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Sample records for clinic histological pattern

  1. Identification of histological patterns in clinically affected and unaffected palm regions in dupuytren's disease.

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    Camilo-Andrés Alfonso-Rodríguez

    Full Text Available Dupuytren's disease is a fibro-proliferative disease characterized by a disorder of the extracellular matrix (ECM and high myofibroblast proliferation. However, studies failed to determine if the whole palm fascia is affected by the disease. The objective of this study was to analyze several components of the extracellular matrix of three types of tissues-Dupuytren's diseased contracture cords (DDC, palmar fascia clinically unaffected by Dupuytren's disease contracture (NPF, and normal forehand fascia (NFF. Histological analysis, quantification of cells recultured from each type of tissue, mRNA microarrays and immunohistochemistry for smooth muscle actin (SMA, fibrillar ECM components and non-fibrillar ECM components were carried out. The results showed that DDC samples had abundant fibrosis with reticular fibers and few elastic fibers, high cell proliferation and myofibroblasts, laminin and glycoproteins, whereas NFF did not show any of these findings. Interestingly, NPF tissues had more cells showing myofibroblasts differentiation and more collagen and reticular fibers, laminin and glycoproteins than NFF, although at lower level than DDC, with similar elastic fibers than DDC. Immunohistochemical expression of decorin was high in DDC, whereas versican was highly expressed NFF, with no differences for aggrecan. Cluster analysis revealed that the global expression profile of NPF was very similar to DDC, and reculturing methods showed that cells corresponding to DDC tissues proliferated more actively than NPF, and NPF more actively than NFF. All these results suggest that NPF tissues may be affected, and that a modification of the therapeutic approach used for the treatment of Dupuytren's disease should be considered.

  2. Sebaceous gland carcinoma of the ocular adnexa - variability in clinical and histological appearance with analysis of immunohistochemical staining patterns.

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    Schmitz, Eva Janine; Herwig-Carl, Martina C; Holz, Frank G; Loeffler, Karin U

    2017-11-01

    The purpose of the study was to evaluate the characteristics of sebaceous gland carcinoma (SGC) of the ocular adnexae, which is due to a high variability in clinical, histological and immunohistochemical characteristics often challenging to diagnose. Records of six patients with SGC were reviewed, who underwent surgical excision and who were histologically diagnosed with SGC. For comparison, there were specimens from four patients with basal cell carcinoma (BCC) and four patients with squamous cell carcinoma (SCC). Histological and immunohistochemical analysis included stains for HE, cytokeratins (CKpan, Cam5.2), epithelial membrane antigen (EMA), androgen receptor (AR441), perforin and adipophilin. SGC's were located in the upper (n = 2) or lower (n = 4) eyelid and were associated with various presenting clinical signs including chalazion-like lesions with pyogenic granuloma (n = 1), papillomatous conjunctival tumors (n = 3), a hyperkeratotic exophytic neoplasm (n = 1) and an ulcerating crusted lesion resembling chronic blepharitis (n = 1). The treatment was tumor resection, followed (if necessary) by adjuvant therapy with topical Mitomycin C (n = 2). Histologic characteristics included basophilic pleomorphic cells with vacuolated cytoplasm, prominent nucleoli, mitotic figures and in some cases pagetoid spread (n = 2). CKpan, EMA and Cam5.2 showed strong positive immunoreactivity in all specimens (SGC, BCC, SCC). Perforin immunostaining showed a varying, but overall weak, non-specific cytoplasmatic staining reaction in all lesions. AR441 positivity was noted with variable intensity in almost all lesions and in particular in pagetoid spread in contrast to non-tumor cells. Adipophilin showed an annular staining of lipid granules in immature sebaceous cells in SGC in contrast to a more granular staining pattern in BCC and SCC. SGCs display a variety of clinical signs and may mimic many other lesions. Tumor resection, followed by histological and

  3. Clinically atypical spitzoid lesions: semi-quantitative histologic index correlation with dermoscopic scores (ABCD rule, 7-point checklist and pattern analysis).

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    Saravia, M; Pellicer, Z; Martin, J M; Monteagudo, C

    2015-04-01

    The distinction of Spitz and Reed nevi with atypical features from melanoma may be a difficult task. In these cases, the dermoscopic scores could bring variable results and not always correlate with the histologic diagnosis. The aim of this study was to compare the histopathologic and dermoscopic findings in a cohort of clinically atypical Spitz and Reed nevi. We retrospectively reviewed 19 cases of atypical Spitz and Reed nevi from our files. We constructed a new semi-quantitative histologic index (HI) based on the reproducible microscopic features, and correlated it with two dermoscopic scores: ABCD and 7-point checklist, as well as with the predominant dermoscopic pattern. The HI values differs significantly when the multicomponent dermoscopic pattern was compared with the rest of patterns (U = 22.5, Z = 2.23, P = 0.01). The ABCD and the 7-point checklist scores did not show statistically significant correlation with the HI. To our knowledge, this is the first report in which a semi-quantitative histologic score is compared to different dermoscopic scores in clinically atypical spitzoid lesions. This score can be used to correlate in an objective way the entire histologic picture with the standardized dermoscopic scores. In our series we found a higher HI for those spitzoid lesions with multicomponent pattern. © 2014 European Academy of Dermatology and Venereology.

  4. Clinical and histological patterns of dermatofibroma without gross skin surface change: A comparative study with conventional dermatofibroma

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    Woo Jin Lee

    2015-01-01

    Full Text Available Background : Dermatofibroma sometimes clinically presents as a nodular lesion without gross skin surface change. Clinicopathologic features of this variant of dermatofibroma have not been evaluated. Aims : To assess clinicopathologic features of dermatofibroma presenting as a subcutaneous nodule. Methods : This study reviewed the clinical and histological features of 42 cases of subcutaneous dermatofibromas and compared them with 95 cases of conventional dermatofibroma. Results : Dermatofibroma without gross skin surface change was associated with a shorter pre-diagnosis duration than conventional dermatofibroma. Increase in size during the pre-diagnosis period was significantly more frequent in the conventional type. In addition, these dermatofibromas were more likely than the conventional type to occur in the head and neck region. Although tumor depth was deeper than in the conventional type, less than half of the dermatofibromas without gross skin surface change were found histologically to be "subcutaneous" or "deep-penetrating dermatofibroma". Subcutaneous extension was more frequent in these dermatofibromas while focal stromal hyalinization and hemosiderin deposits were more common in the conventional type. Limitations: This study is a retrospective, single center design. Conclusion : The present study suggests that dermatofibroma without gross skin surface change is a variant type with distinct clinical and histological features that distinguish them from conventional dermatofibroma.

  5. Histologic pattern of biomechanic properties of the carbon fiber-augmented ligament tendon. A laboratory and clinical study.

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    Mendes, D G; Iusim, M; Angel, D; Rotem, A; Roffman, M; Grishkan, A; Mordohohovich, D; Boss, J

    1985-06-01

    Implantation of carbon fiber tow (CFT) for ligament and tendon augmentation was investigated in ten dogs and 45 patients. CFT produced a new structure with a remarkably consistent structural pattern. The basic pattern of the CFT-augmented unit consisted of a core of carbon fiber surround by concentric layers of fibroblasts and collagen fibers. This unit structure was developed from continuous irritation of physical structure of the carbon fiber. In dogs, ultimate tensile strength of the augmented tendon one year after surgery averaged 88% of natural tendon. Digestion of the connective tissue component of the CFT unit exposed the original carbon fiber tow. The connective tissue-free CFT maintained its original tensile strength. The continuous production of collagenous tissue surrounding carbon fibers produced a ligamentous structure that was physiologically compatible and biomechanically sufficient.

  6. Clinical and Histologic Mimickers of Celiac Disease.

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    Kamboj, Amrit K; Oxentenko, Amy S

    2017-08-17

    Celiac disease is an autoimmune disorder of the small bowel, classically associated with diarrhea, abdominal pain, and malabsorption. The diagnosis of celiac disease is made when there are compatible clinical features, supportive serologic markers, representative histology from the small bowel, and response to a gluten-free diet. Histologic findings associated with celiac disease include intraepithelial lymphocytosis, crypt hyperplasia, villous atrophy, and a chronic inflammatory cell infiltrate in the lamina propria. It is important to recognize and diagnose celiac disease, as strict adherence to a gluten-free diet can lead to resolution of clinical and histologic manifestations of the disease. However, many other entities can present with clinical and/or histologic features of celiac disease. In this review article, we highlight key clinical and histologic mimickers of celiac disease. The evaluation of a patient with serologically negative enteropathy necessitates a carefully elicited history and detailed review by a pathologist. Medications can mimic celiac disease and should be considered in all patients with a serologically negative enteropathy. Many mimickers of celiac disease have clues to the underlying diagnosis, and many have a targeted therapy. It is necessary to provide patients with a correct diagnosis rather than subject them to a lifetime of an unnecessary gluten-free diet.

  7. Correlation between clinical and histologic pulp diagnoses.

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    Ricucci, Domenico; Loghin, Simona; Siqueira, José F

    2014-12-01

    Clinicians routinely face conditions in which they have to decide whether the dental pulp can be saved or not. This study evaluated how reliable the clinical diagnosis of normal pulp/reversible pulpitis (savable pulp) or irreversible pulpitis (nonsavable pulp) is when compared with the histologic diagnosis. The study material consisted of 95 teeth collected consecutively in a general practice over a 5-year period and extracted for reasons not related to this study. Based on clinical criteria, teeth were categorized as having normal pulps, reversible pulpitis, or irreversible pulpitis. The former 2 were grouped together because they represent similar conditions in terms of prognosis. Teeth were processed for histologic and histobacteriologic analyses, and pulps were categorized as healthy, reversibly inflamed, or irreversibly inflamed according to defined criteria. The number of matching clinical/histologic diagnosis was recorded. The clinical diagnosis of normal pulp/reversible pulpitis matched the histologic diagnosis in 57 of 59 (96.6%) teeth. Correspondence of the clinical and histologic diagnosis of irreversible pulpitis occurred in 27 of 32 (84.4%) cases. Infection advancing to the pulp tissue was a common finding in teeth with irreversible pulpitis but was never observed in normal/reversibly inflamed pulps. Findings using defined criteria for clinical and histologic classification of pulp conditions revealed a good agreement, especially for cases with no disease or reversible disease. This means that the classification of pulp conditions as normal pulps, reversible pulpitis, and irreversible pulpitis has high chances of guiding the correct therapy in the large majority of cases. However, there is still a need for refined and improved means for reliable pulp diagnosis. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  8. Pattern of histological types of breast cancer among various age ...

    African Journals Online (AJOL)

    , there is need to define the epidemiological pattern of breast cancer patients in the Niger delta; assessing their age distribution and histological types towards improved health care planning. OBJECTIVE: To determine the pattern of ...

  9. Metanephric Adenoma: clinical, imaging, and histological findings

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    Torricelli, Fabio Cesar Miranda; Marchini, Giovanni Scala, E-mail: fabio_torri@yahoo.com.b [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina. Dept. de Urologica; Campos, Rodrigo Sousa Madeira [Hospital do Servidor Publico Estadual, Sao Paulo, SP (Brazil). Dept. de Urologia; Gil, Antonio Otero [Instituto Dante Pazanezzi, Sao Paulo, SP (Brazil)

    2011-07-01

    Metanephric adenoma (MA), also designated nephrogenic nephroma or renal epithelial tumor resembling immature nephron, has just been recently recognized as a special type of benign renal epithelial tumor. Only few reports are found in the literature regarding this rare renal tumor. The purpose of this paper is to describe our clinical, imaging and histological / immunohistochemical observations of MA diagnosed in two patients and compare these data to previous information reported in medical databases (author)

  10. Clinical and histological healing pattern of peri-implantitis lesions following non-surgical treatment with an Er:YAG laser.

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    Schwarz, F.; Bieling, K.; Nuesry, E.; Sculean, A.; Becker, J.M.

    2006-01-01

    BACKGROUND AND OBJECTIVES: The aim of the present study was to assess clinical and histo-pathological healing pattern of peri-implantitis lesions following non-surgical treatment with an Er:YAG laser (ERL). STUDY DESIGN/MATERIALS AND METHODS: Twelve patients suffering from peri-implantitis (n = 12

  11. Rare Breast Cancer Subtypes: Histological, Molecular, and Clinical Peculiarities

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    Dieci, Maria Vittoria; Orvieto, Enrico; Dominici, Massimo; Conte, PierFranco

    2014-01-01

    Breast cancer encompasses a collection of different diseases characterized by different biological and pathological features, clinical presentation, response to treatments, clinical behavior, and outcome. On the basis of cell morphology, growth, and architecture patterns, breast cancer can be classified in up to 21 distinct histological types. Breast cancer special types, including the classic lobular invasive carcinoma, represent 25% of all breast cancers. The histological diversity of breast carcinomas has relevant prognostic implications. Indeed, the rare breast cancer group includes subtypes with very different prognoses, ranging from the tubular carcinoma, associated with an indolent clinical course, to metaplastic cancer, whose outcome is generally unfavorable. New approaches based on gene expression profiling allow the identification of molecularly defined breast cancer classes, with distinct biological features and clinical behavior. In clinical practice, immunohistochemical classification based on the expression of human epidermal growth factor receptor 2 and Ki67 is applied as a surrogate of the intrinsic molecular subtypes. However, the identification of intrinsic molecular subtypes were almost completely limited to the study of ductal invasive breast cancer. Moreover, some good-prognosis triple-negative histotypes, on the basis of gene expression profiling, can be classified among the poor-prognosis group. Therefore, histopathological classification remains a crucial component of breast cancer diagnosis. Special histologies can be very rare, and the majority of information on outcome and treatments derives from small series and case reports. As a consequence, clear recommendations about clinical management are still lacking. In this review, we summarize current knowledge about rare breast cancer histologies. PMID:24969162

  12. Histological pattern of laryngeal cancers in Komfo Anokye Teaching ...

    African Journals Online (AJOL)

    Carcinoma of the larynx is one of the commonest malignant tumours of the upper respiratory system.The main objective of this study was to highlight the histological pattern and evaluate the occurrence of the malignant tumours of the larynx. This was a retrospective study involving 146 patients aged between 36 to 77 years ...

  13. The clinical value of histological femoral artery plaque analysis

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    Derksen, W.J.M.

    2011-01-01

    This thesis showed that the dissected femoral atherosclerotic plaque contains a predictive value for clinical outcome after femoral endarterectomy. Plaque histology analysis should be incorporated in clinical practice to help predict the patient at risk for restenosis or secondary cardiovascular

  14. Clinical (non-histological) diagnosis of advanced prostate cancer ...

    African Journals Online (AJOL)

    2014-08-03

    histological diagnosis of ACP. Methods. Androgen deprivation therapy (ADT) was used in 825 (56.2%) of 1 467 men with ACP. The diagnosis of ACP was made histologically in 607 patients (73.6%) and clinically alone in 218 ...

  15. Correlation of CT patterns with histologic findings in parauterine masses

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    Miyao, Masayuki; Takahashi, Mutsumasa; Sumi, Minako; Miyazaki, Kohji; Okamura, Hitoshi (Kumamoto Univ. (Japan). School of Medicine)

    CT findings were correlated with histologic and surgical findings in 162 parauterine masses. CT findings were classified into four types and 14 patterns. These classifications were useful in the diagnosis and differential diagnosis of parauterine masses. Malignant ovarian tumors, uterine myogenic tumors, metastatic tumors, endometrial cysts, and benign cystadenoma revealed charactristic CT findings, making differential diagnosis possible on CT. Contrast enhancement of the solid part, bilaterality, and the presence of ascites were useful for differential diagnosis. Although CT is one of the major modalities for the diagnosis of intrapelvic mass lesions, MR imaging will be another important method for the delineation and characterization of these lesions in the future. (author).

  16. Endodontic diagnosis: evaluation between clinical and histological findings

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    Paloma Souza Gonçalves

    2008-01-01

    Full Text Available Objective: In this study, the aim was to analyze the histologic alterations in thirty dental pulps and correlate them with the clinical findings to verify agreement between the clinical and histopathologic diagnosis and contribute to knowledge about endodontic diagnosis. Methods: Using the methodology of Oliveira4, the pulpal conditions were clinically classified as normal, reversible pulpitis, pulpitis at the stage of transition, irreversible pulpitis and necrosis. Results: Lack of correlation was observed between the clinical and histopathologic diagnoses in the cases classified as reversible and at the stage of transition, which histologically consisted of irreversible lesions or degenerative alterations. All the cases clinically classified as irreversible corresponded to the histologic diagnoses. Conclusion: It was concluded that the correlation between clinical and histopathologic diagnosis of dental pulp was shown to be controversial, even though the semiotechnique used had been imperative for guidance about the irreversibility of pulpal lesion.

  17. Lugol staining pattern and histology of esophageal lesions.

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    Mori, M; Adachi, Y; Matsushima, T; Matsuda, H; Kuwano, H; Sugimachi, K

    1993-05-01

    To analyze the relationship between Lugol unstained areas and their histologic features, we applied the Lugol test to 24 specimens of resected esophagus. The staining patterns were graded into four types: grade I, hyperstaining; grade II, normal greenish brown staining; grade III, less intense staining; and grade IV, unstained. Most of the grade IV lesions were invasive carcinomas, carcinomas in situ, or severe dysplasia. The carcinomas in situ and the intraepithelial extension of the carcinomas, which were difficult to detect, were clearly shown as grade IV. On the other hand, moderate to mild dysplasia or atrophy showed grade III staining. Grade IV lesions showed well-demarcated sharp margins, whereas grade III lesions showed ill-demarcated dull margins. The grade III carcinomas, however, by the Lugol test, showed well-demarcated margins. Histologic evaluation disclosed that the staining intensity reflected well the thickness of the glycogen-containing cell layer in the lesion. The sharpness of the margin reflected the abrupt or gradual change from the glycogen-containing to non-containing cell layers. These findings suggest 1) the usefulness of the staining pattern of the Lugol test for the diagnosis of esophageal lesions such as squamous cell carcinoma and severe dysplasia, and 2) the usefulness of the Lugol test for precise delineation of the proximal resection line during surgery of esophageal carcinomas with unexpected wide extension.

  18. Clinical diagnosis and histological analysis of vocal nodules and polyps

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    Nunes, Raquel Buzelin; Behlau, Mara [UNESP; Nunes, Mauricio Buzelin; Paulino, Juliana Gomes

    2013-01-01

    Recent studies emphasize the importance of the clinical-histology correlation in laryngeal pathologies. Objective: To compare the ENT diagnosis with the pathology diagnosis one of 132 surgical specimens, from 119 patients with vocal nodules and polyps. Method: Retrospective study. We investigated the paraffin blocks corresponding to the lesions of the operated patients. We made new histology cross-sections, totaling 396 new slides, divided into three groups: hematoxylin and eosin, Gomori tric...

  19. Infiltration patterns in monoclonal plasma cell disorders: correlation of magnetic resonance imaging with matched bone marrow histology

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    Andrulis, Mindaugas [Institute of Pathology, University of Heidelberg, Heidelberg (Germany); Bäuerle, Tobias [Department of Diagnostic and Interventional Radiology, University of Hamburg, Hamburg (Germany); Goldschmidt, Hartmut [Department of Hematology and Oncology, University of Heidelberg, Heidelberg (Germany); Delorme, Stefan [Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg (Germany); Landgren, Ola [Multiple Myeloma Section, Metabolism Branch, National Cancer Institute, Bethesda (United States); Schirmacher, Peter [Institute of Pathology, University of Heidelberg, Heidelberg (Germany); Hillengass, Jens, E-mail: jens.hillengass@med.uni-heidelberg.de [Department of Hematology and Oncology, University of Heidelberg, Heidelberg (Germany); Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg (Germany)

    2014-06-15

    Objectives: To investigate how plasma cell infiltration patterns detected by MRI match the plasma cell distribution in bone marrow biopsy. Methods: We assessed 50 patients with monoclonal plasma cell disorders of all clinical stages. MRI infiltration pattern was compared with matched BM histology from the same anatomic region. Results: MRI revealed a minimal (n = 11, 22%), focal (n = 5, 10%), diffuse (n = 14, 28%) and mixed (n = 20, 40%) infiltration pattern. Diffuse MRI pattern was predominant in smoldering myeloma patients whereas the MRI patterns with “focal component” (i.e. focal and mixed) were most common in symptomatic myeloma (p < 0.01). In histology an interstitial (n = 13, 26%), nodular (n = 23, 46%) and packed marrow (n = 14, 28%) was found respectively. All three histological types of infiltration were observed in patients with diffuse and mixed MRI patterns. Minimal MRI pattern was found in all MGUS patients and was associated with an interstitial BM infiltration. In two patients with minimal MRI pattern an extensive micro-nodular BM infiltration was found in histology. Conclusions: Infiltration patterns in MRI represent different histological growth patterns of plasma cells, but the MRI resolution is not sufficient to visualize micro-nodular aggregates of plasma cells.

  20. Oesophageal sarcomas in dogs: histological and clinical evaluation.

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    Ranen, Eyal; Dank, Gillian; Lavy, Eran; Perl, Samuel; Lahav, Dan; Orgad, Uri

    2008-10-01

    A histological grading system of oesophageal sarcomas has not been established. Thirty-two cases of oesophageal sarcomas have been reviewed for tumour characteristics and clinical outcome. Nineteen dogs underwent surgical intervention to remove oesophageal tumours; ten of them survived (median 278 days). Primary tumour types included osteosarcoma (47%), osteosarcoma with tumour giant cells (7%), fibroblastic osteosarcoma (13%), chondroblastic osteosarcoma (7%) fibrosarcoma (23%) and undifferentiated sarcoma (3%). Histological grade evaluation revealed 33% grade 1 sarcoma, 50% grade 2 and 17% grade 3. No correlation could be found between survival and signalment, duration of clinical signs, tumour type, tumour grade and chemotherapy. Chemotherapy was found to reduce lung metastases' histological scores in three cases (P=0.0007). Surgery seems to be the treatment of choice but the effect of chemotherapy warrants further investigation. Additional research of cases should be performed in order to further define prognostic factors of oesophageal sarcomas.

  1. Medically uncontrolled conjunctival pyogenic granulomas: correlation between clinical characteristics and histological findings

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    Nakao, Takeshi; Xu, Jianjiang; Liu, Zuguo; Sun, Xinghuai; Chu, Yiwei; Hong, Jiaxu

    2017-01-01

    Background Conjunctival pyogenic granulomas are commonly seen after ocular surgeries or at an ocular wound site. The aim of this study is to describe a novel histological classification for medically uncontrolled conjunctival pyogenic granulomas (MUCPG), and to explore whether the diversity in clinical features correlates to different histological subtypes of MUCPG. Methods This is an observational cross-section case series. We reviewed 46 consecutive patients with conjunctival pyogenic granulomas who did not respond to topical corticosteroids and underwent surgical excision from January 1, 2006 through December 31, 2015. Clinical features and histological findings were presented and analyzed. Results Ocular surgery, accidental injury, and chalazion were the main predisposing causes of MUCPG. The lesions tended to occur unilaterally on the bulbar conjunctiva. Forty patients (87%) presented an enrichment of inflammatory cells and proliferated capillaries in their pathological sections (inflammatory pattern). Six patients (13%) showed relatively few inflammatory cells and capillaries within fibrous stroma (fibrous pattern). Patients with the inflammatory pattern were older (p = 0.025) and tended to be located in bulbar conjunctiva (p = 0.002). The predisposing causes were also different between two histological subtypes (p = 0.007). Conclusions We found the correlation between clinical presentation and histological subtypes in patients with MUCPG, indicating this disease may need a new classification scheme. PMID:28008138

  2. Clinical diagnosis and histological analysis of vocal nodules and polyps.

    Science.gov (United States)

    Nunes, Raquel Buzelin; Behlau, Mara; Nunes, Mauricio Buzelin; Paulino, Juliana Gomes

    2013-08-01

    Recent studies emphasize the importance of the clinical-histology correlation in laryngeal pathologies. To compare the ENT diagnosis with the pathology diagnosis one of 132 surgical specimens, from 119 patients with vocal nodules and polyps. Retrospective study. We investigated the paraffin blocks corresponding to the lesions of the operated patients. We made new histology cross-sections, totaling 396 new slides, divided into three groups: hematoxylin and eosin, Gomori trichrome and PAS. We analyzed the following histological parameters: epithelium, lamina propria, basement membrane, vascular changes. We compared the laryngological and pathological diagnoses, and we did the statistical analysis, checking the predominant histological aspects in each lesion. There was an agreement between the clinical and pathological diagnoses in 123 (93.18%) of 132 lesions analyzed (42.42% nodules and 50.76% polyps). In the histological parameters we found: epithelial changes such as nodules hyperplasia (82.14%) and polyp atrophy (31.34%). Lamina propria: edema in polyps (71.43%), fibrosis in the nodules (57.14%). Basement membrane: thickened nodules (100%), thin/no change in polyps (100%). There was a predominance of vascular changes in the polyps. We found a high correlation between the ENT diagnosis and the pathology report. Histopathologically, the nodules presented with predominantly epithelial changes, lamina propria and basement membrane fibrosis, while the polyps by changes strictly on the lamina propria and vascular aspects.

  3. Preoperative Factors Associated with Infiltrative Histologic Growth Patterns in Extremity Soft Tissue Sarcoma

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    Jong Woong Park

    2017-01-01

    Full Text Available Soft tissue sarcoma (STS with an infiltrative histologic growth pattern, when compared to STS with an expansile pattern, may pose difficulties in local control. Preoperative assessment of the presence of infiltrative histologic growth pattern would be helpful in deciding treatment strategies. A review of 144 patients who underwent surgery for extremity STS was performed. Microscopically, the histologic growth pattern was defined as infiltrative if the penetration of the tumor cells into the surrounding tissue was observed. Possible clinicopathologic factors that might be associated with infiltrative histologic growth pattern were investigated with regard to patient demographics, tumor characteristics, and MRI findings. Of the 144 tumors, 71 (49% showed infiltrative histologic growth pattern. On multivariate analysis, histological subtypes other than liposarcoma (OR = 4.57, p=0.02 and infiltrative border on MRI (OR = 2.48, p=0.01 were independent factors associated with infiltrative histologic growth pattern. Predictive index based on these two factors showed a significant improved accuracy (ROC-AUC = 0.647 for predicting infiltrative histologic growth pattern compared to either factor alone. Our data suggests that liposarcoma histology and tumor border on MRI can predict histologic growth pattern in extremity STS.

  4. [Human warts by Papovavirus. Clinical, histological and ultrastructural correation].

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    Rueda Plata, L A

    1976-01-01

    A clinical, histological and ultraestructural study of 6 cases of epidermodisplacia verruciforme (E.V.). A comparisson with comun warts, plane warts and condilomas are made from this study. The authors attain the conclusion that the E.V. is a precancerous genodermatose in which there is special susceptibility in face to Papova virus group. The E.V. has a typical histological and ultraestructural picture quite diferent from those of the warts. The main characteristic in the presence of an intranuclear vacuole visible at the conventional microscope which is also seen at the electronic microscopy. This vacuole is composed by fibrilar materia and has a peripheric um in which is possible to see abundant viruses. The authors make the first description of intranuclear inclusion in the E.V. Some clinico-evolutive and histological pecularities are underlined in the epidermodisplastia carcinomas. The authors sugest the possibility that the different Papova human tumors could be caused by different Kinds of virus.

  5. Effect of hyaluronan on periodontitis: A clinical and histological study

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    Gauri Gontiya

    2012-01-01

    Full Text Available Background: Conventional, non-surgical periodontal therapy consists of supra- and subgingival tooth debridement. However, it is a technically demanding procedure and is not always efficient at eradicating all periodontal pathogens and in reducing inflammation. Therefore, local subgingival application of other chemotherapeutic agents may be used as an adjunct to non-surgical therapy. The aim of this study was to investigate the clinical and histological outcomes of local subgingival application of 0.2% hyaluronic acid gel (GENGIGEL® as an adjunct to scaling and root planing (SRP in chronic periodontitis patients. Materials and Methods: One hundred and twenty sites were chosen from 26 patients with chronic periodontitis (criteria being periodontal pockets ≥5mm. Experimental sites additionally received HA gel subgingivally at baseline, 1 st , 2 nd , and 3 rd week. Clinical parameters were re-assessed at 4 th , 6 th , and 12 th week. At 4 th week recall, a gingival biopsy was obtained from test and control site for histologic examination. Results: Intra-group analysis of all the clinical parameters at all sites from baseline to 4 th , 6 th , and 12 th week showed statistically significant changes. Experimental sites showed statistically significant improvement in Gingival index and Bleeding index at 6 th and 12 th week when compared with control sites. However, no statistically significant differences were observed in the PPD and RAL between control and experimental sites at 4 th , 6 th , and 12 th week time interval. No statistically significant association was found between the histological grading of the sites that received HA treatment. Conclusion: Subgingival placement of 0.2% HA gel along with SRP provided a significant improvement in gingival parameters. However, no additional benefit was found in periodontal parameters. Histologically, experimental sites showed reduced inflammatory infiltrate, but it was not statistically significant.

  6. Effect of hyaluronan on periodontitis: A clinical and histological study

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    Gontiya, Gauri; Galgali, Sushama R.

    2012-01-01

    Background: Conventional, non-surgical periodontal therapy consists of supra- and subgingival tooth debridement. However, it is a technically demanding procedure and is not always efficient at eradicating all periodontal pathogens and in reducing inflammation. Therefore, local subgingival application of other chemotherapeutic agents may be used as an adjunct to non-surgical therapy. The aim of this study was to investigate the clinical and histological outcomes of local subgingival application of 0.2% hyaluronic acid gel (GENGIGEL®) as an adjunct to scaling and root planing (SRP) in chronic periodontitis patients. Materials and Methods: One hundred and twenty sites were chosen from 26 patients with chronic periodontitis (criteria being periodontal pockets ≥5mm). Experimental sites additionally received HA gel subgingivally at baseline, 1st, 2nd, and 3rd week. Clinical parameters were re-assessed at 4th, 6th, and 12th week. At 4th week recall, a gingival biopsy was obtained from test and control site for histologic examination. Results: Intra-group analysis of all the clinical parameters at all sites from baseline to 4th, 6th, and 12th week showed statistically significant changes. Experimental sites showed statistically significant improvement in Gingival index and Bleeding index at 6th and 12th week when compared with control sites. However, no statistically significant differences were observed in the PPD and RAL between control and experimental sites at 4th, 6th, and 12th week time interval. No statistically significant association was found between the histological grading of the sites that received HA treatment. Conclusion: Subgingival placement of 0.2% HA gel along with SRP provided a significant improvement in gingival parameters. However, no additional benefit was found in periodontal parameters. Histologically, experimental sites showed reduced inflammatory infiltrate, but it was not statistically significant. PMID:23055583

  7. Basal Cell Carcinoma : Evaluation Of Clinical And Histologic Variables

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    Mahanthesh Mamata

    2004-01-01

    Full Text Available A retrospective review of 32 patients with basal cell carcinoma was performed with aims to characterize the demographic profile and to analyze the clinical and histological parameters influencing the treatment of basal cell carcinoma. The maximum number occurred in the sixth decade with an unusual female preponderance. Hisologically, the classic type predominated while the other types included pigmented, morphoea, metatypical, adenoid, eccrine, firoepihelioma and superficial spreading type. All patients had excision of the tumour with involvement of surgical margin in three of them. None of the three patients belonged to aggressive histological types, such as morphoea or metatypical type. Two year follow-up showed no recurrence. Size of the tumor less than 2 cm, absence of ulceration and a good inflammatory response were probably other reasons for non-recurrence.

  8. Histological Pattern of Cervical Malignancies in Southwestern Nigeria

    African Journals Online (AJOL)

    Results: The results revealed 192 cases (45.5%) of cervical malignancies out of the 422 cervical surgical biopsies over the period of study. The age range of the ... Conclusion:Squamous cell carcinoma constitutes the main histological type with a high preponderance of large cell non-keratinising squamous cell carcinoma

  9. A clinical prediction rule for histological chorioamnionitis in preterm newborns.

    Directory of Open Access Journals (Sweden)

    Jasper V Been

    Full Text Available BACKGROUND: Histological chorioamnionitis (HC is an intrauterine inflammatory process highly associated with preterm birth and adverse neonatal outcome. HC is often clinically silent and diagnosed postnatally by placental histology. Earlier identification could facilitate treatment individualisation to improve outcome in preterm newborns. AIM: Develop a clinical prediction rule at birth for HC and HC with fetal involvement (HCF in preterm newborns. METHODS: Clinical data and placental pathology were obtained from singleton preterm newborns (gestational age ≤ 32.0 weeks born at Erasmus UMC Rotterdam from 2001 to 2003 (derivation cohort; n = 216 or Máxima MC Veldhoven from 2009 to 2010 (validation cohort; n = 206. HC and HCF prediction rules were developed with preference for high sensitivity using clinical variables available at birth. RESULTS: HC and HCF were present in 39% and 24% in the derivation cohort and in 44% and 22% in the validation cohort, respectively. HC was predicted with 87% accuracy, yielding an area under ROC curve of 0.95 (95%CI = 0.92-0.98, a positive predictive value of 80% (95%CI = 74-84%, and a negative predictive value of 93% (95%CI = 88-96%. Corresponding figures for HCF were: accuracy 83%, area under ROC curve 0.92 (95%CI = 0.88-0.96, positive predictive value 59% (95%CI = 52-62%, and negative predictive value 97% (95%CI = 93-99%. External validation expectedly resulted in some loss of test performance, preferentially affecting positive predictive rather than negative predictive values. CONCLUSION: Using a clinical prediction rule composed of clinical variables available at birth, HC and HCF could be predicted with good test characteristics in preterm newborns. Further studies should evaluate the clinical value of these rules to guide early treatment individualisation.

  10. Regional odontodysplasia in early childhood: A clinical and histological study

    Directory of Open Access Journals (Sweden)

    Juliana O

    2009-09-01

    Full Text Available Regional odontodysplasia (RO is a rare disorder of dental development. The affected teeth are clinically hypoplastic and hypocalcified, presenting a ghost-like appearance radiographically. The aim of this work was to report a clinical case of a child with both primary and permanent dentition affected by RO. The conducted therapy was based on a conservative approach, which consisted of follow-up clinical evaluations of the anomalous teeth. However, the endodontic treatment of the primary incisors failed. Then, the chosen option for patient rehabilitation became extraction followed by removable of prosthesis confection. The extracted teeth were processed for histological analysis. In spite of the uncertain prognosis, but taking into account the psychological aspects of the patient, a conservative approach in an attempt to maintain those viable teeth in the oral cavity should be established.

  11. Pulmonary Arteriovenous Fistula: Clinical and Histologic Spectrum of Four Cases

    Directory of Open Access Journals (Sweden)

    Soomin Ahn

    2016-09-01

    Full Text Available Pulmonary arteriovenous fistula (PAVF is abnormally dilated vessels that provide a right-to-left shunt between pulmonary artery and pulmonary vein and is clinically divided into simple and complex type. Here, we report four cases of surgically resected sporadic PAVFs presenting various clinical and histologic spectrums. Cases 1 (a 57-old-female and 2 (a 54-old-female presented as incidentally identified single aneurysmal fistulas and the lesions were surgically removed without complication. On the other hand, case 3 (an 11-old-male showed diffuse dilated vascular sacs involving both lungs and caused severe hemodynamic and pulmonary dysfunction. Embolization and surgical resection of the main lesion failed to relieve the symptoms. Case 4 (a 36-old-male had a localized multiloculated cyst clinically mimicking congenital cystic adenomatoid malformation. Microscopically, the lesion consisted of dilated thick vessels, consistent with the diagnosis of fistulous arteriovenous malformation/hemangioma.

  12. Presentation Pattern of Histology and Illustrations in the Histology Text Books Commonly Used by the Medical Undergraduates of Bangladesh.

    Science.gov (United States)

    Amin, N F; Shamim, K M

    2017-01-01

    The teaching-learning and assessment of cell and histology have gone through remarkable changes in recent times. Histology text books recommended by renowned medical institutions should be good reflectors of these changes and the present trends. Cell and histology is categorically visual in nature. So, their presentation in text books is likely to show rational and meaningful use of illustrations. From July 2007 to June 2008, this descriptive observational study was done to analyze the presentation pattern of illustrations in two histology text books commonly recommended for the medical undergraduates of Bangladesh through: a) estimating the relative weights given to (i.e., proportions of printed area allotted to) illustrations and text; b) determining the frequencies of 12 'form's of illustration-defining each 'form' on the basis of how it has been created and how it looks like and c) determining the frequencies of 3 'categories' of illustration-on the basis of their utility as teaching-learning and assessment tools. Illustrations have been found to be allotted more than half of the printed area in the two books together. Regarding the 'form' of illustrations, 'schematic diagram and three-dimensional diagram' has the highest mean frequency (30.11%) and followed by 'photomicrograph - routine stain - high power' (17.56%). More than 90% of the illustrations could be categorized either as 'practically the best tool for the purpose' (70.21%) or as 'a complementary tool to another tool' (21.05%) for using in teaching-learning and assessment. By incorporating the findings of the present study with the present-day ideas and trends in cell and histology education in the renowned institutions of the world and with the understanding of the science of medical education, guidelines can be formulated for improving the methods of teaching and assessment in cell and histology for the medical undergraduates of Bangladesh.

  13. Solitary Rectal Ulcer Syndrome: Demographic, Clinical, Endoscopic and Histological Panorama.

    Science.gov (United States)

    Abbasi, Amanullah; Bhutto, Abdul Rabb; Taj, Ali; Aurangzaib; Baloch, Akhtar; Masroor, Muhammad; Munir, S M

    2015-12-01

    To assess the demographic, clinical, endoscopic and histological spectrum of Solitary Rectal Ulcer Syndrome (SRUS). Cross-sectional observational study. Medical Unit-III, Civil Hospital Karachi (CHK) and Ward 7, Jinnah Postgraduate Medical Centre (JPMC), Karachi, from January 2009 to June 2012. Patients with SRUS, based on characteristic endoscopic and histological findings, were enrolled. Patients were excluded if they had other causes of the rectal lesions (neoplasm, infection, inflammatory bowel disease, and trauma). Endoscopically, lesions were divided on the basis of number (solitary or multiple) and appearance (ulcerative, polypoidal/nodular or erythematous mucosa). Demographic, clinical and endoscopic characteristics of subjects were evaluated. Forty-four patients met the inclusion criteria; 21 (47.7%) were females and 23 (52.3%) were males with overall mean age of 33.73 ±13.28 years. Symptom-wise 41 (93.2%) had bleeding per rectum, 39 (88.6%) had mucous discharge, 34 (77.3%) had straining, 34 (77.3%) had constipation, 32 (72.7%) had tenesmus, 5 (11.4%) had rectal prolapse and 2 (4.5%) had fecal incontinence. Twelve (27.27%) patients presented with hemoglobin less 10 gm/dl, 27 (61.36%) with 10 - 12 gm/dl and 05 (11.36%) subjects had hemoglobin more than 12 gm/dl. Endoscopically, 26 (59.1%) patients had mucosal ulceration, 11 (25.0%) had mucosal ulceration with polypoid characteristics; while only polypoid features were found in 7 (15.9%) subjects. Solitary rectal ulcer syndrome affects adults of both genders with diverse clinical presentation and nonspecific endoscopic features.

  14. Traumatically injured primary incisors: a clinical and histological study.

    Science.gov (United States)

    Croll, T P; Pascon, E A; Langeland, K

    1987-01-01

    World-wide epidemiological studies state that from 8 percent to 30 percent of children up to 7 years of age sustain injury to primary incisors, including crown fracture, root fracture, tooth avulsion, and dental displacement, which result in malformation of permanent incisors depending upon their state of development. In this study, traumatized primary incisors were evaluated clinically and radiographically, with the following data recorded: exact or approximate time-interval of traumatic episode(s) and extraction, mobility, color change, sensitivity to percussion/palpation, swelling, sinus tract, caries, crown/root fracture, periodontal/periapical lesions, external/internal root resorption, mineralization, and obturation. Based upon the local damage and developmental age, 138 teeth were extracted, fixed in 10 percent formalin, and processed for histological evaluation according to routine methodology. Histologic findings were: the presence of varying extent of necrosis, bacteria in the area of necrosis--not in all cases--neutrophilic leukocytes, chronic inflammatory cells, pulpal calcifications, resorption/apposition, and circulatory changes. The blood pigment distinguished hemorrhage due to extraction from pathologic circulatory changes. All the described reactions varied in intensity and extent with the time interval and the assumed force of the original trauma. Physical trauma to primary teeth caused pulpal damage, which could involve periapical tissue, depending on the extent of the initial damage.

  15. The histologic pattern of non-Hodgkin's lymphomas in Ethiopians ...

    African Journals Online (AJOL)

    Non-Hodgkin's lymphomas (NHLs) are among the malignancies that can arise in advanced stages of infection in patients with human immunodefiency virus (HIV). However, the pattern of this malignancy has not been reported in Ethiopia. A sixteen year retrospective review has been carried out to determine the trend, age, ...

  16. Clinical and histological study of permanent alopecia after bone marrow transplantation.

    Science.gov (United States)

    Basilio, Flávia Machado Alves; Brenner, Fabiane Mulinari; Werner, Betina; Rastelli, Graziela Junges Crescente

    2015-01-01

    Permanent alopecia after bone marrow transplantation is rare, but more and more cases have been described, typically involving high doses of chemotherapeutic agents used in the conditioning regimen for the transplant. Busulfan, classically described in cases of irreversible alopecia, remains associated in recent cases. The pathogenesis involved in hair loss is not clear and there are few studies available. In addition to chemotherapeutic agents, another factor that has been implicated as a cause is chronic graft-versus-host disease. However, there are no histopathological criteria for defining this diagnosis yet. the study aims to evaluate clinical and histological aspects in cases of permanent alopecia after bone marrow transplantation, identifying features of permanent alopecia induced by myeloablative chemotherapy and alopecia as a manifestation of chronic graft-versus-host disease. data were collected from medical records of 7 patients, with description of the clinical features and review of slides and paraffin blocks of biopsies. Two distinct histological patterns were found: one similar to androgenetic alopecia, non-scarring pattern, and other similar to lichen planopilaris, scarring alopecia. The first pattern corroborates the literature cases of permanent alopecia induced by chemotherapeutic agents, and the second is compatible with manifestation of chronic graft-versus-host disease on scalp, that has never been described yet. The results contribute to the elucidation of the factors involved in these cases, including the development of therapeutic methods.

  17. Clinical and histological study of permanent alopecia after bone marrow transplantation*

    Science.gov (United States)

    Basilio, Flávia Machado Alves; Brenner, Fabiane Mulinari; Werner, Betina; Rastelli, Graziela Junges Crescente

    2015-01-01

    BACKGROUND Permanent alopecia after bone marrow transplantation is rare, but more and more cases have been described, typically involving high doses of chemotherapeutic agents used in the conditioning regimen for the transplant. Busulfan, classically described in cases of irreversible alopecia, remains associated in recent cases. The pathogenesis involved in hair loss is not clear and there are few studies available. In addition to chemotherapeutic agents, another factor that has been implicated as a cause is chronic graft-versus-host disease. However, there are no histopathological criteria for defining this diagnosis yet. OBJECTIVE the study aims to evaluate clinical and histological aspects in cases of permanent alopecia after bone marrow transplantation, identifying features of permanent alopecia induced by myeloablative chemotherapy and alopecia as a manifestation of chronic graft-versus-host disease. METHODS data were collected from medical records of 7 patients, with description of the clinical features and review of slides and paraffin blocks of biopsies. RESULTS Two distinct histological patterns were found: one similar to androgenetic alopecia, non-scarring pattern, and other similar to lichen planopilaris, scarring alopecia. CONCLUSION The first pattern corroborates the literature cases of permanent alopecia induced by chemotherapeutic agents, and the second is compatible with manifestation of chronic graft-versus-host disease on scalp, that has never been described yet. The results contribute to the elucidation of the factors involved in these cases, including the development of therapeutic methods PMID:26734861

  18. Clinical and histological features of nonalcoholic steatohepatitis in Iranian patients

    Directory of Open Access Journals (Sweden)

    Haghpanah Babak

    2003-10-01

    Full Text Available Abstract Background Although several studies have been performed on risk factors and natural course of NASH, it seems that NASH tends to be more than a disease confined to strict boundaries. The objective of this study was to assess the clinical and paraclinical features and risk factors for non-alcoholic steatohepatitis (NASH patients in an Iranian population Methods Patients with histologically confirmed NASH who had elevated liver aminotransaminases, negative serologic markers of viral or autoimmune hepatitis and no findings in favor of metabolic liver disease were enrolled. A careful history was taken regarding alcohol intake. Results 53 patients consisting of 32 male and 21 female entered the study. The mean age was 37.8 ± 11.3 years. Twenty-six patients (55.3% were overweight, 15 (31.9% obese, 40 (75.5% dyslipidemic, and three patients (5.7% were diabetic. Liver biopsy showed mild steatosis in 35.7%, moderate steatosis in 53.6%, and severe forms in 10.7%. In 80.2% of patients, portal inflammation was present, and 9.4% had cirrhosis. The amount of increase in liver enzymes bore no relationship with fibrosis, portal inflammation, and degree of steatosis. Conclusions The patients in our study showed a male predominancy and were somewhat younger than other studies.

  19. Clinical and histological characterization of an aggressive periodontitis case associated with unusual root canal curvatures.

    Science.gov (United States)

    Stratul, Ştefan Ioan; Roman, Alexandra; Şurlin, Petra; Petruţiu, Ştefan Adrian; Buiga, Petronela; Mihu, Carmen Mihaela

    2015-01-01

    The article presents the histological and clinical characteristics in a severe generalized aggressive periodontitis case associated with multiple root curvatures and the complex therapeutic approach of the severe periodontal destructions. The patient received a complex therapy, including periodontal non-surgical, regenerative and reconstructive approaches, and also endodontic and prosthetic treatments. Recall appointments were fixed at 3-month intervals. One year after the finalization of the active therapy, a hyperplasic, inflamed interdental papilla associated with a recurrent clinical attachment loss was diagnosed at the mesial aspect of the right maxillary second premolar. A biopsy was harvested for histological examination and the recurrent site was treated. The histological study revealed important modifications of the epithelial layer and of the connective tissue of the gingiva. An extremely accentuated pattern of the gingival rete ridges at the epithelial-connective tissue junction, the presence of inflammatory cells infiltrating the epithelial layer and lamina propria and the disorganization of the fascicules of collagen fibers were observed. The inflammatory infiltrate was dominated by plasma and monocytic-like cells as immunohistochemical analyses highlighted. The complex therapeutic approach led to a satisfactory aesthetic and functional outcome. The severe root curvatures may be an unusual trait in this generalized aggressive periodontitis case substantially increasing the amount and the costs of non-periodontal procedures. In this case, the cell make-up of the inflammatory infiltrate and the paucity of collagen in the infiltrated tissue portions are considered to correspond to a fully developed recurrent lesion.

  20. Nonalcoholic fatty liver disease in Brazil. Clinical and histological profile.

    Science.gov (United States)

    Cotrim, Helma P; Parise, Edison R; Oliveira, Claudia P M S; Leite, Natalhie; Martinelli, Ana; Galizzi, João; Silva, Rita de Cássia; Mattos, Angelo; Pereira, Leila; Amorim, Waldir; Ivantes, Claúdia; Souza, Francisco; Costa, Marcelo; Maia, Lizomar; Pessoa, Mário; Oliveira, Frederico

    2011-01-01

    The epidemiology and clinical characteristics of nonalcoholic fatty liver disease (NAFLD) in South America are not well known. Brazil is a largest country in this part of the world and the present study aimed to contribute with this information. This descriptive study included patients from medical centers around Brazil, who had diagnosis of NAFLD. They were selected from chart review and also prospectively in Hepatology out-clinics. Patients with history of alcohol intake and others liver diseases were excluded. Histological diagnosis included: steatosis or steatohepatitis (steatosis, ballooning of hepatocytes or fibrosis). The criteria to perform a liver biopsy was ALT or AST > 1.5 x normal levels. A total of 1280 patients from 16 Brazilian centers and all five regions were included. The mean age was 49.68 ± 13.59 years; 53.3% were males and 85% were asymptomatic. Hyperlipidemia was observed in 66.8% cases, obesity in 44.7%, overweight in 44.4%, diabetes in 22.7%, and toxins exposure in 10%. Metabolic syndrome was observed in 41.3% cases. Elevated levels of ALT, AST and GGT were observed in 55.8%, 42.2% and 63.1% cases, respectively. Liver biopsy performed in 437 cases showed: isolate steatosis in 42% cases, steatohepatitis in 58% and 27% of them also presented fibrosis. Cirrhosis was observed in 15.4% and hepatocellular carcinoma in 0.7%. NAFLD in Brazil is more frequent in asymptomatic males; steatohepatitis with fibrosis and cirrhosis were a significant diagnosis. The genetic predisposition and lifestyle should be influenced in the spectrum; however these findings deserve a future investigation.

  1. Long bone histology and growth patterns in ankylosaurs: implications for life history and evolution.

    Directory of Open Access Journals (Sweden)

    Martina Stein

    Full Text Available The ankylosaurs are one of the major dinosaur groups and are characterized by unique body armor. Previous studies on other dinosaur taxa have revealed growth patterns, life history and evolutionary mechanisms based on their long bone histology. However, to date nothing is known about long bone histology in the Ankylosauria. This study is the first description of ankylosaurian long bone histology based on several limb elements, which were sampled from different individuals from the Ankylosauridae and Nodosauridae. The histology is compared to that of other dinosaur groups, including other Thyreophora and Sauropodomorpha. Ankylosaur long bone histology is characterized by a fibrolamellar bone architecture. The bone matrix type in ankylosaurs is closest to that of Stegosaurus. A distinctive mixture of woven and parallel-fibered bone together with overall poor vascularization indicates slow growth rates compared to other dinosaurian taxa. Another peculiar characteristic of ankylosaur bone histology is the extensive remodeling in derived North American taxa. In contrast to other taxa, ankylosaurs substitute large amounts of their primary tissue early in ontogeny. This anomaly may be linked to the late ossification of the ankylosaurian body armor. Metabolically driven remodeling processes must have liberated calcium to ossify the protective osteodermal structures in juveniles to subadult stages, which led to further remodeling due to increased mechanical loading. Abundant structural fibers observed in the primary bone and even in remodeled bone may have improved the mechanical properties of the Haversian bone.

  2. [Clinical and clinico-histological markers in chronic destructive adult periodontitis].

    Science.gov (United States)

    Hernández Vallejo, G; García Rodríguez, M D; Tejerina Lobo, J M; López Sánchez, A F; De la Roca, C

    1989-05-01

    This study was designed to evaluate the significance and interrelationship of clinical parameters and their association with histologic changes in advanced destructive periodontitis. 158 patients with PDI greater than 4 (Ramfjord) were selected, evaluating the size, contouring, bleeding, consistency, colour and gingival pain. Epithelial ulceration of soft periodontal pockets were also evaluated. The results showed a statistically significant association between purplish colour and gingival fibrosis and advanced stage of the disease. Gingival bleeding on probing was the most important clinical parameter in advanced phases of the disease, either alone or in association with other parameters such as the presence of epithelial ulcerations. The Periodontal Disease Index (Ramfjord) has proven effective in the evaluation of generalized patterns of disease.

  3. Gastrointestinal lymphoma in Western Algeria: pattern of distribution and histological subtypes (retrospective study).

    Science.gov (United States)

    Zeggai, Soumia; Harir, Noria; Tou, Abdenacer; Medjamia, Miloud; Guenaoui, Khaira

    2016-12-01

    Primary gastrointestinal (GI) lymphomas (GIL) are uncommon diseases that can involve the whole GI tract. Considerable variation exists in the literature with respect to incidence of the various histological subtypes and sites of involvement. This study was undertaken to establish the anatomic distribution, histological subtypes and sites of GI lymphomas of patients from Western Algeria. The case records of 58 consecutive patients with GIL diagnosed at the Pathologies Departments of Algerian west region (the Military Hospital of Oran city and the Central University Hospital of Sidi Bel Abbes city) from January 2006 to December 2013 were retrospectively evaluated for epidemiology and histopathology report. All lymphomas were reclassified according to the WHO 2008 classification. A total of 58 patients (39 male, 19 female) with mean age of 61 years and a range of 20-89 years were included in this study. Stomach was the most common site involved (70.7%). The commonest histological subtype was mucosa-associated lymphoid tissue (MALT) B cell lymphoma (46.6%), followed by diffuse large B-cell lymphomas (DLBCL) (43.1%).The frequency of Helicobacter pylori (HP) positivity differ between gastric and intestinal location P=0.003 and correlates with the histological type P=0.01. This retrospective study of patients with GI lymphoma from Western Algeria illustrates the pattern of distribution of various common and rare histological subtypes. More studies are necessary to find a potential cause, risk factor or genetic mutation that can explain these specific characteristics of GIL.

  4. A retrospective study of the clinical, histological, and immunohistochemical manifestations of 5 dogs originally diagnosed histologically as necrotizing scleritis.

    Science.gov (United States)

    Denk, Nora; Sandmeyer, Lynne S; Lim, Christine C; Bauer, Bianca S; Grahn, Bruce H

    2012-03-01

    To describe the clinical, histological, and immunohistochemical manifestations of canine necrotizing scleritis. A retrospective examination of the clinical records and samples of ocular tissues from five dogs with a histological diagnosis 'necrotizing scleritis' was completed. Archived, formalin-fixed, paraffin-embedded samples and two control globes were stained with hematoxylin and eosin, Gram, periodic acid-Schiff (PAS) and Masson trichrome stains, and they were immunohistochemically labeled for CD3, CD18, and CD20. Of the five cases reviewed, only two could be confirmed as idiopathic necrotizing scleritis. The other three cases were retrospectively diagnosed as unilateral focal, non-necrotizing scleritis, one as episcleritis and the third was scleritis secondary to a proptosed globe based on our retrospective clinical, histological, and immunohistochemical evaluations. In these two cases, idiopathic necrotizing scleritis manifested as a bilateral, progressive, inflammatory disease of the sclera and cornea that induces significant uveitis. Light microscopic examination confirmed collagen degeneration and granulomatous inflammation. There was no evidence for an infectious etiology based on Gram's and PAS stainings. Immunohistochemical labeling revealed a predominance of B cells in idiopathic, bilateral necrotizing scleritis. Tinctorial staining abnormalities with Masson's trichrome stain were present in scleral collagen of the two cases with idiopathic necrotizing scleritis as well as a case of secondary traumatic scleritis. Based on a limited number of cases, idiopathic canine necrotizing scleritis shares similar histopathological features with non-necrotizing scleritis and episcleritis; however, necrotizing scleritis is B-cell-dominated and bilateral, and significant collagen alterations manifest with Masson's trichrome stain. © 2011 American College of Veterinary Ophthalmologists.

  5. Visual pattern mining in histology image collections using bag of features.

    Science.gov (United States)

    Cruz-Roa, Angel; Caicedo, Juan C; González, Fabio A

    2011-06-01

    The paper addresses the problem of finding visual patterns in histology image collections. In particular, it proposes a method for correlating basic visual patterns with high-level concepts combining an appropriate image collection representation with state-of-the-art machine learning techniques. The proposed method starts by representing the visual content of the collection using a bag-of-features strategy. Then, two main visual mining tasks are performed: finding associations between visual-patterns and high-level concepts, and performing automatic image annotation. Associations are found using minimum-redundancy-maximum-relevance feature selection and co-clustering analysis. Annotation is done by applying a support-vector-machine classifier. Additionally, the proposed method includes an interpretation mechanism that associates concept annotations with corresponding image regions. The method was evaluated in two data sets: one comprising histology images from the different four fundamental tissues, and the other composed of histopathology images used for cancer diagnosis. Different visual-word representations and codebook sizes were tested. The performance in both concept association and image annotation tasks was qualitatively and quantitatively evaluated. The results show that the method is able to find highly discriminative visual features and to associate them to high-level concepts. In the annotation task the method showed a competitive performance: an increase of 21% in f-measure with respect to the baseline in the histopathology data set, and an increase of 47% in the histology data set. The experimental evidence suggests that the bag-of-features representation is a good alternative to represent visual content in histology images. The proposed method exploits this representation to perform visual pattern mining from a wider perspective where the focus is the image collection as a whole, rather than individual images. Copyright © 2011 Elsevier B.V. All

  6. ALGERIAN SHEEP ARE NONSEASONAL BREEDERS: "CLINICAL, CYTOLOGICAL AND HISTOLOGICAL STUDIES"

    Directory of Open Access Journals (Sweden)

    A NIAR

    2001-12-01

    Full Text Available 4377 pregnant ewes have been used in this study to realise a curve of lambing. This curve prove that the three most important breeds of Algerian sheep can breed all year round.                 To prove also that Algerian sheep are no  seasonal breeder, a cytological and histological study of ewes vaginal mucosa have been done. The exfoliative cytology over all the phases of the oestrous cycle and pregnancy consistent in appearance and appear to be influenced directly by the changes in endogenous ovarian steroid hormones. The histological features of the anterior vaginal epithelium of the ewe sampled all year round, before, during, after oestrus and at pregnancy are described. In the present study, we have never found an arrest of the cyclical genital activity of ewes at any moment of the year. This finding agree with results of the curve of lambing. We can conclude that Algerian ewes are nonseasonal breeders.

  7. Histological and clinical features of primary and recurrent periocular Basal cell carcinoma.

    Science.gov (United States)

    Ben Simon, Guy J; Lukovetsky, Semion; Lavinsky, Fabio; Rosen, Nahum; Rosner, Mordechai

    2012-01-01

    Background. Basal cell carcinoma (BCC) is the most common malignancy of the eyelids. Medial canthal BCCs tends to recur more often. Purpose. To evaluate the clinical and histological features of primary and recurrent periocular BCC, in order to identify any existing associations. Methods. Data from 87 patients (71 primary and 16 recurrent) were analyzed in this study. All patients underwent tumor excision with frozen section margin control at the Goldschleger Eye Institute between 1/1995 to 12/1997. Statistical analysis was performed to identify possible associations between histological and clinical characteristics of primary and recurrent BCC. Main Outcome Measures. Anatomical location, clinical presentation, and histology of peri-ocular BCC. Results. No association was found between histopathological and clinical characteristics of BCC. Similar features with regard to eyelid location and histology were found in primary and recurrent peri-ocular BCCs, whereas recurrent BCCs tended to involve a greater eyelid extent with a longer duration of symptoms. Medial canthal BCCs, morpheaform, or sclerosing histology were not more common in the recurrent BCC group. Conclusions. Similar clinical and histological characteristics were noted in primary and recurrent periocular BCC, implying that incomplete surgical excision rather than anatomical location or histological features is the main cause for recurrence.

  8. The attitudes of medical students in Europe toward the clinical importance of histology.

    Science.gov (United States)

    Moxham, Bernard John; Emmanouil-Nikoloussi, Elpida; Brenner, Erich; Plaisant, Odile; Brichova, Hana; Kucera, Tomas; Pais, Diogo; Stabile, Isobel; Borg, Jordy; Scholz, Michael; Paulsen, Friedrich; Luis Bueno-López, José; Alfonso Arraez Aybar, Luis; De Caro, Raffaele; Arsic, Stojanka; Lignier, Baptiste; Chirculescu, Andy

    2017-07-01

    Many studies have been undertaken to assess the attitudes of medical students to the clinical importance of gross anatomy. However, much less is known about their attitudes toward the clinical importance of histology. Using Thurstone and Chave methods to assess attitudes, over 2,000 early stage medical students across Europe provided responses to a survey that tested the hypothesis that the students have a high regard for histology's clinical relevance. Regardless of the university and country surveyed, and of the teaching methods employed for histology, our findings were not consistent with our hypotheses, students providing a more moderate assessment of histology's importance compared to gross anatomy but more positive than their attitudes toward embryology. Histology should play a significant role in medical education in terms of appreciating not just normal structure and function but also pathology. We conclude that teachers of histology should pay special attention to informing newly-recruited medical students of the significant role played by histology in attaining clinical competence and in underpinning their status as being learned members of a healthcare profession. This work was conducted under the auspices of the Trans-European Pedagogic Research Group (TEPARG). Clin. Anat. 30:635-643, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  9. Patterns in clinical chemistry requests

    OpenAIRE

    Hemel, Jan B.; Hindriks, Frans R.; van der Voet, Hilko; Rijnveld, Leo R.

    1989-01-01

    For each patient sample that is presented to the clinical chemistry laboratory a combination of various tests can be requested. This combination or profile will depend on the condition of the patient, and hence also on the requesting hospital department. Several techniques were applied to detect and describe patterns in tests requested by the cardiology, hepatology and nephrology sections of the out-patient's Department for Internal Medicine. Comparison of the frequencies of ordering the test...

  10. Associations between mutations and histologic patterns of mucin in lung adenocarcinoma: invasive mucinous pattern and extracellular mucin are associated with KRAS mutation.

    Science.gov (United States)

    Kadota, Kyuichi; Yeh, Yi-Chen; D'Angelo, Sandra P; Moreira, Andre L; Kuk, Deborah; Sima, Camelia S; Riely, Gregory J; Arcila, Maria E; Kris, Mark G; Rusch, Valerie W; Adusumilli, Prasad S; Travis, William D

    2014-08-01

    Multiple reports indicate that epidermal growth factor receptor (EGFR) mutations are associated with lepidic-pattern lung adenocarcinoma and that KRAS mutations are associated with invasive mucinous adenocarcinoma. We sought to investigate the association between EGFR and KRAS mutations and specific morphologic characteristics, such as predominant histologic subtype and mucinous features. Clinical data for 864 patients with resected lung adenocarcinoma that underwent molecular testing for EGFR and KRAS mutations were collected. Histologic subtyping was performed according to the IASLC/ATS/ERS lung adenocarcinoma classification, with attention given to signet-ring cell feature and extracellular mucin. EGFR mutations were detected using a polymerase chain reaction-based sizing assay, KRAS mutations were detected using Sanger sequencing, and ALK expression was detected using immunohistochemistry. Invasive mucinous adenocarcinoma was associated with KRAS mutation (Pmutation, a pure mucinous pattern was more common than a mixed mucinous/nonmucinous pattern (P=0.002). Invasive mucinous adenocarcinoma was associated with KRAS transition mutations (G→A) but not transversion mutations (G→T or G→C) compared with nonmucinous tumors (P=0.009). The lepidic-predominant group was associated with EGFR mutation compared with nonlepidic-predominant tumors (P=0.011). Extracellular mucin was associated with KRAS mutation (Pmutation (P=0.517). ALK expression was associated with signet-ring cell feature (P=0.001) but not with extracellular mucin (P=0.089). Our study shows that histologic patterns of mucin in lung adenocarcinoma-including invasive mucinous adenocarcinoma and extracellular mucin-are associated with KRAS mutation.

  11. Cutaneous Manifestations of Non-Celiac Gluten Sensitivity: Clinical Histological and Immunopathological Features

    Directory of Open Access Journals (Sweden)

    Veronica Bonciolini

    2015-09-01

    Full Text Available Background: The dermatological manifestations associated with intestinal diseases are becoming more frequent, especially now when new clinical entities, such as Non-Celiac Gluten Sensitivity (NCGS, are identified. The existence of this new entity is still debated. However, many patients with diagnosed NCGS that present intestinal manifestations have skin lesions that need appropriate characterization. Methods: We involved 17 patients affected by NCGS with non-specific cutaneous manifestations who got much better after a gluten free diet. For a histopathological and immunopathological evaluation, two skin samples from each patient and their clinical data were collected. Results: The median age of the 17 enrolled patients affected by NCGS was 36 years and 76% of them were females. On the extensor surfaces of upper and lower limbs in particular, they all presented very itchy dermatological manifestations morphologically similar to eczema, psoriasis or dermatitis herpetiformis. This similarity was also confirmed histologically, but the immunopathological analysis showed the prevalence of deposits of C3 along the dermo-epidermal junction with a microgranular/granular pattern (82%. Conclusions: The exact characterization of new clinical entities such as Cutaneous Gluten Sensitivity and NCGS is an important objective both for diagnostic and therapeutic purposes, since these are patients who actually benefit from a GFD (Gluten Free Diet and who do not adopt it only for fashion.

  12. Ultrasonographic, endoscopic and histological appearances of the caecum in cats presenting with chronic clinical signs of caecocolic disease.

    Science.gov (United States)

    Hahn, Harriet; Pey, Pascaline; Baril, Aurélie; Charpentier, Julie; Desquilbet, Loic; Le Poder, Sophie; Château-Joubert, Sophie; Laloy, Eve; Freiche, Valerie

    2017-02-01

    Objectives This study aimed to describe the ultrasonographic, endoscopic and histological characteristics of the caecum and ileocaecocolic junction in cats suffering from chronic clinical signs compatible with caecocolic disease. Methods Cats presenting with clinical signs suggestive of a caecocolic disease were prospectively recruited. All cats underwent an ultrasonographic examination of the caecum, ileum, colon, ileocolic lymph nodes and local mesenteric fat, in addition to comprehensive abdominal ultrasonography. This was followed by a colonoscopy with a macroscopic assessment of the caecocolic mucosa; caecocolic tissue samples were systematically collected for histologic analysis. Results Eighteen cats were included. Eleven of 18 cats had ultrasonographic abnormalities adjacent to the ileocaecocolic junction (lymphadenopathy, local steatitis) and 13/18 cats had abnormalities directly related to the junction (wall thickening, loss of wall layering). Seventeen of 18 cats had at least one ultrasonographic abnormality. Endoscopically, hyperaemia, oedema, discoloration and/or erosions were found in all cats. Each cat was classified as having mild or moderate-to-severe lesions according to endoscopic results; no classification could be established statistically for ultrasonographic results. The accentuation of the dimpled pattern tended to be inversely related to the severity of endoscopic lesion scoring. Histologically, a large proportion of cats showed typhlitis (13/16), one had lymphoma and two were normal. All cats with typhlitis also had colitis. There was only slight agreement between endoscopic and histological caecal results regarding the severity of lesions. Loss of caecal wall layering on ultrasound was found in 7/18 cats and, surprisingly, did not appear as a reliable predictor of the severity of inflammation or of malignancy; neither did local steatitis nor lymph node size. Conclusions and relevance Ultrasonography and endoscopy should not be used as the

  13. Dental Pulp: Correspondences and Contradictions between Clinical and Histological Diagnosis

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    Cristian Levente Giuroiu

    2015-01-01

    Full Text Available Dental pulp represents a specialized connective tissue enclosed by dentin and enamel, the most highly mineralized tissues of the body. Consequently, the direct examination as well as pathological evaluation of dental pulp is difficult. Within this anatomical context, our study aimed to evaluate the correlation between dental pulp lesions and clinical diagnosis. Pulpectomies were performed for 54 patients with acute and chronic irreversible pulpitides and for 5 patients (control group with orthodontic extractions. The morphological features were semiquantitatively assessed by specific score values. The clinical and morphological correspondence was noted for 35 cases (68.62%, whereas inconsistency was recorded for 16 cases (31.38%. The results of the statistical analysis revealed the correlations between clinically and pathologically diagnosed acute/chronic pulpitides. No significant differences were established between the score values for inflammatory infiltrate intensity, collagen depositions, calcifications and necrosis, and acute, respectively chronic pulpitides. We also obtained significant differences between acute pulpitides and inflammatory infiltrate and calcifications and between chronic pulpitides and inflammatory infiltrate, collagen deposition, and calcifications. On the basis of the predominant pathological aspects, namely, acute and chronic pulpitis, we consider that the classification schemes can be simplified by adequately reducing the number of clinical entities.

  14. Dental Pulp: Correspondences and Contradictions between Clinical and Histological Diagnosis

    Science.gov (United States)

    Giuroiu, Cristian Levente; Căruntu, Irina-Draga; Lozneanu, Ludmila; Melian, Anca; Vataman, Maria; Andrian, Sorin

    2015-01-01

    Dental pulp represents a specialized connective tissue enclosed by dentin and enamel, the most highly mineralized tissues of the body. Consequently, the direct examination as well as pathological evaluation of dental pulp is difficult. Within this anatomical context, our study aimed to evaluate the correlation between dental pulp lesions and clinical diagnosis. Pulpectomies were performed for 54 patients with acute and chronic irreversible pulpitides and for 5 patients (control group) with orthodontic extractions. The morphological features were semiquantitatively assessed by specific score values. The clinical and morphological correspondence was noted for 35 cases (68.62%), whereas inconsistency was recorded for 16 cases (31.38%). The results of the statistical analysis revealed the correlations between clinically and pathologically diagnosed acute/chronic pulpitides. No significant differences were established between the score values for inflammatory infiltrate intensity, collagen depositions, calcifications and necrosis, and acute, respectively chronic pulpitides. We also obtained significant differences between acute pulpitides and inflammatory infiltrate and calcifications and between chronic pulpitides and inflammatory infiltrate, collagen deposition, and calcifications. On the basis of the predominant pathological aspects, namely, acute and chronic pulpitis, we consider that the classification schemes can be simplified by adequately reducing the number of clinical entities. PMID:26078972

  15. Clinical and Histological Characteristics of Mycetoma in a Tertiary ...

    African Journals Online (AJOL)

    It is a bacterial (actinomycetoma) or fungal (eumycetoma) infection of the skin, subcutaneous tissue and dermis, which may extend to underlying bone. The classical clinical feature of both forms of mycetoma is tumescence with formation of abscesses, painless nodules and sinus tract that discharge grains containing ...

  16. Histological evaluation of pulp tissue from second primary molars correlated with clinical and radiographic caries findings

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    Vellore Kannan Gopinath

    2014-01-01

    Full Text Available Background: Managing dental caries in young children is demanding due to the elusions present on the right diagnostic criteria for treatment. The present study evaluated the histological status of pulp tissues extracted from primary second molar with caries involvement. Histological findings are correlated with clinical and radiographic assessment. Materials and Methods: Simple experimental study was conducted on upper or lower second primary molars with occlusal (22 teeth or proximal (22 teeth dental caries. Selected children were below 6 years of age. Percentage of caries involvement, residual dentin thickness (RDT, radiographic assessment of interradicular and periapical areas, clinical caries depth and signs and symptoms are the parameters considered for comparing with the histological findings. The specimens were grouped based on the nature of the inflammatory process as acute or chronic. The data were analyzed by Student t-test to compare histological types of inflammation with clinical parameters. P value < 0.05 was considered as significant. Results: Four cases revealed severe acute inflammation in coronal and relatively mild acute inflammation in radicular pulp. In the rest of the specimen coronal and radicular pulp had similar acute or chronic inflammatory changes. Histological evidence of pulpitis correlated with dental caries depth of ≥80%, RDT of ≤1 mm, radiographic rarefactions in the interradicular regions and symptoms of pain. Conclusion: Primary second molars with more than two-third caries involvement with symptoms of pain histologically showed inflammation of both coronal and radicular pulp tissues in all cases.

  17. Clinical, Endoscopical and Histological Correlation and Measures of Association in Ulcerative Colitis.

    Science.gov (United States)

    Fluxá, Daniela; Simian, Daniela; Flores, Lilian; Ibáñez, Patricio; Lubascher, Jaime; Figueroa, Carolina; Quera, Rodrigo; Kronberg, Udo; Pizarro, Gonzalo; Castro, Magdalena; Piottante, Antonio; Vial, María Teresa

    2017-09-26

    To determine the correlation between clinical, fecal, endoscopic and histologic activity in patients with ulcerative colitis. A correlational analytic cross-sectional study was performed in patients with ulcerative colitis who underwent colonoscopy between February and December 2016. Clinical, endoscopic, fecal and histologic activities were determined using the Partial Mayo Subscore, Endoscopic Subscore and Mayo Modified Endoscopic Subscore, Fecal Calprotectin and Geboes Score and the presence of basal plasmacytosis, respectively. Scores were analyzed with Spearman's rank correlation coefficient test. To determine the association between scores and some clinical variables and active ulcerative colitis, univariate and multivariate logistic regression were used. 105 endoscopic procedures (91 patients), were included. In 65% of the procedures, the mucosa was inflamed; however, 15% did not show histological inflammation. Endoscopic remission was observed in the other 35% of procedures; however, 22% exhibited histologic inflammation in their biopsies. Mayo Endoscopic Subscore and Mayo Modified Endoscopic Score were well correlated but were only moderately correlated with clinical and histologic scores. Further, there was a moderate correlation between Mayo Endoscopic Score and Geboes Score. Conversely, histologic scores were poorly correlated with Partial Mayo Score. Using multivariate analysis, Geboes Score and basal plasmacytosis were predictive of active disease (OR 3.05; 95% CI: 1.54-7.95 and OR 3.24; 95% CI: 1.12-9.34, respectively), whereas biological therapy usage was found to be protective factor for ulcerative colitis (OR 0.02; 95% CI: 0.00-0.64). Clinical, endoscopic and histologic activities were moderately correlated, while Geboes Score and basal plasmacytosis were predictive of endoscopically active disease. This article is protected by copyright. All rights reserved.

  18. FDG PET/CT patterns of treatment failure of malignant pleural mesothelioma: relationship to histologic type, treatment algorithm, and survival

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    Gerbaudo, Victor H.; Mamede, Marcelo [Brigham and Women' s Hospital, Harvard Medical School, Division of Nuclear Medicine and Molecular Imaging, Boston, MA (United States); Trotman-Dickenson, Beatrice; Hatabu, Hiroto [Brigham and Women' s Hospital, Harvard Medical School, Division of Thoracic Radiology, Boston, MA (United States); Sugarbaker, David J. [Brigham and Women' s Hospital, Harvard Medical School, Division of Thoracic Surgery, Boston, MA (United States)

    2011-05-15

    This study investigated the diagnostic performance and prognostic value of fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT in suspected malignant pleural mesothelioma (MPM) recurrence, in the context of patterns and intensity of FDG uptake, histologic type, and treatment algorithm. Fifty patients with MPM underwent FDG PET/CT for restaging 11 {+-} 6 months after therapy. Tumor relapse was confirmed by histopathology, and by clinical evolution and subsequent imaging. Progression-free survival was defined as the time between treatment and the earliest clinical evidence of recurrence. Survival after FDG PET/CT was defined as the time between the scan and death or last follow-up. Overall survival was defined as the time between initial treatment and death or last follow-up date. Treatment failure was confirmed in 42 patients (30 epithelial and 12 non-epithelial MPM). Sensitivity, specificity, accuracy, negative predictive value, and positive predictive value for FDG PET/CT were 97.6, 75, 94, 86, and 95.3%, respectively. FDG PET/CT evidence of single site of recurrence was observed in the ipsilateral hemithorax in 18 patients (44%), contralaterally in 2 (5%), and in the abdomen in 1 patient (2%). Bilateral thoracic relapse was detected in three patients (7%). Simultaneous recurrence in the ipsilateral hemithorax and abdomen was observed in ten (24%) patients and in seven (17%) in all three cavities. Unsuspected distant metastases were detected in 11 patients (26%). Four patterns of uptake were observed in recurrent disease: focal, linear, mixed (focal/linear), and encasing, with a significant difference between the intensity of uptake in malignant lesions compared to benign post-therapeutic changes. Lesion uptake was lower in patients previously treated with more aggressive therapy and higher in intrathoracic lesions of patients with distant metastases. FDG PET/CT helped in the selection of 12 patients (29%) who benefited from additional previously

  19. Confocal microscopy for the histological fluorescence pattern of a recurrent atypical meningioma: case report.

    Science.gov (United States)

    Whitson, Wesley J; Valdes, Pablo A; Harris, Brent T; Paulsen, Keith D; Roberts, David W

    2011-06-01

    Fluorescence-guided resection with 5-aminolevulinic acid (5-ALA), which has shown promising results in the resection of malignant gliomas, has been used for meningioma resection in an attempt to more clearly delineate the tumor margin. However, no article has investigated the fluorescence pattern of meningiomas on a histological level. Understanding the microscopic pattern of fluorescence could help assess the precision and utility of using 5-ALA for these tumors. We present the case of a recurrent atypical meningioma operated on with 5-ALA fluorescence-guided resection for delineation of tumor tissue from surrounding uninvolved dura. A 53-year-old woman presented with recurrent atypical meningioma of the falx. Prior treatment included surgical resection 6 years earlier with subsequent fractionated radiation therapy and radiosurgery for tumor progression. The patient was given 5-ALA 20 mg/kg body weight dissolved in 100 mL water 3 hours before induction of anesthesia. Intraoperative fluorescence was coregistered with preoperative imaging. Neuropathological analysis of the resected falx with confocal microscopy enabled correlation of fluorescence with the extent of tumor on a histological level. Fluorescence guidance allowed clear intraoperative delineation of tumor tissue from adjacent, uninvolved dura. On a microscopic level, there was a very close correlation of fluorescence with tumor, but some tumor cells did not fluoresce. Copyright © 2011 by the Congress of Neurological Surgeons

  20. Chronic Liver Diseases in Children: Clinical Profile and Histology.

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    Dhole, Sachin Devidas; Kher, Archana S; Ghildiyal, Radha G; Tambse, Manjusha P

    2015-07-01

    The main aim of the study is to study the clinical profile of disorders of the liver and hepatobiliary system in paediatric patients and to correlate the histopathology findings of liver biopsy in chronic liver disease. Another aim being to assess the prognosis and to know the outcome and the effects of treatment in chronic liver diseases in paediatric age group. It was a prospective study, included the clinical profile of Chronic Liver Diseases (CLD) in children and the histopathological correlation. A total of 55 children were thoroughly investigated by doing relevant investigations and liver biopsy. A male predominance (60%) was noted with maximum incidence in the age group of 6-12 years. The incidence of CLD was 1.1% of total admissions. The most common presenting complaint was jaundice and abdominal distension. Hepatic encephalopathy was noted in 29% patients. Hepatomegaly was seen in 63% patients and spleenomegaly was seen in 60% patients. The incidence of cirrhosis on liver biopsy was 42% (23cases) in CLD patients. The most common diagnosis on histopathology was Wilson's disease (22%), followed by hepatitis and autoimmune hepatitis. The predominant spectrum of CLD was metabolic liver disease and also the predominant cause of death. As the incidence of CLD is quite low, a very high index of suspicion is required for its diagnosis. Some uncommon causes of CLD in children were seen in our study like neutral lipid storage disease, α1-Antitrypsin deficiency disease, lupus hepatitis, Alagille syndrome and Budd-Chiari syndrome. A patient of CLD with jaundice and hepatomegaly should be treated aggressively as those are the poor prognostic indicators of the disease. Hepatic encephalopathy and cirrhosis are also associated with poor outcome in patients with CLD. Liver biopsy histopathology by an expert and its correlation with laboratory investigations plays an important role in the diagnosis of CLD. The major cause of deaths in patients with CLD is due to end stage

  1. Folliculotropic mycosis fungoides: clinical and histologic features in five patients

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    Amir Hooshang Ehsani

    2016-01-01

    Full Text Available Background: Alopecia can be a manifestation of mycosis fungoides (MF; however, the prevalence is unknown. Aims: We sought to describe the clinicopathologic presentation of alopecia in patients with diagnosis of MF. Methods: A retrospective analysis of patients with biopsy-proven MF, who were evaluated at our cancer center from 2002 to 2012, was performed to identify patients with alopecia. Results: Five patients with alopecia were identified from reviewing of 157 patients with MF. The male:female ratio was 3:2, and the mean age of patients was 42.8 years. Two of these patients showed patchy hair loss on scalp which was clinically identical to alopecia areata. In remaining three patients, hair loss was seen in areas of MF lesions, and epidermal changes consisted of patch- and plaque-type lesions of MF, tumors, and follicular lesions (follicular MF were also present. In two of these patients, lymphadenopathy without any visceral involvement was detected. Conclusions: Alopecia was observed in 5 (3.18% patients with MF, which makes it a rare finding, which included alopecia areata-like patchy loss in 2 and alopecia within MF lesions in 3.

  2. STUDY OF INTRAOPERATIVELY AND HISTOLOGICALLY NEGATIVE CASES IN CLINICALLY DIAGNOSED CASES OF ACUTE APPENDICITIS

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    Muralidhar Manga

    2016-07-01

    Full Text Available BACKGROUND Acute appendicitis remains the most common cause of acute abdomen requiring surgical intervention. Diagnosis of appendicitis is done on clinical grounds. The aetiology and pathogenesis of appendicitis are poorly understood. The cause of pain in the cases with clinical diagnosis of acute appendicitis but intraoperatively normal looking appendix remains controversial. The present study aims at determining the cause of pain in these cases by combining routine histopathology, IHC to investigate the status of the enteric nervous system in normal and inflamed appendices. MATERIALS AND METHODS In the present study, 694 patients who underwent appendicectomy with diagnosis of acute appendicitis were included. In 89 cases, there were no signs of inflammation intraoperatively. These appendix specimens were followed by histopathological examination by H&E staining. 69 out of 89 specimens did not have signs of inflammation in histological examination by H&E staining. Cases which are diagnosed as acute appendicitis but histologically negative in H&E staining are taken as study cases. 49 acute appendicitis cases- histologically positive acute appendicitis (HPAA and 20 appendices from right hemicolectomy specimens were taken as controls. All these specimens were subjected to; 1 Routine Haematoxylin & Eosin staining. 2 Toluidine blue stain for mast cell evaluation. 3 Immunohistochemistry by S-100 stain for evaluating size and number of the ganglia. OBSERVATION The mean mast cell count was more in the histologically negative acute appendicitis group when compared to histologically positive acute appendicitis and control group. The mean size and number of the ganglia were more in the histologically negative acute appendicitis group when compared to histologically positive acute appendicitis and control groups. CONCLUSION Neuronal hypertrophy and mast cells may play a role in the pathogenesis of “appendicitis like pain” in patients with

  3. Rare idiopathic intestinal pneumonias (IIPs) and histologic patterns in new ATS/ERS multidisciplinary classification of the IIPs

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    Johkoh, Takeshi, E-mail: johkoht@aol.com [Department of Radiology, Kinki Central Hospital of Mutual Aid Association of Public School Teachers (Japan); Fukuoka, Junya, E-mail: fukuokaj@nagasaki-u.ac.jp [Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences (Japan); Tanaka, Tomonori, E-mail: yotsudukayama@yahoo.com [Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences (Japan)

    2015-03-15

    Highlights: •The new (ATS/ERS) update to the multidisciplinary classification of idiopathic interstitial pneumonias (IIPs) defines both rare IIPs and rare histologic patterns of IIPs. •Rare IIPs; lymphoid interstitial pneumonia, pleuroparenchymal fibroelastosis. •Rare histologic pattern, acute fibrionous organizing pneumonia, bronchocentric pattern of interstitial pneumonia. -- Abstract: The new American Thoracic Society/European Respiratory Society (ATS/ERS) update to the multidisciplinary classification of idiopathic interstitial pneumonias (IIPs) defines both rare IIPs and rare histologic patterns of IIPs. Although these diseases are rare, each has some distinguishing imaging and pathologic characteristics. Common findings for IIPs in computed tomography (CT) include cysts in lymphoid interstitial pneumonia (LIP), upper lobe subpleural consolidation in pleuropulmonary fibroelastosis (PPFE), symmetrical consolidation in acute fibrinous organizing pneumonia (AFOP), and peribronchovascular consolidation or centrilobular nodules in bronchiolocentric pattern of interstitial pneumonia.

  4. Histological Validity and Clinical Evidence for Use of Fractional Lasers for Acne Scars

    Science.gov (United States)

    Sardana, Kabir; Garg, Vijay K; Arora, Pooja; Khurana, Nita

    2012-01-01

    Though fractional lasers are widely used for acne scars, very little clinical or histological data based on the objective clinical assessment or the depth of penetration of lasers on in vivo facial tissue are available. The depth probably is the most important aspect that predicts the improvement in acne scars but the studies on histology have little uniformity in terms of substrate (tissue) used, processing and stains used. The variability of the laser setting (dose, pulses and density) makes comparison of the studies difficult. It is easier to compare the end results, histological depth and clinical results. We analysed all the published clinical and histological studies on fractional lasers in acne scars and analysed the data, both clinical and histological, by statistical software to decipher their significance. On statistical analysis, the depth was found to be variable with the 1550-nm lasers achieving a depth of 679 μm versus 10,600 nm (895 μm) and 2940 nm (837 μm) lasers. The mean depth of penetration (in μm) in relation to the energy used, in millijoules (mj), varies depending on the laser studied. This was statistically found to be 12.9–28.5 for Er:glass, 3–54.38 for Er:YAG and 6.28–53.66 for CO2. The subjective clinical improvement was a modest 46%. The lack of objective evaluation of clinical improvement and scar-specific assessment with the lack of appropriate in vivo studies is a case for combining conventional modalities like subcision, punch excision and needling with fractional lasers to achieve optimal results. PMID:23060702

  5. Histological validity and clinical evidence for use of fractional lasers for acne scars

    Directory of Open Access Journals (Sweden)

    Kabir Sardana

    2012-01-01

    Full Text Available Though fractional lasers are widely used for acne scars, very little clinical or histological data based on the objective clinical assessment or the depth of penetration of lasers on in vivo facial tissue are available. The depth probably is the most important aspect that predicts the improvement in acne scars but the studies on histology have little uniformity in terms of substrate (tissue used, processing and stains used. The variability of the laser setting (dose, pulses and density makes comparison of the studies difficult. It is easier to compare the end results, histological depth and clinical results. We analysed all the published clinical and histological studies on fractional lasers in acne scars and analysed the data, both clinical and histological, by statistical software to decipher their significance. On statistical analysis, the depth was found to be variable with the 1550-nm lasers achieving a depth of 679 μm versus 10,600 nm (895 μm and 2940 nm (837 μm lasers. The mean depth of penetration (in μm in relation to the energy used, in millijoules (mj, varies depending on the laser studied. This was statistically found to be 12.9-28.5 for Er:glass, 3-54.38 for Er:YAG and 6.28-53.66 for CO 2 . The subjective clinical improvement was a modest 46%. The lack of objective evaluation of clinical improvement and scar-specific assessment with the lack of appropriate in vivo studies is a case for combining conventional modalities like subcision, punch excision and needling with fractional lasers to achieve optimal results.

  6. Histological Disease Activity as a Predictor of Clinical Relapse Among Patients With Ulcerative Colitis: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Park, Sunhee; Abdi, Tsion; Gentry, Mark; Laine, Loren

    2016-12-01

    Endoscopic remission in ulcerative colitis (UC) is associated with improved clinical outcomes. We assessed whether histological remission predicts clinical outcomes, estimated the magnitude of effect, and determined whether histological remission provides additional prognostic utility beyond clinical or endoscopic remission. Bibliographic databases were searched for studies in inflammatory bowel disease providing baseline histological status and relation to an outcome of clinical relapse or exacerbation. Our primary analysis compared the proportion of patients with study-defined histological remission vs. the proportion with histological activity who developed clinical relapse/exacerbation. Additional analyses compared the proportion with relapse/exacerbation for the presence vs. absence of different histological features and for histological remission vs. endoscopic remission and clinical remission. A fixed-effect model was used for meta-analysis, with a random-effects model if statistical heterogeneity was present. Fifteen studies met inclusion criteria. The major methodological shortcoming was lack of blinding of the assessor of clinical relapse/exacerbation to baseline histological status in 13 of the 15 studies. Relapse/exacerbation was less frequent with baseline histological remission vs. histological activity (relative risk (RR)=0.48, 95% confidence interval (CI) 0.39-0.60) and vs. baseline clinical and endoscopic remission (RR=0.81, 95% CI 0.70-0.94). Relapse/exacerbation was also less common in the absence vs. presence of specific histological features: neutrophils in epithelium (RR=0.32, 95% CI 0.23-0.45), neutrophils in lamina propria (RR=0.43, 95% CI 0.32-0.59), crypt abscesses (RR=0.38, 95% CI 0.27-0.54), eosinophils in the lamina propria (RR=0.43, 95% CI 0.21-0.91), and chronic inflammatory cell infiltrate (RR=0.28, 95% CI 0.10-0.75). Histological remission was present in 964 (71%) of the 1360 patients with combined endoscopic and clinical remission

  7. Clinical staging in bitches with mammary tumors: Influence of type and histological grade.

    Science.gov (United States)

    Gundim, Lígia F; de Araújo, Camila P; Blanca, William T; Guimarães, Ednaldo C; Medeiros, Alessandra A

    2016-10-01

    Breast tumors are the most common tumors in dogs and the study of disease prognostic factors is important for establishing the appropriate treatment protocols. The purpose of this study was to clinically stage mammary tumors of bitches and correlate the stages with histological type and grade. The tumors of 63 dogs were clinically staged based on the findings of tumor sizing, lymph node evaluation, and radiographic examination. After surgical excision, the tumors were classified histologically and graded. The relationship between the tumor grade, stage, and histological type was evaluated using a binomial test. Stage I tumors were the most numerous (31.75%), followed by tumors at stages II, III, IV, and V. Animals with histological grade I carcinomas presented stage I, II, or III tumors more frequently and stage IV and V tumors less frequently. The number of animals with simple carcinomas that were at stage I of the disease was greater than that at stage V. Carcinomas in the mixed tumors were less aggressive; however, the small number of animals in stage V of the disease made any statistical association impossible. The complex carcinomas presented with the invasion of the lymph nodes and less cellular differentiation in a larger number of animals than did simple carcinomas. Histological grading proved to be the best parameter for the prognostic evaluation of the breast carcinomas.

  8. Interobserver reproducibility study of the histological patterns of primary lung adenocarcinoma with emphasis on a more complex glandular pattern distinct from the typical acinar pattern.

    Science.gov (United States)

    Wang, Congli; Durra, Heba Y; Huang, Yajue; Manucha, Varsha

    2014-04-01

    The newly proposed International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society (IASLC/ATS/ERS) classification of lung adenocarcinoma has emphasized the prognostic significance of histological subtyping. In this study, 2 surgical pathologists reevaluated 49 consecutive cases of invasive primary pulmonary adenocarcinomas; histological subtyping was performed according to the IASLC/ATS/ERS classification. The 2 reviewers agreed on the predominant pattern in 23 out of 32 independently reviewed cases (71.9%, k = 0.628, 95% confidence interval = 0.442-0.815). Postconsensus, a complex glandular pattern consisting of fused, closely packed glands and cribriform architecture was identified in 9 of 49 (18%) cases. This pattern has a strong association with lymphovascular invasion (78%; P = .0091), high mitotic activity (89%), and higher tumor stage (78%). Frequent association of complex glandular pattern with poor prognostic factors and its overlap with acinar pattern warrant a more detailed description of this pattern in the classification system and a large-scale study to evaluate its prognostic significance.

  9. The Clinical, Radiographic and Histological evaluation of three different concentrations of Formocresol as a pulpotomy agent

    Science.gov (United States)

    Goyal, Swati; Abuwala, Tasnima; Joshi, Keyur; Mehta, Jahnvi; Indushekar, K R; Hallikerimath, Seema

    2014-01-01

    Background: Formocresol, though the center of much controversy is still the most widely used medicament for primary teeth pulpotomy and an intracanal medicament which has undergone a lengthy evolution to shorten the formocresol application time and reduce the concentration of formocresol exposure to the pulp tissue. Hence, the determination of the actual effective dose and concentration of formocresol for clinical application in primary teeth is an important area of research and a thorough clinical, radiographic and histological investigation in human subjects is very much needed. Materials & Methods: The study was conducted on 45 primary molars for the Clinical, Radiographic study and 45 premolars orthodontically indicated for extraction for the Histological study. The samples were randomly and equally divided into 3 groups of 15 each for pulpotomy with full strength formocresol, 1:5 diluted formocresol and 1:25 diluted formocresol respectively. The pulpotomized primary molars were clinically evaluated at 1st, 3rd, 6th and 9th month while the pulpotomized premolars were subjected for histological evaluation after extraction. Results: Obtained by chi-square test revealed that all the pulpotomized primary molars were asymptomatic till the end of the study period; suggesting 100% clinical and radiographic success while histologically, the three concentrations of formocresol showed decreased severity of fixation of the pulp tissue with decreasing concentration of formocresol. Conclusion: It can be inferred that the diluted formulations (1:5 and 1:25) of formocresol are equally efficient when compared to full-strength formocresol and thus, can be recommended for pulpotomy in primary teeth. How to cite the article: Goyal S, Abuwala T, Joshi K, Mehta J, Indushekar KR, Hallikerimath S. The Clinical, Radiographic and Histological evaluation of three different concentrations of Formocresol as a pulpotomy agent. J Int Oral Health 2014;6(2):118-25. PMID:24876712

  10. The histological characteristics of clinically normal mucosa adjacent to oral cancer

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    Milos Cankovic

    2013-01-01

    Conclusions: Histological abnormalities of clinically normal-looking oral mucosa taken at different distances from the tumor lesion indicated the existence of subclinical field change and represent an important parameter during the assessment of the adequacy of surgical resection margins in oral cancer management.

  11. Vascular pattern in enchondroma and chondrosarcoma: clinical and immunohistologic study.

    Science.gov (United States)

    Cintra, Francisco F; Etchebehere, Mauricio; Gonçalves, Jose C B; Cassone, Alejandro E; Amstalden, Eliane M I

    2014-09-01

    Although cartilaginous tumors have low microvascular density, vessels are important for the provision of nutrition so that the tumor can grow and generate metastasis. The aim of this study was to assess the value of the vascular pattern classification as a prognostic tool in chondrosarcomas (CSs) and its relation with vascular endothelial growth factor (VEGF) expression. This was a retrospective study of 21 enchondromas and 57 conventional CSs. Clinical data and outcome were retrieved from medical files. CSs histologic grades (on a scale of 1 to 3) were determined according to the World Health Organization classification. The vascular pattern (on a scale of A to C) was assessed through CD34, according to Kalinski. CD105 and VEGF were also evaluated. Poor outcome was significantly associated with vascular pattern groups B and C. Higher vascular pattern were 6.5 times more frequent in moderate-grade and high-grade CSs than in grade 1 CS. On multivariate analysis, a clear correlation was found between VEGF overexpression and B/C vascular patterns. Only 18 (benign and malignant) tumors stained for CD105. The results point to the use of the vascular pattern classification as a prognostic tool in CSs and to differentiate low-grade from moderate-grade/high-grade CSs. Vascular pattern might be also used to complement histologic grade, VEGF immunostaining, and microvascular density, for indicating a patient's prognosis. Low-grade CSs develop under low neoangiogenesis, which conforms to the slow growth rate of these tumors.

  12. Histologic and Clinical Study of Gingival Recession Treated with Subepithelial Connective Tissue Graft: A Case Report.

    Science.gov (United States)

    García-De-la-Fuente, Ana-María; Aguirre-Zorzano, Luis Antonio; Estefanía-Fresco, Ruth; Roig Ódena, Laia; Aguirre-Urizar, José-Manuel

    Subepithelial connective tissue graft (SCTG) is considered the gold standard for treatment of gingival recessions. For ethical reasons, most studies report only clinical and not histologic results. A 20-year-old woman presenting with a localized gingival recession of 5 mm in the mandibular left central incisor was treated with SCTG. According to the initial treatment plan, the tooth was extracted 11 months later and a histologic study was performed, revealing new attachment of connective tissue with collagen fibers that were directly inserted in a perpendicular way into dentin areas and new cement areas (1.37 mm).

  13. The histological characteristics of clinically normal mucosa adjacent to oral cancer

    OpenAIRE

    Milos Cankovic; Miroslav P Ilic; Nada Vuckovic; Marija Bokor-Bratic

    2013-01-01

    Background: The ′field cancerization′ theory tries to explain the risk of local recurrences and development of second primary tumors in oral sqamous cell carcinoma (OSCC) patients. According to this theory it is assumed that clinically normal mucosa adjacent to oral cancer, except molecular, has already developed certain premalignant histopathological changes. Aims: The aim of this study was to determine histological characteristics of clinically normal-looking mucosa at different distanc...

  14. Anal Cancer Incidence in the United States, 1977–2011: Distinct Patterns by Histology and Behavior

    Science.gov (United States)

    Shiels, Meredith S.; Kreimer, Aimée R.; Coghill, Anna E.; Darragh, Teresa M.; Devesa, Susan S.

    2015-01-01

    Background Although anal squamous cell carcinoma (SCC) and adenocarcinoma (ADC) are generally combined in cancer surveillance, their etiologies likely differ. Here, we describe demographic characteristics and trends in incidence rates (IRs) of anal cancer by histology (SCC, ADC) and behavior (invasive, in situ) in the United States. Methods With data from the Surveillance, Epidemiology and End Results (SEER) Program, we estimated age-adjusted anal cancer IRs across behavior/histology by demographic and tumor characteristics for 2000–2011. Trends in IRs and annual percent changes during 1977–2011 were also estimated and compared to rectal cancer. Results Women had higher rates of SCC (rate ratio [RR]=1.45; 95%CI 1.40–1.50) and lower rates of ADC (RR=0.68; 95%CI 0.62–0.74) and squamous carcinoma in situ (CIS) (RR=0.36; 95%CI 0.34–0.38) than men. Blacks had lower rates of SCC (RR=0.82; 95%CI 0.77–0.87) and CIS (RR=0.90; 95%CI 0.83–0.98) than non-Hispanic whites, but higher rates of ADC (RR=1.48; 95%CI 1.29–1.70). Anal cancer IRs were higher in men and blacks aged anal and rectal cancers. Conclusions Rates of anal SCC and CIS have increased strongly over time, in contrast to rates of anal ADC, similar to trends observed for rectal SCC and ADC. Impact Anal SCC and ADC likely have different etiologies, but may have similar etiologies to rectal SCC and ADC, respectively. Strong increases in CIS IRs over time may reflect anal cancer screening patterns. PMID:26224796

  15. Female Pattern Hair Loss: a clinical and pathophysiological review.

    Science.gov (United States)

    Ramos, Paulo Müller; Miot, Hélio Amante

    2015-01-01

    Female Pattern Hair Loss or female androgenetic alopecia is the main cause of hair loss in adult women and has a major impact on patients' quality of life. It evolves from the progressive miniaturization of follicles that lead to a subsequent decrease of the hair density, leading to a non-scarring diffuse alopecia, with characteristic clinical, dermoscopic and histological patterns. In spite of the high frequency of the disease and the relevance of its psychological impact, its pathogenesis is not yet fully understood, being influenced by genetic, hormonal and environmental factors. In addition, response to treatment is variable. In this article, authors discuss the main clinical, epidemiological and pathophysiological aspects of female pattern hair loss.

  16. The histological characteristics of clinically normal mucosa adjacent to oral cancer.

    Science.gov (United States)

    Cankovic, Milos; Ilic, Miroslav P; Vuckovic, Nada; Bokor-Bratic, Marija

    2013-01-01

    The 'field cancerization' theory tries to explain the risk of local recurrences and development of second primary tumors in oral sqamous cell carcinoma (OSCC) patients. According to this theory it is assumed that clinically normal mucosa adjacent to oral cancer, except molecular, has already developed certain premalignant histopathological changes. The aim of this study was to determine histological characteristics of clinically normal-looking mucosa at different distances from the apparent tumor lesion margins in OSCC patients. Normal-appearing oral mucosa biopsy specimens were obtained from 30 new (untreated) oral cancer patients from sites at a distance of 10 mm and 20 mm from the tumor lesion margins and were compared with normal oral mucosa from 30 control patients with benign oral lesions. A total of 21 patients (70%) in the OSCC group demonstrated histological abnormalities under microscopic examination versus 7 (23.3%) control patients (Poral cancer patients (57%) showed significant difference in incidence and type of histological changes of normal-looking mucosa at a distance of 10 mm from the tumor lesion; 8 (27%) demonstrated reactive changes, 6 (20%) mild dysplasia and 3 (10%) squamous cell carcinoma, compared to histological abnormalities registered in 11 (OSCC) patients (36%) at a distance of 20 mm from the tumor; 10 (33%) displayed reactive changes and 1 (3%) mild dysplasia. Histological abnormalities of clinically normal-looking oral mucosa taken at different distances from the tumor lesion indicated the existence of subclinical field change and represent an important parameter during the assessment of the adequacy of surgical resection margins in oral cancer management.

  17. Mesotherapy for facial skin rejuvenation: a clinical, histologic, and electron microscopic evaluation.

    Science.gov (United States)

    Amin, Snehal P; Phelps, Robert G; Goldberg, David J

    2006-12-01

    Mesotherapy, as broadly defined, represents a variety of minimally invasive techniques in which medications are directly injected into the skin and underlying tissue in order to improve musculoskeletal, neurologic, and cosmetic conditions. There are few clinical studies evaluating the efficacy and safety of mesotherapy in any form. This study evaluates the histologic and clinical changes associated with one of the simplest formulations of mesotheraphy commonly used for skin rejuvenation. Ten subjects underwent four sessions of mesotherapy involving multiple injections of a multivitamin and hyaluronic acid solution. Treatment was conducted at 4 monthly intervals. All subjects had pre- and post-treatment photographs and skin biopsies. Skin biopsies were evaluated with routine histology, mucin and elastin stains, and electron microscopy. Patient surveys were also evaluated. Evaluation of photographs at 0, 3, and 6 months revealed no significant clinical differences. Light microscopic examination of pre- and posttreatment specimens showed no significant changes. Electron microscopic analysis of collagen fibers measurements did show smaller diameter fibres posttreatment. No significant clinical or histologic changes were observed after multivitamin mesotherapy for skin rejuvenation. Multivitamin and hyaluronic acid solution facial mesotherapy does not appear to provide any significant benefit.

  18. Effect of tranexamic acid on melasma: a clinical trial with histological evaluation.

    Science.gov (United States)

    Na, J I; Choi, S Y; Yang, S H; Choi, H R; Kang, H Y; Park, K-C

    2013-08-01

    Melasma is associated with epidermal hyperpigmentation, weak basement membrane, vascular proliferation and increased numbers of mast cell. Tranexamic acid (TXA), a plasmin inhibitor, is reported to improve melasma when injected locally. However, the effects of oral and topical TXA on melasma have not been well studied and the underlying mechanism remains unclear. To elucidate the effects of oral and topical TXA on melasma. A clinical study was conducted with 25 women for 8 weeks from March to July 2010. Volunteers were instructed to take two TXA tablets three times a day and apply a TXA topical agent twice a day for 8 weeks. Skin pigmentation and erythema was measured using a Mexameter(®) during each visit and skin biopsies were collected from eight subjects before and 8 weeks after treatment. Fontana-Masson, anti-CD31, antitryptase and antitype IV collagen staining was performed. Twenty-two subjects completed the study and no serious adverse events occurred during the study period. The mean lesional melanin index (MI) scores decreased significantly. Interestingly, the MI scores for the perilesional skin increased. The erythema index scores of lesional and perilesional skin also showed a similar pattern. Histological analysis showed significant reduction of epidermal pigmentation, vessel numbers and mast cell counts. Type IV collagen staining was not observed in all specimens. TXA decreased epidermal pigmentation associated with melasma and also reversed melasma-related dermal changes, such as vessel number and increased numbers of mast cells. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

  19. Clinical, Neurophysiological and Immunological Peculiarities of Myasthenia Gravis in Patients with Different Histologic Types of Thymoma

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    Olena Tovazhnyanska

    2016-11-01

    Results and conclusions. The severity of the clinical course of myasthenic syndrome on the background of thymoma does not depend on tumor size; it depends on the histologic type and immunological imbalance. The severest clinical picture was observed in patients with type AB thymoma and the least severe course of myasthenic symptoms was found in patients with lymphoid thymoma (type B1. Lymphoepithelial and epithelial thymomas were accompanied by similar immunological disorders. The reduction in the levels of CD3+ and CD4+ lymphocyte subpopulations can be used as a reliable diagnostic criterion. Lymphoid thymomas are characterized by a significant reduction in the indicators of the phagocytic index, the phagocytic number, and the level of CD8+ lymphocyte subpopulations as well as an increase in the level of CD4+ subpopulations. Surgical treatment as a method of choice in case of radical immunosuppression is indicated for all patients with confirmed thymoma regardless of its size and histological characteristics.

  20. Nephrotic Range Proteinuria in Renal Transplantation: Clinical and Histologic Correlates in a 10-year Retrospective Study.

    Science.gov (United States)

    Leal, R; Pinto, H; Galvão, A; Santos, L; Romãozinho, C; Macário, F; Alves, R; Pratas, J; Sousa, V; Marinho, C; Prado E Castro, L; Campos, M; Mota, A; Figueiredo, A

    2017-05-01

    There is a high incidence of nephrotic proteinuria in renal transplant recipients, which is an accurate predictor of graft loss. Despite this, its histologic correlates and prognostic implications are still not well characterized. We assessed the clinical and histological correlates of kidney transplantation patients with nephrotic range proteinuria. We have retrospectively analyzed clinical and histological data from 50 kidney transplantation biopsy specimens from 44 renal transplant recipients with nephrotic range proteinuria between 2006 and 2015. The median follow-up time was 93 months (range, 14 months to 190 months). The mean age of the patients was 45.2 ± 13.7 years and our cohort included 86% recipients of deceased-donor grafts. The maintenance immunosuppressive regimen included calcineurin inhibitors in 68% and mammalian target of rapamycin inhibitors in 32% of patients. The average proteinuria was 6.9 ± 3.8 g/d and 52% of patients presented with nephrotic syndrome. The main histological findings were transplant glomerulopathy (22%), de novo glomerular disease (22%), and recurrence of primary disease (22%). Tubular atrophy and interstitial fibrosis was present in 78% of the biopsy specimens. Thirty-one patients (62%) lost the graft at follow-up. There was no statistically significant difference between the histologic diagnosis nor the proteinuria levels and the outcome of the graft. The main causes of nephrotic range proteinuria in patients undergoing biopsy were transplant glomerulopathy, recurrence of the underlying disease, and de novo glomerulonephritis. Nephrotic range proteinuria was related to a high rate of graft loss. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Intrinsic brainstem schwannoma – A rare clinical entity and a histological enigma

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    Anil Kumar Sharma

    2016-01-01

    Full Text Available Intraparenchymal schwannomas arising in the brainstem are very rare, and only eight cases have been reported in literature till now. We report an intraparenchymal brainstem schwannoma presenting with the classical clinical presentation of an intrinsic brainstem lesion, and discuss its clinicoradiological characteristics and histological origins. We highlight the importance of an intraoperative frozen section diagnosis in such cases. Intraoperative tissue diagnosis significantly may alter the surgical strategy, which should be aimed at near total intracapsular decompression of the schwannoma.

  2. Histological and Clinical Features of Primary and Recurrent Periocular Basal Cell Carcinoma

    OpenAIRE

    Ben Simon, Guy J.; Lukovetsky, Semion; Lavinsky, Fabio; Rosen, Nahum; Rosner, Mordechai

    2012-01-01

    Background. Basal cell carcinoma (BCC) is the most common malignancy of the eyelids. Medial canthal BCCs tends to recur more often. Purpose. To evaluate the clinical and histological features of primary and recurrent periocular BCC, in order to identify any existing associations. Methods. Data from 87 patients (71 primary and 16 recurrent) were analyzed in this study. All patients underwent tumor excision with frozen section margin control at the Goldschleger Eye Institute between 1/1995 to 1...

  3. The association of serum lipids with the histological pattern of rectosigmoid adenoma in Taiwanese adults

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    Lu Feng-Hwa

    2011-05-01

    Full Text Available Abstract Background The mortality rate of colorectal cancer ranks third behind lung and hepatic cancer in Taiwan. Colorectal cancer mostly arises from adenomatous polyps of left colon. The aim of our study was to examine the association of serum lipids with the histological pattern of rectosigmoid adenoma. Methods There were 2,506 eligible examinees aged 20 and above who underwent sigmoidoscopy as a screening examination in National Cheng Kung University Hospital between January 2003 and October 2006. They were classified into three groups: tubular adenoma (333 subjects, villous-rich (tubulovillous/villous adenoma (53 subjects and normal (2,120 subjects. We defined high total cholesterol (TC as a level ≧200 mg/dl, low high-density lipoprotein cholesterol (HDL-C as a level Results Among the study population, 333 subjects (13.3% had tubular adenomas and 53 subjects (2.1% had villous-rich adenomas. The odds ratio (OR for villous-rich adenoma in subjects with TG≧200 mg/dL compared to those with TG Conclusions Our study showed that subjects with high serum TG tended to have a higher risk of tubulovillous/villous adenoma in rectosigmoid colon. Therefore, reducing the serum TG level might be one method to prevent the incidence of colorectal cancer.

  4. Effect of six-food elimination diet on clinical and histologic outcomes in eosinophilic esophagitis.

    Science.gov (United States)

    Kagalwalla, Amir F; Sentongo, Timothy A; Ritz, Sally; Hess, Therese; Nelson, Suzanne P; Emerick, Karan M; Melin-Aldana, Hector; Li, B U K

    2006-09-01

    In children, eosinophilic esophagitis (EE) is predominantly, but not exclusively, a food-hypersensitivity disorder. A crystalline amino acid-based elemental diet (ELED) formula currently remains the most effective nutritional treatment in inducing clinical and histologic remission. However, compliance with an exclusive, poor-tasting liquid formulation is difficult. This retrospective observational study assessed the short-term clinical and histologic responses of 2 cohorts of children with EE evaluated during 2 different time periods: one was treated with the standard 6-food elimination diet (SFED) and the other was treated with ELED. Of the 60 children who met the inclusion criteria and were compliant with the dietary protocol, 35 were treated with a diet excluding cow-milk protein, soy, wheat, egg, peanut, and seafood while allowing all other table foods and 25 were treated exclusively with ELED. Repeat esophageal biopsy specimens were obtained at least 6 weeks later. Twenty-six of 35 (74%) in the SFED group and 22 of 25 (88%) in the ELED group achieved significant improvement of esophageal inflammation (treatment was associated with clinical and histologic improvement in EE in an observational study. It offers advantages of better acceptance, cost, and compliance than ELED and should be considered as an option in the initial management of children with EE.

  5. Recovery patterns, histological observations and genetic integrity in Malus shoot tips cryopreserved using droplet vitrification and encapsulation-dehydration procedures

    Science.gov (United States)

    A droplet-vitrification procedure is described for cryopreservation of Malus shoot tips. Survival patterns, recovery types, histological observations, and genetic integrity were compared for Malus shoot tips cryopreserved using this droplet-vitrification procedure and an encapsulation-dehydration pr...

  6. Ultrasonographic, endoscopic and histological appearance of the caecum in clinically healthy cats.

    Science.gov (United States)

    Hahn, Harriet; Freiche, Valérie; Baril, Aurélie; Charpentier, Julie; Desquilbet, Loïc; Le Poder, Sophie; Servely, Jean-Luc; Laloy, Eve; Pey, Pascaline

    2017-02-01

    Objectives The aim of the study was to describe the ultrasonographic and endoscopic appearance and characteristics of the caecum in asymptomatic cats, and to correlate these findings with histology. Methods Ex vivo ultrasonographic and histologic evaluations of a fresh caecum were initially performed. Then, 20 asymptomatic cats, privately owned or originating from a reproductive colony, were recruited. All cats had an ultrasonographic examination of the ileocaecocolic junction, where the thickness of the caecal wall, ileocolic lymph nodes and the echogenicity of the local fat were assessed. They all underwent a colonoscopy with a macroscopic assessment of the mucosa and biopsies for histology. Results An ultrasonographic hypoechoic nodular inner layer, which corresponded to the coalescence of multiple lymphoid follicles originating from the submucosa and protruding in the mucosa on histology, was visible in all parts of the caecum. The combined mucosa and submucosa was measured ultrasonographically and defined as the follicular layer. Although all cats were asymptomatic, 3/19 cats showed mild caecal inflammation on histology. The most discriminatory ultrasonographic parameter in assessing this subclinical inflammation was the thickness of the follicular layer at the entrance of the caecum, with a cut-off value of 2.0 mm. All cats (20/20) showed some degree of macroscopic 'dimpling' of the caecal mucosa on endoscopy. Conclusions and relevance Lymphoid follicles in the caecal mucosa and submucosa constitute a unique follicular layer on ultrasound. In asymptomatic cats, a subtle, non-clinically relevant inflammation may exist and this is correlated with an increased thickness of the follicular layer on ultrasound. On endoscopy, a 'dimpled aspect' to the caecal mucosa is a normal finding in the asymptomatic cat.

  7. Correlations between clinical presentations of adult trigger digits and histologic aspects of the A1 pulley.

    Science.gov (United States)

    Drossos, K; Remmelink, M; Nagy, N; de Maertelaer, V; Pasteels, J L; Schuind, F

    2009-10-01

    We aimed to report by light microscopy the normal histology of the A1 pulley, describe the histologic abnormalities of A1 pulleys in trigger digits, and look for possible correlations between these findings and the severity of the disease. In a series of 104 trigger digits operated on in 80 adult patients, the A1 pulleys were removed and histologically studied. The findings were compared with 55 normal A1 pulleys obtained from fresh-frozen cadaveric specimens. The normal A1 pulley was composed of 3 layers: layer I, an inner, avascular, concave unicellular or bicellular gliding layer containing cartilage-like cells; layer II, a middle layer, also avascular, characterized by spindle-shaped fibroblasts; and layer III, an outer, richly vascularized layer, continuous with the membranous tendons sheath. We used a 3-grade classification, increasing in severity, to describe the histologic abnormalities observed in trigger digit A1 pulleys. Mild abnormalities (grade 1) were those with a fibrocartilaginous gliding surface almost intact. The margin between the fibrocartilaginous and membranous portions of the pulley was well delineated. In moderate abnormalities (grade 2), the avascular fibrocartilaginous gliding surface appeared fissured and thinner. The inner layer (I) was interrupted and replaced by fibrous tissue, with fissures that did not cross through the middle layer (II). A mild vascular network hyperplasia was observed in the outer layer (III), which began to invade the fibrocartilage. In severe abnormalities (grade 3), the fibrocartilaginous gliding surface was thin, discontinuous, or even completely destroyed. The vascular network hyperplasia became excessive and reached the synovial space of the flexor tendon sheath. The histologic features were correlated with the severity of the clinical symptoms (p pulley of trigger digits are characteristic and not related to inflammation. As the trigger digit worsens, the gliding surface begins to wear and is gradually

  8. Intrastromal Injection of China Painting Ink in Corneas of Male Rabbits: Clinical and Histological Study

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    Alahmady Hamad Alsmman Hassan

    2016-01-01

    Full Text Available Background. Many patients with corneal opacity or complicated cataract in blind eye ask for cosmoses. In this study we tried to investigate the staining of corneas of male rabbits by Rotring China painting ink and to study the histological changes. Method. 10 eyes of 10 male Baladi Egyptian rabbits were injected (0.1 mL intrastromally in the cornea by the use of China painting ink (Rotring Tinta China through insulin syringe (27-gauge needle by single injection; clinical follow-up is for 6 months and lastly the rabbits were scarified and the stained eyes were enucleated for histological analysis. Results. Clinically the stain was stable in color and distribution in corneas with no major complications. Histological results of the stained rabbit corneas showed blackish pigmentation in the corneal stroma without any inflammatory cellular infiltration. Some fibroblast cells had pigment granules in their cytoplasm in the adjacent layers. Conclusion. Corneal staining by China painting ink is effective and safe in staining of male rabbits cornea; however further study in human corneas with longer follow-up period is advisable.

  9. Reconstructive periodontal therapy with simultaneous ridge augmentation. A clinical and histological case series report.

    Science.gov (United States)

    Windisch, Péter; Szendroi-Kiss, Dóra; Horváth, Attila; Suba, Zsuzsanna; Gera, István; Sculean, Anton

    2008-09-01

    Treatment of intrabony periodontal defects with a combination of a natural bone mineral (NBM) and guided tissue regeneration (GTR) has been shown to promote periodontal regeneration in intrabony defects. In certain clinical situations, the teeth presenting intrabony defects are located at close vicinity of the resorbed alveolar ridge. In these particular cases, it is of clinical interest to simultaneously reconstruct both the intrabony periodontal defect and the resorbed alveolar ridge, thus allowing insertion of endosseous dental implants. The aim of the present study was to present the clinical and histological results obtained with a new surgical technique designed to simultaneously reconstruct the intrabony defect and the adjacently located resorbed alveolar ridge. Eight patients with chronic advanced periodontitis displaying intrabony defects located in the close vicinity of resorbed alveolar ridges were consecutively enrolled in the study. After local anesthesia, mucoperiosteal flaps were raised, the granulation tissue removed, and the roots meticulously scaled and planed. A subepithelial connective tissue graft was harvested from the palate and sutured to the oral flap. The intrabony defect and the adjacent alveolar ridge were filled with a NBM and subsequently covered with a bioresorbable collagen membrane (GTR). At 11-20 months (mean, 13.9+/-3.9 months) after surgery, implants were placed, core biopsies retrieved, and histologically evaluated. Mean pocket depth reduction measured 3.8+/-1.7 mm and mean clinical attachment level gain 4.3+/-2.2 mm, respectively. Reentry revealed in all cases a complete fill of the intrabony component and a mean additional vertical hard tissue gain of 1.8+/-1.8 mm. The histologic evaluation indicated that most NBM particles were surrounded by bone. Mean new bone and mean graft area measured 17.8+/-2.8% and 32.1+/-8.3%, respectively. Within their limits, the present findings indicate that the described surgical approach may be

  10. Breast lumps: A 21-year single-center clinical and histological analysis

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    Gabriel E Njeze

    2014-01-01

    Full Text Available Objective: To review the presentation and histological diagnosis of breast lumps of patients seen in Trans Ekulu Hospital Enugu Southeastern Nigeria from 1993 to 2013 in a period of 21 years. Materials and Methods: This is a retrospective study covering a period of 21 years. Case notes of patients containing clinical information and their histology reports were studied. Results: Only 38% of the patients came within 3 months of finding lumps in their breast. One hundred and thirty-seven patients (83% had benign disease, i.e., fibroadenoma, mammary dysplasia, cysts, adenomas, tuberculosis, phyllodes tumor, mastitis, and lipoma. Only 16.9% i.e., 28 patients had breast cancer, out of which two females were in their 20s, and three were males. Conclusions: Benign breast diseases, i.e., fibroadenoma, fibroadenosis, cysts, adenomas, tuberculosis, phyllodes, mastitis, and lipoma are the commoner breast diseases in our locality.

  11. Limb-girdle muscular dystrophy in Brazilian children: clinical, histological and molecular characterization

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    Marco A. Veloso Albuquerque

    2014-06-01

    Full Text Available Limb-girdle muscular dystrophies (LGMD are a heterogeneous group of genetic muscular dystrophies, involving 16 autosomal recessive subtypes and eight autosomal dominant subtypes. Autosomal recessive dystrophy is far more common than autosomal dominant dystrophy, particularly in children. The clinical course in this group is characterized by progressive proximal weakness, initially in pelvic and after in shoulder-girdle musculature, varying from very mild to severe degree. Significant overlap of clinical phenotypes, with genetic and clinical heterogeneity, constitutes the rule for this group of diseases. Muscle biopsies are useful for histopathologic and immunolabeling studies, and DNA analysis is the gold standard to establish the specific form of muscular dystrophy. Objectives: The aim of this study was to characterize the clinical, histological and molecular aspects in children with LGMD who attend a big public neuromuscular centre in our country to determine the frequency of different forms. Method: Thirty seven patients were classified as LGMD and included in this analysis. The study period extended from 2009-2012. The female to male ratio was 3:1. The age of onset ranged from two to 13 years, mean 7,5 years. Onset in the first decade was seen in 90%. Results: The initial clinical signs included: frequent falls (22 cases, difficulty in climbing stairs (13 cases, walk on tip toes (2 cases, difficulty in rising from the floor (2 cases and difficulty on walking (1 case. The serum CK levels were high in all cases. Among the 37 patients, 15 (40,5% were classified as sarcoglycanopathies (LGMD2C-F, five (13,5% as dysferlinopathy (LGMD2B, five (13,5% as calpainopathy (LGMD2A. Mutations in LMNA gene (LGMD1B, FKRP gene (LGMDI and caveolin gene (LGMD 1C were identified in two (5,5%, two (5,5% and one patient (2,5%, respectively. In seven of 37 cases (19% it was impossible to determine specific diagnosis. Calf hypertrophy, scapular winging and scoliosis

  12. Recent advances and clinical implications of the micropapillary histological subtype in lung adenocarcinomas.

    Science.gov (United States)

    Lee, Ming-Ching; Buitrago, Daniel H; Kadota, Kyuichi; Jones, David R; Adusumilli, Prasad S

    2014-06-01

    Micropapillary (MIP) histologic subtype included in the classification of lung adenocarcinomas (ADCs) is associated with both size- and stage-independent poor prognoses. MIP pattern in lung ADCs, even at small, early stages, correlates with high lymphovascular invasion, visceral pleural invasion and lymph node metastases. Recently, we reported that patients with a MIP component are at a higher risk of locoregional recurrence after limited resection. Identification of a MIP pattern is only possible with permanent pathologic sections; preoperative imaging, cytology or intraoperative frozen section specimens remain unreliable. The intermixed, heterogenous morphology of lung ADC presents a technical challenge in investigating the molecular biology of cells with MIP morphology. A comprehensive understanding of the biology of MIP morphology is vital for therapeutic interventions.

  13. Clinical pattern of recurrent herpes simplex keratitis

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    Saini Jagjit

    1999-01-01

    Full Text Available Purpose: To document the clinical pattern in recurrent herpes simplex disease. Methods: Eyes with clinically documented pattern of corneal manifestation on more than one occasion were analysed. For each eye recruited, the clinical pattern of the disease at each recurrence of herpes simplex corneal disease, age, disease-free intervals, triggering factors, laterality and steroid abuse were noted and evaluated. Results: For an average follow up of 6.9 years, a recurrence rate of 0.6 episodes per year was observed. Disease-free intervals of 75.7 months for epithelial herpes simplex disease was considerably longer than the 21.3 months observed for stromal disease. Clinical pattern of recurrence was of the same type following first episode of disciform keratitis, epithelial keratitis and endothelitis in 84%, 72.7%, and 75% of the eyes respectively. Conclusion: Herpes simplex disease often recurs in the same manifest clinical pattern as the first episode. This clinical evidence provides additional support for the potential role of herpes simplex biotypes in determining manifestation of clinical disease pattern.

  14. Clinical and histological challenge in the differential diagnosis of diffuse alopecia: female androgenetic alopecia, telogen effluvium and alopecia areata - Part II*

    Science.gov (United States)

    Werner, Betina; Mulinari-Brenner, Fabiane

    2012-01-01

    Diffuse alopecia is mainly caused by telogen effluvium, diffuse androgenetic alopecia (female-pattern hair loss) and diffuse alopecia areata. Differential diagnosis between the three disorders may be difficult in several occasions. In this second part of our study, chronic telogen effluvium and diffuse alopecia areata are discussed in detail, including clinical, dermoscopic and histological aspects. A flowchart presents a practical and objective differential diagnostic approach to diffuse alopecia. PMID:23197208

  15. Clinical and histological evaluation of white ProRoot MTA in direct pulp capping.

    Science.gov (United States)

    Iwamoto, Claudio E; Adachi, Erika; Pameijer, Cornelis H; Barnes, Douglas; Romberg, Elaine E; Jefferies, Steven

    2006-04-01

    To evaluate the clinical, radiographical and histological findings in human third molars in which mechanical pulp exposures were capped with white ProRoot mineral trioxide aggregate (WMTA). Forty-eight human third molars, caries-free or with incipient caries, scheduled to be extracted, were used and randomly divided into two groups: Group A: (n= 24) received WMTA and control Group B: (n= 24) received chemical set calcium hydroxide (Dycal). The teeth were isolated with rubber dam and Class I cavities prepared. Pulp exposure was performed using a sterile diamond bur and confirmed by frank bleeding. A sterile cotton pellet dipped in saline solution was placed over the exposure for 60 seconds. The preparation was then lightly rinsed with water and gently air-dried. WMTA or CH was placed over the exposure site followed by a small amount of a light-cured compomer. After etching with 35% phosphoric acid gel for 15 seconds, rinsing and blot drying, Prime and Bond NT adhesive was applied and light-cured. The cavity was then restored with a resin composite and light-cured. Evaluations were performed by phone after 7 days and clinically at 30 +/- 5 and 136 +/- 24 days, using standardized tests and radiographs. The teeth were extracted after 136 +/- 24 days; the roots were cut +/- 4-5 mm from the apex to allow for rapid fixation in 10% neutral buffered formalin. They were then processed for routine histological evaluation, embedded in paraffin, sectioned and stained with hematoxylin and eosin and Brown and Brenn for recognition of bacteria. Statistical analyses were performed using a Mann-Whitney U-test, a Chi-square test, a Fisher's exact test and an ANOVA. No significant differences in post-operative sensitivity were reported after 7 days between the two materials (P> 0.05). Clinical examination demonstrated no significant differences at 30 +/- 5 days (P> 0.05) and at 136 +/- 24 days (P> 0.05). Histological findings: 45 of 48 teeth were suitable for microscopic evaluation

  16. Pulsed Nd:YAG laser selective ablation of surface enamel caries: II. Histology and clinical trials

    Science.gov (United States)

    Harris, David M.; Goodis, Harold E.; White, Joel M.; Arcoria, Charles J.; Simon, James; Burkart, John; Yessik, Michael J.; Myers, Terry D.

    2000-03-01

    High intensity infrared light from the pulsed Nd:YAG dental laser is absorbed by pigmented carious enamel and not absorbed by normal enamel. Therefore, this system is capable of selective removal of surface enamel caries. Safety and efficacy of the clinical procedure was evaluated in two sets of clinical trials at three dental schools. Carious lesions were randomized to drill or laser treatment. Pulp vitality, surface condition, preparations and restorations were evaluated by blinded evaluators. In Study 1 surface caries were removed from 104 third molars scheduled for extraction. One week post-treatment teeth were extracted and the pulp was examined histologically. In Study 2 90 patients with 422 lesions on 376 teeth were randomized to laser or drill and followed for six months. There were no adverse events and both clinical and histological evaluations of pulp vitality showed no abnormalities. Caries were removed in all conditions. A significantly greater number of preparations in the drill groups vs. laser groups entered dentin (drill equals 11, laser equals 1, p less than 0.001). This indicates that the more conservative laser treatment removed the caries but not the sound enamel below the lesion.

  17. Clinical and histologic effects from CO2 laser treatment of keloids.

    Science.gov (United States)

    Nicoletti, Gianfranco; De Francesco, Francesco; Mele, Carmine Michele; Cataldo, Chiara; Grella, Roberto; Brongo, Sergio; Accardo, Marina; Ferraro, Giuseppe Andrea; D'Andrea, Francesco

    2013-05-01

    Keloids and hypertrophic scars are abnormal responses to wound healing. In general, keloids exhibit a proliferative growth beyond the margins of the scar and remain persistent; while hypertrophic scars are contained to the original wound and may regress over time. In particular, keloid formation is one of the most challenging clinical problems, with increasing frequency in surgical practice. Many treatments are available such as intralesional corticosteroids, topical applications, cryotherapy, surgical excision, radiation therapy, silicone gel sheeting, pressure therapy, and laser therapy. There are no set guidelines for the treatment of keloids and the most common treatments are individualized and depended on the distribution, size, thickness, and consistency of lesions. The authors have evaluated carbon dioxide laser successfully in the treatment of keloids and the aim of this study was to determine the immediate and long-term histologic and clinical effects of keloids after carbon dioxide laser. Fifty consecutive patients (40 females, 10 males, ages 18-60 years, mean age 40 years) with moderate to severe keloids were evaluated. All the patients received regional treatments (deltoid, elbow, chin, and ear) in an outpatient setting with a high-energy pulsed CO2 laser. Significant immediate and prolonged clinical improvement in skin tone, texture, and appearance of carbon dioxide laser was examined in all patients. Dermal remodeling was observed also on histologic examination of biopsied tissue after treatment. Carbon dioxide laser appears to be effective and well tolerated for the treatment of keloids, avoiding the adverse effects and lengthy recovery time.

  18. The Influence of Acetyl Salicylic Acid (Aspirin) and Acetaminophen on Clinical and Histologic Aspects of Orthodontic Tooth Movement

    Science.gov (United States)

    1988-05-01

    increased levels of prostaglandin during orthodontic tooth movement (38) are consistent with in vitro work on a variety of stressed cell membranes (29) in...of this lipid family. :., t z, , understood but has neverthele’s Iej t,.. ,I nI,-al ramifications. 6f particular !ntor; ,’Jrr.ly I orthodontic ...inhibitors, on clinical and histologic aspects of orthodontic tooth movement. Clinical and histologic results revealed no statistical differences among

  19. Validating EHR clinical models using ontology patterns.

    Science.gov (United States)

    Martínez-Costa, Catalina; Schulz, Stefan

    2017-11-04

    Clinical models are artefacts that specify how information is structured in electronic health records (EHRs). However, the makeup of clinical models is not guided by any formal constraint beyond a semantically vague information model. We address this gap by advocating ontology design patterns as a mechanism that makes the semantics of clinical models explicit. This paper demonstrates how ontology design patterns can validate existing clinical models using SHACL. Based on the Clinical Information Modelling Initiative (CIMI), we show how ontology patterns detect both modeling and terminology binding errors in CIMI models. SHACL, a W3C constraint language for the validation of RDF graphs, builds on the concept of "Shape", a description of data in terms of expected cardinalities, datatypes and other restrictions. SHACL, as opposed to OWL, subscribes to the Closed World Assumption (CWA) and is therefore more suitable for the validation of clinical models. We have demonstrated the feasibility of the approach by manually describing the correspondences between six CIMI clinical models represented in RDF and two SHACL ontology design patterns. Using a Java-based SHACL implementation, we found at least eleven modeling and binding errors within these CIMI models. This demonstrates the usefulness of ontology design patterns not only as a modeling tool but also as a tool for validation. Copyright © 2017. Published by Elsevier Inc.

  20. Vestibuloplasty: porcine collagen matrix versus free gingival graft: a clinical and histologic study.

    Science.gov (United States)

    Schmitt, Christian M; Tudor, Christian; Kiener, Katrin; Wehrhan, Falk; Schmitt, Johannes; Eitner, Stefan; Agaimy, Abbas; Schlegel, Karl A

    2013-07-01

    A free gingival graft (FGG) is currently the gold standard for augmenting small areas of keratinized mucosa. The porcine collagen matrix (CM) represents an alternative to autologous tissue harvesting. This study aims to compare the CM versus FGGs for augmenting keratinized peri-implant mucosa based on clinical and histologic evaluations. The study included 14 patients who underwent a vestibuloplasty with either a FGG from the palate (n = 7) or the CM (n = 7). An implant-fixed vestibular retention splint was inserted for 30 days. Follow-up examinations were performed at 4, 10, 30, and 90 days after surgery. Width of keratinized mucosa was measured in the region of each implant (days 10, 30, and 90). After 90 days, a biopsy was harvested for histologic and immunohistologic analyses. To characterize newly formed soft tissue, the authors stained for tissue-and differentiation-specific markers, cytokeratin (CK) 5/6, 13, and 14, to detect presence or absence of keratinization. The groups showed similar healing, with increased peri-implant keratinized mucosa. The CM group had overall significantly shorter operation times than the FGG group. Both groups showed similar overall shrinkage (32.98% CM versus 28.35% FGG). All biopsies showed a multilayered, keratinized, squamous epithelium. CKs 5/6 and 14 were detected in the basal and suprabasal layers, and spots of CK 13 were detected in the suprabasal layer. During the whole observation period, both groups showed comparable clinical and histologic outcomes. Within the limitations of the present study, CM seems to be a promising alternative for the regeneration of keratinized mucosa without tissue harvesting. Comparative long-term studies are needed to investigate changes over time.

  1. Correlation between hepatitis B viremia and the clinical and histological activity of chronic delta hepatitis.

    Science.gov (United States)

    Lozano, J L; Crespo, J; de la Cruz, F; Casafont, F; Lopez-Arias, M J; Martín-Ramos, L; Pons-Romero, F

    1994-07-01

    To analyze the serological, clinical and histological significance of hepatitis B virus (HBV) replication among a group of patients with chronic delta hepatitis (CDH), we have studied the clinical and the histological activity in 49 patients with CDH. The HBV-DNA was analyzed by dot-blot and polymerase chain reaction (PCR). Concomitant infection with hepatitis C virus (HCV) was analyzed by reverse transcriptase (RT)-PCR, HDV replication by dot-blot, and human immunodeficiency virus (HIV) infection by enzyme-linked immunosorbent assay. The subjects were divided into three groups according to HBV-DNA status: group I: 14 patients HBV-DNA dot-blot positive; group II: 29 patients HBV-DNA positive only by PCR, and group III: 6 patients HBV-DNA negative by dot-blot and PCR. We have found HBV-DNA by dot-blot in 28.5% of patients, and by PCR in 87.7%. Also 22 patients were anti-HCV positive (86.3% had HCV-RNA by RT-PCR). The first group (HBV-DNA dot-blot positive) had significantly higher serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) than those in the second and third groups. Likewise, serum ALT and AST were significantly higher in the second group (HBV-DNA positive by PCR) than in those of the third group. Histological inflammatory activity was significantly higher in the group of patients with HBV-DNA detectable by dot-blot. The prevalence of serum HDV-RNA and IgM anti-HDV were similar in the three groups. These results were similar in the anti-HCV-positive and -negative patients. In conclusion, these data suggest that: (1) persistence of HBV replication is a major determinant of severe liver damage in chronic delta hepatitis, and (2) HCV and HIV infections do not influence the natural history of CDH.

  2. International patterns and trends in ovarian cancer incidence, overall and by histologic subtype.

    Science.gov (United States)

    Coburn, S B; Bray, F; Sherman, M E; Trabert, B

    2017-06-01

    Internationally, ovarian cancer is the 7th leading cancer diagnosis and 8th leading cause of cancer mortality among women. Ovarian cancer incidence varies by region, particularly when comparing high vs. low-income countries. Temporal changes in reproductive factors coupled with shifts in diagnostic criteria may have influenced incidence trends of ovarian cancer and relative rates by histologic subtype. Accordingly, we evaluated trends in ovarian cancer incidence overall (1973-1977 to 2003-2007) and by histologic subtype (1988-1992 to 2003-2007) using volumes IV-IX of the Cancer Incidence in Five Continents database (CI5plus) and CI5X (volume X) database. Annual percent changes were calculated for ovarian cancer incidence trends, and rates of histologic subtypes for individual countries were compared to overall international incidence. Ovarian cancer incidence rates were stable across regions, although there were notable increases in Eastern/Southern Europe (e.g., Poland: Annual Percent Change (APC) 1.6%, p = 0.02) and Asia (e.g., Japan: APC 1.7%, p = 0.01) and decreases in Northern Europe (e.g., Denmark: APC -0.7%, p = 0.01) and North America (e.g., US Whites: APC -0.9%, p histologic subtypes were similar across countries, except for Asian nations, where clear cell and endometrioid carcinomas comprised a higher proportion of the rate and serous carcinomas comprised a lower proportion of the rate than the worldwide distribution. Geographic variation in temporal trends of ovarian cancer incidence and differences in the distribution of histologic subtype may be partially explained by reproductive and genetic factors. Thus, histology-specific ovarian cancer should continue to be monitored to further understand the etiology of this neoplasm. © 2017 UICC.

  3. Clinic Attendance Compliance Pattern of Adult Hypertensive ...

    African Journals Online (AJOL)

    Objective: A number of factors affect the clinic attendance compliance of the average adult Nigerian. The consequent default from treatment could affect the management outcome of such patients. This study was therefore, undertaken to evaluate the clinic attendance compliance pattern of adult hypertensive patients being ...

  4. Infantile fibrosarcoma-a clinical and histologic mimicker of vascular malformations: case report and review of the literature.

    Science.gov (United States)

    Hu, Zhihong; Chou, Pauline M; Jennings, Lawrence J; Arva, Nicoleta C

    2013-01-01

    Infantile fibrosarcoma is a rare soft tissue tumor that usually presents either at birth or in the 1st year of life. Here we describe a case of a 4-month-old female who presented with a congenital right axillary mass. The initial clinical impression was benign vascular/lymphatic malformation. The core biopsy showed a spindle cell lesion with abundant vasculature represented by small vascular channels. However, immunohistochemical analysis did not support a diagnosis of vascular lesion/tumor. Polymerase chain reaction study for ETS Translocation Variant 6/neurotrophic tyrosine kinase receptor, type 3 fusion transcript was positive, and the diagnosis of infantile fibrosarcoma was established. The patient underwent resection of the axillary mass. Microscopic examination of the resection specimen showed numerous vascular channels. Intermixed there were also cellular areas composed of spindle cells similar to those seen in the biopsy material. Molecular studies were repeated and confirmed the diagnosis of infantile fibrosarcoma. Infantile fibrosarcoma has been previously reported in the literature to clinically masquerade as hemangioma. In addition, this case proves that infantile fibrosarcoma could also mimic vascular malformations on clinical, radiologic, and pathologic exams. In fact, the vascular component of the tumor is very unusual in our patient and represents a histologic feature that has not been described before. The case highlights the diagnostic challenges at clinical, radiologic, and pathologic levels in some cases of infantile fibrosarcoma and raises awareness among clinicians and pathologists related to another peculiar pattern that can be encountered in this disease.

  5. Photobiomodulation with LED and laser in repair of mandibular socket rabbit: clinical evaluation, histological, and histomorphometric.

    Science.gov (United States)

    Comunian, Cláudio Rômulo; Custódio, Antônio Luis Neto; de Oliveira, Leandro Junqueira; Dutra, Carlos Eduardo Assis; D'almeida Ferreira Neto, Milton; Rezende, Cleuza Maria Faria

    2017-06-01

    The aim of this study was to evaluate the effects of LED and low-intensity laser on the healing of rabbit dental alveoli. A total of 18 rabbits were divided into three groups of six; all rabbits underwent surgical extraction of the first lower right premolar. Following surgery, group 1 received LED irradiation, group 2 received laser irradiation, and group 3 were untreated controls. The initial applications of LED and laser began 48 h after tooth extraction and were given perpendicularly to the dental alveoli. The three groups were clinically evaluated for 18 days in the postoperative period. At 90 days, the rabbits were euthanized and the mandibular fragments containing the healing alveoli were collected. These fragments initially underwent computed tomography scans and bone density was measured in Hounsfield units. Following this, the fragments were processed and stained with hematoxylin and eosin for histological and histomorphometric analysis. The results were compatible between the clinical, histological, and histomorphometric parameters evaluated. There were no statistical differences between the LED and laser groups. However, the difference of the average bone density between laser and control group was not statistically significant. It was found that photobiomodulation with LASER and LED presented effects. However, only the LED demonstrated a beneficial effect on the process of bone repair in the dental alveoli of rabbits.

  6. [Stomach cancer: Epidemiological, clinical and histological aspects at the Lome Campus teaching hospital (Togo)].

    Science.gov (United States)

    Bouglouga, O; Lawson-Ananissoh, L M; Bagny, A; Kaaga, L; Amegbor, K

    2015-01-01

    To describe the epidemiological, clinical, and histological aspects of stomach cancer in the gastroenterology department of University Hospital Campus of Lome (Togo). This retrospective descriptive and analytical study reviewed records of patients hospitalized for stomach cancer over an 8-year period. With 32 cases among the 250 gastrointestinal tract cancers over the study period, stomach cancer accounted for the largest proportion (12.8%) of these cases. The sex ratio was 2.5 and the mean age of patients was 58.82 years (range: 32 to 85 years). The clinical picture was dominated by epigastric pain (44%). Ulcerative budding lesions were most common, especially in the pyloric antrum (72%). Adenocarcinoma was the most common histological type (94%). Thirteen of our patients were transferred to the visceral surgery department for palliative care. Nine more were lost to follow-up after release against medical advice due to lack of financial support. Five patients died (16%) during hospitalization. Stomach cancer is common in Togo and ranks first among gastrointestinal cancers in our department. Training hepatogastroenterologists and providing adequate technical facilities, on the one hand, and early recognition of warning signs and a reduction in the cost of gastrointestinal endoscopies, on the other, could improve the survival of patients with gastric cancer in Togo.

  7. Color Doppler Ultrasound Study of Glomuvenous Malformations with its Clinical and Histologic Correlations.

    Science.gov (United States)

    Wortsman, X; Millard, F; Aranibar, L

    2017-07-03

    Glomuvenous malformations are hamartomatous lesions characterized by the presence of glomus cells in the vascular smooth muscle. We present the clinical and color Doppler ultrasound features of a series of 13 cases of histologically confirmed glomuvenous malformations. In all cases, the ultrasound study revealed moderately delimited superficial dermal and hypodermal pseudonodular structures of mixed echogenicity, with hypoechoic and heterogeneous areas and anechoic, pseudocystic tubular and lacunar zones. Arterial and venous vessels, mainly with a low flow (≤ 15cm/s) were observed in 85% of patients, but no arteriovenous shunts were present. Deeper structures were not affected and no phleboliths were detected. The clinical and ultrasound findings could facilitate diagnosis, surgical planning, and noninvasive follow-up in these tumors. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Revascularisation pattern of ruptured flexor tendon grafts in anterior cruciate ligament reconstruction: A histological study.

    Science.gov (United States)

    Figueroa, D; Martínez, R; Calvo, R; Scheu, M; Gallegos, M; Vaisman, A; Martínez, C; González, A

    For successful anterior cruciate ligament (ACL) reconstruction, revascularisation and histological maturation are necessary, as their failure can cause graft rupture. The purpose of this study was to describe differences in the histological maturation of early failed plasty (less than 12 months after surgery) and late failed plasty (more than 12 months after surgery) in patients with re-rupture after ACL reconstruction with hamstring tendons. A descriptive observational study was conducted on a consecutive series of 20 patients whose ACL reconstruction had failed. Graft biopsy samples were obtained during the revision surgery from the proximal, medial, and distal graft remnants. The samples were evaluated by light microscopy, and the vascularity and maturation of the samples were established by histological scoring. The most common aetiology of reconstruction failure (86.6%) was a specific event with non-contact mechanism. The patients with re-rupture of their ACL plasty less than 12 months after surgery had substance vessels that were less deep. The distal segment of the graft in those patients showed a delay in histological maturation with fewer collagen fibres. In patients whose ACL grafts failed less than 12 months after surgery, a lower distribution of blood vessels and collagen fibres was found that were less ordered in the distal graft. These results indicate a delay in maturation, which leads to a higher risk of graft failure. Copyright © 2016 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Analysis of angiogenic factors and cyclooxygenase-2 expression in cartilaginous tumors: clinical and histological correlation

    Directory of Open Access Journals (Sweden)

    Francisco Fontes Cintra

    2011-01-01

    Full Text Available OBJECTIVES: To study the role of angiogenesis and cyclooxygenase-2 expression in cartilaginous tumors and correlate these factors with prognosis. INTRODUCTION: For chondrosarcoma, the histological grade is the current standard for predicting tumor outcome. However, a low-grade chondrosarcoma can follow an aggressive course-as monitored by sequential imaging techniques-even when it is histologically indistinguishable from an enchondroma. Therefore, additional tools are needed to help identify the biological potential of these tumors. The degree of angiogenesis that is induced by the tumor could assist in this task. Angiogenesis can be quantified by measuring the expression of vascular endothelial growth factor and CD34, and cyclooxygenase-2 can induce angiogenesis by stimulating the production of proangiogenic factors. METHODS: In total, 21 enchondromas and 58 conventional chondrosarcomas were studied by examining the clinical and histopathological findings in conjunction with the immunostaining markers of angiogenesis and cyclooxygenase- 2 expression. RESULTS: The significant variables that were associated with poor outcome were 1 higher-grade chondrosarcomas, 2 tumors that developed in flat bones, and 3 over-expression of CD34 (with a median count that was higher than 5.9 vessels in 5 high power fields. Moreover, CD34 expression (measured using the Chalkley method revealed significantly higher microvessel density in flat bone chondrosarcomas. DISCUSSION: Previous studies have shown a positive correlation between Chalkley microvessel density and histological grade; however, in our sample, we found that the former is predictive of the outcome. Chondrosarcomas in flat bones have been shown to correlate with a poor prognosis. We also found that CD34 microvessel density values were significantly higher in flat-bone chondrosarcomas. This could explain-at least in part-the more aggressive biological course that is taken by these tumors. CONCLUSIONS

  10. Chronic hepatitis in the English springer spaniel: clinical presentation, histological description and outcome.

    Science.gov (United States)

    Bexfield, N H; Andres-Abdo, C; Scase, T J; Constantino-Casas, F; Watson, P J

    2011-10-15

    Medical records and liver histology of 68 English springer spaniels (ESS) with a histological diagnosis of CH were reviewed retrospectively. PCR was performed on liver tissue for canine adenovirus-1 (CAV-1), canine parvovirus, canine herpesvirus and pathogenic Leptospira species. Follow-up information was obtained to calculate survival times. Median age at presentation was three years seven months (range, seven months to eight years five months) and there were 48 female and 20 male dogs. Clinical signs were non-specific and five dogs were asymptomatic. All dogs had an increase in serum activity of one or more hepatobiliary enzymes. Histopathology demonstrated hepatocyte necrosis and apoptosis with varying amounts of fibrosis. A predominantly lymphoplasmacytic infiltrate throughout the hepatic parenchyma was found in all 68 dogs, but 45 of these dogs also had a neutrophilic component to the inflammatory infiltrate. There was no significant copper accumulation and no aetiological agent was identified by PCR. The median survival time was 189 days (range, 1 to 1211 days), 38 dogs died within three months and 12 dogs survived more than a year following diagnosis.

  11. Clinical and histological evaluation of two dressing materials in the healing of palatal wounds

    Directory of Open Access Journals (Sweden)

    Shanmugam M

    2010-01-01

    Full Text Available Background : Free gingival grafts have been used extensively for gingival augmentation procedures, but are associated with postoperative morbidity because of the open palatal wound. This study compares the clinical efficiency of two dressing materials, a non-eugenol-based dressing (Coe-Pak™ and a collagen dressing (Colla Cote® on palatal wound healing. Materials and Methods : Thirty-two patients in the age group of 25−50 years, who required gingival augmentation, were selected. Free gingival graft was harvested from the palatal mucosa and the wound was then protected using Coe-pak; in control group and Colla Cote; in test group. The subjective parameters pain and burning sensation were recorded on the 2 nd and 7 th day and the objective parameters colour and consistency were recorded on the 7 th and 42 nd day, using a visual analog scale. Thickness of the mucosa was measured using K file at baseline and 42 nd day. Histological examination was done on 42 nd day. Results : The subjective and objective parameters showed significant improvement in the test group when compared to control group. Histologically, there was a greater evidence of collagen formation and turn over in the test group than control group. Conclusions : Collagen-based dressing may thus offer significantly greater advantages over the traditional non-eugenol dressings.

  12. Penile intraepithelial neoplasia. Specific clinical features correlate with histologic and virologic findings.

    Science.gov (United States)

    Aynaud, O; Ionesco, M; Barrasso, R

    1994-09-15

    To evaluate the existence of the morphologic features specific for penile intraepithelial neoplasia (PIN), 1000 male sexual partners of women with genital condyloma or intraepithelial neoplasia were studied. Ninety-two patients who presented with lesions suggesting intraepithelial neoplasia (pigmented or leukoplastic papules, keratinized condylomata, or erythroplastic macules) underwent biopsy for histologic and virologic studies. Histologic results showed penile intraepithelial neoplasia in 93% of the specimens. Human papillomavirus (HPV) DNA from potentially oncogenic papillomaviruses was detected in 75% of patients with Grade I PIN, in 93% of patients with Grade II PIN, and in all patients with Grade III PIN: Uncircumcised and circumcised men showed the same rate (52% vs. 45%; odds ratio [OR] = 1.3; 95% confidence interval, 0.97-1.73) of HPV-associated lesions, whereas the rate of PIN was significantly higher in uncircumcised men than in circumcised men (10% vs. 6%; OR = 1.77; 95% confidence interval, 1.02-3.07). The mean age of patients with Grade III PIN was 7 years older then the mean age of patients with Grade I PIN, which suggests a step progression similar to that of cervical intraepithelial neoplasia. Morphology seems to be a specific-enough indicator of PIN. More data are needed to determine whether treatment of PIN may contribute to preventing cervical or penile cancer. If so, the morphologic criteria here described will be clinically useful.

  13. Solitary rectal ulcer syndrome: clinical, endoscopic, histological and anorectal manometry findings in north Indian patients.

    Science.gov (United States)

    Behera, M K; Dixit, V K; Shukla, S K; Ghosh, J K; Abhilash, V B; Asati, P K; Jain, A K

    2015-01-01

    Solitary rectal ulcer syndrome (SRUS) is a chronic, benign defecation disorder often related to excessive straining. SRUS is diagnosed on the basis of clinical symptoms, endoscopic and histological findings. All patients diagnosed with SRUS by colonoscopy and confirmed by histopathology from October 2012 to August 2014 in the Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, India, were included in the study. Out of 92 patients, thirty-four patients underwent anorectal manometry. Twenty age-matched healthy volunteers were also studied with anorectal manometry to serve as controls. Mean age of the group was 41 ± 19 years with age range of 10-82 years; males were 58 (63%) with male to female ratio of 1.7:1. Bleeding per rectum was present in 83%, constipation in 46.7%, abdominal pain in 27.2%, and diarrhea in 25% of the patients. On endoscopy, ulcerative lesions were seen in 83% patients of whom solitary and multiple lesions were present in 44% and 39%, respectively. Polypoidal lesions were reported in 17.4% whilst rectal polyps and erythematous mucosa were found in 5.4% and 2.2%, respectively. Histological examination revealed fibromuscular obliteration in 100% of patients, surface ulceration in 70.6% and crypt distortion in 20.65% of patients. Anal relaxation and balloon expulsion test was significantly abnormal in SRUS patients compared to healthy controls (53% vs. 20%, p ulcerative lesions the most common endoscopic finding. Fecal evaluation disorder was more prevalent inpatients with SRUS.

  14. A histological and clinical study on oral cancer: descriptive analyses of 365 cases.

    Science.gov (United States)

    Dias, Gonçalo Seguro; Almeida, Arlindo Pereira de

    2007-11-01

    Cancer is the second cause of death in Portugal right after cardio vascular diseases. In Portugal the incidence of oral and pharynx cancer (OPC) is higher than uterus and larynx cancers, and in US its frequency is higher than melanoma or uterus cancer, diseases that concern more population than oral cancer. The aim of this paper is to identify preferable anatomic location for oral cancer, mean age of patients, the use of tobacco and alcohol, histological characteristics, staging, type of therapeutics, presence of metastases and 1 and 5 year follow up. Data was collected from clinical charts of 365 cases from the Centro de Lisboa do Instituto Portugues de Oncologia with histological confirmation of malign tumor of the mouth. These cases are the total of oral malign tumors in the years of 1997, 1998 and 1999 in that institution. We observe that despite modern diagnostic and treatment techniques 37,9% of all patients died after first year with evidence of tumor. From all patients just 23,7% were free of disease after 5 years of treatment. Tongue was the principal region affected and the average age was 62, 25 years. It was concluded that 57, 8% of patient were smokers and 43,8% were alcohol drinkers. A high number of patients were submitted to radiotherapy either alone or with other treatment options.

  15. Computer-aided proximal caries diagnosis: correlation with clinical examination and histology

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Byung Cheol [Chonnam University, School of Dentistry, Gwangju (Korea, Republic of); Scheetz, James P.; Aarman, Allan G. [University of Louisville, School of Dentistry, Louisville (United States)

    2002-09-15

    To evaluate the performance of the LOGICON Caries Detector using RVG-4 and RVG-ui sensors, by comparing results of each detector to the results of clinical and histological examinations. Pairs of extracted teeth were radiographed, and a total of 57 proximal surfaces, which included both carious and non-carious situations, were analyzed. The RVG-4 produced 8-bit images, while the RVG-ui unit produced 12-bit images, which were taken in the high sensitivity mode. The images produced by the LOGICON were evaluated by a trained observer using both automated and manual caries detection software modes. Ground sections of the teeth established the actual absence or existence of caries. LOGICON-aided caries detection and depth discrimination of the RVG-4 and RVG-ui sensors were equally inconsistent irrespective of whether the LOGICON software was set to the automated or manual mode. Sensitivity ranged from 50% to 57% for caries penetration of the enamel-dentin junction. Care needs to be taken when using LOGICON in conjunction with RVG images as an adjunct for treatment planning dental caries. Even when applied by a trained observer, substantial discrepancies exist between the results of the LOGICON software-guided evalutation using RVG images and histologic examination.

  16. Histomorphological classification of focal segmental glomerulosclerosis: A critical evaluation of clinical, histologic and morphometric features

    Directory of Open Access Journals (Sweden)

    Prasenjit Das

    2012-01-01

    Full Text Available Primary focal segmental glomerulosclerosis (FSGS has recently been divided into five subtypes by the Columbia classification. However, little is known about the incidence of these subtypes in the Indian population. In addition, there are very few studies evaluating the clinico-pathologic features with morphometric parameters in these subtypes. This study was aimed at evaluating the clinical, histopathological and morphometric parameters in various subtypes of FSGS at our referral center. Sixty-five (65 cases of idiopathic FSGS, diagnosed over two years (2006-2007, were included in the study. Detailed clinical and biochemical investigations were noted. Histological sections were reviewed and cases classified according to the Columbia classification and various glomerular and tubulo-interstitial features were noted. Glomerular morphometry on digitized images was performed using image analysis software. Renal biopsies with minimal change disease were used as controls for morphometric evaluation. In this study, FSGS not otherwise specified (NOS was the most common subtype (44.6%, followed by perihilar FSGS (24.6%, collapsing (13.8%, tip (12.3% and cellular FSGS (4.6%. Collapsing subtype showed significantly shorter duration of symptoms and higher degree of proteinuria, mean serum urea and creatinine compared with the other subtypes. On histologic analysis, features like glomerular hyalinosis, capsular adhesion, mesangial proliferation and visceral epithelial cell prominence (VEP were frequently seen. The cases with VEP had a shorter duration of symptoms and a higher mean serum creatinine and 24-h urine protein excretion compared with those without VEP. The morphometric study revealed a significant higher mean glomerular area in the NOS, perihilar and collapsing variants as compared with the control biopsies. The present study highlights the differences in the prevalence in the FSGS subtypes in our population compared with the western data. Also, the

  17. Impact of hiatal hernia on histological pattern of non-erosive reflux disease

    Directory of Open Access Journals (Sweden)

    Lyratzopoulos Nikolaos

    2005-01-01

    Full Text Available Abstract Background Hiatus hernia (HH has major pathophysiological effects favoring gastroesophageal reflux and hence contributing to esophageal mucosa injury, especially in patients with severe gastroesophageal disease. However, prospective studies investigating the impact of HH on the esophageal mucosa in non-erosive reflux disease (NERD are lacking. This study evaluated the association between the presence of (HH and the histological findings in symptomatic patients with NERD. Methods Fifty consecutive patients with gastroesophageal reflux disease (GERD were enrolled. After conventional endoscopy, Lugol solution was applied and biopsy specimens were obtained. Histological parameters including basal zone hyperplasia, papillary length and cellular infiltration were evaluated. The chi-square test with Yates' correlation was used for comparing discrete parameters between groups. However, Fisher's exact probability test was used where the expected frequencies were lower than 5. Wilcoxon's test for unpaired samples was preferred in cases of semi-quantitative parameters. Results The presence of HH along with more severe findings (0.01 P P Conclusion The presence of HH is correlated with more severe endoscopy findings, and predisposes for severe histological abnormality in cases of NERD.

  18. Síndrome nefrótica primária grave em crianças: descrição clínica e dos padrões histológicos renais de seis casos Severe primary nephrotic syndrome in children: description of clinical aspects and of the renal histological patterns of six cases

    Directory of Open Access Journals (Sweden)

    Márcia Camegaçava Riyuzo

    2006-10-01

    Full Text Available Os autores relatam os casos de seis crianças com síndrome nefrótica primária grave de padrão histológico renal incomum na rotina cotidiana dos nefrologistas e patologistas. O diagnóstico da doença foi realizado nas faixas etárias de 3 a 9 meses de idade (n = 4, aos 2 anos e 4 meses (n = 1 e aos 11 anos (n = 1. Um paciente foi prematuro, duas pacientes eram irmãs e seus pais eram primos de primeiro grau. Todos apresentavam edema generalizado; dois pacientes apresentavam desnutrição e hipotireoidismo e dois apresentavam hipertensão arterial e insuficiência renal. A histologia renal mostrou esclerose mesangial difusa (n = 3, proliferação mesangial (n = 2 e síndrome nefrótica do tipo finlandês (n = 1. Quatro pacientes faleceram, as causas de óbito foram infecção (n = 2, insuficiência renal (n = 1 e acidose metabólica (n = 1. Entre os sobreviventes, um paciente foi tratado com vitaminas, tiroxina, captopril e indometacina, apresentando aumento da albumina sérica e melhora do crescimento. O outro paciente apresentava insuficiência renal terminal, sendo tratado com diálise e transplante renal.The authors report six children with severe primary nephrotic syndrome with unusual renal histological patterns in the daily routine of nephrologists and pathologists. The diagnosis of the disease was made at the age between 3 to 9 months (n = 4, at 2 years and 4 months (n = 1 and at 11 years (n = 1. One patient was born prematurely; two patients were sisters and their parents were first-degree cousins. All patients presented generalized edema, two patients presented malnutrition and hypothyroidism; two patients presented hypertension and renal failure. The renal histology showed diffuse mesangial sclerosis (n = 3; diffuse mesangial hypercellularity (n = 2 and nephrotic syndrome of the Finnish type (n = 1. Four patients died, causes of death were infection (n = 2, renal failure (n = 1 and metabolic acidosis (n = 1. Among the survivors

  19. Lentiginous melanoma: a histologic pattern of melanoma to be distinguished from lentiginous nevus.

    Science.gov (United States)

    King, Roy; Page, Robert N; Googe, Paul B; Mihm, Martin C

    2005-10-01

    Atypical lentiginous melanocytic proliferations in elderly patients continue to pose a diagnostic dilemma with lesions variably categorized as dysplastic nevus, atypical junctional nevus, melanoma in situ (early or evolving) and premalignant melanosis. We present pigmented lesions from 16 patients (seven male and nine female) and with the exception of one case, all were older than 50 years of age. The anatomical sites included trunk (7), head and neck (6) and upper extremity (3). The clinical diagnosis was variable and included lentigo maligna, atypical nevus, pigmented basal cell carcinoma, seborrheic keratosis and lentigo. The initial biopsies mimicked lentiginous nevus or dysplastic nevus and were characterized by a lentiginous proliferation of melanocytes at the dermoepidermal junction both as single cells and as small nests with areas of confluent growth, extending to the edges of the biopsy. The retiform epidermis was maintained and pagetoid spread of melanocytes was not prominent in hematoxylin- and eosin- stained sections. Dermal fibrosis was variably present and the melanocytic proliferation demonstrated cytological atypia. The subsequent re-excisions demonstrated similar atypical melanocytic proliferation occurring over a broad area flanking the prior biopsy sites. The diagnosis of melanoma was more easily recognized in the complete excision specimens. Immunohistochemical stains for Mitf and Mart-1 highlighted the extent of the basalar melanocytic proliferation as well as foci of pagetoid spread by melanocytes. Familiarity with this pattern of early melanoma should facilitate proper classification of lentiginous melanocytic proliferations in biopsies from older adults.

  20. A distinct chondrodysplasia resembling Kniest dysplasia: clinical, roentgenographic, histologic, and ultrastructural findings.

    Science.gov (United States)

    Sconyers, S M; Rimoin, D L; Lachman, R S; Adomian, G E; Crandall, B F

    1983-12-01

    Two sibs, one girl and one boy, were observed in infancy with a severe lethal skeletal dysplasia syndrome that radiologically and histologically resembled Kniest dysplasia but clearly differed in clinical course and inheritance. Kniest dysplasia is a nonlethal syndrome, whereas both of these infants died in the neonatal period. Kniest dysplasia appears to be inherited as an autosomal dominant trait; the likely transmission in this family was autosomal recessive. Roentgenograms revealed dumbbell-shaped long bones superficially similar to Kniest dysplasia, but with markedly shortened diaphyses and metaphyseal irregularities. Chondro-osseous morphology demonstrated a superficially similar foamy "Swiss cheese" appearance to the cartilage matrix, as seen in Kniest dysplasia, but there were distinctly different changes in the growth plate and resting cartilage. Ultrastructurally, the chondrocytic endoplasmic reticulum was found to have an appearance different from that observed in either normal or Kniest cartilage. These cases likely represent a distinct chondrodysplasia.

  1. Clinical repigmentation patterns in paediatric vitiligo.

    Science.gov (United States)

    Gan, E Y; Gahat, T; Cario-André, M; Seneschal, J; Ezzedine, K; Taïeb, A

    2016-09-01

    Repigmentation is an essential outcome measure in vitiligo. However, clinical studies describing vitiligo repigmentation patterns are lacking. To assess and clearly define the repigmentation patterns in a series of patients with vitiligo, correlating these with clinicoepidemiological characteristics. Patients with vitiligo seen at least at twice (initial consultation and follow-up visit) in the Department of Paediatric Dermatology, Hôpital Pellegrin des Enfants, Bordeaux University Hospital from 2006 to 2014 were included. Clinical photographs and case records were reviewed. There were 109 patients (64 female, 45 male) mostly with Fitzpatrick skin type III (n = 67, 61%). The majority had nonsegmental (n = 71, 65%) or segmental vitiligo (n = 29, 27%). In total 172 representative vitiligo lesions were analysed. Overall, a combined pattern of repigmentation was most commonly seen (n = 106, 62%). The combined pattern occurred more frequently in patients with segmental vs. nonsegmental vitiligo (P = 0·009), whereas the diffuse pattern was more frequent in the latter (P = 0·007). Diffuse repigmentation was the predominant pattern on the eyelids (P < 0·001). We observed a new pattern in sites with few to absent hair follicles, which we propose to call 'medium spotted repigmentation'. This begins as circular macules of repigmentation, wider than 5 mm in diameter, which, from the outset, are larger than the initial macules of perifollicular repigmentation. This study is limited by its retrospective nature and small sample size for subgroup assessment. The combined pattern of repigmentation was most frequently observed. Medium spotted repigmentation is a new pattern, which will benefit from larger studies for a better understanding. © 2016 British Association of Dermatologists.

  2. Original article Clinical Presentation, Pathological Pattern and ...

    African Journals Online (AJOL)

    ABSTRACT. Objective: To report the clinical presentation, pathological pattern and treatment options of Prostate. Cancer (PCa) cases diagnosed at Al-Azhar University Hospitals, Cairo, Egypt over the last 30 years. Patients and Methods: Case sheets and hospital records of 322 consecutive cases of prostate cancer.

  3. Intracoronary near-infrared spectroscopy: an overview of the technology, histologic validation, and clinical applications.

    Science.gov (United States)

    O'Brien, Andrew; LaCombe, Andrew; Stickland, Aubrey; Madder, Ryan D

    2016-06-30

    Intracoronary near-infrared spectroscopy (NIRS) imaging, which is now clinically available in a combined NIRS and intravascular ultrasound catheter, is a novel catheter-based imaging modality capable of identifying lipid core plaque within the coronary arteries of living patients. The present manuscript provides an overview of intracoronary NIRS imaging with a focus on several concepts essential to individuals seeking to better understand this novel imaging modality. One of the major assets of NIRS is that it has been rigorously validated against the gold standard of histopathology and has been shown to accurately identify histologically-proven fibroatheroma. Clinical studies of NIRS have demonstrated its ability to accurately identify large lipid core plaques at culprit lesions across the spectrum of acute coronary syndromes. NIRS has also been shown to detect lesions at increased risk of causing peri-procedural myocardial infarction during PCI. With regards to predicting future risk, NIRS is seemingly capable of identifying vulnerable patients at increased risk of experiencing subsequent patient-level cardiovascular events. In addition to these clinical applications of NIRS, there are several large prospective observational studies underway to determine if NIRS imaging will be able to identify vulnerable plaques at increased risk of triggering site-specific future coronary events. These studies, once completed, are anticipated to provide valuable data regarding the ability of NIRS imaging to identify plaque vulnerability.

  4. Histologic Subtype in Core Lung Biopsies of Early-Stage Lung Adenocarcinoma is a Prognostic Factor for Treatment Response and Failure Patterns After Stereotactic Body Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Leeman, Jonathan E.; Rimner, Andreas [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Montecalvo, Joseph [Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Hsu, Meier; Zhang, Zhigang [Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Reibnitz, Donata von; Panchoo, Kelly [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Yorke, Ellen [Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Adusumilli, Prasad S. [Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Travis, William [Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Wu, Abraham J., E-mail: wua@mskcc.org [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States)

    2017-01-01

    Purpose: Stereotactic body radiation therapy (SBRT) has emerged as an effective treatment for early-stage lung cancer. The histologic subtype of surgically resected lung adenocarcinoma is recognized as a prognostic factor, with the presence of solid or micropapillary patterns predicting poor outcomes. We describe the outcomes after SBRT for early-stage lung adenocarcinoma stratified by histologic subtype. Methods and Materials: We identified 119 consecutive patients (124 lesions) with stage I to IIA lung adenocarcinoma who had undergone definitive SBRT at our institution from August 2008 to August 2015 and had undergone core biopsy. Histologic subtyping was performed according to the 2015 World Health Organization classification. Of the 124 tumors, 37 (30%) were a high-risk subtype, defined as containing a component of solid and/or micropapillary pattern. The cumulative incidences of local, nodal, regional, and distant failure were compared between the high-risk and non–high-risk adenocarcinoma subtypes using Gray's test, and multivariable-adjusted hazard ratios (HRs) were estimated from propensity score–weighted Cox regression models. Results: The median follow-up for the entire cohort was 17 months and for surviving patients was 21 months. The 1-year cumulative incidence of and adjusted HR for local, nodal, regional, and distant failure in high-risk versus non–high-risk lesions was 7.3% versus 2.7% (HR 16.8; 95% confidence interval [CI] 3.5-81.4), 14.8% versus 2.6% (HR 3.8; 95% CI 0.95-15.0), 4.0% versus 1.2% (HR 20.9; 95% CI 2.3-192.3), and 22.7% versus 3.6% (HR 6.9; 95% CI 2.2-21.1), respectively. No significant difference was seen with regard to overall survival. Conclusions: The outcomes after SBRT for early-stage adenocarcinoma of the lung correlate highly with histologic subtype, with micropapillary and solid tumors portending significantly higher rates of locoregional and metastatic progression. In this context, the histologic subtype

  5. Histologic Subtype in Core Lung Biopsies of Early-Stage Lung Adenocarcinoma is a Prognostic Factor for Treatment Response and Failure Patterns After Stereotactic Body Radiation Therapy.

    Science.gov (United States)

    Leeman, Jonathan E; Rimner, Andreas; Montecalvo, Joseph; Hsu, Meier; Zhang, Zhigang; von Reibnitz, Donata; Panchoo, Kelly; Yorke, Ellen; Adusumilli, Prasad S; Travis, William; Wu, Abraham J

    2017-01-01

    Stereotactic body radiation therapy (SBRT) has emerged as an effective treatment for early-stage lung cancer. The histologic subtype of surgically resected lung adenocarcinoma is recognized as a prognostic factor, with the presence of solid or micropapillary patterns predicting poor outcomes. We describe the outcomes after SBRT for early-stage lung adenocarcinoma stratified by histologic subtype. We identified 119 consecutive patients (124 lesions) with stage I to IIA lung adenocarcinoma who had undergone definitive SBRT at our institution from August 2008 to August 2015 and had undergone core biopsy. Histologic subtyping was performed according to the 2015 World Health Organization classification. Of the 124 tumors, 37 (30%) were a high-risk subtype, defined as containing a component of solid and/or micropapillary pattern. The cumulative incidences of local, nodal, regional, and distant failure were compared between the high-risk and non-high-risk adenocarcinoma subtypes using Gray's test, and multivariable-adjusted hazard ratios (HRs) were estimated from propensity score-weighted Cox regression models. The median follow-up for the entire cohort was 17 months and for surviving patients was 21 months. The 1-year cumulative incidence of and adjusted HR for local, nodal, regional, and distant failure in high-risk versus non-high-risk lesions was 7.3% versus 2.7% (HR 16.8; 95% confidence interval [CI] 3.5-81.4), 14.8% versus 2.6% (HR 3.8; 95% CI 0.95-15.0), 4.0% versus 1.2% (HR 20.9; 95% CI 2.3-192.3), and 22.7% versus 3.6% (HR 6.9; 95% CI 2.2-21.1), respectively. No significant difference was seen with regard to overall survival. The outcomes after SBRT for early-stage adenocarcinoma of the lung correlate highly with histologic subtype, with micropapillary and solid tumors portending significantly higher rates of locoregional and metastatic progression. In this context, the histologic subtype determined from core biopsies is a prognostic factor and could have

  6. Analysis of histological and immunohistochemical patterns of benign and malignant adrenocortical tumors by computerized morphometry.

    Science.gov (United States)

    Dalino Ciaramella, Paolo; Vertemati, Maurizio; Petrella, Duccio; Bonacina, Edgardo; Grossrubatscher, Erika; Duregon, Eleonora; Volante, Marco; Papotti, Mauro; Loli, Paola

    2017-07-01

    Diagnosis of benign and purely localized malignant adrenocortical lesions is still a complex issue. Moreover, histology-based diagnosis may suffer of a moment of subjectivity due to inter- and intra-individual variations. The aim of the present study was to assess, by computerized morphometry, the morphological features in benign and malignant adrenocortical neoplasms. Eleven adrenocortical adenomas (ACA) were compared with 18 adrenocortical cancers (ACC). All specimens were stained with H&E, cellular proliferation marker Ki-67 and reticulin. We generated a morphometric model based on the analysis of volume fractions occupied by Ki-67 positive and negative cells (nuclei and cytoplasm), vascular and inflammatory compartment; we also analyzed the surface fraction occupied by reticulin. We compared the quantitative data of Ki-67 obtained by morphometry with the quantification resulting from pathologist's visual reading. The volume fraction of Ki-67 positive cells in ACCs was higher than in ACAs. The volume fraction of nuclei in unit volume and the nuclear/cytoplasmic ratio in both Ki-67 negative cells and Ki-67 positive cells were prominent in ACCs. The surface fraction of reticulin was considerably lower in ACCs. Our computerized morphometric model is simple, reproducible and can be used by the pathologist in the histological workup of adrenocortical tumors to achieve precise and reader-independent quantification of several morphological characteristics of adrenocortical tumors. Copyright © 2017 Elsevier GmbH. All rights reserved.

  7. Clinical and histologic outcomes of socket grafting after flapless tooth extraction: a systematic review of randomized controlled clinical trials.

    Science.gov (United States)

    Jambhekar, Shantanu; Kernen, Florian; Bidra, Avinash S

    2015-05-01

    Several biomaterials and techniques have been reported for socket grafting and alveolar ridge preservation. However, the evidence for clinical and histologic outcomes for socket grafting with different types of materials in flapless extraction is not clear. The purpose of this systematic review was to analyze the outcomes of a socket grafting procedure performed with flapless extraction of teeth in order to determine which graft material results in the least loss of socket dimensions, the maximum amount of vital bone, the least remnant graft material, and the least amount of connective tissue after a minimum of 12 weeks of healing. Secondary outcomes, including the predictability of regenerating deficient buccal bone, necessity of barrier membranes, and coverage with autogenous soft tissue graft, were also evaluated. An electronic search for articles in the English-language literature was performed independently by multiple investigators using a systematic search process with the PubMed search engine. After applying predetermined inclusion and exclusion criteria, the final list of randomized controlled clinical trials (RCTs) for flapless extraction and socket grafting was analyzed to derive results for the various objectives of the study. The initial electronic search resulted in 2898 titles. The systematic application of inclusion and exclusion criteria resulted in 32 RCTs studying 1354 sockets, which addressed the clinical and histologic outcomes of flapless extraction with socket grafting and provided dimensional and histologic information at or beyond the 12-week reentry period. From these RCTs, the mean loss of buccolingual width at the ridge crest was lowest for xenografts (1.3 mm), followed by allografts (1.63 mm), alloplasts (2.13 mm), and sockets without any socket grafting (2.79 mm). Only 3 studies reported on loss of width at 3 mm below the ridge crest. The mean loss of buccal wall height from the ridge crest was lowest for xenografts (0.57 mm) and

  8. Diagnostic capabilities of high-definition white light endoscopy for the diagnosis of gastric intestinal metaplasia and correlation with histologic and clinical data.

    Science.gov (United States)

    Panteris, Vasileios; Nikolopoulou, Stamatina; Lountou, Anastasia; Triantafillidis, John K

    2014-06-01

    The aim of this study was the evaluation of the diagnostic accuracy of a specific high-definition white light endoscopy (HD-WLE) system for the optical recognition of intestinal metaplasia (IM) and the assessment of its correlation with histologic and clinical data. A total of 234 patients undergoing upper gastrointestinal endoscopy in an outpatient endoscopy suite for various indications were prospectively enrolled in this cross-sectional study. Gastric IM was diagnosed on the basis of three mucosal patterns identified using HD-WLE in a per-patient analysis. Histological evaluation was used as the gold standard, and special staining was conducted for subtyping of IM. Main outcome measurements were sensitivity, specificity, and likelihood ratio of HD-WLE and secondary associations with histologic and clinical data. IM was found in 63/234 (27%) patients and low-grade dysplasia in 6/63 patients (9.5%). Sensitivity, specificity, accuracy, and likelihood ratio of all mucosal patterns were 74.6, 94, 88% and 13, respectively. All clinically significant type III IM and dysplasia lesions were endoscopically detected. All nonvisible lesions were of types I and II with mild grade and no dysplasia. Ten patients were considered false positives and the lesions were associated with severe inflammation and antralization. The specific HD-WLE system showed satisfactory accuracy and high specificity during real-time, routine endoscopy practice. Specific mucosal patterns were correlated with level and grade of lesions. The sensitivity of the system is even higher when only clinically significant IM lesions are considered.

  9. The dysplastic nevus: from historical perspective to management in the modern era: part I. Historical, histologic, and clinical aspects.

    Science.gov (United States)

    Duffy, Keith; Grossman, Douglas

    2012-07-01

    Since its description in the 1970s, the dysplastic nevus has been a source of confusion, and whether it represents a precursor to melanoma remains a controversial subject. Although a Consensus Conference in 1992 recommended that the term "dysplastic nevus" no longer be used, the histologic diagnosis continues to present a therapeutic quandary for dermatologists and other physicians, and there remains significant variation in clinical management. In part I of this continuing medical education review, we will discuss the historical origins of the term, the evidence for its distinct histologic basis, and its clinical significance. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  10. Clinical and Histologic Features of 26 Canine Peripheral Giant Cell Granulomas (Formerly Giant Cell Epulis)

    National Research Council Canada - National Science Library

    Desoutter, A. V; Goldschmidt, M. H; Sánchez, M. D

    2012-01-01

    ... (formerly giant cell epulis) are reported. Two main histologic categories were evident: (1) “classic” peripheral giant cell granuloma, characterized by variable numbers of multinucleated giant cells...

  11. Quantifying Histological Features of Cancer Biospecimens for Biobanking Quality Assurance Using Automated Morphometric Pattern Recognition Image Analysis Algorithms

    Science.gov (United States)

    Webster, Joshua D.; Simpson, Eleanor R.; Michalowski, Aleksandra M.; Hoover, Shelley B.; Simpson, R. Mark

    2011-01-01

    Biorepository-supported translational research depends on high-quality, well-annotated specimens. Histopathology assessment contributes insight into how representative lesions are for research objectives. Feasibility of documenting histological proportions of tumor and stroma was studied in an effort to enhance information regarding biorepository tissue heterogeneity. Using commercially available software, unique spatial-spectral algorithms were developed for applying automated pattern recognition morphometric image analysis to quantify histologic tumor and nontumor tissue areas in biospecimen tissue sections. Measurements were acquired successfully for 75/75 (100%) lymphomas, 76/77 (98.7%) osteosarcomas, and 60/70 (85.7%) melanomas. The percentage of tissue area occupied by tumor varied among patients and tumor types and was distributed around medians of 94% [interquartile range (IQR)=14%] for lymphomas, 84% for melanomas (IQR=24%), and 39% for osteosarcomas (IQR=44%). Within-patient comparisons from a subset, including multiple individual patient specimens, revealed ≤12% median coefficient of variation (CV) for lymphomas and melanomas. Phenotypic heterogeneity of osteosarcomas resulted in 33% median CV. Uniformly applied, tumor-specific pattern recognition software permits automated tissue-feature quantification. Furthermore, dispersion analyses of area measurements across collections, as well as of multiple specimens from individual patients, support using limited tissue slices to gauge features for some tumor types. Quantitative image analysis automation is anticipated to minimize variability associated with routine biorepository pathologic evaluations and enhance biomarker discovery by helping to guide the selection of study-appropriate specimens. PMID:21966258

  12. Clinical and Histological Evaluation of Direct Pulp Capping on Human Pulp Tissue Using a Dentin Adhesive System

    Directory of Open Access Journals (Sweden)

    Alicja Nowicka

    2016-01-01

    Full Text Available Objective. This study presents a clinical and histological evaluation of human pulp tissue responses after direct capping using a new dentin adhesive system. Methods. Twenty-eight caries-free third molar teeth scheduled for extraction were evaluated. The pulps of 22 teeth were mechanically exposed and randomly assigned to 1 of 2 groups: Single Bond Universal or calcium hydroxide. Another group of 6 teeth acted as the intact control group. The periapical response was assayed, and a clinical examination was performed. The teeth were extracted after 6 weeks, and a histological analysis was performed. The pulp status was assessed, and the thickness of the dentin bridge was measured and categorized using a histological scoring system. Results. The clinical phase was asymptomatic for Single Bond Universal patients. Patients in the calcium hydroxide group reported mild symptoms of pain, although the histological examination revealed that dentin bridges with or without limited pulpitis had begun forming in each tooth. The universal adhesive system exhibited nonsignificantly increased histological signs of pulpitis (P>0.05 and a significantly weaker thin mineralized tissue layer (P<0.001 compared with the calcium hydroxide group. Conclusion. The results suggest that Single Bond Universal is inappropriate for human pulp capping; however, further long-term studies are needed to determine the biocompatibility of this agent.

  13. Correlation between clinical and histological features in a pig model of choroidal neovascularization

    DEFF Research Database (Denmark)

    Lassota, Nathan; Kiilgaard, Jens Folke; Prause, Jan Ulrik

    2006-01-01

    To analyse the histological changes in the retina and the choroid in a pig model of choroidal neovascularization (CNV) and to correlate these findings with fundus photographic and fluorescein angiographic features.......To analyse the histological changes in the retina and the choroid in a pig model of choroidal neovascularization (CNV) and to correlate these findings with fundus photographic and fluorescein angiographic features....

  14. Analysis of interobserver reproducibility in grading histological patterns of dysplastic nevi*

    Science.gov (United States)

    Nobre, Aretha Brito; Piñeiro-Maceira, Juan; Raggio Luiz, Ronir

    2013-01-01

    BACKGROUND Dysplastic nevi are among the most important cutaneous melanoma simulators. They are important risk markers for this neoplasia and can be its potential precursors. Some authors found a statistically significant relationship between the degree of dysplasia and the risk for developing melanoma. However, reproducibility of grading criteria ranged from poor to fair in the researched articles. OBJECTIVE To test the reproducibility of the grading criteria proposed by Sagebiel et al. regarding dysplastic nevi. METHODS Histological specimens of 75 dysplastic nevi were graded, independently and in a blinded fashion, according to preestablished criteria, by a panel of 10 pathologists with different levels of experience. Diagnostic agreement was calculated using weighted kappa and intraclass correlation coefficients. RESULTS The average of weighted kappa values was 0.13 for all observers, 0.12 for dermatopathologists, 0.18 for general pathologists and 0.05 for residents. Intraclass correlation coefficient values were 0.2 for all observers, 0.18 for dermatopathologists, 0.33 for general pathologists and 0.15 for residents. CONCLUSIONS: Histopathological grading for dysplastic nevi was not reproducible in this Brazilian series, so the criteria used are not a helpful histopathological parameter for clinicopathological correlation. PMID:23539000

  15. Malignant melanoma of sun-protected sites: a review of clinical, histological, and molecular features.

    Science.gov (United States)

    Merkel, Emily A; Gerami, Pedram

    2017-06-01

    In most cases of cutaneous melanoma, ultraviolet (UV) radiation is recognized as a prominent risk factor. Less is known regarding the mechanisms of mutagenesis for melanoma arising in sun-protected sites, such as acral and mucosal melanoma. Acral and mucosal melanoma share many common features, including a late age of onset, a broad radial growth phase with prominent lentiginous growth, the presence of field cancerization cells, and, in most cases, lack of a precursor nevus. In addition to early chromosomal instability, many of the same genes are also involved in these two distinct melanoma subtypes. To better understand non-UV-mediated pathogenesis in melanoma, we conducted a joint literature review of clinical, histological, and molecular features in acral and mucosal melanoma. We also reviewed the current literature regarding aberrations in KIT, PDGFRA, TERT, and other commonly involved genes. By comparing common features of these two subtypes, we suggest potential mechanisms underlying acral and/or mucosal melanoma and offer direction for future investigations.

  16. Clinical and Histologic Evaluation of Platelet-Rich Fibrin Accelerated Epithelization of Gingival Wound.

    Science.gov (United States)

    Bansal, Mansi; Kumar, Ashish; Puri, Komal; Khatri, Manish; Gupta, Geeti; Vij, Hitesh

    2016-01-01

    The foremost indication for gingival depigmentation is patient demand for improved aesthetics. In most cases after the removal of pigmented layer, the area is covered with periodontal packs. These dressings have no curative properties. They only minimise the likelihood of surface trauma during mastication. However, platelet-rich fibrin (PRF) accelerates wound healing by effective neovascularisation and promoting fast cicatricial tissue remodelling. In the present split mouth study, PRF membrane was applied in the first quadrant and non-eugenol dressing (Coe-Pack) in the second quadrant after depigmentation. Clinical evaluation of epithelization with toluidine blue revealed that PRF treated sites stained substantially less indicating better wound healing as compared to Coe-Pack sites, which appeared more erythematous after 5 days. The histologic evaluation also revealed greater inflammatory cell infiltrate on Coe-Pack sites as compared to PRF. Thus, PRF membrane as a periodontal dressing is a successful approach to protect the raw wound area of the depigmented site to reduce healing time and patient discomfort.

  17. Clinical and histologic evaluation of platelet-rich fibrin accelerated epithelization of gingival wound

    Directory of Open Access Journals (Sweden)

    Mansi Bansal

    2016-01-01

    Full Text Available The foremost indication for gingival depigmentation is patient demand for improved aesthetics. In most cases after the removal of pigmented layer, the area is covered with periodontal packs. These dressings have no curative properties. They only minimise the likelihood of surface trauma during mastication. However, platelet-rich fibrin (PRF accelerates wound healing by effective neovascularisation and promoting fast cicatricial tissue remodelling. In the present split mouth study, PRF membrane was applied in the first quadrant and non-eugenol dressing (Coe-Pack in the second quadrant after depigmentation. Clinical evaluation of epithelization with toluidine blue revealed that PRF treated sites stained substantially less indicating better wound healing as compared to Coe-Pack sites, which appeared more erythematous after 5 days. The histologic evaluation also revealed greater inflammatory cell infiltrate on Coe-Pack sites as compared to PRF. Thus, PRF membrane as a periodontal dressing is a successful approach to protect the raw wound area of the depigmented site to reduce healing time and patient discomfort.

  18. Radiological characteristics, histological features and clinical outcomes of lung cancer patients with coexistent idiopathic pulmonary fibrosis.

    Science.gov (United States)

    Khan, K A; Kennedy, M P; Moore, E; Crush, L; Prendeville, S; Maher, M M; Burke, L; Henry, M T

    2015-02-01

    Despite advances in diagnosis and management, the outcomes for both lung cancer and idiopathic pulmonary fibrosis (IPF) are still unfavourable. The pathophysiology and outcomes for patients with concomitant lung cancer and IPF remains unclear. A retrospective analysis was performed of all patients presenting with concomitant IPF and lung cancer to our centre over a 3-year period. Patients with connective tissue disease, asbestos exposure, sarcoidosis, previous thoracic radiation, radiological evidence of fibrosis but no histological confirmation of lung cancer, or the use of medications known to cause pulmonary fibrosis were excluded. We describe clinical, radiological and pathological characteristics of this group. We also report the response to standardized lung cancer therapy in this cohort. Of 637 lung cancer patients, 34 were identified with concomitant IPF (5.3 %) and all were smokers. 85 % had non-small cell lung cancer, 41 % were squamous cell cancers. The majority of tumours were located in the lower lobes, peripheral and present in an area of honeycombing. Despite the fact that approximately 2/3rds of the patients had localised or locally advanced lung cancer, the outcome of therapy for lung cancer was extremely poor regardless of tumour stage or severity of IPF. At our centre, 1/20 patients with lung cancer have concomitant IPF. The majority of these tumours are small in size, peripheral in location and squamous cell carcinoma; in an area of honey combing. The outcome for concomitant lung cancer and IPF regardless of stage or therapy is poor.

  19. Clinical and histological features of non-Alcoholic steatohepatitis in Iranian patients

    Directory of Open Access Journals (Sweden)

    "Ebrahimi Daryani N

    2003-05-01

    Full Text Available Non-alcoholic steatohepatitis (NASH is a disease of unknown origin characterized histologically by alcoholic-like liver injury in the absence in the absence of significant alcohol intake. This study was conducted to assess the clinical and pathological features of NASH patients in Iran. Patients with elevated liver transaminases, negative serologic markers of viral or autoimmune hepatitis and no findings in favor of metabolic liver disease were enrolled. A careful history was taken with special attention to alcohol intake and ultrasonography and liver biopsy were performed in those with no evidence of significant alcohol intake. A histology showing moderate to gross macrovesicular fatty change with inflammation (lobular or portal, with or without Mallory bodies, fibrosis, or cirrhosis, was considered diagnostic for NASH. Patients with mild steatosis were rechecked for the presence of hepatitis C virus (HCV infection. Fifty-three patients who met the above criteria entered the study. Thirty-two patients (60.4% were male and 21 (39.6% were female with the mean age of 37.8±11.3 years. Twenty-six patients (55.3% were diabetic. Mean AST to ALT ratio was 0.95±0.52; 65.3%of patients had a ratio below than 1, and 95.9% were below of 2. Ultrasonography was abnormal in 32 (76.2% patients. Liver biopsy showed mild steatosis in 35.7% moderate steatosis in 53.6% and severe forms in 10.7%. In 80.2% of patients, portal inflammation was present, and 15.1% had some degrees of fibrosis. The amount of increase in liver enzymes bore no relationship with the presence of fibrosis, portal inflammation, and degree of steatosis (P>0.05. The patients wee somewhat younger than other studies, and most of them were male which might be due to the low rate of alcohol consumption in our country. Most of the patients had body mass index (BMI higher than normal. Our findings show that NASH must not be considered a disease confined to high-risk groups only, and its impact be

  20. Histological patterns in healing chronic wounds using Cochliomyia macellaria (Diptera: Calliphoridae) larvae and other therapeutic measures.

    Science.gov (United States)

    de Masiero, Franciéle Souza; Nassu, Mariana Prado; Soares, Mauro Pereira; Thyssen, Patricia Jacqueline

    2015-08-01

    The healing process occurs due to the interaction of cellular, molecular, and biochemical events. Regarding lesions difficult to heal, especially in immunocompromised patients, monitoring and intervention to promote healing is a constant focus of research. Another aggravating factor is the increase in the number of reported cases of microbial resistance, indicating that various dressings and drugs have been increasingly inefficient. Larval therapy (LT) involves the application of sterile fly larvae on chronic and/or infected wounds, and it is an area emerging as an alternative therapy. Before the 1940s, the LT was widely used, but fell into disuse after the appearance of antibiotics. High cost and the development of resistance by certain groups of pathogenic bacteria to these drugs encouraged the resurgence of LT, currently used in approximately 20 countries and more recently in Brazil. However, many mechanisms of action of the larvae in this system remain poorly understood. Thus, the aim of the study was to investigate histopathological findings and to evaluate possible mechanisms of action of dipteran larvae during tissue repair. Lesions were induced in 24 male Wistar rats, to evaluate the effect of the type of treatment applied. The animals were divided into four groups: larval therapy (LT), LT associated with foam dressing with silver release (LTSIL), mechanical debridement and silver foam dressing (DEBSIL), and no treatment (CONT). Skin samples were collected for histopathological analysis. In LT, inflammatory response and angiogenesis were abundant; in LTSIL, inflammatory response with neutrophil infiltration was observed; in DEBSIL, scarce inflammatory response, small numbers of macrophages and lymphocytes, and bacterial colonization in depth; and in CONT, there was bacterial colonization in deeper tissues. The observed histological events show that the larvae had an important role in promoting the inflammatory response in the wound bed, drawing the

  1. Radiosensitivity Differences Between Liver Metastases Based on Primary Histology Suggest Implications for Clinical Outcomes After Stereotactic Body Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Ahmed, Kamran A.; Caudell, Jimmy J. [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); El-Haddad, Ghassan [Department of Interventional Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Berglund, Anders E.; Welsh, Eric A. [Department of Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Yue, Binglin [Department of Biostastistics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Hoffe, Sarah E.; Naghavi, Arash O.; Abuodeh, Yazan A.; Frakes, Jessica M. [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Eschrich, Steven A. [Department of Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Torres-Roca, Javier F., E-mail: Javier.torresroca@moffitt.org [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States)

    2016-08-01

    Purpose/Objectives: Evidence from the management of oligometastases with stereotactic body radiation therapy (SBRT) reveals differences in outcomes based on primary histology. We have previously identified a multigene expression index for tumor radiosensitivity (RSI) with validation in multiple independent cohorts. In this study, we assessed RSI in liver metastases and assessed our clinical outcomes after SBRT based on primary histology. Methods and Materials: Patients were identified from our prospective, observational protocol. The previously tested RSI 10 gene assay was run on samples and calculated using the published algorithm. An independent cohort of 33 patients with 38 liver metastases treated with SBRT was used for clinical correlation. Results: A total of 372 unique metastatic liver lesions were identified for inclusion from our prospective, institutional metadata pool. The most common primary histologies for liver metastases were colorectal adenocarcinoma (n=314, 84.4%), breast adenocarcinoma (n=12, 3.2%), and pancreas neuroendocrine (n=11, 3%). There were significant differences in RSI of liver metastases based on histology. The median RSIs for liver metastases in descending order of radioresistance were gastrointestinal stromal tumor (0.57), melanoma (0.53), colorectal neuroendocrine (0.46), pancreas neuroendocrine (0.44), colorectal adenocarcinoma (0.43), breast adenocarcinoma (0.35), lung adenocarcinoma (0.31), pancreas adenocarcinoma (0.27), anal squamous cell cancer (0.22), and small intestine neuroendocrine (0.21) (P<.0001). The 12-month and 24-month Kaplan-Meier rates of local control (LC) for colorectal lesions from the independent clinical cohort were 79% and 59%, compared with 100% for noncolorectal lesions (P=.019), respectively. Conclusions: In this analysis, we found significant differences based on primary histology. This study suggests that primary histology may be an important factor to consider in SBRT radiation dose selection.

  2. Histological review of the human cellular cementum with special reference to an alternating lamellar pattern.

    Science.gov (United States)

    Yamamoto, Tsuneyuki; Li, Minqi; Liu, Zhucheng; Guo, Ying; Hasegawa, Tomoka; Masuki, Hideo; Suzuki, Reiko; Amizuka, Norio

    2010-07-01

    Cementum is mineralized tissue with collagen fibrils as its major organic component, and it can be roughly classified into acellular and cellular cementum. The latter generally consists of a stack of cellular intrinsic fiber cementum layers, in which intensely and weakly stained lamellae (each about 2.5 microm thick) alternate in light microscopic observations. It has been suggested that the alternate lamellar pattern results from periodic changes of the intrinsic fiber arrangement, but owing to the difficulty of observing the fibril arrangement three dimensionally, details were not understood until recently. The NaOH-maceration method has been developed to overcome this difficulty. For the past two decades, we have studied the structure and development of cementum by scanning electron microscopy using NaOH-maceration, as well as by light and transmission electron microscopy, and have accumulated a significant amount of data with regard to the structure and formation of cementum. In light of these data, we have arrived at the following conclusions: (1) The alternate lamellar pattern conforms to the twisted plywood model, in which collagen fibrils rotate regularly in the same direction to form two alternating types of lamellae; one type consists of transversely and almost transversely cut fibrils and the other consists of longitudinally and almost longitudinally cut fibrils. (2) The development of the intrinsic fiber arrangement may be controlled by cementoblasts; the cementoblasts move finger-like processes synchronously and periodically to create alternate changes in the intrinsic fiber arrangement, and this dynamic sequence results in the alternate lamellar pattern.

  3. RELATION BETWEEN GLUCOLIPID PROFILE AND SMALL INTESTINE HISTOLOGICAL PATTERNS IN DIABETIC RATS EXPOSED TO AN INTERMITTENT DIETARY RESTRICTION

    Directory of Open Access Journals (Sweden)

    Noriyuki Hisano

    2009-01-01

    Full Text Available The effects of an intermittent and prolonged dietary restriction on biochemical variables and histological small intestinal patterns in 12-month-old male eSMT rats are examined. These spontaneously diabetic animals were separated in two groups after weaning: 10 rats fed ad libitum with standard rat chow and 10 rats fed a restricted diet by deprivation of the same food for 24 hours every 72. At 12 months of age, animals were weighed and euthanized after tail vein bleeding for plasma analysis (glycemia- both fasting and 120 minutes after an oral glucose challenge-, triglyceridemia and total cholesterolemia. Small intestines were removed, weighed and measured in length.Intestinal specimens were fixed, embedded in paraffin, semi serially cut at 6 µm and stained with PAS-Hematoxilyn and Hematoxilyn-Eosin. Histometry was performed through a linear devise attached to ocular lens and lectin histochemistry was accomplished employing Canavalis ensiformis, Dolichos biflorus, Arachis hypogea, Ulex europaeus-I, Triticum vulgaris, Ricinus communis and Soy Bean (Glicine Max Agglutinin. Essentially, eSMT rats, a suitable animal model for studying diabetes and/or its complications, revealed at 12 months of age after undergoing the dietary restriction: 1.- An expected improvement in body weight and determined biochemical variables (fasting and after glucose overload glycemias, triglyceridemia and total cholesterolemia without reaching euglycemic values. 2.- Changes in most of the analyzed histometric patterns with no relevant reflection on morphometric ones, and 3.- No modifications in lectinhistochemical patterns.

  4. Histologic, Molecular, and Clinical Evaluation of Explanted Breast Prostheses, Capsules, and Acellular Dermal Matrices for Bacteria

    Science.gov (United States)

    Poppler, Louis; Cohen, Justin; Dolen, Utku Can; Schriefer, Andrew E.; Tenenbaum, Marissa M.; Deeken, Corey; Chole, Richard A.; Myckatyn, Terence M.

    2015-01-01

    Background Subclinical infections, manifest as biofilms, are considered an important cause of capsular contracture. Acellular dermal matrices (ADMs) are frequently used in revision surgery to prevent recurrent capsular contractures. Objective We sought to identify an association between capsular contracture and biofilm formation on breast prostheses, capsules, and ADMs in a tissue expander/implant (TE/I) exchange clinical paradigm. Methods Biopsies of the prosthesis, capsule, and ADM from patients (N = 26) undergoing TE/I exchange for permanent breast implant were evaluated for subclinical infection. Capsular contracture was quantified with Baker Grade and intramammary pressure. Biofilm formation was evaluated with specialized cultures, rtPCR, bacterial taxonomy, live:dead staining, and scanning electron microscopy (SEM). Collagen distribution, capsular histology, and ADM remodeling were quantified following fluorescent and light microscopy. Results Prosthetic devices were implanted from 91 to 1115 days. Intramammary pressure increased with Baker Grade. Of 26 patients evaluated, one patient had a positive culture and one patient demonstrated convincing evidence of biofilm morphology on SEM. Following PCR amplification 5 samples randomly selected for 16S rRNA gene sequencing demonstrated an abundance of suborder Micrococcineae, consistent with contamination. Conclusions Our data suggest that bacterial biofilms likely contribute to a proportion, but not all diagnosed capsular contractures. Biofilm formation does not appear to differ significantly between ADMs or capsules. While capsular contracture remains an incompletely understood but common problem in breast implant surgery, advances in imaging, diagnostic, and molecular techniques can now provide more sophisticated insights into the pathophysiology of capsular contracture. Level of Evidence PMID:26229126

  5. [A Paediatric Orthopaedic outpatient clinic referral patterns].

    Science.gov (United States)

    Moraleda, L; Castellote, M

    2015-08-01

    The aim of this study was to identify the commonest referrals to a paediatric orthopaedic outpatient clinic and, therefore, to be able to improve the paediatric residency program in managing musculoskeletal problems. Demographic data, referrals and final diagnosis were collected prospectively on all patients that were evaluated in a paediatric orthopaedic outpatient clinic. The majority of referrals were to evaluate musculoskeletal pain (37%), foot deformity (20%), spine deformity (15%), walking pattern (11%), alignment of the lower limbs (4%), and development of the hip (4%). A normal physical examination or a normal variation was observed in 42% of patients. A mild condition was observed in 17% of patients that should have only been referred to a paediatric orthopaedic clinic after failing to resolve pain with anti-inflammatories or physiotherapy. A mild deformity that only needed treatment if it became symptomatic was seen in 8% of patients. The majority of referrals were due to a normal variation or mild conditions that only required symptomatic treatment. Paediatric residency programs do not reflect the prevalence of musculoskeletal conditions in clinical practice. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  6. Automatic classification of prostate stromal tissue in histological images using Haralick descriptors and Local Binary Patterns

    Science.gov (United States)

    Oliveira, D. L. L.; Nascimento, M. Z.; Neves, L. A.; Batista, V. R.; Godoy, M. F.; Jacomini, R. S.; Duarte, Y. A. S.; Arruda, P. F. F.; Neto, D. S.

    2014-03-01

    In this paper we presente a classification system that uses a combination of texture features from stromal regions: Haralick features and Local Binary Patterns (LBP) in wavelet domain. The system has five steps for classification of the tissues. First, the stromal regions were detected and extracted using segmentation techniques based on thresholding and RGB colour space. Second, the Wavelet decomposition was applied in the extracted regions to obtain the Wavelet coefficients. Third, the Haralick and LBP features were extracted from the coefficients. Fourth, relevant features were selected using the ANOVA statistical method. The classication (fifth step) was performed with Radial Basis Function (RBF) networks. The system was tested in 105 prostate images, which were divided into three groups of 35 images: normal, hyperplastic and cancerous. The system performance was evaluated using the area under the ROC curve and resulted in 0.98 for normal versus cancer, 0.95 for hyperplasia versus cancer and 0.96 for normal versus hyperplasia. Our results suggest that texture features can be used as discriminators for stromal tissues prostate images. Furthermore, the system was effective to classify prostate images, specially the hyperplastic class which is the most difficult type in diagnosis and prognosis.

  7. Tissue-specific expression pattern and histological distribution of NLRP3 in Chinese yellow chicken.

    Science.gov (United States)

    Ye, Jinhui; Yu, Meng; Zhang, Kaizhao; Liu, Jianxin; Wang, Qingnan; Tao, Pan; Jia, Kun; Liao, Ming; Ning, Zhangyong

    2015-09-01

    Pathogen-associated molecular patterns (PAMPs) play important role in inflammation which means response of the host to stimuli. NOD-like receptor protein 3 (NLRP3) inflammasome is involved in the onset and development of inflammation. NLRP3, as one of the most important inflammasome sensors, has significant effect on the regulation of inflammasome activation to avoid the consequences of over activation. Up to date, there are no detailed tissue specific expression and distribution data about NLPR3 in chicken. Here, NLRP3 of Chinese yellow chicken was cloned and sequence analyzed, the polyclonal antibody was produced by purified protein of recombinant prokaryotic expression. Relative expression levels and tissue distribution of NLRP3 were investigated by real-time quantitative PCR and immunohistochemical analysis, respectively. The results showed that NLRP3 gene is highly variable between mammalian and avian. The nucleotide homology of NLRP3 between yellow chicken and Bos taurus, Hainan black goat, Sus scrofa, Callithrix jacchus, Homo sapiens, Macaca mulatta, Mus musculus and Rattus norvegicus were 54.2%, 53.9%, 53.7%, 55.4%, 54.3%, 54.5%, 53.5% and 53.7%. NLRP3 expressed in all detected tissues and higher in the trachea are lung than in other tissues. Cytoplasmic expression of NLRP3 was detected in ciliated epithelial cells, basal cells and cells in lamina propria of trachea, alveolar epithelial cells, cardiac muscle cells, cerebral cortex neurons, epithelial reticular cells of the spleen, and lymphocytes of medulla in stannius follicle, liver cells and the renal tubule epithelial cells. The results will help to elucidate the role of NLRP3 of different tissues in inflammatory diseases of chicken and provide a basis for further investigations in the function and evolution of NLRP3 in different species, which would be helpful for further research on avian inflammatory diseases.

  8. [Implantation of collagen coated hydroxyapatite particles. A clinical-histological study in humans].

    Science.gov (United States)

    Sanz, M; Bascones, A; Kessler, A; García Nuñez, J; Newman, M G; Robertson, M A; Carranza, F A

    1989-05-01

    In this study, histologic behaviour of collagen coated hydroxylapatite particles implanted in human periodontal osseous defects has been analyzed. This material was surgically implanted in four patients, and reentry and block biopsies were carried out 4 and 6 months later. The histologic results demonstrate that this material is well tolerated by surrounding tissues, not eliciting an inflammatory reaction. At four months, the hydroxylapatite particles appear encapsulated by a very cellular connective tissue and at 6 months are found in direct contact with osteoid and mature bone. This material acts as a filler material, being fully biocompatible and stimulating an osseoconductive reaction of the adjacent alveolar bone.

  9. [Renal angiomyolipomas without fat component: tomodensitometric and histologic characteristics, clinical course].

    Science.gov (United States)

    Negre, T; Faure, A; Andre, M; Daniel, L; Coulange, C; Lechevallier, E

    2011-11-01

    Angiomyolipoma is the most frequent benign renal solid tumor. Because of the lack of fat component on the CT scan, diagnosis of this tumor is hard and can require percutaneous biopsy of unknown renal tumor. The follow-up of the poor fat CT scan component AML (PFCT AML) is uncertain. Five hundred percutaneous renal biopsy under tomodenstitometry have been realised between 1998 and 2008. There was 41 PFCT AML on the 500 biopsy. By definition, a PFCT AML is an AML where the diagnosis is done on a percutaneous biopsy but where there was no fat component on the first CT scan. We studied and compared clinical, tomodensitometric and histologic parameters of these 41 patients (mean age: 56, 9±11.04; sexe rate M/F: 6/35) where renal AML was diagnosed on percutaneous renal biopsy but without fat component on CT scan. Average size was 26.44±14.68mm. We phone-called 16 patients for the long-term follow-up. Average follow-up was 41±28.3 months. For four patients on 16, initial diagnosis was done in front of local symptoms, for one of the 16 diagnosis was done in front of general symptoms, for one of the diagnosis was done during Bourneville tuberous sclerosis evolution and 10 of the 16 was done fortuitously. After review of the initial CT scan, fat density was found on 24% of them. Ten percent was epithelioid angiomyolipoma. Four renal biopsy on 41 (10%) was epithelioid AML. No epithelioid AML had fat component after the second look of the CT scan. Among the 16 patients who were phone-called, three (19%) underwent a complication. Two had abdominal pain and was treated medically. Initial sizes were 26 and 30mm. Only one patient must be operated by radical nephrectomy for acute hemorrhage. Initial size was 45mm. No neoplasic degeneration was identified for those 16 patients. In our study, the PFCT AML rate was 8.2%. In 25% cases, CT scan read-through shown a fat component and could help for the diagnosis. PFCT AML evolution seems to be the same as a classic AML. Conservative

  10. Clinical, Radiographic, and Histologic Evaluation of Regional Odontodysplasia: a Case Report with 5-year Follow-up

    OpenAIRE

    Jahanimoghadam, Fatemeh; Pishbin, Lida; Rad, Maryam

    2016-01-01

    Regional odontodysplasia is a developmental anomaly that affects the primary and permanent dentitions. This disorder is generally localized in only one arch and its etiology is still unknown. Clinically, the affected teeth have an abnormal morphology and are typically discolored. Radiographically, these teeth show a ghost-like appearance. This paper reported the results of radiographic, histologic and laboratory findings about the case of a 5-year-old girl presenting this rare anomaly. Her fa...

  11. Incidence and histological patterns of thyroid cancer in Sri Lanka 2001-2010: an analysis of national cancer registry data.

    Science.gov (United States)

    Jayarajah, Umesh; Fernando, Ashan; Prabashani, Saumyakala; Fernando, Eshani A; Seneviratne, Sanjeewa A

    2018-02-07

    An increasing incidence of thyroid cancer is observed in many developed countries. Increasing incidence may also reflect better reporting or increased diagnostic scrutiny. We conducted this study to examine trends in thyroid cancer incidence and histological patterns in Sri Lanka. A retrospective cohort evaluation of patients with thyroid cancer during 2001-2010 was performed using population based data published from the Sri Lanka National Cancer Registry. Trends in incidence and histological patterns were analysed by age and gender. The age-standardized incidence of thyroid cancer increased from 2.44 per 100,000 in 2001 (95% confidence interval [95% CI]: 2.21-2.67) to 5.16 per 100,000 in 2010 (95% CI: 4.85-5.47); a 2.1-fold increase (p < 0.05 for trend). A greater part of this increase is attributable to increase in incidence of papillary thyroid cancer, which increased from 1.64 to 3.61 per 100,000; a 2.2-fold increase (p < 0.05 for trend). Follicular cancer showed lesser, yet a significant increase from 0.56 to 0.95 per 100,000 (p < 0.05). Other varieties of thyroid cancer showed no significant increases in incidence. Trends in the increases in incidence of papillary cancer in females showed a much greater increase compared with males (from 2.45 to 5.60 per 100,000, a 2.28-fold increase in females compared with from 0.82 to 1.55; a 1.89-fold increase in males, p < 0.001). Highest incidence of papillary cancer was observed in 30-39-year age group, which has increased from 5.56 to 12.9 per 100,000; a 2.32-fold increase (p < 0.001). The increasing incidence of thyroid cancer in Sri Lanka is predominantly due to the increasing incidence of papillary cancers. These trends may reflect increased detection and better reporting, although an inherent increase in the incidence is the likely main contributor. Further studies including tumour stage and mortality may help answer these questions.

  12. Nosocomial Legionnaires’ Disease: Clinical and Radiographic Patterns

    Directory of Open Access Journals (Sweden)

    Thomas J Marrie

    1992-01-01

    Full Text Available From 1981 to 1991, 55 patients (33 males, 22 females, mean age 58.6 years with nosocomial Legionnaires’ disease were studied. The mortality rate was 64%. One-half of the patients developed nosocomial Legionnaires’ disease within three weeks of admission. A surprising clinical feature was the low rate of findings of consolidation on physical examination, despite the fact that 52% of patients had this finding on chest radiograph. More than one-half of patients had pre-existing lung disease, rendering a radiographic diagnosis of pneumonia due to Legionella pneumophila impossible in 16% of cases despite microbiological confirmation. Nineteen per cent of patients who had blood cultures done had a pathogen other than L pneumophila isolated, suggesting dual infection in at least some of the patients. When the clinical and radiographic findings were combined it was noted that 40% of patients had one of three patterns suggestive of nosocomial Legionnaires’ disease: rapidly progressive pneumonia, lobar opacity and multiple peripheral opacities. However, in 60% of patients there were no distinctive features.

  13. Association between histological features in temporal artery biopsies and clinical features of patients with giant cell arteritis.

    Science.gov (United States)

    Breuer, Gabriel S; Nesher, Ronit; Reinus, Konstantin; Nesher, Gideon

    2013-06-01

    In most cases of giant cell arteritis (GCA) the diagnosis is confirmed by temporal artery biopsy. Aside from the diagnostic purpose, histological parameters may serve as prognostic markers. To review positive temporal artery biopsies ofGCA in an attempt to correlate various histological parameters with clinical features, disease complications and outcome. Positive biopsies from 65 GCA patients were randomly selected for review by a single pathologist. In each biopsy the following parameters were scored: intensity and location of the inflammatory infiltrate, presence of giant cells and other cell types, fragmentation and calcification of the internal elastic lamina, intimal thickening, and presence of luminal thrombus. Clinical data were obtained from the patients' charts. Intensity of the initial systemic inflammatory reaction (ISIR) at the time of diagnosis was scored by the presence of five parameters: fever, anemia, thrombocytosis, leukocytosis, and sedimentation rate >100 mm/hr. In cases with bilateral positive biopsy (n=27), there was good correlation between the two sides regarding intensity of inflammation (r= 0.65, P< 0.001), location of the infiltrate (r= 0.7, P< 0.001), degree of intimal thickening (r= 0.54, P 0.001), and presence of giant cells (r= 0.83, P< 0.001). The rate of corticosteroid discontinuation tended to be quicker in patients with inflammatory infiltrates confined mainly to the adventitia, but other histological parameters did not affect this rate. Inflammatory infiltrates confined to the adventitia were associated with more neuro-ophthalmic ischemic manifestations, weak/moderate ISIR at the time of diagnosis, and faster rate of corticosteroid discontinuation. No association was found between other temporal artery biopsy histological parameters and clinical features of GCA patients.

  14. Distinct Patterns of Stromal and Tumor Expression of ROR1 and ROR2 in Histological Subtypes of Epithelial Ovarian Cancer

    Directory of Open Access Journals (Sweden)

    C.E. Henry

    2017-06-01

    Full Text Available OBJECTIVE: The ROR1 and ROR2 receptor tyrosine kinases have both been implicated in ovarian cancer progression and have been shown to drive migration and invasion. There is an increasing importance of the role of stroma in ovarian cancer metastasis; however, neither ROR1 nor ROR2 expression in tumor or stromal cells has been analyzed in the same clinical cohort. AIM: To determine ROR1 and ROR2 expression in ovarian cancer and surrounding microenvironment and examine associations with clinicopathological characteristics. METHODS: Immunohistochemistry for ROR1 and ROR2 was used to assess receptor expression in a cohort of epithelial ovarian cancer patients (n = 178. Results were analyzed in relation to clinical and histopathological characteristics and survival. Matched patient sample case studies of normal, primary, and metastatic lesions were used to examine ROR expression in relation to ovarian cancer progression. RESULTS: ROR1 and ROR2 are abnormally expressed in malignant ovarian epithelium and stroma. Higher ROR2 tumor expression was found in early-stage, low-grade endometrioid carcinomas. ROR2 stromal expression was highest in the serous subtype. In matched patient case studies, metastatic samples had higher expression of ROR2 in the stroma, and a recurrent sample had the highest expression of ROR2 in both tumor and stroma. CONCLUSION: ROR1 and ROR2 are expressed in tumor-associated stroma in all histological subtypes of ovarian cancer and hold potential as therapeutic targets which may disrupt tumor and stroma interactions.

  15. Distinct Patterns of Stromal and Tumor Expression of ROR1 and ROR2 in Histological Subtypes of Epithelial Ovarian Cancer.

    Science.gov (United States)

    Henry, C E; Emmanuel, C; Lambie, N; Loo, C; Kan, B; Kennedy, C J; de Fazio, A; Hacker, N F; Ford, C E

    2017-06-01

    The ROR1 and ROR2 receptor tyrosine kinases have both been implicated in ovarian cancer progression and have been shown to drive migration and invasion. There is an increasing importance of the role of stroma in ovarian cancer metastasis; however, neither ROR1 nor ROR2 expression in tumor or stromal cells has been analyzed in the same clinical cohort. To determine ROR1 and ROR2 expression in ovarian cancer and surrounding microenvironment and examine associations with clinicopathological characteristics. Immunohistochemistry for ROR1 and ROR2 was used to assess receptor expression in a cohort of epithelial ovarian cancer patients (n=178). Results were analyzed in relation to clinical and histopathological characteristics and survival. Matched patient sample case studies of normal, primary, and metastatic lesions were used to examine ROR expression in relation to ovarian cancer progression. ROR1 and ROR2 are abnormally expressed in malignant ovarian epithelium and stroma. Higher ROR2 tumor expression was found in early-stage, low-grade endometrioid carcinomas. ROR2 stromal expression was highest in the serous subtype. In matched patient case studies, metastatic samples had higher expression of ROR2 in the stroma, and a recurrent sample had the highest expression of ROR2 in both tumor and stroma. ROR1 and ROR2 are expressed in tumor-associated stroma in all histological subtypes of ovarian cancer and hold potential as therapeutic targets which may disrupt tumor and stroma interactions. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  16. Histological evaluation of the human testis--approaches to optimizing the clinical value of the assessment

    DEFF Research Database (Denmark)

    McLachlan, R I; Rajpert-De Meyts, E; Hoei-Hansen, C E

    2007-01-01

    Testicular biopsy is a crucial assessment in reproductive practice with diagnostic and prognostic importance for assisted reproductive technologies (ARTs) and risk of testicular neoplasia. Endocrine and genetic tests cannot reliably distinguish obstructive azoospermia (OA) from non......-obstructive azoospermia (NOA) or predict recovery of mature spermatids by testicular sperm extraction (TESE). Currently, divergent histological reporting systems and the use of imprecise terminology seriously degrade the value of the literature on TESE recovery rates and hamper evaluation of treatments and research...

  17. Clinical, computed tomographic, magnetic resonance imaging, and histologic findings associated with myxomatous neoplasia of the temporomandibular joint in two dogs.

    Science.gov (United States)

    Parslow, Arana; Taylor, David P; Simpson, David J

    2016-12-01

    CASE DESCRIPTION A 15-year-old neutered female mixed-breed dog (dog 1) and an 11-year-old neutered female Labrador Retriever (dog 2) were examined because of unilateral exophthalmus, third eyelid protrusion, and periorbital swelling that failed to respond to antimicrobial treatment. CLINICAL FINDINGS Both dogs underwent ultrasonographic, CT, and MRI examination of the head. In both dogs, advanced imaging revealed a poorly defined, peripherally contrast-enhancing, mucous-filled cystic mass that radiated from the temporomandibular joint and infiltrated the periorbital tissues and retrobulbar space. Both dogs underwent surgical biopsy of the periorbital mass. A viscous, straw-colored fluid was aspirated from the retrobulbar region in both dogs. The initial histologic diagnosis for dog 1 was zygomatic sialadenitis and sialocele. However, the clinical signs recurred, and histologic examination of specimens obtained during a second surgical biopsy resulted in a diagnosis of myxoma. The histologic diagnosis was myxosarcoma for dog 2. TREATMENT AND OUTCOME In both dogs, clinical signs recurred within 2 weeks after surgery and persisted for the duration of their lives. Dog 1 received no further treatment after the second surgery and was euthanized 34 months after initial examination because of multicentric lymphoma. Dog 2 was treated with various chemotherapy agents and was euthanized 11 months after initial examination because of a dramatic increase in periocular swelling and respiratory stertor. CLINICAL RELEVANCE Temporomandibular myxomatous neoplasia can be confused with zygomatic sialocele on the basis of clinical signs but has characteristic MRI features. Representative biopsy specimens should be obtained from areas close to the temporomandibular joint to avoid misdiagnosis.

  18. Minimally invasive ridge augmentation using xenogenous bone blocks in an atrophied posterior mandible: a clinical and histological study.

    Science.gov (United States)

    Li, Jingxu; Xuan, Feng; Choi, Byung-Ho; Jeong, Seung-Mi

    2013-04-01

    Although various techniques for the treatment of an atrophic alveolar ridge have been described in the literature, these procedures have increased the morbidity and discomfort for the patient. The purpose of this study was to evaluate histological and clinical results in 9 patients who underwent a subperiosteal tunneling procedure with a Bio-Oss block onlay graft in an atrophic area of the mandible. Nine months after grafting, at the time of dental implantation, biopsy samples were taken from the grafted areas of 9 patients and were analyzed histologically. New bone formation through the bovine bone block was observed consistently in the 9 cases. There was direct deposition of bone on the surface of the graft material. The results of this study indicated that ridge augmentation using a subperiosteal tunneling procedure with Bio-Oss bone blocks might be useful for implant placement in the atrophic alveolar ridges.

  19. Epithelial Inclusions Following a Bilaminar Root Coverage Procedure with a Subepithelial Connective Tissue Graft: A Histologic and Clinical Study.

    Science.gov (United States)

    Romano, Federica; Perotto, Stefano; Cricenti, Luca; Gotti, Stefano; Aimetti, Mario

    The aim of this study was to histologically examine any epithelial cell inclusions in submerged subepithelial connective tissue graft (SCTG) after clinical healing was achieved. A total of 16 patients with Miller Class I or II gingival recessions were consecutively treated with a bilaminar procedure. At 2 months after surgery, a gingival tissue specimen was harvested from all SCTG-treated sites and stained with hematoxylin-eosin. The histologic evaluation revealed connective tissue in active reorganization without epithelial inclusions in 14 of the 16 tissue specimens. In the remaining 2 specimens, epithelial islands were observed deep in the connective tissue. In one case they developed in a solid cystic space, while in the second case they were strictly integrated in the lamina propria. Complete recession coverage was obtained in 14 of the 16 treated defects, with a mean root coverage of 95.1% ± 14.2% at 12 months.

  20. Clinical and histological comparison of polyglycolic acid suture with black silk suture after minor oral surgical procedure.

    Science.gov (United States)

    Balamurugan, R; Mohamed, Masroor; Pandey, Vijayendra; Katikaneni, Hari Krishna Rao; Kumar, K R Ashok

    2012-07-01

    Any suture material, absorbable or nonabsorbable, elicits a kind of inflammatory reaction within the tissue. Nonabsorbable black silk suture and absorbable polyglycolic acid suture were compared clinically and histologically on various parameters. This study consisted of 50 patients requiring minor surgical procedure, who were referred to the Department of Oral and Maxillofacial Surgery. Patients were selected randomly and sutures were placed in the oral cavity 7 days preoperatively. Polyglycolic acid was placed on one side and black silk suture material on the other. Seven days later, prior to surgical procedure the sutures will be assessed. After the surgical procedure the sutures will be placed postoperatively in the same way for 7 days, after which the sutures will be assessed clinically and histologically. The results of this study showed that all the sutures were retained in case of polyglycolic acid suture whereas four cases were not retained in case of black silk suture. As far as polyglycolic acid suture is concerned 25 cases were mild, 18 cases moderate and seven cases were severe. Black silk showed 20 mild cases, 21 moderate cases and six severe cases. The histological results showed that 33 cases showed mild, 14 cases moderate and three cases severe in case of polyglycolic acid suture. Whereas in case of black silk suture 41 cases were mild. Seven cases were moderate and two cases were severe. Black silk showed milder response than polyglycolic acid suture histologically. The polyglycolic acid suture was more superior because in all 50 patients the suture was retained. It had less tissue reaction, better handling characteristics and knotting capacity.

  1. International Cartilage Repair Society (ICRS) Recommended Guidelines for Histological Endpoints for Cartilage Repair Studies in Animal Models and Clinical Trials

    Science.gov (United States)

    Hoemann, Caroline; Kandel, Rita; Roberts, Sally; Saris, Daniel B.F.; Creemers, Laura; Mainil-Varlet, Pierre; Méthot, Stephane; Hollander, Anthony P.; Buschmann, Michael D.

    2011-01-01

    Cartilage repair strategies aim to resurface a lesion with osteochondral tissue resembling native cartilage, but a variety of repair tissues are usually observed. Histology is an important structural outcome that could serve as an interim measure of efficacy in randomized controlled clinical studies. The purpose of this article is to propose guidelines for standardized histoprocessing and unbiased evaluation of animal tissues and human biopsies. Methods were compiled from a literature review, and illustrative data were added. In animal models, treatments are usually administered to acute defects created in healthy tissues, and the entire joint can be analyzed at multiple postoperative time points. In human clinical therapy, treatments are applied to developed lesions, and biopsies are obtained, usually from a subset of patients, at a specific time point. In striving to standardize evaluation of structural endpoints in cartilage repair studies, 5 variables should be controlled: 1) location of biopsy/sample section, 2) timing of biopsy/sample recovery, 3) histoprocessing, 4) staining, and 5) blinded evaluation with a proper control group. Histological scores, quantitative histomorphometry of repair tissue thickness, percentage of tissue staining for collagens and glycosaminoglycan, polarized light microscopy for collagen fibril organization, and subchondral bone integration/structure are all relevant outcome measures that can be collected and used to assess the efficacy of novel therapeutics. Standardized histology methods could improve statistical analyses, help interpret and validate noninvasive imaging outcomes, and permit cross-comparison between studies. Currently, there are no suitable substitutes for histology in evaluating repair tissue quality and cartilaginous character. PMID:26069577

  2. Oral malignant melanoma: A case report of an unusual clinical and histologic presentation

    Directory of Open Access Journals (Sweden)

    Uzma Iqbal Belgaumi

    2013-01-01

    Full Text Available Malignant melanoma is a potentially aggressive tumor of melanocytic origin. Primary oral malignant melanoma is a rare neoplasm, accounting for 0.5% of all oral malignancies. The present case occurred in a 60-year-old female patient, as a pedunculated growth involving the palate and alveolar ridge and histologically showing a desmoplastic differentiation. The article discusses the distinct clinico-pathologic presentation of this case and emphasizes on the need to identify and report such cases for further understanding of their biologic behavior.

  3. Synovial chondromatosis of the temporomandibular joint: a clinical, radiological and histological study.

    Science.gov (United States)

    Martín-Granizo, Rafael; Sánchez, Juan Jesús; Jorquera, Manuela; Ortega, Luis

    2005-01-01

    Synovial chondromatosis (SC) is a cartilaginous metaplasy of the mesenchymal remnants of the synovial tissue of the joints. It is characterized by the formation of cartilaginous nodules in the synovium and inside the articular space (loose bodies). SC mainly affects to big synovial joints such as the knee and the elbow, being uncommon the onset within the TMJ, where 75 cases have been published. The main symptoms are pain, inflammation, limitation of the movements of the jaw and crepitation. Different methods of diagnosis include panoramic radiograph, CT, MR and arthroscopy of the TMJ. We report a new case of unilateral SC of the TMJ, including diagnostic images, treatment performed and histological analysis.

  4. Clinical, histologic, and genetic features of mesothelioma in a 7-year-old child.

    Science.gov (United States)

    Sugalski, Aaron; Davis, Mary; Prasannan, Latha; Saldivar, Victor; Hung, Jaclyn Y; Tomlinson, Gail E

    2013-01-01

    Malignant mesothelioma (MM) is a highly aggressive malignancy that is extremely rare in children. This case report documents a 7-year-old male without previous asbestos exposure with peritoneal MM that initially responded to chemotherapy with cisplatin and gemcitabine but ultimately metastasized to his chest. He was diagnosed with MM based on histology, extensive immunohistochemical analyses, and an elevated serum CA-125 level. Cytogenetics and comparative genomic hybridization (CGH) analysis of his tumor identified a single extra copy number of chromosome 11 with few other changes noted. Copyright © 2012 Wiley Periodicals, Inc.

  5. Characteristic location and growth patterns of functioning pituitary adenomas: correlation with histological distribution of hormone-secreting cells in the pituitary gland.

    Science.gov (United States)

    Baik, Jun Seung; Lee, Mi Hyun; Ahn, Kook-Jin; Choi, Hyun Seok; Jung, So Lyung; Kim, Bum-Soo; Jeun, Sin Soo; Hong, Yong-Kil

    2015-01-01

    To evaluate the correlation between the magnetic resonance imaging findings of functional pituitary adenomas and histological distribution of hormone-secreting cells in pituitary gland. Forty-nine patients with pathologically confirmed functional micro and macro pituitary adenomas were retrospectively reviewed for its location and growth direction. Micro-prolactin, micro-adrenocorticotropic hormone (ACTH), and micro-growth hormone (GH) producing adenomas showed specific location (P-value adenomas showed specific growth direction (P-value adenomas did not. The functional pituitary microadenomas' location and macroadenomas' growth pattern correlate well with histological distribution of hormone-secreting cells in pituitary gland. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Clinical Practice Patterns of Canadian Couple/Marital/Family Therapists

    Science.gov (United States)

    Beaton, John; Dienhart, Anna; Schmidt, Jonathan; Turner, Jean

    2009-01-01

    This clinical practice pattern survey had two unique aspects. It was a national survey of American Association for Marriage and Family Therapy (AAMFT) members in Canada that included all AAMFT membership categories, including student, affiliate, associate, clinical, and supervisor. It compared practice pattern data for clinical members from Canada…

  7. Maxillary alveolar ridge reconstruction with monocortical fresh-frozen bone blocks: a clinical, histological and histomorphometric study.

    Science.gov (United States)

    Acocella, Alessandro; Bertolai, Roberto; Ellis, Edward; Nissan, Joseph; Sacco, Roberto

    2012-09-01

    This investigation is a clinical and histological assessment of fresh-frozen bone use in the reconstruction of maxillary alveolar ridges. The study evaluates the effectiveness of this material as a bone filler prior the placement of dental implants. Sixteen patients with atrophic maxillary ridges underwent maxillary reconstruction with fresh-frozen tibial human block grafts prior to implant placement. Sampling procedures were carried out 4, 6 and 9 months later when a bone core was removed from the grafts for histological and histomorphometric analysis. Eighteen blocks were placed, and each patient received either 1 or 2 blocks. During the sampling procedures, all of the grafts were found to be firm in consistency, well-incorporated, and vascularized. A total of 34 implants were placed into the grafts with a minimum of 40-Newton-cm torque in all cases. The follow-up period ranged from 18 to 30 months. No implants were lost. The histological analysis revealed vital bone with mature and compact osseous tissue surrounded by marrow spaces. Bone allografts can be used successfully as graft material for the treatment of maxillary ridge defects. This type of bone graft can be used safely in the areas of implant placement as a suitable alternative to autogenous grafts. Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  8. Clinical and histologic effects of intracardiac administration of propofol for induction of anesthesia in ball pythons (Python regius).

    Science.gov (United States)

    McFadden, Michael S; Bennett, R Avery; Reavill, Drury R; Ragetly, Guillaume R; Clark-Price, Stuart C

    2011-09-15

    To assess the clinical differences between induction of anesthesia in ball pythons with intracardiac administration of propofol and induction with isoflurane in oxygen and to assess the histologic findings over time in hearts following intracardiac administration of propofol. Prospective randomized study. 30 hatchling ball pythons (Python regius). Anesthesia was induced with intracardiac administration of propofol (10 mg/kg [4.5 mg/lb]) in 18 ball pythons and with 5% isoflurane in oxygen in 12 ball pythons. Induction time, time of anesthesia, and recovery time were recorded. Hearts from snakes receiving intracardiac administration of propofol were evaluated histologically 3, 7, 14, 30, and 60 days following propofol administration. Induction time with intracardiac administration of propofol was significantly shorter than induction time with 5% isoflurane in oxygen. No significant differences were found in total anesthesia time. Recovery following intracardiac administration of propofol was significantly longer than recovery following induction of anesthesia with isoflurane in oxygen. Heart tissue evaluated histologically at 3, 7, and 14 days following intracardiac administration of propofol had mild inflammatory changes, and no histopathologic lesions were seen 30 and 60 days following propofol administration. Intracardiac injection of propofol in snakes is safe and provides a rapid induction of anesthesia but leads to prolonged recovery, compared with that following induction with isoflurane. Histopathologic lesions in heart tissues following intracardiac injection of propofol were mild and resolved after 14 days.

  9. Latent membrane protein 1 (LMP1) expression in Hodgkin lymphoma and its correlation with clinical and histologic parameters.

    Science.gov (United States)

    Hashmi, Atif Ali; Hussain, Zubaida Fida; Hashmi, Kashif Ali; Zafar, Muhammad Irfan; Edhi, Muhammad Muzzammil; Faridi, Naveen; Khan, Mehmood

    2017-04-20

    Hodgkin lymphoma is one of the most prevalent lymphoproliferative disorders in Pakistan; however, no risk factors for this disease have yet to be established in our population. Epstein-Barr virus (EBV) is a well-known risk factor for Hodgkin lymphoma in endemic regions of the world; however, frequency of its association in our population has not been widely studied. Latent membrane protein 1 (LMP1) expression by immunohistochemistry (IHC) is a surrogate marker of EBV in Hodgkin lymphoma. Therefore, we aimed to evaluate the frequency of expression of LMP1 in cases of Hodgkin lymphoma at our institute and its correlation with other clinical and histologic parameters. The study included 66 cases of Hodgkin lymphoma diagnosed at Liaquat National Hospital over a duration of 2 years from January 2014 to December 2015. The slides and blocks of all cases were retrieved, and representative blocks were selected for LMP1 by IHC. LMP1 expression of >10% of cells was considered as positive expression and correlated with histologic subtypes and clinical parameters like age, gender, and site of involvement. The mean age of patients was 35.11 (+20.22). LMP1 expression was found in 68.1% (45/66) of cases of Hodgkin lymphoma. Mean age of the patients with LMP1 expression was 32.04 (+21.02). LMP1 expression was found in 40% cases of lymphocyte-rich, 66.7% of lymphocyte-depleted, 73.9% of mixed cellularity, 66.7% of nodular sclerosis, and 73.7% of classic Hodgkin lymphoma, NOS. No significant correlation of LMP1 expression with any clinical or histological parameter could be established in our studied patient population. A high frequency of expression of LMP1 is seen in cases of Hodgkin lymphoma at our setup comparable to endemic regions of the world; therefore, preventive and treatment protocols should be designed accordingly.

  10. Histological and clinical evaluation of the hard palate mucous membrane graft for treatment of lower eyelid retraction

    DEFF Research Database (Denmark)

    Larsen, Sofie D H; Heegaard, Steffen; Toft, Peter B

    2017-01-01

    PURPOSE: To evaluate the histological appearances of the epithelial cells and the clinical effect of the hard palate mucous membrane (HPM) graft for the treatment of lower eyelid retraction (LER). METHODS: This was a follow-up study involving 15 patients, with a total of 16 eyes operated. Five...... diameter. RESULTS: Median follow-up time was 21.2 [range 4.5-87.9] months. Imprints from the graft and the hard palate showed equally large epithelial cells; imprints from conjunctiva showed small epithelial cells. The mean (±SD) scleral show was 0.12 ± 0.09 cornea diameter before surgery and 0.0003 ± 0...

  11. Diagnostic Workup and Treatment of a Rare Apocrine Hidrocystoma Affecting the Oral Mucosa: A Clinical and Histological Case Report

    Directory of Open Access Journals (Sweden)

    Pier Paolo Poli

    2017-01-01

    Full Text Available Apocrine hidrocystomas are rare benign cystic tumors originating from the secretory portion of apocrine sweat glands. To the best of our knowledge, there is no evidence currently available reporting the presence of apocrine hidrocystomas in the oral cavity. Therefore, this case report aims to describe the clinical and histological features of an apocrine hidrocystoma affecting the oral mucosa. A 69-year-old male patient presented with a 1-year history of a solitary, well-circumscribed, submucosal mass in the left posterior buccal mucosa. The clinical examination revealed a yellowish soft, fluctuant, and painless lesion with no clinical signs of erythema or ulcerations of the overlying epithelium. The entire lesion was excised and histopathological analysis confirmed the diagnosis of apocrine hidrocystoma. No recurrence was observed after a 1-year follow-up.

  12. Centrally necrotizing breast carcinoma: a rare histological subtype, which was cause of misdiagnosis in an evident clinical local recurrence

    Directory of Open Access Journals (Sweden)

    Hernanz Fernando

    2012-08-01

    Full Text Available Abstract Centrally necrotizing carcinoma is a rare subtype of breast carcinoma, which is characterized by an extensive central necrotic zone accounting for at least 70% of the cross-sectional area of the neoplasm. This central necrotic zone, in turn, is surrounded by a narrow rim of proliferative viable tumor cells. We report an unusual clinical situation in which a patient whose evident breast mass suggested an ipsilateral local recurrence and for which numerous attempts to confirm the histological diagnosis had failed. The patient was treated with a radical mastectomy based on clinical suspicion of breast cancer recurrence after an undesirable delay. In this case, the narrow rim of viable malignant tissue had a thickness of 0.5 to 8 mm, and the centrally necrotizing carcinoma had a central zone with a predominance of fibrosis. The special features of this case led to a misdiagnosis and to an evident clinical local recurrence.

  13. Patterns and clinical outcomes of lithium treatment

    NARCIS (Netherlands)

    Wilting, I.

    2008-01-01

    Patterns and consequences of lithium use’. In chapter 2.1 we studied lithium use patterns in out-patients within the last decade. In line with the increase in alternatives and the Dutch guidelines, we observed an increase in use of atypical antipsychotics and valproic acid and a decrease in use

  14. Identifying clinical course patterns in SMS data using cluster analysis

    OpenAIRE

    Kent Peter; Kongsted Alice

    2012-01-01

    Abstract Background Recently, there has been interest in using the short message service (SMS or text messaging), to gather frequent information on the clinical course of individual patients. One possible role for identifying clinical course patterns is to assist in exploring clinically important subgroups in the outcomes of research studies. Two previous studies have investigated detailed clinical course patterns in SMS data obtained from people seeking care for low back pain. One used a vis...

  15. [Assessment of the correlation between histological degeneration and radiological and clinical parameters in a series of patients who underwent lumbar disc herniation surgery].

    Science.gov (United States)

    Munarriz, Pablo M; Paredes, Igor; Alén, José F; Castaño-Leon, Ana M; Cepeda, Santiago; Hernandez-Lain, Aurelio; Lagares, Alfonso

    2017-09-26

    The use of histological degeneration scores in surgically-treated herniated lumbar discs is not common in clinical practice and its use has been primarily restricted to research. The objective of this study is to evaluate if there is an association between a higher grade of histological degeneration when compared with clinical or radiological parameters. Retrospective consecutive analysis of 122 patients who underwent single-segment lumbar disc herniation surgery. Clinical information was available on all patients, while the histological study and preoperative magnetic resonance imaging were also retrieved for 75 patients. Clinical variables included age, duration of symptoms, neurological deficits, or affected deep tendon reflex. The preoperative magnetic resonance imaging was evaluated using Modic and Pfirrmann scores for the affected segment by 2 independent observers. Histological degeneration was evaluated using Weiler's score; the presence of inflammatory infiltrates and neovascularization, not included in the score, were also studied. Correlation and chi-square tests were used to assess the association between histological variables and clinical or radiological variables. Interobserver agreement was also evaluated for the MRI variables using weighted kappa. No statistically significant correlation was found between histological variables (histological degeneration score, inflammatory infiltrates or neovascularization) and clinical or radiological variables. Interobserver agreement for radiological scores resulted in a kappa of 0.79 for the Pfirrmann scale and 0.65 for the Modic scale, both statistically significant. In our series of patients, we could not demonstrate any correlation between the degree of histological degeneration or the presence of inflammatory infiltrates when compared with radiological degeneration scales or clinical variables such as the patient's age or duration of symptoms. Copyright © 2017 Sociedad Española de Neurocirug

  16. The spectrum of bone disease in 200 chronic hemodialysis patients: a correlation between clinical, biochemical and histological findings

    Directory of Open Access Journals (Sweden)

    Maria Eugênia Leite Duarte

    Full Text Available INTRODUCTION: Renal osteodystrophy includes the complete range of mineral metabolism disorders that affect the skeleton in patients with chronic renal failure. PATIENTS AND METHODS: 200 patients with end-stage renal disease and on dialysis were investigated regarding the clinical, biochemical and histological findings of bone disease. RESULTS: The spectrum of renal osteodystrophy consisted mainly of high turnover bone lesions (74.5%, including osteitis fibrosa in 57.5%. Patients with mild bone disease were on dialysis for shorter periods of time and were mostly asymptomatic. Patients with aluminum-related bone disease (16.5% had the greatest aluminum exposure, either orally or parenterally, and together with patients with high turnover mixed disease, were the most symptomatic. Although on a non-regular basis, the vast majority of the patients (82.5% had been receiving vitamin D. The incidence of adynamic bone disease was high (n=8 among parathyroidectomized patients (n=12. Significantly higher serum levels of alkaline phosphatase were observed in osteitis fibrosa. CONCLUSIONS: The use of calcitriol and phosphate-binding agents on a non-regular basis seems to be the reason for the apparent reduced response to the treatment of secondary hyperparathyroidism. Alkaline phosphatase has been shown to be a fair marker for bone turnover in patients with osteitis fibrosa. The severity of the clinical manifestations of bone disease correlates with the histological features of bone lesion and to the time spent on dialysis.

  17. Relationship between Histological and Clinical Course of Psoriasis: A Pilot Investigation by Reflectance Confocal Microscopy during Goeckerman Treatment.

    Science.gov (United States)

    Archid, Rami; Duerr, Hans Peter; Patzelt, Alexa; Philipp, Sandra; Röwert-Huber, Hans-Joachim; Ulrich, Martina; Meinke, Martina Claudia; Knorr, Fanny; Lademann, Jürgen

    2016-01-01

    Alterations of the skin microvasculature are known to play an important role in the development and maintenance of psoriatic skin lesions. In this study, we investigated lesional skin in 11 psoriatic patients during a modified Goeckerman treatment using reflectance confocal microscopy (RCM) to study the relationship between clinical clearance and histological normalization of psoriatic skin and the significance of histological abnormalities on the course of disease. The treatment regimen resulted in a significant reduction of the Psoriasis Area and Severity Index (PASI) as well as capillary and papillary diameters (p < 0.0001). The capillary and papillary diameters were still enlarged when compared to those in normal skin (p < 0.001). Capillary and papillary diameters correlated with each other prior to and after treatment (correlation coefficient = 0.63 and 0.64, p = 0.01 and 0.002, respectively) but not with the PASI. Capillary and papillary diameters after treatment and percentage reduction of the PASI during treatment seemed to be better predictors for the clinical course of relapse than the PASI after treatment. These findings make the subclinical changes of psoriatic skin vessels and dermal papillae a legitimate target for treatment. Further investigations of a large group of patients are needed to evaluate the potential of RCM findings as successor of the PASI in the monitoring of psoriasis. © 2016 S. Karger AG, Basel.

  18. Abuja :1 an Analysis of Clinical Patterns and Neonatal

    African Journals Online (AJOL)

    National Hospital, Abuja: an Analysis of Clinical Patterns and Neonatal Outcome. Nige- rianjcurnalof Paedzarrio 2004;31:131. Background: Neural tube defect is the most common congenital abnormality of the central nervous system. Objectives: To document the clinical patterns and neonatal outcome of babies with open ...

  19. Clinical and histological characterization of hair coat and glandular tissue of Chinese crested dogs.

    Science.gov (United States)

    Wiener, Dominique J; Gurtner, Corinne; Panakova, Lucia; Mausberg, Theresa-Bernadette; Müller, Eliane J; Drögemüller, Cord; Leeb, Tosso; Welle, Monika M

    2013-04-01

    Two varieties exist in the Chinese crested dog breed, namely hairless Chinese crested dogs presenting with hypotrichosis and dentition abnormalities, and the coated powderpuffs. Hairless Chinese crested dogs are obligate heterozygotes for a FOXI3 mutation, and this phenotype is classified as a form of canine ectodermal dysplasia. We provide a detailed histological description of hair follicles and their density for the three subphenotypes (true hairless, semi-coated and powderpuffs) of Chinese crested dogs. Apocrine and exocrine glands of the skin and other tissues were compared with findings reported from dogs with X-linked ectodermal dysplasia. Skin biopsies were collected from 22 Chinese crested dogs. Additionally, the glands of the skin and other tissues were examined from another two dogs available for postmortem examination. Skin biopsies and tissues were processed, stained and evaluated in a blinded fashion. Hair follicular anomalies decreased with increasing number of hairs in the different phenotypes. The FOXI3 mutants had only simple primary hair follicles, whereas the nonmutant powderpuffs had compound follicles identical to other dog breeds. All Chinese crested dogs had an anagen-dominated hair cycle. Furthermore, apocrine glands in the skin and respiratory mucous glands of the mutant Chinese crested dogs were present and normal. We have identified striking histopathological differences between the three subphenotypes of Chinese crested dogs. We clearly demonstrated distinct differences between the canine ectodermal dysplasia in Chinese crested dogs and dogs with X-linked ectodermal dysplasia. © 2013 The Authors. Veterinary Dermatology © 2013 ESVD and ACVD.

  20. Mucocele-like lesions of the breast: a clinical outcome and histologic analysis of 102 cases.

    Science.gov (United States)

    Meares, Annie L; Frank, Ryan D; Degnim, Amy C; Vierkant, Robert A; Frost, Marlene H; Hartmann, Lynn C; Winham, Stacey J; Visscher, Daniel W

    2016-03-01

    Mucocele-like lesions (MLLs) of the breast are characterized by cystic architecture with stromal mucin and frequent atypia, but it is unknown whether they convey long-term breast cancer risk. We evaluated 102 MLLs that were derived from a single-institution benign breast disease cohort of 13412 women who underwent biopsy from 1967 to 2001. MLLs were histologically characterized by type of lining epithelium, architecture of the lesion, associated atypical hyperplasia (AH), and incidence of breast cancer (14.8-year median follow-up). A relatively large proportion of MLLs (42%) were diagnosed in women older than 55 years. AH was significantly more frequent in MLL patient compared to the cohort overall (27% versus 5%; P Breast cancer has developed in 13 patients with MLL. This frequency is only slightly higher than population expected rates overall (standardized incidence ratio, 2.28; 95% confidence interval, 1.21-3.91) and not significantly different from women in the cohort with (nonatypical) proliferative breast lesions. Younger women (breast lesion that is often associated with coexisting AH. However, in women older than 45 years, MLLs do not convey additional risk of breast cancer beyond that associated with the presence of proliferative disease. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Changes of 2015 WHO Histological Classification of Lung Cancer 
and the Clinical Significance

    Directory of Open Access Journals (Sweden)

    Xin YANG

    2016-06-01

    Full Text Available Due in part to remarkable advances over the past decade in our understanding of lung cancer, particularly in area of medical oncology, molecular biology, and radiology, there is a pressing need for a revised classification, based not on pathology alone, but rather on an integrated multidisciplinary approach to classification of lung cancer. The 2015 World Health Organization (WHO Classification of Tumors of the Lung, Pleura, Thymus and Heart has just been published with numerous important changes from the 2004 WHO classification. The revised classification has been greatly improved in helping advance the field, increasing the impact of research, improving patient care and assisting in predicting outcome. The most significant changes will be summarized in this paper as follows: (1 main changes of lung adenocarcinoma as proposed by the 2011 International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS classification, (2 reclassifying squamous cell carcinomas into keratinizing, nonkeratinizing, and basaloid subtypes with the nonkeratinizing tumors requiring immunohistochemistry proof of squamous differentiation, (3 restricting the diagnosis of large cell carcinoma only to resected tumors that lack any clear morphologic or immunohistochemical differentiation with reclassification of the remaining former large cell carcinoma subtypes into different categories, (4 grouping of neuroendocrine tumors together in one category, (5 and the current viewpoint of histologic grading of lung cancer.

  2. The components of somatostatin and ghrelin systems are altered in neuroendocrine lung carcinoids and associated to clinical-histological features.

    Science.gov (United States)

    Herrera-Martínez, Aura D; Gahete, Manuel D; Sánchez-Sánchez, Rafael; Salas, Rosa Ortega; Serrano-Blanch, Raquel; Salvatierra, Ángel; Hofland, Leo J; Luque, Raúl M; Gálvez-Moreno, María A; Castaño, Justo P

    2017-07-01

    Lung carcinoids (LCs) are rare tumors that comprise 1-5% of lung malignancies but represent 20-30% of neuroendocrine tumors. Their incidence is progressively increasing and a better characterization of these tumors is required. Alterations in somatostatin (SST)/cortistatin (CORT) and ghrelin systems have been associated to development/progression of various endocrine-related cancers, wherein they may become useful diagnostic, prognostic and therapeutic biomarkers. We aimed to evaluate the expression levels of ghrelin and SST/CORT system components in LCs, as well as to explore their putative relationship with histological/clinical characteristics. An observational retrospective study was performed; 75 LC patients with clinical/histological characteristics were included. Samples from 46 patients were processed to isolate mRNA from tumor and adjacent non-tumor region, and the expression levels of SST/CORT and ghrelin systems components, determined by quantitative-PCR, were compared to those of 7 normal lung tissues. Patient cohort was characterized by mean age 53±15 years, 48% males, 34% with tobacco exposure; 71.4/28.6% typical/atypical carcinoids, 21.7% incidental tumors, 4.3% functioning tumors, 17.7% with metastasis. SST/CORT and ghrelin system components were expressed at variable levels in a high proportion of tumors, as well as in adjacent non-tumor tissues, while a lower proportion of normal lung samples also expressed these molecules. A gradation was observed from normal non-neoplastic lung tissues, non-tumor adjacent tissue and LCs, being SST, sst4, sst5, GHS-R1a and GHS-R1b overexpressed in tumor tissue compared to normal tissue. Importantly, several SST/CORT and ghrelin system components displayed significant correlations with relevant clinical parameters, such as necrosis, peritumoral and vascular invasion, or metastasis. Altogether, these data reveal a prominent, widespread expression of key SST/CORT/ghrelin system components in LCs, where they display

  3. Clinical, radiographic, and histological observation of a human immature permanent tooth with chronic apical abscess after revitalization treatment.

    Science.gov (United States)

    Shimizu, Emi; Ricucci, Domenico; Albert, Jeffrey; Alobaid, Adel S; Gibbs, Jennifer L; Huang, George T-J; Lin, Louis M

    2013-08-01

    Revitalization procedures have been widely used for the treatment of immature permanent teeth with apical periodontitis. The treatment procedures appear to be capable of encouraging continued root development and thickening of the canal walls. The nature of tissues formed in the canal space and at the root apex after revitalization has been shown histologically in several animal studies; similar studies in humans were recently reported. A 9-year-old boy had a traumatic injury to his upper anterior teeth. Tooth #9 suffered a complicated crown fracture with a pulp exposure, which was restored with a composite resin. The tooth developed a chronic apical abscess. Revitalization procedures were performed on tooth #9 because it was an immature permanent tooth with an open apex and thin canal walls. Twenty-six months after revitalization, the tooth had a horizontal crown fracture at the cervical level and could not be restored. The tooth was extracted and processed for routine histological and immunohistochemical examination to identify the nature of tissues formed in the canal space. Clinically and radiographically, the revitalization of the present case was successful because of the absence of signs and symptoms and the resolution of periapical lesion as well as thickening of the canal walls and continued root development. The tissue formed in the canal was well-mineralized cementum- or bone-like tissue identified by routine histology and immunohistochemistry. No pulp-like tissue characterized by the presence of polarized odontoblast-like cells aligning dentin-like hard tissue was observed. The tissues formed in the canal of revitalized human tooth are similar to cementum- or bone-like tissue and fibrous connective tissue. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  4. [Frequency and clinical, biochemical and histological characteristics of nonalcoholic fatty liver disease in patients with gallstone disease].

    Science.gov (United States)

    Roesch-Dietlen, Federico; Pérez-Morales, Alfonso; Melo-Santisteban, Guadalupe; Díaz-Blanco, Fernando; Martínez-Fernández, Silvia; Martínez, José Angel; Cid-Juárez, Silvia

    2008-01-01

    In 1980, nonalcoholic fatty liver disease (NALFD) was described. It is related to the genesis of gallstones and is considered as a manifestation of the metabolic syndrome. In order to determine the frequency, anatomoclinical characteristics and biochemical and histological alterations in NAFLD, patients underwent cholecystectomy (GD). For this reason, we considered carrying out this study. This was a prospective and observational study. The study population was comprised of patients with gallstone disease who were treated at the "Hospital Español" in Veracruz, Mexico from January 1, 2005 to November 30, 2006 and underwent cholecystectomy and liver biopsy. Analyzed variables were anthropometric characteristics and risk factors, and in each patient biochemical tests, abdominal ultrasound (US) and histological liver study were performed. In 95 patients, according to liver biopsy diagnoses, we found a frequency of 54.74% of NAFLD associated with gallstones. Females were more affected (71.15%) and the average age was 55.6 +/- 17.87 years. Risk factors were obesity (67.3%), diabetes mellitus (17.3%), and dyslipidemia (76.92%). Patients with NAFLD had elevated levels of glucose, glycosylated hemoglobin, cholesterol, triglycerides and HDLcholesterol, and aminotransferases. Abdominal US did not show sufficient specificity and sensitivity to detect NAFLD. Histological findings showed stage I steatosis in 51.93%, stage II in 28.84% and stage III in 19.23%. Cirrhosis was found in 3.15%. Results of our study confirm the high frequency of NAFLD in association with gallstone disease. We consider this the first work to analyze and describe the primary clinical, biochemical and morphological characteristics.

  5. Histological, Immunohistological, and Clinical Features of Merkel Cell Carcinoma in Correlation to Merkel Cell Polyomavirus Status

    Directory of Open Access Journals (Sweden)

    T. Jaeger

    2012-01-01

    Full Text Available Merkel cell carcinoma is a rare, but highly malignant tumor of the skin with high rates of metastasis and poor survival. Its incidence rate rises and is currently about 0.6/100000/year. Clinical differential diagnoses include basal cell carcinoma, cyst, amelanotic melanoma, lymphoma and atypical fibroxanthoma. In this review article clinical, histopathological and immunhistochemical features of Merkel cell carcinoma are reported. In addition, the role of Merkel cell polyomavirus is discussed.

  6. Correlation of clinical, cytological and histological findings in oral squamous cell carcinomas

    OpenAIRE

    SOUSA, MICHELE CARDOSO; ALVES, MONICA GHISLAINE OLIVEIRA; SOUZA, LUCIANO ALBINO; BRANDÃO, ADRIANA AIGOTTI HABERBECK; ALMEIDA, JANETE DIAS; CABRAL, LUIZ ANTONIO GUIMARÃES

    2014-01-01

    The present study aimed to investigate the efficiency of exfoliative cytology by correlating the clinical lesions of oral squamous cell carcinoma (OSCC) with exfoliative cytology and histopathological findings. Cases of OSCC diagnosed between 1984 and 2010 were analyzed. The inclusion criteria for the present study were the availability of detailed clinical findings and a diagnosis of the disease through exfoliative cytology and histopathology. The cases were assessed and assigned scores, whi...

  7. Clinical and histological characteristics of melanocytic nevus in external auditory canals and auricles.

    Science.gov (United States)

    Lim, Hye Jin; Kim, Yun Tae; Choo, Oak-Sung; Park, Keehyun; Park, Hun Yi; Choung, Yun-Hoon

    2013-11-01

    Nevi, which consist of nevus cells arising from external auditory canals (EACs) and auricles, are rare and their characteristics are not thoroughly understood. The purpose of this study was to analyze the clinicopathological characteristics of melanocytic nevus (MN) in EACs and auricles. Medical records were reviewed in 35 cases with junctional, compound and intradermal nevi treated in Ajou University Hospital, Korea between 2001 and 2011. Patient demographic, location, shape, and diameter of nevi, and pathologic results were analyzed according to the location, EACs (23 cases) and auricles (12 cases). Female predominance was noted in both EAC (60.9 %, 14 cases) and auricular (75 %, 9 cases) nevi. The mean age of EAC nevi (37.1 years) was younger than that of auricular nevi (42.2 years). The chief complaint was a symptomless mass in both groups, mostly in dome-like gross appearances. The mean diameter of EAC and auricular nevi was 9.6 (3-16) mm and 12.2 (3-25) mm, respectively. Histological findings chiefly presented intradermal nevi in EACs (78.3 %) and auricles (83.3 %) which showed preference to older patients, in contrast to the compound type. All nevi including five cases with skin grafts were completely excised without any recurrence within the follow-up period (average 5.3 months). A possible dysplastic nevus was detected in only one case. All MNs in EACs or auricles reveal similar characteristics. Early and complete excision is recommended to avoid skin graft, functional problems, and the risk of malignant melanoma.

  8. Primary cutaneous lymphomas: A clinical and histological study of 99 cases in Isfahan, Iran

    Directory of Open Access Journals (Sweden)

    Farahnaz Fatemi Naeini

    2015-01-01

    Full Text Available Background: Primary cutaneous lymphomas (PCLs represent a heterogeneous group of T- and B-cell lymphomas that present in the skin with no evidence of extracutaneous disease at the time of diagnosis. The aim of this study was to assess and report the epidemiological characteristics of PCLs in Isfahan, Isfahan Province, Iran - as a main province of Iran. Materials and Methods: A total of 99 patients were recruited over a recent 10-year period (2003-2013 with diagnosis of PCLs; the patients were classified according to the The World Health Organization/European Organization for Research and Treatment of Cancer (WHO-EORTC criteria. Mean and standard deviations (SDs were used to describe continuous data, numbers, and percentages for categorical data. Statistical significance was defined as P < 0.05. Results: The patients comprised 45 men and 54 women aged 5-80 years (median 36 at diagnosis. The male-to-female ratio was 1:1.2. Histological examination showed features of primary cutaneous B-cell lymphomas (PCBCLs in four cases. The mean ± SD age in primary cutaneous T-cell lymphomas (PCTCLs and PCBCLs was 37.9 ± 16.5 years and 39.7 ± 9.1 years, respectively (P = 0.72. The mean ± SD latent period between the time of diagnosis and initiation of skin lesions in men and women was 2.3 ± 4.1 years and 5.9 ± 10.1 years, respectively (P = 0.02. The most frequent subtypes were mycosis fungoides (MFs (86.9% followed by Sιzary syndrome (SS (4%. Five patients died from PCL-related deaths. Conclusion: The distinguishing epidemiologic characteristics of PCL in Iran are the absence of a male predominance and a lower age of diagnosis. The study highlights the ethnic or regional variations in the clinicoepidemiological characteristics of PCLs.

  9. Left ventricular hypertrophy, geometric patterns and clinical ...

    African Journals Online (AJOL)

    Background: Left ventricular hypertrophy can be due to various reasons including hypertension. It constitutes an increased cardiovascular risk. Various left ventricular geometric patterns occur in hypertension and may affect the cardiovascular risk profile of hypertensive subjects. Methods: One hundred and eighty eight ...

  10. Clinical significance of histological features of thrombi in patients with myocardial infarction.

    Science.gov (United States)

    Sebben, Juliana Canedo; Cambruzzi, Eduardo; Avena, Luisa Martins; Gazeta, Cristina do Amaral; Gottschall, Carlos Antonio Mascia; Quadros, Alexandre Schaan de

    2013-12-01

    Percutaneous Coronary Intervention (PCI) is the most common strategy for the treatment of Acute ST segment elevation Myocardia Infarction (STEMI), and thromboaspiration has been increasingly utilized for removal of occlusive thrombi. To analyze the influence of histopathological features of coronary thrombi in clinical outcomes of patients with STEMI, and the association of these variables with clinical, angiographic, and laboratory features and medications used in hospitalization. Prospective cohort study. All patients were monitored during hospitalization and thirty days after the event. Aspirated thrombi were preserved in formalin and subsequently stained with hematoxylin-eosin and embedded in paraffin. Thrombi were classified as recent and old. The primary outcome was the occurrence of major cardiovascular events within thirty days. During the study period, 1,149 patients were evaluated with STEMI, and 331 patients underwent thrombi aspiration, leaving 199 patients available for analysis. It was identified recent thrombi in 116 patients (58%) and old thrombi in 83 patients (42%). Recent thrombi have greater infiltration of red blood cells than old thrombi (p = 0.02), but there were no statistically significant differences between other clinical, angiographic, laboratory, and histopathological features and medications in both group of patients. The rates of clinical outcomes were similar in both groups. Recent thrombi were identified in 58% of patients with STEMI and it was observed an association with infiltration of red blood cells. There was no association between histopathological features of thrombi and clinical variables and cardiovascular outcomes.

  11. Clinical Significance of Histological Features of Thrombi in Patients with Myocardial Infarction

    Science.gov (United States)

    Sebben, Juliana Canedo; Cambruzzi, Eduardo; Avena, Luisa Martins; Gazeta, Cristina do Amaral; Gottschall, Carlos Antonio Mascia; de Quadros, Alexandre Schaan

    2013-01-01

    Background Percutaneous Coronary Intervention (PCI) is the most common strategy for the treatment of Acute ST segment elevation Myocardial Infarction (STEMI), and thromboaspiration has been increasingly utilized for removal of occlusive thrombi. Objectives To analyze the influence of histopathological features of coronary thrombi in clinical outcomes of patients with STEMI, and the association of these variables with clinical, angiographic, and laboratory features and medications used in hospitalization. Methods Prospective cohort study. All patients were monitored during hospitalization and thirty days after the event. Aspirated thrombi were preserved in formalin and subsequently stained with hematoxylin-eosin and embedded in paraffin. Thrombi were classified as recent and old. The primary outcome was the occurrence of major cardiovascular events within thirty days. Results During the study period, 1,149 patients were evaluated with STEMI, and 331 patients underwent thrombi aspiration, leaving 199 patients available for analysis. It was identified recent thrombi in 116 patients (58%) and old thrombi in 83 patients (42%). Recent thrombi have greater infiltration of red blood cells than old thrombi (p = 0.02), but there were no statistically significant differences between other clinical, angiographic, laboratory, and histopathological features and medications in both group of patients. The rates of clinical outcomes were similar in both groups. Conclusions Recent thrombi were identified in 58% of patients with STEMI and it was observed an association with infiltration of red blood cells. There was no association between histopathological features of thrombi and clinical variables and cardiovascular outcomes. PMID:24162472

  12. Clinical Significance of Histological Features of Thrombi in Patients with Myocardial Infarction

    Energy Technology Data Exchange (ETDEWEB)

    Sebben, Juliana Canedo; Cambruzzi, Eduardo; Avena, Luisa Martins; Gazeta, Cristina do Amaral; Gottschall, Carlos Antonio Mascia; Quadros, Alexandre Schaan de, E-mail: quadros.pesquisa@gmail.com [Instituto de Cardiologia / Fundação Universitária de Cardiologia - IC/FUC, Porto Alegre, RS (Brazil)

    2013-12-15

    Percutaneous Coronary Intervention (PCI) is the most common strategy for the treatment of Acute ST segment elevation Myocardial Infarction (STEMI), and thromboaspiration has been increasingly utilized for removal of occlusive thrombi. To analyze the influence of histopathological features of coronary thrombi in clinical outcomes of patients with STEMI, and the association of these variables with clinical, angiographic, and laboratory features and medications used in hospitalization. Prospective cohort study. All patients were monitored during hospitalization and thirty days after the event. Aspirated thrombi were preserved in formalin and subsequently stained with hematoxylin-eosin and embedded in paraffin. Thrombi were classified as recent and old. The primary outcome was the occurrence of major cardiovascular events within thirty days. During the study period, 1,149 patients were evaluated with STEMI, and 331 patients underwent thrombi aspiration, leaving 199 patients available for analysis. It was identified recent thrombi in 116 patients (58%) and old thrombi in 83 patients (42%). Recent thrombi have greater infiltration of red blood cells than old thrombi (p = 0.02), but there were no statistically significant differences between other clinical, angiographic, laboratory, and histopathological features and medications in both group of patients. The rates of clinical outcomes were similar in both groups. Recent thrombi were identified in 58% of patients with STEMI and it was observed an association with infiltration of red blood cells. There was no association between histopathological features of thrombi and clinical variables and cardiovascular outcomes.

  13. Platelet Rich Fibrin (P.R.F.) in reconstructive surgery of atrophied maxillary bones: clinical and histological evaluations.

    Science.gov (United States)

    Tatullo, Marco; Marrelli, Massimo; Cassetta, Michele; Pacifici, Andrea; Stefanelli, Luigi Vito; Scacco, Salvatore; Dipalma, Gianna; Pacifici, Luciano; Inchingolo, Francesco

    2012-01-01

    Maxillary bone losses often require additional regenerative procedures: as a supplement to the procedures of tissue regeneration, a platelet concentrate called PRF (Platelet Rich Fibrin) was tested for the first time in France by Dr. Choukroun. Aim of the present study is to investigate, clinically and histologically, the potential use of PRF, associated with deproteinized bovine bone (Bio-Oss), as grafting materials in pre-implantology sinus grafting of severe maxillary atrophy, in comparison with a control group, in which only deproteinized bovine bone (Bio-Oss) was used as reconstructive material. 60 patients were recruited using the cluster-sampling method; inclusion criteria were maxillary atrophy with residual ridge bone. The reopening of the surgical area was scheduled at 3 different times. 72 sinus lifts were performed with subsequent implants insertions.We want to underline how the histological results proved that the samples collected after 106 days (Early protocol) with the adding of PRF were constituted by lamellar bone tissue with an interposed stroma that appeared relaxed and richly vascularized. The use of PRF and piezosurgery reduced the healing time, compared to the 150 days described in literature, favoring optimal bone regeneration. At 106 days, it is already possible to achieve good primary stability of endosseous implants, though lacking of functional loading.

  14. Use of subepithelial connective tissue graft as a biological barrier: a human clinical and histologic case report.

    Science.gov (United States)

    Santagata, Mario; Guariniello, Luigi; Prisco, Rosario V E; Tartaro, Gianpaolo; D'Amato, Salvatore

    2014-08-01

    The aim of the present study was to develop a method to study the healing process after gingival grafting and to observe the histologic results after use of the modified edentulous ridge expansion technique. A 47-year-old nonsmoking woman with a noncontributory past medical history affected by edentulism associated with a horizontal alveolar ridge defect was referred to the authors for surgical correction of the deficit to improve implant support and the final esthetics of an implant-borne prosthesis. At the 4-month follow-up visit, a biopsy was performed by a punch technique in the same sites of healing abutment connection. The tissue was elevated from the attached gingival. Clinically, the grafted tissues seemed to be attached to the bone surfaces. The histologic findings revealed dense grafted tissues, providing long-term stability to the area. No ligament or bone, characteristic for periodontal regeneration, were observed. The presence of thick attached keratinized tissue around implants may constitute a protective factor against marginal inflammation or trauma.

  15. Inflammatory bowel disease activity assessed by fecal calprotectin and lactoferrin: correlation with laboratory parameters, clinical, endoscopic and histological indexes

    Directory of Open Access Journals (Sweden)

    Rossini Lucio

    2009-10-01

    Full Text Available Abstract Background Research has shown that fecal biomarkers are useful to assess the activity of inflammatory bowel disease (IBD. The aim of the study is: to evaluate the efficacy of the fecal lactoferrin and calprotectin as indicators of inflammatory activity. Findings A total of 78 patients presenting inflammatory bowel disease were evaluated. Blood tests, the Crohn's Disease Activity Index (CDAI, Mayo Disease Activity Index (MDAI, and Crohn's Disease Endoscopic Index of Severity (CDEIS were used for the clinical and endoscopic evaluation. Two tests were performed on the fecal samples, to check the levels of calprotectin and lactoferrin. The performance of these fecal markers for detection of inflammation with reference to endoscopic and histological inflammatory activity was assessed and calculated sensitivity, specificity, accuracy. A total of 52 patient's samples whose histological evaluations showed inflammation, 49 were lactoferrin-positive, and 40 were calprotectin-positive (p = 0.000. Lactoferrin and calprotectin findings correlated with C-reactive protein in both the CD and UC groups (p = 0.006; p = 0.000, with CDAI values (p = 0.043; 0.010, CDEIS values in DC cases (p = 0,000; 0.000, and with MDAI values in UC cases (p = 0.000. Conclusion Fecal lactoferrin and calprotectin are highly sensitive and specific markers for detecting intestinal inflammation. Levels of fecal calprotectin have a proportional correlation to the degree of inflammation of the intestinal mucosa.

  16. Changing prevalence patterns in endoscopic and histological diagnosis of gastritis? Data from a cross-sectional Central European multicentre study.

    Science.gov (United States)

    Wolf, Eva-Maria; Plieschnegger, Wolfgang; Geppert, Michael; Wigginghaus, Bernd; Höss, Gabriele M; Eherer, Andreas; Schneider, Nora I; Hauer, Almuthe; Rehak, Peter; Vieth, Michael; Langner, Cord

    2014-05-01

    Traditionally, Helicobacter infection is considered to be the most common cause of gastritis. In the cross-sectional Central European histoGERD trial, we assessed the prevalence of different types of gastritis, correlating histological and endoscopic diagnoses. A total of 1123 individuals participated in an observational multicentre study. Endoscopists classified individuals as positive or negative for gastritis and rendered the putative cause. Pathologists evaluated biopsy specimens based upon the Updated Sydney System. Histological diagnosis of gastritis was made in 639 (56.9%) participants. In all, 210 (18.7%) individuals were diagnosed with Helicobacter gastritis, 215 (19.1%) with post Helicobacter gastritis, 234 (20.8%) with reactive gastropathy, 26 (2.3%) with autoimmune gastritis, and 6 (0.5%) with focally enhanced gastritis related to Crohn's disease. In 46 out of 639 (7.2%) individuals diagnosed with gastritis, combinations of different histological subtypes were noted the most common being reactive gastropathy and post Helicobacter gastritis. Endoscopic diagnosis of gastritis was made in 534 (47.6%) individuals. Reactive gastropathy was more common than active Helicobacter gastritis, and the majority of cases attributable to Helicobacter infection were no longer ongoing, i.e. post Helicobacter gastritis. Agreement between histological and endoscopic diagnoses was better in reactive gastropathy than in Helicobacter gastritis. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  17. Quantified analysis of histological components and architectural patterns of gleason grades in apparent diffusion coefficient restricted areas upon diffusion weighted MRI for peripheral or transition zone cancer locations.

    Science.gov (United States)

    Helfrich, Olivier; Puech, Philippe; Betrouni, Nacim; Pinçon, Claire; Ouzzane, Adil; Rizk, Jérome; Marcq, Gauthier; Randazzo, Marco; Durand, Matthieu; Lakroum, Said; Leroy, Xavier; Villers, Arnauld

    2017-12-01

    To quantify and compare the histological components and architectural patterns of Gleason grades in cancerous areas with restriction on apparent diffusion coefficient (ADC) maps. Twelve consecutive cases with 14 separate ADC restriction areas, positive for cancer in the peripheral zone (PZ) and transition zone (TZ) were included. All had 3 Tesla MRI and radical prostatectomy. Ten regions of interest (ROIs) within and outside the 14 ADC restriction areas positive for cancer were selected. For each ROI, we performed quantitative analysis of (a) prostate benign and malignant histological component surface ratios, including stroma, glands, epithelium, lumen, cellular nuclei; (b) percent of Gleason grades and measures of ADC values. Means of histological components according to ADC restriction for cancerous area were compared with analyses of variance with repeated measures. Independent predictors of the probability of cancer were median epithelium/ROI ratio (P = 0.001) and nuclei/ROI ratio (P = 0.03). Independent predictors of the probability of ADC restriction were malignant glands/ROI and luminal space/ROI (P histological components for the comparison of true positive and false negative (P Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2017;46:1786-1796. © 2017 International Society for Magnetic Resonance in Medicine.

  18. Breast Lumps: A 21‑Year Single‑Center Clinical and Histological ...

    African Journals Online (AJOL)

    Patients complaining of breast disorders form a large proportion of outpatients in general surgical clinics. The presence of a lump in the breast is a great cause of anxiety and apprehension in females, young and old. Public awareness of breast cancer has contributed largely to this, and the consequence is a steady flow.

  19. Pseudoxanthoma elasticum: clinical, histologic, and genetic studies--a report of two sisters

    NARCIS (Netherlands)

    Kaimbo, Dieudonne Kaimbo Wa; Mutosh, Anne; Leys, Anita; Parys-van Ginderdeuren, Rita; Bergen, A. A. B.

    2011-01-01

    CASE 1: A 24-year-old black woman was referred to our clinic in September 1999 by the department of dermatology. She was referred to confirm the diagnosis of pseudoxanthoma elasticum (PXE). Her medical history was normal. Dermatologic examination revealed confluent papules that gave the skin a

  20. Clinical Features and Pattern of Presentation of Breast Diseases in ...

    African Journals Online (AJOL)

    of breast diseases. This is a prospective study of the clinical features and pattern of presentation of breast diseases in surgical outpatient clinic of our hospital. .... and four patients with clinical diagnosis of breast cancer. Table 1: Presenting breast complaints in 121 patients. Complaints. Frequency. Percentage. Lump. 111.

  1. Clinical, radiographic, biochemical and histological findings of florid cemento-osseous dysplasia and report of a case.

    Science.gov (United States)

    Gonçalves, Marcelo; Píspico, Ronaldo; Alves, Fábio de Abreu; Lugão, Carlos Eduardo B; Gonçalves, Andréa

    2005-01-01

    Florid cemento-osseous dysplasia has been described as a condition that characteristically affects the jaws of middle-aged black women. It usually manifests as multiple radiopaque cementum-like masses distributed throughout the jaws. This condition has also been classified as gigantiform cementoma, chronic sclerosing osteomyelitis, sclerosing osteitis, multiple estenosis and sclerotic cemental masses. The authors present a case of an uncomplicated florid cemento-osseous dysplasia in a 48-year-old black woman. Multiple sclerotic masses with radiolucent border in the mandible were identified radiographically. Histopathologic findings revealed formation of calcified dense sclerotic masses similar to cementum. All clinical, radiographic, biochemical and histological features were suggestive of the diagnosis of florid cemento-osseous dysplasia.

  2. Correlation of clinical, cytological and histological findings in oral squamous cell carcinomas.

    Science.gov (United States)

    Sousa, Michele Cardoso; Alves, Monica Ghislaine Oliveira; Souza, Luciano Albino; Brandão, Adriana Aigotti Haberbeck; Almeida, Janete Dias; Cabral, Luiz Antonio Guimarães

    2014-08-01

    The present study aimed to investigate the efficiency of exfoliative cytology by correlating the clinical lesions of oral squamous cell carcinoma (OSCC) with exfoliative cytology and histopathological findings. Cases of OSCC diagnosed between 1984 and 2010 were analyzed. The inclusion criteria for the present study were the availability of detailed clinical findings and a diagnosis of the disease through exfoliative cytology and histopathology. The cases were assessed and assigned scores, which were then submitted to modal expression analysis, which considers the higher frequency scores, thus relating the variables. The cytological findings demonstrated that the majority of the cases had malignant potential. Exfoliative cytology should be used as a supplementary tool for the diagnosis of OSCC, as it enables the early detection of these lesions. However, cytology should not be used as a substitute for histopathological examination.

  3. Histological and clinical evaluation of gingival healing following gingivectomy using different treatment modalities

    Directory of Open Access Journals (Sweden)

    Ajita Meenawat

    2013-01-01

    Full Text Available Gingival enlargement is a commonly encountered problem in clinical practice. The treatment of choice is gingivectomy. The wound healing takes place by secondary intention and is associated with significant patient morbidity during the healing period. Newer techniques like the use of laser can be employed to enhance patient comfort during procedure and better healing of the gingivectomy sites. Laser use is beneficial as it requires minimal anaesthesia, lesser surgical time and good post-operative healing.

  4. Clinical, radiographic, and histological manifestations of dentin dysplasia, type I: Report of case.

    Science.gov (United States)

    Brenneise, C V; Dwornik, R M; Brenneise, E E

    1989-12-01

    Dentin dysplasia, type I, is a rare dental anomaly characterized by abnormal dentin formation affecting the roots of both primary and permanent teeth. Short, conical roots with occlusion of the pulp chamber and canal are produced. Periapical radiolucent areas are common, although no evidence of caries or trauma to the tooth may be seen. Coronal mantle dentin is unaffected, resulting in an apparently normal clinical crown. An abnormality may not be suspected until radiographs reveal pulp and root changes. Orthodontic treatment can be a successful variation of the usual treatment offered to patients, and is discussed in this case report.

  5. The correlation between clinical, nuclear and histologic findings in a patient with Von Recklinghausen's disease

    Directory of Open Access Journals (Sweden)

    van Diest Paul J

    2007-11-01

    Full Text Available Abstract Background Malignant peripheral nerve sheath tumours (MPNST are known to develop in patients with Neurofibromatosis type I (NF1 resulting in a decreased overall survival. The association between NF1 and the development of such MPNST has been investigated in detail. The biological behaviour however of multiple disseminated neurofibromas in patients with NF1 and the risk factors for malignant transformation remain unknown. Clinical signs are unreliable and additional imaging techniques are therefore required. Of such, positron emission tomography using [18F]-2-fluoro-2-deoxy-D-glucose (18FDG PET is used to detect malignant changes in neurofibromas. Case presentation A case is presented of a patient suffering from NF1 with clinical signs of malignant change and accumulation of 18FDG in multiple neurofibromas. Histopathological examination of 20 lesions however, did not reveal any malignant features. There was no statistically significant relation between18FDG accumulation and malignant change, but rather with pain, size and growth. Conclusion This case adds to the knowledge of the diverse biological behaviour of neurofibromas in patients with NF1

  6. A Comparative Examination of the Clinical Outcome and Histological Appearance of Cryopreserved and Fresh Split-Thickness Skin Grafts.

    Science.gov (United States)

    Holzer, Paul W; Leonard, David A; Shanmugarajah, Kumaran; Moulton, Krysta N; Ng, Zhi Yang; Cetrulo, Curtis L; Sachs, David H

    The clinical use of frozen, human allogeneic skin grafts is considered a suitable alternative to freshly harvested allogeneic skin grafts when the latter are not available. However, limited functional and histological information exists regarding the effects of cryopreservation on allogeneic skin grafts, especially those across mismatched histocompatibility barriers. Thus, we performed a side-by-side comparative study of fresh vs frozen skin grafts, across both minor and major histocompatibility barriers, in a miniature swine model. Since porcine skin shares many physical and immunological properties with human skin, our findings have relevance to current clinical practices involving allogeneic grafting and may support future, temporary wound therapies involving frozen xenografts, comprised genetically modified porcine skin. Four miniature swine underwent harvest and grafting of split-thickness skin, with and without cryopreservation, in order to observe autologous grafts and grafts across minor and major histocompatibility barriers. A biopsy of the grafts was done at regular intervals for study of architecture, vascularization, and outcomes. All grafts vascularized without technical complications. Differences were noted in the early appearance of some fresh vs frozen grafts, but no significant difference was observed in overall survival times in any of the experimental groups. These results demonstrate that despite early observable differences in the healing process, cryopreservation and thawing does not significantly affect long-term graft survival or time to rejection, thus supporting the clinical and experimental use of fresh and frozen split-thickness skin grafts as comparable and interchangeable.

  7. Foreign Body Granulomas after the Use of Dermal Fillers: Pathophysiology, Clinical Appearance, Histologic Features, and Treatment

    Directory of Open Access Journals (Sweden)

    Jeong Min Lee

    2015-03-01

    Full Text Available A foreign body granuloma is a non-allergic chronic inflammatory reaction that is mainly composed of multinucleated giant cells. Foreign body granulomas may occur after the administration of any dermal filler. Factors such as the volume of the injection, impurities present in the fillers, and the physical properties of fillers affect granuloma formation. The formation of granulomas involves five phases: protein adsorption, macrophage adhesion, macrophage fusion, and crosstalk. The clinical and pathologic features of granulomas vary depending on the type of filler that causes them. Foreign body granulomas can be treated effectively with intralesional corticosteroid injections. Surgical excisions of granulomas tend to be incomplete because granulomas have ill-defined borders and moreover, surgical excisions may leave scars and deformities.

  8. Corneal Wound Repair After Rose Bengal and Green Light Crosslinking: Clinical and Histologic Study.

    Science.gov (United States)

    Gallego-Muñoz, Patricia; Ibares-Frías, Lucía; Lorenzo, Elvira; Marcos, Susana; Peréz-Merino, Pablo; Bekesi, Nandor; Kochevar, Irene E; Martínez-García, M Carmen

    2017-07-01

    To evaluate corneal wound healing after treatment with a new collagen crosslinking protocol using rose bengal dye and green light (RGX). One cornea of 20 New Zealand rabbits was de-epithelialized (DE) in an 8-mm diameter circle and, in another group (n = 25), the DE corneas were then stained with 0.1% rose bengal for 2 minutes and exposed to green light (532 nm) for 7 minutes (RGX). The contralateral eyes without treatment acted as controls. The animals were clinically followed including fluorescein staining and pachymetry. Healing events were analyzed after euthanasia at 2, 30, and 60 days. Cell death (TUNEL assay), cell proliferation (5-bromo-2'-deoxyuridine incorporation), and cell differentiation to myofibroblasts (α-SMA labeling) were carried out. In addition, loss of keratocytes and subsequent repopulation of the corneal stroma were quantified on hematoxylin-eosin-stained sections. Wound closure was slower after RGX (4.4 days) then after DE (3.3 days). Cell death was restricted to the anterior central stroma, and the cellular decrease did not differ significantly between RGX and DE corneas. Cell proliferation in the epithelium and stroma appeared at 2 days. In both DE and RGX corneas, recovery of the epithelium was complete at day 30, although cell repopulation of the stroma was not complete at 60 days. The healing response in corneas after RGX is very similar to that observed after DE alone, suggesting that, along with its short treatment time and limited effect on keratocytes, RGX displays good potential for clinical cornea stiffening.

  9. Modeling clinically relevant blast parameters based on scaling principles produces functional & histological deficits in rats.

    Science.gov (United States)

    Turner, Ryan C; Naser, Zachary J; Logsdon, Aric F; DiPasquale, Kenneth H; Jackson, Garrett J; Robson, Matthew J; Gettens, Robert T T; Matsumoto, Rae R; Huber, Jason D; Rosen, Charles L

    2013-10-01

    Blast-induced traumatic brain injury represents a leading cause of injury in modern warfare with injury pathogenesis poorly understood. Preclinical models of blast injury remain poorly standardized across laboratories and the clinical relevance unclear based upon pulmonary injury scaling laws. Models capable of high peak overpressures and of short duration may better replicate clinical exposure when scaling principles are considered. In this work we demonstrate a tabletop shock tube model capable of high peak overpressures and of short duration. By varying the thickness of the polyester membrane, peak overpressure can be controlled. We used membranes with a thickness of 0.003, 0.005, 0.007, and 0.010 in to generate peak reflected overpressures of 31.47, 50.72, 72.05, and 90.10 PSI, respectively. Blast exposure was shown to decrease total activity and produce neural degeneration as indicated by fluoro-jade B staining. Similarly, blast exposure resulted in increased glial activation as indicated by an increase in the number of glial fibrillary acidic protein expressing astrocytes compared to control within the corpus callosum, the region of greatest apparent injury following blast exposure. Similar findings were observed with regard to activated microglia, some of which displayed phagocytic-like morphology within the corpus callosum following blast exposure, particularly with higher peak overpressures. Furthermore, hematoxylin and eosin staining showed the presence of red blood cells within the parenchyma and red, swollen neurons following blast injury. Exposure to blast with 90.10 PSI peak reflected overpressure resulted in immediate mortality associated with extensive intracranial bleeding. This work demonstrates one of the first examples of blast-induced brain injury in the rodent when exposed to a blast wave scaled from human exposure based on scaling principles derived from pulmonary injury lethality curves. © 2013.

  10. Clinical Patterns of Candida Infections in Bombay

    Directory of Open Access Journals (Sweden)

    J Pratiba Dalal

    1980-01-01

    Full Text Available One hundred consecutive cases of candidiasis in Bombay were studied. In each case the suspicion was confirmed by isolation typing of the Candida species. The clinical was as follows: vulvo-vaginitis 30%; intertrigo 18%; onychia and paronychia 12%; thrush 16%; generalised cutaneous candidasis 8%, enteritis 3%; bronchitis 12% and urinary tract infection 1%. When compared to a study carried out in Bombay in 1966, there was an increase in the frequency of disseminated cutaneous candidiasis and a reduction in the cases of intertrigo and onychia and paronychia.

  11. Confocal microscopy patterns in nonmelanoma skin cancer and clinical applications.

    Science.gov (United States)

    González, S; Sánchez, V; González-Rodríguez, A; Parrado, C; Ullrich, M

    2014-06-01

    Reflectance confocal microscopy is currently the most promising noninvasive diagnostic tool for studying cutaneous structures between the stratum corneum and the superficial reticular dermis. This tool gives real-time images parallel to the skin surface; the microscopic resolution is similar to that of conventional histology. Numerous studies have identified the main confocal features of various inflammatory skin diseases and tumors, demonstrating the good correlation of these features with certain dermatoscopic patterns and histologic findings. Confocal patterns and diagnostic algorithms have been shown to have high sensitivity and specificity in melanoma and nonmelanoma skin cancer. Possible present and future applications of this noninvasive technology are wide ranging and reach beyond its use in noninvasive diagnosis. This tool can also be used, for example, to evaluate dynamic skin processes that occur after UV exposure or to assess tumor response to noninvasive treatments such as photodynamic therapy. We explain the characteristic confocal features found in the main nonmelanoma skin tumors and discuss possible applications for this novel diagnostic technique in routine dermatology practice. Copyright © 2012 Elsevier España, S.L. and AEDV. All rights reserved.

  12. Imbalanced target prediction with pattern discovery on clinical data repositories.

    Science.gov (United States)

    Chan, Tak-Ming; Li, Yuxi; Chiau, Choo-Chiap; Zhu, Jane; Jiang, Jie; Huo, Yong

    2017-04-20

    Clinical data repositories (CDR) have great potential to improve outcome prediction and risk modeling. However, most clinical studies require careful study design, dedicated data collection efforts, and sophisticated modeling techniques before a hypothesis can be tested. We aim to bridge this gap, so that clinical domain users can perform first-hand prediction on existing repository data without complicated handling, and obtain insightful patterns of imbalanced targets for a formal study before it is conducted. We specifically target for interpretability for domain users where the model can be conveniently explained and applied in clinical practice. We propose an interpretable pattern model which is noise (missing) tolerant for practice data. To address the challenge of imbalanced targets of interest in clinical research, e.g., deaths less than a few percent, the geometric mean of sensitivity and specificity (G-mean) optimization criterion is employed, with which a simple but effective heuristic algorithm is developed. We compared pattern discovery to clinically interpretable methods on two retrospective clinical datasets. They contain 14.9% deaths in 1 year in the thoracic dataset and 9.1% deaths in the cardiac dataset, respectively. In spite of the imbalance challenge shown on other methods, pattern discovery consistently shows competitive cross-validated prediction performance. Compared to logistic regression, Naïve Bayes, and decision tree, pattern discovery achieves statistically significant (p-values data and tweaking, the prediction performance of pattern discovery is consistently comparable to the best achievable performance. Pattern discovery has demonstrated to be robust and valuable for target prediction on existing clinical data repositories with imbalance and noise. The prediction results and interpretable patterns can provide insights in an agile and inexpensive way for the potential formal studies.

  13. Clinical and histological effects of the temporary occlusion of the rabbit nasolacrimal duct and point using cyanoacrylate adhesives

    Directory of Open Access Journals (Sweden)

    K.C.F. Cardoso

    2013-12-01

    Full Text Available The objective of this study was to evaluate the clinical and histological effects of occluding the nasolacrimal ducts and points of rabbits. For this study, 20 adult New Zealand rabbits, both males and females, weighing 3.2±0.4kg were allocated into two groups for n-butyl-cyanoacrylate occlusion (GB, n=10 or 2-octyl-cyanoacrylate occlusion (GO, n=10. The contralateral eyes served as the controls. The persistence of tears was evaluated daily using the Schirmer I test. Discomfort, eye discharge, epiphora, and conjunctival hyperemia were assessed prior to the procedure (T0 and during the 14 subsequent days (T1-T14. On days seven and 14, five animals from each group were euthanized, and their nasolacrimal ducts were collected, processed and analyzed by histology. In the GB group, the Schirmer test values differed from that at T0 at all of the subsequent time points, whereas there was no difference in the values observed from the GO group. Compared with the corresponding controls, the GO and GB groups differed significantly at almost all of the time points. When comparing the treatment groups, differences were found at T6, T7, T9, T10, T11, T12 and T14, with higher Schirmer values in the GB group. Epiphora was observed in the GB group from T1 to T8 and in the GO group from T1 to T6. Within seven days post-occlusion, histology revealed a moderate foreign body reaction, with marked necrosis and sloughing of the canalicular epithelium, in the GO group, which was absent at day 14. In the GB group, a marked inflammatory reaction and a mild foreign body reaction were found at day seven, and the foreign body reaction was prevalent at day 14. This study demonstrated that both adhesives were effective in obstructing the nasolacrimal ducts and points of rabbits and that their application and handling are easy and free of complications. However, both adhesives promoted inflammatory and foreign body reactions that evolved to repair and regeneration at day 14 of

  14. Endodontic Surgery of a Symptomatic Overfilled MTA Apical Plug: A Histological and Clinical Case Report

    Science.gov (United States)

    Asgary, Saeed; Fayazi, Sara

    2017-01-01

    This case report presents the successful surgical treatment of a symptomatic open apex upper central incisor with a failed overfilled mineral trioxide aggregate (MTA) apical plug. Unintentional overextension of the MTA had occurred two years before the initial visit. An apical lesion adjacent to the excess MTA was radiographically detectable. Endodontic surgery was performed using calcium-enriched mixture (CEM) cement as a root-end filling material. Curettage of the apical lesion showed a mass of unset MTA particles; histopathological examination revealed fragments of MTA and granulation tissues. Up to 18-month follow-up, the tooth was clinically asymptomatic and fully functional. Periapical radiograph and CBCT images showed a normal periodontal ligament around the root. In conclusion, favorable outcomes in this case study suggested that root-end filling with CEM cement might be an appropriate approach; in addition, however many factors probably related to the initial failure of the case, the extrusion of MTA into the periapical area should be avoided. PMID:28808469

  15. Anti-tumor necrosis factor treatment in cherubism--clinical, radiological and histological findings in two children.

    Science.gov (United States)

    Hero, M; Suomalainen, A; Hagström, J; Stoor, P; Kontio, R; Alapulli, H; Arte, S; Toiviainen-Salo, S; Lahdenne, P; Mäkitie, O

    2013-01-01

    Cherubism is a rare and disfiguring genetic disorder with excessive bone resorption and multilocular lesions in the mandible and/or maxilla. The disease-causing gain-of-function mutations in the SH3-binding protein 2 (SH3BP2) gene result in increased myeloid cell responses to macrophage colony stimulating factor and RANK ligand, formation of hyperactive osteoclasts (giant cells), and hyper-reactive macrophages that produce excessive amounts of the inflammatory cytokine tumor necrosis factor α (TNF-α). Recent findings in the cherubism mouse model suggest that TNF-α plays a major role in disease pathogenesis and that removal of TNF-α prevents development of the bone phenotype. We treated two children with cherubism with the TNF-α antagonist adalimumab for approximately 2.5 years and collected extensive clinical, radiological and histological follow-up data during the treatment. Histologically the treatment resulted in a significant reduction in the number of multinucleated giant cells and TNF-α staining positivity in both patients. As evaluated by computed tomography and magnetic resonance imaging, the lesions in Patient 1 showed either moderate enlargement (mandibular symphysis) or remained stable (mandibular rami and body, the maxilla). In Patient 2, the lesions in mandibular symphysis showed enlargement during the first 8 months of treatment, and thereafter the lesions remained unchanged. Bone formation and resorption markers remained unaffected. The treatment was well tolerated. Based on our findings, TNF-α antagonist may decrease the formation of pathogenic giant cells, but does not result in lesion regression or prevent lesion expansion in active cherubism. TNF-α modulator treatment thus does not appear to provide sufficient amelioration for patients suffering from cherubism. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Static and dynamic modes of 810 nm diode laser hair removal compared: A clinical and histological study.

    Science.gov (United States)

    Omi, Tokuya

    2017-03-31

    Laser hair removal has recently become a major indication. Diode lasers have become commercially available offering two modes of application: a stamping or static mode, and a dynamic mode whereby the handpiece is continuously moved across the target tissue. The present study was designed to compare the efficacy of these two approaches clinically and histologically. Twenty-five subjects participated in the study, 12 males and 13 females, ages ranging from 20 to 57 yr (Mean age 41.6 yr). A baseline hair count was performed on both the target areas. The ms-pulsed diode laser delivered 810 nm via a handpiece with a cooled tip, offering both static and dynamic modes which were used on the subjects' left and right crura, respectively. Pain during treatment was assessed using a visual analog scale (VAS) and gross inspection was performed immediately after treatment for any abnormality in the treated skin. Hair counts were performed on both crura at 1 and 3 months after the treatment, and compared with the baseline counts. Biopsies were performed in the dynamic mode treated skin at baseline and at 1 month after the treatment, and assessed with light microscopy, immunohistochemistry and transmission electron microscopy (TEM). All subjects completed the study. Compared with baseline, hair counts were significantly lower at 1 and 3 months post-treatment with no significant difference between the static and dynamic laser depilation modes, nor in the severity of the pain experienced during the procedure. Histologically, degenerative changes in the hair follicles were noted immediately after laser treatment. At one month, cystic formation was seen in the hair follicles showing a strong tendency towards apoptotic cell death. With the diode laser system and at the parameters used in the present study, high depilation efficacy was seen with no significant difference between the static and dynamic modes. Interestingly, good long-term depilation is probably a result of induced

  17. Patterns of lymph node sampling and the impact of lymph node density in favorable histology Wilms tumor: An analysis of the national cancer database.

    Science.gov (United States)

    Saltzman, A F; Carrasco, A; Amini, A; Aldrink, J H; Dasgupta, R; Gow, K W; Glick, R D; Ehrlich, P F; Cost, N G

    2017-10-31

    There is controversy about the role of lymph node (LN) sampling or dissection in the management of favorable histology (FH) Wilms tumor (WT), specifically how it performed and how it may impact survival. The objective of this study was to analyze factors affecting LN sampling patterns and the impact of LN yield and density (number of positive LNs/LNs examined) on overall survival (OS) in patients with advanced-stage favorable histology Wilms tumor (FHWT). The National Cancer Database (NCDB) was queried for patients with FHWT during 2004-2013. Demographic, clinical and OS data were abstracted for those who underwent surgical resection. Poisson regression was performed to analyze how factors influenced LN yield. Patients with positive LNs had LN density calculated and were further analyzed. A total of 2340 patients met criteria, with a median age at diagnosis of 3 years (range 0-78 years). The median number of LNs examined was three (range 0-87). Lymph node yield was affected by age, race, insurance, tumor size, laterality, advanced stage, LN positivity, and institutional volume. A total of 390 (16.6%) patients had LN-positive disease. Median LN density for these LN-positive patients was 0.38 (range 0.02-1) (Summary Figure). Estimated 5-year OS was significantly improved for those with LN density ≤0.38 vs. >0.38 (94% vs. 84.6%, P = 0.012). In this population, on multivariate analysis, age and LN density were significant predictors of OS. It is difficult to compile large numbers of cases in rare diseases like WT, and fortunately a large administrative database such as the NCDB can serve as a great resource. However, administrative data come with inherent limitations such as missing data and inability to account for a variety of factors that may influence LN yield and/or OS (specimen designation, pathologist experience, surgeon experience/volume, institutional Children's Oncology Group (COG) association, etc.). In this specific disease, the American Joint Committee

  18. Accuracy of Grading Gleason Score 7 Prostatic Adenocarcinoma on Needle Biopsy: Influence of Percent Pattern 4 and Other Histological Factors.

    Science.gov (United States)

    Meliti, Abdelrazak; Sadimin, Evita; Diolombi, Mario; Khani, Francesca; Epstein, Jonathan I

    2017-05-01

    Recognition of Gleason pattern 4 in prostatic needle biopsies is crucial for both prognosis and therapy. Recently, it has been recommended to record percent pattern 4 when Gleason score 7 cancer is the highest grade in a case. Four hundred and five prostate needle core biopsies received for a second opinion at our institution from February-June, 2015 were prospectively diagnosed with prostatic adenocarcinoma Gleason score 7 as the highest score on review by a consultant urological pathologist. Percentage of core involvement by cancer, percentage of Gleason pattern 4 per core, distribution of Gleason pattern 4 (clustered, scattered), morphology of pattern 4 (cribriform, non-cribriform), and whether the cancer was continuous or discontinuous were recorded. Better agreement was noted between the consultant and referring pathologists when pattern 4 was clustered as opposed to dispersed in biopsies (P = 0.009). The percentage of core involvement by cancer, morphology of pattern 4, and continuity of cancer did not affect the agreement between the consultant and referring pathologists. There was a trend (P = 0.06) for better agreement based on the percent of pattern 4. When pattern 4 is scattered amongst pattern 3 as opposed to being discrete foci, there is less interobserver reproducibility in grading Gleason score 7 cancer, and in this setting pathologists should consider obtaining second opinions either internally within their group or externally. Prostate 77: 681-685, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  19. Fractional 1,550 nm Ytterbium/Erbium fiber laser in the treatment of lichen amyloidosis: clinical and histological study.

    Science.gov (United States)

    Panchaprateep, Ratchathorn; Tusgate, Sai; Munavalli, Girish S; Noppakun, Nopadon

    2015-03-01

    Lichen amyloidosis is characterized by amyloid deposition in the papillary dermis, presenting clinically with intensely pruritic hyperkeratotic papules. Various treatment modalities have been used but the results are generally unsatisfactory. Several studies show that non-ablative fractional lasers can be used to treat depositional diseases due to their capability of inducing transepidermal elimination of the dermal content. To investigate the efficacy and safety of a non-ablative fractional 1,550 nm Yttrium/Erbium fiber laser for the treatment of lichen amyloidosis. Ten subjects with a clinical and histological diagnosis of lichen amyloidosis were treated with fractional non-ablative laser using a 7-cm tip, with the parameter of 30 mJ/cm2 and 1,000 microscopic treatment zones (MTZ)/cm2 for three sessions at 4-week intervals. Clinical improvement (in terms of global improvement score, brownish/hyperpigmentation, thickness, and number of papules) was evaluated using a quartile grading scale at baseline, and 4, 12, and 24 weeks after the last treatment. Itch score and subjective satisfaction rates were also assessed. Adverse events were recorded, and pain was scored using a visual analog scale (VAS). Histologic changes were observed using standard staining with hematoxylin and eosin, as well as special stains of alkaline congo red and crystal violet at baseline and 4 weeks after treatment. At 4 and 24 weeks after treatment, the lichen amyloid lesions had statistically significantly improved in all aspects compared to baseline (P = 0.01 and P = 0.016, respectively; Wilcoxon signed-rank test). However, partial recurrence was reported in 2 out of 10 subjects. All subjects rated itching symptom significantly improved after only the first treatment (P material deposition in the papillary dermis. There was no amyloid material deposition noted in two out of eight histopathology studies. The non-ablative fractional 1,550 nm Ytterbium/Erbium fiber laser is

  20. Sexual patterns and protogynous sex reversal in the rusty parrotfish, Scarus ferrugineus (Scaridae): histological and physiological studies.

    Science.gov (United States)

    Abdel-Aziz, El-Sayedah H; Bawazeer, Fayzah A; El-Sayed Ali, Tamer; Al-Otaibi, Mashael

    2012-08-01

    Gonadal histology confirmed that Scarus ferrugineus is a diandric protogynous fish. The process of protogynous sex reversal was investigated through histological observations on the gonads of females changing sex to male. This process was divided into three stages on the basis of changes in the structure of the germinal and somatic elements. Ovaries of functional females (stages IV-V) were filled with vitellogenic oocytes during the breeding season but contained no trace of spermatogenic tissue. During post-spawning period, the remaining vitellogenic oocytes began to degenerate and accompanied by a drop in plasma levels of estradiol-17β. At the commencement of sex change, previtellogenic oocytes began to degenerate and stromal cell aggregation was observed in the central region of the lamellae. At mid-reversal stage, steroid-producing cells (Leydig cells) developed at the border of the stromal aggregate and spermatogonial cysts appear at the periphery of lamellae. Finally, sex change to secondary males was considered complete, with the beginning of active spermatogenesis and spermiation. Plasma levels of testosterone remained low throughout the sex change, but II-KT increased rapidly parallel to the increased number of Leydig cells while the level of estradiol-17β decreased. The results indicate also that the sex-changed males had higher level of II-KT than primary males, while primary males had higher level of testosterone. Histological examination revealed that testes of primary and secondary males are almost identical in organization of the spermatogenic cysts, association of sertoli cells, and developing germ cells but differ in clustering and development of Leydig cells.

  1. Clinical pattern of knee osteoarthritis in patients seen at ...

    African Journals Online (AJOL)

    Clinical pattern of knee osteoarthritis in patients seen at rheumatology clinic of Aminu Kano Teaching Hospital, Northwestern Nigeria. ... Forty per cent of the patients had history of knee swelling, with a median duration of 24 months (range 1-120) before presentation. Majority of the patients (92%) had morning stiffness, with ...

  2. Prevalence, Clinical Pattern and Major Causes of Male Infertility in ...

    African Journals Online (AJOL)

    BACKGROUND: Infertility is a major cause of marital disharmony in Nigeria because of the high premium placed on child bearing. Unfortunately, the blame is on the woman most times. OBJECTIVES: To determine the prevalence, clinical pattern and major causes of infertility based on the clinical and laboratory findings of ...

  3. Clinical profile and pattern of adenoid hypertrophy among children ...

    African Journals Online (AJOL)

    Introduction: The objective of this study was to determine the pattern, clinical profile and surgical intervention in children presenting with adenoids hypertrophy in a private hospital. Methods: The study was conducted at the general pediatric clinic of a private hospital in Enugu, south east Nigeria in collaboration with a ...

  4. Pattern recognition in paediatric ecgs: the hidden secrets to clinical ...

    African Journals Online (AJOL)

    In general, medical practitioners (and paediatricians in particular) are trained to recognise common patterns of abnormalities in order to derive clues to disease diagnosis. This is typical of most clinical settings, especially in history taking and clinical examination, but also for investigations such as X-rays and common routine ...

  5. Usual and unusual histologic patterns of high Gleason score 8 to 10 adenocarcinoma of the prostate in needle biopsy tissue.

    Science.gov (United States)

    Gottipati, Srinivas; Warncke, Jason; Vollmer, Robin; Humphrey, Peter A

    2012-06-01

    High Gleason score 8 to 10 adenocarcinoma is the most aggressive and potentially lethal form of prostate cancer. The 2005 International Society of Urological Pathology (ISUP)-modified Gleason grading scheme defines several gland arrangements of high Gleason grade patterns 4 and 5. The aim of this investigation was to quantitate the frequency of the ISUP-defined high Gleason grade patterns in needle biopsy tissue, to determine the common admixtures and to characterize patterns not presented in the 2005 ISUP report. For patients who underwent radical prostatectomy, we analyzed for association of specific high-grade patterns in needle biopsy with extraprostatic extension in radical prostatectomy tissues. A total of 268 prostate needle biopsy cases with Gleason score of 8 to 10 were examined. A mean of 3.6 patterns (range, 1 to 8) were identified per case and only 12% of cases had a pure single pattern. Ill-defined glands with poorly formed lumina (at 57%) and fused microacinar glands (at 53%) comprised the predominant and most frequently admixed patterns. Single cells and single signet ring cells were present in 53% and 31% of cases, respectively. Additional patterns in order of frequency included cords (35%), cribriform glands (25%), sheets of cells (19%), chains (4%), glomeruloid (3%), comedonecrosis (2%), and hypernephromatoid (1 case=0.3%). Gleason score 8 to 10 carcinomas are typically extensive in needle core tissue, with a mean of 4.4 positive cores (range, 1 to 15 cores) per case. Only 14 cases (5%) had high-grade minimal carcinoma measuring Gleason grade patterns not described in the 2005 ISUP report include single file growth, solid cylinders, and nested patterns. The single file pattern was present in 40% of cases, and the small solid nested pattern was detected in 24% of cases. One case displayed solid cylinders. Only the single file pattern was associated with extraprostatic extension at radical prostatectomy (P=0.005). These results show that the 2005

  6. Mandibular tori as bone grafts: an alternative treatment for periodontal osseous defects - clinical, radiographic and histologic morphology evaluation.

    Science.gov (United States)

    Hassan, Khalid S; Al-Agal, Adel; Abdel-Hady, Adel I; Swelam, Wael M; Elgazzar, Reda F

    2015-03-01

    The present study was designed to evaluate the clinical, radiographic and histochemical significance of using the mandibular tori as autogenous bone graft for treatment of intraosseous defects in patients with chronic periodontitis. Twenty-eight sites from 14 patients with chronic periodontitis were included in this study. Each patient was treated with split mouth design; one site received torus mandibularis bone graft and the other site received a full-thickness fap alone. Histopathologic assessment was evaluated on removal of torus mandibularis to evaluate its histologic structure and by the end of the study 9 month later. Clinical and radiographic parameters were re-evaluated at 3 months interval for 1 year. The results of the present study revealed significant gain in the clinical attachment level (CAL) (88.4%, 4.53 ± 0.06 mm) for torus mandibularis sites compared to (39.7%, 2.01 ± 0.04 mm) for full-thickness fap. Moreover, there was a reduction in the probing pocket depth (PPD) of (75.4%, 5.75 ± 0.12 mm) for torus mandibularis sites and (49.6%, 3.73 ± 0.14 mm) for sites treated with a full-thickness fap only; CAL and PPD differences were significant at p-value ≤0.01. Concomitantly, significant radiographic increase in the bone height and density were recorded in the test group. The use of mandibular tori as autogenous bone graft could provide benefits as a periodontal therapeutic modality and enhance regenerative potential of periodontal intraosseous defects.

  7. Next Generation Molecular Histology Using Highly Multiplexed Ion Beam Imaging (MIBI) of Breast Cancer Tissue Specimens for Enhanced Clinical Guidance

    Science.gov (United States)

    2016-07-01

    AWARD NUMBER: W81XWH- 14-1-0192 TITLE: Next-Generation Molecular Histology Using Highly Multiplexed Ion Beam Imaging (MIBI) of Breast Cancer...DATES COVERED 4. TITLE AND SUBTITLE Next-Generation Molecular Histology Using Highly Multiplexed Ion Beam Imaging (MIBI) of Breast Cancer Tissue

  8. Comparing the clinical and histological diagnosis of leprosy and leprosy reactions in the INFIR cohort of Indian patients with multibacillary leprosy.

    Science.gov (United States)

    Lockwood, Diana N J; Nicholls, Peter; Smith, W Cairns S; Das, Loretta; Barkataki, Pramila; van Brakel, Wim; Suneetha, Sujai

    2012-01-01

    The ILEP Nerve Function Impairment in Reaction (INFIR) is a cohort study designed to identify predictors of reactions and nerve function impairment in leprosy. The aim was to study correlations between clinical and histological diagnosis of reactions. Three hundred and three newly diagnosed patients with World Health Organization multibacillary (MB) leprosy from two centres in India were enrolled in the study. Skin biopsies taken at enrolment were assessed using a standardised proforma to collect data on the histological diagnosis of leprosy, leprosy reactions and the certainty level of the diagnosis. The pathologist diagnosed definite or probable Type 1 Reactions (T1R) in 113 of 265 biopsies from patients at risk of developing reactions whereas clinicians diagnosed skin only reactions in 39 patients and 19 with skin and nerve involvement. Patients with Borderline Tuberculoid (BT) leprosy had a clinical diagnosis rate of reactions of 43% and a histological diagnosis rate of 61%; for patients with Borderline Lepromatous (BL) leprosy the clinical and histological diagnosis rates were 53.7% and 46.2% respectively. The sensitivity and specificity of clinical diagnosis for T1R was 53.1% and 61.9% for BT patients and 61.1% and 71.0% for BL patients. Erythema Nodosum Leprosum (ENL) was diagnosed clinically in two patients but histologically in 13 patients. The Ridley-Jopling classification of patients (n = 303) was 42.8% BT, 27.4% BL, 9.4% Lepromatous Leprosy (LL), 13.0% Indeterminate and 7.4% with non-specific inflammation. This data shows that MB classification is very heterogeneous and encompasses patients with no detectable bacteria and high immunological activity through to patients with high bacterial loads. Leprosy reactions may be under-diagnosed by clinicians and increasing biopsy rates would help in the diagnosis of reactions. Future studies should look at sub-clinical T1R and ENL and whether they have impact on clinical outcomes.

  9. HPV-negative vulvar intraepithelial neoplasia (VIN) with basaloid histologic pattern: an unrecognized variant of simplex (differentiated) VIN.

    Science.gov (United States)

    Ordi, Jaume; Alejo, Maria; Fusté, Victòria; Lloveras, Belen; Del Pino, Marta; Alonso, Immaculada; Torné, Aureli

    2009-11-01

    Vulvar intraepithelial neoplasia (VIN) is classified into 2 clinicopathologic subtypes, classic, related to human papillomavirus (HPV) infection and affecting relatively young women, and simplex (differentiated), negative for HPV and affecting elderly women. Histologically, classic VIN may be basaloid and characterized by a replacement of the whole epidermis by a homogeneous population of small, "undifferentiated" keratinocytes, which are diffusely positive for p16(INK4a) and negative for p53. Simplex VIN is characterized by atypia of the basal layer with high degree of cellular differentiation and shows negative staining for p16(INK4a) and frequent positivity for p53. Simplex VIN is frequently associated with squamous cell hyperplasia and lichen sclerosus. From a series of 110 invasive squamous cell carcinomas of the vulva negative for HPV by highly sensitive polymerase chain reaction, 51 had VIN lesions located at least 1 cm away from the tumor. In 4 (7.8%) cases, the VIN had basaloid histologic features. All cases showed obvious architectural disorganization with a homogeneous population of basaloid, undifferentiated keratinocytes with scanty cytoplasm replacing the whole epidermis. Immunohistochemically, all cases were negative for p16(INK4a) and strongly positive for p53 with suprabasilar extension of positive cells. All patients were postmenopausal (median age 61.0 y; range, 45-76). Squamous cell hyperplasia was identified in 1 case and lichen sclerosus in 1 case. The invasive squamous cell carcinoma was of keratinizing type in 3 cases and basaloid in 1 case. In conclusion, simplex, HPV-negative VIN may occasionally have basaloid morphology. Immunostaining for p16(INK4a) and p53 protein may be helpful in the identification of these lesions and the differential diagnosis with classic, HPV-positive basaloid VIN.

  10. Eosinophilic Esophagitis: Demographic, Clinical, Endoscopic, Histologic, and Atopic Characteristics of Children and Teenagers in a Region in Central Spain.

    Science.gov (United States)

    Gómez Torrijos, E; Sánchez Miranda, P; Donado Palencia, P; Castro Jimenez, A; Rodriguez Sánchez, J; Mendez Díaz, Y; Moreno Lozano, L; García Rodríguez, R

    Eosinophilic esophagitis (EoE) is an increasingly prevalent chronic inflammatory disease of the esophagus with an immunoallergic etiology. Few studies have been published on EoE in children and adolescents. The objective of this study was to analyze the demographic, clinical, serologic, endoscopic-histologic, and atopic characteristics of pediatric patients with EoE and to identify atopic and digestive comorbidities. We conducted a prospective observational study in children and adolescents (family history of atopy. The most common symptom was dysphagia (51%). Eosinophilia was detected in the blood of 60% of patients. Eosinophil cationic protein and total IgE were elevated in 88% and 77% of patients, respectively. The most frequent endoscopic finding was linear grooves (57%). Skin tests with aeroallergens were positive in 82% of patients (pollen 62% and food 60%). The main atopic comorbidities were asthma (48%) and rhinoconjunctivitis (37%). Digestive diseases were more often associated with gastritis and Helicobacter pylori infection (17%). Our results are similar to those previously reported. EoE is more common in boys and in individuals with a history of atopy and sensitization to airborne allergens and food. These results support the consideration of EoE as an atopic disease and underline the important role of allergists in early diagnosis and treatment.

  11. Florid cemento-osseous dysplasia: Report of a case documented with clinical, radiographic, biochemical and histological findings.

    Science.gov (United States)

    Kutluay Köklü, Harika; Cankal, Dilek A; Bozkaya, Süleyman; Ergün, Gülfem; Bar, Emre

    2013-02-01

    Florid cemento-osseous dysplasia (FCOD) has been described as a condition that characteristically affects the jaws of middle-aged black women. This condition has also been classified as gigantiform cementoma, chronic sclerosing osteomyelitis, sclerosing osteitis, multiple estenosis and sclerotic cemental masses. It usually exhibits as multiple radiopaque cementum-like masses distributed throughout the jaws. Radiographically, FCOD appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. Computed tomography, because of its ability to give axial, sagittal, and frontal views, is useful in the evaluation of these lesions. This article reports the case of a 45-year-old white man who was diagnosed with FCOD on the basis of clinical, radiographic, biochemical and histological findings. It is of major importance to realize that all dentists have a unique opportunity as well as ethical obligation to assist in the struggle against wrong dental treatments that might save patients dental health. This case report illustrates the point that periapical radiolucencies may represent benign fibro-osseous lesions that may be overlooked or result in unnecessary endodontic treatment. Key words:Florid cemento-osseous dysplasia, florid osseous dysplasia, fibro-osseous lesions.

  12. Comparative study of the clinical, histological, and biological characteristics of squamous cell carcinomas in areas previously treated with photodynamic therapy.

    Science.gov (United States)

    Gracia Cazaña, Tamara; Salazar, Nerea; Vera-Álvarez, Jesús; González, Salvador; Juarranz, Angeles; Gilaberte, Yolanda

    2017-12-01

    Although photodynamic therapy (PDT) is an effective treatment option for non-melanoma skin cancer, the development of aggressive tumours in PDT-treated areas has been described. To evaluate the clinical, histological, and biological characteristics of squamous cell carcinomas (SCCs) in areas previously treated with PDT vs those arising in areas never treated with this therapeutic modality. A retrospective observational study was designed. We collected all cases of invasive SCCs in areas previously treated with PDT. The control group consisted of an equivalent number of SCCs randomly selected from the database of our pathology department. Expression of specific markers implicated in SCC progression, including p53, Ki67, COX-2, cyclin D1, E-cadherin, EGFR, survivin, and pERK, was analysed. A total of 699 patients were treated with PDT for non-melanoma skin cancer during the course of the study. Ten invasive SCCs arising in areas previously treated with methylaminolevulinate-PDT were diagnosed in six patients. The control group consisted of 10 invasive SCCs from 10 patients never treated with PDT. In the PDT group, the mean tumour size was significantly lower and the absence of ulceration was more frequent than in the control group (pareas previously treated with PDT was very low and did not differ significantly from that of SCCs developing in non-PDT-treated areas.

  13. Clinical, instrumental, serological and histological findings suggest that hemophilia B may be less severe than hemophilia A.

    Science.gov (United States)

    Melchiorre, Daniela; Linari, Silvia; Manetti, Mirko; Romano, Eloisa; Sofi, Francesco; Matucci-Cerinic, Marco; Carulli, Christian; Innocenti, Massimo; Ibba-Manneschi, Lidia; Castaman, Giancarlo

    2016-02-01

    Recent evidence suggests that patients with severe hemophilia B may have a less severe disease compared to severe hemophilia A. To investigate clinical, radiological, laboratory and histological differences in the arthropathy of severe hemophilia A and hemophilia B, 70 patients with hemophilia A and 35 with hemophilia B with at least one joint bleeding were consecutively enrolled. Joint bleedings (50), regimen of treatment (prophylaxis/on demand), World Federation of Hemophilia, Pettersson and ultrasound scores, serum soluble RANK ligand and osteoprotegerin were assessed in all patients. RANK, RANK ligand and osteoprotegerin expression was evaluated in synovial tissue from 18 hemophilia A and 4 hemophilia B patients. The percentage of patients with either 10-50 or more than 50 hemarthrosis was greater in hemophilia A than in hemophilia B (Phemophilia B (PHemophilia (36.6 vs. 20.2; Phemophilia A patients. Serum osteoprotegerin and soluble RANK ligand were decreased in hemophilia A versus hemophilia B (Phemophilia A patients. In conclusion, the reduced number of hemarthrosis, the lower World Federation of Hemophilia and ultrasound scores, and higher osteoprotegerin expression in serum and synovial tissue in hemophilia B suggest that hemophilia B is a less severe disease than hemophilia A. Osteoprotegerin reduction seems to play a pivotal role in the progression of arthropathy in hemophilia A. Copyright© Ferrata Storti Foundation.

  14. Clinico-Histologic Conferences: Histology and Disease

    Science.gov (United States)

    Shaw, Phyllis A.; Friedman, Erica S.

    2012-01-01

    Providing a context for learning information and requiring learners to teach specific content has been demonstrated to enhance knowledge retention. To enhance students' appreciation of the role of science and specifically histology in clinical reasoning, disease diagnosis, and treatment, a new teaching format was created to provide clinical…

  15. Clinical and histologic evaluation of an enamel matrix protein derivative combined with a bioactive glass for the treatment of intrabony periodontal defects in humans.

    NARCIS (Netherlands)

    Sculean, A.; Windisch, P.; Keglevich, T.; Gera, I.

    2005-01-01

    The present study clinically and histologically evaluated healing of human intrabony defects following treatment with a combination of enamel matrix derivative (EMD) and bioactive glass (BG) or BG alone. Six patients displaying either combined one- and two-walled (five patients) or three-walled (one

  16. Comparing the clinical and histological diagnosis of leprosy and leprosy reactions in the infir cohort of indian patients with multibacillary leprosy

    NARCIS (Netherlands)

    Lockwood, D.N.J.; Nicholls, P.; Smith, W.C.S.; Das, L.; Barkataki, P.; van Brakel, W.H.; Suneetha, S.

    2012-01-01

    Background: The ILEP Nerve Function Impairment in Reaction (INFIR) is a cohort study designed to identify predictors of reactions and nerve function impairment in leprosy. The aim was to study correlations between clinical and histological diagnosis of reactions. Methodology/Principal Findings:

  17. Identifying clinical course patterns in SMS data using cluster analysis

    Science.gov (United States)

    2012-01-01

    Background Recently, there has been interest in using the short message service (SMS or text messaging), to gather frequent information on the clinical course of individual patients. One possible role for identifying clinical course patterns is to assist in exploring clinically important subgroups in the outcomes of research studies. Two previous studies have investigated detailed clinical course patterns in SMS data obtained from people seeking care for low back pain. One used a visual analysis approach and the other performed a cluster analysis of SMS data that had first been transformed by spline analysis. However, cluster analysis of SMS data in its original untransformed form may be simpler and offer other advantages. Therefore, the aim of this study was to determine whether cluster analysis could be used for identifying clinical course patterns distinct from the pattern of the whole group, by including all SMS time points in their original form. It was a ‘proof of concept’ study to explore the potential, clinical relevance, strengths and weakness of such an approach. Methods This was a secondary analysis of longitudinal SMS data collected in two randomised controlled trials conducted simultaneously from a single clinical population (n = 322). Fortnightly SMS data collected over a year on ‘days of problematic low back pain’ and on ‘days of sick leave’ were analysed using Two-Step (probabilistic) Cluster Analysis. Results Clinical course patterns were identified that were clinically interpretable and different from those of the whole group. Similar patterns were obtained when the number of SMS time points was reduced to monthly. The advantages and disadvantages of this method were contrasted to that of first transforming SMS data by spline analysis. Conclusions This study showed that clinical course patterns can be identified by cluster analysis using all SMS time points as cluster variables. This method is simple, intuitive and does not require

  18. Identifying clinical course patterns in SMS data using cluster analysis

    Directory of Open Access Journals (Sweden)

    Kent Peter

    2012-07-01

    Full Text Available Abstract Background Recently, there has been interest in using the short message service (SMS or text messaging, to gather frequent information on the clinical course of individual patients. One possible role for identifying clinical course patterns is to assist in exploring clinically important subgroups in the outcomes of research studies. Two previous studies have investigated detailed clinical course patterns in SMS data obtained from people seeking care for low back pain. One used a visual analysis approach and the other performed a cluster analysis of SMS data that had first been transformed by spline analysis. However, cluster analysis of SMS data in its original untransformed form may be simpler and offer other advantages. Therefore, the aim of this study was to determine whether cluster analysis could be used for identifying clinical course patterns distinct from the pattern of the whole group, by including all SMS time points in their original form. It was a ‘proof of concept’ study to explore the potential, clinical relevance, strengths and weakness of such an approach. Methods This was a secondary analysis of longitudinal SMS data collected in two randomised controlled trials conducted simultaneously from a single clinical population (n = 322. Fortnightly SMS data collected over a year on ‘days of problematic low back pain’ and on ‘days of sick leave’ were analysed using Two-Step (probabilistic Cluster Analysis. Results Clinical course patterns were identified that were clinically interpretable and different from those of the whole group. Similar patterns were obtained when the number of SMS time points was reduced to monthly. The advantages and disadvantages of this method were contrasted to that of first transforming SMS data by spline analysis. Conclusions This study showed that clinical course patterns can be identified by cluster analysis using all SMS time points as cluster variables. This method is simple

  19. Human Papillomavirus Type Distribution and Correlation with Cyto-Histological Patterns in Women from the South of Italy

    Directory of Open Access Journals (Sweden)

    Paola Menegazzi

    2009-01-01

    Full Text Available Human papillomavirus (HPV type-specific distribution was evaluated in genital samples collected from 654 women from the South of Italy undergoing voluntary screening and correlated with cyto-histological abnormalities. HPV DNA was detected in 45.9% of the samples, 41.7% of which had multiple infection and 89.0% had high-risk HPV infection. The prevalence of HPV infection and the rate of multiple infections decreased with age, suggesting natural selection of HPV types with better fitness. In line with other Italian studies, the most common HPV types were HPV-6 and HPV-16, followed by HPV-51, HPV-31, HPV-53, and HPV-66, in women with both normal and abnormal cytology. Cervical intraepithelial lesions grade 2 or 3 were associated with high-risk HPV-16, HPV-18, HPV-31, and HPV-51 infection. These data indicate that prophylactic HPV vaccination is expected to reduce the burden of HPV-related cervical lesions in this population, but also suggest the potential utility of new vaccines with larger type coverage.

  20. Effectiveness of Cryogen Tetrfluoroethane on Elimination of Gingival Epithelium and its Clinical Application in Gingival Depigmentation–Histological Findings and Case Series

    Science.gov (United States)

    Kumar, Santhosh; Bhat, G. Subraya; Bhat, K. Mahalinga

    2013-01-01

    Objective: To histologically assess and clinically co-relate the effectiveness of cryogen Tetrafluoroethane (TFE) for gingival depigmentation procedure. Material and Methods: Twelve patients having unaesthetic gingival melanin pigmentation were included in the study. Gingival tissues of eight patients having gingival melanin pigmentation undergoing gingivoplasty or gingivectomy for crownlengthening were exposed to the cryogen and this was used for the histological examination. Gingivectomies were done after 8, 24, 96 hours and after a week of application of tetrafluoroethane. Four fair skinned patients complaining of unaesthetic gingival hyperpigmentation underwent gingival depigmentation using Tetrafluoroethane cryogen. Results: Histologically after 96 hours of application of cryogen there was complete loss of retepegs and epithelial detachment from the corium was evident. Complete re – epithelialisation was noted after a week and was clinically correlated. Conclusion: We therefore, concluded that histologically tetrafluoroethane can effectively destroy gingival epithelium without causing damage to the connective tissue and clinically the color of the gingiva had more pleasing appearance 6 months postoperatively. Hence the cryogen can be used safely for depigmentation procedure. PMID:24551730

  1. Effectiveness of cryogen tetrfluoroethane on elimination of gingival epithelium and its clinical application in gingival depigmentation-histological findings and case series.

    Science.gov (United States)

    Kumar, Santhosh; Bhat, G Subraya; Bhat, K Mahalinga

    2013-12-01

    To histologically assess and clinically co-relate the effectiveness of cryogen Tetrafluoroethane (TFE) for gingival depigmentation procedure. Twelve patients having unaesthetic gingival melanin pigmentation were included in the study. Gingival tissues of eight patients having gingival melanin pigmentation undergoing gingivoplasty or gingivectomy for crownlengthening were exposed to the cryogen and this was used for the histological examination. Gingivectomies were done after 8, 24, 96 hours and after a week of application of tetrafluoroethane. Four fair skinned patients complaining of unaesthetic gingival hyperpigmentation underwent gingival depigmentation using Tetrafluoroethane cryogen. Histologically after 96 hours of application of cryogen there was complete loss of retepegs and epithelial detachment from the corium was evident. Complete re - epithelialisation was noted after a week and was clinically correlated. We therefore, concluded that histologically tetrafluoroethane can effectively destroy gingival epithelium without causing damage to the connective tissue and clinically the color of the gingiva had more pleasing appearance 6 months postoperatively. Hence the cryogen can be used safely for depigmentation procedure.

  2. Type 1 and type 2 diabetes in celiac disease: prevalence and effect on clinical and histological presentation.

    Science.gov (United States)

    Kylökäs, Antti; Kaukinen, Katri; Huhtala, Heini; Collin, Pekka; Mäki, Markku; Kurppa, Kalle

    2016-07-25

    Association between celiac disease and type 1 diabetes in adults is still somewhat unclear, and that between celiac disease and type 2 diabetes even less known. We studied these issues in a large cohort of adult celiac disease patients. The prevalence of type 1 and type 2 diabetes in 1358 celiac patients was compared with the population-based values. Furthermore, patients with celiac disease and concomitant type 1 or type 2 diabetes and those with celiac disease only underwent comparisons of clinical and histological features and adherence to gluten-free diet. The prevalence of type 1 diabetes (men/women) was 8.0 % /1.8 % in celiac patients and 0.7 % /0.3 % in the population, and that of type 2 diabetes 4.3 % /2.5 % and 4.4 % /3.0 %, respectively. Celiac patients with concomitant type 1 diabetes were younger (45 years vs 65 years and 52 years, P celiac patients with concomitant type 2 diabetes and patients with celiac disease only. Patients with concomitant type 2 diabetes had more hypercholesterolemia than the other groups (8 % vs 6 % and 4 %, P = 0.024), and both diabetes groups more hypertension (47 % and 31 % vs 15 %, P celiac disease only. Type 1 diabetes was markedly overrepresented in celiac disease, especially in men, whereas the prevalence of type 2 diabetes was comparable with the population. Concomitant type 1 or type 2 diabetes predisposes celiac patients to severe co-morbidities and type 1 diabetes also to poor dietary adherence.

  3. The Sinus Membrane-Maxillary Lateral Wall Complex: Histologic Description and Clinical Implications for Maxillary Sinus Floor Elevation.

    Science.gov (United States)

    Insua, Angel; Monje, Alberto; Urban, Istvan; Kruger, Laura G; Garaicoa-Pazmiño, Carlos; Sugai, James V; Wang, Hom-Lay

    Maxillary sinus floor elevation has been documented as a safe and predictable procedure for gaining vertical bone height in the atrophic posterior maxillae. Conversely, there is a lack of basic research on the characteristics of the union between the sinus membrane (SM) and the bone. Clinical implications of an impaired union in healthy or pathologic membranes remain unknown. The objective of this study was to present a comprehensive histologic and morphologic description of the sinus membrane-lateral bone wall complex. In 14 fresh cadaver heads, 28 lateral wall sinus augmentation procedures were performed to obtain SM samples. Samples were assessed using hematoxylin-eosin, Masson trichrome, and toluidine blue staining and immunofluorescence and immunohistochemistry procedures. Specimens were coded and studied by a trained examiner using an optical microscope at ×4, ×10, ×40, and ×100 objectives. Thickness and inflammation status were assessed in these samples. Overall SM thickness of the samples was 0.40 ± 0.12 mm and was positively correlated to the inflammatory condition of the membranes. Such low values are the consequence of limited inflammation. Most of the fibers and cells in the deeper layers of the SM ran in a horizontal direction, oriented parallel to the underlying bone wall. In the immunohistochemistry study, 3 out of 7 samples showed a certain degree of nestin expression, suggesting osteogenic potential in spite of the elderly specimens. Large variations in thickness across the SM were found. These were noted to be partially correlated to the SM inflammatory status. The vast majority of the fibers were oriented parallel to the maxillary lateral wall, and only a few isolated areas showed a stronger perpendicular attachment. This might indicate the surpassing importance of the SM inflammatory status, operator skill, and other anatomical factors over the sinus membrane-maxillary lateral wall complex interface. Moreover, about half of the SM

  4. Pattern of premenstrual symptoms among pre-clinical medical ...

    African Journals Online (AJOL)

    Background: Premenstrual syndrome is a recognized entity which causes much distress to women at some stage during the reproductive period of their lives. Objective: To evaluate the pattern of premenstrual symptoms among pre-clinical female medical students at the University of Nigeria, Enugu Campus. Methodology: ...

  5. Pattern and clinical profile of children with complex cardiac anomaly ...

    African Journals Online (AJOL)

    Pattern and clinical profile of children with complex cardiac anomaly at University of Nigeria Teaching Hospital, Ituku‑Ozalla, Enugu State, Nigeria. ... ventricle) with left sided aorta, hypoplastic tricuspid valve with a PDA (patent ductus artriosus), TOF (tetralogy of fallot), prolapse of aortic valve, and pulmonary regurgitation.

  6. Sensitivity pattern of clinical isolates of Candida albicans from hiv ...

    African Journals Online (AJOL)

    This study was carried out to investigate the sensitivity pattern of clinical isolates of C. albicans from HIV/AIDS patients to combined P. grisea extract and tioconazole. Twenty isolates of C. albicans were obtained from high vaginal swab (HVS) from HIV/AIDS patients in Bishop Shanahan Hospital, Nsukka after their ...

  7. Identifying clinical course patterns in SMS data using cluster analysis

    DEFF Research Database (Denmark)

    Kent, Peter; Kongsted, Alice

    2012-01-01

    group, by including all SMS time points in their original form. It was a 'proof of concept' study to explore the potential, clinical relevance, strengths and weakness of such an approach. METHODS: This was a secondary analysis of longitudinal SMS data collected in two randomised controlled trials...... clinically interpretable and different from those of the whole group. Similar patterns were obtained when the number of SMS time points was reduced to monthly. The advantages and disadvantages of this method were contrasted to that of first transforming SMS data by spline analysis. CONCLUSIONS: This study...... subgroups in the outcomes of research studies. Two previous studies have investigated detailed clinical course patterns in SMS data obtained from people seeking care for low back pain. One used a visual analysis approach and the other performed a cluster analysis of SMS data that had first been transformed...

  8. CLINICAL, HISTOLOGICAL AND RADIOLOGICAL ASPECTS REGARDING THE INFLUENCE OF SOME EXTERNAL FACTORS ON THE PULP-DENTIN COMPLEX

    Directory of Open Access Journals (Sweden)

    C. Giuroiu

    2012-12-01

    Full Text Available The present study aimed at assesssing – by clinical, histological and radiological investigations – the influence of some external factors on the pulp-dentin complex, and at providing a causal interpretation of the structural changes observed. Materials and methods. Clinical and radiological exams were performed on 65 old patients with ages between 60-75, and also on 40 young patients with ages between 20-35, presenting different dental-periodontal pathologies. The pulp-dentin complex was submitted to a morphopathological examination, to highlight the structural changes observed at microscopic level. Fragments of dental pulp were imersed in a 4% formaldehyde solution with phosphate buffer 0.1 M., pH 7.2, for 12 -14 hours, at a temperature of 4ºC, and 3-5 µm thick slices were prepared. The slices were coloured with hematoxylin-eosine (HE, by the trichromic technique – Masson. Photographies were taken with a Zeiss microscope, with Kodak 200 ASA. Results. Significant differences were observed, between the two groups of patients, as to the external factors that produce structural changes on pulp-dentin organ. In the group of young patients dental caries and coronal fillings prevailed, while the group of old patients was mostly associated with atrition and chronic marginal periodontitis. Out of the 40 young patients, 30 presented chronic dental caries (75%, while, among the 65 old patients, only 24 presented dental caries (36.9%. The percentages of coronary fillings between the two study groups were close, which could be considered as one of the causes producing changes in the pulp-dentin organ, following aggresive preparation of cavities, the action of materials used for the protection of pulp-dentin complex or of the materials used for coronry fillings. Conclusions. Dental pulp has a remarkable ability to counteract the action of harmful factors, producing a mineral barrier and stimulating the reparatory processes. Changes in the endodontic

  9. Histology far away from Flatland: 3D roller-coasting into grade-dependent angiogenetic patterns in oligodendrogliomas.

    Science.gov (United States)

    Cassoni, P; Gaetano, L; Senetta, R; Bussolati, B; Molinaro, L; Bussolati, G

    2008-04-01

    Angiogenesis plays a key role in tumour progression, and undergoes structural changes associated to tumour biology itself. Although vessel density can be easily evaluated in brain tumours using a traditional immuno-histochemical approach, other parameters of conceptual/biological interest, such as the complex patterns of vascular growth, cannot be fully understood using a traditional bi-dimensional evaluation. We use here surgical specimens derived from oligodendrogliomas as a model for a novel elucidative 3D reconstruction of the grade-dependent vascular arborisation in brain tumours.

  10. Are clinical features able to predict Helicobacter pylori gastritis patterns? Evidence from tertiary centers.

    Science.gov (United States)

    Carabotti, Marilia; Lahner, Edith; Porowska, Barbara; Colacci, Enzo; Trentino, Paolo; Annibale, Bruno; Severi, Carola

    2014-12-01

    Outcome of Helicobacter pylori infection is different according to gastritis extension (i.e. antrum-restricted gastritis or pangastritis). The aim of this study is to evaluate whether different gastritis patterns are associated with specific gastrointestinal symptoms or clinical signs that could be suggestive of the topography of gastritis. 236 consecutive symptomatic outpatients were recruited in two tertiary centers. They filled in a validated and self-administered Rome III modular symptomatic questionnaire, and underwent gastroscopy with histological sampling. 154 patients with Helicobacter pylori infection were included. Clinical presentation did not differ between antrum-restricted gastritis and pangastritis, gastro-esophageal reflux disease being present in 48.2 and 54.1 % of patients and dyspepsia in 51.8 and 45.9 %, respectively. However, pangastritis statistically differed from antrum-restricted gastritis in that the presence of clinical signs (p gastritis pattern whereas their association with signs, accurately detected, is indicative for the presence of pangastritis.

  11. Carotenoids co-localize with hydroxyapatite, cholesterol, and other lipids in calcified stenotic aortic valves. Ex vivo Raman maps compared to histological patterns

    Directory of Open Access Journals (Sweden)

    A. Bonetti

    2015-04-01

    Full Text Available Unlike its application for atherosclerotic plaque analysis, Raman microspectroscopy was sporadically used to check the sole nature of bioapatite deposits in stenotic aortic valves, neglecting the involvement of accumulated lipids/lipoproteins in the calcific process. Here, Raman microspectroscopy was employed for examination of stenotic aortic valve leaflets to add information on nature and distribution of accumulated lipids and their correlation with mineralization in the light of its potential precocious diagnostic use. Cryosections from surgically explanted stenotic aortic valves (n=4 were studied matching Raman maps against specific histological patterns. Raman maps revealed the presence of phospholipids/triglycerides and cholesterol, which showed spatial overlapping with one another and Raman-identified hydroxyapatite. Moreover, the Raman patterns correlated with those displayed by both von-Kossa-calcium- and Nile-blue-stained serial cryosections. Raman analysis also provided the first identification of carotenoids, which co-localized with the identified lipid moieties. Additional fit concerned the distribution of collagen and elastin. The good correlation of Raman maps with high-affinity staining patterns proved that Raman microspectroscopy is a reliable tool in evaluating calcification degree, alteration/displacement of extracellular matrix components, and accumulation rate of different lipid forms in calcified heart valves. In addition, the novel identification of carotenoids supports the concept that valve stenosis is an atherosclerosis-like valve lesion, consistently with their previous Raman microspectroscopical identification inside atherosclerotic plaques.

  12. Clinical outcomes and histological findings of patients with advanced metastatic germ cell tumors undergoing post-chemotherapy resection of retroperitoneal lymph nodes and residual extraretroperitoneal masses.

    Science.gov (United States)

    Nakamura, Terukazu; Oishi, Masakatsu; Ueda, Takashi; Fujihara, Atsuko; Nakanishi, Hiroyuki; Kamoi, Kazumi; Naya, Yoshio; Hongo, Fumiya; Okihara, Koji; Miki, Tsuneharu

    2015-07-01

    To assess clinical outcomes of patients with advanced germ cell tumor undergoing post-chemotherapy retroperitoneal lymph node dissection with or without extraretroperitoneal mass resection. Between 1998 and 2013, 175 retroperitoneal lymph node dissections for advanced metastatic germ cell tumors were carried out at Kyoto Prefectural University of Medicine, Kyoto, Japan. Of patients receiving retroperitoneal lymph node dissections, 156 underwent post-chemotherapy retroperitoneal lymph node dissection with or without extraretroperitoneal mass resection as first surgery after completion of chemotherapy. Of these 156 patients, 47 underwent both post-chemotherapy retroperitoneal lymph node dissection and extraretroperitoneal mass resection. The histological findings were necrosis in 59.6%, teratoma in 31.4% and viable cancer in 9.0% at retroperitoneal lymph node. At extraretroperitoneal mass resection, necrosis was present in 59.6%, teratoma in 31.9% and viable cancer in 8.5%. Overall histological discordance between retroperitoneal lymph node and extraretroperitoneal mass was found in 31.9%. Five-year disease-free survival stratified by retroperitoneal lymph node histology in 156 patients was 91.3% for necrosis, 78.7% for teratoma and 63.5% for viable cancer (log-rank, P = 0.009). Antegrade ejaculation was preserved in 80.9%. In the worst histology of post-chemotherapy retroperitoneal lymph node dissection or extraretroperitoneal mass resection in 156 patients, 5-year disease-free survival was 93.2% for necrosis, 79.0% for teratoma and 63.4% for viable cancer (log-rank, P retroperitoneal lymph node histology and salvage chemotherapy. The presence of viable cancer at the retroperitoneal lymph node is an independent predictor of disease recurrence. In approximately one-third of cases, there is a histological discordance between retroperitoneal lymph node and extraretroperitoneal mass. Resection of residual retroperitoneal lymph node and extraretroperitoneal masses

  13. Clinical and histological findings after intravitreal injection of bevacizumsb (Avastin®) in a porcine model of choroidal neovascularisation

    DEFF Research Database (Denmark)

    Lassota, Nathan; Prause, Jan Ulrik; Scherfig, Erik

    2010-01-01

    PURPOSE: To examine the effect of intravitreally injected bevacizumab (Avastin) on the histological and angiographic morphology of choroidal neovascularization (CNV) in a masked and placebo-controlled animal study. METHODS: Choroidal neovascularization was induced surgically in 11 porcine eyes...... leaking on FA, whereas only one of five bevacizumab-injected eyes exhibited leakage. On histological examination, all 11 eyes contained CNV membranes of similar size, regardless of treatment. The number of vascular endothelial cells was significantly reduced (p = 0.03) in CNV membranes from eyes that had...

  14. Establishment of indicators to improve clinical analysis prescribing patterns.

    Science.gov (United States)

    Zaepfel, Sabine; Fontaine, Mathieu; Agi, Danièle; Pecquet, Matthieu

    2017-10-01

    An appropriate medical analysis prescribing pattern is part of the medical biologists' work as it enhances patient care and reduces costs. In this study, we use four indicators to aim to evaluate the relevance of clinical analysis prescription. We confronted clinical data and medical analysis prescribed in June 2013 in the emergency department (ED) and found that prescriptions were justified in 73% of TnT prescriptions but only in less than 50% of NTproBNP (27%), APTT (37%), PR (33%) or INR (23%) prescriptions. We noted that staff training, an improved communication between biologists and clinical physicians, and better computing devices, have led to better prescribing patterns. From 2013 to 2015, inappropriate associations of PR and APTT have significantly declined in the intensive care unit. At the same period, amounts of medical analysis as well as department spendings decreased in the ED. The use of indicators is essential to evaluate and monitor the relevance of medical analysis patterns. In this work, we propose to combine a global indicator (cost/day of hospitalization or medical analysis amount/month) with a regular follow up on inadequate prescribed analysis associations. These indicators will need to be adjusted to each clinical department.

  15. Comparing the clinical and histological diagnosis of leprosy and leprosy reactions in the INFIR cohort of Indian patients with multibacillary leprosy.

    Directory of Open Access Journals (Sweden)

    Diana N J Lockwood

    Full Text Available BACKGROUND: The ILEP Nerve Function Impairment in Reaction (INFIR is a cohort study designed to identify predictors of reactions and nerve function impairment in leprosy. The aim was to study correlations between clinical and histological diagnosis of reactions. METHODOLOGY/PRINCIPAL FINDINGS: Three hundred and three newly diagnosed patients with World Health Organization multibacillary (MB leprosy from two centres in India were enrolled in the study. Skin biopsies taken at enrolment were assessed using a standardised proforma to collect data on the histological diagnosis of leprosy, leprosy reactions and the certainty level of the diagnosis. The pathologist diagnosed definite or probable Type 1 Reactions (T1R in 113 of 265 biopsies from patients at risk of developing reactions whereas clinicians diagnosed skin only reactions in 39 patients and 19 with skin and nerve involvement. Patients with Borderline Tuberculoid (BT leprosy had a clinical diagnosis rate of reactions of 43% and a histological diagnosis rate of 61%; for patients with Borderline Lepromatous (BL leprosy the clinical and histological diagnosis rates were 53.7% and 46.2% respectively. The sensitivity and specificity of clinical diagnosis for T1R was 53.1% and 61.9% for BT patients and 61.1% and 71.0% for BL patients. Erythema Nodosum Leprosum (ENL was diagnosed clinically in two patients but histologically in 13 patients. The Ridley-Jopling classification of patients (n = 303 was 42.8% BT, 27.4% BL, 9.4% Lepromatous Leprosy (LL, 13.0% Indeterminate and 7.4% with non-specific inflammation. This data shows that MB classification is very heterogeneous and encompasses patients with no detectable bacteria and high immunological activity through to patients with high bacterial loads. CONCLUSIONS/SIGNIFICANCE: Leprosy reactions may be under-diagnosed by clinicians and increasing biopsy rates would help in the diagnosis of reactions. Future studies should look at sub-clinical T1R and ENL

  16. Comparing the Clinical and Histological Diagnosis of Leprosy and Leprosy Reactions in the INFIR Cohort of Indian Patients with Multibacillary Leprosy

    Science.gov (United States)

    Lockwood, Diana N. J.; Nicholls, Peter; Smith, W. Cairns S.; Das, Loretta; Barkataki, Pramila; van Brakel, Wim; Suneetha, Sujai

    2012-01-01

    Background The ILEP Nerve Function Impairment in Reaction (INFIR) is a cohort study designed to identify predictors of reactions and nerve function impairment in leprosy. The aim was to study correlations between clinical and histological diagnosis of reactions. Methodology/Principal Findings Three hundred and three newly diagnosed patients with World Health Organization multibacillary (MB) leprosy from two centres in India were enrolled in the study. Skin biopsies taken at enrolment were assessed using a standardised proforma to collect data on the histological diagnosis of leprosy, leprosy reactions and the certainty level of the diagnosis. The pathologist diagnosed definite or probable Type 1 Reactions (T1R) in 113 of 265 biopsies from patients at risk of developing reactions whereas clinicians diagnosed skin only reactions in 39 patients and 19 with skin and nerve involvement. Patients with Borderline Tuberculoid (BT) leprosy had a clinical diagnosis rate of reactions of 43% and a histological diagnosis rate of 61%; for patients with Borderline Lepromatous (BL) leprosy the clinical and histological diagnosis rates were 53.7% and 46.2% respectively. The sensitivity and specificity of clinical diagnosis for T1R was 53.1% and 61.9% for BT patients and 61.1% and 71.0% for BL patients. Erythema Nodosum Leprosum (ENL) was diagnosed clinically in two patients but histologically in 13 patients. The Ridley-Jopling classification of patients (n = 303) was 42.8% BT, 27.4% BL, 9.4% Lepromatous Leprosy (LL), 13.0% Indeterminate and 7.4% with non-specific inflammation. This data shows that MB classification is very heterogeneous and encompasses patients with no detectable bacteria and high immunological activity through to patients with high bacterial loads. Conclusions/Significance Leprosy reactions may be under-diagnosed by clinicians and increasing biopsy rates would help in the diagnosis of reactions. Future studies should look at sub-clinical T1R and ENL and whether

  17. Breast Pain: Clinical pattern and aetiology in a breast clinic in Eastern Nigeria

    Directory of Open Access Journals (Sweden)

    Ochonma A Egwuonwu

    2016-01-01

    Full Text Available Background: Patients with breast pain are likely to be very worried because some consider pain in the breast as an indication of malignancy. Objective: To highlight the causes of pain in the patients are presenting to our breast clinic. Materials and Methods: A prospective study of all consenting patients with breast disease presenting to the breast clinic was conducted from January 2004 to December 2008. Results: A total of 664 patients presented to the breast clinic during the study period. Of this number, 127 presented with breast pain either as the sole symptom or in association with other symptoms. The presenting complaints were a pain, pain with lump, and pain with nipple discharge in 63 (49.6%, 59 (46.4%, and 5 (4.0% patients, respectively. The pain was noncyclical in 96 (75.6% patients. The site of the pain was whole breast in 87 (68.5% patients and a lump in 40 (31.5%. The clinical diagnosis in 31 (24.4% cases was fibrocystic disease, 28 (22.0% cancer, 23 (18.1% unknown, 10 (7.9% fibroadenoma, 8 (6.3% duct ectasia, 6 (4.7% normal breast, and others 21 (16.5% cases benign diseases were diagnosed. The histological diagnosis was fibrocystic changes, carcinoma, and fibroadenoma in 15 (42.9%, 10 (28.6%, and 5 (14.3% patients, respectively. Others were benign phyllodes, abscess, duct ectasia, chronic mastitis, and lipoma, each constituting 1 (2.9% case. Conclusion: Breast pain constitutes a small proportion of complaints to our breast clinic. Fibrocystic changes were the most common cause of breast pain both clinically and histologically.

  18. Clinical and histological challenge in the differential diagnosis of diffuse alopecia: female androgenetic alopecia, telogen effluvium and alopecia areata - part II

    OpenAIRE

    Werner, Betina; Mulinari-Brenner, Fabiane

    2012-01-01

    Diffuse alopecia is mainly caused by telogen effluvium, diffuse androgenetic alopecia (femalepattern hair loss) and diffuse alopecia areata. Differential diagnosis between the three disorders may be difficult in several occasions. In this second part of our study, chronic telogen effluvium and diffuse alopecia areata are discussed in detail, including clinical, dermoscopic and histological aspects. A flowchart presents a practical and objective differential diagnostic approach to diffuse alop...

  19. The Fresh Frozen Bone Allograft (FFBA) to reconstruc the atrophic maxilla: evaluation of the clinical and histological viability at six and nine months in the maxillary sinus

    OpenAIRE

    Bassi, Ana Paula Farnezi; Vieira, Rogeria A; Matsumoto, Marisa Akemi; Stecklberg, Iris Monica; Ferreira,Gabriel Ramalho; FAVERANI,Leonardo Perez

    2013-01-01

    This work aimed to analyze clinically and histologically the allogen bone graft behavior at 6 and 9 months. A leukoderm, female, 55 years old patient sought dental care for oral rehabilitation with dental implants and implant supported fixed prosthesis in the maxilla. Bilateral sinus lifting procedure were performed in a same patient, the analysis were made after 6 and 9 months, respectively. At 6 months, there was lack of a better bone remodeling in the region, associated to the presence of ...

  20. The morphological substrate for Renal Denervation: Nerve distribution patterns and parasympathetic nerves. A post-mortem histological study.

    Science.gov (United States)

    van Amsterdam, Wouter A C; Blankestijn, Peter J; Goldschmeding, Roel; Bleys, Ronald L A W

    2016-03-01

    Renal Denervation as a possible treatment for hypertension has been studied extensively, but knowledge on the distribution of nerves surrounding the renal artery is still incomplete. While sympathetic and sensory nerves have been demonstrated, there is no mention of the presence of parasympathetic nerve fibers. To provide a description of the distribution patterns of the renal nerves in man, and, in addition, provide a detailed representation of the relative contribution of the sympathetic, parasympathetic and afferent divisions of the autonomic nervous system. Renal arteries of human cadavers were each divided into four longitudinal segments and immunohistochemically stained with specific markers for afferent, parasympathetic and sympathetic nerves. Nerve fibers were semi-automatically quantified by computerized image analysis, and expressed as cross-sectional area relative to the distance to the lumen. A total of 3372 nerve segments were identified in 8 arteries of 7 cadavers. Sympathetic, parasympathetic and afferent nerves contributed for 73.5% (95% CI: 65.4-81.5%), 17.9% (10.7-25.1%) and 8.7% (5.0-12.3%) of the total cross-sectional nerve area, respectively. Nerves are closer to the lumen in more distal segments and larger bundles that presumably innervate the kidney lie at 1-3.5mm distance from the lumen. The tissue-penetration depth of the ablation required to destroy 50% of the nerve fibers is 2.37 mm in the proximal segment and 1.78 mm in the most distal segments. Sympathetic, parasympathetic and afferent nerves exist in the vicinity of the renal artery. The results warrant further investigation of the role of the parasympathetic nervous system on renal physiology, and may contribute to refinement of the procedure by focusing the ablation on the most distal segment. Copyright © 2015 Elsevier GmbH. All rights reserved.

  1. Clinical patterns of primary stabbing headache: a single clinic-based prospective study.

    Science.gov (United States)

    Kim, Dong Yeop; Lee, Mi Ji; Choi, Hyun Ah; Choi, Hanna; Chung, Chin-Sang

    2017-12-01

    The clinical features and disease courses of primary stabbing headache (PSH) are diverse. We aimed to identify distinct clinical patterns of PSH. We prospectively screened consecutive first-visit patients who presented with stabbing headache at the Samsung Medical Centre Headache Clinic from June 2015 to March 2016. Demographics, headache characteristics, and disease courses were prospectively evaluated. After discerning factors related to the chronicity at the time of presentation, clinical patterns were identified based on the frequency (daily vs. intermittent), clinical course (remitted or not), and total disease duration (3 months). In the 65 patients with PSH included in this study, monophasic (n = 31), intermittent (n = 17), and chronic daily (n = 12) patterns were identified. The median disease durations were 9 days for monophasic PSH, 9 months for chronic daily PSH, and 2 years for intermittent PSH. The features of monophasic PSH were greater severity, single and side-locked locations, more attacks per day, daily occurrence, and good treatment response. Chronic daily PSH was associated with female predominance, longer-lasting stabs, and multiple or migrating locations on bilateral or alternating sides. The characteristics of intermittent PSH included female predominance and sporadic stabs with less intensity. Our study demonstrated distinct clinical patterns of PSH. In addition to help early recognition of disease, our findings suggest different pathophysiologic mechanisms. Future prospective studies are required to reveal the etiologies of these different PSH patterns and their optimal treatment strategies.

  2. Patterns of clinical nail appearances in patients with cutaneous psoriasis.

    Science.gov (United States)

    Marina, Elena Mihaela; Botar-Jid, Carolina; Bolboaca, Sorana Daniela; Roman, Iulia Ioana; Senila, Corina Simona; Mihu, Carmen Mihaela; Tataru, Dumitru Alexandru

    2017-01-01

    Nail manifestations are often an overlooked aspect in psoriatic disease, cutaneous and joint involvement being far more often reported and investigated. The reported prevalence of nail changes varies in literature, specific fingernail clinical features having different degrees of occurrence. The aim of this study was to describe specific clinical patterns of fingernail alterations in adult patients with plaque-type psoriasis in a university hospital in the North-West of Romania. Clinical data of 35 patients with fingernail psoriasis were collected and analyzed. Psoriasis Area and Severity Index (PASI) and Nail Psoriasis Severity Index (NAPSI) scores were used to quantify disease extension in each patient. PASI score proved linearly correlated with NAPSI score (pright hand and first fingernail in the left hand were in most of the cases severely affected. The most common observed nail pattern was pitting, followed by salmon patches and subungual hyperkeratosis. Important nail changes appear even in moderate forms of cutaneous psoriasis. Particular localization of specific fingernail psoriasis pattern enables the possibility of detecting early stage disease.

  3. Effects of intramuscular injection of a sublethal dose of the Egyptian cobra snake on the histological and histochemical pattern of the kidney.

    Science.gov (United States)

    Rahmy, T R

    2000-05-01

    The effects of intramuscular (i.m.) injection of a sub-lethal dose of cobra venom (0.015 microgram/gm body weight) on the histological and histochemical patterns of the kidney of rabbit were examined after 3, 6, and 12 hr. of envenomation. The histological observations after 3 hr. of envenomation showed glomerular congestion together with slight swelling of the cortical tubular epithelia. However, no changes were recorded in the medullar tubules. Serious alterations were recorded after 6 hr. of envenomation. It included thickening of the Bowman's capsules, signs of mesangiolysis, and glomerular collapse. The cortical tubular epithelia were swollen and revealed cytoplasmic granulation, coagulation, or depletion. Nuclear pyknosis and cellular damage were recorded in some areas. The medullar tubules showed cytoplasmic degeneration with no nuclear changes. By 12 hr. of envenomation a higher degree of severity was recorded. The glomerular tufts were hypertrophied or suffered from partial damage. Mesangiolysis and glomerulolysis were common and some glomerular tufts were completely transformed to clumps of hyaline casts. The cortical tubules showed hyaline coagulation, together with severe tubular damage in which the boundaries of the individual tubule cannot be identified. Numerous inflammatory cells were observed invading the damaged epithelial cells and the intertubular spaces. The medullar tubules showed swollen epithelia with cytoplasmic changes and nuclear pyknosis or karyolysis. Histochemically, the polysaccharide inclusion was increased in the glomerular tufts, the Bowman's capsules, and the basement membranes and brush borders of the renal tubules after 3 and 6 hr. of envenomation. By 12 hr. of envenomation, decreased PAS reactivity was recorded in all renal components except the glomerular tufts which exhibited intensive reactivity. Time-dependent depletion of lipid, protein, and RNA components was recorded in the renal tissues of the three envenomed groups

  4. Clinical and histological findings after intravitreal injection of bevacizumab (Avastin) in a porcine model of choroidal neovascularization

    DEFF Research Database (Denmark)

    Lassota, Nathan; Prause, Jan Ulrik; Scherfig, Erik

    2010-01-01

    PURPOSE: To examine the effect of intravitreally injected bevacizumab (Avastin) on the histological and angiographic morphology of choroidal neovascularization (CNV) in a masked and placebo-controlled animal study. METHODS: Choroidal neovascularization was induced surgically in 11 porcine eyes...... leaking on FA, whereas only one of five bevacizumab-injected eyes exhibited leakage. On histological examination, all 11 eyes contained CNV membranes of similar size, regardless of treatment. The number of vascular endothelial cells was significantly reduced (p = 0.03) in CNV membranes from eyes that had...... been injected with bevacizumab when compared with CNV membranes from placebo-injected eyes. There was a trend towards more retinal pigment epithelium cells (p = 0.16) and fewer glial fibres (p = 0.08) in membranes from bevacizumab-treated eyes compared with placebo-treated eyes. Bevacizumab...

  5. The value of student scientific society at the Department of Histology, Cytology and Embryology in clinical professional orientation

    OpenAIRE

    Evtushenko V.M.

    2014-01-01

    Background. Histology with embryology and cytology are core of basic medical and biological sciences, allowing us to formulate a better understanding of the principle of multi-level structure of the human body and hierarchical relationships within it, as well as the mechanisms of interaction of the human body with the environment in the norm and pathology. Objective. The aim of this study was to determine the effect of training students in the Student Scientific Society at the Department of H...

  6. Histologic features of the liver biopsy predict the clinical outcome for patients with graft-versus-host disease of the liver.

    Science.gov (United States)

    Duarte, Rafael F; Delgado, Julio; Shaw, Bronwen E; Wrench, David J; Ethell, Mark; Patch, David; Dhillon, Amar P; Mackinnon, Stephen; Potter, Mike N; Quaglia, Alberto F

    2005-10-01

    We reviewed liver histologic results from all allogeneic hematopoietic stem cell transplant recipients from our institution with a confirmed diagnosis of liver graft-versus-host disease (L-GVHD), no concomitant causes of liver dysfunction, and at least 1 diagnostic liver biopsy sample (n=33) to ascertain whether histologic features predicted clinical outcome. The 1-year probability of nonrelapse mortality (NRM) from the onset of liver dysfunction was 68.15%, with a median overall survival (OS) of 6.2 months for the entire group. Histologic features traditionally linked to the diagnosis of L-GVHD (eg, bile duct damage, bile duct lymphocytic infiltration, portal inflammation, and ductopenia) had no association with patient outcome. However, an extended histologic analysis showed that a high level of lobular inflammation (LI) and a low level of hepatocyte ballooning (HB) were independent favorable prognostic factors for NRM (RR, 5.14; P=.033; and relative risk (RR), 0.18; P=.018, respectively) and OS (RR, 3.99; P=.032; and RR, 0.23; P=.037, respectively). The presence and severity of LI and HB were not associated with patient- or transplant-related characteristics or L-GVHD clinical factors such as timing of the biopsy from the onset of L-GVHD, acute versus chronic presentation, or whether the patients had started immunosuppressive treatment with steroids at the time of the biopsy. In multivariate analysis that included clinical prognostic factors, the combined histologic risk posed by high LI and low HB retained independent favorable prognostic value for NRM (RR, 5.05; P=.015) and OS (RR, 3.31; P=.038). This information, if replicated in other studies, could expand current indications for liver biopsy in patients with L-GVHD, not only to exclude other causes of liver injury, but also to predict clinical outcome, and should be considered in the selection of patients and the design of future trials with new experimental therapies for this complication. Prospective

  7. Gross, computed tomographic and histological findings in mandibular cheek teeth extracted from horses with clinical signs of pulpitis due to apical infection.

    Science.gov (United States)

    Casey, M B; Pearson, G R; Perkins, J D; Tremaine, W H

    2015-09-01

    The most prevalent type of equine dental pulpitis due to apical infection is not associated with coronal fractures or periodontal disease. The pathogenesis of this type of pulpitis is not fully understood. Computed tomography (CT) is increasingly used to investigate equine dental disorders. However, gross, tomographic and histopathological changes in equine dental pulpitis have not been compared previously. To compare gross, CT and histological appearances of sectioned mandibular cheek teeth extracted from horses with clinical signs of pulpitis without coronal fractures or periodontal disease. To contribute to understanding the pathogenesis of equine dental pulpitis. Descriptive study using diseased and healthy teeth. Mandibular cheek teeth extracted from horses with clinical signs of pulpitis (cases), and from cadavers with no history of dental disease (controls), were compared using CT in the transverse plane at 1 mm intervals. Teeth were then sectioned transversely, photographed and processed for histopathological examination. Tomographs were compared with corresponding gross and histological sections. Cement, dentine and bone had similar ranges of attenuation (550-2000 Hounsfield Units, HU) in tomographs but could be differentiated from pulp (-400 to 500 HU) and enamel (> 2500 HU). Twelve discrete dental lesions were identified grossly, 10 of which were characterised histologically. Reactive and reparative dentinogenesis and extensive pulpar mineralisation, previously undescribed, were identified. Pulpar oedema, neutrophilic inflammation, cement and enamel defects, and reactive cemental deposition were also observed. The CT and pathological findings corresponded well where there was mineralised tissue deposited, defects in mineralised tissue, or food material in the pulpar area. Pulpar and dentinal necrosis and cement destruction, evident grossly and histologically, did not correspond to CT changes. Computed tomography is useful for identifying deposition and

  8. Role of [{sup 18}F]FDG PET/CT in the assessment of suspected recurrent ovarian cancer: correlation with clinical or histological findings

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Hyun Hoon; Kim, Jae Weon; Park, Noh-Hyun; Song, Yong-Sang; Kang, Soon-Beom; Lee, Hyo-Pyo [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Seoul (Korea); Kang, Won Jun; Chung, June-Key [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea)

    2007-04-15

    To evaluate the accuracy of integrated positron emission tomography (PET) and computed tomography (CT) for depiction of suspected recurrent ovarian carcinoma after treatment, with use of clinical or histological findings as the reference standard. Seventy-seven women (median age, 51 years) with ovarian carcinoma treated with primary cytoreductive surgery followed by platinum-based combination chemotherapy were included, and [{sup 18}F]fluorodeoxyglucose (FDG) PET/CT was performed for suspected recurrence. In all patients, imaging findings were compared with results of histological examination after surgical exploration or clinical follow-up to determine the diagnostic accuracy of PET/CT in the evaluation of disease status. Fisher's exact test was used to measure the ability of PET/CT to predict recurrent lesions. Forty-five (58.4%) of the 77 patients had documented recurrence during surgical exploration or clinical follow-up, while 32 (41.6%) had no evidence of recurrent tumour. Of the 45 patients with recurrent disease, 27 (60%) were confirmed to have recurrence by surgical biopsy. A correlation was found between PET/CT and histological or clinical analyses ({kappa} = 0.894). The overall sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PET/CT were 93.3%, 96.9%, 94.8%, 97.7% and 91.2%, respectively. PET/CT modified the diagnostic or treatment plan in 19 (24.7%) patients, by leading to the use of previously unplanned therapeutic procedures in 11 (57.9%) patients and the avoidance of previously planned diagnostic procedures in eight (42.1%) patients. Integrated FDG PET/CT is a sensitive post-therapy surveillance modality for the detection of recurrent ovarian cancer; it aids decisions on treatment plans and may ultimately have a favourable impact on prognosis. (orig.)

  9. Do evidence-based guidelines change clinical practice patterns?

    DEFF Research Database (Denmark)

    Kessel, Line; Erngaard, Ditte; Flesner, Per

    2017-01-01

    In 2013, the Danish Health and Medicines Authorities published a National Clinical Guideline on the treatment of age-related cataracts. The guideline provided evidence-based recommendations on the indication for cataract surgery, cataract surgery in patients with age-related macular degeneration...... medicine. Thus, evidence-based guidelines do change practice patterns unless they are counteracted by the reimbursement system....... likely to prescribe non-steroidal anti-inflammatory eye drops and to not prescribe topical antibiotic eye drops after the guideline was published. Other parameters, most notably the use of toric IOLs and use of postoperative examinations were more guided by reimbursement standards than by evidence-based...

  10. Is the performance of MRI in preoperative staging of breast cancer independent of clinical and histological factors? A subgroup analysis.

    Science.gov (United States)

    Carreira Gómez, C; Zamora Romero, J; Gil de Miguel, A; Chiva de Agustín, M; Plana Farrás, M N; Martínez González, J

    2015-01-01

    To determine whether preoperative breast MRI is more useful in patients according to their breast density, age, menopausal status, and biopsy findings of carcinoma in situ. We retrospectively studied 264 patients treated for breast cancer who had undergone mammography, ultrasonography, and MRI. We compared the size of the tumor on the three techniques and the sensitivity of the techniques for detecting additional lesions both in the overall group and in subgroups of patients classified according to their breast density, age, menopausal status, and histological findings of intraductal carcinoma. The definitive histological diagnosis was used as the gold standard. MRI was the technique that was most concordant with the histological findings for the size of the lesion, and it was also the technique that detected the most additional lesions. With MRI, we observed no differences in lesion size between the overall group and the subgroups in which MRI provided added value. Likewise, we observed no differences in the number of additional lesions detected in the overall group except for multicentric lesions, which was larger in older patients (P=.02). In the subgroup of patients in which MRI provided added value, the sensitivity for bilateral lesions was higher in patients with fatty breasts (P=.04). Multifocal lesions were detected significantly better in premenopausal patients (P=.03). MRI is better than mammography and better than ultrasonography for establishing the size of the tumor and for detecting additional lesions. Our results did not identify any subgroups in which the technique was more useful. Copyright © 2013 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  11. Clinical, endocrinological and histopathological patterns of infertile Saudi men subjected to testicular biopsy: A retrospective study from a single center.

    Science.gov (United States)

    Madbouly, Khaled; Al-Hooti, Qais; Albkri, Abdullah; Ragheb, Samir; Alghamdi, Khaled; Al-Jasser, Abdullah

    2012-09-01

    To evaluate the outcome of testicular biopsies as well as the etiology of azoospermia and severe oligospermia in Saudi men referred for tertiary care. To correlate testicular histology with patients' clinical and hormonal profiles. Charts of men subjected to testicular biopsies in the last 10-year period were retrospectively reviewed. Relative history and physical examination findings were reported. Results of male fertility profile tests and semen analysis of at least two ejaculates were collected. Reported histopathology was obtained. Reports of 229 patients were included; 199 (86.9%) with azoospermia and 30 (13.1%) with severe oligospermia. The mean (SD) age was 30.6 (6.4) years. A small right or left testis was reported in 88 (38.4%) and 87 (38%) of the patients, respectively. The mean (SD) testosterone and follicle stimulating hormone (FSH) values were 17.2 (7.2) nmol/L and 13.1 (10.9) IU/L, respectively. Hypospermatogenesis was the most common histology encountered (36.5%), followed by Sertoli cell-only (SCO) histology (31.5%). Low testicular volume (P = 0.000), high FSH (P = 0.001) and high leutenizing hormone (LH) (P = 0.001) were found to be of significantly adverse effect on spermatogenesis. Despite having bilateral small testes, high serum FSH and LH, 24.3% of our patients showed active spermatogenesis. Hypospermatogenesis was the most common pattern of spermatogenic defect in our patients. SCO histology was the most common pattern in patients with small testes, primary testicular failure, primary infertility and azoospermia. Low testicular volume, high FSH and LH are significantly associated with impaired spermatogenesis. Even with severe male factor infertility disorders, infertile men can have some spermatogenesis.

  12. Evaluation of clinical and histologic factors associated with survival time in dogs with stage II splenic hemangiosarcoma treated by splenectomy and adjuvant chemotherapy: 30 cases (2011-2014).

    Science.gov (United States)

    Moore, Antony S; Rassnick, Kenneth M; Frimberger, Angela E

    2017-09-01

    OBJECTIVE To determine histologic and clinical factors associated with survival time in dogs with stage II splenic hemangiosarcoma treated by splenectomy and a chemotherapy protocol in which an anthracycline was alternated with lomustine. DESIGN Retrospective case series. ANIMALS 30 dogs with stage II splenic hemangiosarcoma. PROCEDURES Medical records of 3 facilities were reviewed to identify dogs treated for stage II splenic hemangiosarcoma between June 2011 and October 2014. Information collected included signalment, disease staging data, whether anemia was present, date of splenectomy, chemotherapy protocol, adverse effects, and date of death or last follow-up. Histologic slides were reviewed and scored by pathologists. Associations between variables of interest and survival data were evaluated statistically. RESULTS Median survival time for all dogs was 158 days (range, 55 to 560 days), and the 1-year survival rate was 16%. On multivariate analysis, only the histologically determined mitotic score was significantly associated with survival time. The median survival time of 292 days for dogs with a mitotic score of 0 (hemangiosarcoma.

  13. Resistance patterns in clinical isolates of pathogenic Actinomyces species.

    Science.gov (United States)

    Steininger, C; Willinger, Birgit

    2016-02-01

    Actinomyces spp. are commensals that may occasionally invade deep tissue structures, causing difficult-to-treat and disfiguring lesions. Information on antimicrobial resistance patterns is limited to observations from two previous studies. Therefore, we examined antimicrobial resistance patterns in clinical isolates of Actinomyces spp. In this retrospective assessment of antimicrobial resistance patterns, we identified 392 Actinomyces spp. at a tertiary care centre from January 2008 to December 2014. MICs of various antimicrobial agents, including ampicillin/sulbactam, meropenem, clindamycin, metronidazole and vancomycin for anaerobic actinomycetes, were obtained by Etest. For aerobic actinomycetes, imipenem, cefotaxime, amikacin, linezolid, moxifloxacin, trimethoprim/sulfamethoxazole and clarithromycin were tested. MIC results were interpreted based on guidelines published by the CLSI (formerly NCCLS). Actinomyces meyeri was predominantly isolated and accounted for 34% of all Actinomyces spp. identified, followed by Actinomyces turicensis with 23%. Actinomyces neuii is considered to be a rare Actinomyces sp., but accounted for 8% of isolates. Antimicrobial susceptibility testing of isolates showed that the Actinomyces spp. were almost uniformly susceptible to β-lactam antimicrobials (with and without β-lactamase inhibitors), carbapenems, tetracyclines and vancomycin. In contrast, Actinomyces spp. isolates were almost uniformly resistant to metronidazole. β-Lactam antimicrobial agents remain the first choice, whereas metronidazole should be avoided, in the treatment of actinomycosis. Reasonable alternatives for treatment are tetracyclines and carbapenems. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  14. Prognostic impact of proliferation for resected early stage 'pure' invasive lobular breast cancer: Cut-off analysis of Ki67 according to histology and clinical validation.

    Science.gov (United States)

    Carbognin, Luisa; Sperduti, Isabella; Fabi, Alessandra; Dieci, Maria Vittoria; Kadrija, Dzenete; Griguolo, Gaia; Pilotto, Sara; Guarneri, Valentina; Zampiva, Ilaria; Brunelli, Matteo; Orvieto, Enrico; Nortilli, Rolando; Fiorio, Elena; Parolin, Veronica; Manfrin, Erminia; Caliò, Anna; Nisticò, Cecilia; Pellini, Francesca; Scarpa, Aldo; Pollini, Giovanni Paolo; Conte, Pierfranco; Tortora, Giampaolo; Bria, Emilio

    2017-10-01

    The intent of this analysis was to investigate and validate the prognostic potential of Ki67 in a multi-center series of patients affected by early stage 'pure' invasive lobular carcinoma (ILC). Clinical-pathological data of patients affected by ILC were correlated with overall survival and disease-free survival (OS/DFS); data from a parallel invasive ductal carcinoma (IDC) patients' cohort were gathered as well. The maximally selected Log-Rank statistics analysis was applied to Ki67 continuous variable to estimate the appropriate cut-off. The Subpopulation Treatment Effect Pattern Plot (STEPP) analysis was performed as well. Data from overall 1097 (457/222 ILC: training/validation set; 418 IDC) patients were gathered. The identified optimal Ki67 cut-offs were 4% and 14% for DFS in ILC and IDC cohort, respectively. In ILC patients, the Ki67 cut-off was an independent OS predictor. Ten-years OS and DFS were 89.9% and 77.2% (p = 0.007) and 79.4% and 69.2% (p = 0.03) for patients with Ki67 ≤ 4% and >4%, respectively. In IDC patients, 10-years OS was 93.8% and 71.7%, p = 0.02, DFS was 84.0% and 52.6%, p = 0.0003, for patients with Ki67 ≤ 14% and >14%, respectively. In the validation set, the optimal Ki67 OS cut-off was 5%. The STEPP analysis showed that in the presence of low Ki67 values, IDC patients have a better DFS than ILC patients, while with the increase of values the prognosis tends to overlap. Despite the retrospective design of the study, the prognostic relevance of Ki67 (as well as its optimal cut-off) seems to significantly differ according to breast cancer histology. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Normalizing clinical terms using learned edit distance patterns.

    Science.gov (United States)

    Kate, Rohit J

    2016-03-01

    Variations of clinical terms are very commonly encountered in clinical texts. Normalization methods that use similarity measures or hand-coded approximation rules for matching clinical terms to standard terminologies have limited accuracy and coverage. In this paper, a novel method is presented that automatically learns patterns of variations of clinical terms from known variations from a resource such as the Unified Medical Language System (UMLS). The patterns are first learned by computing edit distances between the known variations, which are then appropriately generalized for normalizing previously unseen terms. The method was applied and evaluated on the disease and disorder mention normalization task using the dataset of SemEval 2014 and compared with the normalization ability of the MetaMap system and a method based on cosine similarity. Excluding the mentions that already exactly match in UMLS and the training dataset, the proposed method obtained 64.7% accuracy on the rest of the test dataset. The accuracy was calculated as the number of mentions that correctly matched the gold-standard concept unique identifiers (CUIs) or correctly matched to be without a CUI. In comparison, MetaMap's accuracy was 41.9% and cosine similarity's accuracy was 44.6%. When only the output CUIs were evaluated, the proposed method obtained 54.4% best F-measure (at 92.1% precision and 38.6% recall) while MetaMap obtained 19.4% best F-measure (at 38.0% precision and 13.0% recall) and cosine similarity obtained 38.1% best F-measure (at 70.3% precision and 26.1% recall). The novel method was found to perform much better than the MetaMap system and the cosine similarity based method in normalizing disease mentions in clinical text that did not exactly match in UMLS. The method is also general and can be used for normalizing clinical terms of other semantic types as well. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association

  16. Adult medulloblastoma: clinical characters, prognostic factors, outcomes and patterns of relapse.

    Science.gov (United States)

    Zhang, Na; Ouyang, Taohui; Kang, Huicong; Long, Wang; Thomas, Benjamin; Zhu, Suiqiang

    2015-09-01

    To analyze the clinical characters, prognostic factors, patterns of relapse and treatment outcomes for medulloblastoma in adults. The clinical materials of 73 consecutive adult patients (age, ≥16 years) with medulloblastoma were analyzed retrospectively. Follow-up data were available in 62 patients, ranging from 10 to 142 months (median, 78.4 months). Outcome in survival was assessed by the progression-free survival (PFS) and overall survival (OS). Univariate and multivariate analysis were performed to determine the prognostic factors. Total or near-total tumor resection was achieved in 37 cases (59.7 %), subtotal in 19 cases (30.6 %), and partial resection in 6 cases (9.7 %).Twenty-two patients experienced recurrences, and 45 % percent of all recurrences occurred more than 4 years after initial surgery. The PFS rates at 5 and 8 years were 60.1 and 37.0 %, respectively. The OS rates at 5 and 8 years were 82.6 and 57.3 %, respectively. In univariate analysis, less tumor resection, non-desmoplastic pathology, and brainstem involvement were risk factors for worse PFS and OS (P medulloblastoma, late relapse is common and therefore long-term follow-up is important for evaluating the real impact of treatments. Risk category had prognostic value just for PFS, but not for OS. Complete resection and desmoplastic histology are independently predictive factors for favorable outcomes.

  17. Comprehensive clinic-pathological characteristics of cervical cancer in southwestern China and the clinical significance of histological type and lymph node metastases in young patients.

    Directory of Open Access Journals (Sweden)

    LingYun Yang

    Full Text Available OBJECTIVE: To analyze the clinic-pathological characteristics of women with cervical cancers in southwestern China and discuss the features and prognosis of young patients. METHODS: A retrospective study was performed, which consisted of 1,543 patients diagnosed with cervical cancer and underwent treatment at West China Second University Hospital between November 2005 and December 2010. Among them, 154 young patients with surgical procedures between November 2005 and December 2008 were selected for a 5-year follow-up and prognostic analysis. RESULTS: The proportion of advanced FIGO stage in patients aged over 35 years was higher than in patients aged 35 years or younger (55.1% vs 38.8%, P<0.001, and strong correlation was found between FIGO stages and the postoperative pathological risk factors (P<0.05. 312 patients (20.2% were under 35 years old in the last 5 years. The proportion of cervical adenocarcinoma remained high in young patients (13.6%, and young women with adenocarcinoma had a higher rate of LN metastases, comparing with those with squamous cell carcinoma (42.9% vs 15.8%, P = 0.004. Young patients with adenocarcinoma had shorter progression-free survival than those who had squamous cell carcinoma (P = 0.024. Patients aged 35 years or younger with positive postoperative pathological risk factors had shorter progression-free survival, comparing with those with negative factors (P<0.01. CONCLUSION: Patients over 35 years were preliminarily diagnosed as advanced FIGO stage and they were more likely to have deep stromal invasion, LVSI, LN metastases, parametrial and surgical margin involvement. Regarding to young patients, cervical adenocarcinoma increased the risk of LN metastases and positive postoperative pathological risk factors could apparently worsen the prognosis. Histological type and LN metastases were independent prognostic factors for young patients in southwestern China. We re-emphasize the importance of health

  18. Clinical and histological determinants of smooth-muscle cell outgrowth in cultured atherectomy specimens: importance of thrombus organization

    NARCIS (Netherlands)

    J. Escaned (Javier); A.G. Violaris (Andonis); D.C. MacLeod (Donald); V.A.W.M. Umans (Victor); R-J. van Suylen (Robert-Jan); P.J. de Feyter (Pim); P.D. Verdouw (Pieter); P.W.J.C. Serruys (Patrick); M. de Jong (Marcel)

    1993-01-01

    textabstractBACKGROUND: Coronary atherectomy provides a unique opportunity to obtain plaque tissue from a wide variety of clinical syndromes. We investigated the relation between the clinical status and histopathological substrate of tissue retrieved during directional coronary atherectomy and the

  19. Association between fecal S100A12 concentration and histologic, endoscopic, and clinical disease severity in dogs with idiopathic inflammatory bowel disease.

    Science.gov (United States)

    Heilmann, Romy M; Grellet, Aurélien; Allenspach, Karin; Lecoindre, Patrick; Day, Michael J; Priestnall, Simon L; Toresson, Linda; Procoli, Fabio; Grützner, Niels; Suchodolski, Jan S; Steiner, Jörg M

    2014-04-15

    Idiopathic inflammatory bowel disease (IBD) in dogs can be challenging to diagnose and fecal markers of disease that correlate with its severity could potentially be clinically useful. Surrogate inflammatory markers, such as the concentration of fecal S100A12, are used to detect active IBD in humans. The aim of this study was to determine the relationship between fecal canine S100A12 concentrations and clinical, endoscopic, and histologic disease severity. Twenty-six dogs with IBD and 90 healthy control dogs were enrolled. Spot fecal samples were collected and fecal canine S100A12 concentrations measured by an in-house ELISA. The correlation of fecal canine S100A12 concentrations with clinical disease activity (using the canine chronic enteropathy clinical activity index scoring system) and with endoscopic and histologic disease severity (using semi-quantitative grading systems) was assessed in dogs with IBD. Concentrations of fecal canine S100A12 were significantly higher in dogs with IBD (median [interquartile range]: 223 [21-3477]ng/g) than in healthy controls (median [interquartile range]: 9 [5-31]ng/g; Pdogs with moderate to severe endoscopic disease in any GI section from dogs with at most mild endoscopic disease, and (b) dogs with very severe clinical disease (i.e., a CCECAI score of ≥12) from dogs with a CCECAI score of dogs with IBD. Further, this study showed that fecal canine S100A12 is associated with the clinical disease activity, the severity of endoscopic lesions, and the severity of colonic inflammation in dogs with IBD. Fecal S100A12 concentrations are potentially useful as a biomarker of inflammation in dogs with IBD. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Clinical and histological evaluation of large macular hole surgery using the inverted internal limiting membrane flap technique

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    Kase S

    2016-12-01

    Full Text Available Satoru Kase, Wataru Saito, Shohei Mori, Michiyuki Saito, Ryo Ando, Zhenyu Dong, Tomohiro Suzuki, Kousuke Noda, Susumu Ishida Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan Purpose: The aims of this study were to analyze optical coherence tomography (OCT imaging of large macular holes (MHs treated with inverted internal limiting membrane (ILM flap technique and to perform a histological examination of an ILM-like membrane tissue obtained during vitrectomy.Patients and methods: This is a retrospective observational case study. Nine patients, comprising of five males and four females, showing large and myopic MHs, underwent pars plana vitrectomy (PPV with inverted ILM flap technique assisted by brilliant blue G (BBG staining. Ophthalmological findings including visual acuity and OCT were investigated based on medical records. Formalin-fixed paraffin-embedded tissue section of an ILM-like membrane was submitted for immunohistochemistry with glial fibrillary acidic protein (GFAP.Results: ILM was clearly stained with BBG in eight patients, whereas the ILM in one case revealed no staining with BBG during PPV. Visual acuities improved to >0.2 LogMAR in six patients. The complete closure of MH following PPV with inverted ILM technique was eventually achieved in all patients determined by OCT imaging (100%. Only one patient showed recovery of ellipsoid zone and interdigitation zone following the surgery. Elongation of outer nuclear layer was noted in three eyes. The ILM-like membrane not stained with BBG histologically revealed an amorphous structure admixed with GFAP-positive mononuclear cell infiltration.Conclusion: PPV with inverted ILM flap technique achieved 100% closure rates with favorable configuration at an initial surgery in large MHs. Our histopathological data also suggest that even BBG staining-negative membrane may be a useful material for autologous transplantation to the hole. Keywords

  1. Use of a latex biomembrane for bladder augmentation in a rabbit model: biocompatibility, clinical and histological outcomes

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    Andre L. A. Domingos

    2009-04-01

    Full Text Available PURPOSE: To investigate histological features and biocompatibility of a latex biomembrane for bladder augmentation using a rabbit model. MATERIAL AND METHODS: After a partial cystectomy, a patch of a non-vulcanized latex biomembrane (2x4 cm was sewn to the bladder with 5/0 monofilament polydioxanone sulfate in a watertight manner. Groups of 5 animals were sacrificed at 15, 45 and 90 days after surgery and the bladder was removed. The 5-µm preparations obtained from grafted area and normal bladder were stained with hematoxylin-eosin. Immunohistochemical staining was performed with a primary antibody against alpha-actin to assess muscle regeneration. RESULTS: No death, urinary leakage or graft extrusion occurred in any group. All bladders showed a spherical shape. Macroscopically, after 90 days, the latex biomembrane was not identifiable and the patch was indistinguishable from normal bladder. A bladder stone was found in one animal (6.6%. On the 90th day, histology revealed continuity of transitional epithelium of host bladder tissue on the patch area. At this time, the muscle layers were well organized in a similar fashion to native bladder muscle layers. The inflammatory process was higher on grafted areas when compared to controls: 15 days - p < 0.0001, 45 days - p < 0.001, and 90 days - p < 0.01. The anti alpha-actin immunoexpression peaked at 45 days, when the graft was observed covered by muscle cells. CONCLUSION: The latex biomembrane is biocompatible and can be used in models for bladder augmentation in rabbits. It promotes epithelium and muscle regeneration without urinary leakage.

  2. Clinical significance of histologic chorioamnionitis with a negative amniotic fluid culture in patients with preterm labor and premature membrane rupture.

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    Jeong Woo Park

    Full Text Available To evaluate the effect of histological chorioamnionitis (HCA with a negative amniotic fluid (AF culture on adverse pregnancy and neonatal outcomes and inflammatory status in the AF compartment in women with preterm labor or preterm premature rupture of membranes (PPROM.This is a retrospective cohort study of 153 women diagnosed as having a preterm labor or PPROM (20-34 weeks who delivered singleton gestations within 48 hours of amniocentesis. AF obtained through amniocentesis was cultured, and interleukin (IL-6, IL-8, and metalloproteinase-9 (MMP-9 levels were determined. The placentas were examined histologically.The prevalence of HCA with negative AF culture was 23.5% (36/153. The women with HCA but with a negative AF culture (group 2 and those with a positive AF culture (group 3 had a significantly lower mean gestational age at amniocentesis and delivery than those with a negative AF culture and without HCA (group 1. Women in group 3 had the highest levels of AF IL-6, IL-8, and MMP-9, followed by those in group 2, and those in group 1. Composite neonatal morbidity was significantly higher in groups 2 and 3 than in group 1, but this was no longer significant after adjusting for confounders caused mainly by the impact of gestational age.In the women who delivered preterm neonates, HCA with a negative AF culture was associated with increased risks of preterm birth, intense intra-amniotic inflammatory response, and prematurity-associated composite neonatal morbidity, and its risks are similar to the risk posed by positive AF culture.

  3. Clinical significance of histologic chorioamnionitis with a negative amniotic fluid culture in patients with preterm labor and premature membrane rupture.

    Science.gov (United States)

    Park, Jeong Woo; Park, Kyo Hoon; Jung, Eun Young

    2017-01-01

    To evaluate the effect of histological chorioamnionitis (HCA) with a negative amniotic fluid (AF) culture on adverse pregnancy and neonatal outcomes and inflammatory status in the AF compartment in women with preterm labor or preterm premature rupture of membranes (PPROM). This is a retrospective cohort study of 153 women diagnosed as having a preterm labor or PPROM (20-34 weeks) who delivered singleton gestations within 48 hours of amniocentesis. AF obtained through amniocentesis was cultured, and interleukin (IL)-6, IL-8, and metalloproteinase-9 (MMP-9) levels were determined. The placentas were examined histologically. The prevalence of HCA with negative AF culture was 23.5% (36/153). The women with HCA but with a negative AF culture (group 2) and those with a positive AF culture (group 3) had a significantly lower mean gestational age at amniocentesis and delivery than those with a negative AF culture and without HCA (group 1). Women in group 3 had the highest levels of AF IL-6, IL-8, and MMP-9, followed by those in group 2, and those in group 1. Composite neonatal morbidity was significantly higher in groups 2 and 3 than in group 1, but this was no longer significant after adjusting for confounders caused mainly by the impact of gestational age. In the women who delivered preterm neonates, HCA with a negative AF culture was associated with increased risks of preterm birth, intense intra-amniotic inflammatory response, and prematurity-associated composite neonatal morbidity, and its risks are similar to the risk posed by positive AF culture.

  4. Comparison of surgical stripping; erbium-doped:yttrium, aluminum, and garnet laser; and carbon dioxide laser techniques for gingival depigmentation: a clinical and histologic study.

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    Hegde, Rashmi; Padhye, Ashvini; Sumanth, S; Jain, A Sanjay; Thukral, Naresh

    2013-06-01

    Gingival melanin depigmentation procedures are commonly associated with recurrence of pigmentation, which starts with migration of melanocytes from the adjacent free gingiva. The extent and rate of recurrence varies according to the treatment modalities used and duration of follow-up. The aim of this study is to compare the surgical stripping; carbon dioxide (CO2); and erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser techniques for gingival depigmentation and to evaluate their effect on histologic changes in melanocyte activity and clinical repigmentation. In this study, 140 sites from 35 patients with bilateral melanin hyperpigmentation were treated with surgical stripping (two sites per patient), "epithelial-peel" (CO2 laser, 2 to 4 W, continuous wave),and "brushstroke" (Er:YAG laser, 180 mJ, 10 Hz, long pulse) techniques. Surgical microscope monitoring was performed intraoperatively. Patient preference and perception of pain, change in Dummett oral pigmentation index (DOPI), Hedin index, and change in area of pigmentation from baseline to 6 months postoperatively were recorded. Twenty samples each from the three treatment modalities were selected for histologic analysis using hematoxylin and eosin and dihydroxyphenylalanine oxidase special stains. At the 6-month postoperative visit, 15 of 70 (21.4%) and three of 20 (15%) of the surgical-treated; 10 of 35 (28.6%) and six of 20 (30%) of the Er:YAG-laser-treated; and eight of 35 (22.8%) and four of 20 (20%) of the CO2-laser-treated sites showed clinical and histologic repigmentation, respectively. Paired t test, analysis of variance, and χ(2) tests were used for statistical analyses. P values for comparison of microscopic evaluation, change in DOPI, Hedin index, and area of pigmentation were 0.001, which were statistically significant. Comparison for patient preference and pain indices gave statistically significant values for Er:YAG laser depigmentation (P = 0.001). Clinical repigmentation after gingival

  5. Bipolar disorder with seasonal pattern: clinical characteristics and gender influences

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    Geoffroy, Pierre Alexis; Bellivier, Frank; Scott, Jan; Boudebesse, Carole; Lajnef, Mohamed; Gard, Sébastien; Kahn, Jean-Pierre; Azorin, Jean-Michel; Henry, Chantal; Leboyer, Marion; Etain, Bruno

    2013-01-01

    Bipolar disorder (BD) has a multifactorial etiology with heterogeneous clinical presentations. Around 25% of BD patients may present with a depressive seasonal pattern (SP). However, there is limited scientific data on the prevalence of SP, its clinical manifestations and any gender influence. Four hundred and fifty-two BD I and II cases (62% female), recruited from three French university-affiliated psychiatric departments, were assessed for SP. Clinical, treatments and socio-demographic variables were obtained from structured interviews. One hundred and two (23%) cases met DSM-IV criteria for SP, with similar frequency according to gender. Multivariate analysis showed a significant association between SP and BD II (OR=1.99, p=0.01), lifetime history of rapid cycling (OR=2.05, p=0.02), eating disorders (OR=2.94, p=0.003) and total number of depressive episodes (OR=1.13, p=0.002). 71% of cases were correctly classified by this analysis. However, when stratifying the analyses by gender, SP was associated with BD II subtype (OR=2.89, p=0.017) and total number of depressive episodes (OR=1.21, p=0.0018) in males but with rapid cycling (OR=3.02, p=0.0027) and eating disorders (OR=2.60, p=0.016) in females. This is the first study to identify different associations between SP and clinical characteristics of BD according to gender. We suggest that SP represents a potentially important specifier of BD. Our findings indicate that seasonality may reflect increased severity or complexity of disorder. PMID:23931033

  6. Bipolar disorder with seasonal pattern: clinical characteristics and gender influences.

    Science.gov (United States)

    Geoffroy, Pierre Alexis; Bellivier, Frank; Scott, Jan; Boudebesse, Carole; Lajnef, Mohamed; Gard, Sébastien; Kahn, Jean-Pierre; Azorin, Jean-Michel; Henry, Chantal; Leboyer, Marion; Etain, Bruno

    2013-11-01

    Bipolar disorder (BD) has a multifactorial etiology with heterogeneous clinical presentations. Around 25% of BD patients may present with a depressive seasonal pattern (SP). However, there are limited scientific data on the prevalence of SP, its clinical manifestations, and any gender influence. Four hundred and fifty-two BD I and II cases (62% female), recruited from three French university-affiliated psychiatric departments, were assessed for SP. Clinical, treatment, and sociodemographic variables were obtained from structured interviews. One hundred and two (23%) cases met DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) criteria for SP, with similar frequency according to gender. Multivariate analysis showed a significant association between SP and BD II (odds ratio [OR] = 1.99, p = 0.01), lifetime history of rapid cycling (OR = 2.05, p = 0.02), eating disorders (OR = 2.94, p = 0.003), and total number of depressive episodes (OR = 1.13, p = 0.002). Seventy-one percent of cases were correctly classified by this analysis. However, when stratifying the analyses by gender, SP was associated with BD II subtype (OR = 2.89, p = 0.017) and total number of depressive episodes (OR = 1.21, p = 0.0018) in males but with rapid cycling (OR = 3.02, p = 0.0027) and eating disorders (OR = 2.60, p = 0.016) in females. This is the first study to identify different associations between SP and clinical characteristics of BD according to gender. The authors suggest that SP represents a potentially important specifier of BD. These findings indicate that seasonality may reflect increased severity or complexity of disorder.

  7. Pattern of dental caries in Mulago Dental School clinic, Uganda.

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    Kutesa, Annet; Mwanika, Andrew; Wandera, Margaret

    2005-03-01

    Information on dental caries among patients attending Mulago Hospital is scarce. Yet knowledge of the pattern of caries can be used to plan preventive and treatment interventions. This study describes the pattern of dental caries (in terms of age group, tooth and tooth surface and gender) among patients attending the Public Health Dental Officers School Clinic, Mulago Hospital. A review of patients' treatment records for the period 1995 to 1999 was done. A total of 1800 cards were reviewed for the diagnosis of dental caries, age, gender and the data was analyzed using EPI INFO 6 program. The patients were from both urban and peri-urban settings and were aged between 10-90 years. The results showed that the most frequently affected tooth surface was the occlusal (68.8%) followed by the interproximal (24%) and the least affected was the lingual/palatal (1.5%). The second molars were found to be the most affected of all teeth, with tooth 37(12%), 47(11%), 17(9.5%) and 27 (9.1%). The distribution of caries was higher in the lower than the upper jaw. There was a slight difference in sex predilection with females having 54.5% and males 45.5% of the lesions and the age group most affected was 20-29 years. The results showed a high occurrence of occlusal surface caries in molars especially the second molars in the 20-29 age group in the patients attending the Public Health Dental Officers School Clinic, Mulago Hospital.

  8. Gastritis: the histology report.

    Science.gov (United States)

    Rugge, Massimo; Pennelli, Gianmaria; Pilozzi, Emanuela; Fassan, Matteo; Ingravallo, Giuseppe; Russo, Valentina M; Di Mario, Francesco

    2011-03-01

    Gastritis is defined as inflammation of the gastric mucosa. In histological terms, it is distinguishable into two main categories, i.e. non-atrophic and atrophic. In the gastric mucosa, atrophy is defined as the loss of appropriate glands. There are several etiological types of gastritis, their different etiology being related to different clinical manifestations and pathological features. Atrophic gastritis (resulting mainly from long-standing Helicobacter pylori infection) is a major risk factor for the onset of (intestinal type) gastric cancer. The extent and site of the atrophic changes correlate significantly with the cancer risk. The current format for histology reporting in cases of gastritis fails to establish an immediate link between gastritis phenotype and risk of malignancy. Building on current knowledge of the biology of gastritis, an international group of pathologists [Operative Link for Gastritis Assessment (OLGA)] has proposed a system for reporting gastritis in terms of its stage (the OLGA Staging System): this system places the histological phenotypes of gastritis on a scale of progressively increasing gastric cancer risk, from the lowest (Stage 0) to the highest (Stage IV). The aim of this tutorial is to provide unequivocal information on how to standardize histology reports on gastritis in diagnostic practice. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd.. All rights reserved.

  9. Histologic comparison between the internal mammary artery and the deep inferior epigastric artery and clinical implications for microsurgical breast reconstruction.

    Science.gov (United States)

    Jeong, Woo Shik; Yun, Jiyoung; Lee, Taik Jong; Eom, Jin Sup; Kim, Eun Key

    2015-01-01

    The internal mammary artery (IMA) is one of the most popular recipients for microsurgical breast reconstruction. However, it is often separated into sleeve-like layers when it is handled. This study tried to explain this unique behaviour of the IMA through histologic observation. Nine pairs of IMAs and DIEAs were harvested and subject for haematoxylin-eosin and Verhoeff's elastic staining. Thickness of the tunica media and the number of elastic lamellae were compared. Samples of the IMA, the DIEA, and the thoracodorsal artery from another patient were observed through the transmission electron microscope to further show the structural differences. The most notable difference was presence of multiple elastic lamellae in tunica media in the IMAs, which was barely present in the DIEAs. The mean number of elastic lamellae was 9.2 in the IMA group and 1.0 in the DIEA group (p DIEA and the TDA was densely packed with smooth muscle cells, while the muscle cells distributed sparsely in the IMA. The IMA is an elastic artery which is characterised by multiple layers of elastic lamellae while relatively lacking in smooth muscle cells. The wall of the IMA is easily dissected between the tunica media and the adventitia, or at the outer 1/3 of the tunica media. The inner structure is easily torn if microsutures do not engage the tunica adventitia.

  10. The changing clinical pattern of Reye's syndrome 1982-1990.

    Science.gov (United States)

    Hardie, R M; Newton, L H; Bruce, J C; Glasgow, J F; Mowat, A P; Stephenson, J B; Hall, S M

    1996-05-01

    To describe trends in the clinical pattern of Reye's syndrome in the British Isles between 1982 and 1990; and to determine the relation between any changes and the June 1986 warnings against the use of aspirin in children. Development, and application to reported cases, of a scoring system designed such that patients showing the typical clinical and pathological features of 'classical' Reye's syndrome scored highly. The relations between 'Reye scores' and a number of explanatory variables were explored using multivariable analysis. British Isles. 445 cases fulfilling the Reye's syndrome case definition reported to the surveillance scheme between January 1982 and December 1990. Individual 'Reye score'. Cases with high scores were more likely to have occurred in the 4 1/2 year period before June 1986 compared with the subsequent period (p Reye's syndrome after the aspirin warnings cannot be explained entirely, as has been proposed, by improved diagnosis of 'Reye-like' inherited metabolic and other disorders: this would not account for the greater decline of the high scoring subgroup which also contained those cases most likely to resemble 'classical' Reye's syndrome and to have received aspirin. This study provides further evidence for the role of aspirin in a subset of cases meeting the standard diagnostic criteria for Reye's syndrome and supports the need to consider this disorder as a heterogeneous group of conditions including Reye-like inherited metabolic disorders.

  11. Tuberculosis in Spain: epidemiological pattern and clinical practice.

    Science.gov (United States)

    Diez, M; Huerta, C; Moreno, T; Caloto, T; Guerra, D; Pozo, F; Alcaide, J; Castells, C; Cardenal, J I; Domínguez, A; Gayoso, P; Gutiérrez, G; López, M J; Muñoz, F; Navarro, C; Picó, M; Quirós, J R; Robles, F; Sánchez, J M; Vanaclocha, H; Vega, T

    2002-04-01

    Thirteen Autonomous Regions in Spain. To study the incidence of all forms of tuberculosis (TB) and investigate clinical practice in TB. Cases of all forms of tuberculosis diagnosed in the study setting from May 1986 to April 1997 were identified though active search of different databases. Clinical and epidemiological information on cases was collected from clinical records or by interview with physicians. The overall incidence of all forms of tuberculosis was 38.5/100,000 and the incidence of smear-positive disease was 13.83/100,000. Most cases (97.1%) were Spanish nationals, with rates higher in men than in women (52.7/100,000 vs. 24.87/100,000) and in groups aged 25-34 and 75 years and over (61.35/100,000 and 59.35/100,000, respectively). Disseminated forms were frequent (6.6%), and the most common risk factor was human immunodeficiency virus (HIV) infection (17.7% of cases). Hospitalisation was common (71.6%). Microbiological confirmation of diagnosis was sought for 87.7% of the cases (91.8% of pulmonary vs. 75.5% of extra-pulmonary cases), and 65.2% were culture-positive (73.8% of pulmonary vs. 39.7% of extra-pulmonary cases). HIV-infected patients were treated in almost equal proportions with three or four drugs (49.7% and 48.2%, respectively), while HIV-negative cases or those whose HIV status was unknown were usually treated with three drugs. The epidemiological pattern of TB in Spain is different to other industrialised countries in the age distribution of cases and the proportions of foreigners and cases with HIV infection. Microbiological confirmation of diagnosis is more common in pulmonary than in extra-pulmonary disease, and treatment with four drugs more frequent in HIV-positive cases.

  12. Brain MRI Pattern Recognition Translated to Clinical Scenarios

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    Andreia V. Faria

    2017-10-01

    Full Text Available We explored the performance of structure-based computational analysis in four neurodegenerative conditions [Ataxia (AT, n = 16, Huntington's Disease (HD, n = 52, Alzheimer's Disease (AD, n = 66, and Primary Progressive Aphasia (PPA, n = 50], all characterized by brain atrophy. The independent variables were the volumes of 283 anatomical areas, derived from automated segmentation of T1-high resolution brain MRIs. The segmentation based volumetric quantification reduces image dimensionality from the voxel level [on the order of O(106] to anatomical structures [O(102] for subsequent statistical analysis. We evaluated the effectiveness of this approach on extracting anatomical features, already described by human experience and a priori biological knowledge, in specific scenarios: (1 when pathologies were relatively homogeneous, with evident image alterations (e.g., AT; (2 when the time course was highly correlated with the anatomical changes (e.g., HD, an analogy for prediction; (3 when the pathology embraced heterogeneous phenotypes (e.g., AD so the classification was less efficient but, in compensation, anatomical and clinical information were less redundant; and (4 when the entity was composed of multiple subgroups that had some degree of anatomical representation (e.g., PPA, showing the potential of this method for the clustering of more homogeneous phenotypes that can be of clinical importance. Using the structure-based quantification and simple linear classifiers (partial least square, we achieve 87.5 and 73% of accuracy on differentiating AT and pre-symptomatic HD patents from controls, respectively. More importantly, the anatomical features automatically revealed by the classifiers agreed with the patterns previously described on these pathologies. The accuracy was lower (68% on differentiating AD from controls, as AD does not display a clear anatomical phenotype. On the other hand, the method identified PPA clinical phenotypes and their

  13. Histological and radiological evaluation of sintered and non-sintered deproteinized bovine bone substitute materials in sinus augmentation procedures. A prospective, randomized-controlled, clinical multicenter study.

    Science.gov (United States)

    Fienitz, Tim; Moses, Ofer; Klemm, Christoph; Happe, Arndt; Ferrari, Daniel; Kreppel, Matthias; Ormianer, Zeev; Gal, Moti; Rothamel, Daniel

    2017-04-01

    The objective of this study is to histologically and radiologically compare a sintered and a non-sintered bovine bone substitute material in sinus augmentation procedures. Thirty-three patients were included in the clinically controlled randomized multicentre study resulting in a total of 44 treated sinuses. After lateral approach, sinuses were filled with either a sintered (SBM, Alpha Bio's Graft(®)) or a non-sintered (NSBM, Bio Oss(®)) deproteinized bovine bone substitute material. The augmentation sites were radiologically assessed before and immediately after the augmentation procedure as well as prior to implant placement. Bone trephine biopsies for histological analysis were harvested 6 months after augmentation whilst preparing the osteotomies for implant placement. Healing was uneventful in all patients. After 6 months, radiological evaluation of 43 sinuses revealed a residual augmentation height of 94.65 % (±2.74) for SBM and 95.76 % (±2.15) for NSBM. One patient left the study for personal reasons. Histological analysis revealed a percentage of new bone of 29.71 % (±13.67) for SBM and 30.57 % (±16.07) for NSBM. Residual bone substitute material averaged at 40.68 % (±16.32) for SBM compared to 43.43 % (±19.07) for NSBM. All differences between the groups were not statistically significant (p > 0.05, Student's t test). Both xenogeneic bone substitute materials showed comparable results regarding new bone formation and radiological height changes in external sinus grafting procedures. Both bone substitute materials allow for a predictable new bone formation following sinus augmentation procedures.

  14. Clinical, histologic, and histomorphometric evaluation of mineralized solvent-dehydrated bone allograf (Puros) in human maxillary sinus grafts.

    Science.gov (United States)

    Noumbissi, Sammy S; Lozada, Jaime L; Boyne, Philip J; Rohrer, Michael D; Clem, Donald; Kim, Jay S; Prasad, Hari

    2005-01-01

    Demineralized freeze-dried bone allografts (DFDBA) have been successfully used alone or in composite grafts for many decades. Little research has been done on the effect of retaining the mineral content of bone allografts. This study histologically and histomorphometrically evaluated a new mineralized bone allograft material placed in human atrophic maxillary sinuses. Seven partially edentulous patients requiring sinus grafts before implant placement were selected for this study Their age range was 56 to 81 years (mean 67.7 years). Test grafts consisted of a mineralized solvent-dehydrated cancellous bone allograft, and control grafts were a composite of DFDBA and deproteinized bovine bone xenograft (1:1). Bilateral cases (n = 3) received both test and control grafts on opposite sides, and unilateral cases received either a test (n = 3) or control (n = 1) graft only. At 10 months, core biopsies were taken from each graft site, and dental implants were placed into the augmented bone. All bone grafts resulted in new bone formation and all implants osseointegrated. Test grafts resorbed and were replaced by newly formed bone significantly faster and in greater quantities than were control grafts. No complications with grafts or implants were noted. Both test and control grafts achieved excellent results. The faster bone formation observed with the test graft may be due, in part, to its smaller particle size compared with the bovine portion of the control graft. Test grafts were either replaced by new bone or displayed new bone-to-particle surface contact in higher percentages than did control grafts. No differences in osseointegration or graft stability were noted 2 years after the study.

  15. Correlation between extraintestinal manifestations and clinical parameters with the histologic activity index in patients with inflammatory bowel diseases

    Directory of Open Access Journals (Sweden)

    Štulić Miloš

    2013-01-01

    Full Text Available Bacground/Aim. Crohn's disease (CD and ulcerative colitis (UC are chronic, idiopathic, inflammatory diseases of the digestive tract. The aim of this study was to determine a possible correlation between the clinical parameters of the disease activity degree and the presence of extraintestinal manifestations with disease activity histopathological degree, in patients presented with CD and UC. Methods. This cross-sectional study included 134 patients (67 with CD and UC, respectively treated at the Clinic of Gastroenterology, Clinical Center of Serbia, Belgrade. After clinical, laboratory, endoscopic, histopathologic and radiologic diagnostics, the patients were divided into two groups according to their histopathological activity. The group I comprised 79 patients whose values of five-grade histopathological activity were less than 5 (45 with CD and 34 with UC, while the group II consisted of 55 patients with the values higher than 5 (22 with CD and 33 with UC. The CD activity index (CDAI and Truelove and Witts' scale of UC were used for clinical evaluation of the disease activity. Results. CD extraintestinal manifestations were present in 28.9% and 63.6% of the patients in the groups I and II, respectively (p 0.05. Conclusion. In the patients presented with CD, the extraintestinal manifestations with higher CDAI suggested a higher degree of histopathological activity. On the contrary, in the UC patients, Truelove and Witts' scale and extraintestinal manifestations were not valid predictors of the disease histopathological activity.

  16. Clinical and histological findings of cutaneous wound healing in the red-eared slider turtle (Trachemys scripta elegans) housed in unheated outdoor enclosures.

    Science.gov (United States)

    Negrini, Joao; Ginel, Pedro J; Novales, Manuel; Guerra, Rafael; Mozos, Elena

    2016-10-01

    Cutaneous wounds are common in chelonians. The clinical and histological features of wound healing in these species are not well described and this prevents evaluation of new therapies. To describe clinical and histopathological features of cutaneous wound healing in the red-eared slider turtle (Trachemys scripta elegans). Twenty four healthy adult females housed in outdoor facilities with free access to water and exposed to daily variations in temperature. Full thickness 6 mm skin biopsy punch wounds were created in the rear limbs. The turtles were assigned to Group 1 (n = 12 for clinical evaluation) and Group 2 (n = 12 for microscopic study). Group 1 was photographed on Day 1 and weekly, until 28 days post wounding. Wound retraction was expressed as the percentage of perimeter reduction. For Group 2, three skin wounds were sampled at 2, 7, 14, 21, 28, 42, 60 and 135 days post wounding for histological study. The avidin-biotin-peroxidase (ABC) staining method was used to evaluate five commercial antibodies. Wound contraction was limited; crust persisted at least 28 days. Re-epithelialization was complete by Day 14 in many animals; active inflammation persisted until 28 days; connective tissue re-constitution and remodelling was achieved from 42 to 135 days. Antibodies AE1/AE3, Factor VIII, MAC 387, CD3 and NCL-MSA showed cross reactivity with the cell counterpart in turtle tissues. Second intention wound healing progressed slowly and with an indolent behaviour. Microscopically there was marked overlapping of the inflammatory and proliferative phases over a long time period. © 2016 ESVD and ACVD.

  17. Evaluation of Guided Bone Regeneration around Oral Implants over Different Healing Times Using Two Different Bovine Bone Materials: A Randomized, Controlled Clinical and Histological Investigation.

    Science.gov (United States)

    Kohal, Ralf Joachim; Straub, Lisa Marie; Wolkewitz, Martin; Bächle, Maria; Patzelt, Sebastian Berthold Maximilian

    2015-10-01

    To evaluate the potential of two bone substitute materials and the influence of different healing periods in guided bone regeneration therapy of osseous defects around implants. Twenty-four edentulous patients received implants in the region of the lost lower incisors. Around two standardized osseous defects were created, treated either with a 50:50 mixture of PepGen P-15® and OsteoGraf®/N-700 (test group) or with BioOss® (control group), and covered with titanium membranes. After healing periods of 2, 4, 6, or 9 months, the implants were removed together with the surrounding bone and subsequently prepared for histological evaluations. Defect depths in both groups showed a clinical reduction after intervention. The histologically measured distance from the implant shoulder to the first point of bone-implant contact (BIC) after treatment did not differ between the two groups. The healing time influenced the level of the first point of BIC, with a longer healing period producing a more coronal first point of BIC. A greater percentage BIC and a higher fraction of mineralized bone were found in the pristine bone area compared with the augmented defect area. It can be concluded that in the treatment of osseous defects around oral implants, both materials were equally effective bone substitute materials when used in combination with guided bone regeneration. © 2014 Wiley Periodicals, Inc.

  18. A new animal model for the imaging of melanoma: correlation of FDG PET with clinical outcome, macroscopic aspect and histological classification in Melanoblastoma-bearing Libechov Minipigs

    Energy Technology Data Exchange (ETDEWEB)

    Boisgard, Raphael; Tavitian, Bertrand [Laboratoire d' Imagerie de l' Expression des Genes, CEA, Service Hospitalier Frederic Joliot, INSERM 0103, 91401, Orsay (France); Vincent-Naulleau, Silvia; Leplat, Jean-Jacques; Bouet, Stephan; Le Chalony, Catherine; Tricaud, Yves; Geffrotin, Claudine; Frelat, Gerard [Laboratoire de Radiobiologie et d' Etude du Genome, Joint CEA INRA Research Unit, Domaine de Vilvert, 78352, Jouy-en-Josas (France); Horak, Vratislav [Institute of Animal Physiology and Genetics, Academy of Sciences of the Czech Republic, 277 21, Libechov (Czech Republic)

    2003-06-01

    The aim of this study was to evaluate the Melanoblastoma-bearing Libechov Minipigs (MeLiM) as an animal model of melanoma for in vivo imaging. Serial whole-body 2-deoxy-2-[{sup 18}F]fluoro-d-glucose positron emission tomography (FDG PET) scans were conducted on five MeLiM. In order to explore different clinical stages of the tumoural lesions, each animal was scanned two to four times, at intervals of 30-155 days. PET images were analysed by a semiquantitative method based on the tumour to muscle metabolic ratio. Histology was performed on biopsies taken between or after the scans and the histological grading of the tumours was compared with the FDG uptake. The overall sensitivity of FDG PET for the detection of cutaneous melanoma was 75%; 62.5% of involved lymph nodes were positive. Sensitivity was better for tumours with vertical growth than for flat lesions. FDG PET did not detect tumours with epidermal involvement only, nor did it detect small metastatic foci. The metabolic ratio was correlated with the evolution of the melanoma. FDG PET is effective in the staging of cutaneous melanoma and the follow-up of tumoural extension and regression in Melanoblastoma-bearing Libechov Minipigs. The results obtained in this animal model correlate well with those described in human melanoma. Accordingly, this model may be useful in testing new tracers specific for melanoma and in helping to detect molecules expressed early during tumoural regression. (orig.)

  19. Synthetic bone substitute material comparable with xenogeneic material for bone tissue regeneration in oral cancer patients: First and preliminary histological, histomorphometrical and clinical results

    Science.gov (United States)

    Ghanaati, Shahram; Barbeck, Mike; Lorenz, Jonas; Stuebinger, Stefan; Seitz, Oliver; Landes, Constantin; Kovács, Adorján F.; Kirkpatrick, Charles J.; Sader, Robert A.

    2013-01-01

    Background: The present study was first to evaluate the material-specific cellular tissue response of patients with head and neck cancer to a nanocrystalline hydroxyapatite bone substitute NanoBone (NB) in comparison with a deproteinized bovine bone matrix Bio-Oss (BO) after implantation into the sinus cavity. Materials and Methods: Eight patients with tumor resection for oral cancer and severely resorbed maxillary bone received materials according to a split mouth design for 6 months. Bone cores were harvested prior to implantation and analyzed histologically and histomorphometrically. Implant survival was followed-up to 2 years after placement. Results: Histologically, NB underwent a higher vascularization and induced significantly more tartrate-resistant acid phosphatase-positive (TRAP-positive) multinucleated giant cells when compared with BO, which induced mainly mononuclear cells. No significant difference was observed in the extent of new bone formation between both groups. The clinical follow-up showed undisturbed healing of all implants in the BO-group, whereas the loss of one implant was observed in the NB-group. Conclusions: Within its limits, the present study showed for the first time that both material classes evaluated, despite their induction of different cellular tissue reactions, may be useful as augmentation materials for dental and maxillofacial surgical applications, particularly in patients who previously had oral cancer. PMID:24205471

  20. Clinical and histological comparison of tissue damage and healing following incisions with the CO2-laser and stainless steel surgical blade in dogs.

    Science.gov (United States)

    Durante, E J; Kriek, N P

    1993-09-01

    The tissue damage and subsequent healing of skin, linea alba and intestinal wall incisions made with a CO2-laser and a stainless steel surgical blade were evaluated clinically and histologically in dogs (n = 10). The amount of blood lost in each type of skin incision was measured by taking the pre- and postoperative mass of surgical swabs. The tissues were sutured and the skin incisions examined every day. The animals were subsequently euthanased (Day 12) and all incisions examined histologically. A delay in the healing process was observed in the laser incisions of the skin during the first 4 d, but there was no difference in the healing rate of the intestinal wounds or of the linea alba. The blood loss due to the laser incisions was significantly less than that caused by the surgical blade. It was concluded that the CO2-laser can be used with confidence when incising the skin and intestine and that, due to its precision, the surgical blade is by far a more accurate method to incise the linea alba.

  1. Clinical and histological results in the treatment of atrophic and hypertrophic scars using a combined method of radiofrequency, ultrasound, and transepidermal drug delivery.

    Science.gov (United States)

    Trelles, Mario A; Martínez-Carpio, Pedro A

    2016-08-01

    Scars are problematic for thousands of patients. Scarring is a natural part of the healing process after an injury. However, the appearance of a scar and its treatment depend on multiple factors and on the experience of the therapist and the options available. Despite a plethora of rapidly evolving treatment options and technical advances, the management of atrophic and hypertrophic scars remains difficult. Innovative technologies provide an attractive alternative to conventional methods in the treatment of scars. The purpose of this trial was to determine the clinical and histological results of a method of treatment that combines radiofrequency, ultrasound, and transepidermal drug delivery. This was a prospective study conducted on 14 patients with scars of different sizes, types, and characteristics. All patients underwent six treatment sessions with the Legato device. Atrophic scars were treated with retinoic acid and hypertrophic scars with triamcinolone. Photographs and biopsies were taken before treatment and at 6 months after the last treatment session. The scars improved significantly (P histological images of scar tissue in six patients in whom attenuation in the range of 55-75% was achieved are shown. Biopsies show regenerative changes in the scar tissue, in both the epidermis and dermis. The method makes it possible to treat extensive, heterogeneous scars on different sites with good results that are similar and predictable. © 2016 The International Society of Dermatology.

  2. Evolving patterns in the diagnosis of reactive gastropathy: data from a prospective Central European multicenter study with proposal of a new histologic scoring system.

    Science.gov (United States)

    Wolf, Eva-Maria; Plieschnegger, Wolfgang; Schmack, Bertram; Bordel, Hartmut; Höfler, Bernd; Eherer, Andreas; Schulz, Tilman; Vieth, Michael; Langner, Cord

    2014-12-01

    Histologic examination of gastric biopsies is crucial for determining the cause of gastritis. This prospective multicenter study was undertaken to investigate different histologic parameters arguing in favor or against the diagnosis of reactive gastropathy and to correlate findings with patient's symptoms and endoscopic findings. A total of 1123 individuals aged 15-93 years participated in a prospective multicenter study (histoGERD trial). Diagnosis of Helicobacter gastritis was made following the Updated Sydney System. Diagnosis of reactive gastropathy was based upon Dixon's parameters of foveolar hyperplasia, smooth muscle fibers in the lamina propria and vasodilatation and congestion of mucosal capillaries. Including paucity of acute and chronic inflammatory cells in analysis, a new score with visual analog scales for the diagnosis of reactive gastropathy was developed. All three histologic parameters in favor of the diagnosis of reactive gastropathy were positively associated with the endoscopic diagnosis of gastritis (p acute and chronic inflammatory cells in lamina propria was positively associated with Helicobacter infection (p gastritis. Our score demonstrated strong association between histologic and endoscopic diagnoses (p < 0.001), yet not with patient's symptoms. In conclusion, our data prove foveolar hyperplasia, smooth muscle fibers and vasodilatation and congestion as key histologic parameters for the diagnosis of reactive gastropathy. The proposed score may enhance the diagnostic accuracy. It should be validated in future studies. Copyright © 2014 Elsevier GmbH. All rights reserved.

  3. Does Clinical Staging and Histological Grading Show Parallelism In Oral Submucous Fibrosis? A Retrospective Study from an Indian City

    Directory of Open Access Journals (Sweden)

    Manish Narayan

    2014-06-01

    Conclusions: There was no correlation between clinical staging and histopathological grading of oral submucous fibrosis. The test results were statistically not significant. (p=0.635 This may be due to difference in severity and extent of fibrosis in different parts of the oral mucosa. [J Interdiscipl Histopathol 2014; 2(3.000: 145-149

  4. The Effect of Control-released Basic Fibroblast Growth Factor in Wound Healing: Histological Analyses and Clinical Application

    Directory of Open Access Journals (Sweden)

    Shigeru Matsumoto, MD

    2013-09-01

    Conclusions: These findings suggest that control-released bFGF using gelatin sheet is effective for promoting wound healing. Such therapeutic strategy was considered to offer several clinical advantages including rapid healing and reduction of the dressing change with less patient discomfort.

  5. Clinical presentation, histology, and prognoses of malignant melanoma in ethnic Chinese: A study of 522 consecutive cases

    Directory of Open Access Journals (Sweden)

    Han Mei

    2011-02-01

    Full Text Available Abstract Background Malignant melanoma is a rare disease in Asia, and knowledge on its characteristics and clinical outcome in Asian patients is limited. The purpose of this observational study was to determine the clinical presentation and outcome of patients with melanoma in China. Methods A database was prospectively established for the purpose of this analysis. The elements of the database included basic demographic data of patients and prognosticators previously reported in literature, as well as follow-up data including clinical outcome after treatment. Medical record of all patients with pathologically diagnosed malignant melanoma consulted in our center since 2006 were retrieved and reviewed. No patient was excluded in this study. Statistical analyses including survival and multivariate analyses of factors associated with survival were respectively performed by Kaplan-Meier method and Cox proportional hazard model. Results A total of 522 consecutive and nonselected cases were evaluated. There were 218 cases (41.8% of acral lentiginous melanoma (ALM, 118 (22.6% of mucosal melanoma (MCM, 103 (19.7% of nodular melanoma (NM, 33 (6.3% of superficial spreading melanoma (SSM, and others were Lentigo maligna melanoma or unclassifiable disease. The proportion of patients with clinical stage I, II, III, and IV diseases were 6.1%, 55.9%, 25.1%, and 12.8%, respectively. Among the 357 cases of cutaneous melanoma, 234 patients (65.5% had ulceration. The 5-year overall survival rate of all 522 patients was 41.6%, and the median survival time was 3.92 years (95% CI, 3.282 to 4.558. Five-year survival rates of patients with stage I, II, III, and IV diseases were 94.1%, 44.0%, 38.4% and 4.6% respectively (P Conclusions Prognoses of patients with malignant melanoma diagnosed in China were suboptimal, and most patients were diagnosed with locally advanced disease (i.e., stage II or above. ALM and MCM are the two most commonly diagnosed pathological subtypes

  6. Clinical and histological resolution of a basal cell carcinoma in a patient undergoing concurrent treatment of B-cell lymphoma with systemic R-CHOP.

    Science.gov (United States)

    Rahman, Shakeel M; Bhat, W; Wiper, J D; Platt, A J

    2014-09-01

    Surgical resection is the definitive treatment modality for basal cell carcinoma (BCC). However, not all patients may be suitable for surgery. We describe a patient with a BCC, which resolved clinically and histologically when he underwent systemic R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone) for treatment of a high grade B-cell lymphoma. Although topical and intra-lesional 5-fluorouracil (5-FU) has been used as an adjunct to treatment, more recent reports have illustrated the treatment of BCC with systemic 5-FU in combination with bleomycin and cisplatin. We postulate that the combination of cyclophosphamide and doxorubicin with rituximab and prednisolone, which has not been previously reported in the literature, contributed to remission in this case. Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. Pancreatic surgical biopsy in 24 dogs and 19 cats: postoperative complications and clinical relevance of histological findings.

    Science.gov (United States)

    Pratschke, K M; Ryan, J; McAlinden, A; McLauchlan, G

    2015-01-01

    To assess the immediate postoperative complications associated with pancreatic biopsy in dogs and cats and review the clinical relevance of biopsy findings. Retrospective review of clinical records from two referral institutions for cases undergoing pancreatic biopsy between 2000 and 2013. Twenty-four dogs and 19 cats that had surgical pancreatic biopsy had sufficient detail in their clinical records and fulfilled the inclusion criteria. Postoperative complications were seen in 10 cases of which 5 were suggestive of post-surgical pancreatitis. Two patients were euthanased within 10 days of surgery because of the underlying disease; neither suffered postoperative complications. Pancreatic pathology was found in 19 cases, 7 cases showed no change other than benign pancreatic nodular hyperplasia, and no abnormalities were seen in 18 cases. Complications may be encountered following surgical pancreatic biopsy, although the risk should be minimal with good surgical technique. Pancreatic biopsy may provide a useful contribution to case management but it is not clear whether a negative pancreatic biopsy should be used to rule out pancreatic disease. Dogs were more likely to have no significant pathology found on pancreatic biopsy than cats, where chronic pancreatitis was the most common finding. © 2014 British Small Animal Veterinary Association.

  8. Malignant melanoma in pigmented skin: does the current interventional model fit a different clinical, histologic, and molecular entity?

    Science.gov (United States)

    Alexandrescu, Doru T; Maslin, Benjamin; Kauffman, Catherine Lisa; Ichim, Thomas E; Dasanu, Constantin A

    2013-09-01

    Although the incidence of malignant melanoma in African Americans is considerably lower than in Caucasians, African Americans have a less-favorable prognosis related to later presentation and more deeply invasive lesions at diagnosis. To review the current literature addressing the specific clinical, histopathologic, and molecular features of melanoma in darkly pigmented individuals. We reviewed the most up-to-date literature pertaining to melanoma in this patient population, including data from clinical studies, epidemiologic analyses, and molecular and genetic studies. Several studies have suggested differences between lightly and darkly pigmented populations with regard to clinicopathologic character and the underlying genetic processes affecting its pathogenesis. Further investigation is warranted to better elucidate the clinical and underlying biological differences in melanoma between Caucasians and African Americans. Such research may help to ameliorate the disparities in melanoma outcomes through improved screening, public health measures aimed at prevention, and potentially novel targeted therapeutic approaches. © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

  9. Clinical and histologic evaluation of an enamel matrix protein derivative combined with a bioactive glass for the treatment of intrabony periodontal defects in humans.

    Science.gov (United States)

    Sculean, Anton; Windisch, Péter; Keglevich, Tibor; Gera, István

    2005-04-01

    The present study clinically and histologically evaluated healing of human intrabony defects following treatment with a combination of enamel matrix derivative (EMD) and bioactive glass (BG) or BG alone. Six patients displaying either combined one- and two-walled (five patients) or three-walled (one patient) intrabony defects around teeth scheduled for extraction were included. A notch was placed at the most apical extent of the calculus on the root surface to serve as a reference. Six months after surgery, the teeth or roots were extracted, together with some of their surrounding soft and hard tissues, and processed for histologic evaluation; a gain of clinical attachment was found in all cases. Healing in all three defects treated with EMD + BG was mainly characterized by new cementum with inserting collagen fibers and new periodontal ligament; most graft particles were surrounded by bone-like tissue, indicating ongoing mineralization. Treatment with BG resulted in epithelial down-growth and connective tissue encapsulation of the graft material in all three specimens. Reformation of cementum and periodontal ligament was observed in one of the specimens, limited to the most apical part of the defect. Formation of bone-like tissue around the graft particles was observed in only one of the three specimens treated with BG. Direct contact between the BG particles and root surface (cementum or dentin) was not observed in any of the six specimens. BG alone has low potential to facilitate periodontal regeneration. However, EMD + BG resulted in formation of new cementum with an associated periodontal ligament, as well as enhanced mineralization around the BG particles.

  10. Clinical and histologic evaluation of bone-replacement grafts in the treatment of localized alveolar ridge defects. Part 1: Mineralized freeze-dried bone allograft.

    Science.gov (United States)

    Feuille, Frank; Knapp, Charles I; Brunsvold, Michael A; Mellonig, James T

    2003-02-01

    The purpose of this study was to evaluate the use of mineralized freeze-dried bone allograft (FDBA) in conjunction with a titanium-reinforced expanded polytetrafluoroethylene (TR e-PTFE) barrier in the treatment of localized alveolar ridge deficiencies prior to endosseous dental implant placement. Twelve patients (aged 23 to 65 years) requiring tooth replacement with ridge augmentation were recruited to participate in this study. During ridge augmentation surgery, measurements were made prior to grafting with FDBA plus a TR e-PTFE barrier. Six months later, ridge measurements were repeated, and suitability for implant placement was assessed. At each implant site, a biopsy was taken from the grafted site. The implants were placed and allowed to osseointegrate for 13 weeks prior to phase-two surgery. Clinical data analyzed were horizontal ridge width changes and vertical ridge height changes. Histologic evaluation revealed the formation of new bone and residual particles in each graft site at the time of implant placement Ten patients completed the study. The mean alveolar ridge width increased by 3.2 +/- 1.0 mm (P < .0005). Histomorphometric analysis revealed a range of new bone from 42.9% to 70.5%, with a mean of 47.6%. Graft particles remaining ranged from 29.5% to 57.1%, with a mean of 52.4%. The clinical and histologic findings of this study demonstrate that sites grafted with FDBA in conjunction with an e-PTFE barrier can provide a predictable way to augment deficient alveolar ridges prior to implant placement.

  11. Influence of Healing Period Upon Bone Turn Over on Maxillary Sinus Floor Augmentation Grafted Solely with Deproteinized Bovine Bone Mineral: A Prospective Human Histological and Clinical Trial.

    Science.gov (United States)

    Wang, Feng; Zhou, Wenjie; Monje, Alberto; Huang, Wei; Wang, Yueping; Wu, Yiqun

    2017-04-01

    To investigate the influence of maturation timing upon histological, histomorphometric and clinical outcomes when deproteinized bovine bone mineral (DBBM) was used as a sole biomaterial for staged maxillary sinus floor augmentation (MSFA). Patients with a posterior edentulous maxillary situation and a vertical bone height ≤ 4 mm were included in this study. A staged MSFA was carried out. After MSFA with DBBM as a sole grafting material, biopsy cores were harvested with simultaneous implant placement followed by a healing period of 5, 8, and 11 months, respectively. Micro-CT, histologic and histomorphometric analyses were performed. Forty-one patients were enrolled and 38 bone core biopsies were harvested. Significantly greater BV/TV was observed between 5- and 8-month healing from micro-CT analysis. Histomorphometric analyses showed the ratio of mineralized newly formed bone increased slightly from 5 to 11 months; however, no statistically significant difference was reached (p = .409). Residual bone substitute decreased from 37.3 ± 5.04% to 20.6 ± 7.45%, achieving a statistical significant difference from of 5 up to 11 months (p technical complication occurred after 12-month follow-up of functional loading. DBBM utilized as sole grafting material in staged MSFA demonstrated to be clinically effective regardless of the healing period. Histomorphometrical and micro-CT assessments revealed that at later stages of healing (8 and 11 months) there is a higher proportion of newly-bone formation compared to earlier stages (5 months). Moreover, the longer the maturation period, the substantially lesser remaining biomaterial could be expected. Even though, these facts did not seem to negatively impact on the implant prognosis 1-year after loading. © 2016 Wiley Periodicals, Inc.

  12. The Effect of Control-released Basic Fibroblast Growth Factor in Wound Healing: Histological Analyses and Clinical Application.

    Science.gov (United States)

    Matsumoto, Shigeru; Tanaka, Rica; Okada, Kayoko; Arita, Kayo; Hyakusoku, Hiko; Miyamoto, Masaaki; Tabata, Yasuhiko; Mizuno, Hiroshi

    2013-09-01

    Basic fibroblast growth factors (bFGFs) play a crucial role in wound healing by promoting fibroblast proliferation and neovascularization. However, drawback of bFGF is short half-life in free form. Gelatin has a capability of sustaining growth factors, which are gradually released while degradation. The purpose of this study is to see whether bFGF-impregnated gelatin sheet is effective in a murine model and whether it could also be available for patients in a safe manner. Full-thickness skin defect was created on C57BL/6J mice and covered with bFGF with gelatin sheet (group A), bFGF without gelatin sheet (group B), phosphate buffer saline (PBS) with gelatin sheet (group C), and only PBS (group D). Wound healing was evaluated in terms of percent wound closure, granulation thickness, wound maturity, and vascular density. Clinical trial was conducted for patients who received either acute or chronic ulcers. The sheets were put onto the wounds and covered by hydrocolloid dressing, which was changed weekly. Groups A and B exhibited better wound healing than groups C and D in all aspects. Moreover, group A showed better results than group B at day 7 in terms of wound closure, collagen maturity, and vascularity. Efficacy without any adverse events was found in the clinical series. These findings suggest that control-released bFGF using gelatin sheet is effective for promoting wound healing. Such therapeutic strategy was considered to offer several clinical advantages including rapid healing and reduction of the dressing change with less patient discomfort.

  13. Clinical and Histologic Evaluation of Ingenol Mebutate 0.015% Gel for the Cosmetic Improvement of Photoaged Skin.

    Science.gov (United States)

    Handler, Marc Z; Bloom, Bradley S; Goldberg, David J

    2017-08-30

    No studies have examined the use of topical ingenol mebutate for improvement of photoaged skin. To evaluate clinical results of ingenol mebutate gel applied to photoaged skin and to quantify improvement at 7, 30, and 60 days after application. Twenty-five subjects were enrolled in the study. Picato (ingenol mebutate) (LEO Pharma, Parsippany, NJ) gel was applied to an area with a known actinic keratosis daily for 3 days. Subjects self-evaluated and were investigator evaluated on 6 characteristics on Days 7, 30, and 60 using an objective scale. The scale evaluated actinic keratosis, overall skin appearance, wrinkling, dyschromia, erythema, and texture. The subjects were also evaluated using the Griffiths' Photonumeric Photoaging Scale for overall improvement. Twenty-two subjects completed the clinical study and demonstrated statistically significant improvement by Day 60 in actinic keratosis, overall skin appearance, wrinkling, dyschromia, erythema, and texture (p < .05). Topical ingenol mebutate 0.015% gel produces cosmetic improvement of photoaged skin within 60 days of application.

  14. Immunological and histological evaluation of clinical samples from psoriasis patients treated with anti-CD6 itolizumab.

    Science.gov (United States)

    Aira, Lazaro E; López-Requena, Alejandro; Fuentes, Dasha; Sánchez, Liset; Pérez, Teresita; Urquiza, Aleida; Bautista, Heber; Falcón, Leopoldina; Hernández, Patricia; Mazorra, Zaima

    2014-01-01

    Psoriasis is a chronic inflammatory disease with a prevalence of approximately 2-3% in the general population. The majority of diagnosed patients have plaque psoriasis, and about 20% have moderate-to-severe disease. Itolizumab, a new monoclonal antibody specific for the CD6 molecule mainly expressed on T lymphocytes, has demonstrated to inhibit in vitro ligand-induced proliferation and pro-inflammatory cytokine production. We assessed the immunological and histopathological effect of the antibody using clinical samples taken from 26 patients with moderate-to-severe psoriasis included in a clinical trial. The precursor frequency of lymphocytes activated with anti-CD2/CD3/CD28 beads, as well as the number of interferon (IFN)-γ-secreting T cells after stimulation, were measured at different time points of the study. Serum cytokine levels and anti-idiotypic antibody response to itolizumab were also evaluated. Additionally, lymphocyte infiltration and epidermis hyperplasia were studied in five patients. A significant reduction in T cell proliferation capacity and number of IFN-γ-producing T cells was found in treated patients. Serum levels of interleukin-6, tumor necrosis factor and IFN-γ showed an overall trend toward reduction. No anti-idiotypic antibody response was detected. A significant reduction in the epidermis hyperplasia was observed in analyzed patients. These results support the relevance of the CD6 molecule as a therapeutic target for the treatment of this disease.

  15. Oral squamous cell carcinoma associated with proliferative verrucous leukoplakia compared with conventional squamous cell carcinoma--a clinical, histologic and immunohistochemical study.

    Science.gov (United States)

    Akrish, Sharon; Ben-Izhak, Ofer; Sabo, Edmond; Rachmiel, Adi

    2015-03-01

    Proliferative verrucous leukoplakia (PVL), a potentially malignant disorder, often undergoes malignant transformation to oral squamous cell carcinoma. The aim of our study was to document and compare the histologic, immunohistochemical, and clinical features and the survival rates of carcinoma arising in patients with PVL (p-scca) with conventional squamous cell carcinoma (c-scca) in order to determine if p-scca should be categorized as a separate clinical entity. A retrospective review of 11 patients with PVL, 38 with p-scca tumors and 49 with c-scca tumors: buccal mucosa (n = 28) and gingiva or palate (n = 21). Immunohistochemistry was performed by using antibodies directed against p16, p53, and ki67. P-scca had lower clinical stage (P = .0001), smaller tumor size (P = .0033), no lymph node metastasis (P = .0002) or distant metastasis (P = .05), and better short term (P = .03), but not long term (P = .12) survival. Microscopically, p-scca tumor thickness was significantly less (P = .0001). P-53 overexpression was more common in p-scca (P = .0043) but not ki67 or p16 overexpression. P-scca, compared with c-scca, presented with significantly better prognostic factors and short-term survival rates and longer duration of disease. Our results suggest that p-scca may represent a distinct entity, which may have practical implications when deciding on treatment. Further studies on a larger cohort of patients are recommended. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Magnetic resonance imaging and morphometric histologic analysis of prostate tissue composition in predicting the clinical outcome of terazosin therapy in benign prostatic hyperplasia

    Energy Technology Data Exchange (ETDEWEB)

    Isen, K. [Karaelmas Univ., Zonguldak (Turkey). School of Medicine; Sinik, Z.; Alkibay, T.; Sezer, C.; Soezen, S.; Atilla, S.; Ataoglu, O.; Isik, S.

    2001-02-01

    The purpose of this study was to determine whether magnetic resonance imaging (MRI) or quantitative color-imaged morphometric analysis (MA) of the prostate gland are related to the clinical response to terazosin. Thirty-six male patients with symptomatic benign prostatic hyperplasia (BPH) with a serum prostate-specific antigen level of 4-10 ng/mL underwent MRI with body coil, transrectal prostate unltrasonography and biopsy prior to terazosin therapy. For MRI-determined stromal and non-stromal BPH, the ratio of the signal intensity of the inner gland to the obturator internus muscle was evaluated. Histologic sections were stained with hematoxylin and eosin. The MA of the specimens was performed by Samba 2000. Results of the two techniques were interpreted according to the terazosin therapy results. The mean stromal percentage was 60.5{+-}18.0%. No statistically significant relationship was found between the clinical outcome of terazosin and the MRI findings. The MA results showed a significant relationship between the percentage of stroma and the percent change of the peak urinary flow rate, but not with the percent change of the international prostate symptom score after terazosin therapy (P<0.05). Magnetic resonance imaging alone is not sufficient in predicting the response to terazosin therapy. Morphometric analysis of BPH tissue composition can be used in predicting the clinical outcome of terazosin therapy but it is suitable only in patients for whom prostatic biopsy is necessary in order to rule out prostate cancer. (author)

  17. Healing of periodontal flaps when closed with silk sutures and N-butyl cyanoacrylate: A clinical and histological study

    Directory of Open Access Journals (Sweden)

    Kulkarni Sudhindra

    2007-01-01

    Full Text Available Background: The closure of the periodontal flaps post-surgery is a necessity for attainment of a primary union between the flap margins and the establishment of a healthy dentogingival junction. N-butyl cyanoacrylate is a tissue adhesive, which can be used for the closure of the incised wounds to overcome the problems associated with conventional suture materials like silk. Objective: The present study was carried out to assess the healing of the periodontal flaps when closed with the conventional silk sutures and N-butyl cyanoacrylate. Materials and Methods: The study was carried out on 24 patients who needed flap surgical procedure for pocket therapy. Results: It was found that healing with the cyanoacrylate is associated with less amount of inflammation during the first week when compared with silk. However, over a period of 21 days to 6 weeks, the sites treated with both the materials showed similar healing patterns. Conclusion: It can be concluded that cyanoacrylate aids in early initial healing.

  18. Histologic Evidence of New Collagen Formulation Using Platelet Rich Plasma in Skin Rejuvenation: A Prospective Controlled Clinical Study

    Science.gov (United States)

    Abuaf, Ozlem Karabudak; Baloglu, Hüseyin; Bilgili, Memet Ersan; Simsek, Hasan Aktug; Dogan, Bilal

    2016-01-01

    Background Platelet-rich plasma (PRP) is an autologous concentration of human platelets contained in a small volume of plasma and has recently been shown to accelerate rejuvenate aging skin by various growth factors and cell adhesion molecules. Objective This study was conducted to evaluate the efficacy and safety of intradermal injection of PRP in the human facial rejuvenation. Methods This study was a prospective, single-center, single-dose, open-label, non-randomized controlled clinical study. PRP injected to the upper site of this right infra-auricular area and all face. Saline was injected to the left infra-auricular area. Histopathological examinations were performed before PRP treatment, 28 days after the PRP, and saline (control) treatments. Results Twenty women ranging in age from 40 to 49 years (mean age, 43.65±2.43 years) were enrolled in the study. The mean optical densities (MODs) of collagen in the pre-treatment, control, and PRP-treated area were measured. They were 539±93.2, 787±134.15, 1,019±178, respectively. In the MOD of PRP, 89.05 percent improvement was found when MOD of PRP was compared with MOD of pre-treatment. The mean MOD of collagen fibers was clearly highest on the PRP side (pmesotherapy technique 'point by point'). PRP application could be considered as an effective (even a single application) and safety procedure for facial skin rejuvenation. PMID:27904271

  19. Cardiovascular risk across the histological spectrum and the clinical manifestations of non-alcoholic fatty liver disease: An update

    Science.gov (United States)

    Athyros, Vasilios G; Tziomalos, Konstantinos; Katsiki, Niki; Doumas, Michael; Karagiannis, Asterios; Mikhailidis, Dimitri P

    2015-01-01

    Non-alcoholic fatty liver disease (NAFLD) is considered to be an independent cardiovascular disease (CVD) risk factor. However, simple steatosis has a benign clinical course without excess mortality. In contrast, the advanced form of NAFLD, non-alcoholic steatohepatitis (NASH) with liver fibrosis increases mortality by approximately 70%, due to an increase in CVD mortality by approximately 300%. Chronic kidney disease (CKD) may be caused by NAFLD/NASH and it substantially increases CVD risk, especially in the presence of type 2 diabetes mellitus. Moreover, CKD may trigger NAFLD/NASH deterioration in a vicious cycle. NAFLD/NASH is also related to increased arterial stiffness (AS), an independent CVD risk factor that further raises CVD risk. Diagnosis of advanced liver fibrosis (mainly by simple non-invasive tests), CKD, and increased AS should be made early in the course of NAFLD and treated appropriately. Lifestyle measures and statin treatment may help resolve NAFLD/NASH and beneficially affect the CVD risk factors mentioned above. PMID:26078558

  20. Pattern of mental illness among women attending an infertility clinic ...

    African Journals Online (AJOL)

    Background: Female infertility is highly co-morbid with mental illness. In Nigeria, very few studies have been conducted to determine the pattern of mental illness among women with infertility. We aimed to determine the pattern of mental illness in a sample of women with female infertility as well as its associated correlates.

  1. Pattern of dental caries in Mulago Dental School clinic, Uganda ...

    African Journals Online (AJOL)

    Information on dental caries among patients attending Mulago Hospital is scarce. Yet knowledge of the pattern of caries can be used to plan preventive and treatment interventions. This study describes the pattern of dental caries (in terms of age group, tooth and tooth surface and gender) among patients attending the ...

  2. Histologic distribution of borderline ovarian tumors worldwide: a systematic review.

    Science.gov (United States)

    Song, Taejong; Lee, Yoo-Young; Choi, Chel Hun; Kim, Tae-Joong; Lee, Jeong-Won; Bae, Duk-Soo; Kim, Byoung-Gie

    2013-01-01

    The histologic types of borderline ovarian tumors (BOTs) exhibit striking differences in clinical behavior and prognosis. Yet, there is no information available on the histologic distribution of BOTs according to geographic region. The purpose of this study was to systematically review this issue worldwide. A comprehensive search of the literature was conducted using electronic databases. Studies were eligible if BOTs were investigated and the histologic distribution of the data was shown. The studies were grouped by geographic region and totaled by country. Of 487 potentially relevant studies, 51 met our inclusion criteria, as follows: 8 studies from North America (2 countries); 26 studies from Europe (14 countries); 7 studies from the Middle East (3 countries); and 10 studies from East Asia (5 countries). The histologic distribution of BOTs was considerably different in different parts of the world, but follows specific patterns. In general, serous-type BOTs were the predominantly identified histology in North America, the Middle East, and Europe, while mucinous-type BOTs predominated in East Asia. Significant geographic variation is evident among BOT histology in different parts of the world. More research is needed to understand this phenomenon.

  3. Clinical usefulness of portal venous flow ratio by hepatic angiography with /sup 99m/Tc-Sn colloid in chronic liver diseases. A comparison with histological finding

    Energy Technology Data Exchange (ETDEWEB)

    Takegoshi, Kunio; Tohyama, Tatsuhiko; Okuda, Kohji; Seto, Hikaru; Nakanuma, Yasuni.

    1989-04-01

    The ratio of portal venous to hepatic blood flow was measured in chronic liver diseases by radionuclide angiography with /sup 99m/Tc-Sn colloid and its clinical value was discussed. The ratio was proportionally decreased to the progression of the diseases (normal 74.5+-7.3%, chronic hepatitis 58.8+-9.2%, compensated liver cirrhosis 49.0+-10.4%, and decokmpensated liver cirrhosis 29.3+-19.3%). In alcoholic liver diseases, the standard deviation of the ratio was large as 52.7+-23.7%, and the low ratio in the early period of the disease increased within one or two months as the disease recovered. In comparison with the histological findings of the liver, the ratio in the alcoholic liver diseases was well correlated with the severity of liver fibrosis and liver cell swelling. In conclusion, this noninvasive and simple method is valuable in diagnosing the chronic liver disease, especially alcoholic liver diseases, and also in estimating its clinical course. (author).

  4. Investigation of a pre-clinical mandibular bone notch defect model in miniature pigs: clinical computed tomography, micro-computed tomography, and histological evaluation.

    Science.gov (United States)

    Carlisle, Patricia L; Guda, Teja; Silliman, David T; Lien, Wen; Hale, Robert G; Brown Baer, Pamela R

    2016-02-01

    To validate a critical-size mandibular bone defect model in miniature pigs. Bilateral notch defects were produced in the mandible of dentally mature miniature pigs. The right mandibular defect remained untreated while the left defect received an autograft. Bone healing was evaluated by computed tomography (CT) at 4 and 16 weeks, and by micro-CT and non-decalcified histology at 16 weeks. In both the untreated and autograft treated groups, mineralized tissue volume was reduced significantly at 4 weeks post-surgery, but was comparable to the pre-surgery levels after 16 weeks. After 16 weeks, CT analysis indicated that significantly greater bone was regenerated in the autograft treated defect than in the untreated defect (P=0.013). Regardless of the treatment, the cortical bone was superior to the defect remodeled over 16 weeks to compensate for the notch defect. The presence of considerable bone healing in both treated and untreated groups suggests that this model is inadequate as a critical-size defect. Despite healing and adaptation, the original bone geometry and quality of the pre-injured mandible was not obtained. On the other hand, this model is justified for evaluating accelerated healing and mitigating the bone remodeling response, which are both important considerations for dental implant restorations.

  5. Clinical, endocrinological and histopathological patterns of infertile Saudi men subjected to testicular biopsy: A retrospective study from a single center

    Directory of Open Access Journals (Sweden)

    Khaled Madbouly

    2012-01-01

    Conclusions: Hypospermatogenesis was the most common pattern of spermatogenic defect in our patients. SCO histology was the most common pattern in patients with small testes, primary testicular failure, primary infertility and azoospermia. Low testicular volume, high FSH and LH are significantly associated with impaired spermatogenesis. Even with severe male factor infertility disorders, infertile men can have some spermatogenesis.

  6. Clinical practice guideline implementation strategy patterns in Veterans Affairs primary care clinics.

    Science.gov (United States)

    Hysong, Sylvia J; Best, Richard G; Pugh, Jacqueline A

    2007-02-01

    The Department of Veterans Affairs (VA) mandated the system-wide implementation of clinical practice guidelines (CPGs) in the mid-1990s, arming all facilities with basic resources to facilitate implementation; despite this resource allocation, significant variability still exists across VA facilities in implementation success. This study compares CPG implementation strategy patterns used by high and low performing primary care clinics in the VA. Descriptive, cross-sectional study of a purposeful sample of six Veterans Affairs Medical Centers (VAMCs) with high and low performance on six CPGs. One hundred and two employees (management, quality improvement, clinic personnel) involved with guideline implementation at each VAMC primary care clinic. MEASURES; Participants reported specific strategies used by their facility to implement guidelines in 1-hour semi-structured interviews. Facilities were classified as high or low performers based on their guideline adherence scores calculated through independently conducted chart reviews. High performing facilities (HPFs) (a) invested significantly in the implementation of the electronic medical record and locally adapting it to provider needs, (b) invested dedicated resources to guideline-related initiatives, and (c) exhibited a clear direction in their strategy choices. Low performing facilities exhibited (a) earlier stages of development for their electronic medical record, (b) reliance on preexisting resources for guideline implementation, with little local adaptation, and (c) no clear direction in their strategy choices. A multifaceted, yet targeted, strategic approach to guideline implementation emphasizing dedicated resources and local adaptation may result in more successful implementation and higher guideline adherence than relying on standardized resources and taxing preexisting channels.

  7. [Pleural mesothelioma in a Mexican population: clinical and radiological similarities among histopathologic patterns].

    Science.gov (United States)

    Pérez-Guzmán, Carlos; Vargas, Mario H; Torre-Bouscoulet, Luis

    2008-01-01

    To describe clinical and radiological features of patients with pleural mesothelioma, according to main histological types. Clinical records of inpatients admitted with diagnosis of pleural mesothelioma to the Instituto Nacional de Enfermedades Respiratorias in the last 11 years, were reviewed. We analyzed 85 cases confirmed by immunohistochemistry. The most frequent histological type was epithelial (84.7 %), followed by sarcomatous (12.9 %) and mixed (2.4 %) types. Comparison between epithelial and sarcomatous types showed no differences in age (53.7 +/- 13.1 vs. 55.9 +/- 11.0 years, respectively), male : female ratio (2.3 : 1 vs. 1.8 : 1), history of asbestos exposure (34.7 vs. 27.2 %), tobacco habit (54.2 vs 45.4 %), occupation, evolution time (4.8 +/- 3.3 vs. 4.4 +/- 3.7 months), pain, dyspnea and cough, right-side predominance (55.6 vs. 81.8 %), radiological image with pleural effusion (59.7 vs. 36.4 %) or pleural thickening (38.9 vs. 63.6 %), and diagnostic efficiency of closed pleural biopsy (58.3 vs. 27.2 %). Our results suggest that clinical and radiological features of epithelial and sarcomatous histological types are very similar. Additionally, we found a high frequency of epithelial mesothelioma, which contrasts with findings from other countries, suggesting that the type of asbestos or other factors involved in the development of pleural mesothelioma differ from those existing in other regions of the world.

  8. Pattern of Dental Clinic Attendance of Registered Diabetic Patients ...

    African Journals Online (AJOL)

    A study on a stratified sample of 120 adult registered diabetic patients from the only two diabetes clinics in Ibadan, University College Hospital (UCH) and Ring Road Government Hospital and fifty (50) healthy adult nondiabetic volunteers as control, shows that 51.48% of the interviewees have never visited the dental clinic ...

  9. Prevalence and Susceptibility Patterns of Clinical Isolates of ...

    African Journals Online (AJOL)

    The purpose of this study is to determine the prevalence of Escherichia coli as an aetiologic agent in bacterial infections and its antimicrobial susceptibility patterns to ciprofloxacin, ofloxacin, norfloxacin, perfloxacin, gentamycin and cotrimoxazole as a guide for empiric therapy. A retrospective study was carried out using a ...

  10. The impact of germline BHD mutation on histological concordance and clinical treatment of patients with bilateral renal masses and known unilateral oncocytoma.

    Science.gov (United States)

    Boris, Ronald S; Benhammou, Jihane; Merino, Maria; Pinto, Peter A; Linehan, W Marston; Bratslavsky, Gennady

    2011-06-01

    Managing oncocytoma in the setting of bilateral renal masses is a challenging scenario. Nevertheless, to our knowledge the pathological concordance of an oncocytic neoplasm in 1 kidney with tumors in the contralateral kidney is not known. We evaluated the influence of germline Birt-Hogg-Dubé mutation on concordance rates to assist in managing these cases. We reviewed the records of patients at the National Institutes of Health between 1983 and 2009 who had bilateral renal masses, known pathology bilaterally and oncocytoma or an oncocytic neoplasm in at least 1 kidney. Oncocytoma or an oncocytic neoplasm in 2 renal units was considered concordant. Demographic, pathological and clinical data were collected. The population consisted of 40 patients, including 23 with and 17 without a diagnosis of Birt-Hogg-Dubé syndrome. Patients with the syndrome were younger (p renal masses showed 100% oncocytoma concordance between renal units. Of patients with bilateral renal masses those with Birt-Hogg-Dubé syndrome have significantly lower histological concordance than those without the syndrome. Patients with Birt-Hogg-Dubé syndrome should be monitored and treated differently than those without detected genetic mutations, especially patients with multifocal oncocytomas. Genetic testing for Birt-Hogg-Dubé should be considered in the treatment algorithm of patients with bilateral renal masses and known oncocytoma. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  11. The impact of germline BHD mutation on histologic concordance and clinical management of patients with bilateral renal masses and known unilateral oncocytoma

    Science.gov (United States)

    Boris, Ronald S; Benhammou, Jihane; Merino, Maria; Pinto, Peter A.; Linehan, W. Marston; Bratslavsky, Gennady

    2011-01-01

    Introduction and Objective Managing patients presenting with oncocytoma in the setting of bilateral renal masses is a challenging scenario. Nevertheless, pathologic concordance of oncocytic neoplasm in one kidney with tumors in the contralateral kidney is not known. We aim to evaluate the influence of germline Birt-Hogg-Dubé (BHD) mutation on concordance rates to assist in management of these patients. Methods We reviewed records of the NIH patients between 1983 and 2009 having bilateral renal masses, known pathology bilaterally, and presence of oncocytoma or oncocytic neoplasm in at least one kidney. The presence of oncocytoma or oncocytic neoplasm in two renal units was considered concordant. Demographic, pathological and clinical data were collected. Results The patient population consisted of 40 patients: 23 with BHD and 17 patients without diagnosis of BHD. Patients with BHD were younger (prenal masses demonstrated 100% oncocytoma concordance between renal units. Conclusions In patients with bilateral renal masses BHD patients have significantly lower histologic concordance rates compared to patients without BHD. Patients with BHD should be monitored and managed differently than patients without detected genetic mutations, especially those with multifocal oncocytomas. Genetic testing for BHD should be considered in the algorithm for management of patients with bilateral renal masses and known oncocytoma. PMID:21496834

  12. A Clinic-based Survey of Clinical Characteristics and Practice Pattern of Dry Eye in Japan.

    Science.gov (United States)

    Kawashima, Motoko; Yamada, Masakazu; Suwaki, Kazuhisa; Shigeyasu, Chika; Uchino, Miki; Hiratsuka, Yoshimune; Yokoi, Norihiko; Tsubota, Kazuo

    2017-03-01

    The aim of this study was to investigate the clinical characteristics and practice pattern of patients with dry eye disease (DED) in eye clinics across Japan. A multi-center, cross-sectional study was conducted among patients with DED who visited eye clinics in Japan. Subjective symptoms, patient's background, ocular surface features, and tear function were evaluated. Main outcome measures were tear break-up time (TBUT), Schirmer I value, kerato-conjunctival staining score, and dry eye symptom questionnaire score. Initially, 463 subjects were enrolled, and 449 cases (63 male and 386 female; mean age, 62.6 ± 15.7 years) were included in the final analysis. Overall, 94.9% of patients had a shortened TBUT (≤5 s), and 54.6% had an aqueous tear deficiency (Schirmer I value ≤5 mm). The most prevalent subtype of dry eye was aqueous-deficient dry eye, which was present in 35.0% of all patients, followed by short-BUT-type dry eye, which was seen in 26.7%. The two most common DED subtypes were aqueous-deficient and short-BUT-type dry eye. Shortened TBUT is the most common feature of dry eye, regardless of subtype. The current treatment choice mainly consisted of hyaluronic acid, two novel mucin secretagogues, diquafosol and rebamipide, and steroidal eye drops. University Hospital Medical Information Network: UMIN (registries no. UMIN 000015890). Japan Dry Eye Society, Tokyo, Japan, and Santen Pharmaceutical Co., Ltd., Osaka, Japan.

  13. Clinical Approach to the Standardization of Oriental Medical Diagnostic Pattern Identification in Stroke Patients

    Directory of Open Access Journals (Sweden)

    Han Jung Kim

    2011-01-01

    Full Text Available In Korea, many stroke patients receive oriental medical care, in which pattern-identification plays a major role. Pattern-identification is Oriental Medicine's unique diagnostic system. This study attempted to standardize oriental medical pattern-identification for stroke patients. This was a community-based multicenter study that enrolled stroke patients within 30 days after their ictus. We assessed the patients' general characteristics and symptoms related to pattern-identification. Each patient's pattern was determined when two doctors had the same opinion. To determine which variables affect the pattern-identification, binary logistic regression analysis was used with the backward method. A total of 806 stroke patients were enrolled. Among 480 patients who were identified as having a certain pattern, 100 patients exhibited the Fire Heat Pattern, 210 patients the Phlegm Dampness Pattern, nine patients the Blood Stasis Pattern, 110 patients the Qi Deficiency Pattern, and 51 patients the Yin Deficiency Pattern. After the regression analysis, the predictive logistic equations for the Fire Heat, Phlegm Dampness, Qi Deficiency, and Yin Deficiency patterns were determined. The Blood Stasis Pattern was omitted because the sample size was too small. Predictive logistic equations were suggested for four of the patterns. These criteria would be useful in determining each stroke patient's pattern in clinics. However, further studies with large samples are necessary to validate and confirm these criteria.

  14. Malignant melanoma in the penguin: characterization of the clinical, histologic, and immunohistochemical features of malignant melanoma in 10 individuals from three species of penguin.

    Science.gov (United States)

    Duncan, Ann E; Smedley, Rebecca; Anthony, Simon; Garner, Michael M

    2014-09-01

    Malignant melanomas are aggressive neoplasms that are relatively common in penguins compared to other avian species. In this study, the clinical and pathologic characteristics of melanocytic neoplasms in five macaroni (Eudyptes chrysolophus), three rock hopper (Eudyptes chrysocome), and two Humboldt (Spheniscus humboldti) penguins are described. Tumors most commonly occurred in the skin of the foot or hock, and were seen in the subcutaneous muscle, especially near the beak/oral cavity. Gross lesions were usually heavily pigmented, becoming raised and ulcerated over time. Humboldt penguins had a unique presentation, forming variably pigmented, cornified lesions in the inguinal area. Original case materials were obtained from all but two cases, and were assessed to define the characteristics of malignancy, evaluate four immunohistochemical markers for melanoma, and look for factors useful to informing prognosis and clinical decisions. Diagnosis was made histologically, based on morphologic features and pigmentation. Though not necessary for diagnosis, PNL-2 was found to be a useful immunohistochemical marker. HMB-45 showed unreliable positive labelling and S-100, Melan-A and Ki67 were not useful. Several factors were associated with prognosis, including gross surface dimension, mitotic index, depth of neoplastic cell invasion, and degree of surface ulceration. Metastatic spread occurred to the liver, lung, adrenal gland, brain, and bone; all lesions showed positive labelling to PNL-2. The average survival after diagnosis was 7 mo, though complete surgical excision of tumors less than 2.0 cm was curative in two cases and radiation therapy prolonged survival in one penguin. The underlying pathogenesis associated with the high prevalence of melanocytic neoplasms in captive penguins could not be identified. Three different molecular methods were performed to look for viral particles and results were negative. Advanced age is the most probable associated risk factor

  15. Clinical patterns of Compositae dermatitis in Danish monosensitized patients

    DEFF Research Database (Denmark)

    Paulsen, Evy; Andersen, Klaus E

    2017-01-01

    BACKGROUND: Compositae dermatitis was originally described as airborne contact dermatitis. More recent studies have reported a wider clinical spectrum, but often in polysensitized patients. OBJECTIVE: To evaluate the clinical features of patients sensitized to Compositae only. PATIENTS/METHODS: C......BACKGROUND: Compositae dermatitis was originally described as airborne contact dermatitis. More recent studies have reported a wider clinical spectrum, but often in polysensitized patients. OBJECTIVE: To evaluate the clinical features of patients sensitized to Compositae only. PATIENTS....../METHODS: Consecutive Compositae-sensitive eczema patients, tested between 1990 and 2015, who, at the patch testing session diagnosing their Compositae allergy, were found to be sensitized only to the plant family, were included. RESULTS: Altogether, 529 of 13 139 patients tested (4.0%) were sensitized to Compositae......: The prevalence of Compositae sensitization is continuously high in consecutive eczema patients. Sensitization may occur at any age. Clinical features in monosensitized patients vary, but, with continuing exposure, the patients may develop more widespread dermatitis similar to classic Compositae dermatitis...

  16. Patterns of clinical mastitis manifestations in Danish organic dairy herds

    DEFF Research Database (Denmark)

    Vaarst, Mette; Enevoldsen, Carsten

    1997-01-01

    coli infections were typically (truly) acute cases. Bacteriologically negative mastitis (20% of the cases) showed strong similarities with clinical coliform mastitis. Staphylococcus aureus cases (18% of the cases) occurred most frequently in late lactation or around drying-off. Prior isolation of Staph....... aureus and slight decreases in milk yield were two factors that interacted but both were strongly and positively related to clinical Staph. aureus. Staph. aureus mastitis typically had a subclinical debut, and increasing degrees and duration of inflammation decreased shedding of this pathogen...

  17. Three-year randomised clinical trial to evaluate the clinical performance, quantitative and qualitative wear patterns of hybrid composite restorations

    OpenAIRE

    Palaniappan, Senthamaraiselvi; Elsen, Liesbeth; Lijnen, Inge; Peumans, Marleen; Van Meerbeek, Bart; Lambrechts, Paul

    2009-01-01

    The aim of the study was to compare the clinical performance, quantitative and qualitative wear patterns of conventional hybrid (Tetric Ceram), micro-filled hybrid (Gradia Direct Posterior) and nano-hybrid (Tetric EvoCeram, TEC) posterior composite restorations in a 3-year randomised clinical trial. Sixteen Tetric Ceram, 17 TEC and 16 Gradia Direct Posterior restorations were placed in human molars and evaluated at baseline, 6, 12, 24 and 36?months of clinical service according to US Public H...

  18. Pattern and clinical presentation of constipation in children in Sudan ...

    African Journals Online (AJOL)

    ... 12 children (8%) had Hirschsprung's disease, 2children (1.3%) had hypothyroidism, 2 children (1.3%) had celiac disease, and 1child (0.7%) had cerebral palsy. The main clinical characteristic of functional constipation were faecal impaction presented in 59.4% of patients, straining in 43%, withholding behavior in 32.3%, ...

  19. Clinical implications of ST segment time-course recovery patterns ...

    African Journals Online (AJOL)

    Arun Kumar Agnihotri

    Angiographic findings were used as the gold standard with which to compare the results of the exercise stress test and the sensitivity and specificity determined. The parameters analysed were: the clinical features (chest pain, breathlessness) and demographics of the sample population, the onset of ST depression, the.

  20. The prevalence and clinical pattern of infertility in Bauchi, northern ...

    African Journals Online (AJOL)

    Conclusion: Infertility is a common presentation in the clinics and the secondary type is predominant in this setting. The cause of infertility most commonly identified in the studied population was tubal factor and its best option of treatment is not available in the study area. Keywords: Infertility, Prevalence, Women, Nigeria ...

  1. Nonconvulsive Status Epilepticus Resembling Clinical Absence with Atypical EEG Pattern

    Directory of Open Access Journals (Sweden)

    Channaiah Srikanth Mysore

    2017-01-01

    Full Text Available Objective. We are reporting two cases: a patient with steroid responsive encephalopathy associated with autoimmune thyroiditis (SREAT and another patient with secondary progressive multiple sclerosis (SPMS, both presenting with altered mental status (AMS and later diagnosed with nonconvulsive atypical absence status epilepticus (AS, with atypical EEG changes. Methods. A report of two cases. Results. A patient with history of SREAT and the other with SPMS had multiple admissions due to AMS. For both, EEG revealed the presence of a high voltage generalized sharply contoured theta activity. A diagnosis of NCSE with clinical features of AS was made based on both clinical and EEG features. There was significant clinical and electrographic improvement with administration of levetiracetam for both patients in addition to sodium valproate and Solumedrol for the SREAT patient. Both patients continued to be seizure free on follow-up few months later. Conclusions. This is a report of two cases of atypical AS, with atypical EEG, in patients with different neurological conditions. Prompt clinical and EEG recovery occurred following appropriate medical treatment. We think that this condition might be underreported and could significantly benefit from prompt treatment when appropriately diagnosed.

  2. Antimicrobial susceptibility patterns of E. coli from clinical sources in ...

    African Journals Online (AJOL)

    Background: Escherichia coli is the leading cause of urinary tract, ear, wound and other infections in humans. Increasing rates of antimicrobial resistance among E. coli is a growing concern worldwide. Objectives: The aim of this study was to determine the prevalence and antimicrobial susceptibility of E. coli from clinical ...

  3. PATTERN OF CLINICAL FEATURES OF CHRONIC SIMPLE RHINO-'

    African Journals Online (AJOL)

    hearing impairment, tinnitus, photophobia, eye pain, dental pain, sore throat, cough and hoarseness 1'6. The symptom complex for each patient is different. Diagnosis of this disease is done largely on clinical grounds. Serological, immunological and radiological tests are useful for confirmation and determining the extent of ...

  4. Clinical Features and Patterns of Imaging in Cerebral Venous Sinus ...

    African Journals Online (AJOL)

    ... pregnancy, puerperium and oral contraceptive use. The most common clinical finding in patients with CVST is headache, followed by seizures, neck pain, neurological deficits and visual disturbance. Infective cause is much more common in our population and other developed countries compared to the developed world.

  5. Depression Screening Patterns for Women in Rural Health Clinics

    Science.gov (United States)

    Tudiver, Fred; Edwards, Joellen Beckett; Pfortmiller, Deborah T.

    2010-01-01

    Context: Rates and types of screening for depression in rural primary care practices are unknown. Purpose: To identify rates of depression screening among rural women in a sample of rural health clinics (RHCs). Methods: A chart review of 759 women's charts in 19 randomly selected RHCs across the nation. Data were collected from charts of female…

  6. Next-Generation Molecular Histology Using Highly Multiplexed Ion Beam Imaging (MIBI) of Breast Cancer Tissue Specimens for Enhanced Clinical Guidance

    Science.gov (United States)

    2015-07-01

    channels specific for each region of interest. Histone H3 and dsDNA are being used as nuclear markers; lamin A/C and nuclear pore complex are...AWARD NUMBER: W81XWH-14-1-0180 TITLE: Next-Generation Molecular Histology Using Highly Multiplexed Ion Beam Imaging (MIBI) of Breast Cancer Tissue...4. TITLE AND SUBTITLE Next-Generation Molecular Histology Using Highly Multiplexed Ion Beam Imaging (MIBI) of Breast Cancer Tissue Specimens for

  7. Strokes in the subinsular territory: clinical, topographical, and etiological patterns.

    Science.gov (United States)

    Kumral, Emre; Ozdemirkiran, Tolga; Alper, Yaprak

    2004-12-28

    The authors studied 11 patients with subinsular stroke (subIS) located in a deep border zone between lenticulostriate arteries and small insular cortical penetrating branches of the middle cerebral artery. The typical clinical features of subIS were motor deficits (11 patients), sensory disturbances (6 patients), transcortical motor aphasia and hypophonia (2 patients), and transient dysphagia at stroke onset (5 patients). Large artery disease and cardioembolic mechanisms may give rise to subIS by hemodynamic mechanisms.

  8. Clinical, biochemical and histological study of the effect of antimicrobial photodynamic therapy on oral mucositis induced by 5-fluorouracil in hamsters.

    Science.gov (United States)

    Cruz, Érika de Paula da; Campos, Luana; Pereira, Filipi da Silva; Magliano, Gabriela Campos; Benites, Bernar Monteiro; Arana-Chavez, Victor Elias; Ballester, Rafael Yagüe; Simões, Alyne

    2015-06-01

    Oral mucositis (OM) is a debilitating side effect of chemotherapy, which can be relieved by phototherapy. Antimicrobial photodynamic therapy (aPDT) may be used for the treatment of OM, when infection is present. However, there are no studies showing that aPDT affects tissue repair process when used in the treatment of lesions caused by OM. This work aims to evaluate the effect of aPDT in healing OM induced by 5-Fluorouracil (5-FU). Two hundred forty-five hamsters were divided into two groups, control (C) and experimental, which were subdivided into 4 subgroups (Ch, ChP, ChL, aPDT). C group received only the vehicle of chemotherapy and anesthesia, whereas all animals of the experimental groups received anesthesia and chemotherapy agent 5-FU to induce OM. Ch group received no OM treatment; ChP group received an application of methylene blue (MB) 0.01%; ChL received irradiation with low-power-laser (LPL-660 nm/120 J /cm(2)/40 mW/4.4 J per point); and aPDT received MB and LPL irradiation. OM Clinical severity were daily assessed by a blinded examiner. The animals were sacrificed after 5, 7 and 10 days of experiment and their oral mucosa were removed for biochemical (enzymatic activity of SOD and catalase) and histological analyzes (light microscopy). After statistical analysis was performed, results showed that aPDT reduced the severity of OM on the tenth day of the experiment, when compared to the initial OM score (p < 0.05), as well as increased keratinization with organized collagen deposition in the lamina propria. In conclusion, aPDT can be safely used in animals with infected OM because it does not affect lesion-repairing processes. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Veterinarian-client-patient communication patterns used during clinical appointments in companion animal practice.

    Science.gov (United States)

    Shaw, Jane R; Bonnett, Brenda N; Adams, Cindy L; Roter, Debra L

    2006-03-01

    To identify communication patterns used by veterinarians during clinical appointments in companion animal practice. Cross-sectional descriptive study. A random sample of 50 companion animal practitioners in southern Ontario and a convenience sample of 300 clients and their pets. For each practitioner, 6 clinical appointments (3 wellness appointments and 3 appointments related to a health problem) were videotaped. The Roter interaction analysis system was used to analyze the resulting 300 videotapes, and cluster analysis was used to identify veterinarian communication patterns. 175 (58%) appointments were classified as having a biomedical communication pattern, and 125 (42%) were classified as having a biolifestyle-social communication pattern. None were classified as having a consumerist communication pattern. Twentythree (46%) veterinarians were classified as using a predominantly biomedical communication pattern, 19 (38%) were classified as using a mixed communication pattern, and 8 (16%) were classified as using a predominantly biolifestyle-social communication pattern. Pattern use was related to the type of appointment. Overall, 103 (69%) wellness appointments were classified as biolifestyle-social and 127 (85%) problem appointments were classified as biomedical. Appointments with a biomedical communication pattern (mean, 11.98 minutes) were significantly longer than appointments with a biolifestyle-social communication pattern (10.43 minutes). Median relationship-centered care score (ie, the ratio of client-centered talk to veterinarian-centered talk) was significantly higher during appointments with a biolifestyle-social communication pattern (1.10) than during appointments with a biomedical communication pattern (0.40). Results suggest that veterinarians in companion animal practice use 2 distinct patterns of communication. Communication pattern was associated with duration of visit, type of appointment, and relationship-centeredness. Recognition of these

  10. Sarcoidosis: a pattern of clinical and morphological presentation.

    Science.gov (United States)

    Valantine, H; McKenna, W J; Nihoyannopoulos, P; Mitchell, A; Foale, R A; Davies, M J; Oakley, C M

    1987-01-01

    The diagnosis of cardiac sarcoidosis, particularly when there is no overt systemic involvement, is frequently delayed because of its varied manifestations. Focal left ventricular wall motion abnormalities were recognised in five patients with sarcoidosis. Three patients showed abnormal regional wall motion in the basal portion of the ventricular septum and free wall with sparing of the apex. The angiographic appearances supported the echocardiographic findings which were atypical of ischaemic heart disease. The remaining two patients both had diffuse left ventricular hypokinesia, with a focal abnormality that was most pronounced in the anteroapical region; this pattern is often seen with coronary disease. The recognition by echocardiography or angiography of focal abnormalities of wall motion affecting the basal portion of the ventricular septum should suggest the possibility of myocardial sarcoidosis even in the absence of recognised systemic manifestations. Images Fig 1 Fig 2 Fig 3 Fig 4 Fig 5 Fig 6 Fig 7 PMID:3566984

  11. Are personality patterns and clinical syndromes associated with patients' motives and percieved outcome of othognathic surgery?

    DEFF Research Database (Denmark)

    Petersen, Jesper Øland; Jensen, J.; Melsen, Birte

    2010-01-01

    A study of surgical-orthodontic patients was performed to assess whether signs of personality patterns and psychologically defined clinical syndromes influenced patients' motives for treatment, perceived oral function, self-concept, social interaction, and overall satisfaction with treatment....

  12. Computer-assisted interpretation of the EEG background pattern: a clinical evaluation

    NARCIS (Netherlands)

    Lodder, Shaun; Askamp, Jessica; van Putten, Michel Johannes Antonius Maria

    2014-01-01

    Objective Interpretation of the EEG background pattern in routine recordings is an important part of clinical reviews. We evaluated the feasibility of an automated analysis system to assist reviewers with evaluation of the general properties in the EEG background pattern. Methods Quantitative EEG

  13. REVIEW ARTICLE Complications, disease profile and histological ...

    African Journals Online (AJOL)

    14 SA JOURNAL OF RADIOLOGY • March 2011. REVIEW ARTICLE. Complications, disease profile and histological yield from percutaneous renal biopsy .... ranged from 13 months to 72 years (average 41.5 years) and race was included in the analysis. Information was collected from clinical notes, and histology results.

  14. Safe and effective one-session fractional skin resurfacing using a carbon dioxide laser device in super-pulse mode: a clinical and histologic study.

    Science.gov (United States)

    Trelles, Mario A; Shohat, Michael; Urdiales, Fernando

    2011-02-01

    Carbon dioxide (CO(2)) laser ablative fractional resurfacing produces skin damage, with removal of the epidermis and variable portions of the dermis as well as associated residual heating, resulting in new collagen formation and skin tightening. The nonresurfaced epidermis helps tissue to heal rapidly, with short-term postoperative erythema. The results for 40 patients (8 men and 32 women) after a single session of a fractional CO(2) resurfacing mode were studied. The treatments included resurfacing of the full face, periocular upper lip, and residual acne scars. The patients had skin prototypes 2 to 4 and wrinkle degrees 1 to 3. The histologic effects, efficacy, and treatment safety in various clinical conditions and for different phototypes are discussed. The CO(2) laser for fractional treatment is used in super-pulse mode. The beam is split by a lens into several microbeams, and super-pulse repetition is limited by the pulse width. The laser needs a power adaptation to meet the set fluence per microbeam. Laser pulsing can operate repeatedly on the same spot or be moved randomly over the skin, using several passes to achieve a desired residual thermal effect. Low, medium, and high settings are preprogrammed in the device, and they indicate the strength of resurfacing. A single treatment was given with the patient under topical anesthesia. However, the anesthesia was injected on areas of scar tissue. Medium settings (2 Hz, 30 W, 60 mJ) were used, and two passes were made for dark skins and degree 1 wrinkles. High settings (2 Hz, 60 W, 120 mJ) were used, and three passes were made for degree 3 wrinkles and scar tissue. Postoperatively, resurfaced areas were treated with an ointment of gentamycin, Retinol Palmitate, and DL-methionine (Novartis; Farmaceutics, S.A., Barcelona, Spain). Once epithelialization was achieved, antipigment and sun protection agents were recommended. Evaluations were performed 15 days and 2 months after treatment by both patients and

  15. 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?

    Energy Technology Data Exchange (ETDEWEB)

    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)

    2015-10-15

    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

  16. HistologiQuiz

    DEFF Research Database (Denmark)

    Brent, Mikkel Bo

    2015-01-01

    HistologiQuiz er en quiz-app udviklet til almen og speciel histologi. Den består af mere end 1400 spørgsmål og over 320 histologiske billeder. Alle spørgsmål tager udgangspunkt i lærebogen Genesers Histologi af Annemarie Brüel m.fl.......HistologiQuiz er en quiz-app udviklet til almen og speciel histologi. Den består af mere end 1400 spørgsmål og over 320 histologiske billeder. Alle spørgsmål tager udgangspunkt i lærebogen Genesers Histologi af Annemarie Brüel m.fl....

  17. Positive Oct -3/4 and D2-40 Immunohistochemical Expression in Germ Cells and Suspected Histology Pattern of Intratubular Germ Cell Neoplasia in Boys with Cryptorchidism Vanish after the Age of 2 Years

    DEFF Research Database (Denmark)

    Thorup, Jorgen; Clasen-Linde, Erik; Cortes, Dina

    2017-01-01

    , but no increased risk of malignancy.  Materials and Methods  Histology sections from 373 testicular biopsies from 289 boys aged 1 month to 2 years operated for cryptorchidism were incubated with primary antibodies including anti-placental-like-alkaline phosphatase, antiOct-3/4, anti-C-kit, anti-D2-40, and in case...... of repeat biopsy with anti-stem cell factor (SCF) receptor.  Results  The prevalence of Oct-3/4 and D2-40-positive staining of germ cells in testicular biopsies were in age groups less than 6 months, 100% and 50%; 6-12 months, 60% and 17%; and 1-2 years, 12% and 4%. A 1 year, 1-month-old boy with Prader...... months, 3.5 years, and 3 years, 10months, respectively. In all cases, the Oct-3/4 and D2-40 positive germ cells turned negative and the histological pattern normalized completely. The primary biopsies had SCF negative germ cells.  Conclusion  This study is valuable in identifying the age-related change...

  18. Running patterns of transfemoral amputees: a clinical analysis.

    Science.gov (United States)

    Mensch, G; Ellis, P E

    1986-12-01

    The challenge of rehabilitating young, healthy transfemoral amputees may extend beyond the boundaries of teaching them to adapt to functional activities of daily living. The goal for several of these amputees is to participate and sometimes even compete in recreational activities, including running. These amputee runners require prosthetic adaptations as well as a comprehensive individualized training programme to ensure that their running is as safe and energy efficient as possible. To help amputees achieve this, clinicians must understand normal and prosthetic locomotion. This paper compares the biomechanical differences between walking and running in normal locomotion and analyses the running modes used by transfemoral amputees. The modified running mode achieved with the Terry Fox Running Prosthesis subjectively "looks" more energy efficient to the observer and "feels" more energy efficient to the user. These assumptions have yet to be confirmed or refuted by a rigorous scientific research study. An outline of the proposed physiotherapy protocol includes the familiarization, treatment, and training phases. Physiotherapists involved in amputation rehabilitation may not be commonly confronted with this level of patient expectation. It is their responsibility to give realistic guidance to these amputees so that they can safely and independently pursue their recreational running activities. This need can best be fulfilled by providing sound clinical advice which has been validated by research findings.

  19. Clinical patterns and major causes of infertility among Sudanese couples.

    Science.gov (United States)

    Elussein, Elsir A; Magid, Yagoub M; Omer, Maha M; Adam, Ishag

    2008-10-01

    An understanding of the medical causes of infertility is crucial in order to reduce incidences of Infertility and for improving the clinical management of infertility. Although there were much data on infertility in other African countries, no data exist on infertility in Sudan. Seven hundred and ten Sudanese couples were investigated for the infertility in Khartoum Fertility Center, Sudan: 443 (62.4%) had primary infertility and 267 (37.6%) had secondary infertility. The mean (standard deviation) duration of the infertility was 5.2 (4.3) years. A positive male factor alone was found in 257 (36.2%) couples and a female factor in 350 (49.3%) couples: eleven (1.5%) couples had a combination of male and female factors: and the cause of infertility was unexplained in 92 (13.0%) couples. Oligozoospermia and asthenozoospermia were factors responsible for 16.8% and 17.5% of male infertility, respectively. Failure of ovulation (60.3%) was the most common cause of female infertility. The study revealed a high proportion of secondary infertility and a greater contribution of the female factors to infertility.

  20. Are personality patterns and clinical syndromes associated with patients' motives and perceived outcome of orthognathic surgery?

    Science.gov (United States)

    Øland, Jesper; Jensen, John; Melsen, Birte; Elklit, Ask

    2010-12-01

    A study of surgical-orthodontic patients was performed to assess whether signs of personality patterns and psychologically defined clinical syndromes influenced patients' motives for treatment, perceived oral function, self-concept, social interaction, and overall satisfaction with treatment. The sample consisted of 92 adult surgical-orthodontic patients. They filled out 3 questionnaires from Kiyak et al: one on motives for treatment; another on perceived oral function, self-concept, and social interaction; and a third on satisfaction with treatment outcome. The Millon Clinical Multiaxial Inventory III was used for classification of personality patterns and clinical syndromes. Patients with signs of a schizoid personality pattern expressed stronger presurgical motives than other patients. Concerning self-concept and social interaction, the patients showing signs of personality patterns and clinical syndromes, in general, perceived themselves as worse than the other patients. However, differences were only evident before treatment. Overall satisfaction was independent of the psychological profile. Histrionic and narcissistic personality patterns seemed to be overrepresented among surgical-orthodontic patients compared with the general population. Patients who showed signs of certain personality patterns and clinical syndromes improved most from treatment in terms of self-concept and social interaction, and such traits did not influence their degree of satisfaction. Copyright © 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Patterns in Clinical Students' Self-Regulated Learning Behavior: A Q-Methodology Study

    Science.gov (United States)

    Berkhout, Joris J.; Teunissen, Pim W.; Helmich, Esther; van Exel, Job; van der Vleuten, Cees P.; Jaarsma, Debbie A.

    2017-01-01

    Students feel insufficiently supported in clinical environments to engage in active learning and achieve a high level of self-regulation. As a result clinical learning is highly demanding for students. Because of large differences between students, supervisors may not know how to support them in their learning process. We explored patterns in…

  2. A randomized controlled clinical multicenter trial comparing the clinical and histological performance of a new, modified polylactide-co-glycolide acid membrane to an expanded polytetrafluorethylene membrane in guided bone regeneration procedures.

    Science.gov (United States)

    Schneider, David; Weber, Franz E; Grunder, Ueli; Andreoni, Claude; Burkhardt, Rino; Jung, Ronald E

    2014-02-01

    To compare the clinical and histological outcomes of a resorbable modified polylactide/polyglycolide acid (PLGA) test membrane and a titanium-reinforced expanded polytetrafluorethylene (ePTFE) control membrane used for guided bone regeneration (GBR) around dental implants. A total of 40 patients with peri-implant dehiscence-type defects were randomly allocated to a GBR procedure using either a modified PLGA test or an ePTFE control membrane. Soft tissue condition, implant integration, adverse events and quality of life were recorded during the 6-month healing period. At re-entry peri-implant bone defect dimensions were measured and compared with values recorded at implant/GBR surgery. A biopsy was retrieved for qualitative and quantitative histological analyses. A comparison between the groups was conducted using non-parametric statistical tests. Soft tissue complications were observed in five test patients and two control patients. Except for soft tissue complications and incomplete regeneration, no procedure- or device-related adverse events were observed. The vertical bone defect component was, in mean, reduced by-5.1 mm (95% CI -6.8, -3.3) in the test group and -6.9 mm (95% CI -8.2, -5.5 mm) in the control group. The mean residual vertical defect height measured 1.2 ± 2.4 mm in the test group and 0.3 ± 1.1 mm in the control group meaning a mean defect resolution of 81% in the test group and 96% in the control group (P = 0.161). The horizontal bone thickness at implant shoulder level decreased from a mean of 3.2 mm to 1.4 mm (-56%, mean -1.7 mm, 95% CI -2.3, -1.1) in the test group and from 3.3 mm to 2.5 mm (-24%, mean -0.8 mm, 95% CI -1.3, -0.3) in the control group (P = 0.022). Qualitative and quantitative histological analyses did not show significant differences in the tissue composition between groups. Peri-implant GBR was successfully performed using either of the membranes. The control membrane was able to better maintain the horizontal thickness of

  3. Distinct Patterns of Stromal and Tumor Expression of ROR1 and ROR2 in Histological Subtypes of Epithelial Ovarian Cancer 1

    OpenAIRE

    Henry, CE; Emmanuel, C.; Lambie, N; C. Loo; Kan, B; Kennedy, CJ; de Fazio, A; Hacker, NF; Ford, CE

    2017-01-01

    OBJECTIVE: The ROR1 and ROR2 receptor tyrosine kinases have both been implicated in ovarian cancer progression and have been shown to drive migration and invasion. There is an increasing importance of the role of stroma in ovarian cancer metastasis; however, neither ROR1 nor ROR2 expression in tumor or stromal cells has been analyzed in the same clinical cohort. AIM: To determine ROR1 and ROR2 expression in ovarian cancer and surrounding microenvironment and examine associations with clinicop...

  4. Normal and pathological breast, the histological basis

    Energy Technology Data Exchange (ETDEWEB)

    Guinebretiere, J.M. [Department of Pathology, Centre Rene-Huguenin, 35 rue Dailly, 92210 Saint Cloud (France)]. E-mail: jm.guinebretiere@stcloud-huguenin.org; Menet, E. [Department of Pathology, Centre Rene-Huguenin, 35 rue Dailly, 92210 Saint Cloud (France); Tardivon, A. [Department of Radiology, Institut Curie, 26 rue d' Ulm, 75248 Paris Cedex 5 (France); Cherel, P. [Department of Radiology, Centre Rene-Huguenin, 35 rue Dailly, 92210 Saint Cloud (France); Vanel, D. [Department of Diagnostic Radiology, Institut Gustave-Roussy, 39 rue Camille Desmoulins, 94805 Villejuif (France)

    2005-04-01

    Breast tissue is heterogeneous, associating connective and glandular structures, which grow and change cyclically under hormonal regulation. Hormones are also thought to be the main determinant of the major benign and malignant pathologies encountered in the breast. Benign lesions are more frequent and fibrocystic changes are by far the most common among them. They usually associate different entities (adenosis, fibrosis, cysts and hyperplasia) but vary in intensity and extension. Thus, their clinical and radiographic presentation is extremely different from one patient to another. Adenofibroma is the most frequent tumour. It also undergoes modifications according to hormonal conditions. About 90% of malignant tumours are primary carcinoma. The incidence of intra-ductal carcinoma has risen dramatically since the development of screening because of its ability to induce calcification. Two mechanisms could be involved in the formation of calcification: one active (tumour cell secretion of vesicles), the other passive (necrotic cell fragments are released). Invasive carcinoma comprises numerous histological types. Stromal reactions essentially determines their shape: a fibrous reaction commonly found in ductal carcinoma creates a stellate lesion while other stroma, inflammatory (medullary carcinoma), vascular (papillary carcinoma) or mucinous determine nodular lesions whose borders push the surrounding tissue. The histological features which give rise to the radiographic pattern will be emphasised.

  5. Histology of psoriatic erythroderma in infants: Analytical study of eight cases

    Directory of Open Access Journals (Sweden)

    Parimalam Kumar

    2015-01-01

    Full Text Available Background: Erythroderma in infants is a rare condition of varied etiology. Psoriasis is now emerging as the most common cause of erythroderma in infants. Early diagnosis of the etiological cause much depends upon the histological confirmation, which is essential for an early and appropriate treatment. Aim: It was aimed to study the histological findings in psoriatic erythroderma in infants. Materials and Methods: A total of 8 infants up to 1 year of age presenting with erythroderma, clinically suspected to be of psoriatic etiology attending private clinic were included. After detailed history taking and astute clinical exam, all of them were biopsied. In case 6, with a positive family history of psoriasis and asthma in parents, biopsy was taken from two sites. The histological findings of all nine biopsies were studied and analyzed. Results: Histology of all eight children showed psoriasi form pattern with acanthosis (AC and dilated papillary capillaries (PC. Spongiform (SF pattern was seen in the second biopsy (6b of child with features of both psoriasis and atopy. SF pustule of Kogoj or Munro′s abscess was not seen in any of them. Conclusion: Regular AC and PC dilatation were the consistent histological findings observed in infants with erythrodermic psoriasis. These were the early findings observed in younger infants. Co-existence of psoriasis with atopic dermatitis may indicate a common pathogenic mechanism or an immunogenetic spin-off.

  6. Current patterns of presentation and treatment of renal masses: a clinical research office of the endourological society prospective study

    NARCIS (Netherlands)

    Laguna, M. Pilar; Algaba, Ferran; Cadeddu, Jeffrey; Clayman, Ralph; Gill, Inderbir; Gueglio, Guillermo; Hohenfellner, Markus; Joyce, Adrian; Landman, Jaime; Lee, Benjamin; van Poppel, Hein

    2014-01-01

    To assess epidemiologic characteristics, clinical and pathologic patterns of presentation, and treatment strategies in a contemporary population with renal masses (RMs). The Clinical Research Office of the Endourological Society collected prospective epidemiologic, clinical, and pathologic data on

  7. A rare case of concomitant tuberculosis of the nose, paranasal sinuses and larynx: clinical, histological and immunohistochemical aspects. A case report.

    Science.gov (United States)

    Budu, Vlad Andrei; Bulescu, Ioan Alexandru; Schnaider, Alexandra; Popp, Cristiana Gabriela; Toma, Claudia Lucia; Mogoantă, Carmen Aurelia; Mühlfay, Gheorghe

    2015-01-01

    Extrapulmonary tuberculosis is a rare condition determined by Mycobacterium tuberculosis. It can affect any organ, and has a higher incidence with the increase of HIV infection, or in countries with high pulmonary tuberculosis. Diagnosis is difficult, mostly because of non-specific symptoms and a low rate of presentation for medical consult when symptoms do occur. Complete diagnosis is usually set by histological, immunohistochemical examinations, and also with Polymerase Chain Reaction (PCR) in selected cases. The authors present a case of concomitant tuberculosis of the nose, paranasal sinuses and subglottic larynx, without primary involvement of the lungs. The diagnosis was imposed by histological examination and immunostaining of probes obtained in surgery. The treatment was surgical debridement followed by specific antituberculosis medication.

  8. Atypical clinical and electroencephalographic pattern in a patient with subacute sclerosing panencephalitis

    Directory of Open Access Journals (Sweden)

    Délrio F. Silva

    1995-06-01

    Full Text Available We describe an atypical clinical and electroencephalographic (EEG pattern observed during the course of subacute sclerosing panencephalitis in a 14 year-old boy. In this patient with a two weeks history of partial complex seizures, the atypical EEG pattern was characterized by an initial left temporal focus which evolved to periodic lateralized epileptiform discharges (PLEDs and, only during the 3rd and 4th weeks the typical bilateral and generalized periodic complexes appeared.

  9. Three-year randomised clinical trial to evaluate the clinical performance, quantitative and qualitative wear patterns of hybrid composite restorations.

    Science.gov (United States)

    Palaniappan, Senthamaraiselvi; Elsen, Liesbeth; Lijnen, Inge; Peumans, Marleen; Van Meerbeek, Bart; Lambrechts, Paul

    2010-08-01

    The aim of the study was to compare the clinical performance, quantitative and qualitative wear patterns of conventional hybrid (Tetric Ceram), micro-filled hybrid (Gradia Direct Posterior) and nano-hybrid (Tetric EvoCeram, TEC) posterior composite restorations in a 3-year randomised clinical trial. Sixteen Tetric Ceram, 17 TEC and 16 Gradia Direct Posterior restorations were placed in human molars and evaluated at baseline, 6, 12, 24 and 36 months of clinical service according to US Public Health Service criteria. The gypsum replicas at each recall were used for 3D laser scanning to quantify wear, and the epoxy resin replicas were observed under scanning electron microscope to study the qualitative wear patterns. After 3 years of clinical service, the three hybrid restorative materials performed clinically well in posterior cavities. Within the observation period, the nano-hybrid and micro-hybrid restorations evolved better in polishability with improved surface gloss retention than the conventional hybrid counterpart. The three hybrid composites showed enamel-like vertical wear and cavity-size dependant volume loss magnitude. Qualitatively, while the micro-filled and nano-hybrid composite restorations exhibited signs of fatigue similar to the conventional hybrid composite restorations at heavy occlusal contact area, their light occlusal contact areas showed less surface pitting after 3 years of clinical service.

  10. Histological and clinical survey of polylactic-polyglycolic acid and dextrane copolymer in maxillary sinus lift: a pilot in vivo study.

    Science.gov (United States)

    Martuscelli, R; Maltarello, M C; Maraldi, N M; Sbordone, C; Sbordone, L

    2008-01-01

    Of various proposed alternatives to autogenous bone, a synthetic, degradable copolymer of PLA-GLA and dextrane seems to be a promising biomaterial for maxillary sinus lift. Consecutive partially edentulous patients showing severe monolateral posterior maxillary atrophy were treated via sinus lift using PLA-GLA-dextrane copolymer as the sole filler. Delayed implant positioning was performed and cores of regenerated tissues and native bone controls were retrieved and evaluated by light and electron microscopy, histomorphometry, microhardness and qualitative X-ray analysis. Seven sinuses in 7 patients were augmented with PLA-GLA-dextrane copolymer. Six to nine months after the copolymer 'graft', 17 bone cores were retrieved: all histological sections contained newly synthesized, mineralized material and new bone in various stages of development. Histomorphometry revealed average Trabecular Bone Volume (TBV) values ranging from 51% (6 months) to 77% (9 months). Backscattered scanning electron microscopy (BSE) in experimental and control samples confirmed histology findings. Microhardness values suggested newly formed bone at nine months was not as hard as native bone. Ca and P content was similar in 9-month regenerated and native bone. Seventeen implants were inserted in the second stage of surgery: resulting Implant Success (SR) and Cumulative Success (CSR) up to 3 years were 100% following Albrektssons criteria. Sinus lift augmentation using PLA-GLA-dextrane copolymer as the sole filler resulted in uneventful surgeries. New bone formation was evident histologically and its maturation was still in progress after 9 months. Successful, staged implant positioning was achieved in regenerated tissue.

  11. Increased signal intensity at the proximal patellar tendon: correlation between MR imaging and histology in eight cadavers and clinical MR imaging studies

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Seong Jong; Jin, Wook; Yoon, So Hee; Park, So Young [Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Department of Radiology, Seoul (Korea, Republic of); Park, Yong-Koo [Kyung Hee University Medical Center, Department of Pathology, Seoul (Korea, Republic of); Kim, Gou Young [Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Department of Pathology, Seoul (Korea, Republic of); Lee, Jung Eun; Park, Ji Seon; Ryu, Kyung Nam [Kyung Hee University Medical Center, Department of Radiology, Seoul (Korea, Republic of)

    2015-10-15

    We set out to investigate the cause of persistently increased signal intensity (SI) in the posterior portion of the proximal patellar tendon (pPT) on T1-weighted images (T1WI). MR imaging was performed in eight cadavers, followed by gross histological examination. In addition, 84 patients without trauma history or anterior knee pain were included to compare the SI of the PTs. The patients were divided according to their age, sex, and Kellgren-Lawrence (KL) grades. The length and thickness of the increased SI portion in the pPT and whole PT (wPT) on T1WI were recorded. Histological specimens demonstrated that the adipose tissue, vessels, and perivascular connective tissue invaginated into the posterior portion of the pPT. This histological anatomy corresponded to the pPT signal change on MR imaging. There was linear and interdigitating increased SI of the pPT in all of the 84 patients (100 %). There were no differences in the lengths and thicknesses of the increased SI portion of pPTs and wPTs according to age, sex, and KL grade (all p > 0.05). The increased SI of the pPT on T1WI and fluid-sensitive MR images results from invaginating fat, vessels, and perivascular connective tissue. It is not pathological, but a normal and common finding. (orig.)

  12. Patterns of Weakness, Classification of Motor Neuron Disease, and Clinical Diagnosis of Sporadic Amyotrophic Lateral Sclerosis.

    Science.gov (United States)

    Statland, Jeffrey M; Barohn, Richard J; McVey, April L; Katz, Jonathan S; Dimachkie, Mazen M

    2015-11-01

    When approaching a patient with suspected motor neuron disease (MND), the pattern of weakness on examination helps distinguish MND from other diseases of peripheral nerves, the neuromuscular junction, or muscle. MND is a clinical diagnosis supported by findings on electrodiagnostic testing. MNDs exist on a spectrum, from a pure lower motor neuron to mixed upper and lower motor neuron to a pure upper motor neuron variant. Amyotrophic lateral sclerosis (ALS) is a progressive mixed upper and lower motor neuron disorder, most commonly sporadic, which is invariably fatal. This article describes a pattern approach to identifying MND and clinical features of sporadic ALS. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Associations between Dietary Patterns and Blood Pressure in a Clinical Sample of Overweight Adults.

    Science.gov (United States)

    Ndanuko, Rhoda N; Tapsell, Linda C; Charlton, Karen E; Neale, Elizabeth P; Batterham, Marijka J

    2017-02-01

    Dietary pattern analysis provides important evidence revealing diet-disease relationships. It may be especially useful in areas less well researched, such as diet and hypertension in clinical populations. The aim of this study was to identify the association between dietary patterns and blood pressure (BP) in a sample of overweight adults volunteering for a clinical trial for weight loss. This cross-sectional analysis used baseline data from the HealthTrack study, a 12-month randomized controlled trial. Dietary intake was evaluated with 4-day food records. Participants were 328 adults recruited from the Illawarra region of New South Wales, Australia, between May 2014 and April 2015. Resting BP and 24-hour urine sodium and potassium were measured. Dietary patterns were derived by principal component analysis from 21 food groups. Multiple regression analysis was performed to assess the association between the extracted dietary patterns and BP. The participants' mean age was 43.6±8.0 years, mean body mass index was 32.4±4.2, and mean systolic BP/diastolic BP was 124.9±14.5/73.3±9.9 mm Hg. Six major dietary patterns were identified: "nuts, seeds, fruit, and fish," "milk and meat," "breads, cereals, and snacks," "cereal-based products, fats, and oils," "alcohol, eggs, and legumes," and "savoury sauces, condiments, and meat." The "nuts, seeds, fruit, and fish" dietary pattern was significantly and inversely associated with systolic BP (F [7,320]=15.248; Pnuts, seeds, fruit, and fish was inversely associated with blood pressure in this clinical sample. The findings suggest that current dietary guidelines are relevant to an overweight clinical population and support the value of dietary pattern analysis when exploring the diet-disease relationship. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  14. Leveraging workflow control patterns in the domain of clinical practice guidelines.

    Science.gov (United States)

    Kaiser, Katharina; Marcos, Mar

    2016-02-10

    Clinical practice guidelines (CPGs) include recommendations describing appropriate care for the management of patients with a specific clinical condition. A number of representation languages have been developed to support executable CPGs, with associated authoring/editing tools. Even with tool assistance, authoring of CPG models is a labor-intensive task. We aim at facilitating the early stages of CPG modeling task. In this context, we propose to support the authoring of CPG models based on a set of suitable procedural patterns described in an implementation-independent notation that can be then semi-automatically transformed into one of the alternative executable CPG languages. We have started with the workflow control patterns which have been identified in the fields of workflow systems and business process management. We have analyzed the suitability of these patterns by means of a qualitative analysis of CPG texts. Following our analysis we have implemented a selection of workflow patterns in the Asbru and PROforma CPG languages. As implementation-independent notation for the description of patterns we have chosen BPMN 2.0. Finally, we have developed XSLT transformations to convert the BPMN 2.0 version of the patterns into the Asbru and PROforma languages. We showed that although a significant number of workflow control patterns are suitable to describe CPG procedural knowledge, not all of them are applicable in the context of CPGs due to their focus on single-patient care. Moreover, CPGs may require additional patterns not included in the set of workflow control patterns. We also showed that nearly all the CPG-suitable patterns can be conveniently implemented in the Asbru and PROforma languages. Finally, we demonstrated that individual patterns can be semi-automatically transformed from a process specification in BPMN 2.0 to executable implementations in these languages. We propose a pattern and transformation-based approach for the development of CPG models

  15. Disease spectrum and treatment patterns in a local male infertility clinic.

    Science.gov (United States)

    Ho, K L; Tsu, James H L; Tam, P C; Yiu, M K

    2015-02-01

    To review disease spectrum and treatment patterns in a local male infertility clinic. Case series. Male infertility clinic in a teaching hospital in Hong Kong. Patients who were seen as new cases in a local male infertility clinic between January 2008 and December 2012. Infertility assessment and counselling on treatment options. Disease spectrum and treatment patterns. A total of 387 new patients were assessed in the male infertility clinic. The mean age of the patients and their female partners was 37.2 and 32.1 years, respectively. The median duration of infertility was 3 years. Among the patients, 36.2% had azoospermia, 8.0% had congenital absence of vas deferens, and 48.3% of patients had other abnormalities in semen parameters. The commonest causes of male infertility were unknown (idiopathic), clinically significant varicoceles, congenital absence of vas deferens, mumps after puberty, and erectile or ejaculatory dysfunction. Overall, 66.1% of patients chose assisted reproductive treatment and 12.4% of patients preferred surgical correction of reversible male infertility conditions. Altogether 36.7% of patients required either surgical sperm retrieval or correction of male infertility conditions. The present study provided important local data on the disease spectrum and treatment patterns in a male infertility clinic. The incidences of azoospermia and congenital absence of vas deferens were much higher than those reported in the contemporary literature. A significant proportion of patients required either surgical sperm retrieval or correction of reversible male infertility conditions.

  16. Prevalence of EGFR mutations in newly diagnosed locally advanced or metastatic non-small cell lung cancer Spanish patients and its association with histological subtypes and clinical features: The Spanish REASON study.

    Science.gov (United States)

    Esteban, E; Majem, M; Martinez Aguillo, M; Martinez Banaclocha, N; Dómine, M; Gómez Aldaravi, L; Juan, O; Cajal, R; Gonzalez Arenas, M C; Provencio, M

    2015-06-01

    The aim of the REASON study is to determine the frequency of EGFR mutation in advanced non-small cell lung cancer (aNSCLC) patients in Spain (all histologies), and to better understand the clinical factors (gender, smoking habits and histological subtypes) that may be associated with EGFR mutations, in an unselected sample of aNSCLC patients. All newly diagnosed aNSCLC patients from 40 selected centers in Spain were prospectively included for a 6-month period. Patient characteristics were obtained from clinical records. Mutation testing was performed on available tumor samples. Exploratory analyses were performed to characterize the clinico-pathological factors associated with presence of EGFR mutations. From March 2010 to March 2011, 1113 patients were included in the study, of which 1009 patients provided sample for EGFR mutation analysis (90.7%). Mutation analysis was not feasible in 146/1113 patients (13.1%) due to either sample unavailability (79/1113; 7.1%) or sample inadequacy (67/1113; 6.0%). Twenty-five out of 1113 patients (2.3%) were excluded due to unavailable information. Most patients (99.5%) were Caucasian, 74.5% were male, and predominantly were current (38.1%) or former smokers (44.0%). Median age was 66 years (range 25-90) and 70.7% of patients had non-squamous histology (57.8% adenocarcinoma, 1.8% bronchoalveolar, 11.1% large-cell carcinoma). Exon 19 deletions and the exon 21 L858R point mutation were analyzed in 942/1009 (93.4%) samples. Mutation rate was 11.6% (82.6% exon 19 dels and 17.4% L858R). To be never smoker (38.1%), female (25.4%), with bronchioloalveolar carcinoma (22.2%) or adenocarcinoma (15.4%) histology was associated with a higher prevalence of EGFR mutations. Exons 18, 20 and 21 (excluding L858R) were analyzed in 505/942 samples, and EGFR mutations were found in 22/505 samples (4.4%). The estimated prevalence of sensitizing EGFR mutations (exon 19 del, exon 21 L858R) in an unselected samples of newly diagnosed aNSCLC patients in

  17. Histologic Evaluation of Metastases in Renal Cell Carcinoma With Sarcomatoid Transformation and Its Implications for Systemic Therapy

    Science.gov (United States)

    Shuch, Brian; Said, Jonathan; LaRochelle, Jeffrey C.; Zhou, Ying; Li, Gang; Klatte, Tobias; Pouliot, Frederic; Kabbinavar, Fairooz F.; Belldegrun, Arie S.; Pantuck, Allan J.

    2011-01-01

    BACKGROUND Sarcomatoid features in renal cell carcinoma may represent an aggressive subclone arising from the primary tumor. The patterns of metastases for these tumors were evaluated to determine if sarcomatoid features were retained at metastasis and whether the percentage of sarcomatoid features in the primary tumor influenced spread. METHODS All patients with sarcomatoid features found at nephrectomy with synchronous or metachronous resection of metastases were evaluated. The histology, grade, and percentage of sarcomatoid features in the primary and metastatic site were recorded. The association between percentage of sarcomatoid features, grade, histology, and pattern of metastases was evaluated. RESULTS Thirty-two patients were identified with sarcomatoid features and resected metastases. Fifty-two metastatic sites were evaluated. A single histologic appearance (sarcomatoid or carcinomatoid) was present in 50 of 52 sites (96%). Thirty sites (58%) demonstrated only a sarcomatoid pattern, whereas 20 (38%) contained only a carcinoma pattern. Histology and carcinoma grade did not influence metastatic pattern; however, greater percentage of sarcomatoid features was associated with the presence of distant sarcomatoid histology. A cutoff of 30% sarcomatoid features in the primary tumor was useful in predicting systemic sarcomatoid histology. CONCLUSIONS Sarcomatoid elements are frequently observed in the metastases of primary tumors with sarcomatoid features, and these metastases generally contain a solitary pattern supporting the subclone hypothesis. However, both components can metastasize in the same patient. The percentage of sarcomatoid features influences the pattern of spread, and patients with >30% sarcomatoid features in the primary tumor frequently have distant sarcomatoid histology. This cutpoint may be helpful for inclusion criteria for future clinical trials. PMID:19998348

  18. Subjective and clinical assessment criteria suggestive for five clinical patterns discernible in nonspecific neck pain patients. A Delphi-survey of clinical experts.

    Science.gov (United States)

    Dewitte, Vincent; Peersman, Wim; Danneels, Lieven; Bouche, Katie; Roets, Arne; Cagnie, Barbara

    2016-12-01

    Nonspecific neck pain patients form a heterogeneous group with different musculoskeletal impairments. Classifying nonspecific neck pain patients into subgroups based on clinical characteristics might lead to more comprehensive diagnoses and can guide effective management. To establish consensus among a group of experts regarding the clinical criteria suggestive of a clinical dominance of 'articular', 'myofascial', 'neural', 'central' and 'sensorimotor control' dysfunction patterns distinguishable in patients with nonspecific neck pain. Delphi study. A focus group with 10 academic experts was organized to elaborate on the different dysfunction patterns discernible in neck pain patients. Consecutively, a 3-round online Delphi-survey was designed to obtain consensual symptoms and physical examination findings for the 5 distinct dysfunction patterns resulting from the focus group. A total of 21 musculoskeletal physical therapists from Belgium and the Netherlands experienced in assessing and treating neck pain patients completed the 3-round Delphi-survey. Respectively, 33 (response rate, 100.0%), 27 (81.8%) and 21 (63.6%) respondents replied to rounds 1, 2 and 3. Eighteen 'articular', 16 'myofascial', 20 'neural', 18 'central' and 10 'sensorimotor control' clinical indicators reached a predefined ≥80% consensus level. These indicators suggestive of a clinical dominance of 'articular', 'myofascial', 'neural', 'central', and 'sensorimotor control' dysfunction patterns may help clinicians to assess and diagnose patients with nonspecific neck pain. Future validity testing is needed to determine how these criteria may help to improve the outcome of physical therapy interventions in nonspecific neck pain patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Ontology-driven extraction of linguistic patterns for modelling clinical guidelines

    NARCIS (Netherlands)

    Serban, Radu; Teije, Annette Ten; Van Harmelen, Frank; Marcos, Mar; Polo-Conde, Cristina

    2005-01-01

    Evidence-based clinical guidelines require frequent updates duo to research and technology advances. The quality of guideline updates can be improved if the knowledge underlying the guideline text is explicitly modelled using the so-called guideline patterns (GPs), mappings between a text fragment

  20. Early clinical manifestations and eating patterns in patients with urea cycle disorders

    NARCIS (Netherlands)

    Gardeitchik, T.; Humphrey, M.; Nation, J.; Boneh, A.

    2012-01-01

    OBJECTIVES: To characterize dietary habits and eating patterns in patients with a urea cycle disorder (UCD), and to identify dietary habits that may serve as clues to lead to earlier diagnosis of these disorders. STUDY DESIGN: This was a retrospective study of clinical and dietary data from hospital

  1. Associations between pathogen-specific clinical mastitis and somatic cell count patterns

    NARCIS (Netherlands)

    Haas, de Y.; Veerkamp, R.F.; Barkema, H.W.; Gröhn, Y.T.; Schukken, Y.H.

    2004-01-01

    Associations were estimated between pathogen-specific cases of clinical mastitis (CM) and somatic cell count (SCC) patterns based on deviations from the typical curve for SCC during lactation and compared with associations between pathogen-specific CM and lactation average SCC. Data from 274 Dutch

  2. Associations between somatic cell count patterns and the incidence of clinical mastitis

    NARCIS (Netherlands)

    Haas, de Y.; Barkema, H.W.; Schukken, Y.H.; Veerkamp, R.F.

    2005-01-01

    Associations between clinical mastitis (CM) and the proportional distribution of patterns in somatic cell count (SCC) on a herd level were determined in this study. Data on CM and SCC over a 12-month period from 274 Dutch herds were used. The dataset contained parts of 29,719 lactations from 22,955

  3. the pattern of cardiac diseases at the cardiac clinic of jimma ...

    African Journals Online (AJOL)

    user

    the pattern of cardiac diseases among adult patients on follow-up at the cardiac follow-up clinic of. Jimma University ... version 12.0. RESULTS: Rheumatic heart disease was the diagnosis in 256 (32.8%) of the cardiac cases on follow-up followed by ..... The global burden of group A streptococcal diseases. Lancet Infect Dis ...

  4. Clinical patterns and characteristics of uveitis in a tertiary center for uveitis in China

    NARCIS (Netherlands)

    Yang, P.; Zhang, Z.; Zhou, H.; Li, B.; Huang, X.; Gao, Y.; Zhu, L.; Ren, Y.; Klooster, J.; Kijlstra, A.

    2005-01-01

    Purpose: To address the clinical pattern and characteristics of uveitis in a tertiary center for uveitis in China and compare the similarity and difference in the distribution of uveitis entities between China and other countries. Methods: A retrospective study was performed on the patients with

  5. Clinical characteristics, treatment patterns, and socio-economic burden of COPD in Bulgaria

    NARCIS (Netherlands)

    Kamusheva, Maria; Dimitrova, Maria; van Boven, Job F. M.; Postma, Maarten J.; van der Molen, Thys; Kocks, Janwillem W. H.; Mitov, Konstantin; Doneva, Miglena; Petrova, Daniela; Georgiev, Ognyan; Petkova, Valentina; Petrova, Guenka

    Background: While the impact of COPD in Western-Europe is known, data from Eastern-Europe is scarce. This study aimed to evaluate clinical characteristics, treatment patterns, and the socio-economic burden of COPD in Eastern-Europe, taking Bulgaria as a reference case. Methods: A representative

  6. Genetic polymorphism of cytochrome P450 4F2, vitamin E level and histological response in adults and children with nonalcoholic fatty liver disease who participated in PIVENS and TONIC clinical trials.

    Directory of Open Access Journals (Sweden)

    Shaminie Athinarayanan

    Full Text Available Vitamin E improved liver histology in children and adults with NAFLD who participated in TONIC and PIVENS clinical trials, but with significant inter-individual variability in its efficacy. Cytochrome P450 4F2 (CYP4F2 is the major enzyme metabolizing Vit E, with two common genetic variants (V433M, rs2108622 and W12G, rs3093105 found to alter its activity. We investigated the relationship between CYP4F2 genotypes, α-tocopherol levels and histological improvement in these two trials. V433M and W12G variants were genotyped in TONIC (n = 155 and PIVENS (n = 213 DNA samples. The relationships between CYP4F2 genotypes, plasma α-tocopherol levels at baseline and weeks 48 (w48 and 96 (w96 and histological end points (overall improvement in liver histology and resolution of NASH were investigated. As a result, the V433M genotype was significantly associated with baseline plasma α-tocopherol in the TONIC trial (p = 0.004, but not in PIVENS. Among those receiving Vit E treatment, CYP4F2 V433M genotype was associated with significantly decreased plasma α-tocopherol levels at w48 (p = 0.003 for PIVENS and p = 0.026 for TONIC but not at w96. The w96 α-tocopherol level was significantly associated with resolution of NASH (p = 0.006 and overall histology improvement (p = 0.021in the PIVENS, but not in the TONIC trial. There was no significant association between CYP4F2 genotypes and histological end points in either trial. Our study suggested the a moderate role of CYP4F2 polymorphisms in affecting the pharmacokinetics of Vit E as a therapeutic agent. In addition, there may be age-dependent relationship between CYP4F2 genetic variability and Vit E pharmacokinetics in NAFLD.

  7. Histological stain evaluation for machine learning applications

    Directory of Open Access Journals (Sweden)

    Jimmy C Azar

    2013-01-01

    Full Text Available Aims: A methodology for quantitative comparison of histological stains based on their classification and clustering performance, which may facilitate the choice of histological stains for automatic pattern and image analysis. Background: Machine learning and image analysis are becoming increasingly important in pathology applications for automatic analysis of histological tissue samples. Pathologists rely on multiple, contrasting stains to analyze tissue samples, but histological stains are developed for visual analysis and are not always ideal for automatic analysis. Materials and Methods: Thirteen different histological stains were used to stain adjacent prostate tissue sections from radical prostatectomies. We evaluate the stains for both supervised and unsupervised classification of stain/tissue combinations. For supervised classification we measure the error rate of nonlinear support vector machines, and for unsupervised classification we use the Rand index and the F-measure to assess the clustering results of a Gaussian mixture model based on expectation-maximization. Finally, we investigate class separability measures based on scatter criteria. Results: A methodology for quantitative evaluation of histological stains in terms of their classification and clustering efficacy that aims at improving segmentation and color decomposition. We demonstrate that for a specific tissue type, certain stains perform consistently better than others according to objective error criteria. Conclusions: The choice of histological stain for automatic analysis must be based on its classification and clustering performance, which are indicators of the performance of automatic segmentation of tissue into morphological components, which in turn may be the basis for diagnosis.

  8. Pediatric nurse practitioners' clinical competencies and knowing patterns in nursing: Focus group interviews.

    Science.gov (United States)

    Lee, Hyejung; Kim, Anna; Meong, Anna; Seo, Minjeong

    2017-04-19

    The generic competency domains of advanced nursing practice have been reported on in numerous countries, but rather few studies have examined competencies specific to pediatric nurse practitioners (PNPs). We identified the core clinical competencies of PNPs in South Korea and related these identified competencies to the five patterns of knowing in nursing. Focus group interviews were conducted with five PNP students and four PNPs using two thematic questions, one on clinical competencies required for PNPs and the other on competencies specific to Korean PNPs. A purposive sampling method was used to choose nurses with varying work experience and age from different hospital units. The inclusion criterion for PNP students was having at least two years of clinical experience and that for PNPs was having at least two years of clinical experience as a PNP in pediatric units in tertiary hospitals. The verbatim transcriptions of these interviews were analysed by two researchers using inductive content analysis. Six clinical competency domains were identified including advanced pediatric-specific knowledge and clinical skills, education and counseling, utilization and engagement in research, professional identity development, clinical and professional leadership, and holistic care. Some competencies identified were related to empirical and ethical knowledge that could be taught in nursing, whereas others were based on esthetic and personal knowledge, which can be mastered through professional experience. To provide holistic care for children and families, PNPs must acquire all necessary patterns of knowing through continuing education and individual reflection on personal practice.

  9. Increasing workload and changing referral patterns in paediatric cardiology outreach clinics: implications for consultant staffing

    Science.gov (United States)

    Wagstaff, M; Rigby, M; Redington, A

    1998-01-01

    Objective—To assess the workload of, and referral patterns to, paediatric cardiology outreach clinics to provide data for future planning.
Design—Descriptive study of outpatient attendance during 1991 and 1996.
Setting—Five district general hospitals with unchanged local demographics and referral patterns during the study period.
Methods—Postal, telephone, and on site survey of clinic records and case notes.
Results—The number of outpatients increased by 61%, with a consequent increase in the number of clinics held and patients seen in each clinic. The number of patients aged between 10 and 15 years doubled.
Conclusion—These data confirm the impression that demands for paediatric cardiology services are increasing. The increased need for attendance at outreach clinics has inevitable consequences for the clinical, teaching, and research activities of specialists in tertiary centres. An increase in the number of paediatric cardiologists, or development of local expertise (general paediatricians with an interest in cardiology), will be required. Furthermore, the increasingly large cohort of older teenagers and young adults with congenital heart disease underscores the need for the development of specialist facilities.

 Keywords: paediatric clinics;  workload;  congenital heart disease PMID:9602652

  10. Burst-suppression pattern in the electroencephalogram of newborns and infants. Its clinical expression

    Directory of Open Access Journals (Sweden)

    Cervantes Blanco Jorge Mauricio

    2014-07-01

    Full Text Available Burst-suppression pattern in the electroencephalogram (EEG is associated with severe brain damage and has a bad prognosis in 85% of the cases. Objectives. To identify the prevalence of the EEG burst-suppression pattern (BSP in fullterm newborns and infants, determine its etiol- ogy, clinical features and course. Methods. A retrospective study was conducted. Between January 2008 and December 2012, 4,891 EEGs were reviewed. The EEGs of newborns and infants (< 3 months of age with BSP were selected. Results. 11 cases identified with burst suppression pattern. The overall prevalence of which was 3.5%; 8.1% among the newborns and 1.2% among infants. Seizures were the main reason for doing an EEG in the newborn period in 7 patients and after day 28 in three. The clinical manifestations were abnormal level of consciousness (n=8, hypotonia (n=2, and spasticity (n=6. The main causes were hypoxic ischemic injury, stroke and kernicterus. There were two cases of early infantile epileptic encephalopathy. Two patients died before the third month of age; 8 survived an average of 13 months. All had epilepsy, neurologic retardation and disability. Two patients had persistent EEG burst-suppression pattern; 1 and 3 months after the neonatal period respectively; 7 had focal spikes and an asymmetric pattern. Conclusions. Electroencephalographic burst-suppression pat- tern predicts a severe neurologic injury in fullterm newborns and infants.

  11. Preimplantation filling of tooth socket with beta-tricalcium phosphate/polylactic-polyglycolic acid (beta-TCP/PLGA) root analogue: clinical and histological analysis in a patient.

    Science.gov (United States)

    Koković, Vladimir; Todorović, Ljubomir

    2011-04-01

    Bone resorption is a physiological process after tooth extraction. The use of bone substitutes to fill the tooth socket is suggested to prevent bone resorption and establish good bone architecture for implant placement. A pure beta-tricalcium phosphate coated with copolymer (polylactic-polyglycolic acid) as a root analogue, is suitable for filling tooth sockets. We presented a patient successfully treated with root analogue after extraction of the right second lower premolar. Three months later, the patient was planned for the placement of six TE ITI dental implants into the mandible. During the sugery, the biopsy of bone-like tissue from the previously treated socket was taken. All the implants were immediately loaded due to good primary stability. Histological analysis of the specimen revealed fibrous healing in the area treated with root analogue. The use of beta-tricalcium phosphate coated with copolymers after tooth extraction enables satisfactory bone architecture for consequent implant treatment.

  12. Clinical and imaging correlates of EEG patterns in hospitalized patients with encephalopathy.

    Science.gov (United States)

    Sutter, Raoul; Stevens, Robert D; Kaplan, Peter W

    2013-04-01

    To identify the relationship between pathologic electroencephalographic (EEG) patterns, clinical and neuroradiological abnormalities, and outcome in hospitalized patients with acute encephalopathy. This 5-year cohort study was performed at an academic tertiary care center. EEGs in 154 patients with altered mental status were classified according to five predefined patterns: Isolated continuous slowing of background activity (theta, theta/delta, and delta activity) and patterns with slowing background activity with episodic transients [i.e., triphasic waves (TWs) or frontal intermittent delta activity (FIRDA)]. Clinical characteristics, blood tests and neuroimaging were compared among groups. Associations between EEG patterns and structural and non-structural abnormalities were calculated. Glasgow Outcome Score >3 at discharge was defined as favorable and 1-3 as unfavorable outcome. In multivariable analyses, theta was associated with brain atrophy (OR 2.6, p = 0.020), theta/delta with intracerebral hemorrhages (OR 6.8, p = 0.005), FIRDA with past cerebrovascular accidents (OR 2.7, p = 0.004), TWs with liver or multi-organ failure (OR 6, p = 0.004; OR 4, p = 0.039), and delta activity with alcohol/drug abuse with or without intoxication, and HIV infection (OR 3.8, p = 0.003; OR 9, p = 0.004). TWs were associated with death (OR 4.5, p = 0.005); theta/delta with unfavorable outcomes (OR 2.5, p = 0.033), while patients with FIRDA had favorable outcomes (OR 4.8, p = 0.004). In encephalopathic patients, well-defined EEG patterns are associated with specific pathological conditions and outcomes, suggesting that mechanistic hypotheses underlie these abnormal EEG patterns. To clarify the respective contributions of non-structural and structural abnormalities to encephalopathy reflected in specific EEG patterns, prospective studies using continuous EEG monitoring during the acute onset of encephalopathy are needed.

  13. Pattern of pseudoexfoliation deposits on the lens and their clinical correlation--clinical study and review of literature.

    Directory of Open Access Journals (Sweden)

    Aparna Rao

    Full Text Available PURPOSE: To study the clinical correlates of pattern of deposits over the lens in patients with pseudoexfoliation syndrome (PXF or pseudoexfoliation glaucoma. METHODS: This retrospective observational study screened 346 patients with PXF seen in glaucoma clinic of a tertiary hospital from 2011-2013. Details like pattern of deposits, location on the lens surface and pupillary abnormalities in slit lamp photographs and their correlation with clinical and demographic variables, were analysed. RESULTS: A total of 84 eyes of 42 patients with bilateral PXF were included for the study. Glaucoma was seen in 30 eyes with baseline IOP of 24+3.8 mm Hg. Comparing the type of deposits, namely classical (n = 39 eyes, radial pigmentary (RP form (n = 39 eyes and combined classical and radial pigmentary (CR forms (n = 6 eyes of deposits, pupillary ruff atrophy was common in all forms while poor dilatation was rare in the RP type (n = 5 vs n = 25 in classical forms, p < 0.001. Mean deviation (MD was worse in the classical and CR form as compared to RP type with the latter presenting much earlier, 43 ± 3.2 years vs 48 ± 4.1 years in CR and 56 ± 5.7 years in classical form, p < 0.001. The baseline IOP in the RP group (18 ± 2.3 mm Hg was significantly lower than the other two forms (CR 20 ± 3.2 mm Hg, classical 28 ± 2.3 mm Hg, p < 0.001, with only 2 eyes on anti-glaucoma drugs at presentation. CONCLUSION: Pattern of exfoliation deposits may indicate the stage and severity of the disease process in evolution with the RP representing an earlier/less severe form of pseudoexfoliation syndrome.

  14. Topografia do carcinoma basocelular e suas correlações com o gênero, a idade e o padrão histológico: um estudo retrospectivo de 1.042 lesões Topography of basal cell carcinoma and their correlations with gender, age and histologic pattern: a retrospective study of 1042 lesions

    Directory of Open Access Journals (Sweden)

    Cláudia Fernanda Dias Souza

    2011-04-01

    Full Text Available FUNDAMENTOS: O carcinoma basocelular corresponde a 75% dos tumores cutâneos. A exposição solar e a genética estão relacionadas à sua etiologia. Espera-se que diferenças comportamentais e biológicas proporcionem padrões diferenciados de acometimento entre os sexos. OBJETIVOS: Avaliar a topografia das lesões e suas correlações com gênero, idade e tipo histológico. MÉTODOS: Estudo retrospectivo de pacientes tratados por carcinoma basocelular entre 1999 e 2008 no ambulatório de câncer da pele da Santa Casa de Misericórdia de Curitiba. Avaliamos sexo, idade, localização, tipo histológico, situação das margens, histórico de fotoexposição e antecedentes familiares de câncer cutâneo. RESULTADOS: Contabilizamos 1.042 lesões em 545 pacientes (61% mulheres, sendo mais numerosas nos homens (p BACKGROUND: Basal cell carcinoma accounts for 75% of skin cancer. Sun exposure and genetics are related to its etiology. It's expected that biological and behavioral differences provide different patterns of involvement between sexes. OBJECTIVES: To evaluate the topography of lesions and their correlations with gender, age and histological type. METHODS: Retrospective study of basal cell carcinoma patients treated between 1999 and 2008 in the Skin Cancer Clinic of Santa Casa de Misericordia of Curitiba. We evaluated sex, age, location, histological type, margins commitment, sun exposure and family skin cancer history. RESULTS: We found 1042 lesions in 545 patients (61% women, being more numerous in men (p<0.01. Their ages ranged between 27 and 95 years (median=65. Men had more sun exposure (p<0.01. The lesions were more frequent extra-cephalic recently (p<0.01. The margin involvement was higher in the head (p<0.01. The superficial type was less frequent on the head (p<0.01 and was associated with younger ages in women (p<0.01. The head housed 74% of lesions and the legs 2%. Women had a predilection for the legs, nose and upper lip and men

  15. Cortical atrophy patterns in multiple sclerosis are non-random and clinically relevant.

    Science.gov (United States)

    Steenwijk, Martijn D; Geurts, Jeroen J G; Daams, Marita; Tijms, Betty M; Wink, Alle Meije; Balk, Lisanne J; Tewarie, Prejaas K; Uitdehaag, Bernard M J; Barkhof, Frederik; Vrenken, Hugo; Pouwels, Petra J W

    2016-01-01

    %). Several cortical atrophy patterns relevant for multiple sclerosis were found. This suggests that cortical atrophy in multiple sclerosis occurs largely in a non-random manner and develops (at least partly) according to distinct anatomical patterns. In addition, these cortical atrophy patterns showed stronger associations with clinical (especially cognitive) dysfunction than global cortical atrophy. © The Author (2015). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Comparative investigations of Klebsiella species of clinical origin: plasmid patterns, biochemical reactions, antibiotic resistances and serotypes.

    Science.gov (United States)

    Podschun, R; Heineken, P; Ullmann, U; Sonntag, H G

    1986-09-01

    A total of 124 K. pneumoniae and 52 K. oxytoca isolates obtained from clinical specimens was investigated for plasmid patterns, biochemical reactions, antibiotic resistances and serotypes regarding to the distribution and relationships of these characters. A great diversity of plasmid patterns, bio/serotypes and resistance patterns was revealed. About 90% of strains contained plasmid DNA and up to seven plasmid bands per isolate could be shown. For K. pneumoniae, serotype 7 and for K. oxytoca, type 55 were most common. In general, little difference between both species was found and characters were similarly distributed. With respect to the site of isolation, serotype 7 was predominating in K. pneumoniae strains from the respiratory tract. Highly multiple-resistant organism were found in the largest number in specimens from the urogenital tract, in the lowest in specimens from wounds. Extensive statistical analyses did not detect any relationship among the characters investigated.

  17. How to Diagnose and Classify Tattoo Complications in the Clinic: A System of Distinctive Patterns.

    Science.gov (United States)

    Serup, Jørgen

    2017-01-01

    Tattoo complications represent a broad spectrum of clinical entities and disease mechanisms. Infections are known, but chronic inflammatory reactions have hitherto been inconsistently reported and given many interpretations and terms. A clinical classification system of distinct patterns with emphasis on inflammatory tattoo reactions is introduced. Allergic reactions prevalent in red tattoos and often associated with azo pigments are manifested as the 'plaque elevation', 'excessive hyperkeratosis', and 'ulceronecrotic' patterns. The allergen is a hapten. Nonallergic reactions prevalent in black tattoos and associated with carbon black are manifested as the 'papulonodular' pattern. Carbon black nanoparticles agglomerate in the dermis over time forming foreign bodies that elicit reactions. Many black tattoos even develop sarcoid granuloma, and the 'papulonodular' pattern is strongly associated with sarcoidosis affecting other organs. Tattoo complications include a large group of less frequent but nevertheless specific entities, i.e. irritant and toxic local events, photosensitivity, urticaria, eczematous rash due to soluble allergen, neurosensitivity and pain syndrome, lymphopathies, pigment diffusion or fan, scars, and other sequels of tattooing or tattoo removal. Keratoacanthoma occurs in tattoos. Carcinoma and melanoma are rare and occur by coincidence only. Different tattoo complications require different therapeutic approaches, and precise diagnosis is thus important as a key to therapy. The proposed new classification with characteristic patterns relies on simple tools, namely patient history, objective findings, and supplementary punch biopsy. By virtue of simplicity and broad access, these methods make the proposed classification widely applicable in clinics and hospitals. The system is reported to the 11th revision of the WHO diagnosis classification used as international standard. © 2017 S. Karger AG, Basel.

  18. Textbook of comparative histology

    National Research Council Canada - National Science Library

    Andrew, W

    1959-01-01

    ... made to their environment over the course of the eons during which life has existed on this earth. In this sense, it is hoped that the study of Comparative Histology will be accepted as a desirable part of a liberal education...

  19. Histologic classification of gliomas

    NARCIS (Netherlands)

    Perry, Arie; Wesseling, Pieter|info:eu-repo/dai/nl/157872866

    2016-01-01

    Gliomas form a heterogeneous group of tumors of the central nervous system (CNS) and are traditionally classified based on histologic type and malignancy grade. Most gliomas, the diffuse gliomas, show extensive infiltration in the CNS parenchyma. Diffuse gliomas can be further typed as astrocytic,

  20. Initial patterns of clinical care and recovery from whiplash injuries: a population-based cohort study.

    Science.gov (United States)

    Côté, Pierre; Hogg-Johnson, Sheilah; Cassidy, J David; Carroll, Linda; Frank, John W; Bombardier, Claire

    2005-10-24

    Little is known about the most effective pattern of clinical care for acute whiplash. We designed a cohort study to determine whether patterns of early clinical care (involving visits to general practitioners, chiropractors, or specialists) were associated with different rates of recovery. We studied 2486 Saskatchewan adults with whiplash injuries. We defined 8 initial patterns of care that integrated type of provider and number of visits. We used multivariable Cox models to estimate the association between patterns of care and time to recovery while controlling for injury severity and other confounders. There was an independent association between the type and intensity of initial clinical care and time to recovery. We found that patients in the low-utilization general practitioner group had the fastest recovery, even after controlling for injury severity and other confounders. Compared with this group, the high-utilization general practitioner group experienced a 1-year rate of recovery that was 27% slower (adjusted hazard rate ratio [HRR], 0.73; 95% confidence interval [CI], 0.61-0.87); for the high-utilization chiropractic group it was 39% slower (HRR, 0.61; 95% CI, 0.46-0.81); for the high-utilization general practitioner plus chiropractic combined group it was 28% slower (HRR, 0.72; 95% CI, 0.57-0.91); and for those who consulted general practitioners and specialists, it was 31% slower (HRR, 0.69; 95% CI, 0.55-0.87). The type and intensity of clinical care initiated within the first month after the injury is associated with the rate of recovery from whiplash injuries. Our study does not support the hypothesis that early aggressive care promotes faster recovery.

  1. Clinical and histologic evaluation of bone-replacement grafts in the treatment of localized alveolar ridge defects. Part 2: bioactive glass particulate.

    Science.gov (United States)

    Knapp, Charles I; Feuille, Frank; Cochran, David L; Mellonig, James T

    2003-04-01

    The purpose of this study was to evaluate the feasibility of using a bioactive alloplast and a physical barrier to augment localized alveolar ridge defects for the subsequent placement of dental implants. Twelve systemically healthy patients (aged 29 to 55 years) with inadequate dental alveolar ridge widths were selected for study. All patients completed initial therapy, which included scaling, root planing, and oral hygiene instruction. All ridge defects were augmented with a bioactive glass alloplast and a titanium-reinforced e-PTFE barrier. Vertical (height) and horizontal (width) hard tissue measurements were taken the day of ridge augmentation surgery (baseline) and at the 6-month reentry surgery. The change in ridge width varied from a loss of 1 mm to a gain of 4.5 mm, with a mean gain of 1.1 mm (P .08). Mean ridge width gain was 1.1 mm for both maxillary and mandibular sites. There was a loss in bone height of 0.3 mm from baseline. Four implants in four patients could not be placed because of inadequate ridge width augmentation. Histologic examination of the grafted sites revealed connective tissue encapsulation of most residual graft particles. In this study, bioactive glass particulate and an e-PTFE barrier did not consistently augment localized ridge defects for dental implant placement.

  2. Hereditary Spastic Paraplegia: Beyond Clinical Phenotypes toward a Unified Pattern of Central Nervous System Damage.

    Science.gov (United States)

    Agosta, Federica; Scarlato, Marina; Spinelli, Edoardo G; Canu, Elisa; Benedetti, Sara; Bassi, Maria Teresa; Casali, Carlo; Sessa, Maria; Copetti, Massimiliano; Pagani, Elisabetta; Comi, Giancarlo; Ferrari, Maurizio; Falini, Andrea; Filippi, Massimo

    2015-07-01

    To investigate whether specific patterns of brain gray matter (GM) regional volumes and white matter (WM) microstructural abnormalities and spinal cord atrophy occur in patients with pure and complicated hereditary spastic paraplegias (HSPs). Relationships between clinical and cognitive features of patients with HSP who had brain and cervical cord damage were also investigated. This study was approved by the local ethical committees on human studies, and written informed consent from all subjects was obtained prior to enrollment. Forty-four patients with HSP (20 genetically defined cases and 24 without genetic diagnosis) and 19 healthy control subjects underwent clinical, neuropsychological, and advanced magnetic resonance (MR) imaging evaluations. Patterns of GM atrophy and WM microstructural damage obtained by using structural and diffusion-tensor MR imaging were compared between groups. Cervical cord atrophy was also assessed by using an active surface method. Correlations between clinical, cognitive, and diffusion-tensor MR imaging measures were evaluated. Clinical data showed that spastic paraplegia is accompanied by a number of other features, including sensory disturbances, and verbal and spatial memory deficits, not only in complicated HSP but also in pure HSP. MR imaging demonstrated a similar involvement of motor, association, and cerebellar WM pathways (P spasticity (P < .05, family-wise error corrected) and cognitive impairment (r values, -0.39 to 0.51; P values, .001-.05) in both pure and complicated HSP. The detection of a distributed pattern of central nervous system damage in patients with pure and complicated HSP suggests that the "primary" corticospinal tract involvement known to occur in these patients may be associated with a neurodegenerative process, which spreads out to extramotor regions, likely via anatomic connections. This observation is in line with emerging pieces of evidence that, independent of the clinical phenotype, there is a

  3. Big Data Mining and Adverse Event Pattern Analysis in Clinical Drug Trials.

    Science.gov (United States)

    Federer, Callie; Yoo, Minjae; Tan, Aik Choon

    2016-12-01

    Drug adverse events (AEs) are a major health threat to patients seeking medical treatment and a significant barrier in drug discovery and development. AEs are now required to be submitted during clinical trials and can be extracted from ClinicalTrials.gov ( https://clinicaltrials.gov/ ), a database of clinical studies around the world. By extracting drug and AE information from ClinicalTrials.gov and structuring it into a database, drug-AEs could be established for future drug development and repositioning. To our knowledge, current AE databases contain mainly U.S. Food and Drug Administration (FDA)-approved drugs. However, our database contains both FDA-approved and experimental compounds extracted from ClinicalTrials.gov . Our database contains 8,161 clinical trials of 3,102,675 patients and 713,103 reported AEs. We extracted the information from ClinicalTrials.gov using a set of python scripts, and then used regular expressions and a drug dictionary to process and structure relevant information into a relational database. We performed data mining and pattern analysis of drug-AEs in our database. Our database can serve as a tool to assist researchers to discover drug-AE relationships for developing, repositioning, and repurposing drugs.

  4. Ichthyosis, exocrine pancreatic insufficiency, impaired neutrophil chemotaxis, growth retardation, and metaphyseal dysplasia (Shwachman syndrome). : Report of a case with extensive skin lesions (clinical, histological, and ultrastructural findings)

    NARCIS (Netherlands)

    M. Goeteyn (M.); A.P. Oranje (Arnold); V.D. Vuzevski (Vojislav); R. de Groot (Ronald); L.W.A. van Suijlekom-Smit (Lisette)

    1991-01-01

    textabstractThe Shwachman syndrome comprises exocrine pancreatic insufficiency, growth retardation, and bone marrow hypoplasia resulting in neutropenia. Clinical, morphological, and ultrastructural studies, as well as hair analysis, were performed in a patient with Shwachman's syndrome and severe

  5. Scientific communication in clinical psychology: examining patterns of citations and references.

    Science.gov (United States)

    Kiselica, Andrew M; Ruscio, John

    2014-01-01

    Previous studies of scientific communication used citation mapping, establishing psychology as a 'hub science' from which many other fields draw information. Within psychology, the clinical and counselling discipline is a major 'knowledge broker'. This study analyzed scientific communication among three major subdisciplines of clinical psychology-the cognitive-behavioural, psychodynamic and humanistic schools of thought-by examining patterns of references within and citations to 305 target articles published in leading journals of these subdisciplines. The results suggest that clinical researchers of each theoretical orientation engage in more insular scientific communication than an integrationist would find desirable and that cognitive-behavioural articles are more closely connected to mainstream psychology and related fields. Eclectic practitioners draw on several different theoretical orientations to inform their practice; as such, they should be interested in understanding the patterns of scientific communication within and across theoretical orientations. Practitioners work in a variety of different mental health settings, with a variety of other professionals in psychology-related fields, and should be interested in how much influence their particular theoretical orientation has on the work of colleagues. Many practitioners rely on new, evidence-based research to inform their work. The results of this study provide these individuals with an objective measure of the influence of empirical work in different areas of clinical psychology. Copyright © 2012 John Wiley & Sons, Ltd.

  6. Coupled variable selection for regression modeling of complex treatment patterns in a clinical cancer registry.

    Science.gov (United States)

    Schmidtmann, I; Elsäßer, A; Weinmann, A; Binder, H

    2014-12-30

    For determining a manageable set of covariates potentially influential with respect to a time-to-event endpoint, Cox proportional hazards models can be combined with variable selection techniques, such as stepwise forward selection or backward elimination based on p-values, or regularized regression techniques such as component-wise boosting. Cox regression models have also been adapted for dealing with more complex event patterns, for example, for competing risks settings with separate, cause-specific hazard models for each event type, or for determining the prognostic effect pattern of a variable over different landmark times, with one conditional survival model for each landmark. Motivated by a clinical cancer registry application, where complex event patterns have to be dealt with and variable selection is needed at the same time, we propose a general approach for linking variable selection between several Cox models. Specifically, we combine score statistics for each covariate across models by Fisher's method as a basis for variable selection. This principle is implemented for a stepwise forward selection approach as well as for a regularized regression technique. In an application to data from hepatocellular carcinoma patients, the coupled stepwise approach is seen to facilitate joint interpretation of the different cause-specific Cox models. In conditional survival models at landmark times, which address updates of prediction as time progresses and both treatment and other potential explanatory variables may change, the coupled regularized regression approach identifies potentially important, stably selected covariates together with their effect time pattern, despite having only a small number of events. These results highlight the promise of the proposed approach for coupling variable selection between Cox models, which is particularly relevant for modeling for clinical cancer registries with their complex event patterns. Copyright © 2014 John Wiley & Sons

  7. Predicting inpatient clinical order patterns with probabilistic topic models vs conventional order sets.

    Science.gov (United States)

    Chen, Jonathan H; Goldstein, Mary K; Asch, Steven M; Mackey, Lester; Altman, Russ B

    2017-05-01

    Build probabilistic topic model representations of hospital admissions processes and compare the ability of such models to predict clinical order patterns as compared to preconstructed order sets. The authors evaluated the first 24 hours of structured electronic health record data for > 10 K inpatients. Drawing an analogy between structured items (e.g., clinical orders) to words in a text document, the authors performed latent Dirichlet allocation probabilistic topic modeling. These topic models use initial clinical information to predict clinical orders for a separate validation set of > 4 K patients. The authors evaluated these topic model-based predictions vs existing human-authored order sets by area under the receiver operating characteristic curve, precision, and recall for subsequent clinical orders. Existing order sets predict clinical orders used within 24 hours with area under the receiver operating characteristic curve 0.81, precision 16%, and recall 35%. This can be improved to 0.90, 24%, and 47% ( P  topic models to summarize clinical data into up to 32 topics. Many of these latent topics yield natural clinical interpretations (e.g., "critical care," "pneumonia," "neurologic evaluation"). Existing order sets tend to provide nonspecific, process-oriented aid, with usability limitations impairing more precise, patient-focused support. Algorithmic summarization has the potential to breach this usability barrier by automatically inferring patient context, but with potential tradeoffs in interpretability. Probabilistic topic modeling provides an automated approach to detect thematic trends in patient care and generate decision support content. A potential use case finds related clinical orders for decision support.

  8. Rationale and design of the Clinical and Histologic Analysis of Mesenchymal Stromal Cells in AmPutations (CHAMP) trial investigating the therapeutic mechanism of mesenchymal stromal cells in the treatment of critical limb ischemia.

    Science.gov (United States)

    Wang, S Keisin; Green, Linden A; Drucker, Natalie A; Motaganahalli, Raghu L; Fajardo, Andres; Murphy, Michael P

    2018-01-30

    Currently, there are no accepted nonsurgical therapies that improve the delivery of blood-derived nutrients to patients with critical limb ischemia. Here, we describe the ongoing phase 1/2 Clinical and Histologic Analysis of Mesenchymal Stromal Cells in AmPutations (CHAMP) trial, which will provide crucial evidence of the safety profile of mesenchymal stromal cells (MSCs) and explore their therapeutic mechanisms in the setting of critical limb ischemia requiring below-knee amputation (BKA). In the CHAMP and the parallel marrowCHAMP trials (hereafter grouped together as CHAMP), a total of 32 extremities with rest pain or tissue loss requiring BKA will be enrolled to receive intramuscular injections of allogeneic MSCs (CHAMP; n = 16) or autogenous concentrated bone marrow aspirate (marrowCHAMP; n = 16) along the distribution of the BKA myocutaneous flap and proximal tibialis anterior. After treatment, subjects are randomized to BKA at four time points after injection (days 3, 7, 14, and 21). At the time of amputation, skeletal muscle is collected at 2-cm increments from the tibialis injection site and used to determine proangiogenic cytokine description, MSC retention, quantification of proangiogenic hematopoietic progenitor cells, and histologic description. Clinical limb perfusion before and after treatment will be quantified using transcutaneous oximetry, toe-brachial index, ankle-brachial index, and indocyanine angiography. Additional clinical end points include all-cause mortality, need for amputation revision, and gangrene incidence during the 6-month post-treatment follow-up. Enrollment is under way, with 10 patients treated per protocol thus far. We anticipate full conclusion of follow-up within the next 24 months. CHAMP will be pivotal in characterizing the safety, efficacy, and, most important, therapeutic mechanism of allogeneic MSCs and autogenous concentrated bone marrow aspirate in ischemic skeletal muscle. Copyright © 2017 Society for Vascular

  9. Glomerular sparing pattern in primary kidney neoplasms: clinical, morphological and immunohistochemical study.

    Science.gov (United States)

    Ronny, Faisal M Huq; Sarungbam, Judy; Zhong, Xuelin; Yusuf, Yasmin; Yang, Ximing; Zhong, Minghao

    2014-01-01

    Glomerular sparing (GS) is defined as a unique growth pattern in which tumor cells replace the majority of renal tubes and overrun intact glomeruli. This phenomenon has been well recognized by pathologists as a typical infiltrative pattern and some studies suggested it was an independent risk factor. Here, we study the clinical, pathological, and immunohistochemical features of primary kidney neoplasms with glomerular sparing pattern. We searched the archives of our pathology department for nephrectomy specimens and reviewed all pathology reports from 2009-2013. We selected cases with tumor and collected clinicopathological information, focusing on re-evaluation of cases with glomerular sparing pattern. To facilitate our study we performed immunohistochemical stains of PAX-8, p63, and InI-1 on selected cases. We selected a total of 204 nephrectomy cases in this study, including 163 cases of renal cell carcinoma; 37 cases of urothelial carcinoma; 4 cases from other categories (Wilms tumor, primary diffuse large B-cell lymphoma, angiolipoma, rhabdoid tumor). Finally, we identified 7 cases of primary kidney tumors with glomerular sparing pattern: 2 cases of clear cell renal cell carcinomas (ccRCC), 1 case of collecting duct carcinoma, 2 cases of urothelial carcinoma (UC), 1 case of diffuse large B-cell lymphoma and 1 case of malignant rhabdoid tumor. The primary kidney tumors with glomerular sparing pattern are rare and incidence in our study is <4% (7/204). There is no specificity for any tumor type, but more commonly seen in high grade UC rather than RCC. It can also be seen in rare neoplasms such as collecting duct carcinoma, lymphoma and malignant rhabdoid tumor. These GS cases need to be recognized as they are often associated with high grade, high stage, large tumor size, and worse prognosis.

  10. Transrectal ultrasound-guided biopsy of the prostate: Histological ...

    African Journals Online (AJOL)

    Transrectal ultrasound-guided biopsy of the prostate: Histological pattern of prostatic diseases seen in Sokoto Northwest Nigeria. ... Thirty subjects had prostatitis associated with their histological diagnosis (28 subjects with BPH, 2 subjects with cancer of the prostate), while 2 patients had schistosomiasis of the prostate with ...

  11. Effect of two different healing times on the mineralization of newly formed bone using a bovine bone substitute in sinus floor augmentation: a randomized, controlled, clinical and histological investigation.

    Science.gov (United States)

    Kohal, Ralf Joachim; Gubik, Sonja; Strohl, Christine; Stampf, Susanne; Bächle, Maria; Hurrle, Adrian Alexander; Patzelt, Sebastian Berthold Maximilian

    2015-11-01

    To investigate the amount of the mineralization of a bovine bone substitute material in sinus floor augmentation after healing times of 3 and 6 months. Fifty-one patients were randomized into two healing time groups and received sinus floor augmentations with a bovine bone material. After 3 or 6 months of healing, trephine bone biopsies were retrieved. The biopsies were processed for histological and histomorphometric evaluations to primarily investigate the amount of mineralized bone in the augmented area and secondarily compare the amount of mineralized bone in the augmented area and in the pristine bone. Statistical tests were performed to analyse the fraction of the mineralized bone (p < 0.05). The biopsies of both groups showed remnants of the well-integrated bone substitute material. The histology revealed osteoblasts, osteocytes with osteoid, and osteoclasts. The mean percentage of mineralized bone in the augmented area was 23.8% (3 months group) and 23.6% (6 months group; p = 0.9246); the amount of remaining bone substitute material was 35% (3 months group) and 33.9% (6 months group; p = 0.6325). It can be concluded that the bone maturation in the augmented sinus using the bovine bone material is similar after 3 and 6 months. Thus, implant installation after 3 months following a lateral window sinus floor augmentation approach using a bovine bone material seems to be clinically acceptable. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Long-Term Clinical and Histological Effects of a Bipolar Fractional Radiofrequency System in the Treatment of Facial Atrophic Acne Scars and Acne Vulgaris in Japanese Patients: A Series of Eight Cases.

    Science.gov (United States)

    Kaminaka, Chikako; Furukawa, Fukumi; Yamamoto, Yuki

    2016-12-01

    This retrospective case series was designed to compare the long-term safety and efficacy of bipolar fractional radiofrequency (FRF) therapy as a treatment for atrophic acne scars (ASs) and acne vulgaris. Few clinical and histological studies have examined the long-term utility of bipolar FRF therapy as a treatment for ASs and acne in people with darker skin. Eight Japanese patients with ASs and mild-to-severe acne on both cheeks were treated with a bipolar FRF system (eMatrix; Syneron). Five treatment sessions with the same settings (coverage rate: 10%; peak energy: 62 mJ/pin; two passes) were carried out at 1-month intervals, and the patients were followed up for at least 1 year after the final treatment. Assessments of ASs and acne severity were performed and samples were removed for histological examination. We demonstrated that mild ASs responded better than moderate and severe ASs, and at least 50% improvement in scar severity was seen in 50% of patients after the final treatment. Six patients remained disease free at 1.5 years without the use of any additional therapies. The biopsy specimens showed a marked improvement characterized by a decrease in dermal pilosebaceous units and perivascular inflammatory cell infiltrates with an increase in elastin content and collagen deposition in the upper dermis. Bipolar FRF treatment showed long-term effectiveness against mild ASs and acne in Asian patients and had minimal side effects.

  13. Terminal ileum of patients who underwent colonoscopy: endoscopic, histologic and clinical aspects Íleo terminal de pacientes submetidos a colonoscopia: aspectos endoscópicos, histológicos e clínicos

    Directory of Open Access Journals (Sweden)

    Marcelo Maia Caixeta de Melo

    2009-06-01

    Full Text Available CONTEXT: For the diagnosis of the diseases which affect the terminal ileum, the colonoscopy allows macroscopic evaluation and the performing of biopsies. Studies with criteria for the endoscopic and histological characterization of this segment are scarce and there are still some doubts about the need of biopsies in patients with normal ileoscopy. OBJECTIVE: Study the terminal ileum of patients who underwent colonoscopy considering: endoscopic and histological correlation; agreement between results of the initial histological evaluation and slides review, and the chance of subjects with normal ileoscopy with abdominal pain and/or chronic diarrhea to show histological alterations. METHODS: In a prospective study, 111 patients who presented smooth mucosa without enanthema in the endoscopic exam of the terminal ileum were selected. Biopsies of the ileal mucosa of such patients were performed, being the slides routinely examined and reviewed afterwards. RESULTS: The correlation between patients with normal ileoscopy and ileum with preserved histological architecture was of 99.1%. The agreement between initial histological evaluation and slides review calculated by the Kappa test was 0.21. In patients with abdominal pain and/or chronic diarrhea, the chance of showing histological alterations was 2.5 times higher than the others. CONCLUSIONS: The correlation between endoscopic and histological findings was high. The agreement between the initial histologic evaluation and slides review was not satisfactory. The chance of subjects with normal ileoscopy with abdominal pain and/or chronic diarrhea, showing histological alterations was higher in relation to the asymptomatic ones or with other symptoms, although the clinical importance of this datum was not evaluated.CONTEXTO: Para o diagnóstico de doenças que afetam o íleo terminal, a colonoscopia permite avaliação macroscópica e realização de biopsias. Estudos com critérios para caracteriza

  14. Effect of 1- and 6-Hour-Delayed Corneal Collagen Cross-Linking on Corneal Healing in a Rabbit Alkali-Burn Model: Clinical and Histological Observations.

    Science.gov (United States)

    Karti, Omer; Zengin, Mehmet Ozgur; Cinar, Esat; Tutuncu, Merve; Karahan, Eyyup; Celik, Asl; Kucukerdonmez, Cem

    2016-12-01

    To study the effect of 1- and 6-hour-delayed corneal collagen cross-linking (CXL) on wound-healing of experimental alkali burns of the cornea. Twenty-four albino rabbits were used. Alkali burns were created using 1 M NaOH. The animals were divided randomly into 2 groups: group 1 (control group, n = 6) and group 2 (experimental group, n = 18). The experimental group was further divided into 3 subgroups as follows: group 2A, untreated (non-CXL) subgroup; group 2B, 1-hour-delayed CXL treatment subgroup; and group 2C, 6-hour-delayed CXL treatment subgroup. All rabbits were examined periodically for 21 days after treatment and then killed. The corneas were excised and histologically examined. Corneal ulceration, edema, and opacity scores were 4.0 ± 1.64, 1.6 ± 0.65, and 3.5 ± 1.21 in group 2A, 1.5 ± 1.76, 1.3 ± 0.87, and 3.1 ± 1.12 in group 2B, and 2.0 ± 1.90, 1.5 ± 0.79, and 3.3 ± 1.09 in group 2C, respectively. These scores were significantly less in groups 2B and 2C than in group 2A (P = 0.023, P = 0.043, and P = 0.034, respectively). Corneal epithelialization, evident upon staining, was best in group 2B and worst in group 2A (P = 0.012). Histopathology revealed that destruction of corneal collagen fibers and infiltration of inflammatory cells into corneal tissue were reduced in groups 2B and 2C compared with group 2A. We found that CXL treatment exerted positive effects on severe alkali-induced corneal burns. However, the effects were more pronounced in the 1-hour treatment group. We believe that CXL treatment may be a possible treatment for corneal alkali burn.

  15. Hypospadias in a male (78,XY; SRY-positive) dog and sex reversal female (78,XX; SRY-negative) dogs: clinical, histological and genetic studies.

    Science.gov (United States)

    Switonski, M; Payan-Carreira, R; Bartz, M; Nowacka-Woszuk, J; Szczerbal, I; Colaço, B; Pires, M A; Ochota, M; Nizanski, W

    2012-01-01

    Hypospadias is rarely reported in dogs. In this study we pre-sent 2 novel cases of this disorder of sexual development and, in addition, a case of hereditary sex reversal in a female with an enlarged clitoris. The first case was a male Moscow watchdog with a normal karyotype (78,XY) and the presence of the SRY gene. In this dog, perineal hypospadias, bilateral inguinal cryptorchidism and testes were observed. The second case, representing the Cocker spaniel breed, had a small penis with a hypospadic orifice of the urethra, bilateral cryptorchidism, testis and a rudimentary gonad inside an ovarian bursa, a normal female karyotype (78,XX) and a lack of the SRY gene. This animal was classified as a compound sex reversal (78,XX, SRY-negative) with the hypospadias syndrome. The third case was a Cocker spaniel female with an enlarged clitoris and internally located ovotestes. Cytogenetic and molecular analyses revealed a normal female karyotype (78,XX) and a lack of the SRY gene, while histology of the gonads showed an ovotesticular structure. This case was classified as a typical hereditary sex reversal syndrome (78,XX, SRY-negative). Molecular studies were focused on coding sequences of the SRY gene (case 1) and 2 candidates for monogenic hypospadias, namely MAMLD1 (mastermind-like domain containing 1) and SRD5A2 (steroid-5-alpha-reductase, alpha polypeptide 2). Sequencing of the entire SRY gene, including 5'- and 3'-flanking regions, did not reveal any mutation. The entire coding sequence of MAMLD1 and SRD5A2 was analyzed in all the intersexes, as well as in 4 phenotypically normal control dogs (3 females and 1 male). In MAMLD1 2 SNPs, including 1 missense substitution in exon 1 (c.128A>G, Asp43Ser), were identified, whereas in SRD5A2 7 polymorphisms, including 1 missense SNP (c.358G>A, Ala120Thr), were found. None of the identified polymorphisms cosegregated with the intersexual phenotype, thus, we cannot confirm that hypospadias may be associated with polymorphism

  16. Intervertebral disc disease in dogs - Part 2: Comparison of clinical, magnetic resonance imaging, and histological findings in 74 surgically treated dogs

    NARCIS (Netherlands)

    Kranenburg, H.C.; Grinwis, G.C.M.; Bergknut, N.; Gahrmann, Ninke; Voorhout, G.; Hazewinkel, H.A.W.

    The relationship between intervertebral disc (IVD) disease and IVD degeneration remains unclear. The aim of the present study was to compare the clinical severity of IVD herniation (IVDH), determined with a neurological grading system, with findings of magnetic resonance imaging (MRI) and

  17. Evaluation of Simulated Clinical Breast Exam Motion Patterns Using Marker-Less Video Tracking.

    Science.gov (United States)

    Azari, David P; Pugh, Carla M; Laufer, Shlomi; Kwan, Calvin; Chen, Chia-Hsiung; Yen, Thomas Y; Hu, Yu Hen; Radwin, Robert G

    2016-05-01

    This study investigates using marker-less video tracking to evaluate hands-on clinical skills during simulated clinical breast examinations (CBEs). There are currently no standardized and widely accepted CBE screening techniques. Experienced physicians attending a national conference conducted simulated CBEs presenting different pathologies with distinct tumorous lesions. Single hand exam motion was recorded and analyzed using marker-less video tracking. Four kinematic measures were developed to describe temporal (time pressing and time searching) and spatial (area covered and distance explored) patterns. Mean differences between time pressing, area covered, and distance explored varied across the simulated lesions. Exams were objectively categorized as either sporadic, localized, thorough, or efficient for both temporal and spatial categories based on spatiotemporal characteristics. The majority of trials were temporally or spatially thorough (78% and 91%), exhibiting proportionally greater time pressing and time searching (temporally thorough) and greater area probed with greater distance explored (spatially thorough). More efficient exams exhibited proportionally more time pressing with less time searching (temporally efficient) and greater area probed with less distance explored (spatially efficient). Just two (5.9 %) of the trials exhibited both high temporal and spatial efficiency. Marker-less video tracking was used to discriminate different examination techniques and measure when an exam changes from general searching to specific probing. The majority of participants exhibited more thorough than efficient patterns. Marker-less video kinematic tracking may be useful for quantifying clinical skills for training and assessment. © 2015, Human Factors and Ergonomics Society.

  18. Professional or administrative value patterns? Clinical pathways in medical problem-solving processes.

    Science.gov (United States)

    Holmberg, Leif

    2007-11-01

    A health-care organization simultaneously belongs to two different institutional value patterns: a professional and an administrative value pattern. At the administrative level, medical problem-solving processes are generally perceived as the efficient application of familiar chains of activities to well-defined problems; and a low task uncertainty is therefore assumed at the work-floor level. This assumption is further reinforced through clinical pathways and other administrative guidelines. However, studies have shown that in clinical practice such administrative guidelines are often considered inadequate and difficult to implement mainly because physicians generally perceive task uncertainty to be high and that the guidelines do not cover the scope of encountered deviations. The current administrative level guidelines impose uniform structural features that meet the requirement for low task uncertainty. Within these structural constraints, physicians must organize medical problem-solving processes to meet any task uncertainty that may be encountered. Medical problem-solving processes with low task uncertainty need to be organized independently of processes with high task uncertainty. Each process must be evaluated according to different performance standards and needs to have autonomous administrative guideline models. Although clinical pathways seem appropriate when there is low task uncertainty, other kinds of guidelines are required when the task uncertainty is high.

  19. Applications of multivariate pattern classification analyses in developmental neuroimaging of healthy and clinical populations

    Directory of Open Access Journals (Sweden)

    Signe L Bray

    2009-10-01

    Full Text Available Analyses of functional and structural imaging data typically involve testing hypotheses at each voxel in the brain. However, it is often the case that distributed spatial patterns may be a more appropriate metric for discriminating between conditions or groups. Multivariate pattern analysis has been gaining traction in neuroimaging of adult healthy and clinical populations; studies have shown that information present in neuroimaging data can be used to decode intentions and perceptual states, as well as discriminate between healthy and diseased brains. While few studies to date have applied these methods in pediatric populations, in this review we discuss exciting potential applications for studying both healthy, and aberrant, brain development. We include an overview of methods and discussion of challenges and limitations.

  20. Resistance patterns to beta-lactams and quinolones in clinical isolates of bacteria from Cuban hospitals.

    Science.gov (United States)

    Gonzáles, I; Niebla, A; Vallin, C

    1995-01-01

    The resistance patterns to 26 beta-lactams and 8 quinolones of clinical isolates from Cuban hospitals were evaluated using the disk susceptibility test, according to the NCCLS guidelines (1992). The genera studied were Escherichia sp (320), Enterobacter sp (10), Klebsiella sp (90), Proteus sp (10), Pseudomonas sp (90), Serratia sp (20), and Staphylococcus sp (80). Higher resistance to beta-lactams was observed in the genera Pseudomonas, Escherichia and Klebsiella. For fluoroquinolones we found no significant resistance, with the exception of the genus Klebsiella. The most effective antibiotics were cephalosporins of the second and third generations, fluoroquinolones, and non-classical beta-lactams (cephamycins, moxalactam and monobactams). On the contrary, a pronounced resistance was found to penicillin, oxacillin, ticarcillin, ampicillin, methicillin, nalidixic acid and cinoxacin. These resistance patterns correspond to the high consumption of these antibiotics throughout the country.

  1. Tanycytic Ependymoma: A Challenging Histological Diagnosis

    Directory of Open Access Journals (Sweden)

    Khaled M. Krisht

    2013-01-01

    Full Text Available Tanycytic ependymoma is a rare form of ependymoma that usually arises in the intramedullary spine. It has a unique histology emphasized by the inconspicuous ependymal pattern of cells and close resemblance to schwannoma and astrocytoma. The authors report a 50-year-old man with a cervical tanycytic ependymoma that was initially thought to be a schwannoma. The frozen histology section showed spindle cells with oval and elongated nuclei with occasional hemosiderin deposits present suggesting a preliminary diagnosis of schwannoma. Immunohistochemical staining of the permanent section revealed strong immunoreactivity for glial fibrillary acidic protein with intermittent S-100 positivity, confirming that the tumor was a tanycytic ependymoma. This underlines the challenges involved in making an accurate diagnosis and demonstrates that careful and detailed histological inspection with immunohistochemical stains and ultrastructural microscopy may be necessary to distinguish tanycytic ependymoma from other neoplasms.

  2. Visual Analytics for Pattern Discovery in Home Care. Clinical Relevance for Quality Improvement.

    Science.gov (United States)

    Radhakrishnan, Kavita; Monsen, Karen A; Bae, Sung-Heui; Zhang, Wenhui

    2016-07-27

    Visualization can reduce the cognitive load of information, allowing users to easily interpret and assess large amounts of data. The purpose of our study was to examine home health data using visual analysis techniques to discover clinically salient associations between patient characteristics with problem-oriented health outcomes of older adult home health patients during the home health service period. Knowledge, Behavior and Status ratings at discharge as well as change from admission to discharge that was coded using the Omaha System was collected from a dataset on 988 de-identified patient data from 15 home health agencies. SPSS Visualization Designer v1.0 was used to visually analyze patterns between independent and outcome variables using heat maps and histograms. Visualizations suggesting clinical salience were tested for significance using correlation analysis. The mean age of the patients was 80 years, with the majority female (66%). Of the 150 visualizations, 69 potentially meaningful patterns were statistically evaluated through bivariate associations, revealing 21 significant associations. Further, 14 associations between episode length and Charlson co-morbidity index mainly with urinary related diagnoses and problems remained significant after adjustment analyses. Through visual analysis, the adverse association of the longer home health episode length and higher Charlson co-morbidity index with behavior or status outcomes for patients with impaired urinary function was revealed. We have demonstrated the use of visual analysis to discover novel patterns that described high-needs subgroups among the older home health patient population. The effective presentation of these data patterns can allow clinicians to identify areas of patient improvement, and time periods that are most effective for implementing home health interventions to improve patient outcomes.

  3. Prevalence and clinical patterns of psoriatic arthritis in Indian patients with psoriasis

    Directory of Open Access Journals (Sweden)

    Ramesh Kumar

    2014-01-01

    Full Text Available Background: The prevalence and clinical patterns of psoriatic arthritis (PsA varies in different parts of the world and there is little clinical and epidemiological data from the Indian subcontinent. Aims: Our study was designed to evaluate the prevalence and clinical patterns of PsA in Indian patients. Methods: This was a non-interventional, cross-sectional study, in which 1149 consecutive psoriasis patients seen over 1 year were screened for PsA according to classification of psoriatic arthritis (CASPAR criteria. Demographic and disease parameters were recorded including Psoriasis Area and Severity Index (PASI, Nail Psoriasis Severity Index (NAPSI, and number of swollen and tender joints. Results: Among 1149 patients with psoriasis, 100 (8.7% patients had PsA, of which 83% were newly diagnosed. The most common pattern was symmetrical polyarthritis (58%, followed by spondyloarthropathy 49%, asymmetric oligoarthritis (21%, isolated spondyloarthropathy (5%, predominant distal interphalangeal arthritis (3%, and arthritis mutilans (1%. Enthesitis and dactylitis were present in 67% and 26% of cases, respectively. The mean number of swollen and tender joints were 3.63 ± 3.59 (range, 0-22 and 7.76 ± 6.03 (range, 1-26, respectively. Nail changes were present in 87% of the cases. The median PASI and NAPSI of the subjects with PsA was 3.6 and 20, respectively. There was no significant correlation of number of swollen/tender joints with PASI or NAPSI. Conclusion: There is a relatively low prevalence of PsA among Indian psoriasis patients presenting to dermatologists. No correlation was found between the severity of skin and nail involvement and articular disease.

  4. Clinically Relevant Injury Patterns After an Anterior Cruciate Ligament Injury Provide Insight Into Injury Mechanisms

    Science.gov (United States)

    Levine, Jason W.; Kiapour, Ata M.; Quatman, Carmen E.; Wordeman, Samuel C.; Goel, Vijay K.; Hewett, Timothy E.; Demetropoulos, Constantine K.

    2014-01-01

    Background The functional disability and high costs of treating anterior cruciate ligament (ACL) injuries have generated a great deal of interest in understanding the mechanism of noncontact ACL injuries. Secondary bone bruises have been reported in over 80% of partial and complete ACL ruptures. Purpose The objectives of this study were (1) to quantify ACL strain under a range of physiologically relevant loading conditions and (2) to evaluate soft tissue and bony injury patterns associated with applied loading conditions thought to be responsible for many noncontact ACL injuries. Study Design Controlled laboratory study. Methods Seventeen cadaveric legs (age, 45 ± 7 years; 9 female and 8 male) were tested utilizing a custom-designed drop stand to simulate landing. Specimens were randomly assigned between 2 loading groups that evaluated ACL strain under either knee abduction or internal tibial rotation moments. In each group, combinations of anterior tibial shear force, and knee abduction and internal tibial rotation moments under axial impact loading were applied sequentially until failure. Specimens were tested at 25° of flexion under simulated 1200-N quadriceps and 800-N hamstring loads. A differential variable reluctance transducer was used to calculate ACL strain across the anteromedial bundle. A general linear model was used to compare peak ACL strain at failure. Correlations between simulated knee injury patterns and loading conditions were evaluated by the χ2 test for independence. Results Anterior cruciate ligament failure was generated in 15 of 17 specimens (88%). A clinically relevant distribution of failure patterns was observed including medial collateral ligament tears and damage to the menisci, cartilage, and subchondral bone. Only abduction significantly contributed to calculated peak ACL strain at failure (P = .002). While ACL disruption patterns were independent of the loading mechanism, tibial plateau injury patterns (locations) were

  5. Correlation Between the Evaluation of Pigmented Lesions by a Multi-spectral Digital Skin Lesion Analysis Device and the Clinical and Histological Features of Melanoma.

    Science.gov (United States)

    Winkelmann, Richard R; Rigel, Darrell S; Ferris, Laura; Sober, Arthur; Tucker, Natalie; Cockerell, Clay J

    2016-03-01

    To correlate Multi-spectral Digital Skin Lesion Analysis classifier scores with histopathological severity of pigmented lesions and clinical features of melanoma. Classifier scores were computed for 1,632 skin lesions. Dermatologists evaluated the same lesions for Asymmetry, Border Irregularity, Color variegation, Diameter >6mm, Evolution, Patient's Concern, Regression, and/or "Ugly Duckling" sign. Classifier scores were correlated to the number of clinical risk features and for six histopathological severity levels of pigmented lesions. Average classifier score, Welch's t-test, and chi-square analysis. Melanomas had higher mean classifier scores (3.5) than high-grade dysplastic nevi (2.7, p=0.002), low-grade dysplastic nevi (1.7, plesions (2.0, pSkin Lesion Analysis in assessing the risk of pigmented lesions requiring biopsy. Optimizing outcomes of dermatologist decisions to biopsy suspicious pigmented lesions may be enhanced utilizing Multi-spectral Digital Skin Lesion Analysis.

  6. Ichthyosis, exocrine pancreatic insufficiency, impaired neutrophil chemotaxis, growth retardation, and metaphyseal dysplasia (Shwachman syndrome). Report of a case with extensive skin lesions (clinical, histological, and ultrastructural findings)

    Science.gov (United States)

    Goeteyn, M; Oranje, A P; Vuzevski, V D; de Groot, R; van Suijlekom-Smit, L W

    1991-02-01

    The Shwachman syndrome comprises exocrine pancreatic insufficiency, growth retardation, and bone marrow hypoplasia resulting in neutropenia. Clinical, morphological, and ultrastructural studies, as well as hair analysis, were performed in a patient with Shwachman's syndrome and severe ichthyosis. Clinical findings were lamellar ichthyosiform desquamation on the extremities. The hair was scanty and short on the scalp, in the eyelashes, and in the eyebrows. The nails were hyperkeratotic. Morphologic findings were slight, regular acanthosis and severe diffuse hyperkeratosis with variable parakeratosis. The granular layer was thickened. The papillary dermis showed very slight perivascular lymphocyte infiltration. The most prominent ultrastructural finding was the presence of solitary or multiple droplets of varying size in the cytoplasm of the keratinocytes. Hair analysis revealed no abnormalities; the cystine concentration in hair specimens was normal.

  7. Effect of respiratory pattern on automated clinical blood pressure measurement: an observational study with normotensive subjects.

    Science.gov (United States)

    Herakova, Natalia; Nwobodo, Nnenna Harmony Nzeribe; Wang, Ying; Chen, Fei; Zheng, Dingchang

    2017-01-01

    It has been reported that deep breathing could reduce blood pressures (BP) in general. It is also known that BP is decreased during inhalation and increased during exhalation. Therefore, the measured BPs could be potentially different during deep breathing with different lengths of inhalation and exhalation. This study aimed to quantitatively investigate the effect of different respiratory patterns on BPs. Forty healthy subjects (20 males and 20 females, aged from 18 to 60 years) were recruited. Systolic and diastolic BPs (SBP and DBP) were measured using a clinically validated automated BP device. There were two repeated measurement sessions for each subject. Within each session, eight BP measurements were performed, including 4 measurements during deep breathing with different respiratory patterns (Pattern 1: 4.5 s vs 4.5 s; Patter 2: 6 s vs 2 s; Pattern 3: 2 s vs 6 s; and Pattern 4: 1.5 s vs 1.5 s, respectively for the durations of inhalation and exhalation) and additional 4 measurements from 1 min after the four different respiratory patterns. At the beginning and end of the two repeated measurement sessions, there were two baseline BP measurements under resting condition. The key experimental results showed that overall automated SBP significantly decreased by 3.7 ± 5.7 mmHg, 3.9 ± 5.2 mmHg, 1.7 ± 5.9 mmHg and 3.3 ± 5.3 mmHg during deep breathing, respectively for Patterns 1, 2, 3 and 4 (all p Pattern 3). Similarly, the automated DBPs during deep breathing in pattern 1, 2 and 4 decreased by 3.7 ± 5.0 mmHg, 3.7 ± 4.9 mmHg and 4.6 ± 3.9 mmHg respectively (all p Pattern 3 with a decrease of 1.0 ± 4.3 mmHg, p = 0.14). Correspondingly, after deep breathing, automated BPs recovered back to normal with no significant difference in comparison with baseline BP (all p > 0.05, except for SBP in Pattern 4). In summary, this study has quantitatively demonstrated that the measured automated BPs decreased

  8. Epidemiology And Clinical Pattern Of Atopic Dermatitis In 100 Children seen In A City Hospital

    Directory of Open Access Journals (Sweden)

    Dhar Sandipan

    2002-01-01

    Full Text Available A topic desmatitis is a fairly common disorder in the paediatric population. One hundred children were evaluated for epidemiology and clinical pattern with reference to age, age of onset, history of atopy, seasonal variation, type, distribution and extent of eczema etc. The results were tabulated, analysed and compared with data from previous studies. Findings such as onset at a very young age, a male preponderance, summer aggravation, facial dermatitis in preschool children, more acute presentation less disease severity and other regional variations are discussed.

  9. Charysanthemum contact dermatitis: Clinical patterns and patch testing with ethanolic extracts

    Directory of Open Access Journals (Sweden)

    Tanwar R

    1990-01-01

    Full Text Available Forty patients with suspected chrysanthemum contact dermatitis and 20 age and sex matched controls were patch tested with ethanolic extracts of Chrysanthemum morifolium. Eighteen (45% patients demonstrated positive patch tests. Out of these 10 (56% patients gave a history of photoaggravation and 9 (50% of seasonal variation. Dermatitis involving hands and face only, widespread dermatitis and airborne contact dermatitis were the common clinical patterns seen. Patients with occupational exposure to chrysanthemums demonstrated the maximum positive reactions. All the 18 patients showed positive patch tests with the extracts of flowers, 17 with leaves, 16 with whole plant and only 4 with the stem.

  10. Comprehensive histological evaluation of bone implants

    Science.gov (United States)

    Rentsch, Claudia; Schneiders, Wolfgang; Manthey, Suzanne; Rentsch, Barbe; Rammelt, Stephan

    2014-01-01

    To investigate and assess bone regeneration in sheep in combination with new implant materials classical histological staining methods as well as immunohistochemistry may provide additional information to standard radiographs or computer tomography. Available published data of bone defect regenerations in sheep often present none or sparely labeled histological images. Repeatedly, the exact location of the sample remains unclear, detail enlargements are missing and the labeling of different tissues or cells is absent. The aim of this article is to present an overview of sample preparation, staining methods and their benefits as well as a detailed histological description of bone regeneration in the sheep tibia. General histological staining methods like hematoxylin and eosin, Masson-Goldner trichrome, Movat’s pentachrome and alcian blue were used to define new bone formation within a sheep tibia critical size defect containing a polycaprolactone-co-lactide (PCL) scaffold implanted for 3 months (n = 4). Special attention was drawn to describe the bone healing patterns down to cell level. Additionally one histological quantification method and immunohistochemical staining methods are described. PMID:24504113

  11. Patterns of cerebral injury and clinical presentation in the vascular disruptive syndrome of monozygotic twins.

    Science.gov (United States)

    Weig, S G; Marshall, P C; Abroms, I F; Gauthier, N S

    1995-11-01

    The prenatal histories, clinical courses, and neuroradiographic studies of 8 infants who had survived the in utero demise of a homozygous co-twin were reviewed. Three distinct modes of clinical presentation were found: (1) severe neonatal encephalopathy with seizures; (2) a more benign neonatal course with onset of seizures and profound developmental disabilities within the first 6 months of age; (3) late infantile presentation with seizures. Only the third group had milder outcomes. Neuroradiographic studies demonstrated two pathologic patterns: varying degrees of periventricular white matter infarction with migrational abnormalities observed with earlier demise of the co-twin, and multicystic encephalomalacia observed when demise occurred at or near term. Pathophysiology is uncertain and most likely multifactorial. Exsanguination injury to the survivor can occur acutely following co-twin demise, so urgent delivery may be appropriate at or near term.

  12. Expression pattern of clinically relevant markers in paediatric germ cell- and sex-cord stromal tumours is similar to adult testicular tumours

    DEFF Research Database (Denmark)

    Mosbech, Christiane Hammershaimb; Svingen, Terje; Nielsen, John Erik

    2014-01-01

    Paediatric germ cell tumours (GCTs) are rare and account for less than 3 % of childhood cancers. Like adult GCTs, they probably originate from primordial germ cells, but the pattern of histopathological types is different, and they occur predominantly in extragonadal sites along the body midline....... but not in mature granulosa cell tumours. Our findings indicate that the expression pattern of these antigens is similar between paediatric and adult GCTs, even though they develop along different developmental trajectories......., elaborate on clinical-pathological associations and better understand their developmental divergence. The tumours were screened for expression of stemness-related factors (OCT4, AP-2γ, SOX2), classical yolk sac tumours (YSTs; AFP, SALL4), GCTs (HCG, PLAP, PDPN/D2-40), as well as markers for sex-cord stromal....... Because they are rare, histology of paediatric GCTs is poorly documented, and it remains unclear to what extent they differ from adult GCTs. We have analysed 35 paediatric germ cell tumours and 5 gonadal sex-cord stromal tumours from prepubertal patients aged 0-15 years, to gain further knowledge...

  13. Mécano-Stimulation™ of the skin improves sagging score and induces beneficial functional modification of the fibroblasts: clinical, biological, and histological evaluations

    Directory of Open Access Journals (Sweden)

    Humbert P

    2015-02-01

    Full Text Available Philippe Humbert,1,2 Ferial Fanian,1,2 Thomas Lihoreau,1,2 Adeline Jeudy,1,2 Ahmed Elkhyat,1,2 Sophie Robin,3 Carol Courderot-Masuyer,3 Hélène Tauzin,3 Christine Lafforgue,1,2,4 Marek Haftek5 1Research and Studies Center on the Integument (CERT, Department of Dermatology, Clinical Investigation Center (CIC 1431, Besançon University Hospital; 2INSERM UMR1098, FED4234 IBCT, University of Franche-Comté, Besançon, France; 3SARL BIOEXIGENCE, Besançon, France; 4Dermopharmacology and Cosmetology Unit, University of Paris Sud, France; 5University of Lyon 1, EA4169, Experimental, clinical and therapeutic aspects of the skin barrier function, INSERM US7 – CNRS UMS3453, Lyon, France Background: Loss of mechanical tension appears to be the major factor underlying decreased collagen synthesis in aged skin. Numerous in vitro studies have shown the impact of mechanical forces on fibroblasts through mechanotransduction, which consists of the conversion of mechanical signals to biochemical responses. Such responses are characterized by the modulation of gene expression coding not only for extracellular matrix components (collagens, elastin, etc. but also for degradation enzymes (matrix metalloproteinases [MMPs] and their inhibitors (tissue inhibitors of metalloproteinases [TIMPs]. A new device providing a mechanical stimulation of the cutaneous and subcutaneous tissue has been used in a simple, blinded, controlled, and randomized study. Materials and methods: Thirty subjects (aged between 35 years and 50 years, with clinical signs of skin sagging, were randomly assigned to have a treatment on hemiface. After a total of 24 sessions with Mécano-Stimulation™, biopsies were performed on the treated side and control area for in vitro analysis (dosage of hyaluronic acid, elastin, type I collagen, MMP9; equivalent dermis retraction; GlaSbox®; n=10 and electron microscopy (n=10. Furthermore, before and after the treatment, clinical evaluations and self

  14. Clinical patterns and outcomes of status epilepticus in patients with tuberous sclerosis complex

    Science.gov (United States)

    Shehata, Hatem S; AbdelGhaffar, Hadeer Mahmoud; Nasreldin, Mohammed; Elmazny, Alaa; Abdelalim, Ahmed; Sabbah, Asmaa; Shalaby, Nevin M

    2017-01-01

    Introduction Refractory epilepsy is a common clinical manifestation in patients with tuberous sclerosis complex (TSC), which can be complicated by many life-threatening conditions, such as status epilepticus (SE). However, very few reports mention the patterns and semiology of SE in those patients. Objective To study the clinical characteristics and outcomes of SE in TSC patients. Materials and methods This observational, prospective study was carried out on 36 Egyptian children with definite TSC. Clinical history, general and neurological examination and psychometric evaluation by standard questionnaires were used to explore characteristics of epileptic manifestations and clinical patterns of SE. All included patients were required to have long-term video electroencephalograms (EEGs) and brain MRI performed. Results A total of 32 attacks of SE were recorded in 21 patients (58.3%) in our cohort during a follow-up period of 2.8±1.1 years; of those patients, 15 had convulsive status, 7 had non-convulsive SE, 6 had refractory/super-refractory SE and 14 patients had a history of infantile spasms (epileptic spasms). The duration of status ranged from 40 to 150 min (mean ± standard deviation: 90±15). Fourteen patients with SE had severe mental retardation, 9 had autistic spectrum disorder and 22 had severe epileptogenic EEG findings. Patients with SE had higher tuber numbers (mean: 9.6), 5 patients had subependymal giant cell astrocytomas and 2 patients had their SE after receiving everolimus. Conclusions The incidence of SE in our patient sample is high (>50%); severe mental retardation, autistic features, history of infantile spasm (epileptic spasms) and high tuber burden are risk factors for developing SE. PMID:28721058

  15. Prognostically distinct clinical patterns of systemic lupus erythematosus identified by cluster analysis.

    Science.gov (United States)

    To, C H; Mok, C C; Tang, S S K; Ying, S K Y; Wong, R W S; Lau, C S

    2009-12-01

    The objective of this study was to evaluate the patterns of clinical manifestations and their mortality in a large cohort of Chinese patients with systemic lupus erythematosus. The cumulative clinical manifestations of a large group of Chinese systemic lupus erythematosus patients who fulfilled at least four American College of Rheumatology criteria for systemic lupus erythematosus were studied. Patients were divided into distinct groups by using the K-mean cluster analysis. Clinical features, prevalence of proliferative lupus nephritis (World Health Organization class III, IV), autoantibody profile, and treatment data were compared and the standardized mortality ratios were calculated for each cluster of patients. There were 1082 patients included in the study (mean age at systemic lupus erythematosus diagnosis 30.5 years; mean systemic lupus erythematosus duration 10.3 years). Three distinct groups of patients were identified. Cluster 1 (n = 347) was characterized predominantly by mucocutaneous manifestations (malar rash, discoid rash, photosensitivity, oral ulcer) and arthritis but having the lowest prevalence of serositis, hematologic manifestations (hemolytic anemia, leukopenia, and thrombocytopenia), and proliferative lupus nephritis. Patients in cluster 2 (n = 409) had mainly renal and hematological manifestations but having the lowest prevalence of mucocutaneous manifestations. Pulmonary and gastrointestinal manifestations were significantly more frequent in cluster 2 than the other clusters. Cluster 3 patients (n = 326) had the most heterogeneous features. Besides having a high prevalence of mucocutaneous manifestations, serositis and hematologic manifestations, renal involvement, and proliferative lupus nephritis was also most prevalent among the three clusters. Patients in cluster 2 had a much higher standardized mortality ratio [standardized mortality ratio 7.23 (6.7-7.7), p lupus erythematosus could be clustered into prognostically distinct patterns of

  16. Kniest dysplasia: MR correlation of histologic and radiographic peculiarities.

    Science.gov (United States)

    Dwek, Jerry R

    2005-02-01

    Unossified epiphyses of Kniest dysplasia patients histologically reveal a bizarre pattern of chondrocytes lying amid a highly vacuolated matrix giving rise to the name "Swiss cheese" cartilage. The ossified epiphyses also are unusual in showing clouds of dense punctate calcifications randomly distributed throughout. Both unossified and ossified epiphyses reveal on MR imaging a similar pattern of lakes of bright T2 signal against a relatively normal background, which represents an interesting analogue to the histologic and radiographic features.

  17. Relationships Between Clinical Decision-Making Patterns and Self-Efficacy and Nursing Professionalism in Korean Pediatric Nurses.

    Science.gov (United States)

    Choi, Miyoung; Kim, Jisoo

    2015-01-01

    As pediatric nurses must make decisions on a regular basis when caring for hospitalized children, clinical decision-making abilities are necessary in this profession. In the present study, we explored clinical decision-making patterns and their association with self-efficacy and nursing professionalism in pediatric nurses. We surveyed 173 pediatric nurses and analyzed the relationships between their clinical decision-making patterns and self-efficacy and nursing professionalism. Factor analysis identified 5 clinical decision-making patterns: patient-family-nurse collaborative (PNC), individual patient-oriented (IP), nurse model-oriented (NM), pattern-oriented intuitive (PI), and nursing knowledge-oriented (NK). The most frequently observed clinical decision-making pattern was the PNC. The self-efficacy and nursing professionalism were found to be higher in pediatric nurses using the IP and NM, and were lower for those using the PNC. Thus, the present results suggest that pediatric nurses' clinical decision-making patterns are influenced by nursing professionalism and self-efficacy. Therefore, intervention programs focusing on these variables might improve clinical decision-making in pediatric nurses. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Histologic distribution of borderline ovarian tumors worldwide: a systematic review

    OpenAIRE

    Song, Taejong; Lee, Yoo-Young; Choi, Chel Hun; Kim, Tae-Joong; Lee, Jeong-Won; Bae, Duk-Soo; Kim, Byoung-Gie

    2013-01-01

    Objective The histologic types of borderline ovarian tumors (BOTs) exhibit striking differences in clinical behavior and prognosis. Yet, there is no information available on the histologic distribution of BOTs according to geographic region. The purpose of this study was to systematically review this issue worldwide. Methods A comprehensive search of the literature was conducted using electronic databases. Studies were eligible if BOTs were investigated and the histologic distribution of the ...

  19. Chondroinduction Is the Main Cartilage Repair Response to Microfracture and Microfracture With BST-CarGel: Results as Shown by ICRS-II Histological Scoring and a Novel Zonal Collagen Type Scoring Method of Human Clinical Biopsy Specimens.

    Science.gov (United States)

    Hoemann, Caroline D; Tran-Khanh, Nicolas; Chevrier, Anik; Chen, Gaoping; Lascau-Coman, Viorica; Mathieu, Colleen; Changoor, Adele; Yaroshinsky, Alex; McCormack, Robert G; Stanish, William D; Buschmann, Michael D

    2015-10-01

    Current cartilage repair histological scoring systems are unable to explain the relationship between collagen type II deposition and overall repair quality. The purpose of this study was to develop a novel zonal collagen type (ZCT) 5-point scoring system to measure chondroinduction in human clinical biopsy specimens collected after marrow stimulation. The hypothesis was that the ZCT scores would correlate with the International Cartilage Repair Society-II (ICRS-II) overall histological repair assessment score and glycosaminoglycan (GAG) content. Descriptive laboratory study. After optimizing safranin O staining for GAG and immunostaining for human collagen type II and type I (Col2 and Col1, respectively), serial sections from clinical osteochondral repair biopsy specimens (13 months after microfracture or microfracture with BST-CarGel; n = 39 patients) were stained and 3 blinded readers performed histomorphometry for percentage of staining, ICRS-II histological scoring, polarized light microscopy (PLM) scoring, and 5-point ZCT scoring based on tidemark morphology, zonal distribution of Col2 and Col1, and Col1 percentage stain. Because 1 biopsy specimen was missing bone, 38 biopsy specimens were evaluated for ICRS-II, PLM, and ZCT scores. Chondroinduction was identified in 21 biopsy specimens as a Col2 matrix fused to bone that spanned the deep-middle-superficial zones ("full-thickness hyaline repair"), deep-middle zones, or deep zone ("stalled hyaline") that was covered with a variable-thickness Col1-positive matrix, and was scored, respectively, as ZCT = 1 (n = 4 biopsy specimens), ZCT = 2 (n = 6) and ZCT = 3 (n = 11). Other biopsy specimens (n = 17) were fibrocartilage (n = 9; ZCT = 4), fibrous tissue (n = 4, ZCT = 5), or non-marrow derived (n = 4; ZCT = 0). Non-marrow derived tissue had a mean mature tidemark score of 84 out of 100 versus a regenerating tidemark score of 24 for all other biopsy specimens (P = .005). Both "stalled hyaline" repair and

  20. Clinical, radiographic, and histologic analysis of the effects of acemannan used in direct pulp capping of human primary teeth: short-term outcomes.

    Science.gov (United States)

    Songsiripradubboon, Siriporn; Banlunara, Wijit; Sangvanich, Polkit; Trairatvorakul, Chutima; Thunyakitpisal, Pasutha

    2016-09-01

    Acemannan has been previously reported as a direct pulp-capping agent in animal study. This natural material demonstrated its biocompatibility and enhanced reparative dentin formation. The objective of this study was to investigate the action of acemannan as a direct pulp-capping material in human primary teeth with deep caries. Forty-two deeply carious mandibular primary molars from 37 children, aged 7-11 years old diagnosed with reversible pulpitis were studied. After completely removing the infected dentine, teeth with a pinpoint pulpal exposure were randomly divided into two treatment groups: acemannan or calcium hydroxide. A glass-ionomer cement base was applied to all teeth prior to restoration with stainless steel crowns. Clinical and radiographic evaluation was performed 6 months post-treatment. The teeth due to exfoliate were extracted and histopathologically evaluated for inflammation, dentine bridge formation, and soft tissue organization. At 6 months, the overall clinical and radiographic success rates of direct pulp capping with acemannan and calcium hydroxide at 6 months were 72.73 and 70.0 %, respectively. The histopathological results indicated that the acemannan-treated group had significantly better histopathological responses compared with the calcium hydroxide-treated group (p < 0.05). These data suggest acemannan offers a valuable alternative biomaterial for vital pulp therapy in primary teeth.

  1. Inflammatory and repair serum biomarker pattern. Association to clinical outcomes in COPD

    Directory of Open Access Journals (Sweden)

    Pinto-Plata Victor

    2012-08-01

    Full Text Available Abstract Background The relationship between serum biomarkers and clinical expressions of COPD is limited. We planned to further describe this association using markers of inflammation and injury and repair. Methods We studied lung function, comorbidities, exercise tolerance, BODE index, and quality of life in 253 COPD patients and recorded mortality over three years. Serum levels of Interleukins 6,8 and16, tumor necrosis factor alpha (TNF α [inflammatory panel], vascular endothelial growth factor (VEGF, and matrix metalloproteinase 9 (MMP-9 [injury and repair panel] and pulmonary and activation-regulated chemokine (PARC/CCL-18 and monocyte chemotactic protein 1 (MCP-1/CCL2 [chemoattractant panel] were measured. We related the pattern of the biomarker levels to minimal clinically important differences (MCID using a novel visualization method [ObServed Clinical Association Results (OSCAR plot]. Results Levels of the inflammatory markers IL-6, TNF α were higher and those of injury and repair lower (p  Conclusions In COPD, serum biomarkers of inflammation and repair are distinctly associated with important clinical parameters and survival.

  2. Cardiac Hematological Malignancies: Typical Growth Patterns, Imaging Features, and Clinical Outcome.

    Science.gov (United States)

    Voigt, Peter; Wienbeck, Susanne; Weber, Marc-André; Oyama-Manabe, Noriko; Beimler, Maximilian; Schob, Stefan; Kahn, Thomas; Meyer, Hans Jonas; Randaxhe, Jan Frieso; Surov, Alexey

    2018-02-01

    Cardiac hematological malignancies (CHMs) are rare entities and comprise lymphoma, leukemic infiltration, and extramedullary manifestation of multiple myeloma. The aim of this work is to summarize typical growth patterns, imaging features, and outcome parameters of CHM. Overall, 12 cases from 4 centers were reviewed retrospectively together with 604 cases from the literature. Cardiac hematological malignancies were mainly represented by B-cell lymphoma (70.0%). Other entities were rarer. Almost half of the patients showed involvement of multiple cardiac structures. Most commonly right atrium, right ventricle, pericardium, left atrium, and left ventricle were affected in decreased order of frequency. Cardiac hematological malignancies manifested with 3 growth patterns: intracaval masses, heart wall infiltration, and pericardial effusion. Several subtypes of CHM tended to present with different patterns. Clinical presentation is unspecific-frequent signs were dyspnea (54.6%), arrhythmias (30.5%), and thoracic pain (18.5%). Outcome of CHM is poor with mean survival of 283.6 days for leukemias, 260.1 days for T-cell non-Hodgkin lymphoma (NHL), 217.9 days for B-cell NHL, and 155.5 days for multiple myeloma.

  3. The Vital Capacity Is Vital: Epidemiology and Clinical Significance of the Restrictive Spirometry Pattern.

    Science.gov (United States)

    Godfrey, Mark S; Jankowich, Matthew D

    2016-01-01

    Epidemiologic research has revealed a substantial portion of the general population with abnormal spirometry results that are characterized by decreased FEV1 and FVC but a preserved FEV1/FVC ratio. This restrictive spirometry pattern (RSP) is inconsistently defined in the literature and not well addressed by current guidelines; there is an accumulating body of evidence, however, that RSP is prevalent to a similar degree as airflow obstruction. Genetic and other risk factors for RSP, such as inhalational injuries and early life exposures, continue to be actively described. Although it seems that RSP is closely associated with the metabolic syndrome, diabetes, and systemic inflammation, it is not a simple marker of obesity. RSP is associated with adverse cardiovascular outcomes, as well as mortality, and it may be an underappreciated cause of functional impairments and respiratory symptoms. Improvement in outcomes in this population will require that clinicians have an appreciation for the significance of this spirometry pattern; additional research into the clinical and radiologic phenotype of these subjects is also needed. This article provides an overview of the recent developments in our understanding of this prevalent and highly morbid spirometry pattern. Published by Elsevier Inc.

  4. Clinical neurophysiology referral patterns to a tertiary hospital--a prospective audit.

    LENUS (Irish Health Repository)

    Renganathan, R

    2012-02-03

    BACKGROUND: Cork University Hospital (CUH) provides a tertiary service for all neurophysiology referrals in the Southern Health Board region. AIM: To ascertain the number, source, symptoms and diagnosis of neurophysiology referrals at CUH. METHODS: We did a prospective audit of the referral patterns to the neurophysiology department over a 12 -week period. RESULTS: Of 635 referrals, 254 had electromyograms (EMG), 359 had electro-encephalograms (EEG), 18 had visual evoked potentials (VEP), three had somato-sensory evoked potentials (SSEP) and one had multiple sleep latency tests (MSLT). We analysed the demographic pattern, reason for referrals, the average waiting time for neurophysiology tests and the patterns of diagnosis in this audit. CONCLUSIONS: Patients from County Cork are making more use of the neurophysiology services than patients from other counties within the Southern Health Board. The average waiting time for an EEG was 32 days and for an EMG was 74 days. However, more than 35% of those patients waiting for an EEG or an EMG had their tests done within four weeks of referral. The appointments of EEG and EMG were assigned on the basis of clinical need.

  5. Clinical significance of fluoroscopic patterns specific for the mitotic spindle in patients with reumatic diseases

    Directory of Open Access Journals (Sweden)

    S. Todesco

    2011-09-01

    Full Text Available Objective: we proposed to determine the clinical significance of anti-NuMA and anti-HsEg5 antibodies in a group of patients affected with rheumatic diseases. Materials and methods: indirect immunofluorescence on HEp-2000 cells at serum dilution of 1:40 was used to examin 26 sera which had previously showed a “mitotic spindle” fluoroscopic pattern type during laboratory routine. Results: 21 sera (80,7% were identified with NuMA and 5 (19,3% with HsEg5 patterns alone or associated with other ANA patterns. However only patients with isolated positiveness and that is 15 with NuMA and 4 with HsEg5 stainings were included in this study. Of the NuMA positive patients 5 were affected with arthropathies associated to different forms of thyroiditis, 2 with seronegative arthritis, 2 with antiphospholipid syndrome, 1 with systemic lupus erythematosus (SLE, 1 with rheumatoid arthritis, 1 with sicca syndrome, 1 with undifferentiated connective tissue disease, 1 with Mycoplasma pneumaniae infection and 1 with retinal thrombosis. Of the HsEg5 positive patients 3 were affected with SLE and 1 with seronegative arthritis. Conclusions: NuMA does not prevail in any defined rheumatic disease, while HsEg5 staining were more frequent (75% in patients affected with SLE all of whom showing high antibody titres.

  6. Computer-assisted interpretation of the EEG background pattern: a clinical evaluation.

    Directory of Open Access Journals (Sweden)

    Shaun S Lodder

    Full Text Available OBJECTIVE: Interpretation of the EEG background pattern in routine recordings is an important part of clinical reviews. We evaluated the feasibility of an automated analysis system to assist reviewers with evaluation of the general properties in the EEG background pattern. METHODS: Quantitative eeg methods were used to describe the following five background properties: posterior dominant rhythm frequency and reactivity, anterior-posterior gradients, presence of diffuse slow-wave activity and asymmetry. Software running the quantitative methods were given to ten experienced electroencephalographers together with 45 routine EEG recordings and computer-generated reports. Participants were asked to review the EEGs by visual analysis first, and afterwards to compare their findings with the generated reports and correct mistakes made by the system. Corrected reports were returned for comparison. RESULTS: Using a gold-standard derived from the consensus of reviewers, inter-rater agreement was calculated for all reviewers and for automated interpretation. Automated interpretation together with most participants showed high (kappa > 0.6 agreement with the gold standard. In some cases, automated analysis showed higher agreement with the gold standard than participants. When asked in a questionnaire after the study, all participants considered computer-assisted interpretation to be useful for every day use in routine reviews. CONCLUSIONS: Automated interpretation methods proved to be accurate and were considered to be useful by all participants. SIGNIFICANCE: Computer-assisted interpretation of the EEG background pattern can bring consistency to reviewing and improve efficiency and inter-rater agreement.

  7. Prevalence and antimicrobial susceptibility patterns of bacteria from milkmen and cows with clinical mastitis in and around Kampala, Uganda

    National Research Council Canada - National Science Library

    Kateete, David Patrick; Kabugo, Usuf; Baluku, Hannington; Nyakarahuka, Luke; Kyobe, Samuel; Okee, Moses; Najjuka, Christine Florence; Joloba, Moses Lutaakome

    2013-01-01

    .... However, such data from sub-Saharan Africa is scarce. Here we describe the distribution and antimicrobial susceptibility patterns of bacteria from cows with clinical mastitis in Kampala, Uganda...

  8. [Patterns of health behavior for weight loss among adults using obesity clinics].

    Science.gov (United States)

    Yang, Jin Hyang; Cho, Myung Ok; Lee, Kayoung

    2012-10-01

    This ethnography was done to explore patterns of weight management behavior among adults using obesity clinics. The participants were 12 adults who were overweight or obese and 2 family members. Data were collected from iterative fieldwork in the obesity clinics of two hospitals. Data were analyzed using text analysis and taxonomic methods. Weight management behaviors among participants varied according to the recognition of the body and motivation for weight control, Participants' behavior was discussed in the socio-cultural context of obesity. Patterns of weight management behavior among participants were categorized by focus: strategic self-oriented type including managements for the body as a social asset and for health, selective neglect type, and passive group value-oriented type including type dependent on others and managements for beauty. Participants' weight management behavior was guided by folk concepts of body and health. and constructed within the socio-cultural context. It is necessary for health care providers to understand physical and psychological problems arising from the repeated trials, excessive control of weight, and Western cultural discourse on beauty ideals among adults who are overweight or obese. Therefore, interventions should be tailored to address individual and community needs.

  9. Pattern of Uveitis in a Referral Eye Clinic in North India

    Directory of Open Access Journals (Sweden)

    Singh Ramandeep

    2004-01-01

    Full Text Available Purpose: To report the pattern of uveitis in a north Indian tertiary eye center. Methods: A retrospective study was done to identify the pattern of uveitis in a uveitis clinic population of a major referral center in north India from January 1996 to June 2001. A standard clinical protocol, the "naming and meshing" approach with tailored laboratory investigations, was used for the final diagnosis. Results: 1233 patients were included in the study; 641 (51.98% were males and 592 (48.01% females ranging in age from 1.5 to 75 years. The anterior uveitis was seen in 607 patients (49.23% followed by posterior uveitis (247 patients, 20.23%, intermediate uveitis (198 patients, 16.06% and panuveitis (181 patients, 14.68%. A specific diagnosis could be established in 602 patients (48.82%. The infective aetiology was seen in 179 patients, of which tuberculosis was the commonest cause in 125 patients followed by toxoplasmosis (21 patients, 11.7%. Non-infectious aetiology was seen in 423 patients, of which ankylosing spondylitis was the commonest cause in 80 patients followed by sepigionous choroidopathy (62 patients, 14.65% . Conclusion: Tuberculosis and toxoplasmosis were the commonest form of infective uveitis, while ankylosing spondylitis and serpiginous choroidopathy were commonly seen as the non-infective causes of uveitis in North India.

  10. Injury patterns in recreational alpine skiing and snowboarding at a mountainside clinic.

    Science.gov (United States)

    Coury, Tim; Napoli, Anthony M; Wilson, Matthew; Daniels, Jeff; Murray, Ryan; Milzman, Dave

    2013-12-01

    The purpose of this study was to examine the demographic and injury characteristics of skiing and snowboarding at a mountainside clinic. Prospectively collected data of all acutely injured patients at the Big Sky Medical Clinic at the base of Big Sky Ski Area in the Northern Rocky Mountains were reviewed. A total of 1593 patients filled out the study questionnaire during the 1995-2000 and 2009-2010 ski seasons. Injury patterns by sport, demographics, and skill level were analyzed and compared over time. The mean overall age was 32.9 ± 14.9 years, 35.4 ± 15.2 for skiers and 23.6 ± 9.5 for snowboarders (P skiing injuries, the shoulder 12%, and the thumb 8%. The wrist accounted for 18% of all snowboarding injuries, the shoulders 14%, and the ankle and knee each 13%. Beginner snowboarders were more likely to present with wrist injuries compared with intermediate (P = .04) and advanced snowboarders (P ski injuries are to the knee and shoulder, regardless of skill level. Beginning snowboarders most frequently injure their wrists whereas shoulder injuries remain frequent at all skill levels. Knowledge of these injury patterns may help manage patients who present for medical care in the prehospital setting as well as help in designing targeted educational tools for injury prevention. © 2013 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  11. Validation of histology image registration

    Science.gov (United States)

    Shojaii, Rushin; Karavardanyan, Tigran; Yaffe, Martin; Martel, Anne L.

    2011-03-01

    The aim of this paper is to validate an image registration pipeline used for histology image alignment. In this work a set of histology images are registered to their correspondent optical blockface images to make a histology volume. Then multi-modality fiducial markers are used to validate the alignment of histology images. The fiducial markers are catheters perfused with a mixture of cuttlefish ink and flour. Based on our previous investigations this fiducial marker is visible in medical images, optical blockface images and it can also be localized in histology images. The properties of this fiducial marker make it suitable for validation of the registration techniques used for histology image alignment. This paper reports on the accuracy of a histology image registration approach by calculation of target registration error using these fiducial markers.

  12. Is 'virtual histology' the next step after the 'virtual autopsy'? Magnetic resonance microscopy in forensic medicine.

    Science.gov (United States)

    Thali, M J; Dirnhofer, R; Becker, R; Oliver, W; Potter, K

    2004-10-01

    The study aimed to validate magnetic resonance microscopy (MRM) studies of forensic tissue specimens (skin samples with electric injury patterns) against the results from routine histology. Computed tomography and magnetic resonance imaging are fast becoming important tools in clinical and forensic pathology. This study is the first forensic application of MRM to the analysis of electric injury patterns in human skin. Three-dimensional high-resolution MRM images of fixed skin specimens provided a complete 3D view of the damaged tissues at the site of an electric injury as well as in neighboring tissues, consistent with histologic findings. The image intensity of the dermal layer in T2-weighted MRM images was reduced in the central zone due to carbonization or coagulation necrosis and increased in the intermediate zone because of dermal edema. A subjacent blood vessel with an intravascular occlusion supports the hypothesis that current traveled through the vascular system before arcing to ground. High-resolution imaging offers a noninvasive alternative to conventional histology in forensic wound analysis and can be used to perform 3D virtual histology.

  13. New Colors for Histology: Optimized Bivariate Color Maps Increase Perceptual Contrast in Histological Images

    Science.gov (United States)

    Kather, Jakob Nikolas; Weis, Cleo-Aron; Marx, Alexander; Schuster, Alexander K.; Schad, Lothar R.; Zöllner, Frank Gerrit

    2015-01-01

    Background Accurate evaluation of immunostained histological images is required for reproducible research in many different areas and forms the basis of many clinical decisions. The quality and efficiency of histopathological evaluation is limited by the information content of a histological image, which is primarily encoded as perceivable contrast differences between objects in the image. However, the colors of chromogen and counterstain used for histological samples are not always optimally distinguishable, even under optimal conditions. Methods and Results In this study, we present a method to extract the bivariate color map inherent in a given histological image and to retrospectively optimize this color map. We use a novel, unsupervised approach based on color deconvolution and principal component analysis to show that the commonly used blue and brown color hues in Hematoxylin—3,3’-Diaminobenzidine (DAB) images are poorly suited for human observers. We then demonstrate that it is possible to construct improved color maps according to objective criteria and that these color maps can be used to digitally re-stain histological images. Validation To validate whether this procedure improves distinguishability of objects and background in histological images, we re-stain phantom images and N = 596 large histological images of immunostained samples of human solid tumors. We show that perceptual contrast is improved by a factor of 2.56 in phantom images and up to a factor of 2.17 in sets of histological tumor images. Context Thus, we provide an objective and reliable approach to measure object distinguishability in a given histological image and to maximize visual information available to a human observer. This method could easily be incorporated in digital pathology image viewing systems to improve accuracy and efficiency in research and diagnostics. PMID:26717571

  14. New Colors for Histology: Optimized Bivariate Color Maps Increase Perceptual Contrast in Histological Images.

    Directory of Open Access Journals (Sweden)

    Jakob Nikolas Kather

    Full Text Available Accurate evaluation of immunostained histological images is required for reproducible research in many different areas and forms the basis of many clinical decisions. The quality and efficiency of histopathological evaluation is limited by the information content of a histological image, which is primarily encoded as perceivable contrast differences between objects in the image. However, the colors of chromogen and counterstain used for histological samples are not always optimally distinguishable, even under optimal conditions.In this study, we present a method to extract the bivariate color map inherent in a given histological image and to retrospectively optimize this color map. We use a novel, unsupervised approach based on color deconvolution and principal component analysis to show that the commonly used blue and brown color hues in Hematoxylin-3,3'-Diaminobenzidine (DAB images are poorly suited for human observers. We then demonstrate that it is possible to construct improved color maps according to objective criteria and that these color maps can be used to digitally re-stain histological images.To validate whether this procedure improves distinguishability of objects and background in histological images, we re-stain phantom images and N = 596 large histological images of immunostained samples of human solid tumors. We show that perceptual contrast is improved by a factor of 2.56 in phantom images and up to a factor of 2.17 in sets of histological tumor images.Thus, we provide an objective and reliable approach to measure object distinguishability in a given histological image and to maximize visual information available to a human observer. This method could easily be incorporated in digital pathology image viewing systems to improve accuracy and efficiency in research and diagnostics.

  15. Relation of erythrocyte indices and serum iron level with clinical and histological progression of oral squamous cell carcinoma in Central India.

    Science.gov (United States)

    Anees Ahmed, Riyaz Ahmed; Ganvir, Sindhu M; Hazarey, Vinay K

    2014-02-01

    This study aims to evaluate the relation of erythrocyte indices and serum iron level with clinical and histopathological progression of oral squamous cell carcinoma (OSCC). Eighty newly diagnosed OSCC patients recruited for the study were divided according to tumor size int three groups. Erythrocyte indices (e.g., hemoglobin [Hb], red blood cell [RBC] count, packed cell volume [PCV]) and serum iron level (S.Fe) were evaluated with normal reference values, control subject, primary tumor size and histopathological grading. Correlation of Hb to S.Fe was also analyzed. We found that 56.36, 61.81, and 83.63% of males and 76, 32, and 88% of female patients were anemic in terms of Hb%, RBC count and PCV respectively, whereas the remainding indices and S.Fe were within normal range (P  0.05). Moderate to weak correlation was observed between Hb and S.Fe (P < 0.05). Tumor-induced hemolysis appeared to be responsible for anemia in OSCC and its severity increased with the progression of tumor. Moderate to weak correlation exists between Hb and S.Fe probably owing to the dual requirement of iron for bone marrow and the tumor. © 2012 Wiley Publishing Asia Pty Ltd.

  16. STUDY ON SMOKING PATTERN AND KNOWLEDGE OF CESSATION METHODS AMONG PATIENTS ATTENDING A PULMONOLOGY CLINIC

    Directory of Open Access Journals (Sweden)

    Vinod Kumar Viswanathan

    2017-08-01

    Full Text Available BACKGROUND Tobacco is a public health problem globally and an important cause of preventable premature death in middle and low income countries. The government of India has taken several measures to ensure tobacco control and suggested that a systematic surveillance system is a key strategy in tobacco control. However the fact remains that people continue to smoke. This study was undertaken to understand the smoking patterns among patients attending a Pulmonology clinic and to assess their knowledge of smoking cessation methods. Data from this study can be used for planning and resource allocation of a smoking cessation clinic. The aim is to study the smoking patterns and the knowledge of cessation strategies and to analyse the willingness of the patients to quit smoking in patients attending a Pulmonology clinic. MATERIALS AND METHODS Around 489 patients visiting the Pulmonology clinic for 15 days were screened and patients with history of smoking habit were included in the study. 133 such patients were assessed with a structured questionnaire and results were analysed. RESULTS The prevalence of patients with smoking habits was 27.2%. The mean age of smoking initiation was 20.9 years of age. Percentage of beedi smokers (52.6% was much higher than the cigarette smokers (37.6%. The average number of cigarettes or beedis smoked per day was 16.6. Only 12.8% were aware of therapeutic options for nicotine de-addiction. Most of the patients had difficulty in smoking cessation. CONCLUSION Most of the patients lack health education regarding the ill effects of smoking or about smoking cessation strategies. Many of them still have inhibitions and fail to seek health services at the earliest, hence we should be able to bridge the gap and give due importance to information, education and communication (IEC activities. Creation of smoking cessation clinics with trained personnel offering various cessation strategies such as psychological counselling

  17. Lexical patterns, features and knowledge resources for coreference resolution in clinical notes.

    Science.gov (United States)

    Gooch, Phil; Roudsari, Abdul

    2012-10-01

    Generation of entity coreference chains provides a means to extract linked narrative events from clinical notes, but despite being a well-researched topic in natural language processing, general-purpose coreference tools perform poorly on clinical texts. This paper presents a knowledge-centric and pattern-based approach to resolving coreference across a wide variety of clinical records from two corpora (Ontology Development and Information Extraction (ODIE) and i2b2/VA), and describes a method for generating coreference chains using progressively pruned linked lists that reduces the search space and facilitates evaluation by a number of metrics. Independent evaluation results give an F-measure for each corpus of 79.2% and 87.5%, respectively. A baseline of blind coreference of mentions of the same class gives F-measures of 65.3% and 51.9% respectively. For the ODIE corpus, recall is significantly improved over the baseline (p0.05). For the i2b2/VA corpus, recall, precision, and F-measure are significantly improved over the baseline (papproach offers performance at least as good as human annotators and greatly increased performance over general-purpose tools. The system uses a number of open-source components that are available to download. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. Clinical Patterns and Treatment Outcome in Patients with Melancholic, Atypical and Non-Melancholic Depressions

    Science.gov (United States)

    Gili, Margalida; Roca, Miquel; Armengol, Silvia; Asensio, David; Garcia-Campayo, Javier; Parker, Gordon

    2012-01-01

    Objective To assess sociodemographic, clinical and treatment factors as well as depression outcome in a large representative clinical sample of psychiatric depressive outpatients and to determine if melancholic and atypical depression can be differentiated from residual non-melancholic depressive conditions. Subjects/Materials and Method A prospective, naturalistic, multicentre, nationwide epidemiological study of 1455 depressive outpatients was undertaken. Severity of depressive symptoms was assessed by the Hamilton Depression Rating Scale (HDRS) and the Self Rated Inventory of Depressive Symptomatology (IDS-SR30). IDS-SR30 defines melancholic and atypical depression according to DSM-IV criteria. Assessments were carried out after 6–8 weeks of antidepressant treatment and after 14–20 weeks of continuation treatment. Results Melancholic patients (16.2%) were more severely depressed, had more depressive episodes and shorter episode duration than atypical (24.7%) and non-melancholic patients. Atypical depressive patients showed higher rates of co-morbid anxiety disorders and substance abuse. Melancholic patients showed lower rates of remission. Conclusion Our study supports a different clinical pattern and treatment outcome for melancholic and atypical depression subtypes. PMID:23110213

  19. Histological effect of ethanolic leaf extract of Codiaeum variegatum ...

    African Journals Online (AJOL)

    Histological effect of ethanolic leaf extract of Codiaeum variegatum on the cerebrum of adult Wistar rats. ... Journal of Experimental and Clinical Anatomy ... They were sacrificed on the 15th day of the experiment; cerebrum was harvested, processed, and stained using the hematoxylin and eosin histological technique.

  20. Risk Factors for Invasive Epithelial Ovarian Cancer by Histologic Subtype

    Directory of Open Access Journals (Sweden)

    Quirk JT

    2004-10-01

    Full Text Available It is unclear whether the different histologic subtypes of epithelial ovarian carcinoma have different risk factors. We investigated the relationships between selected epidemiologic variables (i.e., parity, family history of ovarian cancer, oral contraceptive use, a history of tubal ligation and noncontraceptive estrogen use and the major histologic subtypes of epithelial ovarian cancer in a hospital-based case-control study of adult women at Roswell Park Cancer Institute in Buffalo, NY, USA. Multivariate unconditional logistic regression models were used for statistical analysis. We observed a pattern of increased risk associated with family history and a pattern of risk reduction associated with parity, noncontraceptive estrogen use and tubal ligation across all histologic subtype groups. However, we did not observe a consistent pattern of risk associated with oral contraceptive use. These results provide some additional support for the hypothesis that the effects of various ovarian cancer risk factors may differ according to the histologic subtype.

  1. Defining the key clinical indicators for ineffective breathing pattern in paediatric patients: a meta-analysis of accuracy studies.

    Science.gov (United States)

    de Sousa, Vanessa Emille Carvalho; Lopes, Marcos Venícios de Oliveira; da Silva, Viviane Martins; Keenan, Gail M

    2015-07-01

    The purpose of this study was to identify the key clinical indicators of ineffective breathing pattern among paediatric patients. When nurses perform clinical reasoning, certain characteristics represent the clinical indicators necessary to confirm the presence of a particular diagnosis. Some quantitative studies have reported the prevalence of ineffective breathing pattern in different samples of patients. However, these findings should be synthesised. Meta-analysis of quantitative nursing studies. Studies were identified via systematic searches of CINAHL, LILACS, PubMed and Scopus using the key search terms 'ineffective', 'breathing' and 'pattern'. Additional quality-related inclusion criteria were gleaned from the Cochrane Collaboration for Systematic Reviews of Diagnostic Test Accuracy, the Standards for Reporting of Diagnostic Accuracy and the Quality Assessment of Diagnostic Accuracy Studies. The pertinent results from each study were extracted and analysed via meta-analysis. Six studies using paediatric populations met the inclusion criteria. Summary measures indicated that the following defining characteristics had the highest accuracy values for ineffective breathing pattern among children: bradypnoea, dyspnoea, nasal flaring, orthopnoea, tachypnoea and the use of accessory muscles to breathe. This meta-analysis provides information regarding the accuracy of the clinical indicators of ineffective breathing pattern from studies sampling diverse paediatric populations. Nurses can better use clinical indicators to infer the presence of ineffective breathing pattern when they are aware of the most relevant defining characteristics. Nursing students and professionals can also improve their critical thinking abilities and diagnostic reasoning based on these findings. © 2015 John Wiley & Sons Ltd.

  2. Clinical and histologic study of autogenous oral mucosa in experimental lamellar ketatoplasty/ Estudo clínico e histológico da mucosa oral autógena na ceratoplastia lamelar experimental

    Directory of Open Access Journals (Sweden)

    Vinícius Rivera Cardoso Prado

    2004-05-01

    Full Text Available Eight male dogs of non-specified breed, weighing about 12,4 kg, were subjected to surgical oral mucosa detachment using among others a 5 mm diameter trepan followed by it fixation on 4,5 mm diameter corneal lesion made in an eye, using 9-0 nylon thread in interrupted simple suture pattern. The animals were divided to 4 groups constituted by 2 animals, for histologic study at 15, 30, 45, 60 days of post surgical phase. Meanwhile, clinical findings such as blepharospasm, opacity, neovascularization, ocular discharge, chemosis and characteristics of the graft (vascularization, pigmentation and adhesiveness, were qualitative and quantitatively evaluated at 0-2 days, 3-7 days, 8-15 days, 16-30 days and 31-60 days of postoperative period. Blepharospasm and chemosis were more intense at initial periods, corneal opacity and vascularization (of cornea and grafts at intermediate periods, both with regressing tendency on the latest periods. Serous mucous exsudate was predominant in higher degrees at the initial and intermediate phases and was absent on the later phases. Clinically, the integration of the graft was verified at 15th day. Pigment deposition was seen on two animals on the later periods. The microscopic study revealed on initial and intermediate periods a thick epithelium in comparasion with the underlying cornea, with vacuolization of the inmost cells, intense fibroplasia and collagen fibers deposition on a disorganized setting and intense vascularization of the graft. Mild polymorphonuclear infiltration in graft was observed at 15th day. Plasmocyte infiltration at intermediate phase was mild to moderate. On the 60th day, were observed reasonably thick epithelium with projections to stroma, moderate presence of fibrocytes, collagen on a more organized setting, vascularization ranging from mild to absent and lymphoplasmocitary infiltration in moderate degree. The results allowed us to admit that keratoplasty technique employing buccal mucosa is

  3. Myocardial Architecture and Patient Variability in Clinical Patterns of Atrial Fibrillation

    CERN Document Server

    Manani, Kishan A; Peters, Nicholas S

    2016-01-01

    Atrial fibrillation (AF) increases the risk of stroke by a factor of four to five and is the most common abnormal heart rhythm. The progression of AF with age, from short self-terminating episodes to persistence, varies between individuals and is poorly understood. An inability to understand and predict variation in AF progression has resulted in less patient-specific therapy. Likewise, it has been a challenge to relate the microstructural features of heart muscle tissue (myocardial architecture) with the emergent temporal clinical patterns of AF. We use a simple model of activation wavefront propagation on an anisotropic structure, mimicking heart muscle tissue, to show how variation in AF behaviour arises naturally from microstructural differences between individuals. We show that the stochastic nature of progressive transversal uncoupling of muscle strands (e.g., due to fibrosis or gap junctional remodelling), as occurs with age, results in variability in AF episode onset time, frequency, duration, burden ...

  4. Patterns of Enrollment and Engagement of Custodial Grandmothers in a Randomized Clinical Trial of Psychoeducational Interventions

    Science.gov (United States)

    Smith, Gregory C.; Strieder, Frederick; Greenberg, Patty; Hayslip, Bert; Montoro-Rodriguez, Julian

    2016-01-01

    The authors used Andersen’s (2008) behavior model to investigate patterns of enrollment and treatment engagement among 343 custodial grandmothers who participated in a randomized clinical trial of three psychosocial interventions:(a) a behavioral parenting program, (b) a cognitive behavioral coping program, or (c) an information-only condition. Treatment completion was superior to that typically found with birth parents, even though the grandmothers and their target grandchildren both had high levels of mental and physical health challenges. Compliance did not differ significantly by condition but was higher among grandmothers who self-reported less positive affect, were older, and were using mental health professionals. Treatment satisfaction was highest in grandmothers who attended more treatment sessions, reported lower annual family income, had a health problem, and were using mental health professionals. The practice and policy implications of these findings are discussed, especially in terms of strategies for enhancing the engagement of custodial grandfamilies in future psychoeducational interventions. PMID:27667888