medical Department, Brookhaven National Laboratory, Upton, NY (United States); Physics Department, University of Cagliari, Sardinia (Italy); Olschowka, John [Department of Neurobiology and Anatomy, University of Rochester, Rochester, NY (United States); Desnoyers, Nicolle R. [Medical Department, Brookhaven National Laboratory, Upton, NY (United States); Ross University School of Veterinary Medicine, Basseterre, St. Kitts, West Indies (Country Unknown); Park, Jane Y. [Medical Department, Brookhaven National Laboratory, Upton, NY (United States); College of Veterinary Medicine, Cornell University, Ithaca, NY (United States); Dioszegi, Istvan [Nonproliferation and National Security Department, Brookhaven National Laboratory, Upton, NY (United States); Dane, Bari; Wang Ruiliang [Medical Department, Brookhaven National Laboratory, Upton, NY (United States); Tomasi, Dardo [Medical Department, Brookhaven National Laboratory, Upton, NY (United States); National Institute on Alcoholism and Alcohol Abuse, Bethesda, MD (United States); Lee, Hedok [Medical Department, Brookhaven National Laboratory, Upton, NY (United States); Hurley, Sean D. [Department of Neurobiology and Anatomy, University of Rochester, Rochester, NY (United States); Coyle, Patricia K. [Department of Neurology, Stony Brook University Medical Center, NY (United States); Meek, Allen G. [Department of Radiation Oncology, Stony Brook University Medical Center, NY (United States); O' Banion, M. Kerry [Department of Neurobiology and Anatomy, University of Rochester, Rochester, NY (United States)


    Purpose: To evaluate the efficacy of 'interleaved carbon minibeams' for ablating a 6.5-mm target in a rabbit brain with little damage to the surrounding brain. The method is based on the well-established tissue-sparing effect of arrays of thin planes of radiation. Methods and Materials: Broad carbon beams from the National Aeronautics and Space Agency Space Radiation Facility at Brookhaven National Laboratory were segmented into arrays of parallel, horizontal, 0.3-mm-thick planar beams (minibeams). The minibeams' gradual broadening in tissues resulted in 0.525-mm beam thickness at the target's proximal side in the spread-out Bragg peak. Interleaving was therefore implemented by choosing a 1.05 mm beam spacing on-center. The anesthetized rabbit, positioned vertically on a stage capable of rotating about a vertical axis, was exposed to arrays from four 90 Degree-Sign angles, with the stage moving up by 0.525 mm in between. This produced a solid radiation field at the target while exposing the nontargeted tissues to single minibeam arrays. The target 'physical' absorbed dose was 40.2 Gy. Results: The rabbit behaved normally during the 6-month observation period. Contrast magnetic resonance imaging and hematoxylin and eosin histology at 6 months showed substantial focal target damage with little damage to the surrounding brain. Conclusion: We plan to evaluate the method's therapeutic efficacy by comparing it with broad-beam carbon therapy in animal models. The method's merits would combine those of carbon therapy (i.e., tight target dose because of the carbon's Bragg-peak, sharp dose falloff, and high relative biological effectiveness at the target), together with the method's low impact on the nontargeted tissues. The method's smaller impact on the nontargeted brain might allow carbon therapy at higher target doses and/or lower normal tissue impact, thus leading to a more effective treatment of radioresistant

  11. Methods and clinical applications of positron emission tomography in endocrinology

    Positron emission tomography (PET) allows to detect in coincidence photons issued from annihilation between positrons and electrons nearby situated. Tomographic detection (plane by plane) and tomographic reconstruction will lead to the quantitation of radioactive distribution per voxel, in the organ of interest. Recent tomographs can acquire simultaneously several transaxial slices, with a high sensitivity and a spatial resolution of 3-5 mm. Commonly used positron emitters have a short half-life: 2, 10, 20 and 110 min for 150, 13N, 11C and 18F, respectively. The use of these isotopes requires on line production of radionuclides and synthesis of selected molecules. In endocrinology, PET allows among others to study noninvasively the receptor density of hormonodependent neoplasms such as breast, uterus, prostate tumors and prolactinomas. These last tumors represent a particular entity because of several combined characteristics: high turnover rate of amino acids, high density of dopaminergic receptors and response to bromocriptine (analogue of dopamine inhibiting the secretion of prolactine) in relation to the level of receptors. Because PET permits to evaluate the density of dopaminergic receptors and the metabolism of amino acids, theoretical response of the prolactinoma to bromocriptin can be predicted, the achieved therapeutic efficacy can be estimated and the long-term follow up of tumor growth can be assessed. This example illustrates the clinical value of PET in endocrinology

  12. Topographic EEG analysis. Methods for graphic representation and clinical applications.

    Scarpino, O; Guidi, M; Bolcioni, G


    Topographic EEG analysis includes different techniques to display the spatial distribution of brain electrical activity. The correct reconstruction of the scalp potentials and the consequent inference on cortical generators is influenced by many factors. In this study we focused our attention on the topographical representation of high resolution spectral EEG parameters, the choice of the interpolation algorithms for EEG mapping and the application of a spatial filtering method to scalp potential distribution. From our results there is evidence that different approaches are needed with relation to the EEG spatial features to be detected. The actual standard procedures seem not entirely adequate and the new methods proposed can improve significantly the visual reading of the EEG and its sensitivity. PMID:2082724

  13. Clinical trial of three treatment methods for pterygium

    LI Ying; WU Li-an; ZHANG Lin; MA Qiang


    Objective:To study the effect of simple excision, amniotic membrane transplantation(AMT)and limbal-conjunctival autograft transplantation(LCAT)for treating pterygium. Methods: Forty-eight cases (48 eyes) with pterygium were randomly assigned to 3 groups:16 cases (16 eyes) with pterygium underwent simple excision (group A), 16 eyes underwent amniotic membrane transplantation (AMT) (group B), and 16 eyes with pterygia underwent limbal- conjunctival transplantation (group C).Results: With follow-up of 3 months to 25 months, 5 cases (31%) of pterygia in group A and 1 case (6.2%) of pterygia in group B showed recurrence. No patients in group C developed recurrence. Conclusion: The recurrent rate of pterygium after amniotic membrane transplantation and limbal-conjunctival autograft transplantation were much lower, but the latter was more simple, safe and no rejection .So limbal - conjunctival autograft transplantation is the best surgery method for pterygium.

  14. New evidence-based adaptive clinical trial methods for optimally integrating predictive biomarkers into oncology clinical development programs

    Robert A.Beckman; Cong Chen


    Predictive biomarkers are important to the future of oncology; they can be used to identify patient populations who will benefit from therapy,increase the value of cancer medicines,and decrease the size and cost of clinical trials while increasing their chance of success.But predictive biomarkers do not always work.When unsuccessful,they add cost,complexity,and time to drug development.This perspective describes phases 2 and 3 development methods that efficiently and adaptively check the ability of a biomarker to predict clinical outcomes.In the end,the biomarker is emphasized to the extent that it can actually predict.

  15. Fluoroscope guided epidural needle insertioin in midthoracic region: clinical evaluation of Nagaro's method

    Kim, Won Joong; Kim, Tae Hwa; Shin, Hwa Yong; Kang, Hyun; Baek, Chong Wha; Jung, Yong Hun; Woo, Young Cheol; Kim, Jin Yun; Koo, Gill Hoi; Park, Sun Gyoo


    Background In the midthoracic region, a fluroscope guided epidural block has been proposed by using a pedicle as a landmark to show the height of the interlaminar space (Nagaro's method). However, clinical implication of this method was not fully evaluated. We studied the clinical usefulness of a fluoroscope guided thoracic epidural block in the midthoracic region. Methods Twenty four patients were scheduled to receive an epidural block at the T6-7 intervertebral space. The patients were plac...

  16. Clinical value of some hematological methods applying radioisotopes

    A review of some widely used haematological diagnostic methods in which radioactive isotopes are applied. Plasma iron clearance, plasma iron turnover, red cell utilization and erythrocyte iron turnover are carried out by means of 59Fe. The same radioisotope is used for surface detection above the heart, liver, spleen, and sacral region. Plasma levels of ferritin, vitamin B12, and folic acid can be determined by radioimmunoassays applying as tracer 125I, 57Co and 125I respectively. The normal values of these tests are indicated as well as some pathological reasons of abnormal values. (L.E.) 13 refs.; 3 figs

  17. Methods Used in Internal Industry Clinical Trials to Assess Tobacco Risk Reduction

    Rees, Vaughan W.; Kreslake, Jennifer M.; O’Connor, Richard J.; Cummings, K. Michael; Parascandola, Mark; Hatsukami, Dorothy; Shields, Peter G.; Connolly, Gregory N.


    Objective Methods to assess reduced exposure products should include those which aid in determining likely patterns of human use and exposure. Tobacco industry clinical trial methods may provide insight into strategies to assess potential reduced exposure products (PREPs) for public health purposes. Internal tobacco industry documents detailing human clinical research with PREPs were examined to document major research strategies used and identify potentially fruitful methods not currently used in the mainstream arena. Methods Primary data were obtained from records of research conducted internally by tobacco companies and affiliated researchers, and included manuscript drafts, presentations, protocols, and instruments relating to internal clinical trials of human tobacco use and exposure. Results Tobacco industry clinical research has focused on reduced exposure products, most notably Premier, Accord and Eclipse. The most widely used strategy observed was switching studies, and details of study designs and protocols favored by the industry are described. Key measures include biomarkers of exposure (e.g. cotinine, CO and specific carcinogens), and acute health effects such as physical health and fitness. Conclusions Tobacco industry clinical research has used relatively standard switching study methods, but with a broad set of measures. Clinical switching studies have been conducted by the industry primarily to support existing claims or to develop new claims. Knowledge of prior industry activity can guide and inform future public health research efforts. While industry clinical trial methods are comparable to current mainstream methods, limited information about the validity of outcome measures used limit their viability for immediate adoption in mainstream science. PMID:19959673

  18. Clinical use of new methods of MR-tomography

    MR-tomography was used for investigation of 129 patients with various diseases of the kidneys, liver, pancreas, organs of the small pelvis, brain and spinal marrow. Possibilities of the use and practical value of new MRT methods - MR-urography and MR-myelography (MRu and MRm) were studied. They made it possible to detect within a short period of time (40-60 sec.) the presence of fluid in an examined volume. MRu was the most informative method in cystic lesions of various organs looking like round-shaped formations with a high intensity signal. MRm was highly informative in the diagnosis of syringomyelia, informative for the determination of the state of the brain ventricular system. MRm performed in different planes and their summation with images of common MR-sections makes the interpretation of the obtained data much easier. MRm/u is desirable in suspected fluid in en examined volume or in order to specify the state of the serebral liquor system

  19. Optimization of tumor cell culture conditions in soft agar for subsequent immunohistochemical analysis

    Khoruzhenko A. I.


    Full Text Available Aim. The aim of this work is to optimize conditions of malignant cells cultivation in soft agar for subsequent immunohistochemical analysis of formed three-dimensional colonies. Methods. Cultivation of breast carcinoma cell line MCF-7 in soft agar, immunohistochemical and im- munofluorescence detection of epithelial antigen and mTOR kinase in cultured cells. Results. We describe a methodical approach to the cultivation of cells in soft agar, which allows to carry out morphological, morphometric and immunochemical analysis of the studied cells. Conclusions. The proposed method provides an additional characteriza tion of cells growing in soft agar, which will be useful in basic research and in evaluation of the effectiveness of anticancer drugs.

  20. Interleaved Carbon Minibeams: An Experimental Radiosurgery Method With Clinical Potential

    Purpose: To evaluate the efficacy of “interleaved carbon minibeams” for ablating a 6.5-mm target in a rabbit brain with little damage to the surrounding brain. The method is based on the well-established tissue-sparing effect of arrays of thin planes of radiation. Methods and Materials: Broad carbon beams from the National Aeronautics and Space Agency Space Radiation Facility at Brookhaven National Laboratory were segmented into arrays of parallel, horizontal, 0.3-mm-thick planar beams (minibeams). The minibeams’ gradual broadening in tissues resulted in 0.525-mm beam thickness at the target’s proximal side in the spread-out Bragg peak. Interleaving was therefore implemented by choosing a 1.05 mm beam spacing on-center. The anesthetized rabbit, positioned vertically on a stage capable of rotating about a vertical axis, was exposed to arrays from four 90° angles, with the stage moving up by 0.525 mm in between. This produced a solid radiation field at the target while exposing the nontargeted tissues to single minibeam arrays. The target “physical” absorbed dose was 40.2 Gy. Results: The rabbit behaved normally during the 6-month observation period. Contrast magnetic resonance imaging and hematoxylin and eosin histology at 6 months showed substantial focal target damage with little damage to the surrounding brain. Conclusion: We plan to evaluate the method’s therapeutic efficacy by comparing it with broad-beam carbon therapy in animal models. The method’s merits would combine those of carbon therapy (i.e., tight target dose because of the carbon’s Bragg-peak, sharp dose falloff, and high relative biological effectiveness at the target), together with the method’s low impact on the nontargeted tissues. The method’s smaller impact on the nontargeted brain might allow carbon therapy at higher target doses and/or lower normal tissue impact, thus leading to a more effective treatment of radioresistant tumors. It should also make the method more

  1. Immunohistochemical Study of c-KIT (CD117) Expression in Renal Cell Carcinoma

    Certain subtypes of Renal cell carcinomas (RCCs) are diagnostically challenging owing to their overlapping histopathological features. Recently, c-KIT (CD117) has come into focus as a potential diagnostic marker of some renal tumors. c-KIT also provides a potentially suitable for targeted tumor therapy. The present study was designed to investigate the expression of c-KIT in RCCs in order to evaluate its diagnostic usefulness as a phenotypic marker and to establish the basis for a new possible therapeutic modality. Material and Methods: The present work was conducted on 49 patients with RCC: Clear cell RCC (CRCC): 30 cases (61.22%); chromophobe RCC (ChRCC): 9 cases (18.37%); papillary RCC (PRCC), type I: 5 cases (10.20%); and carcinoma of the collecting ducts of Bellini (CdRCC): 5 cases (10.20%). The expression of c-KIT was assessed using immunohistochemistry. The diagnostic performance of c-KIT expression was evaluated using ROC curve analysis. Results: Overall, 11 (22.5%) cases of RCC showed c-KIT expression: 2 (6.7%) CRCC, 7 (77.8%) ChRCC, and 2 (40.0%) CdRCC. Among the study group, ChRCC had the highest frequency (p=.001) and staining score (p=.001) for c-KIT. In addition, only ChRCC showed membranous pattern of c-KIT staining, while other tumors showed cytoplasmic staining (p=.013). c-KIT showed a sensitivity of 77.78% and a specificity of 95% for the diagnosis of ChRCC. The relation between c-KIT expression and clinico pathological parameters was not significant. High grade tumors had a statistically significant higher total score of c-KIT expression (p=.023). Conclusions: c-KIT is frequently and significantly expressed in chromophobe RCC suggesting that it might play a role in its pathogenesis. Immunohistochemical detection of c-KIT expression could be used to aid histological diagnosis of chromophobe RCC with a high sensitivity and specificity. The substantial c-Kit immunoreactivity in chromophobe RCC may be of clinical importance especially in the field of

  2. Features of morphological variants of squamous cell carcinoma of the maxillary sinus: immunohistochemical characteristic

    Kovtunenko A.V.


    Full Text Available Background. The feature of malignant tumours in maxillary sinus is a late appeal of patients (T3-T4, as a result of the absence of pain and minor clinical manifestations, it requires large amounts of surgical interventions and leads to disability. Objective. The article analyzes the morphological variants of maxillary sinus squamous cell carcinoma (SCC with their immunohistochemical characteristic. Methods. In the study we analyzed the original biopsy material from 37 patients with maxillary sinus cancer T3-4N0-1M0 (31 men and 6 women aged from 37 to 71 years with histologically confirmed diagnosis of SCC for 2010-2014. The primary monoclonal antibodies CK HMW (clone AE3, p63 (clone 4A4, р16INK4 (clone DCS 240 were used. Results. Analyzing the distribution of various forms of maxillary sinus SCC, it was found that the typical forms of SCC are found in most of cases, 29 of 37 (78.4%, compared with specific morphological forms that accounted for just 21.6%. Conclusions. Due to the expression of the marker CK HMW it was found that in typical forms of SCC and in some special morphological forms (spindle cell carcinoma and verrucous carcinoma with decreasing degree of squamous cell differentiation, the level of the expression of CK HMW also decreases (p<0,001, r = 0.861; p <0,001, r = 0,638. It is an indicator of poor prognosis, but aggressive behavior of basaloid SCC and adenosquamous carcinoma do not depend on the presence or absence of CK HMW. High expression of marker p63 (average level 92,5±3,67% is a key-point of verification of basaloid SCC. Lack of positive reaction with the marker of viral lesions p16INK4 in forms with keratinization confirms the idea of different etiologic factors and ways of carcinogenesis of typical forms of SCC. Citation: Kovtunenko AV, Bakaev AA, Shpon’ka IS, Poslavskaya AV. [Features of morphological variants of squamous cell carcinoma of the maxillary sinus: immunohistochemical characteristic]. Morphologia. 2014

  3. Prognostic value of immunohistochemical stratification of invasive duct carcinoma of the breast

    Asmaa Salama; Habiba El-Fendy; Sahar Talaat; Badaweya Bayomi; Amr Amin


    Objective: Gene expression profiling of breast cancer has identified five molecularly distinct subtypes of breast cancer that have different biological behavior and clinical outcomes. These subtypes are termed luminal A, luminal B, luminal HER2, HER2-enriched and triple negative breast cancers (TNBC). We aimed at identification of breast cancer subtypes among Egyptian population and their clinicopathologic features using ER, PR and HER2, Ki-67 and CK5/6. Methods: Tumors from 100 patients with invasive duct carcinoma were subtyped by immunohistochemistry using ER, PR, HER2, Ki-67 and CK5/6. The prognostic value of the immunohistochemical assignment for breast cancer disease-specific survival was investigated by using Kaplan-Meier curves. Results: Immunohistochemical profiling classified 22 cases as luminal A, 33 cases as luminal B, 9 cases as luminal HER2, 26 cases as HER2-enriched and 10 cases as TNBC. Tumors that measured more than 3.5 cm, showed predominance of HER2-enriched subtype. HER2-enriched and luminal B subtypes dominated the node positive cases (35.4% and 33.8%; respectively). Large tumor size (> 3.5 cm), hormone receptor negative state and HER2 positive state were associated with poor prognosis. Disease free survivals (DFSs) were significantly different (P < 0.0001) among different breast subtypes with worst 2-year DFS for HER2-enriched subtype (40.77%) followed by luminal A (63.56%). DFS was almost similar in the remaining other subtypes, and luminal B, luminal HER2 and TNBC which were 86.85%, 87.5% and 88.89%; respectively. Conclusion: ER, PR, HER2 and Ki-67 constituted a strong surrogate for molecular breast cancer subtypes and can be easily applied. HER2-enriched subtype carries worse features being associated with large tumor size, nodal metastasis and is associated with poor outcome. Luminal A is a heterogeneous subtype with underlying several factors that can turn its prognosis adversely. TNBC subtype may behave unexpected in a favorable way.

  4. Clinical management methods for out-patients with alcohol dependence

    Boulze Isabelle


    Full Text Available Abstract Background In France outpatient centres for the care of alcoholics are healthcare establishments providing medical, psychological and social support. Although they meet the practical needs of these patients, their degree of use in each of these domains and the respective mobilisation of different skills by the care team are not well understood. Our aim was therefore to determine in detail the management involved as a function of the severity of alcohol dependence. For this purpose, all the procedures involved were compiled in a thesaurus describing its type (psychological, medical, social, reception, its scheduled or unscheduled nature, its method (face-to-face, telephone, letter and its duration. The severity of dependence was evaluated using the Addiction Severity Index (ASI. Results 45 patients were included and followed-up during 291 ± 114 days. The mean initial ASI scores (± SD were: medical (M = 0.39 ± 0.3, working-income (ER = 0.5 ± 0.3, alcohol (A = 0.51 ± 0.2, illicit drugs (D = 0.07 ± 0.08, legal (L = 0.06 ± 0.13, familial and social environment (FS = 0.34 ± 0.26, psychological (P = 0.39 ± 0.22. The total number of procedures was 1341 (29.8 per patient corresponding to 754.4 hours (16.7 per patient. The intensity of management peaked during the first month of treatment, and then declined rapidly; the maximum incidence of abstinence was observed during the 3rd month of management. Interviews with patients, group therapy and staff meetings represented 68.7%, 9.9% and 13.9% of all procedures, respectively. In patients with severe dependence, as compared to moderate, management was twice as intense in the psychological and social domains, but not in the medical domain. The ASI questionnaire was completed a second time by 24 patients, after an average of 3.2 months. The improvement was significant in the M, A, D and P domains only. Conclusion This study provided an overview of the methods employed in managing a sample of

  5. Onychomycosis: Clinical findings, etiological agents and evaluation of laboratory methods

    Dubljanin Eleonora


    Full Text Available The aim of this study was to identify the etiological agents in patients with suspected onychomycosis, and to carry out comparative testing of individual or combinations of tests: direct microscopy with KOH and Blankophor (BP, culturing on Sabouraud’s dextrose agar (SDA, diluted Sabouraud’s dextrose agar (D-SDA and dermatophyte test medium (DTM. From 70 nail samples (65 toenails, 5 fingernails, 46 (60.5% had at least one of five positive tests. Isolation was possible in 41, while in 5 samples the presence of fungi was observed by KOH and/or BP. Dermatophytes were most frequently isolated (80.5% where Trichophyton rubrum was predominant. Candida spp. was isolated in 9.8%, Aspergillus spp. 4.9%, Alternaria spp. 2.4% and Fusarium spp. 2.4%. Application of BP as an individual test was the most sensitive method. The combination of BP with DTM or D-SDA provides the best sensitivity and allows the identification of fungi to the species/genus level.

  6. Osteoclastic giant cell tumor of the pancreas: an immunohistochemical study

    Dizon, M A; Multhaupt, H A; Paskin, D L;


    A case of an osteoclastic giant cell tumor of the pancreas is presented. Immunohistochemical studies were performed, which showed keratin (CAM, AE1) and epithelial membrane antigen positivity in the tumor cells. The findings support an epithelial origin for this tumor.......A case of an osteoclastic giant cell tumor of the pancreas is presented. Immunohistochemical studies were performed, which showed keratin (CAM, AE1) and epithelial membrane antigen positivity in the tumor cells. The findings support an epithelial origin for this tumor....

  7. Translating Basic Behavioral and Social Science Research to Clinical Application: The EVOLVE Mixed Methods Approach

    Peterson, Janey C.; Czajkowski, Susan; Charlson, Mary E.; Link, Alissa R.; Wells, Martin T.; Isen, Alice M.; Mancuso, Carol A.; Allegrante, John P.; Boutin-Foster, Carla; Ogedegbe, Gbenga; Jobe, Jared B.


    Objective: To describe a mixed-methods approach to develop and test a basic behavioral science-informed intervention to motivate behavior change in 3 high-risk clinical populations. Our theoretically derived intervention comprised a combination of positive affect and self-affirmation (PA/SA), which we applied to 3 clinical chronic disease…

  8. Study of immunohistochemical demonstration of Bcl-2 protein in ameloblastoma and keratocystic odontogenic tumor

    C S Sindura


    Full Text Available Background: The Bcl-2 (B-cell lymphoma gene product also known as apoptotic inhibitor is expressed in many normal and tumor tissues. This Bcl-2 gene protects the cell by blocking postmitotic differentiation from apoptosis, thus maintaining the stem cell pool. Objective: To study the expression of Bcl-2 protein in ameloblastoma and keratocystic odontogenic tumor (KCOT to determine their apoptotic behaviors and to analyze biological nature of KCOT, which has higher proliferative potential and aggressive clinical behavior like odontogenic tumors. Materials and Methods: Formalin-fixed paraffin sections of ameloblastoma (n = 20 and KCOT (n = 20 are considered for immunohistochemical analysis using monoclonal antibody against antihuman Bcl-2 oncoprotein. Lymphomas (n = 3 were used as controls. Statistical Analysis: The statistical analysis was performed using software package of social science version 16.The data were analyzed using Chi-square test and Student′s t test. In all the above tests, P < 0.05 was accepted as statistically significant. Results: The positive ratio of Bcl-2 was 85% (17/20 in ameloblastoma, 85% (17/20 in KCOT and 100% (3/3 in lymphomas. Bcl-2 was expressed in peripheral cells and few scattered cells of stellate reticulum in ameloblastoma. KCOT showed strong positivity for Bcl-2 mainly in the basal layer. Interpretation and Conclusion: The present study demonstrates the aggressive nature of KCOT and intrinsic growth potential of its lining epithelium. This study clearly demonstrates that KCOT like ameloblastoma demonstrates aggressive clinical and noticeable invasive behavior. Therefore, it is now considered as no longer a developmental cyst but as odontogenic tumor.

  9. Student Preferences Regarding Teaching Methods in a Drug-Induced Diseases and Clinical Toxicology Course

    Rivkin, Anastasia; Gim, Suzanna


    Objectives. To determine which teaching method in a drug-induced diseases and clinical toxicology course was preferred by students and whether their preference correlated with their learning of drug-induced diseases.

  10. Transplantation of Deprenyl-Induced Tyrosine Hydroxylase-Positive Cells Improves 6-OHDA-Lesion Rat Model of Parkinson’s Disease: Behavioral and Immunohistochemical Evaluation

    Leili Hosseinpour


    Full Text Available Objective: There is longstanding experimental and clinical evidence that supports the idea that replacement of dopaminergic (DAergic neurons can ameliorate functional disabilities of Parkinson’s disease (PD. The purpose of the present study is to examine the efficacy of transplantation of rat bone marrow stromal cell (BMSCs-derived tyrosine hydroxylase-positive (TH+ cells induced by deprenyl into 6-hydroxydopamine (6-OHDA-lesioned rat models, using behavioral tests and immunohistochemical evaluations.Materials and Methods: In this experimental study, undifferentiated BrdU-labeled BMSCs were incubated in serum-free medium that contained 10-8 M deprenyl for 24 hours. Afterwards, BMSCs were cultured for 48 hours in α-minimal essential medium (α-MEM supplemented with 10% FBS, then differentiated into TH+ neurons. We randomly divided 24 hemiparkinsonian rats as follows: group 1 (control received only medium, while groups 2 and 3 were injected with 2×105 BMSCs and deprenyl-treated cells in 4 μl medium. Injections were made into the injured strata of the rats. Rotational behavior in response to apomorphine was tested before transplantation and at 2, 4, and 6 weeks post-graft. Animals were then sacrificed, and the brains were extracted for immunohistochemical and electron microscopic studies.Results: Apomorphine-induced rotation analysis indicated that animals with grafted cells in groups 2 and 3 exhibited significantly less rotational behavior than those in the control group at 2, 4, and 6 weeks after transplantation. Immunohistochemical analysis demonstrated that BrdU-labeled cells expressed specific neuronal markers, such as NF 200 and TH, at the implantation site. The presence of TH+ cells in conjunction with the reduction in rotation might show the capacity of grafted cells to release dopamine. Ultrastructural analysis revealed the presence of immature neurons and astrocyte-like cells at the graft site.Conclusion: TH+ neurons induced by

  11. An investigation on clinical, radiological and biochemical methods for assessing periodontitis activity

    In order to recognize in which stage rapidly progressing destruction of periodontal ligament fibers occurs, a number of diagnostic methods are studied in this thesis. It turns out that the actual much utilized clinical methods can not be improved while radiological and biochemical diagnositic methods are much more promising. 106 refs.; 20 figs.; 36 tabs

  12. Nurses? and Midwives? clinical leadership development needs: A mixed methods study

    Casey, Mary; McNamara, Martin S; Fealy, Gerard M.; Geraghty, Ruth; Halligan, Philomena A; Treacy, Margaret; Butler, Michelle M.; Johnson, Maree


    Abstract Aim This paper is a report of a descriptive study of nurses? and midwives? clinical leadership development needs. Background Nurses and midwives are expected to fulfill a leadership role at all levels, yet efforts to strategically support them are often unfocused. An analysis of clinical leadership development needs can provide the foundation for leadership initiatives to support staff. Method A mixed methods design was used. A questionnaire was sent to ...

  13. A call to the use of the clinical method in the practice of perinatal medicine

    Carlos Esteban Zerquera Álvarez


    A reflection on the appropriateness and current application of the clinical method, defined as the diagnostic process inherent to the practice of human medicine is presented. Considerations about the scientific nature of the clinical method and its application in perinatal medicine along with its specific characteristics in this field are stated. Several considerations about the impact of high technology and the risk of its use when the appropriate balance is not achieved, which could lead to...

  14. Clinical way method in treatment of out-patients with ischemic heart disease after cardiosurgery

    Vardosanidze S.L.; Galstyan A.S.


    158 patients with ischemic heart disease (IHD) have been understudy during the period of 12 months in out-patient conditions. After completion of the primary examination all the patients of basic group (118 patients) received clinical way method of treatment. Patients of the comparison group (40 patients) after provided treatment were cared by their local therapeutists (cardiologists). The findings proved the fact that treatment of patients after cardiosurgery by clinical way method in out-pa...


    Katarina Bevizova


    Full Text Available Malignant cancers of urinary bladder are the second most common malignancy of the urinary tract and the fourth most common malignancy in general, especially in men. The aim of this study was a retrospective analysis of selected markers (p53, Ki-67 and E-cadherin of urinary bladder cancers from the Department of Urology in Bratislava, Slovak Republic between years 2007 and 2009. We analysed 244 patients (202 males, 42 females with diagnosed bladder cancer via cystoscopy and subsequent transurethral resection. Patients’ age varied from 36 to 98 years. Obtained samples were fixed by 10% buffered formalin for 24 to 48 h. Subsequently, they were dehydrated in ascending ethanol series and embedded in paraffin. The parafin sections of 5 µm were prepared by microtome and they were stained by haematoxylin and eosin. The antibodies against to p53, Ki-67 and E-cadherin were used in immunohistochemical analysis. Statistical evaluation was performed via SPSS using non-parametric Kruskal-Wallis test and p values<0.05 were considered statistically significant. No significant differences in the expression of selected markers were found between genders. Expression of p53 and Ki-67, in G1 and G2 of low grade tumours was lower in comparison to their expression in G3 tumors. Expression of E-cadherin was the opposite in this case. The expression of p53 and Ki-67 positively correlated with tumor’s depth of invasion, while the expression of E-cadherin significantly decreased. In case of T4 tumors, the expression of all markers exhibited consistently high values. When analysing tumor multiplicity, the expression of p53 and Ki-67 significantly decreased, while the expression of E-cadherin significantly increased. Based on the obtained results it can be concluded that the analysis of p53, Ki-67 and E-cadherin expression is essential for diagnostics and prognostics of bladder cancer and should be routinely used in daily practise together with

  16. Clinical and Histopathological Characteristics between Familial and Sporadic Melanoma in Barcelona, Spain

    Aguilera, Paula; Malvehy, Josep; Carrera, Cristina; Palou, Josep; Puig-Butillé, Joan Anton; Alòs, Llúcia; Badenas, Celia; Puig, Susana


    Background About 6 to 14% of melanoma cases occur in a familial setting. Germline mutations in CDKN2A are detected in 20 to 40% of melanoma families. Objective To characterise the clinical and histopathological characteristics of familial melanoma thus providing more information to clinicians and contribute to the understanding of the genetic-environment interplay in the pathogenesis of melanoma. Methods Clinical, histological and immunohistochemical characteristics of 62 familial melanomas w...

  17. Expression of human chorionic gonadotropin beta in gastric carcinoma: A retrospective immunohistochemical study

    Murhekar Kanchan; Anuratha Jayaram; Majhi Urmila; Rajkumar Thangarajan


    Context: Beta Human Chorionic Gonadotropin (βHCG), a marker of the trophoblastic neoplasm, is also secreted by non-trophoblastic neoplasms including gastric carcinomas. Its role in disease progression remains unclear. Aim: To investigate the incidence of βHCG positivity in gastric carcinomas and correlate its presence with the biological behavior of the tumor. Setting and Design: A hospital-based, immunohistochemical study. Materials and Methods: One hundred and fifty formali...

  18. Adult Immunohistochemical Markers Fail to Detect Intratubular Germ Cell Neoplasia in Prepubertal Boys with Cryptorchidism

    Kvist, Kolja; Clasen-Linde, Erik; Cortes, Dina;


    Intratubular germ cell neoplasia (ITGCN) is a precursor to testicular germ cell cancer. It is characterized by large germ cells with large nuclei with a hyperchromatic, coarse chromatin pattern, large prominent nucleoli and abundant pale cytoplasm. In prepubertal boys these cells are located both...... centrally and peripherally mixed with normal cells in the seminiferous tubules. The aim of study was to evaluate the impact of adult ITGCN-marking immunohistochemical methods in screening for ITGCN in boys with cryptorchidism....

  19. Serological and immunohistochemical HER-2/neu statuses do not correlate and lack prognostic value for ovarian cancer patients.

    Hoopmann, M; Sachse, K; Valter, M M; Becker, M; Neumann, R; Ortmann, M; Göhring, U-J; Thomas, A; Mallmann, P; Schöndorf, T


    The serodiagnostics of extracellular domain (ECD) HER-2/neu has turned into an evidenced-based tumour marker for HER-2/neu-positive breast cancer patients. This study investigated the clinical relevance of immunohistochemical and serum HER-2/neu in 44 patients with advanced ovarian cancer. The Hercept-Test® from DAKO Diagnostics was used to analyse immunohistochemical HER-2/neu expression. The HER-2/neu ECD in serum was determined quantitatively by Bayer Immuno 1™ Immunoanalyser. The HER-2/neu serum values were correlated to the clinical course of disease and to established prognostic factors, i.e. progression-free and overall survival. Some 23% of patients (n = 11) expressed HER-2/neu serum levels higher than 15 ng/mL, whereas only 7.7% (n = 2) of the patients examined by immunohistochemistry showed a HER-2/neu overexpression of the tissue. None of them revealed an overexpression of HER-2/neu ECD by serodiagnostics. HER-2/neu overexpression did not correlate significantly to any of the analysed prognostic factors. According to progression-free and overall survival, there was no significant difference between serologically HER-2/neu-positive or negative patients. For ovarian cancer patients, neither high HER-2/neu serum levels, nor immunohistochemically determined HER-2/neu positivity, appear to predict the course of disease. This study shows a lack of association between the immunohistochemical HER-2/neu status and the serum level of solute extracelluar HER-2/neu domain. PMID:20105224

  20. Image files of planarians analyzed by in situ hybridication and immunohistochemical staining - Plabrain DB | LSDB Archive [Life Science Database Archive metadata

    Full Text Available Plabrain DB Image files of planarians analyzed by in situ hybridication and immunohistochemical staining Dat...a detail Data name Image files of planarians analyzed by in situ hybridication and immunohistochemical Description of data contents Image files of gene expression patterns by whole-mount in situ hybrid...planarians analyzed by in situ hybridication and immunohistochemical staining sim...labrain-db/LATEST/ File size: 2.74MB Simple search URL - Data acquisition method Whole-mount in situ hybrid

  1. Clinical and morphological characteristics of chronic duodenitis in children

    Tishchenko D.V.; Matveeva O.V.; Chernenkov Yu.V.; Maslyakova G.N.; Bucharskaya A.B.



    The research goal is to determine clinical, endoscopic and morphological signs of chronic duodenitis in children. Materials and methods: The diagnostic value of molecular markers has been revealed by immunohistochemical research of biopsy. It has been received from endoscopic examination of 32 children aged from 3 to 17 years old with chronic duodenitis. Morphometric investigation of markers expression has been ca...

  2. Immunohistochemical detection of P53 and Mdm2 in vitiligo

    Ola A Bakry


    Full Text Available Background: Vitiligo is a common depigmented skin disorder that is caused by selective destruction of melanocytes. It is generally accepted that the main function of melanin resides in the protection of skin cells against the deleterious effect of ultraviolet rays (UVRs. Association of vitiligo and skin cancer has been a subject of controversy. Occurrence of skin cancer in long-lasting vitiligo is rare despite multiple evidences of DNA damage in vitiliginous skin. Aim: To detect the expression of P53 and Mdm2 proteins in both depigmented and normally pigmented skin of vitiligo patients and to compare it to control subjects suffering from nonmelanoma skin cancer (NMSC. Materials and Methods: Thirty-four patients with vitiligo and 30 age and sex-matched patients with nodulo-ulcerative basal cell carcinoma (BCC as a control group were selected. Both patients and control subjects had outdoor occupations. Skin biopsies were taken from each case and control subjects. Histopathological examination of Hematoxylin and eosin-stained sections was done. Expression of P53 and Mdm2 proteins were examined immunohistochemically. Results: Both P53 and Mdm2 were strongly expressed in depigmented as well as normally pigmented skin of vitiligo patients. This expression involved the epidermis, skin adnexa and blood vessels with significant differences between cases and controls. Conclusions: The overexpression of P53 and Mdm2 proteins in both normally pigmented and depigmented skin of patients with vitiligo could contribute to the decreased occurrence of actinic damage and NMSC in these patients.

  3. Immunohistochemical analysis of Metadherin in proliferative and cancerous breast tissue

    Zhang Qinghui


    Full Text Available Abstract Background Metadherin (MTDH has been reported to be associated with cancer progression in various types of human cancers including breast cancer. Whether MTDH contributes to carcinogenesis of breast cancer is still unknown. In the present study, we investigated the expression of MTDH in normal, UDH (usual ductal hyperplasia, ADH (atypical ductal hyperplasia, DCIS (ductal carcinoma in situ and invasive cancer to explore the possible role of MTDH for breast cancer carcinogenesis. Methods Immunohistochemistry was employed on paraffin sections of surgical removed breast samples. Results The immunohistochemical results showed almost no staining in normal tissue, moderate staining in ADH and UDH, intense MTDH stains in DCIS and cancer. Statistical analysis demonstrated significant different MTDH expression between proliferative and cancerous breast lesions (p p = 0.028. In breast cancer, statistical analysis revealed a significant correlation between MTDH expression with patients' age (p = 0.042, ER status (p = 0.018 and p53 status (p = 0.001. We also examined the effect of MTDH on cell proliferation in DCIS and cancer, and we found that MTDH overexpression was significantly correlated with high Ki67 index (p = 0.008 and p = 0.036, respectively. Conclusions MTDH overexpression could be identified in proliferative breast lesions and may contribute to breast cancer progression.

  4. The clinically-integrated randomized trial: proposed novel method for conducting large trials at low cost

    Scardino Peter T


    Full Text Available Abstract Introduction Randomized controlled trials provide the best method of determining which of two comparable treatments is preferable. Unfortunately, contemporary randomized trials have become increasingly expensive, complex and burdened by regulation, so much so that many trials are of doubtful feasibility. Discussion Here we present a proposal for a novel, streamlined approach to randomized trials: the "clinically-integrated randomized trial". The key aspect of our methodology is that the clinical experience of the patient and doctor is virtually indistinguishable whether or not the patient is randomized, primarily because outcome data are obtained from routine clinical data, or from short, web-based questionnaires. Integration of a randomized trial into routine clinical practice also implies that there should be an attempt to randomize every patient, a corollary of which is that eligibility criteria are minimized. The similar clinical experience of patients on- and off-study also entails that the marginal cost of putting an additional patient on trial is negligible. We propose examples of how the clinically-integrated randomized trial might be applied in four distinct areas of medicine: comparisons of surgical techniques, "me too" drugs, rare diseases and lifestyle interventions. Barriers to implementing clinically-integrated randomized trials are discussed. Conclusion The proposed clinically-integrated randomized trial may allow us to enlarge dramatically the number of clinical questions that can be addressed by randomization.

  5. The immunohistochemical features of chorion and endometrium in women with early pregnancy losses

    Trohimovych O.V.


    Full Text Available Background. According to present views proliferation and apoptosis plays an important role in the mechanisms of placenta formation, particularly in process of vasculogenesis that begins on the third week of pregnancy. Objective: To investigate the immunohistochemical features of chorion and endometrium in women with early pregnancy losses. Methods. 98 samples of abortive and surgical material in pregnant women in terms of 4-10 weeks of pregnancy were analyzed. 48 samples were obtained from women with missed abortion (1st group, 20 samples from women with spontaneous abortion (2nd group; 20 samples from women with tubal pregnancy (3rd group; 10 samples from pregnant women with normal singleton pregnancy, after medical abortion on their own wish (control group. Histological, histochemical and immunohistochemical methods were used. Monoclonal antibodies (MAbs to Ki-67 and bcl-2 were applied. Results. Pathological picture of spontaneous abortion is characterized by the dominance of violation of blood circulation, presence of significant foci of hemorrhage occurring parallel with a pronounced disruption of apoptosis and proliferation in chorionic villi and decidual tissue, leading to the detachment of placenta. Conclusion. In 75% of cases of tubal pregnancy ectopic cytotrophoblast invasion is caused by prominent changes in the structure of the fallopian tube. First of all due to the inflammatory process and a sharp reduction of proliferation in the basal chorion and parietal deciduitis in 65% of cases. Citation: Trohimovych OV. [The immunohistochemical features of chorion and endometrium in women with early pregnancy losses]. Morphologia. 2015;9(1:58-64. Russian.

  6. Immunohistochemical investigations of xenotransplanted human adenocarcinomas on nude mice: Correlation to radioimaging

    Immunohistochemical investigations of xenotransplanted human adenocarcinomas on nude mice; correlation to radioimaging Human carcinomas were subcutanously grafted to nude mice (Balb/c-nu/nu) and were investigated in four passages by immunohistochemical methods and by the fluorochrome bisbenzimid. In this way there could be observed a successful differentiation between the nourishing murine stroma and the human tumor parenchym. Especially the use of a monoclonal antibody (rat/mouse fusion) directed against human tissue turned out to be a suitable method. Four adenocarcinomas were tested: Colon-, mamma-, stomach- and testicle carcinoma. During the first four passages atypical parts of murine connective tissue and some changes in the human parenchyma could be seen. These results demonstrate that also in nude mice variations of the transplanted tumor material could happen. They could be detected in time with a routine immunohistochemical test. The consequences of tumor morphological variations for the development of therapeutic and diagnostic tools were studied with the help of radioimaging by external scintigraphy. Furthermore the biodistribution, tumoruptake and the whole body counting were studied by means of radionuclid marked monoclonal antibodies. The morphological variations of the passages of mammary, testicle and colon carcinomas were not big enough to influence the results in a certain way. Therefore especially the relation between the activity uptake in the tissue, the size of the tumor and the whole body uptake was studied in view of immunoscintigraphy. (orig./MG)

  7. Peritoneal Malignant Mesothelioma with Epithelioid Type, Demonstrating High Serum and Ascitic KL-6 Levels: Immunohistochemical Analyses.

    Nahar, Saifun; Nakamoto, Manabu; Hokama, Akira; Kobashigawa, Chiharu; Kaida, Masatoshi; Kinjo, Tetsu; Hirata, Tetsuo; Kinjo, Nagisa; Saio, Masanao; Yoshimi, Naoki; Ohtsuki, Yuji; Fujita, Jiro


    We report a case of KL-6 producing peritoneal malignant mesothelioma. A 56-year-old woman was referred to our hospital on November 2005 with severe abdominal distention. Peritoneal malignant mesothelioma with epithelioid type was diagnosed by clinical symptoms, laboratory investigations, imaging studies, and immunohistochemical examination of known tumor markers. In addition, high serum and ascitic KL-6 levels were observed and the immunostaining of the tumor for KL-6 was evident. We thus consider KL-6 to be a potential novel marker for peritoneal malignant mesothelioma with epithelioid type. PMID:26500734

  8. Peritoneal malignant mesothelioma with epithelioid type, demonstrating high serum and ascitic KL-6 levels: immunohistochemical analyses

    Saifun Nahar


    Full Text Available We report a case of KL-6 producing peritoneal malignant mesothelioma. A 56-year-old woman was referred to our hospital on November 2005 with severe abdominal distention. Peritoneal malignant mesothelioma with epithelioid type was diagnosed by clinical symptoms, laboratory investigations, imaging studies, and immunohistochemical examination of known tumor markers. In addition, high serum and ascitic KL-6 levels were observed and the immunostaining of the tumor for KL-6 was evident. We thus consider KL-6 to be a potential novel marker for peritoneal malignant mesothelioma with epithelioid type.

  9. Methods and technique of roentgenoradionuclide investigations of gallbladder and biliary tract. Characteristics of clinical materials

    Methods for X-ray radionuclide investigation of gallbladder and biliary tracts-peroral, intravenous and infusion cholecystocholangiography, tomocholecystography, γ-scintigraphy, as well as pharmacologic contrast substances used in the methods given, are described. The characteristic of clinical material is presented


    Vladimir M. Popkov; Galina N. Maslyakova; Elena S. Voronina


    The comparative assessment of molecular markers expression during prostate gland diseases of dishormonal and tumorous nature was carried out and peculiarities of histochemical characteristics have been revealed on the basis of physical examination of 57 patients, which have been treated at the Research Institute of Fundamental and Clinical Uronephrology of Saratov State Medical University n.a. V.I. Rasumovsky.

  11. Introducing a Method for Achieving Standardization and Harmonization in Clinical and Research Laboratory Centers

    Dastmardi, M. (MSc


    Full Text Available Background and Objective: Proficiency testing schemes as a part of quality system in clinical and research laboratory centers provides the opportunity to evaluate the quality of test results. In this paper, we try to introduce the proficiency testing schemes as a useful method for achieving standardization and homogenization of test results in clinical and research laboratory centers. Keywords: Proficiency Testing Schemes; Quality Improvement; Laboratory Centers

  12. Fit-for-purpose biomarker method validation for application in clinical trials of anticancer drugs

    Cummings, J.; Raynaud, F; Jones, L.; Sugar, R; Dive, C


    Clinical development of new anticancer drugs can be compromised by a lack of qualified biomarkers. An indispensable component to successful biomarker qualification is assay validation, which is also a regulatory requirement. In order to foster flexible yet rigorous biomarker method validation, the fit-for-purpose approach has recently been developed. This minireview focuses on many of the basic issues surrounding validation of biomarker assays utilised in clinical trials. It also provides an ...

  13. Committee Opinion No 672: Clinical Challenges of Long-Acting Reversible Contraceptive Methods.


    Long-acting reversible contraceptive methods are the most effective reversible contraceptives and have an excellent safety record. Although uncommon, possible long-acting reversible contraceptive complications should be included in the informed consent process. Obstetrician-gynecologists and other gynecologic care providers should understand the diagnosis and management of common clinical challenges. The American College of Obstetricians and Gynecologists recommends the algorithms included in this document for management of the most common clinical challenges. PMID:27548557

  14. Committee Opinion No 672 Summary Clinical Challenges of Long-Acting Reversible Contraceptive Methods.


    Long-acting reversible contraceptive methods are the most effective reversible contraceptives and have an excellent safety record. Although uncommon, possible long-acting reversible contraceptive complications should be included in the informed consent process. Obstetrician-gynecologists and other gynecologic care providers should understand the diagnosis and management of common clinical challenges. The American College of Obstetricians and Gynecologists recommends the algorithms included in this document for management of the most common clinical challenges. PMID:27548551

  15. Post graduate clinical placements:evaluating benefits and challenges with a mixed methods cross sectional design

    Yiend, Jenny; Tracy, Derek K.; Sreenan, Brian; Cardi, Valentina; Foulkes, Tina; Koutsantoni, Katerina; Kravariti, Eugenia; Tchanturia, Kate; Willmott, Lucy; Shergill, Sukhi; Reedy, Gabriel


    Background: Systematic evaluations of clinical placements are rare, especially when offered alongside academic postgraduate courses. An evidence-based approach is important to allow pedagogically-driven provision, rather than that solely governed by opinion or market demand. Our evaluation assessed a voluntary clinical placement scheme allied to a mental health course.Methods: Data were collected over academic years 2010/11- 2013/14, from participating students (n = 20 to 58) and clinician su...

  16. Assessment of clinical methods and ultrasound in predicting fetal birth weight in term pregnant women

    Ruby Yadav


    Conclusions: Clinical estimation of birth weight clearly has a role in management of labour and delivery in a term pregnancy. Clinical estimation especially by SFH and times;AG method is as accurate as routine USG estimated in average birth weight. SFH and times; AG clinical formula can be of great value in developing countries like ours, where ultrasound is not available at many health care centers especially in a rural area. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2775-2779

  17. Helen Flanders Dunbar, John Dewey, and clinical pragmatism: reflections on method in psychosomatic medicine and bioethics.

    Hart, Curtis W


    This article outlines the method utilized by physicians and major figures in the founding of Clinical Pastoral Education, Helen Flanders Dunbar, in her work of 1943, Psychosomatic Diagnosis, and relates it to the currently evolving approach in bioethics known as clinical pragmatism. It assesses Dewey's influence on both Dunbar in psychosomatic medicine and clinical pragmatism in bioethics, and illustrates the breadth of influence of the school of philosophical thought known as pragmatism with which Dewey's name and those of William James and Charles Sanders Pierce are most often identified. PMID:12385140

  18. A comparison of photographic, replication and direct clinical examination methods for detecting developmental defects of enamel

    Pakshir Hamid-Reza


    Full Text Available Abstract Background Different methods have been used for detecting developmental defects of enamel (DDE. This study aimed to compare photographic and replication methods with the direct clinical examination method for detecting DDE in children's permanent incisors. Methods 110 8-10-year-old schoolchildren were randomly selected from an examined sample of 335 primary Shiraz school children. Modified DDE index was used in all three methods. Direct examinations were conducted by two calibrated examiners using flat oral mirrors and tongue blades. Photographs were taken using a digital SLR camera (Nikon D-80, macro lens, macro flashes, and matt flash filters. Impressions were taken using additional-curing silicon material and casts made in orthodontic stone. Impressions and models were both assessed using dental loupes (magnification=x3.5. Each photograph/impression/cast was assessed by two calibrated examiners. Reliability of methods was assessed using kappa agreement tests. Kappa agreement, McNemar's and two-sample proportion tests were used to compare results obtained by the photographic and replication methods with those obtained by the direct examination method. Results Of the 110 invited children, 90 were photographed and 73 had impressions taken. The photographic method had higher reliability levels than the other two methods, and compared to the direct clinical examination detected significantly more subjects with DDE (P = 0.002, 3.1 times more DDE (P Conclusion The photographic method was much more sensitive than direct clinical examination in detecting DDE and was the best of the three methods for epidemiological studies. The replication method provided less information about DDE compared to photography. Results of this study have implications for both epidemiological and detailed clinical studies on DDE.

  19. Methods underpinning national clinical guidelines for hypertension : describing the evidence shortfall.

    Eccles Martin; Beyer Fiona R; Cook Julia VF; Dickinson Heather O; Campbell Fiona; Mason James M


    Abstract Background To be useful, clinical practice guidelines need to be evidence based; otherwise they will not achieve the validity, reliability and credibility required for implementation. Methods This paper compares the methods used in gathering, analysing and linking of evidence to guideline recommendations in ten current hypertension guidelines. Results It found several guidelines had failed to implement methods of searching for the relevant literature, critical analysis and linking to...

  20. Role of Histological Criteria and Immunohistochemical Markers in Predicting Risk of Malignancy in Parathyroid Neoplasms.

    Kumari, Niraj; Chaudhary, Nandita; Pradhan, Roma; Agarwal, Amit; Krishnani, Narendra


    Parathyroid carcinoma (PC) is a rare neoplasm accounting for 0.5-6 % of primary hyperparathyroidism. Histological criteria are currently considered as established means to diagnose malignancy in parathyroid neoplasms; however, it does not accurately predict the risk of aggressive behaviour of PC. Immunohistochemical (IHC) markers have been used in the literature with variable results. This work was planned to study whether IHC markers would have any added advantage over histology in predicting outcome in parathyroid neoplasms. Two hundred twenty-seven parathyroid neoplasms were reviewed according to older and revised histological criteria. IHC was performed for parafibromin, APC, galectin-3, PGP9.5 and Ki67. Diagnostic categories were correlated with clinical, biochemical, histological features and IHC markers. Chi-square test was used to analyse categorical variables. Review of histology by earlier and revised criteria showed a change in diagnosis of five cases of atypical adenoma (15.1 %), all of which were diagnosed as carcinoma according to earlier criteria. Change in diagnosis did not affect behaviour of disease as none of the cases showed recurrence or metastasis on follow-up. Combination of PF, Gal-3 and PGP9.5 showed 50 % sensitivity, 97.9 % specificity and 95.4 % predictive accuracy for PC. Histological criteria still remains the most established method for predicting risk of malignancy in parathyroid neoplasms irrespective of whether old or revised criteria are used. Combination of positive (Gal-3, PGP9.5) and negative (PF) IHC markers may be used as an adjunct to histology in histological, atypical and malignant parathyroid neoplasms to obviate the need for repeated follow-up. PMID:26984237

  1. Immunohistochemical detection of ROS1 is useful for identifying ROS1 rearrangements in lung cancers.

    Yoshida, Akihiko; Tsuta, Koji; Wakai, Susumu; Arai, Yasuhito; Asamura, Hisao; Shibata, Tatsuhiro; Furuta, Koh; Kohno, Takashi; Kushima, Ryoji


    The recent discovery and characterization of an oncogenic ROS1 gene fusion in a subset of lung cancers has raised significant clinical interest because small molecule inhibitors may be effective to these tumors. As lung cancers with ROS1 rearrangements comprise only 1-3% of lung adenocarcinomas, patients with such tumors must be identified to gain optimal benefit from molecular therapy. Recently, immunohistochemical analyses using a novel anti-ROS1 rabbit monoclonal antibody (D4D6) have shown promise for accurate identification of ROS1-rearranged cancers. To validate this finding, we compared the immunostaining results of tissue microarrays (TMAs) containing 17 ROS1-rearranged and 253 ROS1-non-rearranged lung carcinomas. All 17 ROS1-rearranged cancers showed ROS1 immunoreactivity mostly in a diffuse and moderate-to-strong manner with an H-score range of 5-300 (median, 260). In contrast, 69% of ROS1-non-rearranged cancers lacked detectable immunoreactivity, whereas the remaining 31% showed reactivity mainly in a weak or focal manner. The H-score for the entire ROS1-non-rearranged group ranged from 0 to 240 (median, 0). The difference in H-score between the two cohorts was statistically significant, and the H-score cutoff (≥150) allowed optimal discrimination (94% sensitivity and 98% specificity). Similar but slightly less-specific performance was achieved using the extent of diffuse (≥75%) staining or ≥2+ staining intensity as cutoffs. CD74-ROS1 and EZR-ROS1 fusions were significantly associated with at least focal globular immunoreactivity and plasma membranous accentuation, respectively, and these patterns were specific to ROS1-rearranged cases. Although full-length ROS1 is expressed in some ROS1-non-rearranged cases, we showed that establishment of an optimal set of interpretative criteria makes ROS1 immunohistochemistry a valuable method to rapidly and accurately screen lung cancer patients for appropriate molecular therapy. PMID:24186139

  2. Prognostic impact of immunohistochemical expression of CK7 and CK20 in curatively resected ampulla of Vater cancer

    Yun, Sung Pil; Seo, Hyung Il


    Background In the consideration of ampullary adenocarcinoma, T stage, lymph node metastases, perineural invasion, tumor differentiation, pancraticobiliary type, and lymph node ratio are considered prognostic factors. The objectives of this study were to investigate surgical outcomes and the clinicopathological predictors affecting survival and recurrence, and to examine the prognostic roles of histopathological subtype and immunohistochemical markers. Methods From April 2006 to September 2012...

  3. Immunohistochemical study of epidermal and dermal expression of Bcl-X, Bcl-2 and bax in psoriasis.


    Objective: To investigate the regulation of cell proliferation and apoptosis in psoriasis. Methods: The expressions of Bcl-X, Bcl-2 and Bax were studied with immunohistochemical technique (SP) in the lesional and non-lesional psoriatic skin. Results: There were significant overexpressions of Bcl-X in all layers of epidermis, inflammatory cells and vascular endothelia in dermis;

  4. Main ideas to consider in the elaboration of a new theoretical model of the clinical method.

    Luis Alberto Corona Martínez


    Full Text Available In this article are exposed the main ideas that has been used for the elaboration of a new theoretical model of the clinical process, with the aim of being used as a teaching content in the Medicine career. Such ideas are: the necessity of a total correspondence between the process method and its objective, the conception of the medical attention process as a decision-taking process, the necessity of highlighting the human dimension of the medical practice, and the convenience of counting with a synthetic representation of the clinical method that facilitates its learning and comprehension. These elements will make possible that the clinical method model facilitates the learning and posterior performance of a more effective and efficient medical attention process, with the following betterment of the medical services’ quality and of the patients’ satisfaction.

  5. Measurement properties of exsisting clinical assessment methods evaluating scapular positioning and function. A systematic review

    Larsen, Camilla Marie; Juul-Kristensen, B; Lund, H;


    MEASUREMENT PROPERTIES OF EXISTING CLINICAL ASSESSMENT METHODS EVALUATING SCAPULAR POSITIONING AND FUNCTION. A SYSTEMATIC REVIEW1,2Camilla Marie Larsen, 1,3Birgit Juul-Kristensen, 1,3Hans Lund, 1Karen Søgaard1Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark2...... of the available clinical scapular assessment methods and critically appraise the methodological quality of the involved studies. METHODS A systematic, computer-assisted literature search using Medline, CINAHL, SportDiscus and EMBASE was performed from inception to October 2013. Reference lists in...... groups: Static positioning assessment (n=19), Semi-dynamic (n=13), and Dynamic functional assessment (n=22). Fifteen studies were excluded for evaluation due to no/few clinimetric results, leaving 35 studies for evaluation. Graded according to the COnsensus-based Standards for the selection of health...

  6. Clinical way method in treatment of out-patients with ischemic heart disease after cardiosurgery

    Vardosanidze S.L.


    Full Text Available 158 patients with ischemic heart disease (IHD have been understudy during the period of 12 months in out-patient conditions. After completion of the primary examination all the patients of basic group (118 patients received clinical way method of treatment. Patients of the comparison group (40 patients after provided treatment were cared by their local therapeutists (cardiologists. The findings proved the fact that treatment of patients after cardiosurgery by clinical way method in out-patient conditions enabled to raise patient motivation to treatment, thereby assisting them to feel better, promoting normalization of arterial pressure data. The research results stated that clinical way method of treatment may be considered as rational and effective

  7. Immunohistochemical localization of epidermal growth factor in rat and man

    Poulsen, Steen Seier; Nexø, Ebba


    Epidermal growth factor (EGF) is a peptide which stimulates cell mitotic activity and differentiation, has a cytoprotective effect on the gastroduodenal mucosa, and inhibits gastric acid secretion. The immunohistochemical localization of EGF in the Brunner's glands and the submandibular glands is...... well documented. The localization of EGF in other tissues is still unclarified. In the present study, the immunohistochemical localization of EGF in tissues from rat, man and a 20 week human fetus were investigated. In man and rat, immunoreaction was found in the submandibular glands, the serous glands...

  8. Combining knowledge- and data-driven methods for de-identification of clinical narratives.

    Dehghan, Azad; Kovacevic, Aleksandar; Karystianis, George; Keane, John A; Nenadic, Goran


    A recent promise to access unstructured clinical data from electronic health records on large-scale has revitalized the interest in automated de-identification of clinical notes, which includes the identification of mentions of Protected Health Information (PHI). We describe the methods developed and evaluated as part of the i2b2/UTHealth 2014 challenge to identify PHI defined by 25 entity types in longitudinal clinical narratives. Our approach combines knowledge-driven (dictionaries and rules) and data-driven (machine learning) methods with a large range of features to address de-identification of specific named entities. In addition, we have devised a two-pass recognition approach that creates a patient-specific run-time dictionary from the PHI entities identified in the first step with high confidence, which is then used in the second pass to identify mentions that lack specific clues. The proposed method achieved the overall micro F1-measures of 91% on strict and 95% on token-level evaluation on the test dataset (514 narratives). Whilst most PHI entities can be reliably identified, particularly challenging were mentions of Organizations and Professions. Still, the overall results suggest that automated text mining methods can be used to reliably process clinical notes to identify personal information and thus providing a crucial step in large-scale de-identification of unstructured data for further clinical and epidemiological studies. PMID:26210359

  9. Correlation between PET/CT results and histological and immunohistochemical findings in breast carcinomas

    Almir Galvão Vieira Bitencourt


    Full Text Available Objective To correlate the results of 18F-fluoro-2-deoxy-D-glucose (18F-FDG positron emission tomography/computed tomography (PET/CT performed with a specific protocol for assessment of breasts with histological/immunohistochemical findings in breast carcinoma patients. Materials and Methods Cross-sectional study with prospective data collection, where patients with biopsy-confirmed breast carcinomas were studied. The patients underwent PET/CT examination in prone position, with a specific protocol for assessment of breasts. PET/CT findings were compared with histological and immunohistochemical data. Results The authors identified 59 malignant breast lesions in 50 patients. The maximum diameter of the lesions ranged from 6 to 80 mm (mean: 32.2 mm. Invasive ductal carcinoma was the most common histological type (n = 47; 79.7%. At PET/CT, 53 (89.8% of the lesions demonstrated anomalous concentrations of 18F-FDG, with maximum SUV ranging from 0.8 to 23.1 (mean: 5.5. A statistically significant association was observed between higher values of maximum SUV and histological type, histological grade, molecular subtype, tumor diameter, mitotic index and Ki-67 expression. Conclusion PET/CT performed with specific protocol for assessment of breasts has demonstrated good sensitivity and was associated with relevant histological/immunohistochemical factors related to aggressiveness and prognosis of breast carcinomas.

  10. Immunohistochemical consistency between primary tumors and lymph node metastases of gastric neuroendocrine carcinoma

    Uchiyama Chieko


    Full Text Available Abstract Background Gastric neuroendocrine carcinoma (G-NEC is a rare, highly malignant tumor that exhibits aggressive growth leading to vascular invasion, distant metastasis and extremely poor prognosis. We studied the clinicopathological findings of seven patients at our institute to better under this disease. Methods Seven cases of G-NEC were identified among 1,027 cases of gastric carcinoma that underwent gastrectomy at Kansai Rousai Hospital between 2002 and 2010. We studied the pathological and immunohistochemical features of gastric neuroendocrine carcinomas at both the primary site and metastatic lymph nodes. Results The mean patient age was 73 years (range 63 to 86 years. There were no females in this series. The final staging was Stage I in one case, Stage II in two, Stage III in two and Stage IV in two. A total of 31 metastatic lymph nodes were found in these patients. This study revealed that the ratio of neuroendocrine cells was similar between the primary and metastatic sites, which tended to show the same expression patterns of neuroendocrine markers. Conclusions Metastatic lymph nodes showed heterogeneous immunohistochemical expression patterns similar to the primary sites. G-NEC is far advanced at diagnosis and rapidly reaches the lymph nodes retaining its heterogeneity, carrying a worse prognosis than common gastric cancer. Mini abstract G-NEC grows rapidly and metastasizes to the lymph nodes, retaining its pathological and immunohistochemical heterogeneity even at the metastatic sites.

  11. Eritema-papulosis form rosacea – results of immunohistochemical research of the condition of the lesions

    Haritonova E.G.


    Full Text Available Studying and the analysis of links pathogenesis of eritema-papulosis forms of rosacea by means of a wide spec-trum of immunohistochemical markers became a research problem. Fo r the decision of tasks in view by the author it is used a material of 12 diagnosed cases eritema-papulosis forms of rosacea at men at the age from 32 till 64 years. Use of immunohis-tochemical methods of research has allowed to reveal new links in pathogenesis rosacea and to establish a role of some cellu-lar populations of a skin and cages of imm une system in disease progressing. Besides, at use of the offered scheme of treat-ment dynamics of immunohistochemical indicators was observed considerably more expressed at erit ema-papulosis forms. Treatment influence on an immune link was has been confirmed essential, concerning control, reduction of quantity CD4 + cages, and also changes in quantity CD1 а +, CD138 + that CD68 + cages. Essential re sult the offered scheme gives in a di-rection of suppression of fibrous changes in derma and myofib roblastic transformations dendroc ytes. Considerably the meta-bolism extracellular of matrix improves. Influence of treatment on a vascular component proves to be true reduction of densi-ty of vessels in parallel with decrease in expression VEGF.

  12. Immunohistochemical aspects of apoptosis in gingival mucosa with papilloma and condyloma acuminata.

    Scrieciu, Monica; Mercuţ, Veronica; Mercuţ, Răzvan; Amărăscu, Marina Olimpia; Popescu, Sanda Mihaela; Predescu, Anca Mihaela; Baniţă, Ileana Monica


    The oral mucosa is a component of the oral ecosystem, which can be aggressed by corrosion products released from the dental alloys used in prosthetic dentistry therapy. The purpose of this study was to compare the in vivo effect of nickel and copper compounds on the oral mucosa cells, including their ability to induce cell death, by analyzing the cytochrome c (cyt. c) immunohistochemical expression. Gingival mucosa fragments obtained from the subjects with dentures manufactured by nickel or copper casting alloys were processed through the histological technique of paraffin inclusion. The sections obtained were stained by usually histological methods in order to highlight the histopathological lesions and also analyzed using the immunohistochemical technique in order to study the cyt. c expression. The papillomatosis lesions were observed in the gingival mucosa fragments obtained from the subjects with nickel-based alloy dentures and the condyloma acuminata lesions were observed in those obtained from the subjects with copper-based alloy dentures. The cyt. c immunohistochemical expression was different in the epithelial layer of two types of mucosal fragments but it was the same in their lamina propria connective tissue. We can conclude that the two types of metal alloys have different effects on the adjacent gingival mucosa. PMID:26193209

  13. Immunohistochemical evaluation of experimental Vagococcus salmoninarum infection in rainbow trout (Oncorhynchus mykiss, Walbaum 1792).

    Yardimci, B; Didinen, B I; Onuk, E E; Metin, S; Ciftci, A; Kubilay, A; Pekmezci, G Z; Eralp, H


    The aim of this study was to investigate the pathogenesis and histopathological and immunohistochemical findings in rainbow trout (Oncorhynchus mykiss) following experimental vagococcosis. For this purpose, 60 rainbow trout were used. The experimental study used the pathogen Vagococcus salmoninarum. The fish were intraperitoneally (IP) administered with an inoculate containing 0.1 mL of the bacteria, resulting in a dose of 1.2 × 10(9)  cfu mL(-1) per fish. For histopathological observations, tissue samples were taken from fish that died during the experiment and fish that survived until the end of the trial (60th day). All the tissue samples were immunohistochemically stained by the avidin-biotin-peroxidase complex and immunofluorescence methods using polyclonal antibody to detect V. salmoninarum antigens. In immunoperoxidase staining, positive reactions to bacterial antigens were most commonly seen in the kidney, heart and liver. In the immunofluorescence analysis, the distribution of antigens in the tissue and organs was similar to that observed with the immunoperoxidase staining. The results reveal an important correlation between histochemical and immunohistochemical staining in demonstrating the distribution of V. salmoninarum antigens in the affected tissues. PMID:26095881

  14. An immunohistochemical study of the sciatic nerve in a rat knee immobilization model.

    Yoshida, Shinya; Matsuzaki, Taro; Hoso, Masahiro


    [Purpose] This study was performed to immunohistochemically evaluate changes in the periphery of the sciatic nerve in a rat model of knee immobilization, and to assess the effects of range of motion exercise. [Subjects and Methods] Twenty-one male rats were divided randomly into three groups: control (C), immobilized (I), and exercise (E group). Rats in the I and E groups had the right knee joint immobilized for 2 weeks. In the E group, range of motion exercise was also performed. After the experimental period, the periphery of the sciatic nerve was immunohistochemically observed. [Results] Immunohistochemical staining revealed that the myelin sheath and the perineurium in all groups were laminin positive. In the C and E groups, all rats showed normal staining. In contrast, 4 rats in the I group exhibited weak labeling. [Conclusion] Our results suggest that immobilization alters the perineurium at a molecular level and the range of motion exercise is essential for maintaining the environment of the perineurium. PMID:27190437

  15. The frequency of Listeria monocytogenes strains recovered from clinical and non-clinical samples using phenotypic methods and confirmed by PCR

    abazar pournajaf; lida lotfollahi; gholamreza irajian; abdollah ardebili; Behrooz Sadeghi kalani; mojtabata Taghizadeh armaki


    Background: Listeria monocytogenes is a facultative intracellular pathogen that causes listeriosis which has extensive clinical manifestations. Infections with L. monocytogenes are a serious threat to immunocompromised persons. The aim of this study was to determine the frequency of L. monocytogenes strains recovered from clinical and non-clinical samples using phenotypic methods and confirmed by PCR. Materials and Methods: In this study, 617 specimens were analyzed. All specimens were cu...

  16. Detection of clarithromycin-resistant Helicobacter pylori in clinical specimens by molecular methods: A review.

    Xuan, Shi-Hai; Wu, Li-Pei; Zhou, Yu-Gui; Xiao, Ming-Bing


    Various molecular methods have been developed to rapidly detect clarithromycin (CLR) resistance in Helicobacter pylori isolates in clinical specimens. All of these assays for detecting CLR resistance in H. pylori are based on detection of mutations in the 23S rRNA gene. In this article, we summarise current knowledge regarding the detection of H. pylori CLR resistance in clinical specimens by molecular tests. The available data showed that restriction fragment length polymorphism (RFLP), 3'-mismatch PCR, DNA sequencing, the PCR line probe assay (PCR-LiPA) and fluorescence in situ hybridisation assay (FISH) are able to detect CLR-resistant H. pylori in clinical specimens with excellent specificity and sensitivity. However, several factors limit their clinical application, including fastidious, time-consuming preparation and low-throughput as well as carrying a risk of contamination. Furthermore, as an invasive method, FISH is not suitable for children or the elderly. Among the molecular methods, one that is most promising for the future is real-time PCR probe hybridisation technology using fluorescence resonance energy transfer (FRET) probes, which can rapidly detect CLR resistance with high sensitivity and specificity in biopsies and stool specimens, even though mixed infections are present in clinical specimens. Moreover, due to the advantages that this method is simple, rapid and economical, real-time PCR is technically feasible for clinical application in small- and medium-sized hospitals in developing countries. Second, with high sensitivity, specificity and throughput, DNA chips will also be a valuable tool for detecting resistant H. pylori isolates from cultures and clinical specimens. PMID:27436390

  17. Evaluation of different detection methods of biofilm formation in the clinical isolates

    Afreenish Hassan


    Full Text Available BACKGROUND: Microorganisms growing in a biofilm are associated with chronic and recurrent human infections and are highly resistant to antimicrobial agents. There are various methods to detect biofilm production like Tissue Culture Plate (TCP, Tube method (TM, Congo Red Agar method (CRA, bioluminescent assay, piezoelectric sensors, and fluorescent microscopic examination. OBJECTIVE: This study was conducted to compare three methods for the detection of biofilms. METHOD: The study was carried out at the Department of Microbiology, Army Medical College, National University of Sciences and Technology, Pakistan, from January 2010 to June 2010. A total of 110 clinical isolates were subjected to biofilm detection methods. Isolates were identified by standard microbiological procedures. Biofilm detection was tested by TCP, TM and CRA. Antibiotic susceptibility test of biofilm producing bacteria was performed by using the Kirby-Bauer disc diffusion technique according to CLSI guidelines. RESULTS: The TCP method was considered to be superior to TM and CRA. From the total of 110 clinical isolates, TCP method detected 22.7% as high, 41% moderate and 36.3% as weak or non-biofilm producers. We have observed higher antibiotic resistance in biofilm producing bacteria than non-biofilm producers. CONCLUSION: We can conclude from our study that the TCP method is a more quantitative and reliable method for the detection of biofilm forming microorganisms as compared to TM and CRA methods, and it can be recommended as a general screening method for detection of biofilm producing bacteria in laboratories.

  18. Prognostic Value of Immunohistochemical Staining of p53, bcl-2, and Ki-67 in Small Cell Lung Cancer

    Paik, Kwang Hyun; Park, Yeon Hee; Ryoo, Baek-Yeol; Yang, Sung Hyun; Lee, Jae Cheol; Kim, Cheol Hyun; Ki, Seung Seog; Kim, Jung Min; Park, Myung Joon; Ahn, Heui June; Choi, Won; Chung, Jin Haeng


    Small cell lung cancer (SCLC) is one of the most fatal cancers in humans and many factors are known to be related to its poor prognosis. Immunohistochemical (IHC) stainings were done on SCLC specimens in order to investigate the prognostic value of the apoptosis-related gene expression and the tumor proliferative maker, and the relationships among these IHC results and patients clinical characteristics, chemoresponsiveness, and survival were analyzed. The medical records of 107 patients were ...

  19. Pathohistological and immunohistochemical parameters significant for prognosis and therapy of tumours in cats and dogs

    Aleksić-Kovačević Sanja


    Full Text Available The development of tumours implies a disproportion between proliferation, growth and differentiation, which is accompanied by significant genotypic and phenotypic variations in the diseased. The scenario of multiple oncogenic effects on the inhibition of cell growth, apoptosis and maturation, on the stimulation of proliferation, on cell migration and tissue invasion, is responsible for the occurrence of tumours both in humans and in animals. The qualitative and quantitative determination of biological prognostic factors in the tissue of affected cats and dogs directly indicates a possible tumour metastasizing, and consequently also the prognosis of neoplastic disease. Monitoring of clinical and biological prognostic factors is important for therapy and prediction of tumours in humans and animals. The determination of the proliferative potential of tumour cells by immunohistochemical detection of Ki-67 and PCNA is used in grading certain tumours in cats and dogs. It is also possible immunohistochemically to prove factors of angiogenesis and numerous activating and inhibiting proteins in the tumour tissue. In addition to other histological, clinical and biological parameters, they are significant for the further prognosis and therapy of neoplastic diseases.

  20. Enrichment methods to detect bone marrow micrometastases in breast carcinoma patients: clinical relevance

    Improving technologies for the detection and purification of bone marrow (BM) micrometastatic cells in breast cancer patients should lead to earlier prognosis of the risk of relapse and should make it possible to design more appropriate therapies. The technique used has to overcome the challenges resulting from the small number of target cells (one per million hematopoietic cells) and the heterogeneous expression of micrometastatic cell markers. In the present study, we have assessed the clinical relevance of current methods aimed at detecting rare disseminated carcinoma cells. BM aspirates from 32 carcinoma patients were screened for the presence of micrometastatic cells positive for epithelial cell adhesion molecule and positive for cytokeratins, using optimized immunodetection methods. A comparison with data obtained for 46 control BM aspirates and a correlation with the clinical status of patients were performed. We developed a sensitive and efficient immunomagnetic protocol for the enrichment of BM micrometastases. This method was used to divide 32 breast carcinoma patients into three categories according to their epithelial cell adhesion molecule status. These categories were highly correlated with the recently revised American Joint Committee on Cancer staging system for breast cancer, demonstrating the clinical relevance of this simple and reliable immunomagnetic technique. We also evaluated immunocytochemical detection of cytokeratin-positive cells and cytomorphological parameters. Immunocytochemistry-based methods for the detection of BM micrometastases did not provide any information about the clinical status of patients, but helped to refine the immunomagnetic data by confirming the presence of micrometastases in some cases. We also tested a new density gradient centrifugation system, able to enrich the tumor fraction of BM specimens by twofold to threefold as compared with standard Ficoll methods. These improved methods for the detection of

  1. Canine aural cholesteatoma: a histological and immunohistochemical study.

    Banco, Barbara; Grieco, Valeria; Di Giancamillo, Mauro; Greci, Valentina; Travetti, Olga; Martino, Pieranna; Mortellaro, Carlo M; Giudice, Chiara


    Canine aural cholesteatoma is an epidermoid cyst that forms in the middle ear cavity as a rare complication of otitis media but the aetiopathogenesis remains controversial. In the present study, 13 cases of canine aural cholesteatoma were investigated histologically and immunohistochemically and compared with cases of chronic otitis. The immunohistochemical investigation was performed using the following monoclonal antibodies: anti-cytokeratins (CK) 14, 16, 8/18, and 19, and anti-Ki67. The proliferative indexes (PIs) of cholesteatomata and otitis epithelium were calculated as the percentage of Ki67 positive nuclei/total nuclei. Histologically, the cholesteatomata were composed of a hyperplastic, hyperkeratotic epithelium (matrix) resting on a fibrous perimatrix, infiltrated by inflammatory cells and devoid of cutaneous adnexa. Immunohistochemically, the cholesteatoma epithelium was CK14- and CK16-positive, and CK8/18- and CK19-negative. A similar pattern of CK expression was found in otitis externa. In otitis media, ciliated epithelium stained CK8/18- and CK19-positive in all layers, CK14-positive in the basal layers, and CK16-negative. The mean PIs in cholesteatomata and otitides were 18.8 and 17.8, respectively. The immunohistochemical pattern of CK expression in cholesteatomata, when compared with chronic otitis, was suggestive of hyperproliferative epithelium, but its origin could not be demonstrated. Comparable PI values were obtained in cholesteatoma and in chronic otitis, which confirmed that Ki67 is a valuable indicator of a hyperproliferative state, but not a predictor of aggressiveness. PMID:24775276

  2. Immunohistochemical and Morphological Changes in Chipmunk Carotid Body during Hibernaiton

    FUKUHARA, Kohko; YOSHIZAKI, Katsuaki; Wu, Yi; Senoo, Haruki; OHTOMO, Kazuo


    Mammalian hibernators experience drastic changes in vital signs such asbody temperature, respiratory rate, and heart rate during hibernation because of periodicarousals during which vital signs return to non-hibernating levels. The carotid body, anarterial chemoreceptor organ regulating respiration, contains several neuroactive substances.However, little is known about changes of neuroactive substances in the carotidbody during hibernation. Immunohistochemical study using antibodies against n...

  3. Circumscribed sebaceous neoplasms: a morphological, immunohistochemical and molecular analysis.

    Harvey, Nathan Tobias; Tabone, Tania; Erber, Wendy; Wood, Benjamin Andrew


    Sebaceous neoplasms encompass a range of lesions, including benign entities such as sebaceous adenoma and sebaceoma, as well as sebaceous carcinoma. The distinction of sebaceous carcinoma from benign lesions relies on histological identification of architectural or cytological features of malignancy. In this study we have assessed the diagnostic discriminatory ability of mitotic rate and immunohistochemical markers (p53, bcl-2 and p16) in a selected group of well circumscribed sebaceous neoplasms, incorporating examples of sebaceous adenoma, sebaceoma and sebaceous carcinoma. We found that mitotic rate was significantly higher in malignant lesions as compared to benign lesions, but none of the immunohistochemical markers showed a discriminatory expression pattern. In addition, we performed a mutational analysis on the same group of lesions using next generation sequencing (NGS) technology. The most commonly mutated gene was TP53, although there was no correlation between the p53 immunohistochemical results and number or type of TP53 mutation detected. CDKN2A, EGFR, CTNNB1 and KRAS were also commonly mutated across all lesions. No particular gene, mutation profile or individual mutation could be identified which directly correlated with the consensus histological diagnosis. In conclusion, within this diagnostically challenging group of lesions, mitotic activity, but not immunohistochemical labelling for p16 or bcl-2, correlates with diagnostic category. While a number of genes potentially involved in the genesis of sebaceous neoplasia were uncovered, any molecular differences between the histological diagnostic categories remain unclear. PMID:27311873

  4. Caracterización de las fibras del músculo gluteus medius en equinos por métodos histoquímicos e inmunohistoquímicos Characterization of fibers from gluteus medius muscle in horses by histochemical and immunohistochemical methods

    A. ISLAS


    Full Text Available Se tomó una biopsia a cuatro centímetros de profundidad en el músculo Gluteus medius de 16 equinos. Los animales tenían una edad promedio de 6 años y durante 3 meses previo a la toma de la biopsia no habían realizado entrenamiento. Las muestras fueron analizadas por medio de la técnica mATPasa miofibrilar, NADH-TR e inmuno-histoquímica. Los porcentajes de fibras tipo I, IIA, IIB oxidativas y no oxidativas fueron de un 14, 39, 30 y 17%, respectivamente, para la técnica histoquímica y un 16, 35, 29 y 20% para las fibras tipo I , IIA, IIX y IIA+IIX para la técnica inmuno-histoquímica. El análisis estadístico demostró que no existen diferencias signifi-cativas entre ambas técnicas para la determinación de las fibras. Los resultados obtenidos permiten concluir que la inmunohistoquímica es una técnica que permite realizar una clasificación adecuada de la población fibrilar del músculo Gluteus medius en equinos adultos.Biopsies were taken at a depth of 4cm from the Gluteus medius muscle of 16 horses. The animals were 6 years old and had not been trained during 3 months before the study. The samples were analized by mATPase miofibrillar technique to determine the fibrillar composition by NADH-TR technique to determine the oxidative capacity of the fibres and immunohistochemistry to determine the fibre type. The histochemical study revealed an average fibrillar composition of 14, 39, 30 and 17 % for fibres typed I, IIA, IIX oxidative and IIX no oxidative and the inmunohistochemistry study showed 16, 35, 29 y 20% for fibres type I, IIA, IIX and IIA-IIX. The statistical analyses showed a good relationship between the histochemical and inmunohistochemical method in the determination of fiber types. The immunohistochemical method allows a good identification of the fiber in adult horses.

  5. Protein Profile study of clinical samples using Laser Induced Fluorescence as the detection method

    Karemore, Gopal Raghunath; Raja, Sujatha N.; Rai, Lavanya;


      Protein profiles of tissue homogenates were recorded using HPLC separation and LIF detection method. The samples were collected from volunteers with clinically normal or cervical cancer conditions. It is shown that the protein profile can be classified as belonging to malignant or normal state ...

  6. HLA genotyping in the clinical laboratory: comparison of next-generation sequencing methods.

    Profaizer, T; Lázár-Molnár, E; Close, D W; Delgado, J C; Kumánovics, A


    Implementation of human leukocyte antigen (HLA) genotyping by next-generation sequencing (NGS) in the clinical lab brings new challenges to the laboratories performing this testing. With the advent of commercially available HLA-NGS typing kits, labs must make numerous decisions concerning capital equipment and address labor considerations. Therefore, careful and unbiased evaluation of available methods is imperative. In this report, we compared our in-house developed HLA NGS typing with two commercially available kits from Illumina and Omixon using 10 International Histocompatibility Working Group (IHWG) and 36 clinical samples. Although all three methods employ long range polymerase chain reaction (PCR) and have been developed on the Illumina MiSeq platform, the methodologies for library preparation show significant variations. There was 100% typing concordance between all three methods at the first field when a HLA type could be assigned. Overall, HLA typing by NGS using in-house or commercially available methods is now feasible in clinical laboratories. However, technical variables such as hands-on time and indexing strategies are sufficiently different among these approaches to impact the workflow of the clinical laboratory. PMID:27524804

  7. A large series of immunohistochemically confirmed cases of congenital muscular dystrophy seen over a period of one decade

    Madhu Nagappa


    Full Text Available Background: Although congenital muscular dystrophies (CMD is a common condition among primary muscle disorders, there are only a few small series reported from India. Aims, Settings, and Design: Retrospective analysis to characterize histopathologically and/or immunohistochemically confirmed cases of CMD. Materials and Methods: Patients were identified retrospectively from the archived muscle biopsy reports between 1997 and 2007 at the Department of Neuropathology of the institute. Medical records were scrutinized for all details. Results: There were 102 cases which were characterized by clinical phenotype and histopathology. Among these 56 had immunohistochemical staining and were included in the final analysis. Merosin staining performed in 53 samples identified nine patients with merosin negative CMD. The male to female ratio (M:F was 2:1 and the mean age at presentation was 69.7 ± 62.2 months. All had grossly delayed motor milestones. There were 13 cases of Ullrich CMD confirmed by absent staining for collagen 6A1 in muscle. Mean age at diagnosis was 63.7 ± 27.9 months. Onset of symptoms was in infancy in 12 patients. All had significant delay in motor milestones and had classical features of proximal contractures, distal hyperextensibility, prominent calcaneum, velvety palms and soles with absent palmar creases. Mean creatine kinase (CK value was 259.1 ± 109.4 IU/l. Alpha-dystroglycan (α-DG deficiency was identified in three cases. Illness onset was in infancy. Classical magnetic resonance imaging (MRI features were seen in all. Large group of 31 cases of merosin positive CMD had clinical findings of early onset limb weakness, hypotonia, and contractures; with histopathological evidence of dystrophy, and normal staining pattern of merosin, collagen 6A1 and α-DG. Mean age at evaluation was 58.61 ± 48.4 months. Majority (87.1% had onset of symptom in infancy with delay in motor milestones. Conclusions: This study provides a significant

  8. Dry eye evaluation and immunohistochemical study of the conjunctiva and lacrimal gland of patients submitted to bone marrow transplantation

    Cunha Rosana Nogueira Pires da


    Full Text Available PURPOSE: The primary ocular targets of chronic graft-versus-host disease (GVHD are the lacrimal gland (LG and the conjunctiva, and their involvement results in keratoconjunctivitis sicca (KCS. The purpose of the present study was to evaluate the frequency of signs and symptoms of KCS present in patients submitted to BMT, to identify the cellular phenotype of the conjunctival and lacrimal gland biopsies of these patients by immunohistochemistry and to correlate the findings with the presence of dry eye due to GVHD. METHODS: Forty-seven patients were clinically classified into two groups: Group I, with ocular GVHD, submitted to allogeneic BMT and Group II, without ocular GVHD, submitted to autologous and allogeneic BMT. Thorough eye examination, including clinical lacrimal function tests and biopsies of the conjunctiva and of the LG were performed in the pre- and posttransplantation period. The biopsies were submitted to immunohistochemical analysis using a panel of monoclonal antibodies. RESULTS: Of the 28 (82.4% patients with chronic GVHD, 13 (46.4% presented ocular GVHD. Of the six patients without GVHD, one (16.7% presented ocular GVHD. None of those submitted to autologous BMT presented ocular GVHD and 14 (41.2% of 34 patients with allogeneic BMT presented ocular GVHD. All patients with ocular GVHD (Group I had symptoms and the most frequent were burning, foreign body sensation, blurred vision and dryness. The rose bengal test was one of the most sensitive in this study and slit lamp examination was very useful in the evaluation of corneal and conjunctival alterations, since these alterations were always present in patients with dry eye in our study. Neither symptoms and signs of dry eye nor significant immunologic reaction was observed in the conjunctiva and in the LG of patients without ocular GVHD (Group II. There was an increase in the T lymphocyte population, of T helper lymphocyte (Th/i and T suppressor-cytotoxic lymphocyte (Ts

  9. Clinical application of a rapid flow-cytometric immunofluorescence method for studing lymphocyte subsets

    In this study, we report a clinical application of a rapid flow-cytometric immunofluorescence method for studing lymphocyte subsets in whole blood by using fluorescein-conjugated monoclonal antibodies OKT 3, OKT 4, OKT 8, OKI a 1, OKT 6, OKT 11, OKT 9, OKT 10 and OKM 1. Changes in the relative percentages and absolute counts of various lymphocyte subsets during radiotherapy of cancer patients were evaluated by this method. (author)

  10. Lung scintigraphy in the diagnosis of pulmonary embolism: current methods and interpretation criteria in clinical practice

    Skarlovnik, Ajda; Hrastnik, Damjana; Fettich, Jure; Grmek, Marko


    Background In current clinical practice lung scintigraphy is mainly used to exclude pulmonary embolism (PE). Modified diagnostic criteria for planar lung scintigraphy are considered, as newer scitigraphic methods, especially single photon emission computed tomography (SPECT) are becoming more popular. Patients and methods. Data of 98 outpatients who underwent planar ventilation/perfusion (V/Q) scintigraphy and 49 outpatients who underwent V/Q SPECT from the emergency department (ED) were retr...

  11. Successful recruitment methods in the community for a two-site clinical trial.

    Fairbanks, Eileen; Shah, Shivani; Wilde, Mary H; McDonald, Margaret V; Brasch, Judith; McMahon, James M


    Effective screening and recruitment are essential to the success of randomized clinical trials. This report is to describe key screening and recruitment strategies in a two site randomized clinical trial (RCT) conducted in community settings with a vulnerable chronically ill population and to suggest valuable approaches when planning trials. Differences between sites in a complex study with two considerably different environments (academic versus home care) and their participant pools presented challenges which required different screening and recruitment methods. A high level of communication between sites, creative problem solving and the ability to be flexible when problems were encountered were needed for successful screening and recruitment. PMID:24852451

  12. A New Method for Cardiovascular Disease Clinical Diagnosis Based on Artificial Neural Network Model

    Huang Zhao-Ming


    Full Text Available Diagnosis. In order to improve the accuracy of Clinical Diagnosis for Cardiovascular Disease, ANN(Artificial Neural Network is introduced in this paper. 200 cases of cardiovascular disease which have similar symptom and different diagnosis are sampled from our database. BP Network model in Matlab environment is created for these cases. Simulation results show that the Diagnosis after training is much better than that with the doctor’ diagnosis opinion. It can be concluded that this new method is of important value for realistic scale in clinical.

  13. Live births following Karyomapping of human blastocysts: experience from clinical application of the method.

    Konstantinidis, Michalis; Prates, Renata; Goodall, N-Neka; Fischer, Jill; Tecson, Victoria; Lemma, Tsion; Chu, Bo; Jordan, Amy; Armenti, Erin; Wells, Dagan; Munné, Santiago


    The clinical application of a new, widely applicable method known as Karyomapping to carry out a total of 55 clinical cases of preimplantation genetic diagnosis (PGD) for single gene disorders is reported. Conventional polymerase chain reaction (PCR) testing was carried out in parallel to the new method for all cases. Clinical application of Karyomapping in this study resulted in three live births and nine clinical pregnancies out of 20 cases with a transfer. All in all, results presented in this study indicate that Karyomapping is a highly efficient, accurate and robust method for PGD of single gene disorders. Karyomapping can offer a more comprehensive assessment of the region of interest than conventional PCR analysis, allowing for more embryos to receive diagnosis (99.6% versus 96.8%), whereas its wide applicability reduces substantially the time that patients have to wait before starting their in vitro fertilization (IVF) cycle. Nonetheless, inclusion of elements of conventional PCR methodology, such as direct mutation detection, may be required in cases in which the gene of interest is in a region with reduced single nucleotide polymorphism (SNP) coverage (e.g. telomeric regions), when offering PGD for consanguineous couples, or in cases where no samples from additional family members are available. PMID:26206283

  14. Immunohistochemical markers for arthritis in psoriasis.

    Veale, D J; Barnes, L.; Rogers, S.; FitzGerald, O


    OBJECTIVES--To examine the immunohistological features in the involved skin of patients with psoriatic arthritis (PA) (n = 15), compared with those in involved skin from patients with psoriasis but no arthritis (n = 5), and with a group with normal skin (n = 4), to identify markers for arthritis in psoriasis. METHODS--Skin was obtained from patients by 6 mm punch biopsy and normal skin was provided by the department of plastic surgery. Samples were stained with monoclonal antibodies against T...

  15. Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review

    Larsen, Camilla Marie; Juul-Kristensen, B; Lund, H;


    Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review Larsen CM1, Juul-Kristensen B1,2 Lund H1,2, Søgaard K1 1University of Southern Denmark, Institute of Sports Science and Clinical Biomechanics 2Institute of Occupational....... Methods A systematic, computer-assisted literature search using Medline, CINAHL, SportDiscus and EMBASE was performed from inception to October 2013. Reference lists in articles were also screened for publications. The overall method used in this review can be divided into four steps: 1) Compile an...... evaluation due to no/few clinimetric results, leaving 35 studies for evaluation. Graded according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN checklist), the methodological quality in the reliability and validity domains was ‘fair’ (57%) to ‘poor’ (43%), with...

  16. Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review

    Larsen, Camilla Marie; Juul-Kristensen, Birgit; Lund, Hans;

    ABSTRACT OARSI Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review Larsen CM1, Juul-Kristensen B1,2 Lund H1,2, Søgaard K11University of Southern Denmark, Institute of Sports Science and Clinical Biomechanics2Institute of...... studies.MethodsA systematic, computer-assisted literature search using Medline, CINAHL, SportDiscus and EMBASE was performed from inception to October 2013. Reference lists in articles were also screened for publications. The overall method used in this review can be divided into four steps: 1) Compile an...... evaluation due to no/few clinimetric results, leaving 35 studies for evaluation. Graded according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN checklist), the methodological quality in the reliability and validity domains was ‘fair’ (57%) to ‘poor’ (43%), with...

  17. A comparison of three clustering methods for finding subgroups in MRI, SMS or clinical data

    Kent, Peter; Jensen, Rikke K; Kongsted, Alice


    BACKGROUND: There are various methodological approaches to identifying clinically important subgroups and one method is to identify clusters of characteristics that differentiate people in cross-sectional and/or longitudinal data using Cluster Analysis (CA) or Latent Class Analysis (LCA). There is...... a scarcity of head-to-head comparisons that can inform the choice of which clustering method might be suitable for particular clinical datasets and research questions. Therefore, the aim of this study was to perform a head-to-head comparison of three commonly available methods (SPSS TwoStep CA...... each program's ease of use and interpretability of the presentation of results.We analysed five real datasets of varying complexity in a secondary analysis of data from other research projects. Three datasets contained only MRI findings (n = 2,060 to 20,810 vertebral disc levels), one dataset contained...

  18. Chromogens in Multiple Immunohistochemical Staining Used for Visual Assessment and Spectral Imaging: The Colorful Future

    C.M. van der Loos


    For the chromogenic visualization of immunohistochemical enzymatic reaction products, only a limited series of different enzymatic activities and chromogens are available. Consequently, combinations of two chromogens for double immunohistochemical staining are even more limited for visual assessment

  19. Comparative analysis of two and three marker immunohistochemical cocktails in the diagnosis of prostata carcinoma

    Dabir, Parag Deepak; Ottosen, Peter; Hamilton-Dutoit, Stephen Jacques;


    Comparative analysis of two and three marker immunohistochemical cocktails in the diagnosis of prostata carcinoma......Comparative analysis of two and three marker immunohistochemical cocktails in the diagnosis of prostata carcinoma...

  20. Comparative analysis of two and three marker immunohistochemical cocktails in the diagnosis of prostata carcinoma

    Dabir, Parag Deepak; Ottosen, Peter; Hamilton-Dutoit, Stephen Jacques;


    Comparative analysis of two and three marker immunohistochemical cocktails in the diagnosis of prostata carcinoma......Comparative analysis of two and three marker immunohistochemical cocktails in the diagnosis of prostata carcinoma...

  1. A rapid, single vessel method for preparation of clinical grade ligand conjugated monoclonal antibodies

    A rapid, single vessel method for the preparation of clinical grade chelate conjugated monoclonal antibodies has been developed. By use of an Amicon concentrator with reservoir, each of the steps necessary for the preparation of the conjugated drug may be performed in a single vessel. Advantages include reduced risk of metal, pyrogen and bacterial contamination; buffer exchanges are achieved rapidly and efficiently using a continuous dilution method. The radiolabeling efficiency, the radiochemical purity, the total immunoreactivity and the affinity of the final product have been evaluated in the production of CHXA-DTPA-chelate conjugated HuM195. The characteristics compare favorably to those achieved using our conventional synthetic methods

  2. Immunohistochemical evaluation of expression of heat shock proteins HSP70 and HSP90 in mammary gland neoplasms in bitches.

    Badowska-Kozakiewicz, A M; Malicka, E


    Heat shock proteins have essential roles in a number of pathophysiologic conditions including carcinogenesis and represent a group of novel molecular markers in cancer management. The aim of this study was to investigate heat shock protein expression in correlation with other neoplasm traits such as: histological type, differentiation grade, proliferative activity, estrogenic receptor expression, and cyclooxygenase-2 and p53 proteins. Material for the investigation comprised 133 tumors of the mammary gland collected from bitches. In total 14 adenomas, 66 complex carcinomas, 47 simple carcinomas and 6 solid carcinomas were collected. Evaluations were conducted with histopathological and immunohistochemical methods using suitable antibodies. Expression of heat shock protein 70 was observed in all types of evaluated neoplasms. A higher average number of cells undergoing expression of heat shock protein 70, which was statistically insignificant, was established in complex and simple cancers and in cancers with the 1st and the 2nd degree of histological malignancy. Expression of heat shock protein 90 was observed in all studied neoplasms; it was very insignificant in adenomas, compared to cancers, and the highest expression was established in the solid cancers, as well as in cancers with the 2nd degree of histological malignancy. This high expression of heat shock protein 90 was correlated with proliferative activity. The results suggest that heat shock protein 90 is involved in canine mammary gland carcinogenesis. The results also suggest that heat shock protein 90 may be a prognostic factor, but this requires detailed clinical confirmation. PMID:22844695

  3. Immunohistochemical localization of androgen receptor in rat caput epididymis during postnatal development

    Sema Timurkaan


    Full Text Available Objectives: The aim of this study was to investigate the developmental pattern of androgen receptor (AR in caput epididymis.Materials and methods: In this study three randomly selected rats were sacrificed at ages 21, 56, 90 and 120 days old. All male rats were anesthetized with ethyl ether before killing. Then, the caput epididymides were removed and fixed in Bouin’s fixative at +4°C for 36 hour. Afterwards the tissue samples were embedded in paraffin for routine histological methods. Later the tissues were sectioned at 5μm and mounted on poly-L-lysin-coated slides. To solve the antigen masking problem, we performed microwave stimulated antigen retrieval technique before the immunohistochemical staining. Avidin-Biotin-Peroxidase Complex (ABC method was applied for immunohistochemical staining.Results: In all age groups of rats studied, positive immunohistochemical staining for the AR appeared in nuclei of epididymal cells. The staining intensity of AR positive cells did not change depending on age. In caput epididymis, immunostainable AR was found in tubular epithelial cells (principal cells, basal cells and apical cells and peritubular smooth muscle cells. The AR staining in the epithelial cells appeared to be stronger than in the peritubular smooth muscle cells. In the epithelial cells; staining intensity was stronger in principal cells than in basal cells and apical cells.Conclusion: Staining intensity of AR positive epididymal cells irrespective of age indicated the necessity of androgens for postnatal differentiation and maintaining the structure of the epididymis. Stronger staining intensity in principal cells suggested that principal cells are more sensitive to androgen stimulation. J Clin Exp Invest 2011; 2 (3: 260-266.

  4. Evaluating current automatic de-identification methods with Veteran’s health administration clinical documents

    Ferrández Oscar


    Full Text Available Abstract Background The increased use and adoption of Electronic Health Records (EHR causes a tremendous growth in digital information useful for clinicians, researchers and many other operational purposes. However, this information is rich in Protected Health Information (PHI, which severely restricts its access and possible uses. A number of investigators have developed methods for automatically de-identifying EHR documents by removing PHI, as specified in the Health Insurance Portability and Accountability Act “Safe Harbor” method. This study focuses on the evaluation of existing automated text de-identification methods and tools, as applied to Veterans Health Administration (VHA clinical documents, to assess which methods perform better with each category of PHI found in our clinical notes; and when new methods are needed to improve performance. Methods We installed and evaluated five text de-identification systems “out-of-the-box” using a corpus of VHA clinical documents. The systems based on machine learning methods were trained with the 2006 i2b2 de-identification corpora and evaluated with our VHA corpus, and also evaluated with a ten-fold cross-validation experiment using our VHA corpus. We counted exact, partial, and fully contained matches with reference annotations, considering each PHI type separately, or only one unique ‘PHI’ category. Performance of the systems was assessed using recall (equivalent to sensitivity and precision (equivalent to positive predictive value metrics, as well as the F2-measure. Results Overall, systems based on rules and pattern matching achieved better recall, and precision was always better with systems based on machine learning approaches. The highest “out-of-the-box” F2-measure was 67% for partial matches; the best precision and recall were 95% and 78%, respectively. Finally, the ten-fold cross validation experiment allowed for an increase of the F2-measure to 79% with partial matches

  5. Immunohistochemical study on gastrointestinal endocrine cells of four reptiles

    Xu-Gen Huang; Xiao-Bing Wu


    AIM: To darify the types, regional distributions and distribution densities as well as morphological features of gastrointestinal (GI) endocrine cells in various parts of the gastrointestinal track (GIT) of four reptiles, Gekko japonicus, Eumeces chinensis, Sphenomorphus indicus and Eumeces elegans.METHODS: Paraffin-embedded sections (5 μm) of seven parts (cardia, fundus, pylorus, duodenum, jejunum, ileum,rectum) of GIT dissected from the four reptiles were prepared. GI endocrine cells were revealed by using immunohistochemical techniques of streptavidin-peroxidase (S-P) method. Seven types of antisera against 5-hydroxytryptamine (5-HT), somatostatin (SS), gastrin (GAS),glucagon (GLU), substance P (SP), insulin and pancreatic polypeptide were identified and then GI endocrine cells were photomicrographed and counted.RESULTS: The GI endocrine system of four reptiles was a complex structure containing many endocrine cell types similar in morphology to those found in higher vertebrates.Five types of GI endocrine cells, namely 5-HT, SS, GAS,SP and GLU immunoreactive (IR) cells were identified in the GIT of G. japonicus, E. chinensis and S. indicus, while in the GIT of E. elegans only the former three types of endocrine cells were observed. No PP- and INS- IR cells were found in all four reptiles. 5-HT-IR cells, which were most commonly found in the pylorus or duodenum, distributed throughout the whole GIT of four reptiles. However, their distribution patterns varied from each other. SS-IR cells,which were mainly found in the stomach especially in the pylorus and/or fundus, were demonstrated in the whole GIT of E. chinensis, only showed restricted distribution in the other three species. GAS-IR cells, with a much restricted distribution, were mainly demonstrated in the pylorus and/or the proximal small intestine of four reptiles. GLU-IR cells exhibited a limited and species-dependent variant distribution in the GIT of four reptiles. SP-IR cells were found throughout the

  6. Comparative study among calibration methods of clinical applicators of beta radiation

    90Sr+90Y clinical applicators are instruments used in brachytherapy procedures and they have to be periodically calibrated, according to international standards and recommendations. In this work, four calibration methods of dermatological and ophthalmic applicators were studied, comparing the results with those given by the calibration certificates of the manufacturers. The methods included the use of the standard applicator of the Calibration Laboratory (LCI), calibrated by the National Institute of Standards and Technology; an Amersham applicator (LCI) as reference; a mini-extrapolation chamber developed at LCI as an absolute standard; and thermoluminescent dosimetry. The mini-extrapolation chamber and a PTW commercial extrapolation chamber were studied in relation to their performance through quality control tests of their response, as leakage current, repeatability and reproducibility. The distribution of the depth dose in water, that presents high importance in dosimetry of clinical applicators, was determined using the mini extrapolation chamber and the thermoluminescent dosimeters. The results obtained were considered satisfactory for the both cases, and comparable to the data of the IAEA (2002) standard. Furthermore, a dosimetry postal kit was developed for the calibration of clinical applicators using the thermoluminescent technique, to be sent to clinics and hospitals, without the need of the transport of the sources to IPEN for calibration. (author)

  7. Immunohistochemical staining of human sperm cells in smears from sexual assault cases

    Christoffersen, S.


    significantly decreases the time used to screen smears. By further using an EnVision+ (DAKO) protocol, it was possible to create an immunohistochemical staining method to visualize sperm cells in bright-field microscopy with the same level of certainty as when using SPERM HY-LITER (TM)....... sperm cells. In this work the goal was to develop a procedure to rapidly visualize human sperm cells in smear slides with the use of bright-field microscopy. Using SPERM HY-LITER (TM) by Independent Forensics, human sperm cells are visualized using a fluorescently labeled mouse antibody which...

  8. Immunohistochemical Detection of Changes in Tumor Hypoxia

    Purpose: Although hypoxia is a known prognostic factor, its effect will be modified by the rate of reoxygenation and the extent to which the cells are acutely hypoxic. We tested the ability of exogenous and endogenous markers to detect reoxygenation in a xenograft model. Our technique might be applicable to stored patient samples. Methods and Materials: The human colorectal carcinoma line, HT29, was grown in nude mice. Changes in tumor hypoxia were examined by injection of pimonidazole, followed 24 hours later by EF5. Cryosections were stained for these markers and for carbonic anhydrase IX (CAIX) and hypoxia-inducible factor 1α (HIF1α). Tumor hypoxia was artificially manipulated by carbogen exposure. Results: In unstressed tumors, all four markers showed very similar spatial distributions. After carbogen treatment, pimonidazole and EF5 could detect decreased hypoxia. HIF1α staining was also decreased relative to CAIX, although the effect was less pronounced than for EF5. Control tumors displayed small regions that had undergone spontaneous changes in tumor hypoxia, as judged by pimonidazole relative to EF5; most of these changes were reflected by CAIX and HIF1α. Conclusion: HIF1α can be compared with either CAIX or a previously administered nitroimidazole to provide an estimate of reoxygenation

  9. Using Experience Sampling Methods/Ecological Momentary Assessment (ESM/EMA) in Clinical Assessment and Clinical Research: Introduction to the Special Section

    Trull, Timothy J.; Ebner-Priemer, Ulrich W.


    This article introduces the special section on experience sampling methods and ecological momentary assessment in clinical assessment. We review the conceptual basis for experience sampling methods (ESM; Csikszentmihalyi & Larson, 1987) and ecological momentary assessment (EMA; Stone & Shiffman, 1994). Next, we highlight several advantageous features of ESM/EMA as applied to psychological assessment and clinical research. We provide a brief overview of the articles in this special section, ea...

  10. Immunohistochemical evidence of HLA-G expression in extravillous trophoblast invading decidual tissues

    V. Prada


    Full Text Available HLA-G is a non classical HLA I gene product involved in the regulation of implantation and in the immune tolerance during pregnancy, by modulating maternal immune responses at the fetal-maternal interface. In pregnancies lacking immune tolerance and ending in miscarriage, the expression of HLA-G is very probably defective or altered. In order to contribute to further investigations about HLA-G expression in autoimmune miscarriages, we have tried to describe HLA-G immunohistochemical patterns of expression in a homogeneous cohort of normal first trimester choriodecidual specimens, in the three different extravillous trophoblast (EVT populations ("cell islands", "cell columms", and intravascular EVT cells. We expected to demonstrate HLA-G reactivity to the tested antibody (MEMG/01 in all three populations. All choriodecidual specimens were histologically and clinically reviewed to exclude any pathologic finding. Immunohistochemical identification of trophoblast cells in the selected specimens was performed via wellknown immunostains such as Cytokeratin 8/18 (CAM5.2 and NCL-PLp; anti-Ki67 was also used to point out proliferating EVT cells. Then, MEM-G/01 was tested at various dilutions, with or without pretreatment, to find the optimal protocol. As expected, HLA-G specifically stained all three EVT populations, with decreasing reactivity from EVT cell islands to EVT cell columns or intravascular EVTs. The next step will be the investigation of HLA-G pattern of expression in autoimmune aborters.