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Sample records for clinical immunohistochemical method

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

    DEFF Research Database (Denmark)

    Grabau, D A; Thorpe, S M; Knoop, A

    2000-01-01

    of patients, receptor positive cases fared better than negative cases in all situations. Investigation of the prognostic power revealed that classification based on IHA allowed better discrimination of patients than classification based on the DCC method. The reason for this difference might be because...... distinction between benign and malignant tissue is possible using the IHAmethod. Thus, IHAresults appear to be more clinically relevant....

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

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    Sha JJ

    2013-10-01

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

  3. [Prospects for using immunohistochemical methods in forensic medical thanatology].

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    Bogomolov, D V; Bogomolova, I N; Karavaeva, I E

    2009-01-01

    This review of Russian and foreign literature is focused on the use of immunohistochemical methods in forensic medical practice. It shows that forensic medical specialists not infrequently underestimate the value of these techniques. Recommendations are proposed for a more extensive application of immunohistochemical methods in practical and fundamental medico-legal thanatology.

  4. Clinical, pathological, immunohistochemical and molecular characterization of feline chronic gingivostomatitis.

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    Rolim, Veronica Machado; Pavarini, Saulo Petinatti; Campos, Fabrício Souza; Pignone, Viviam; Faraco, Cláudia; Muccillo, Marcelo de Souza; Roehe, Paulo Michel; da Costa, Fernanda Viera Amorim; Driemeier, David

    2017-04-01

    Objectives This study presents the clinical, pathological, immunohistochemical and molecular characterization of 26 cats with feline chronic gingivostomatitis (FCG). Methods Oral mucosal biopsies, blood and swabs were collected from cats presenting with oral lesions. The tissue sections were submitted for histopathology and immunohistochemical analysis for feline calicivirus (FCV), feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV). The swabs were subjected to PCR analysis for FCV, and blood for FeLV and FIV. Results The main clinical findings were dysphagia (88.2%), halitosis (76.5%), sialorrhea (47.1%), weight loss (41.2%), intense oral discomfort (35.3%), oral hemorrhage (17.6%), and lackluster and fragile coat (11.8%). Gross inspection revealed bilateral lesions across the palatoglossal fold to the lateral tongue base. The lesions were diffuse, proliferative, intensely red and friable, and bled easily upon examination in 80.8% of cases. In 23.1% of cases, the lesions were multifocal to coalescent, at times forming multiple vesicles on a reddened, edematous palatoglossal fold. Microscopic examination showed that 15.4% of lesions had moderate (grade 2) and 84.6% had severe (grade 3) inflammation. Immunohistochemistry revealed the presence of FeLV antigens in the epithelium and the inflammatory infiltrate of 30.8% of the cats with FCG. FCV antigens were not detected in the FCG lesions. Conclusions and relevance The FCG cases analyzed could not be correlated with FCV. It is possible that FeLV plays a role as a causal agent of lesions in cases where the presence of the virus has been confirmed by immunohistochemistry in epithelial samples.

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

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

    2016-04-01

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

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

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

    2015-02-01

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

  7. Granuloma faciale: clinical, morphological and immunohistochemical aspects in a series of 10 patients*

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    Oliveira, Cristiano Claudino; Ianhez, Pedro Eugênio de Carvalho; Marques, Silvio Alencar; Marques, Mariângela Esther Alencar

    2016-01-01

    Granuloma faciale is a chronic, benign, cutaneous vasculitis with well-established clinical and morphological patterns, but with an unknown etiology. This study describes clinical and pathologic aspects of patients diagnosed with granuloma faciale. The authors analyzed demographic, clinical, morphological and immunohistochemical data from patients with a final diagnosis of granuloma faciale, confirmed between 1998 and 2012. There was a proportional and mixed inflammatory infiltrate, Grenz zones were present in almost all the samples. Immunophenotyping confirmed a higher intensity of T lymphocytes than B lymphocytes in thirteen samples, with a predominance of T CD8 lymphocytes in 64% of cases, in contrast to the literature, which indicates that the major component is T CD4 lymphocytes. All cases were positive for IgG4 but the majority (12/14) had less than 25% of stained cells. The pathogenesis of granuloma faciale remains poorly understood, making studies of morphological and immunohistochemical characterization important to better understand it. PMID:28099604

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

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    D. Cabibi

    2014-03-01

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

  9. The sessile drop method for immunohistochemical processing of unmounted sections of nervous tissue.

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    Nadelhaft, I

    1984-12-01

    A novel method for the immunohistochemical processing of free-floating tissue sections is described. Sections are immersed within drops of solution arranged on a hydrophobic surface. The procedure consists of sequentially suctioning away one fluid drop and replacing it by another, while the section remains in place. The technique permits easy testing of different antiserum dilutions, comparisons among different immunohistochemical protocols, and comparison of different antisera on serial tissue sections. Comparison is made to processing mounted sections.

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

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    Rishi Arvind

    2010-01-01

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

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

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    Elisa B. Neuwald

    2014-04-01

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

  12. Syringoma of vulva: an unusual presentation. Clinical, morphological and immunohistochemical aspects.

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    Núñez-Troconis, José; Viloria de Alvarado, María Elena

    2015-03-01

    The case of a 34-year-old woman, who consulted because she observed the appearance of numerous yellow-white asymptomatic papules on the vulva, is presented. Clinical diagnosis of syringoma of vulva was established. The pathological and immunohistochemical studies confirmed the diagnosis. Vulvar syringoma usually occurs as a multiple flesh-colored or brownish papules on both sides of labia majora of women in their third decade. Its diagnosis should be considered when the patient complaints of vulvar pruritus and/or sweating.

  13. Immunohistochemical and calcium imaging methods in wholemount rat retina.

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    Sargoy, Allison; Barnes, Steven; Brecha, Nicholas C; Pérez De Sevilla Müller, Luis

    2014-10-13

    In this paper we describe the tools, reagents, and the practical steps that are needed for: 1) successful preparation of wholemount retinas for immunohistochemistry and, 2) calcium imaging for the study of voltage gated calcium channel (VGCC) mediated calcium signaling in retinal ganglion cells. The calcium imaging method we describe circumvents issues concerning non-specific loading of displaced amacrine cells in the ganglion cell layer.

  14. Immunohistochemical and Calcium Imaging Methods in Wholemount Rat Retina

    OpenAIRE

    SARGOY, ALLISON; Barnes, Steven; Brecha, Nicholas C.; De Sevilla Müller, Luis Pérez

    2014-01-01

    In this paper we describe the tools, reagents, and the practical steps that are needed for: 1) successful preparation of wholemount retinas for immunohistochemistry and, 2) calcium imaging for the study of voltage gated calcium channel (VGCC) mediated calcium signaling in retinal ganglion cells. The calcium imaging method we describe circumvents issues concerning non-specific loading of displaced amacrine cells in the ganglion cell layer.

  15. Paragangliomas of the head and neck: clinical, morphological and immunohistochemical aspects

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    Pedro de Alcântara de Andrade Filho

    2001-05-01

    Full Text Available CONTEXT: Protein marker positivity can assist in the definition of the therapeutic approach towards head and neck paragangliomas. The establishment of the therapeutic approach should incorporate the results of such an investigation. OBJECTIVE: To establish criteria for benignancy and malignancy of vagal and jugular-tympanic paragangliomas, via the study of the relationships of sex, age, tumor size, duration of complaints, site, family history, presence of metastases, treatment, histological architecture and cell type with the immunohistochemical reactions to S100 protein, chromogranin and AgKi67. DESIGN: A retrospective study of histological and clinical records. SETTING: The Heliópolis and Oswaldo Cruz tertiary general hospitals, São Paulo. SAMPLE: 8 cases of head and neck paragangliomas. MAIN MEASUREMENTS: Determination of degree of positivity to paragangliomas via immunohistochemical reactions. RESULTS: 1. The protein markers for the principal cells (AgKi67 and chromogranin were sensitive in 100% of the tumors when used together. 2. S100 protein was well identified in the cytoplasm and nucleus of sustentacular cells and underwent reduction in the neoplasias. CONCLUSIONS: Chromogranin was proven to be a generic marker for neuroendocrine tumors; S100 protein was positive in all 8 cases and the AgKi67 had low positivity in all cases.

  16. Nipple eczema, an indicative manifestation of atopic dermatitis? A clinical, histological, and immunohistochemical study.

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    Song, Hyo Sang; Jung, Soo-Eun; Kim, You Chan; Lee, Eun-So

    2015-04-01

    Nipple eczema exhibits as a minor manifestation of atopic dermatitis (AD) or occurs as a single skin symptom on the nipple. To characterize the relationship between nipple eczema and AD, a clinical evaluation and an immunohistochemical study were performed. All cases of nipple eczema were confirmed histopathologically. We divided the patients with nipple eczema into 2 groups, namely, those with AD and those without AD, and compared several clinical features. Upon histological examination, the degree of inflammation was subjectively graded as mild, moderate, or severe by 2 separate investigators. Immunohistochemical stainings were performed by using antiinterleukin (IL)-4, anti-IL-13, anti-CD4, and anti-CD8 antibodies, and the results were scored semiquantitatively. In 43 cases evaluated, 12 were nipple eczema with AD. The clinical analysis and histological examination showed no significant differences between the groups. There were consistent findings of IL-4 expressions throughout the epidermis and IL-13 expression mainly in the perivascular area of the dermis. Although CD4 and CD8 were expressed in the cells in the dermis, CD8 expression was detected in the serocrusts of the epidermis. Expression levels of IL-4, IL-13, CD4, and CD8 exhibited no significant differences between the nipple eczema group with AD and the nipple eczema group without AD. Although nipple eczema may accompany AD, we found no definite differences in the degree or pattern of inflammation and cytokine expression level regardless of whether AD was present or not. Serocrust formation seemed to be mainly a collection of CD8-positive cells.

  17. A Novel Image Cytometric Method for Quantitation of Immunohistochemical Staining of Cytoplasmic Antigens

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    M. Guillaud

    1997-01-01

    Full Text Available Evaluation of molecular markers by immunohistochemical labelling of tissue sections has traditionally been performed by qualitative assessment by trained pathologists. For those markers with a staining component present outside of the nucleus, there has been no image histometric method available to reliably and consistently define cell interfaces within the tissue. We present a new method of approximating cellular boundaries to define cellular regions within which quantitative measurements of staining intensity may be made. The method is based upon Voronoi tessellation of a defined region of interest (ROI, and requires only the position of the nuclear centroids within the ROI.

  18. Immunohistochemical methods as an aid in estimating the time since death.

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    Ortmann, Jan; Doberentz, Elke; Madea, Burkhard

    2017-02-14

    For the estimation of time since death in the early postmortem interval, a large repertoire of valid methods is available. With increasing time since death the estimation of the postmortem interval becomes more imprecise and unreliable because validated methods are missing. Wehner et al. developed a method to estimate the time since death using immunohistochemical staining. Proteins undergo degradation after death and this reduces their stainability. Previous studies have explored the development of a method to estimate the time since death using immunohistochemical staining. A systematic analysis (Wehner et al., 1999-2002) demonstrated that calcitonin can still be stained 4 days, thyreoglobulin 5 days, glucagon 6 days, and insulin 12 days after death. After 12 days, calcitonin and thyroglobulin can no longer be stained, glucagon after 14 days, and insulin after 29 days. The aim of the present study was to test this original data on independent case material. Included in this control study were 105 cases with known time since death (between several hours and 22 days). Pancreatic tissue was stained for insulin and glucagon, and the thyroid gland for thyreoglobulin and calcitonin. The original findings could be generally confirmed, however for calcitonin and thyreoglobulin we observed earlier negative stainings. Altogether immunohistochemistry may still be useful as an additional method for estimating time since death in forensic cases.

  19. Geographic tongue and psoriasis: clinical, histopathological, immunohistochemical and genetic correlation - a literature review*

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    Picciani, Bruna Lavinas Sayed; Domingos, Tábata Alves; Teixeira-Souza, Thays; dos Santos, Vanessa de Carla Batista; Gonzaga, Heron Fernando de Sousa; Cardoso-Oliveira, Juliana; Gripp, Alexandre Carlos; Dias, Eliane Pedra; Carneiro, Sueli

    2016-01-01

    Geographic tongue is a chronic, inflammatory, and immune-mediated oral lesion of unknown etiology. It is characterized by serpiginous white areas around the atrophic mucosa, which alternation between activity, remission and reactivation at various locations gave the names benign migratory glossitis and wandering rash of the tongue. Psoriasis is a chronic inflammatory disease with frequent cutaneous involvement and an immunogenetic basis of great importance in clinical practice. The association between geographic tongue and psoriasis has been demonstrated in various studies, based on observation of its fundamental lesions, microscopic similarity between the two conditions and the presence of a common genetic marker, human leukocyte antigen (HLA) HLA-C*06. The difficulty however in accepting the diagnosis of geographic tongue as oral psoriasis is the fact that not all patients with geographic tongue present psoriasis. Some authors believe that the prevalence of geographic tongue would be much greater if psoriatic patients underwent thorough oral examination. This study aimed to develop a literature review performed between 1980 and 2014, in which consultation of theses, dissertations and selected scientific articles were conducted through search in Scielo and Bireme databases, from Medline and Lilacs sources, relating the common characteristics between geographic tongue and psoriasis. We observed that the frequency of oral lesions is relatively common, but to establish a correct diagnosis of oral psoriasis, immunohistochemical and genetic histopathological analyzes are necessary, thus highlighting the importance of oral examination in psoriatic patients and cutaneous examination in patients with geographic tongue. PMID:27579734

  20. [Cutaneous histiocytosarcoma: clinical, immunohistochemical and ultrastructural aspects; difficulties of study and problems of nosology (author's transl)].

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    Forestier, J Y; Schmitt, D; Thivolet, J

    1980-01-01

    Reporting a case of cutaneous tumor of the back of recent occurrence and rapid increase in a 79-years-old woman, according to Crosti's "reticulosis", the authors discuss the following points:--the histiocytic nature of the tumor cells particularly based on immunohistochemical studies (peroxidase activity, anti-HTLA serum) and on electron microscopy with special reference to the multivesicular bodies found in their cytoplasm;--the tests for correct identification of the histiocyte (including electron microscopy, tests for HTLA and HBLA antigens, peroxidatic reaction, acid phosphatase activity, and in vivo or in vitro phagocytosis);--the out of date character of the concept of malignant "reticulosis" in the hematologica and dermatologic classifications, the recent advances in the knowledge of the nature of the so-called "reticulum" (or "reticular") cell which seems to be a distinct entity derived from the mesenchymal cell (as the fibroblast);--the clinical and evolutive characteristics of histiocytic tumors (no hematologic involvement, slow evolution, high radiosensitivity), the difficulties in defining their malignancy and, above all, in finding comparable references in the literature with complete cellular study;--the nosologic place of this affection among the group of haematodermas and in the pathology of the mononuclear phagocyte system. The generic term of cutaneous histiocytosarcoma (stage I or II) is suggested, including the whole malignant and isolated tumoral proliferations developing from the dermic histiocyte.

  1. A Method for Sectioning and Immunohistochemical Analysis of Stem Cell-Derived 3-D Organoids.

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    Wiley, Luke A; Beebe, David C; Mullins, Robert F; Stone, Edwin M; Tucker, Budd A

    2016-05-12

    This unit describes a protocol for embedding, sectioning, and immunocytochemical analysis of pluripotent stem cell-derived 3-D organoids. Specifically, we describe a method to embed iPSC-derived retinal cups in low-melt agarose, acquire thick sections using a vibratome tissue slicer, and perform immunohistochemical analysis. This method includes an approach for antibody labeling that minimizes the amount of antibody needed for individual experiments and that utilizes large-volume washing to increase the signal-to-noise ratio, allowing for clean, high-resolution imaging of developing cell types. The universal methods described can be employed regardless of the type of pluripotent stem cell used and 3-D organoid generated. © 2016 by John Wiley & Sons, Inc.

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

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    Lukas eBauer

    2015-04-01

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

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

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    Chang LIU

    2016-01-01

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

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

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    Shigeru Sasaki

    2015-01-01

    Full Text Available Objective. Can polymer-based immunohistochemical staining of p57kip2 replace DNA analysis as an inexpensive means of differentiating complete mole from partial mole or hydropic abortion? Methods and Materials. Original paraffin-embedded tissue blocks from 14 equivocal cases were turned over to our laboratory and examined by immunohistochemical staining of p57kip2. Results. Four of the 14 cases showed clearly negative nuclear staining in cytotrophoblasts and villous stromal cells: these results were fully concordant with the control staining. The remaining 10 cases showed apparently positive staining in cytotrophoblasts and villous stromal cells. Without DNA analysis we are able to clearly differentiate the 4 cases of complete mole among the 14 equivocal cases. During follow-up, secondary low-risk gestational trophoblastic neoplasia (GTN developed in 1 of the 4 cases of complete mole: the GTN was treated by single-agent chemotherapy. No subsequent changes were observed during follow-up in the other cases. Conclusion. Polymer-based immunohistochemical staining of p57kip2 (paternally imprinted gene, expressed from maternal allele is a very effective method that can be used to differentiate androgenetic complete mole from partial mole and hydropic abortion. We might be able to avoid the cost of DNA analysis.

  5. Characterization of atherosclerosis by histochemical and immunohistochemical methods in African grey parrots (Psittacus erithacus) and Amazon parrots (Amazona spp.).

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    Fricke, Cornelia; Schmidt, Volker; Cramer, Kerstin; Krautwald-Junghanns, Maria-Elisabeth; Dorrestein, Gerry M

    2009-09-01

    The aim of the study was to characterize atherosclerotic changes in African grey parrots (Psittacus erithacus) and Amazon parrots (Amazona spp.) by histochemical and immunohistochemical methods. Samples of the aorta ascendens and trunci brachiocephalici from 62 African grey parrots and 35 Amazon parrots were stained by hematoxylin and eosin and Elastica van Gieson for grading of atherosclerosis in these birds. Four different stages were differentiated. The incidence of atherosclerosis in the examined parrots was 91.9% in African grey parrots and 91.4% in Amazon parrots. To evaluate the pathogenesis in birds, immunohistochemical methods were performed to demonstrate lymphocytes, macrophages, smooth muscle cells, and chondroitin sulfate. According to the missing lymphocytes and macrophages and the absence of invasion and proliferation of smooth muscle cells in each atherosclerotic stage, "response-to-injury hypothesis" seems inapplicable in parrots. Additionally, we found alterations of vitally important organs (heart, lungs) significantly correlated with atherosclerosis of the aorta ascendens.

  6. Immunohistochemical analysis of estrogen receptors in prostate and clinical correlation in men with benign prostatic hyperplasia

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    Gangkak, Goto; Mittal, Alka; Yadav, Sher Singh; Tomar, Vinay; Yadav, Ajay; Mehta, Jayanti

    2017-01-01

    Purpose Estrogens act through interaction with 2 receptor subtypes, ER alpha (ERα) and ER beta (ERβ), in human prostate. The aim of the present study was to semiquantitatively assess the differential expression of ER subtypes in human benign prostatic hyperplasia (BPH) by use of immunocytochemistry (IHC) methods and to explore their relationship with various measures of BPH. Materials and Methods A total of 45 patients with BPH undergoing transurethral resection of the prostate and 22 patients with bladder cancer with normal prostate undergoing surveillance cystoscopy were studied as cases and controls, respectively. Quantitative immunolabeling of ER subtypes was scored by use of a semiquantitative scale. Also, correlations were assessed between ER levels in prostate and various measures of BPH. Results Overall, we found strong immunostaining for ERα in stroma and for ERβ in epithelium, respectively. The IHC score for ERα differed significantly between BPH patients and controls in both stroma (p≤0.001) and epithelium (p=0.008), respectively. The ERβ IHC score was also significantly higher in the epithelium of BPH patients (p=0.01). Also, we found a significant correlation between prostatic ER levels and various clinical measures of BPH. Conclusions ERs may play an important role in the pathogenesis of BPH.

  7. Vascular leiomyoma of the oral cavity. Clinical, histopathological and immunohistochemical characteristics. Presentation of five cases and review of the literature.

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    Gaitan Cepeda, Luis Alberto; Quezada Rivera, Daniel; Tenorio Rocha, Fernando; Leyva Huerta, Elba Rosa; Mendez Sánchez, Edgar Ramiro

    2008-08-01

    Leiomyoma, a benign neoplasia arising from smooth muscle is an uncommon neoplasia of the oral cavity. The most common histological subtype in the oral cavity is the vascular one. To supplement information on vascular leiomyoma of the oral cavity (VLOC), we present cases of VLOC describing their clinical, histological, and immunohistochemical characteristics. Case reports. Five cases of VLOC (3 females; 2 males) from the Clinical and Experimental Pathology Laboratory, Dental School, National Autonomous University of México, are included. The most frequent clinical characteristic of VLOC was a single, asymptomatic, slow growing nodule. The age average of the cases was 40.6, however 3 out of our 5 cases were < or = 40 years old at the moment of their diagnosis. The lesions were composed of fusiform cells arranged in bundles or fascicles. The neoplastic cells were characterized by eosinophilic cytoplasm and tapered nuclei. The presence of vascular spaces was prominent in all cases. The immunocharacteristics of VLOC neoplastic cells were: alpha smooth muscle (+); vimentin (+), desmin (+), CD34 (-) and S-100 protein (-). The endothelial cells of vascular spaces were CD34 (+). Differential diagnosis of VLOC with fusocellular neoplasm is discussed.

  8. Immunohistochemical Expression of CXCR4 on Breast Cancer and Its Clinical Significance

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    Marina Okuyama Kishima

    2015-01-01

    Full Text Available Many tumor cells express chemokines and chemokine receptors, and, for this reason, these molecules can affect the tumor progression. It is known that breast cancer is a complex and heterogeneous neoplasia comprising distinct diseases, histological characteristics, and clinical outcomes. The most studied role for CXCL12 chemokine and its receptor CXCR4 in breast cancer pathogenesis is the metastasis event, although several reports have demonstrated its involvement in other processes, such as angiogenesis and tumor growth. It has been found that CXCR4 is required for breast cancer cell migration to other sites such as lung, bone, and lymph nodes, which express high levels of CXCL12 chemokine. Therefore, CXCR4 is being considered a prognostic marker in breast cancer. Within this context, this review summarizes established studies involving expression of CXCR4 on breast cancer, focusing on its clinical significance.

  9. Immunohistochemical differentiation of inflammatory myopathies

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    Jayalakshmi B Panicker

    2011-01-01

    Full Text Available Background: Idiopathic inflammatory myopathies are a heterogeneous group of acquired muscle disorders with considerable overlap in the histological features, making histological diagnosis difficult at times. Aims: To determine the immunohistochemical profile of clinically suspected cases of inflammatory myopathies, using monoclonal antibodies to HLA-1 and membrane attack complex (MAC, and to correlate the clinical, serological, and electromyographic profile and the histopathological picture, with the immunohistochemical profile. Settings and Design: This was a retrospective study analyzing the clinical and histopathological features in muscle of clinically suspected cases of inflammatory myopathy and correlating it to their HLA-1 and MAC immunostaining profiles. Material and Methods: The study subjects included 33 cases with suspected inflammatory myopathy and 59 with non-inflammatory muscle disease, as controls. Clinical data, electromyographic findings, serological profile, and details of therapy were obtained from patient records. Statistical Analysis: Student ′T′ test, Pearson′s Chi square test, and Kappa statistics were used appropriately. Results: Although HLA-1 and MAC immunostaining did not help to differentiate the individual subtypes of inflammatory myopathy, when either HLA-1 or MAC was positive, inflammatory myopathy could be ruled in with 86.5% certainty and when both HLA-1 and MAC were negative, it could be ruled out with 95% certainty. Conclusions: A combination of clinical presentation, serological profile, electromyographic and histopathological features, together with the immunoprofile for HLA-1 and MAC, contribute toward making a diagnosis of inflammatory myopathy.

  10. The clinical method and the scientific method

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    José Arteaga Herrera

    2010-12-01

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

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

    LENUS (Irish Health Repository)

    Gallagher, David J

    2012-02-01

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

  12. Orbital floor reconstruction with poly-L/D-lactide implants: clinical, radiological and immunohistochemical study in sheep.

    Science.gov (United States)

    Kontio, R; Suuronen, R; Konttinen, Y T; Hallikainen, D; Lindqvist, C; Kommonen, B; Kellomäki, M; Kylmä, T; Virtanen, I; Laine, P

    2004-06-01

    In this study the reconstruction capacity of orbital wall in sheep was evaluated when poly-L/D-lactide (PLDLA96) implants were used for large blow-out defects in 18 sheep. The contralateral side, where the defects healed spontaneously, served as controls. The follow-up was 12, 16, 22 and 36 weeks. Healing was evaluated clinically, radiologically, histologically and immunohistochemically. Physiochemical properties of the implants were also studied. At first, the implants were surrounded by elastic capsules, which gradually ossified. At 36 weeks, 60% were still visible and deformed but surrounded by bone. Light microscopy revealed a low grade inflammatory reaction. Expression of Tn-c and cFn was intense throughout the study. Shear strength decreased gradually and was not measurable after 16 weeks. Crystallinity increased steadily from 1.5 to 29.30% and molecular weight decreased from 49,000 to 4186. In CT, the final bony defect was smaller in the reconstructed sides than in the controls. Based on this study it can be concluded that PLDLA96 implant provokes a local inflammation, which does not prevent bone healing. The deformation of the implant, however, indicates that this PLDLA96 plate is not suitable for orbital floor reconstruction.

  13. Duchenne or Becker muscular dystrophy: A clinical, genetic and immunohistochemical study in China

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    Qian Wang

    2011-01-01

    Full Text Available Background and Objective: Duchenne and Becker muscular dystrophies are X-linked diseases caused by mutations in the dystrophin gene, which affect approximately 1 in 3,500 and 1 in 18,000 boys, respectively. The aim of this work was to develop a method to assist the diagnosis and classification of the disease. Materials and Methods: A large data set of dystrophin mutations was detected in 167 Chinese patients by multiplex ligation-dependent probe amplification and sequencing. Muscle biopsy, immunohistochemistry and STR analysis were also carried out in the patients and carriers. Results: One hundred and three deletions, 23 duplications and two-point mutations. The deletion of one or more exons was detected in 103 (61.7% patients. The region spanning exons 44-55 was the most frequent deletion. The duplication was identified in 23 (13.8% patients, which was more common than previously reported. Most duplications were found in exons 2-18. Six out of the 45 muscle biopsies analyzed showed the presence of other muscle diseases. Conclusions: This study may be important to enable comparisons of mutation type and the most appropriate analytical approach for samples from different geographical areas and ethnicities.

  14. A New Cell Block Method for Multiple Immunohistochemical Analysis of Circulating Tumor Cells in Patients with Liver Cancer

    Science.gov (United States)

    Nam, Soo Jeong; Yeo, Hyun Yang; Chang, Hee Jin; Kim, Bo Hyun; Hong, Eun Kyung; Park, Joong-Won

    2016-01-01

    Purpose We developed a new method of detecting circulating tumor cells (CTCs) in liver cancer patients by constructing cell blocks from peripheral blood cells, including CTCs, followed by multiple immunohistochemical analysis. Materials and Methods Cell blockswere constructed from the nucleated cell pellets of peripheral blood afterremoval of red blood cells. The blood cell blocks were obtained from 29 patients with liver cancer, and from healthy donor blood spikedwith seven cell lines. The cell blocks and corresponding tumor tissues were immunostained with antibodies to seven markers: cytokeratin (CK), epithelial cell adhesion molecule (EpCAM), epithelial membrane antigen (EMA), CK18, α-fetoprotein (AFP), Glypican 3, and HepPar1. Results The average recovery rate of spiked SW620 cells from blood cell blocks was 91%. CTCs were detected in 14 out of 29 patients (48.3%); 11/23 hepatocellular carcinomas (HCC), 1/2 cholangiocarcinomas (CC), 1/1 combined HCC-CC, and 1/3 metastatic cancers. CTCs from 14 patients were positive for EpCAM (57.1%), EMA (42.9%), AFP (21.4%), CK18 (14.3%), Gypican3 and CK (7.1%, each), and HepPar1 (0%). Patients with HCC expressed EpCAM, EMA, CK18, and AFP in tissue and/or CTCs, whereas CK, HepPar1, and Glypican3 were expressed only in tissue. Only EMA was significantly associated with the expressions in CTC and tissue. CTC detection was associated with higher T stage and portal vein invasion in HCC patients. Conclusion This cell block method allows cytologic detection and multiple immunohistochemical analysis of CTCs. Our results show that tissue biomarkers of HCC may not be useful for the detection of CTC. EpCAM could be a candidate marker for CTCs in patients with HCC. PMID:27034142

  15. Immunohistochemical classification and prognosis of diffuse large B-cell lymphoma in China

    Institute of Scientific and Technical Information of China (English)

    陈燕

    2014-01-01

    Objective To study the immunohistochemical classification and prognosis of diffuse large B-cell lymphoma(DLBCL).Methods A total of 148 cases of DLBCL were classified into germinal center B-cell-like(GCB)and non-GCB/activated B-cell-like(ABC)subtypes by Hans,Choi and Tally immunohistochemical stain algorithms.The clinical features and survival data of GCB

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

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    Greenlee Justin J

    2011-09-01

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

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

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    Piotr Siermontowski

    2015-12-01

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

  18. A Simple Method for Immunohistochemical Staining of Zebrafish Brain Sections for c-fos Protein Expression.

    Science.gov (United States)

    Chatterjee, Diptendu; Tran, Steven; Shams, Soaleha; Gerlai, Robert

    2015-12-01

    Immediate early genes (IEGs) are transcription factors whose own transcription is initiated rapidly, for example, in the brain in response to environmental stimuli. c-fos is an IEG often used as a marker of neuronal activation. c-fos mRNA expression has started to be quantified and localized in the zebrafish brain following environmental manipulations but analysis of the expression of c-fos protein in the zebrafish brain has rarely been attempted. Here, we describe an immunofluorescence staining method for quantifying c-fos protein expression in different regions of the zebrafish brain. In addition, we expose zebrafish to caffeine, a positive control for c-fos activation in the brain. To confirm cell nucleus specific binding of the c-fos antibody, we counterstained brain sections with the nuclear fluorescent stain DAPI. Furthermore, we describe a method for reducing background autofluorescence often observed in zebrafish brain tissue. Our analysis showed that exposure to caffeine increased the number of c-fos protein-positive cells in specific zebrafish brain regions detected by the immunofluorescence method. Our results demonstrate the feasibility of immunofluorescence-based methods in the analysis of neuronal activation in the zebrafish brain, and reinforce the utility of the zebrafish in behavioral neuroscience research.

  19. Clinical, histologic, and immunohistochemical characterization of wart-like lesions on the paw pads of dogs: 24 cases (2000-2007).

    Science.gov (United States)

    Balara, Jason M; McCarthy, Robert J; Kiupel, Matti; Buote, Melanie A; Wise, Annabel G; Maes, Roger K

    2009-06-15

    OBJECTIVE- To determine clinical, histologic, and immunohistochemical findings for dogs with wart-like lesions involving the paw pads. DESIGN- Retrospective case series. ANIMALS- 24 dogs (18 Greyhounds and 6 dogs of other breeds). PROCEDURES- Medical records were reviewed for information on signalment, physical examination findings, concurrent disease processes, location of all lesions, and, when available, results of histologic examination of biopsy specimens. Available biopsy specimens (n = 11) were submitted for immunohistochemical staining and a PCR assay to identify viral inclusion bodies. RESULTS- In Greyhounds, most lesions involved the pads of the third and fourth digits, had a consistent histologic appearance without evidence of inflammation, were negative for papillomavirus, and had an unsatisfactory response to treatment. In other breeds, lesions often involved the pads of non-weight-bearing digits, had histologic evidence of inflammation, were positive for papillomavirus, and responded to surgical treatment. CONCLUSIONS AND CLINICAL RELEVANCE- Results suggested that wart-like lesions involving the paw pads of Greyhounds were a distinct clinical entity with features resembling porokeratosis plantaris discreta in humans. In Greyhounds, these lesions were not associated with an underlying viral etiology and, therefore, should not be considered plantar warts. Alternative treatments should be investigated because current treatments were generally unsuccessful in Greyhounds. Wart-like lesions of the paw pads in other breeds were often associated with papillomavirus, and surgical excision appeared curative.

  20. Determination of optimal rehydration, fixation and staining methods for histological and immunohistochemical analysis of mummified soft tissues.

    Science.gov (United States)

    Mekota, A-M; Vermehren, M

    2005-01-01

    During an excavation headed by the German Institute for Archaeology, Cairo, at the tombs of the nobles in Thebes-West, Upper Egypt, three types of tissues from different mummies were sampled to compare 13 well known rehydration methods for mummified tissue with three newly developed methods. Furthermore, three fixatives were tested with each of the rehydration fluids. Meniscus (fibrocartilage), skin, and a placenta were used for this study. The rehydration and fixation procedures were uniform for all methods. The stains used were standard hematoxylin and eosin, elastica van Gieson, periodic acid-Schiff, and Grocott, and five commercially obtained immunohistochemical stains including pancytokeratin, vimentin, alpha-smooth-muscle-actin, basement membrane collagen type IV, and S-100 protein. The sections were examined by transmitted light microscopy. Our study showed that preservation of the tissue is dependent on the quality and effectiveness of the combination of the rehydration and fixation solutions, and that the quality of the histological and histochemical stains is dependent on the tissue quality. In addition, preservation of the antigens in the tissues is dependent on tissue quality, and fungal permeation had no influence on the tissue. Finally, the results are tissue specific. For placenta the best solution combination was Sandison and solution III (both fixed with formaldehyde) while results for skin were best with Ruffer I (using formaldehyde and Schaffer as fixatives), Grupe et al. (using formaldehyde as a fixative) and solution III (in combination with formaldehyde and Bouin fixatives). Ruffer II (using formaldehyde as a fixative) and solution III (in combination with Schaffer fixative) gave the best results for fibrocartilage.

  1. Immunohistochemically detected p53 mutations in epithelial tumors and results of treatment with chemotherapy and radiotherapy. A treatment-specific overview of the clinical data

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    Thames, H.D. [University of Texas, Houston, TX (United States); Petersen, C.; Baumann, M. [University Hospital Dresden (Germany); Petersen, S. [Hospital Dresden-Friedrichstadt (Germany); Nieder, C. [Klinikum rechts der Isar, Munich (Germany)

    2002-08-01

    Background: The aim was to ascertain whether many hundreds of clinical reports over the last decade are consistent with the prediction of a poorer outcome in cancer patients with p53 abnormalities treated with cytotoxic drugs and radiation. Material and method: There are 301 studies on the influence of p53 overexpression published through summer 2000, in which chemotherapy or radiotherapy was used alone or in combination with surgery. From 45 reports meeting stringent selection rules, comparison groups are identified in whom the same measure of outcome was reported for the same treatment applied to the same tumor, with results corrected for important prognostic factors. Metaanalysis techniques are then applied to the comparison groups. Attention was limited to reports using immunohistochemical techniques, to form comparison groups of sufficient size. Results: Four comparison groups were identified by treatment and endpoint: (1) Stage-I-III breast cancer (surgery and chemotherapy, disease-free survival, seven studies); (2) stage I-III breast cancer (surgery and chemotherapy, overall survival, six studies); (3) stage II-IV head and neck cancer (radiotherapy and chemotherapy, overall survival, five studies); (4) FIGO I-IV ovarian cancer (surgery and chemotherapy, overall survival, six studies). In the breast (disease-free survival) and ovarian (overall survival) comparison groups, the hazard ratio for a deleterious effect of p53 overexpression was significant or marginally significant, depending on assumed ranges for unreported hazard ratios in non-significant studies. Conclusions: Despite the many caveats related to metaanalysis applied to retrospective data, high variability of immunohistochemical technique, etc., a nearly significant negative effect of p53 overexpression on outcome of treatment with cytotoxic drugs and radiation emerges in the few studies where heterogeneity can be sufficiently reduced or accounted for. (orig.) [German] Hintergrund: Es sollte

  2. Primary extra-cranial meningioma of head and neck: clinical, histopathological and immunohistochemical study of three cases.

    Science.gov (United States)

    Possanzini, P; Pipolo, C; Romagnoli, S; Falleni, M; Moneghini, L; Braidotti, P; Salvatori, P; Paradisi, S; Felisati, G

    2012-10-01

    Extracranial meningiomas of the head and neck region are rare neoplasms, the majority being a secondary location of a primary intracranial tumour. We herewith report three rare cases of extracranial meningiomas, located in the temporal muscle, parotid gland and nasal cavity, together with complete pathological, immunohistochemical and ultrastructural studies. Prognosis of this tumour is generally excellent. Surgical excision is the treatment of choice, with no need for further treatment; nevertheless, differential diagnosis must consider other more common tumours of the head and neck and be based on histopathologic examination and relative techniques, including examination of frozen sections. This procedure is particularly useful assessing surgical treatment and should be performed whenever possible to exclude the malignant nature of the lesion and avoid over-treatment. All three patients underwent surgery and are alive and disease-free.

  3. Vulnerability of the clinical method

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    José Carlos Hernández Aragonés

    2010-12-01

    Full Text Available This article is aimed at outlining the general aspects that undermine the use of the clinical method in everyday medical practice and also at exposing those that cause a negative effect on the use of the various steps leading to the correct diagnosis and treatment of a patient. A presentation is made on the issues and situations that may contribute not to take into account the clinical method and the requirements for its implementation. Finally, it is concluded that the importance and appropriate management of the clinical method is not still widely known and that the decline of the doctor-patient relationship is a key element that hinders its application.

  4. Annular Lichenoid Dermatitis (of Youth) Immunohistochemical and Serological Evidence for Another Clinical Presentation of Borrelia Infection in Patients of Western Austria.

    Science.gov (United States)

    Wilk, Michael; Zelger, Bettina G; Emberger, Michael; Zelger, Bernhard

    2017-03-01

    Annular lichenoid dermatitis of youth (ALDY) is a more recently described inflammatory disease of the skin of unknown etiology with clinical similarities to morphea. The authors clinically, histopathologically, and immunohistochemically investigated 14 biopsies from 12 patients in western Austria with this disease. There were 6 female and 6 male patients with solitary (n = 7) and multiple lesions (n = 5) affecting the trunk (n = 11), upper arm (n = 2), thigh (n = 1), and calf (n = 1). Clinically, early lesions were erythematous in nature leading to central paleness, scaling, wrinkling, dermal atrophy, slight pigmentation, and telangiectasia later on. Histopathologically, all specimens showed the typical features of ALDY with a superficial lichenoid process with sprinkling of lymphocytes along the basal cell layer and within the epidermis accompanied by mild fibrosis. Pigment incontinence, superficial fibrosis, and dilatation of superficial capillary vessels are prominent features in more advanced stages of disease. Immunohistologically, using a polyclonal antibody against Borrelia, 11/14 specimens revealed spirochetes, either vital (n = 4) or degenerated (n = 7), in close proximity to collagen bundles. Thirteen of 14 specimens in addition showed focal (n = 4) or clustered (n = 9) positivity for CD20 in the papillary dermis. Nine of 12 sera tested for Borrelia with an enzyme-linked immunosorbent assay were positive. Lichen sclerosus et atrophicus and morphea have previously been reported to be possibly related to Borrelia infection. We postulate that a similar relationship to Borrelia infection may be true for ALDY implying that ALDY may be an early superficial stage of morphea.

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

    Institute of Scientific and Technical Information of China (English)

    禹亚丽

    2014-01-01

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

  6. Immunohistochemical profiling of caspase signaling pathways predicts clinical response to chemotherapy in primary nodal diffuse large B-cell lymphomas.

    NARCIS (Netherlands)

    Muris, J.J.; Cillessen, S.A.; Vos, W.; Houdt, I.S. van; Kummer, J.A.; Krieken, J.H.J.M. van; Jiwa, N.M.; Jansen, P.A.M.; Kluin-Nelemans, H.C.; Ossenkoppele, G.J.; Gundy, C.; Meijer, C.J.M.; Oudejans, J.J.

    2005-01-01

    We used biopsy specimens of primary nodal diffuse large B-cell lymphoma (DLBCL) to investigate whether the inhibition of caspase 8 and/or 9 apoptosis signaling pathways predicts clinical outcome. Expression levels of cellular FLICE inhibitory protein (c-Flip) and numbers of active caspase 3-positive

  7. Immunohistochemical profiling of caspase signaling pathways predicts clinical response to chemotherapy in primary nodal diffuse large B-cell lymphomas

    NARCIS (Netherlands)

    Muris, JJF; Cillessen, SAGM; Vos, W; van Houdt, IS; Kummer, JA; van Krieken, JHJM; Jiwa, NM; Jansen, PM; Kluin-Nelemans, HC; Ossenkoppele, GJ; Gundy, C; Meijer, CJLM; Oudejans, JJ

    2005-01-01

    We used biopsy specimens of primary nodal diffuse large B-cell lymphoma (DLBCL) to investigate whether the inhibition of caspase 8 and/or 9 apoplosis signaling pathways predicts clinical outcome. Expression levels of cellular FLICE inhibitory protein (c-Flip) and numbers of active caspase 3-positive

  8. The Clinical Method and the Clinical Dilemmas.

    Directory of Open Access Journals (Sweden)

    Luis Alberto Corona Martinez

    2011-10-01

    Full Text Available The term ‘’clinic’’, among other meanings, refers to any information that suggests the presence of an illness and is obtained through questioning and physical examination processes that take place in the course of doctor-patient relationship. The purpose of this article is to summarize the challenges and dilemmas to be considered by students and young doctors in the patient's clinical approach, which completes the vision of the unquestionable positive role of clinical medical diagnosis. Different factors that can diminish the quality of obtained clinical information, thus interfering with the diagnostic process, have been classified into four groups: dependent on disease process, dependent on the individual patient or the source of information, dependent on the setting where information was obtained and dependent on the physician. As a generalization we state that the existence of the so-called challenges or dilemmas in clinical approach imply limitations to the clinical information obtained to be used with total reliability. Nevertheless, these dilemmas do not detract, nor even slightly, the values of clinical approach in the diagnostic process.

  9. Lack of relationship between EGFR-1 immunohistochemical expression and prognosis in a multicentre clinical trial of 93 patients with advanced primary ovarian epithelial cancer (GINECO group).

    Science.gov (United States)

    Elie, C; Geay, J F; Morcos, M; Le Tourneau, A; Girre, V; Broët, P; Marmey, B; Chauvenet, L; Audouin, J; Pujade-Lauraine, E; Camilleri-Broët, S

    2004-08-02

    Epidermal growth factor receptor 1 (EGFR-1) overexpression is usually described as linked with a worse prognosis in a variety of tumours of epithelial origin. However, its role in ovarian cancer is still controversial. The aim of the present study was to analyse the prognostic impact of EGFR-1 in a retrospective series of 93 stage III-IV primary ovarian epithelial tumours. All patients, enrolled in a multicentre GINECO prospective clinical trial, were treated with the same platinum-based combination chemotherapy, and were followed up with a median of 69 months. Epidermal growth factor receptor 1 plasma membrane expression, assessed by immunohistochemistry on paraffin-embedded tissues, was correlated with clinical parameters as well as immunohistochemical expression results of HER-2 (c-erbB-2), BAX, BCL-2, p53 and anti-Ki-67, previously studied in the same series of patients. Positive immunostaining for EGFR-1 was seen in 31 of the 93 analysed cases (33%). No correlation was found between EGFR-1 expression and clinical parameters. No correlation was found between EGFR-1 expression and other biological markers, except for HER-2, which was limit for significance. Indeed, among the EGFR-1-negative cases, 10.3% expressed HER-2, whereas the HER-2-expressing tumours accounted for 27.6% of EGFR-1-positive cases (P=0.06). Epidermal growth factor receptor 1 overexpression had no prognostic impact on both overall and progression-free survival through univariate and multivariate analyses. The potential effect of EGFR-1 and HER-2 co-expression on targeted therapy against EGFR-1 and/or HER-2 molecules has to be further analysed.

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

    Directory of Open Access Journals (Sweden)

    S.L.G. Antunes

    2006-08-01

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

  11. Phenotypic and immunohistochemical characterization of sarcoglycanopathies

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    Ana F. B. Ferreira

    2011-01-01

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

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

    DEFF Research Database (Denmark)

    Evensen, O.; Olesen, Niels Jørgen

    1997-01-01

    The influence of the primary antibody, the fixative, and the antigen unmasking technique on the method sensitivity of immunohistochemistry as a method for the identification of viral hemorrhagic septicemia (VHS) virus in paraffin-embedded specimens of naturally infected rainbow trout (Oncorhynchus...... was performed an formalin-, PLP-, and Bouin's fluid-fixed specimens. The presence of virus peptides in situ or N-protein in the artificial antigen substrates was Visualized using an immunohistochemical method based on alkaline phosphatase or peroxidase and one polyclonal and five monoclonal polypeptide......-specific antibodies. VHS virus was identified in situ in specimens with high virus titers (10(7-8) TCID50/ml) regardless of the fixative and without the need of an unmasking procedure. A pronounced masking effect was observed for the cross-linking formalin and PLP fixatives. Regardless of the primary antibodies used...

  13. Association of nucleophosmin/B23 with bladder cancer recurrence based on immunohistochemical assessment in clinical samples

    Institute of Scientific and Technical Information of China (English)

    Ke-hung TSUI; Homg-heng JUANG; Tsong-hai LEE; Phei-lang CHANG; Chien-lun CHEN; Benjamin Yat-ming YUNG

    2008-01-01

    Aim:To investigate the possible correlation of nucleophosmin/B23 expression with bladder carcinoma recurrence.Methods:Surgically-resected bladder tumors staged pTa to pT4 were examined for nucleophosmin/B23 expression by immuno-histochemistry.The study group consisted of 132 consecutive patients surgi-cally treated at Chang Gung Memorial Hospital between December 1998 and No-vember 1999.The mean follow up was 72 months (range:48-84 months).Results:Nuclear nucleophosmin/B23 staining was detected in 96% of advanced stage and poorly-differentiated tumors.Higher nucleophosmin/B23 levels were linked to more advanced tumor stages,grades,poor prognosis,and likelihood of recur-rence (P<0.05).The Cox multivariate analysis indicated the nucleophosmin/B23 expression as an independent indicator for tumor recurrence (P=0.009).Conclusion:The results suggest that nucleophosmin/B23 is a favorable prognos-tic indicator for bladder cancer.Nucleophosmin/B23 could be a useful molecular tumor marker for predicting bladder cancer recurrence.

  14. Epithelial ovarian tumors: Clinicopathological correlation and immunohistochemical study

    OpenAIRE

    2015-01-01

    Background: Ovarian cancer is the third leading site of cancer among women, trailing behind cervix and breast cancer. Aim: This study was undertaken to analyze the immunohistochemical (IHC) profile of estrogen receptors (ER), progesterone receptors (PR), Ki-67, and p53 in various ovarian epithelial tumors and attempt correlation with clinical and histopathological findings. Materials and Methods: The present study was conducted over a period of 4 years. A technique of manual tissue ar...

  15. Nemaline myopathy: clinical, histochemical and immunohistochemical features Miopatia nemalínica: achados clínicos, histoquímicos e imuno-histoquímicos

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    Nazah Cherif Mohamad Youssef

    2009-09-01

    Full Text Available Nemaline myopathy (NM is a congenital disease that leads to hypotonia and feeding difficulties in neonates. Some cases have a more benign course, with skeletal abnormalities later in life. We analyzed a series of eight patients with NM obtained from a retrospective analysis of 4300 muscle biopsies. Patients were classified as having the typical form in five cases, intermediate form in two cases and severe form in one case. Histochemical analysis showed mixed rods distribution in all cases and predominance of type I fibers in five cases. Immunohistochemical analysis showed abnormal nebulin expression in all patients (four heterogeneous and four absent, homogeneous desmin expression in four cases, strongly positive in three and absent in one, fast myosin expression in a mosaic pattern in six cases and absent in two cases. There was no specific relation between these protein expression patterns and the clinical forms of NM.Miopatia nemalínica (NM é uma doença congênita que leva a hipotonia e dificuldade de sugar em neonatos. Alguns casos possuem uma evolução benigna, com deformidades ósseas tardias. Nós analisamos uma série de oito pacientes com NM obtidos da análise retrospectiva de 4300 biópsias musculares. Os pacientes foram classificados como forma típica em cinco casos, forma intermediária em dois casos e forma severa em um caso. Análise histoquímica mostrou distribuição mista dos rods em todos os casos e predominância de fibras tipo I em cinco casos. Análise imuno-histoquímica mostrou expressão anormal da nebulina em todos os pacientes (quatro heterogênea e quatro ausente, expressão homogenea da desmina em quatro casos, fortemente positiva em tres e ausente em um, expressão da miosina (rápida com padrão em mosaico em seis casos e ausente em dois casos. Não há relação específica entre a expressão destas proteínas e as formas clínicas da NM.

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

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    Xinyun WANG

    2010-02-01

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

  17. Eruptive dermal clear cell desmo-plastic mesenchymal tumors with perivascular myoid differentiation in a young boy. A clinical, histopathologic, immunohistochemical and electron microscopy study of 17 lesions.

    Science.gov (United States)

    Tomasini, Carlo; Metze, Dieter; Osella-Abate, Simona; Novelli, Mauro; Kutzner, Heinz

    2014-02-01

    Clear cell tumors of the skin are observed in a wide variety of benign and malignant conditions with different histogenesis, sharing the presence of cells with abundant clear cytoplasm. Herein, we report the clinicopathologic features of a healthy young patient affected by asymptomatic, eruptive and disseminated, benign clear cell dermal tumors since early infancy. Neither family history nor genetic testing and counseling provided further useful information. The lesions were mostly confined to the face and lower left extremity with pink teleangiectatic papules and small nodules. Over a 4-year period, a total of 16 different cutaneous lesions were biopsied and histopathologic and immunohistochemical studies carried out; an additional lesion was also removed for electron microscopy examination. Histopathology evidenced multiple perivascular growths of spindle to oval and round cells intermingled with clear/granular cells throughout the dermis, with prominent desmoplasia and numerous capillary-like vessels with focal hemangiopericytoma-like features. Immunohistochemical neoplastic cells were uniformly positive for h-caldesmon and focally smooth muscle α-actin and CD13 indicating myoid differentiation whereas the consistent diffuse cytoplasmic staining for lysosome antigen, such as CD68PG-M1 and NKI/C3 along with the ultrastructural findings supported the view of a lysosome-mediated apoptotic process. The differential diagnosis with other clear cell cutaneous neoplasms is discussed.

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

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    Jane Rocha Duarte Cintra

    2012-04-01

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

  19. 四项免疫组化标志物在诊断甲状腺乳头状癌中的临床探讨%The Clinical Application of Diagnosing Papillary Thyroid Carcinoma by Four Items Immunohistochemical Markers

    Institute of Scientific and Technical Information of China (English)

    陈桂军; 董征

    2015-01-01

    Objective To approach expression of diagnosing papillary thyroid carcinoma by four items immunohistochemical markers.Method The 50 cases clinical data of papillary thyroid carcinoma patients in the center hospita of jinzhoul from February 2010 to March 2014, which was detection group. the benign thyroid nodules 200 cases were selected, which was to be control group.Result The Ki67, TTF-1, HBME-1 and HER-2/neu positive rate dection group were higher than control group,P<0.05, the difference statistical signiifcance. The sensitivity of the diagnosis of thyroid papillary carcinoma of HER-2/neu was 92%, speciifcity of TTF-1 was 96%.Conclusion Thyroid papillary carcinoma accuracy of HER-2/neu and TTF-1 are improved, which is to be used.%目的:探讨四项免疫组化标志物在诊断甲状腺乳头状癌中的表达情况。方法分析锦州市中心医院2010年2月至2014年3月收治的甲状腺乳头状癌患者50例临床资料,作为观察组,选取同期良性甲状腺结节患者200例作为对照组。结果观察组Ki67、TTF-1、HBME-1和HER-2/neu阳性率明显高于对照组,P<0.05,差异均有统计学意义。HER-2/neu诊断甲状腺乳头状癌的敏感性最高92%, TTF-1特异性最高96%。结论 HER-2/neu联合TTF-1可能明显的提高诊断甲状腺乳头状癌准确率,值得临床推广应用。

  20. Optimization and staining characteristic of immunohistochemical methods in detecting isocitrate dehydrogenase-1 mutations in human gliomas%免疫组化染色检测脑胶质瘤IDH1的优化及染色特点

    Institute of Scientific and Technical Information of China (English)

    黎相照; 薛小磊; 张中满; 张颖芬; 丁彦青; 韩慧霞

    2016-01-01

    Objective To compare the advantages and disadvantages of different immunohistochemical methods in detecting isocitrate dehydrogenase-1 (IDH 1) mutations in gliomas,and to optimize the processes these detection.Methods One hundred and thirty-eighty glioma specimens,collected and conformed by pathology in our hospital from January 2013 to December 2013,were used in our study,including 18 of WHO grade Ⅰ,49 of WHO grade Ⅱ,24 of WHO grade Ⅲ and 47 of WHO grade Ⅳ.Manual immunohistochemical method and automatic immunohistochemical instrument were used to detect the IDH1 mutation.PCR-high resolution melting curve analysis (PCR-HRM) was used to verify the above results.Results There were 65.9% positive specimens those had IDH1 positive tumor cells higher than 75%,and 70.7% positive specimens those were strong staining.Manual immunohistochemical method enjoyed advantages as clean background,clearness and easy reading,and no interpretation difficulty or false-positive result were noted with this method;while automatic immunohistochemical instrument enjoyed dark background,which led to interpretation difficulty or false-positive result;the results of IDH1 staining had significant differences between and automatic immunohistochemical instrument (x2=22.042,P=0.000).The positive detection rate of automatic immunohistochemical instrument was significantly higher than that of manual immunohistochemical method,and the results of IDH1 detection had no significant difference between manual immunohistochemical method and PCR-HRM (x2=0.800,P=0.371).Conclusions The results of IDH1 detection by manual immunohistochemical method are more accurate than that of immunohistochemical instrument.IDH1 gene mutation only has a relationship with the number of positive tumor cells,and not the staining intensity.The specimen can be considered to IDH1 gene mutation when the positive cells are more than 5%.%目的 比较胶质瘤中异柠檬酸脱氢酶-1(IDH1)不同检测方法的优

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

    Directory of Open Access Journals (Sweden)

    Roberto Hernández Hernández

    2010-12-01

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

  2. Luz intensa pulsada no fotoenvelhecimento: avaliação clínica, histopatológica e imuno-histoquímica Intense pulsed light in photoaging: a clinical, histopathological and immunohistochemical evaluation

    Directory of Open Access Journals (Sweden)

    Régia Celli Ribeiro Patriota

    2011-12-01

    Full Text Available FUNDAMENTOS: A luz intensa pulsada tem sido muito utilizada no tratamento do fotoenvelhecimento sem completo conhecimento de seu mecanismo de ação. OBJETIVO: Estudar a ação da luz intensa pulsada no fotoenvelhecimento e na resposta imunológica cutânea por meio de estudo clínico, histopatológico, avaliando células de Langerhans (CD1, expressão da molécula de adesão intercelular, de linfócitos CD4 e CD8 e quantificação de colágeno e fibras elásticas. MÉTODOS: Um total de 26 pacientes, com idades entre 40 e 65 anos, com fototipos II a III de Fitzpatrick, foram tratadas do fotoenvelhecimento usando LIP, em 5 sessões, com intervalo mensal, durante o ano de 2006. Todas as pacientes foram submetidas à avaliação histológica e imuno-histoquímica 6 meses após o tratamento. RESULTADOS: Ao término do tratamento, houve melhora clínica em 76,92% dos casos, estando relacionada ao aumento significante de fibras colágenas (51,33% e elásticas (44,13%. O tratamento com luz intensa pulsada promoveu redução de linfócitos CD4 e não alterou a intensidade de linfócitos CD8. Além disso, promoveu aumento significante de pequenos vasos sanguíneos, não ectásicos, molécula de adesão intercelular positivos. CONCLUSÃO: O tratamento facial com luz intensa pulsada promoveu intensa melhora clínica que foi comprovada pelo estudo histopatológico da pele, constituindo boa opção de tratamento para o fotoenvelhecimento cutâneo, por ser técnica não- ablativa, segura e eficazBACKGROUND: Intense pulsed light has been used in the treatment of photoaging without a full understanding of its mechanism of action. OBJECTIVE: To study the effect of intense pulsed light on photoaging and on the skin immune response by means of a clinical and histopathological study, evaluating Langerhans cells (CD1, expression of intercellular adhesion molecule, of CD4 and CD8 lymphocytes and quantification of collagen and elastic fibers. METHODS: In 2006 a total

  3. Versatility of immunohistochemical reactions: comprehensive survey of detection systems.

    Science.gov (United States)

    Mokrý, J

    1996-01-01

    The field of immunohistochemistry comprises histological methods enabling detection of tissue antigens via specific antibodies. Although all these techniques take an advantage of a large specificity of antibody to a particular tissue antigen there are many different approaches for enhancement and visualization of the signal. The aim of the present review article was to briefly outline the historical milestones that made the rapid progress of this discipline possible and give a comprehensive survey of immunohistochemical methods applicable to biomedical research. The survey starts with a description of the direct immunohistochemical method and then pays attention to a huge number of indirect methods. For better explanation of principles of individual techniques, the text is accompanied with graphical schemes. The highest attention is given to immunohistochemical methods that are most generally used, i.e. enzyme anti-enzyme complex methods (e.g. Peroxidase Anti-Peroxidase/PAP/ or Alkaline Phosphatase Anti-Alkaline Phosphatase /APAAP/) and methods based on avidin-biotin interactions (Bridged Avidin-Biotin/BRAB/, Avidin-Biotin Complex /ABC/, Labelled Avidin-Biotin/LAB/). Nevertheless, the principles of other immunohistochemical methods like two- or three-step indirect immunohistochemical methods, methods based on protein A-antibody interaction and Hapten Antibody Anti-Hapten method (HAAH), are also thoroughly characterized. Usefulness of each method for a specific utilization, its advantages and disadvantages are mentioned and compared with the latest immunohistochemical techniques, like Multi-Layered Peroxidase-Labelled Antibody (MLP) and water soluble polymer conjugates, e.g. Enhanced Polymer One-Step staining (EPOS) or EnVision. The last paragraphs are devoted to immunohistochemical amplification systems (Catalyzed Signal Amplification/CSA/ and label anti-label) that dramatically increase sensitivity of detection systems and enable to compare sensitivity of

  4. Plantar fibromatosis: an immunohistochemical and ultrastructural study.

    Science.gov (United States)

    de Palma, L; Santucci, A; Gigante, A; Di Giulio, A; Carloni, S

    1999-04-01

    The analogies between plantar fibromatosis and Dupuytren's disease (palmar fibromatosis) are well known. The latter is clinically more frequent and has been the object of extensive immunohistochemical and ultrastructural studies, with a view to investigating its pathogenesis. By contrast, such data on plantar fibromatosis are quite scarce. A histochemical, immunohistochemical, and ultrastructural study was performed on nodule tissue from six patients who were subjected to total fasciectomy for plantar fibromatosis. The study of myofibroblasts revealed features suggestive of their fibroblastic origin and evidenced a cytoskeleton and an extracellular filamentous system that could enable myofibroblasts to generate and exert the intracellular forces that contribute to the contraction of the aponeurosis. These aspects are similar to those observed in Dupuytren's disease and seem to lend support to the theory that the two diseases are expressions of the same disorder.

  5. The Sherlock Holmes method in clinical practice.

    Science.gov (United States)

    Sopeña, B

    2014-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Varuna Sipayya

    2012-01-01

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

  7. Features of immunohistochemical diagnostic of melanocytic tumours

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    Shpon’ka I.S.

    2013-12-01

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

  8. Development and evaluation of one-step rRT-PCR and immunohistochemical methods for detection of Rift Valley fever virus in biosafety level 2 diagnostic laboratories.

    Science.gov (United States)

    Drolet, Barbara S; Weingartl, Hana M; Jiang, Jieyuan; Neufeld, James; Marszal, Peter; Lindsay, Robbin; Miller, Myrna M; Czub, Markus; Wilson, William C

    2012-02-01

    Rift Valley fever virus (RVFV) is a zoonotic insect transmitted virus endemic to Africa and the Arabian Peninsula. Infection causes abortions and high mortality in newborn ruminants. The overall human infection rate is BSL-4 conditions and require inactivation and safety testing for use outside of containment. In this study, antiserum against recombinant RVFV-nucleocapsid (N) was produced to develop an immunohistochemical (IHC) assay which was subsequently evaluated on formalin fixed lamb and calf tissues at BSL-2 laboratory conditions. Antigen was detected by IHC in 79% of rRT-PCR-positive sheep and 70% of rRT-PCR-positive calf tissues tested. Once validated and approved by national regulatory agencies, these assays can be safely produced and distributed to regional diagnostic laboratories, providing capacity for early detection of RVFV in suspected ruminant samples.

  9. IMMUNOHISTOCHEMICAL ANALYSIS OF ORAL MUCOSA LEUKOPLAKIA

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    Yu. G. KOLENKO

    2016-06-01

    Full Text Available In recent years, substantial changes have occurred in the structure of oral mucosa diseases, in particular an increased ratio of precancerous diseases, so that an effective non-invasive detection of any sign of malignancy appears as an urgent and most actual task of dentistry. Aim: To study the proliferative activity of epithelial cells in Ki-67 antigenin patients with leukoplakia of the oral mucosa. Materials and method: A complex clinical and laboratory examination was performed on 155 patients with oral leukoplakia, who addressed the Operative Dentistry Department of the “A.A.Bogomolets” National Medical University of Kiev between 2010 and 2014. All patients have been subjected to a careful clinical examination, which included: dental anamnesis, visual inspection, oral examination and digital palpation of oral mucosa and tongue mucosa, biopsy of leukoplakia lesions for cytological and histological examination. Results: Histological evaluation of the material has been performed according to the WHO (2005 classification of leukoplakia. 10 (14% sites of unaltered mucosa, 10 (14% samples of hyperkeratosis without atypia, 14 (19% biopsy specimens of hyperkeratosis SIN1, 15 (21% – hyperkeratosis SIN2, 10 (14% - SIN3 and 13 (18% cases of squamous cell carcinoma were evidenced. Immunohistochemical investigation evidenced the presence of protein Ki-67 in the nuclei of epithelial cells. In the unmodified epithelium of the oral mucosa, all epithelial cells with stained nuclei are virtually located in the basal layer. Conclusion: Against the general increase of the proliferative activity of epithelial cells with increasing SIN, a characteristic distribution of proliferating cells in the thickness of the epithelium was revealed for each studied group, as follows: in the control group and in leukoplakia without atypia, immunopositive cells are located in the basal layer, in leukoplakia (SIN1, SIN2 and SIN3 – in parabasal position while, in squamous

  10. HPV immunohistochemical testing and cervical dysplasia

    OpenAIRE

    MUREŞAN, DANIEL; Rotar, Ioana Cristina; APOSTOL, SILVANA; COROIU, GEORGIANA; Florin STAMATIAN

    2016-01-01

    Background and aim HPV (Human Papilloma Virus) infection represents a necessary condition for cervical carcinogenesis. The purpose of this study was to evaluate the efficiency of HPV testing using an immunohistochemical staining kit with implications upon both diagnosis and treatment of cervical intraepithelial neoplasia (CIN). Methods Seventy-nine patients and eighty-six controls were enrolled in the study. Each patient had completed a physical examination, gynecological examination with cer...

  11. Nodal diffuse large B-cell lymphomas in children and adolescents: immunohistochemical expression patterns and c-MYC translocation in relation to clinical outcome.

    Science.gov (United States)

    Gualco, Gabriela; Weiss, Lawrence M; Harrington, William J; Bacchi, Carlos E

    2009-12-01

    Diffuse large B-cell lymphoma (DLBCL) is a very infrequent neoplasm in the pediatric age group; therefore there are very few studies on the immunophenotype or genetics of these cases. We studied a series of 16 patients with nodal DLBCL occurring in patients between 10 and 18 years of age. The cases were classified according to the 2008 World Health Organization classification criteria, with application of immunohistochemistry for the detection of CD10, BCL-6, and MUM1 proteins to divide the lymphomas into germinal center and nongerminal center types. In addition, TCL1, BCL-2 expression, and the Ki-67 proliferation index were evaluated by immunohistochemistry, and c-MYC and BCL2 translocations were evaluated by fluorescence in situ hybridization. All these parameters were correlated with clinical features and outcome. Our study revealed that centroblastic morphology and the germinal center type of DLBCL are more prevalent in these young patients (63%), with 37% containing a c-MYC translocation. Only 1 case showed a BCL2 translocation, reflecting a double-hit case with features intermediate between DLBCL and Burkitt lymphoma. We found a higher frequency of BCL-2 expression than previously reported, with no direct influence on the outcome of the disease in univariate or multivariate analysis. The expression of TCL1 has not been specifically studied in nodal pediatric DLBCL before; we found a 31% incidence of TCL1 expression. MUM1 expression was observed in 44% of the cases and these positive cases showed a significant negative impact on clinical outcome. TCL1 is directly and significantly associated with the presence of c-MYC and a high proliferative index. The germinal center and nongerminal center subtypes showed significant differences for both overall survival and disease-free interval. c-MYC translocation was found in 37% of patients, and had a favorable impact on clinical outcome. We conclude that nodal pediatric and adolescent DLBCL are mainly of the germinal

  12. New Methods for Clinical Proteomics in Allergy

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    Zenichiro Kato

    2005-01-01

    Full Text Available Recent genomic studies have revealed many kinds of genetic polymorphisms. Some genetic polymorphisms have a correlation with allergic phenotypes, however there is only a statistical association without a precise molecular mechanism being demonstrated. Analysis of the molecular mechanisms from a proteomic perspective should contribute to a better understanding of diseases and indicate possible therapeutic approaches. Recent advances in identification and characterization of many immunological molecules have led to a shift to profiling research, clinical proteomics, of already known factors. However, analysis of such biomarkers in allergies requires methodological improvements because allergic reactions can be greatly influenced by subtle changes of factors. These subtle changes cannot be detected by conventional techniques such as 2D-PAGE, and the grammar behind the system is not well recognized by conventional proteomics. Examples of innovative methods useful for proteomic approaches to allergies are discussed here ; especially high throughput screening and structural methods for allergy targeting.

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

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

    2013-01-01

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

  14. Postsplenectomy sclerosing extramedullary hematopoietic tumor with unexpected good clinical evolution: morphologic, immunohistochemical, and molecular analysis of one case and review of the literature.

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    Gualco, Gabriela; Ojopi, Elida B P; Chioato, Lucimara; Cordeiro, Danielle Leão; Negretti, Fabio; Bacchi, Carlos E

    2010-05-01

    Sclerosing extramedullary hematopoietic tumor has been described as a rare manifestation of chronic myeloproliferative neoplasm. The lack of knowledge about this entity has caused it to be mistaken for many types of nonhematopoietic and hematopoietic tumors. We present the case of a 71-year-old lady with a long history of primary myelofibrosis, which developed multiple abdominal sclerosing extramedullary hematopoietic tumors with good clinical evolution. Nonchronic myeloid leukemia myeloproliferative neoplasm included a JAK2 mutation as part of the diagnosis algorithm. Particularly, idiopathic myelofibrosis is related with a JAK2 mutation in 50% of the cases with a pejorative prognosis. The absence of JAK2 demonstrated in the paraffin samples of the tumors may be related to the unusual evolution in this particular case. Morphologically differential diagnoses considered in the evaluation of this entity and in our case included sarcomas mainly liposarcoma, anaplastic carcinoma, and Hodgkin lymphoma.

  15. Hepatoid carcinoma of the pancreas with lymphoid stroma: first description of the clinical, morphological, immunohistochemical, and molecular characteristics of an unusual pancreatic carcinoma.

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    Vanoli, Alessandro; Argenti, Francesca; Vinci, Alessio; La Rosa, Stefano; Viglio, Alessandra; Riboni, Roberta; Necchi, Vittorio; Pugliese, Luigi; Sessa, Fausto; Pietrabissa, Andrea; Paulli, Marco

    2015-08-01

    We report a case of tumour in the head of the pancreas observed in a 57-year-old man with a history of worsening jaundice and elevated alpha-fetoprotein (AFP) serum level, who underwent Whipple pancreatoduodenectomy. Histologically, the tumour was predominantly composed of solid sheets of large eosinophilic cells with a prominent lymphoid infiltration without association neither with DNA microsatellite instability nor Epstein-Barr virus infection. The tumour was diffusely and strongly positive for hepatocyte paraffin-1 (Hep Par-1) and glypican-3 leading to the diagnosis of hepatoid carcinoma. Strong cytoplasmic staining for AFP was focally observed. Moreover, tumour cells showed countless cytoplasmic eosinophilic globules immunoreactive for the stress protein p62. A primary hepatocellular carcinoma of the liver was ruled out by careful clinical analysis. Hepatoid carcinoma is an extremely rare pancreatic neoplasm, and here, we describe the first case of such variant associated with lymphoid stroma. The characteristic histologic features and the immunophenotypic profile help in distinguishing this carcinoma from other pancreatic tumours, notably from medullary carcinoma.

  16. Histopathologic and immunohistochemical features of Hashimoto thyroiditis

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    H Kazem Amani

    2011-01-01

    Full Text Available Background: Intrathyroid lymphoid tissue is accrued in Hashimoto thyroiditis (HT. Histologically, this acquired lymphoid tissue bears a close resemblance to mucosa-associated lymphoid tissue (MALT and can evolve to lymphoma. Aim: To demonstrate the morphological, and immunohistochemical profiles of Hashimoto thyroiditis and to ascertain the importance of light chain restriction in distinguishing HT with extensive lymphoplasmacytoid infiltrate from MALT lymphoma. Materials and Methods: We studied histopathologically and immunohistochemically (CD20, CD3, Igk, Igl and cytokeratin 30 cases of HT for evaluation of the lymphoid infiltrate and the presence of lymphoepithelial lesions (LELs. Distinguishing between early thyroid lymphoma and HT was evaluated by light chain restriction. These findings were compared with two cases of primary thyroid lymphoma. Results: The histopathological findings were characteristic of HT. Immunohistochemistry confirmed inconspicuous, rare B-cell LELs as well as a prominent T-lymphocyte population. Testing for light chain restriction showed polyclonal population of plasma cells. The cases of MALT lymphoma had distinct destructive lymphoepithelial lesions, B-cell immunophenotyping and showed kappa light chain restriction in the plasmacytoid population. Conclusions: Hashimoto thyroiditis differs both histopathologically and immunohistochemically from thyroid lymphoma. In suspicious cases, immunohistochemistry could be helpful in reaching a definitive diagnosis.

  17. Differentiation in cutaneous adnexal tumors: Immunohistochemical study

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    Figen BARUT

    2006-09-01

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

  18. 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?

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    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

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

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    Luciana Riacciardi Macedo

    2010-02-01

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

  20. Villoglandular papillary adenocarcinoma of the uterine cervix with immunohistochemical characteristics.

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    Polat, A; Düsmez, D; Pata, O; Aydin, O; Egilmez, R

    2002-09-01

    Villoglandular papillary adenocarcinoma of uterine cervix has been recently described and to date fewer than a hundred cases have been reported in the world literature. Here we present a 38-year-old woman who underwent radical hysterectomy combined bilateral pelvic lymphoadenectomy and after 28 months postoperatively no lymph node metastasis and no evidence of recurrent disease ocurred. Immunohistochemically Ki-67 overexpression was detected in the tumour, with no immunoreactivity with p53, estrogen and progesteron receptors and broadly-reactive human papilloma virus including types 6, 11, 16, 18, 31, 33, 42, 51, 52, 56, and 58. In this paper, clinical, macroscopical, microscopical and immunohistochemical characteristics of this tumour are reviewed.

  1. [Biochemical and immunohistochemical markers of brain injury].

    Science.gov (United States)

    Vajtr, D; Průsa, R; Houst'ava, L; Sámal, F; Kukacka, J; Pachl, J

    2006-07-01

    Proteins released to circulation from affected tissues during primary or secondary trauma brain injury might be used as serum markers of glial or ganglial cells damage (neuron specific enolasis and S100 B protein). Other markers of trauma can be proved as relatively specific of diffuse axonal injury by immunohistochemical detectoin (amyloid prekurzor protein, neuron specific enolasis, glial fibrilar acidic protein and superficial antigen receptor CD 68). Some markers are associated with blood brain barrier damage (matrix metaloproteinases (MMP-2, MMP-9) and synthase of nitric oxide (iNOS)). We aimed in our short communication on biomechanics of developed of trauma, primary or secondary kinds of trauma brain injury and use of trauma brain injury markers for clinical diagnostics and management of patients.

  2. [Application of Delphi method in traditional Chinese medicine clinical research].

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    Bi, Ying-fei; Mao, Jing-yuan

    2012-03-01

    In recent years, Delphi method has been widely applied in traditional Chinese medicine (TCM) clinical research. This article analyzed the present application situation of Delphi method in TCM clinical research, and discussed some problems presented in the choice of evaluation method, classification of observation indexes and selection of survey items. On the basis of present application of Delphi method, the author analyzed the method on questionnaire making, selection of experts, evaluation of observation indexes and selection of survey items. Furthermore, the author summarized the steps of application of Delphi method in TCM clinical research.

  3. EVALUATION OF IMMUNOHISTOCHEMICAL DIAGNOSIS OF RHABDOMYOSARCOMA

    Institute of Scientific and Technical Information of China (English)

    信明军; 施诚仁; 张忠德; 李敏; 陈方; 潘伟华

    2004-01-01

    Objective To evaluate the sensitivity and specificity of regularly used immunohistochemical markers, including Vimentin (Vim), Desmin (Des), Myoglobin (MG), Myosin (MS), Smooth-muscle actin(SMA) and Sarcomeric actin ( Sr-A), in the diagnosis of rhabdomyosarcoma (RMS). Methods After resection, 24 RMSs and other childhood tumor specimens were fixed in 10% neutral-buffered formalin and embeded in paraffin. The immunohistochemical staining was performed by LSAB procedure. Heat-induced epitope retrieval of Des, MS, Sr-A was processed in order to enhence positive rate and positive strength. Results Vim, MG, MS,Des, Sr-A, SMA were arranged in the order of sensitivity from higher to lower. About specificity, Sr-A, Des, SMA,MG, Vim standed in a sequence from higher to lower (the data of MS is insufficient); Des, MG, Sr-A possessed higher experimental efficiency, followed by SMA, Vim in a succession. Conclusion Vim and MG are of the higher sensitivity but lower specificity. On the reverse, Sr-A and Des hold the better specificity but lower sensitivity.So the combination of multiple antibody reactions should be considered to improve the diagnostic ability in poorly differentiated RMS. According to the result of experimental efficiency, we suggest that the combination of Des, MG and Sr-A can make it possible to diagnose the majority of RMS clearly.

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

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

  5. Legal clinic gender sensitive method for law students

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    Petrušić Nevena

    2008-01-01

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

  6. Kinetics methods for clinical epidemiology problems.

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    Corlan, Alexandru Dan; Ross, John

    2015-11-17

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

  7. A microRNA isolation method from clinical samples

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    Sepideh Zununi Vahed

    2016-03-01

    Conclusion: The current isolation method can be applied for most clinical samples including cells, formalin-fixed and paraffin-embedded (FFPE tissues and even body fluids with a wide applicability in molecular biology investigations.

  8. PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA: CLINICOPATHOLOGICAL AND IMMUNOHISTOCHEMICAL PROFILE

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    Kanwardeep Singh

    2016-03-01

    Full Text Available BACKGROUND Primary central nervous system lymphoma (PCNSL is a rare form of extranodal non-Hodgkin lymphoma (NHL confined to the brain, spinal cord and/or eye, occurring in immunocompetent individuals. Histologically, they are diffuse large B-cell lymphomas. Over the last few decades there has been a gradual increase in their incidence. AIM To study the clinical, histopathological and immunohistochemical profile of primary central nervous system lymphoma. SETTING AND DESIGN Retrospective audit of seven cases of PCNSL diagnosed over a period of five years in a tertiary referral hospital of North India. MATERIAL AND METHODS The clinical, radiological and laboratory findings were retrieved from the hospital records. Histopathology slides were reviewed, studied in detail and a panel of immunohistochemical markers comprising of CD3, CD5, CD20, CD10, BCL6, BCL2, MUM1, CD30, EBV (LMP1, Ki-67 and p53 was done on all cases. RESULTS The male to female ratio was 3:4 with a median age of 60 years. The most common form of presentation was neurological deficits and altered sensorium. Imaging showed contrast enhancing, single or multiple, deep seated lesions within the cerebral hemispheres. Histologically, all were high-grade diffuse large B-cell lymphomas showing typical angiocentricity and a median Ki-67 proliferative index of 80%. Based on immunohistochemistry (Hans classifier three cases had germinal centre B-cell (GCB and four had non-germinal centre B-cell (non-GCB phenotype. p53 was expressed in all cases with strong expression in four of them. Four patients died before treatment could be initiated, one received palliative chemo-radiotherapy and two did not follow up after diagnosis. CONCLUSIONS Primary CNS lymphomas are high-grade diffuse large B-cell lymphomas which show high Ki-67 proliferative indices and frequent overexpression of p53. Irrespective of histological subtype, GCB or non-GCB, outcome is uniformly poor. Early and prompt diagnosis is

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

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    MM Chabeli

    2001-09-01

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

  10. Clinicopathological Features and Immunohistochemical Alterations of Keratinocyte Proliferation, Melanocyte Density, Smooth Muscle Hyperplasia and Nerve Fiber Distribution in Becker's Nevus

    Science.gov (United States)

    Sheng, Ping; Cheng, Yun-Long; Cai, Chuan-Chuan; Guo, Wei-Jin; Zhou, Ying; Shi, Ge

    2016-01-01

    Background Although Becker's nevus (BN) is a relatively common disease, the systematic studies of clinicopathological and immunohistochemical results are poorly reported. Objective To investigate the clinicopathological features and immunohistochemical alterations of keratinocyte proliferation, melanocyte density, smooth muscle hyperplasia and nerve fiber distribution in BN. Methods Clinical and pathological data were collected in 60 newly-diagnosed BN cases. Immunohistochemical stain of Ki-67, Melan-A, keratin 15, smooth muscle actin and protein gene product 9.5 was performed in 21 cases. Results The median diagnostic and onset age was 17 and 12 years, respectively. Skin lesions usually appeared on the upper trunk and upper limbs. The pathological features included the rete ridge elongation and fusion and basal hyperpigmentation. Epidermal Ki-67, Melan-A and keratin 15 expression and dermal nerve fiber length were significantly higher in lesional and perilesional skin than in normal skin (p<0.05~0.01), while smooth muscle actin expression was upregulated only in skin lesion (p<0.05). Conclusion Although the clinical diagnosis of BN is often straightforward, histopathology is helpful to differentiate from other pigmentary disorders. The hyperproliferation of keratinocytes, melanocytes, arrector pili muscle and dermal nerve fibers could be involved in the pathogenesis of BN. PMID:27904268

  11. The role of immunohistochemical analysis in the diagnosis of parapsoriasis.

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    Bordignon, Matteo; Belloni-Fortina, Anna; Pigozzi, Barbara; Saponeri, Andrea; Alaibac, Mauro

    2011-02-01

    Parapsoriasis is a chronic dermatosis whose biological distinction from early mycosis fungoides, the most frequent form of cutaneous T-cell lymphoma, is still not clearly defined. Two types of parapsoriasis have been delineated: large-plaque parapsoriasis and small-plaque parapsoriasis. The lack of clinical and histological features, which may allow distinguishing parapsoriasis from early mycosis fungoides has prompted several investigations to assess the role of immunohistochemistry in establishing a conclusive diagnosis of these conditions. However, the additional data obtained by immunohistochemical analysis concerning the CD4/CD8 ratio, the aberrant expression of T-cell antigens and the expression of proliferation markers has not generally helped establish a more definitive diagnosis. This review critically discusses these immunohistochemical markers and their use in diagnosis of parapsoriasis.

  12. Immunohistochemical expression of p16 in lipoblastomas.

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    Cappellesso, Rocco; d'Amore, Emanuele S G; Dall'Igna, Patrizia; Guzzardo, Vincenza; Vassarotto, Elisa; Rugge, Massimo; Alaggio, Rita

    2016-01-01

    Lipoblastoma (LB) is a rare benign adipocytic tumor of childhood occasionally showing histological similarities to myxoid liposarcoma (ML) or well-differentiated liposarcoma (WDL). p16 immunohistochemistry has proved to be useful in distinguishing various types of liposarcomas, in particular WDL from lipoma, with higher sensitivity and specificity than MDM2 and CDK4 immunohistochemistry. In this study, we reported the histologic features of a series of 30 LB with emphasis on the potential diagnostic pitfalls and investigated the immunohistochemical expression of p16. Moreover, p16 immunostaining was performed in 16 liposarcomas (11 WDL and 5 ML), 16 lipomas, and 16 cases of liponecrosis in order to evaluate its usefulness in the differential diagnosis of challenging lesions occurring in older children. Overall, p16 immunostaining was positive in 3 LBs and in 12 out of 16 liposarcomas (10 WDL and 2 ML), with a sensitivity of 75%, a specificity of 90%, a positive predictive value of 80%, and a negative predictive value of 87%. All lipomas were p16 negative, whereas 5 liponecroses were positive. Accounting altogether the benign lesions versus liposarcomas, p16 showed a sensitivity of 75%, a specificity of 87%, a positive predictive value of 60%, and a negative predictive value of 93%. Our data suggest that a negative p16 immunostaining may be helpful in excluding a liposarcoma when occurring in unusual clinical contexts, such as in adolescence or late recurrence. However, such finding should be interpreted with caution since also some liposarcomas lack p16 and occasional LBs are positive.

  13. Gold Nanoparticles and Nanocomposites in Clinical Diagnostics Using Electrochemical Methods

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    Pranjal Chandra

    2013-01-01

    Full Text Available Progress and development in clinical diagnostics certainly focus upon the advances in the nanomaterials, particularly gold nanoparticles (AuNPs that offer promise to solve the biocompatible and sensitive detection systems. This paper focuses on the recent application of AuNPs in clinical diagnosis. Various important methods of AuNPs synthesis and their application in clinical detection of various biomolecules using electrochemical detection methods have been described. AuNPs alone and in various composites are also described based on the various biosensors design recently published for the detection of cancer biomarkers, proteins, bacteria, and cancer cells. The effect of AuNPs type and size in clinical detection has also been briefly illustrated.

  14. Missing data handling methods in medical device clinical trials.

    Science.gov (United States)

    Yan, Xu; Lee, Shiowjen; Li, Ning

    2009-11-01

    One of the major problems in the analysis of clinical trials is missing data caused by patients dropping out before study completion. The issue of missing data can result in biased treatment comparisons and can impact the interpretation of study results. Since the missing data mechanism is unknown and unverifiable in most situations, regulatory agencies often request various sensitivity analyses for handling missing data to evaluate the robustness of study results. This article discusses methods used to handle missing data in medical device clinical trials, focusing on tipping-point analysis as a general approach for the assessment of missing data impact. Tipping points are outcomes that result in a change of study conclusion. Such outcomes can be conveyed to clinical reviewers to determine if they are implausibly unfavorable. The analysis aids clinical reviewers in making judgment regarding treatment effect in the study. Three examples with a reasonably representative range of missing data rate are included to illustrate the methods referred.

  15. Primary lymphoma of the central nervous system: a clinical-pathological and immunohistochemical study of ten autopsy cases Linfoma primário do sistema nervoso central: estudo clínico-patológico e imuno-histoquímico de dez casos de necropsia

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    Henrique Costa

    2006-12-01

    Full Text Available CONTEXT: Primary central nervous system lymphomas (PCNSL are a rare subgroup of lymphomas generally associated with HIV and EBV. OBJECTIVE: To study ten autopsy cases of PCNSL, to describe the neuropathological findings, to characterize the phenotype of the neoplastic cells, to detect EBV in the lesion and to compare the findings with the clinical and laboratory data of the patients. METHOD: The clinical, histological and immunohistochemical data of ten cases of PCNSL, eight cases from patients with AIDS, identified among 265 autopsies of these patients were analyzed. RESULTS: Seven patients were males and the mean age was 40.9 years. The most frequent symptomatology was focal neurologic deficit (70%. Six patients presented with only one lesion. Histologically, densely cellular and polymorphous neoplasms with angiocentrism were observed, in 90% of cases. An association with other diseases was observed in four cases. Most patients had diffuse large B cell non-Hodgkin’s lymphoma. EBV was detected by immunohistochemistry in only one case. The lack of detection of the virus might have been due to the long time of fixation of the brain which might have inactivate epitopes therefore compromising the testing. CONCLUSION: In the present series, PCNSL presented with focal symptoms, with unifocal or multifocal lesions, with a predominant B-cell CD20 positive phenotype, rarely associated with EBV.CONTEXTO: Linfoma primário do sistema nervoso central (LP-SNC é raro subgrupo de linfomas relacionado à AIDS, geralmente associado EBV. OBJETIVO: Identificar os achados clínico-patológicos dos pacientes com LP-SNC. MÉTODO: Foram analisados dados clínicos, histológicos e imuno-histoquímicos de dez necrópsias de LP-SNC, oito deles de pacientes com AIDS, identificados entre 265 autopsias destes. RESULTADOS: Sete pacientes foram masculinos e a idade média foi 40,9 anos. A sintomatologia neurológica mais freqüente era focal (70%. Seis exibiram les

  16. Ingrown toenail: histopathologic and immunohistochemical study.

    Science.gov (United States)

    Fernandez-Flores, Angel; Martínez-Nova, Alfonso; Salgado-Fernandez, Sara

    2009-07-01

    Although ingrown toenail (IT) is a common problem, the morphologic alterations presented in this condition have rarely been presented in literature. We have studied 14 cases from 12 different patients and studied the biopsies of all of them, not only with routine techniques but also with histochemical stains (Masson trichrome, periodic acid-Schiff, and Gram) and with immunohistochemical techniques mindbomb homolog-1 (MIB-1), p63, D2-40, and AE1-AE3). The patients were clinically classified into 4 stages (1, 2a, 2b, and 3). The main changes evidenced were ingrowing of the squamous epithelium (either from the matrix or mostly from the hyponichium) and chronic plasma-cell rich inflammation with prominent vascularization. The intensity of these changes varied depending on the stage: whereas they were mild in stages 1 and 2a, they were prominent in stages 2b and 3. In advanced stages, the epithelial nests showed certain dyskeratosis. The expression of MIB-1 was, nevertheless, only basal and parabasal. p63 was intensively expressed by the epithelial nests. We therefore conclude that (a) IT shows epithelial ingrowing with accompanying granulation tissue; (b) according to the clinical stage of the disease, this pattern can be more or less complex; (c) in advanced stages of IT, the pattern can mimic a well-differentiated squamous cell carcinoma; (d) MIB-1 is not helpful in distinguishing IT from squamous cell carcinoma; (e) the high expression of p63 by the ingrowing epithelium should not be the source of a misdiagnosis of malignancy.

  17. Recognizing Disjoint Clinical Concepts in Clinical Text Using Machine Learning-based Methods

    Science.gov (United States)

    Tang, Buzhou; Chen, Qingcai; Wang, Xiaolong; Wu, Yonghui; Zhang, Yaoyun; Jiang, Min; Wang, Jingqi; Xu, Hua

    2015-01-01

    Clinical concept recognition (CCR) is a fundamental task in clinical natural language processing (NLP) field. Almost all current machine learning-based CCR systems can only recognize clinical concepts of consecutive words (called consecutive clinical concepts, CCCs), but can do nothing about clinical concepts of disjoint words (called disjoint clinical concepts, DCCs), which widely exist in clinical text. In this paper, we proposed two novel types of representations for disjoint clinical concepts, and applied two state-of-the-art machine learning methods to recognizing consecutive and disjoint concepts. Experiments conducted on the 2013 ShARe/CLEF challenge corpus showed that our best system achieved a “strict” F-measure of 0.803 for CCCs, a “strict” F-measure of 0.477 for DCCs, and a “strict” F-measure of 0.783 for all clinical concepts, significantly higher than the baseline systems by 4.2% and 4.1% respectively. PMID:26958258

  18. Immunohistochemical patterns of follicular dendritic cell meshwork and Ki-67 in small B-cell lymphomas

    Institute of Scientific and Technical Information of China (English)

    时云飞

    2013-01-01

    Objective To identify the immunohistochemical patterns of follicular dendritic cell(FDC)meshwork and Ki-67labeling index in small B-cell lymphomas(SBLs) and their significance in differential diagnosis.Methods

  19. A method for encoding clinical datasets with SNOMED CT

    Directory of Open Access Journals (Sweden)

    Quan Hue

    2010-09-01

    Full Text Available Abstract Background Over the past decade there has been a growing body of literature on how the Systematised Nomenclature of Medicine Clinical Terms (SNOMED CT can be implemented and used in different clinical settings. Yet, for those charged with incorporating SNOMED CT into their organisation's clinical applications and vocabulary systems, there are few detailed encoding instructions and examples available to show how this can be done and the issues involved. This paper describes a heuristic method that can be used to encode clinical terms in SNOMED CT and an illustration of how it was applied to encode an existing palliative care dataset. Methods The encoding process involves: identifying input data items; cleaning the data items; encoding the cleaned data items; and exporting the encoded terms as output term sets. Four outputs are produced: the SNOMED CT reference set; interface terminology set; SNOMED CT extension set and unencodeable term set. Results The original palliative care database contained 211 data elements, 145 coded values and 37,248 free text values. We were able to encode ~84% of the terms, another ~8% require further encoding and verification while terms that had a frequency of fewer than five were not encoded (~7%. Conclusions From the pilot, it would seem our SNOMED CT encoding method has the potential to become a general purpose terminology encoding approach that can be used in different clinical systems.

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

    Directory of Open Access Journals (Sweden)

    M Devi

    2014-01-01

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

  1. Cytohistopathological and immunohistochemical correlation of soft tissue tumors

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    J. Chandralekha

    2015-02-01

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

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

    Science.gov (United States)

    Mayer, Susan Jean

    2005-11-01

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    We describe a new method for identification of confident associations within large clinical data sets. The method is a hybrid of two existing methods; Self-Organizing Maps and Association Mining. We utilize Self-Organizing Maps as the initial step to reduce the search space, and then apply...... Association Mining in order to find association rules. We demonstrate that this procedure has a number of advantages compared to traditional Association Mining; it allows for handling numerical variables without a priori binning and is able to generate variable groups which act as “hotspots” for statistically...... significant associations. We showcase the method on infertility-related data from Danish military conscripts. The clinical data we analyzed contained both categorical type questionnaire data and continuous variables generated from biological measurements, including missing values. From this data set, we...

  4. Clinical simulation as an evaluation method in health informatics

    DEFF Research Database (Denmark)

    Jensen, Sanne

    2016-01-01

    Safe work processes and information systems are vital in health care. Methods for design of health IT focusing on patient safety are one of many initiatives trying to prevent adverse events. Possible patient safety hazards need to be investigated before health IT is integrated with local clinical...

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

    Directory of Open Access Journals (Sweden)

    M. Kammoun

    2014-06-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2001-01-01

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

  7. Immunohistochemical studies in equine recurrent uveitis (ERU).

    Science.gov (United States)

    Romeike, A; Brügmann, M; Drommer, W

    1998-11-01

    Despite extensive clinical research, the etiology of equine recurrent uveitis (ERU) is still unknown. After an immunologic pathogenesis was established in recurrent uveitis in humans, a similar pathogenic mechanism was assumed to exist in ERU. To investigate whether immunopathologic mechanisms are involved in ERU, 20 eyes of 15 horses with ERU were examined immunohistochemically with a T cell marker, B cell marker, and anti-major histocompatibility complex (MHC) class II antibodies. Twenty-six eyes of 20 horses were used for investigation of MHC class II antigen expression in normal equine eyes. In 18 eyes of 14 horses, the number of T cells in the inflammatory cell population within the uvea was assessed. In 16/18 eyes (89%), the T lymphocyte fraction was > 70%. This cell population was distributed mostly in a diffuse manner throughout the uvea and also within the mantle zone of follicular lymphocytic aggregates. Foci of B lymphocytes could be found within the center of follicular aggregates in three eyes. The expression of MHC class II antigen on resident ocular cells was evaluated in 10 eyes of six horses with ERU. An increase of MHC class II antigen expression in the trabecular meshwork and on the nonpigmented ciliary epithelium was noted as was a deviant expression on proliferating Müller cells and retinal pigment epithelial cells. The predominance of T cells in the inflammatory infiltrates supports the central role of a cell-mediated immune response. Furthermore, the observation of a deviant MHC class II expression on resident ocular cells suggests that aberrant immune regulation may play a role in the pathogenesis of ERU.

  8. Delineation of Chondroid Lipoma: An Immunohistochemical and Molecular Biological Analysis

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    Ronald S. A. de Vreeze

    2011-01-01

    Full Text Available Aims. Chondroid lipoma (CL is a benign tumor that mimics a variety of soft tissue tumors and is characterized by translocation t(11;16. Here, we analyze CL and its histological mimics. Methods. CL (n=4 was compared to a variety of histological mimics (n=83 for morphological aspects and immunohistochemical features including cyclinD1(CCND1. Using FISH analysis, CCND1 and FUS were investigated as potential translocation partners. Results. All CLs were strongly positive for CCND1. One of 4 myoepitheliomas, CCND1, was positive. In well-differentiated lipomatous tumors and in chondrosarcomas, CCND1 was frequently expressed, but all myxoid liposarcomas were negative. FISH analysis did not give support for direct involvement of CCND1 and FUS as translocation partners. Conclusions. Chondroid lipoma is extremely rare and has several and more prevalent histological mimics. The differential diagnosis of chondroid lipomas can be unraveled using immunohistochemical and molecular support.

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

    LENUS (Irish Health Repository)

    Mylotte, Darren

    2011-01-01

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

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

    LENUS (Irish Health Repository)

    Mylotte, Darren

    2012-02-01

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

  11. Endogenous avidin biotin activity (EABA in thyroid pathology: immunohistochemical study

    Directory of Open Access Journals (Sweden)

    Nikiel Barbara

    2009-04-01

    Full Text Available Abstract Background Immunohistochemical methods based on the high affinity of avidin and biotin (e.g. ABC, LSAB are characterized by high sensitivity and are widely used for detection of immunologic reaction. However, a non-specific reaction, observed in frozen tissues and in paraffin-embedded material, increasing after heat induced epitope retrieval (HIER, and caused either by endogenous biotin or any another chemical compound with high affinity for avidin, may lead to diagnostic mistakes. The aim of our investigation is to study presence of endogenous avidin biotin activity (EABA in thyrocytes originating from various thyroid pathological lesions (neoplastic and non-neoplastic. Materials and methods The immunohistochemical study was performed on paraffin-embedded specimens of surgically resected thyroid tissue from 97 patients with thyroid diseases: 65 patients with papillary carcinoma (PTC, 11 patients with nodular goiter in whom features of benign papillary hyperplasia were found, 9 with lymphocytic thyroiditis (LT, 8 with follicular adenoma, and 4 patients with follicular carcinoma. In PTC immunohistochemical study was performed both in primary tumors and in lymph node metastases. After HIER, incubation with streptavidin from LSAB+ (DakoCytomation kit was done. Results Strong cytoplasmic EABA was observed in 56 of 65 (87.5% PTC and in oxyphilic cells in 8 of 9 cases of LT. Significant correlation between EABA in primary PTC tumor and EABA in lymph node metastases was stated. Normal surrounding thyroid tissues showed absence or weak EABA. Aberrant intranuclear localization of biotin was noted in morules of cribriform-morular variant of PTC. No statistically significant correlation between patient's age, sex, metastases presence and EABA was observed. Conclusion Among thyroid lesions, false positive reactions are highly probable in papillary thyroid carcinoma and in lymphocytic thyroiditis if immunohistochemical detection is used on systems

  12. Automated patient and medication payment method for clinical trials

    Directory of Open Access Journals (Sweden)

    Yawn BP

    2013-01-01

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

  13. Immunohistochemical diagnosis of myocarditis on (infantile) autopsy material: Does it improve the diagnosis?

    Science.gov (United States)

    Grasmeyer, Sarah; Madea, Burkhard

    2015-06-01

    The standard for the histopathologic diagnosis of myocarditis has been the Dallas criteria. Recently, immunohistochemical studies that include the specification and quantification of interstitial inflammatory cells have been proposed as the diagnostic approach for myocarditis. Cut-off limits regarding inflammatory cell numbers for the positive diagnosis of myocarditis have been recommended. However, it is unclear whether these can be applied to postmortem tissues or to infants, as they were established from endomyocardial biopsies and for adults. Nevertheless, cut-off limits for the postmortem diagnosis of myocarditis in the first year of life have been proposed. Studies using these cut-off limits identified myocarditis in a high percentage of presumed sudden infant death syndrome (SIDS) cases. These results were re-evaluated by the present study, which examined heart specimens from infants less than 1 year of age. The study had a test group of 92 SIDS cases and a control group of 15. Myocardial tissue was examined from eight standardized locations, stained with hematoxylin-eosin and for three different immunohistochemical reagents (LCA for leukocytes, CD68 for macrophages, CD45-RO for T-lymphocytes). Histopathological assessment of the number of inflammatory cells was carried out on an aggregate of 80 mm(2) of myocardial tissue per case. Myocarditis, based on the Dallas criteria, was histologically diagnosed in only two cases. Immunohistochemical quantification revealed elevated cell counts in the SIDS group for LCA and CD45-RO. However, those differences were neither statistically significant nor clinically relevant as the mean cell counts per mm(2) were low. The density of inflammatory cells differed considerably from section to section and even within single sections. Therefore the commonly used arithmetic mean value was not diagnostically relevant, suggesting cut-off values based on the arithmetic mean value as recommended in the literature, cannot be regarded

  14. CLINICAL APPLICATION OF LIDUI (ST 45) BLEEDING METHOD

    Institute of Scientific and Technical Information of China (English)

    李春研; 王军

    2004-01-01

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

  15. Helicobacter pylori in Cholecystectomy Specimens-Morphological and Immunohistochemical Assessment

    Science.gov (United States)

    Reddy, Venkatarami; Jena, Amitabh; Gavini, Siva; Thota, Asha; Nandyala, Rukamangadha; Chowhan, Amit Kumar

    2016-01-01

    Introduction Helicobacter pylori (H.pylori) is associated with gastritis, peptic ulcer, gastric carcinoma and gastric lymphoma. Current literature describes presence of H.pylori in various extra-gastric locations and its association with many diseases. Apart from the conventional location of gastric and duodenal mucosa, H.pylori have been isolated and cultured from gallbladder. Aim Analysis of cholecystectomy specimens to detect H.pylori by means of immunohistochemical staining. Materials and Methods There were a total of 118 cholecystectomy specimens received in the Department of Pathology in three months duration. We have performed immunostaining for H.pylori in 45 consecutive cases of cholecystectomy specimen. Clinical and other investigational information were retrieved from the medical records department. For each case, routine Haematoxylin and Eosin stain was studied. Immunohistochemistry (IHC) was done using purified polyclonal Helicobacter pylori antiserum. Results Majority of the patients had undergone laparoscopic cholecystectomy for the presenting complaint of right hypochondrial pain. Multiple pigmented stones were present in majority (27/45) of them. Immunostain for H.pylori was positive in ten cases. Six of these cases had pigmented gall stones, two had stones not specified and in two of the cases there were no stones. Conclusion Helicobacter pylori is present in gall bladder and is commonly seen in association with stones. A more detailed study of cholecystectomy cases (both neoplastic and non-neoplastic) with serological, culture and molecular data of H.pylori is desirable to study the pathogenesis of cholecystitis, its association with gall stones and other gall bladder disorders. PMID:27437221

  16. DIAGNOSTIC IMPLICATIONS OF IMMUNOHISTOCHEMICAL MARKERS IN UTERINE SMOOTH MUSCLE TUMORS

    Institute of Scientific and Technical Information of China (English)

    朱雪琼; 石一复; 陈晓端; 吴裕中

    2004-01-01

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

  17. Skin signs in Ehlers-Danlos syndrome: clinical tests and para-clinical methods

    DEFF Research Database (Denmark)

    Remvig, L; Duhn, Ph; Ullman, S

    2010-01-01

    The criteria for Ehlers-Danlos syndrome (EDS) and the hypermobility syndrome (HMS) should be reliable. Examination for general joint hypermobility has high reliability but there is only sparse information on the reliability of skin tests, and no information on the level of normal skin extensibili....... The present study aimed to assess skin signs by means of clinical and para-clinical methods.......The criteria for Ehlers-Danlos syndrome (EDS) and the hypermobility syndrome (HMS) should be reliable. Examination for general joint hypermobility has high reliability but there is only sparse information on the reliability of skin tests, and no information on the level of normal skin extensibility...

  18. The clinical method as a diagnosis method. A critique to a standing conception.

    Directory of Open Access Journals (Sweden)

    Luis Alberto Corona Martínez

    2006-12-01

    Full Text Available The importance of the clinical method in the assistance practice is out of question. In this article, through a systemic point of view and from the medical assistance perspective, it is analyzed how, historically conditioned, the clinical method has been considered up to this moment as a method for medical diagnosis, which limits the fulfillment of the general objective of the medical attention process. That’s why we consider the actual theory an insufficiently developed model for, as a teaching content in the Medicine career; contribute to the learning of the medical attention process.

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

    Directory of Open Access Journals (Sweden)

    El Maged Rabee A

    2007-01-01

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

  20. Skin signs in Ehlers-Danlos syndrome: clinical tests and para-clinical methods

    DEFF Research Database (Denmark)

    Remvig, Lars; Duhn, Ph; Ullman, S;

    2010-01-01

    extensibility. The present study aimed to assess skin signs by means of clinical and para-clinical methods. Methods: A total of 31 EDS patients and 28 healthy controls were examined blinded and in random order. Inter-examiner analysis of clinical tests for skin extensibility, consistency, scarring, and bruising...... demonstrated kappa values of: 0.72 for extensibility, 0.23 for consistency, 0.53 for scarring, and 0.63 for bruising. Skin extensibility measurements in healthy controls (n = 28) were 2.79 and 2.93 cm (mean + 2 SD), respectively, by the two examiners. There were significant differences between patients...... with classical-type EDS and controls with respect to skin extensibility by SC (4.91 vs. 12.52 kPa/mm) and skin consistency by STSM (0.59 vs. 0.76 N). We found no difference in skin thickness. Conclusion: The reproducibility of the clinical skin tests was substantial to good, apart from the consistency...

  1. Diagnostic Methods for Bile Acid Malabsorption in Clinical Practice

    Science.gov (United States)

    Vijayvargiya, Priya; Camilleri, Michael; Shin, Andrea; Saenger, Amy

    2013-01-01

    Altered bile acid (BA) concentrations in the colon may cause diarrhea or constipation. BA malabsorption (BAM) accounts for >25% of patients with irritable bowel syndrome (IBS) with diarrhea and chronic diarrhea in Western countries. As BAM is increasingly recognized, proper diagnostic methods are desired in clinical practice to help direct the most effective treatment course for the chronic bowel dysfunction. This review appraises the methodology, advantages and disadvantages of 4 tools that directly measure BAM: 14C-glycocholate breath and stool test, 75Selenium HomotauroCholic Acid Test (SeHCAT), 7 α-hydroxy-4-cholesten-3-one (C4) and fecal BAs. 14C-glycocholate is a laborious test no longer widely utilized. 75SeHCAT is validated, but not available in the United States. Serum C4 is a simple, accurate method that is applicable to a majority of patients, but requires further clinical validation. Fecal measurements to quantify total and individual fecal BAs are technically cumbersome and not widely available. Regrettably, none of these tests are routinely available in the U.S., and a therapeutic trial with a BA binder is used as a surrogate for diagnosis of BAM. Recent data suggest there is an advantage to studying fecal excretion of the individual BAs and their role in BAM; this may constitute a significant advantage of the fecal BA method over the other tests. Fecal BA test could become a routine addition to fecal fat measurement in patients with unexplained diarrhea. In summary, availability determines the choice of test among C4, SeHCAT and fecal BA; more widespread availability of such tests would enhance clinical management of these patients. PMID:23644387

  2. Expression of immunohistochemical markers in diagnosis of endometrial adenocarcinoma and cervical adenocarcinoma and its clinical significance%免疫组化标记物在子宫内膜样腺癌与宫颈腺癌诊断中的表达及临床意义

    Institute of Scientific and Technical Information of China (English)

    黄敬皓

    2015-01-01

    目的:探讨波形蛋白(Vim)、癌胚抗原(CEA)、雌激素受体(ER)、孕激素受体(PR)和P16蛋白等免疫组化标记物在子宫内膜样腺癌与宫颈腺癌鉴别诊断中的表达,并分析其临床意义。方法选取2013年1月至2014年6月广西壮族自治区妇幼保健院收治的子宫内膜样腺癌(A组)与宫颈腺癌(B组)患者各80例。采用免疫组化法检测Vim、CEA、ER和P16蛋白表达,并比较Vim、CEA、ER三联检测与Vim、CEA、ER和P16蛋白四联检测的各项功能指标。结果 A组的Vim和ER阳性率分别为71.25%、73.75%,均高于B组,差异均有统计学意义(P<0.05);B组的CEA和P16阳性率分别为73.75%、67.50%,均高于A组,差异均有统计学意义(P<0.05)。A组四联检测的特异度、敏感度及准确度分别为92.43%、56.44%、71.21%,B组分别为98.62%、58.57%、74.62%,均分别高于同组三联检测的特异度、敏感度及准确度,比较差异均有统计学意义(P<0.05)。结论子宫内膜样腺癌组织Vim和ER阳性表达较高,宫颈腺癌组织CEA和P16阳性表达较高,p16蛋白联合传统三联检测可以提高子宫内膜样腺癌与宫颈腺癌鉴别诊断的准确性。%Objective To explore the expression of immunohistochemical markers vimentin (Vim) ,carcinoem‐bryonic antigen (CEA) ,estrogen receptor (ER) ,progesterone receptor (PR) and P16 protein in the differential diag‐nosis of endometrioid adenocarcinoma and cervical adenocarcinoma ,and to analyze its clinical significanceMethods 80 cases of endometrioid adenocarcinoma (group A) and 80 cases of cervical adenocarcinoma (group B) in our hospital from Jan .2013 to Jun .21014 were selected .The expression of Vim ,CEA ,ER and P16 protein was measured by the immunohistochemical method .The functional indexes were compared between the 3‐item combined detection of Vim , CEA and ER and the 4

  3. Myeloid sarcomas: a histologic, immunohistochemical, and cytogenetic study

    Directory of Open Access Journals (Sweden)

    Rodgers William H

    2007-10-01

    Full Text Available Abstract Context. - Myeloid sarcoma (MS is a neoplasm of immature granulocytes, monocytes, or both involving any extramedullary site. The correct diagnosis of MS is important for adequate therapy, which is often delayed because of a high misdiagnosis rate. Objective. - To evaluate the lineage differentiation of neoplastic cells in MS by immunohistochemistry, and to correlate the results with clinicopathologic findings and cytogenetic studies. Design. - Histologic and immunohistochemical examinations were performed on formalin-fixed paraffin-embedded tissue samples from 13 cases of MS. They were classified according to the World Health Organization criteria. Chromosomal analysis data were available in 11 cases. Clinical, pathological, and cytogenetic findings were analyzed. Results. - The study included six male and seven female patients with an age range of 25 to 72 years (mean, 49.3 years and a male to female ratio of 1:1.2. MS de novo occurred in 4/13 (31% of cases examined. The most sensitive immunohistochemical markers were CD43 and lysozyme present in all cases with MS (13/13, 100%. All de novo MS showed a normal karyotype, monoblastic differentiation, and lack of CD34. The most common chromosomal abnormalities in MS associated with a hematopoietic disorder were trisomy 8 and inv(16 (2/11, 18%. Conclusion. - An immunohistochemical panel including CD43, lysozyme, myeloperoxidase (MPO, CD68 (or CD163, CD117, CD3 and CD20 can successfully identify the vast majority of MS variants in formalin-fixed paraffin-embedded tissue sections. The present report expands the spectrum of our knowledge showing that de novo MS has frequent monoblastic differentiation and frequently carries a normal karyotype.

  4. Clinical value of isotope methods in adrenal morphology investigations

    Energy Technology Data Exchange (ETDEWEB)

    Jakubowski, W.; Feltynowski, T.; Graban, W. (Akademia Medyczna, Warsaw (Poland))

    1981-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Mani Anand

    2013-01-01

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

  6. Recognizing Disjoint Clinical Concepts in Clinical Text Using Machine Learning-based Methods

    OpenAIRE

    Tang, Buzhou; Chen, Qingcai; Wang, Xiaolong; Wu, Yonghui; Zhang, Yaoyun; Jiang, Min; Wang, Jingqi; Xu, Hua

    2015-01-01

    Clinical concept recognition (CCR) is a fundamental task in clinical natural language processing (NLP) field. Almost all current machine learning-based CCR systems can only recognize clinical concepts of consecutive words (called consecutive clinical concepts, CCCs), but can do nothing about clinical concepts of disjoint words (called disjoint clinical concepts, DCCs), which widely exist in clinical text. In this paper, we proposed two novel types of representations for disjoint clinical conc...

  7. Nerve fibre studies in skin biopsies in peripheral neuropathies. I. Immunohistochemical analysis of neuropeptides in diabetes mellitus

    DEFF Research Database (Denmark)

    Lindberger, M; Schröder, H D; Schultzberg, M

    1989-01-01

    Standardised skin biopsies followed by immunohistochemical examination for the presence of terminal nerve fibres reacting for neuropeptides substance P (SP) and calcitonin gene-related peptide (CGRP) were evaluated. Healthy subjects regularly displayed free nerve endings of both fibre types...... in the dermis layers. Five type I diabetes patients without clinical or neurophysiological evidence of polyneuropathy also had reduced density of both fibre types, being significant for CGRP fibres when compared with controls. Skin biopsy with immunohistochemical staining for neuropeptides may represent...

  8. Yeast identification in the clinical microbiology laboratory: phenotypical methods.

    Science.gov (United States)

    Freydiere, A M; Guinet, R; Boiron, P

    2001-02-01

    Emerging yeast pathogens are favoured by increasing numbers of immunocompromised patients and by certain current medical practices. These yeasts differ in their antifungal drug susceptibilities, and rapid species identification is imperative. A large variety of methods have been developed with the aim of facilitating rapid, accurate yeast identification. Significant recent commercial introductions have included species-specific direct enzymatic colour tests, differential chromogenic isolation plates, direct immunological tests, and enhanced manual and automated biochemical and enzymatic panels. Chromogenic isolation media demonstrate better detection rates of yeasts in mixed cultures than traditional media, and allow the direct identification of Candida albicans by means of colony colour. Comparative evaluation of rapid methods for C. albicans identification, including the germ tube test, shows that chromogenic media may be economically advantageous. Accurate tests for single species include the Bichrolatex Albicans and Krusei Color tests, both immunologically based, as well as the Remel Rapid Trehalose Assimilation Broth for C. glabrata. Among broad-spectrum tests, the RapID Yeast Plus system gives same-day identification of clinical yeasts, but performance depends on inoculum density and geographic isolate source. The API 20 C AUX system is considered a reference method, but newer systems such as Auxacolor and Fungichrom are as accurate and are more convenient. Among automated systems, the ID 32 C strip, the Vitek Yeast Biochemical Card and the Vitek 2 ID-YST system correctly identify >93% of common yeasts, but the ID-YST is the most accurate with uncommon yeasts, including C. dubliniensis. Spectroscopic methods such as Fourier transformed-infrared spectroscopy offer potential advantages for the future. Overall, the advantages of rapid yeast identification methods include relative simplicity and low cost. For all rapid methods, meticulous, standardized

  9. Histological and Immunohistochemical Evaluation of the Efficacy of a New Cosmetic Formulation in the Treatment of Skin Photoaging

    Science.gov (United States)

    Jiménez, N.; Miguel-Gomez, L.; Hermosa, A.; Sánchez-Neila, N.; Cuevas, J.

    2017-01-01

    Objective. Mechanism of action of cosmetic products is not often studied. The aim of this study is to determine the histological, immunohistochemical, and clinical changes of a new cosmetic formulation. Methods. Prospective, single-blind, patient-controlled, randomized study in 10 volunteers with mild to moderate skin photoaging on the back of their hands. The product was applied on one hand and a standard cream on the other hand, twice a day for three months. Standardized photographs were taken on basal (T0) and final visit (T1) and skin biopsies were performed. Changes on histological and immunohistochemical markers were studied. Subjective clinical changes were determined. Results. After treatment, a 26.3% improvement on epidermal thickness was detected and a significant increase on collagens I and III, elastin, and fibronectin fibers was achieved (p cosmetic product with combination of three registered technologies (IFC-CAF, WGC, and RetinSphere), focused on regenerating dermal matrix and activating proliferation of skin cells, has shown to be efficient in the reversion of skin photoaging. PMID:28167957

  10. CLINICOPATHOLOGICAL AND IMMUNOHISTOCHEMICAL PROFILE OF ENDOCERVICAL ADENOCARCINOMA

    Directory of Open Access Journals (Sweden)

    Arockiasamy Babiya Infant

    2016-07-01

    Full Text Available BACKGROUND Primary adenocarcinoma of cervix constitutes 10-15% of all cases of carcinoma of cervix, which is the second most common carcinoma next to squamous cell carcinoma. Endocervical adenocarcinoma have a considerable morphological overlap with endometrial adenocarcinoma though they differ in their aetiologies, behaviour, and treatments. This makes their diagnosis very difficult particularly in biopsy or curetting specimens or when a fractional dilation and curettage specimens show adenocarcinoma in both components of it. This study was done in the aim to suggest the possible origin of the tumour with the help of immunohistochemistry. AIMS AND OBJECTIVES To identify the incidence, distribution, clinicopathological, histomorphological features of endocervical adenocarcinomas and to determine the immunohistochemical expression of CEA, Vimentin, ER and PR in endometrioid type of adenocarcinoma detected in endocervical biopsies, fractional dilation and curettage specimens (Both the components showing similar morphology, and in hysterectomy specimens to suggest the site of origin of tumour. MATERIALS AND METHODS It is a retrospective descriptive study of cervical adenocarcinomas conducted in the Institute of Obstetrics and Gynaecology, Madras Medical College, Chennai for a period of 4 years during the period between 2009 November to 2013 October. The statistical analysis was performed using statistical package for social science software version 11.5 the clinicopathological profile of the tumour were calculated using Student t-test and chi-square test. OBSERVATION AND RESULTS Among the total 13499 cases received during the study period, 2489 were cervical malignancies comprising 148 adenocarcinoma. It includes 101 mucinous (Endocervical type, 44 endometrioid type, 2 serous type, and 1 clear cell type. Among the 30 cases of endometrioid type, 16 cases showed definite immunophenotype of cervical origin, 9 cases of endometrial origin and in the

  11. Cell kinetics in a model of artificial skin. An immunohistochemical and flow cytometric analysis

    Directory of Open Access Journals (Sweden)

    A Casasco

    2009-12-01

    Full Text Available Bioengineered organs raised in vitro are candidate substitutes for natural organs in biological, pharmacological and clinical applications. We have studied cell kinetics in a human skin equivalent (HSE using a combined immunohistochemical and flow cytometric approach. Morphological analysis has shown that, relative to unstimulated natural skin, cell proliferation mainly occurs in the basal layer of the epidermal equivalent. Immunohistochemical and flow cytometric measurements of the growth fraction suggested a cell turnover comparable to that of natural skin. Immunohistochemical labelling indices matched well with flow cytometric data. These observations are consistent with morphological and histochemical data demonstrating normal cell differentiation and tissue architecture in HSE and suggest that such HSE may be a usefull substitute for human skin.

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

    Directory of Open Access Journals (Sweden)

    Morufu Olusola Ibitoye

    2014-12-01

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

  13. Mechanomyographic parameter extraction methods: an appraisal for clinical applications.

    Science.gov (United States)

    Ibitoye, Morufu Olusola; Hamzaid, Nur Azah; Zuniga, Jorge M; Hasnan, Nazirah; Wahab, Ahmad Khairi Abdul

    2014-12-03

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

  14. Clinical significance and immunohistochemical assays ofP-glycoprotein of preoperative chemotherapy for Wilms' tumor%肾母细胞瘤术前化疗前后P-糖蛋白表达的变化及临床意义

    Institute of Scientific and Technical Information of China (English)

    魏光辉; 金先庆; 李旭良; 林涛; 何大维

    2001-01-01

    目的:探讨肾母细胞瘤术前化疗耐药性的生物学特性及与疗效相关性。方法:对18例未术前化疗和经不同疗程术前化疗病理档案,以JSD-单克隆抗体对肾母细胞瘤组织多药耐药蛋白(P-glycoprotein,P-gp)进行免疫组织化学,检测P-gp在术前化疗不同疗程的表达,确定其耐药性;同时对15例资料记录完整、术前化疗>5周的小儿肾母细胞瘤,通过B超随访测量术前化疗不同疗程肿瘤大小,了解其疗效及与耐药性的相关性。结果:术前化疗后的肿瘤细胞P-gp表达比未经术前化疗的肿瘤细胞强,而术前化疗疗程越长,肿瘤细胞P-gp表达越强,疗效降低。结论:术前化疗4周后疗效降低与瘤组织对化疗药物耐药性明显增强有关,免疫组织化学检测P-gp可为制定或更改肾母细胞瘤术前化疗方案及术后化疗方案提供有用的依据。%Objective: To explore the decrease of the efficacy of preoperative chemotherapy decreases with the period of chemotherapy due to multidrug resistance. Methods: We analyzed 18 cases with or without preoperative chemotherapy. Monoclonal antibody was used to detect the expression of P-glycoprotein (P-gp) in Wilms' tumor.Fifteen Wilms' tumor cases with complete clinical records and more than five weeks preoperative chemotherapy were followed up by ultrosonography to identify the relationship between the volume of tumor and the period of chemotherapy and multidrug resistance. Results: It was suggested that the expression of multidrug resistance increases after preoperative chemotherapy. The longer the preoperative chemotherapy, the stronger the expression of multidrug resistance. Conclusion:We have found that decrease of efficacy of chemotherapy after four weeks preoperative chemotherapy is due to the increase of multidrug resistance. We recommend that determination of Pgp using immunohistochemical assay can be served as a basis to formulate

  15. Methods for diagnosis of bile acid malabsorption in clinical practice.

    Science.gov (United States)

    Vijayvargiya, Priya; Camilleri, Michael; Shin, Andrea; Saenger, Amy

    2013-10-01

    Altered concentrations of bile acid (BA) in the colon can cause diarrhea or constipation. More than 25% of patients with irritable bowel syndrome with diarrhea or chronic diarrhea in Western countries have BA malabsorption (BAM). As BAM is increasingly recognized, proper diagnostic methods are needed to help direct the most effective course of treatment for the chronic bowel dysfunction. We review the methodologies, advantages, and disadvantages of tools that directly measure BAM: the (14)C-glycocholate breath and stool test, the (75)selenium homotaurocholic acid test (SeHCAT), and measurements of 7 α-hydroxy-4-cholesten-3-one (C4) and fecal BAs. The (14)C-glycocholate test is laborious and no longer widely used. The (75)SeHCAT has been validated but is not available in the United States. Measurement of serum C4 is a simple and accurate method that can be used for most patients but requires further clinical validation. Assays to quantify fecal BA (total and individual levels) are technically cumbersome and not widely available. Regrettably, none of these tests are routinely available in the United States; assessment of the therapeutic effects of a BA binder is used as a surrogate for diagnosis of BAM. Recent data indicate the advantages to studying fecal excretion of individual BAs and their role in BAM; these could support the use of the fecal BA assay, compared with other tests. Measurement of fecal BA levels could become a routine addition to the measurement of fecal fat in patients with unexplained diarrhea. Availability ultimately determines whether the C4, SeHCAT, or fecal BA test is used; more widespread availability of such tests would enhance clinical management of these patients.

  16. System-wide immunohistochemical analysis of protein co-localization.

    Directory of Open Access Journals (Sweden)

    Minjung Kim

    Full Text Available The analysis of co-localized protein expression in a tissue section is often conducted with immunofluorescence histochemical staining which is typically visualized in localized regions. On the other hand, chromogenic immunohistochemical staining, in general, is not suitable for the detection of protein co-localization. Here, we developed a new protocol, based on chromogenic immunohistochemical stain, for system-wide detection of protein co-localization and differential expression.In combination with a removable chromogenic stain, an efficient antibody stripping method was developed to enable sequential immunostaining with different primary antibodies regardless of antibody's host species. Sections were scanned after each staining, and the images were superimposed together for the detection of protein co-localization and differential expression. As a proof of principle, differential expression and co-localization of glutamic acid decarboxylase67 (GAD67 and parvalbumin proteins was examined in mouse cortex.All parvalbumin-containing neurons express GAD67 protein, and GAD67-positive neurons that do not express parvalbumin were readily visualized from thousands of other neurons across mouse cortex. The method provided a global view of protein co-localization as well as differential expression across an entire tissue section. Repeated use of the same section could combine assessments of co-localization and differential expression of multiple proteins.

  17. Predicting the coexistence of an endometrial adenocarcinoma in the presence of atypical complex hyperplasia: immunohistochemical analysis of endometrial samples

    NARCIS (Netherlands)

    Robbe, E.J.; Kuijk, S.M. van; Boed, E.M. de; Smits, L.J.; Wurff, A.A. van der; Kruitwagen, R.F.P.M.; Pijnenborg, J.M.A.

    2012-01-01

    OBJECTIVE: This study aimed to determine whether immunohistochemical markers in complex atypical endometrial hyperplasia could predict the presence of a concurrent endometrial carcinoma. METHODS: Endometrial biopsies of 39 patients with complex atypical hyperplasia were selected retrospectively betw

  18. Mycosis fungoides and Sézary syndrome: clinical, histopathological and immunohistochemical review and update Micose fungóide e síndrome de Sézary: revisão e atualização clínica, histopatológica e imuno-histoquímica

    Directory of Open Access Journals (Sweden)

    Thamy Yamashita

    2012-12-01

    Full Text Available This paper reviews the diagnostic and classificatory concepts of mycosis fungoides and Sézary syndrome in light of the latest normative publications. It describes the great variability of the clinical expression of mycosis fungoides in its early stages as well as the histopathological and immunohistochemical aspects that help with diagnosis. The diagnostic criteria required for characterizing Sézary syndrome and the staging system used for both mycosis fungoides and Sézary syndrome are described.O artigo revisa os conceitos diagnósticos e de classificação da micose fungóide e da síndrome de Sézary a luz das publicações normativas mais recentes. Descreve a grande variabilidade de expressão clinica da micose fungóide em seus estágios iniciais assim como os aspectos histopatológicos e imuno-histoquímicos auxiliares ao diagnóstico. São descritos os critérios de diagnósticos exigidos para que se caracterize a síndrome de Sézary e o sistema de estadiamento, utilizado para ambas, micose fungóide e síndrome de Sézary.

  19. Clinical and Immunohistochemical Research of Piyan Xiaojin Decoction-2 Combining with Narrow-Spectrum UVB Exposure Treating Atopic Dermatitis (AD) with Blood Deficiency and Wind Dryness%皮炎消净饮Ⅱ号联合窄谱UVB照射治疗血虚风燥型特应性皮炎的临床及免疫组化研究

    Institute of Scientific and Technical Information of China (English)

    吴蓓玲; 杨晓红; 曹毅; 余土根; 奚爱妮; 程立峰; 金瀛凯; 陈琼

    2012-01-01

    Objective: The aim of the article is to observe the clinical effectiveness of Piyan Xiaojin Decoction - 2 combining with narrow - spectrum UVB exposure to treat Atopic Dermatitis (AD) with blood deficiency and wind dryness, and to evaluate the expressions of 1CAM - 1 and VCAM -1 in local impaired skin before and after the treatment, therefore to investigate its pathogenesis and clinical significance. Method; 29 AD patients with blood deficiency and wind dry-ness have been treated by combination of Piyan Xiaojin Decoction - 2 and narrow - spectrum UVB exposure. The authors used SCORAD integral system to evaluate clinical severity of impaired skin before and after the treatment, meanwhile a-dopting SABC immunohistochemical method to assess the positive area, average optical density, total optical density,expressions of ICAM - 1 and VCAM - 1 in impaired skin. Result; Among 29 AD patients, 6 were completely healed (20. 69% ) , 16 gained significant effect (55.17% ) , 7 had good effect (24. 14% ), no patient showed ineffective, and the total efficiency rate was 75. 86%. After and before the treatment, AD patients'positive expressions of ICAM - 1 and VCAM - 1 of impaired skin were all higher than those in normal group (P < 0. 01); After the treatment, AD patients' positive expressions of ICAM - 1 and VCAM - 1 in skin impairment were all declined ( P <0.05). Conclusion; Piyan Xiaojin Decoction -2 combining with exposure of narrow - spectrum UVB is effective and safe in treating blood deficiency and wind dryness AD. The possible mechanism is suppressing the release of inflammatory factor, and modulating the expressions of ICAM - 1 and VCAM - 1 in local impaired skin , consequently suppressing the conglutination of cells and the aggregation of inflammatory corpuscles, thus to reach the goal of anti - inflammation and regulating immune system.%目的:观察皮炎消净饮Ⅱ号联合窄谱UVB照射对血虚风燥型特应性皮炎(AD)的临床疗效,及对AD患

  20. Immunohistochemical investigations of genital ulcers caused by Haemophilus ducreyi.

    Science.gov (United States)

    Abeck, D; Freinkel, A L; Korting, H C; Szeimis, R M; Ballard, R C

    1997-09-01

    To gain information on the specific composition of the inflammatory infiltrate of genital ulcers caused by Haemophilus ducreyi, biopsies of 6 genital ulcers which were diagnosed as chancroid on clinical and microbiological grounds were subjected to immunohistochemical investigations after conventional haematoxylineosin staining. A variety of antibodies reactive against B- and T-cells, plasma cells and granulocytes were used with each tissue sections. The lymphocytic infiltrate of chancroid ulcers consisted of both B- and T-lymphocytes and showed a cluster-like formation. B-lymphocytes were preferentially localized perivascularly in the middle layer, T-lymphocytes mainly in the deep layer of the inflamed oedematous tissue. Results stress the importance of both B- and T-cell mediated immune responses in Haemophilus ducreyi infection.

  1. Relationship Between Dual Time Point FDG PET and Immunohistochemical Parameters in Preoperative Colorectal Cancer: Preliminary Study

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jai Hyuen; Lee, Won Ae; Park, Seok Gun; Park, Dong Kook; Namgung, Hwan [Dankook Univ. College of Medicine, Cheonan (Korea, Republic of)

    2012-03-15

    The clinical availability of 2 deoxy 2 [18F] fluoro D glucose (FDG) dual time point positron emission tomography/computerized tomography (DTPP) has been investigated in diverse oncologic fields. The aim of this preliminary study was to evaluate the relationship between various immunohistopathologic markers reflecting disease progression of colorectal cancer and parameters extracted from FDG DTPP in colorectal cancer patients. Forty seven patients with histologically confirmed colorectal cancer were analyzed in this preliminary study. FDG DTPP consisted of an early scan 1 h after FDG injection and a delayed scan 1.5 h after the early scan. Based on an analysis of FDG DTPP, we estimated the maximum standardized uptake value (SUV) of tumors on the early and delayed scans (SUV{sup earlya}nd SUV{sup delayed,} respectively). The retention index (RI) was calculated as follows: (SUV{sup delayed-} SUV{sup early)} x 100/ SUV{sup early.} The clinicopathological findings (size and T and N stages) and immunohistochemical factors [glucose transporter 1 (GLUT 1), hexokinase 2 (HK 2), p53, P504S, and {beta} catenin] were analyzed by visual analysis. The RIs calculated from the SUVs ranged from -1.8 to 73.4 (31.8{+-}15.5). The RIs were significantly higher in patients with high T stages (T3 and T4) than with low T stages (T1 and T2; P<0.05). Among the immunohistochemical analytic markers, GLUT 1 had the highest positive staining rate (93.6%) compared to other markers. Based on unvariable analysis, it was shown that the RI of high level GLUT 1 expression was significantly higher than low level GLUT 1 expression (p=0.01), and the RI of high level p53 expression (p=0.08). Multivariate analysis to investigate a link between RI and clinico pathologic parameters of colorectal carcinoma showed that GLUT 1, p53, and T staging were independently connected with increased RIs (p<0.05, total) using backward selection methods. There was no significant statistical relationship between SUV

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

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    Blashki Grant

    2012-08-01

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

  3. Immunohistochemical detection of hTERT in urothelial lesions: a potential adjunct to urine cytology

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    Khalbuss Walid

    2006-08-01

    Full Text Available Abstract Background Urine cytology has a critical role in evaluation for bladder carcinoma. Due to the low sensitivity of this technique, ancillary modalities such as the detection of markers of malignancy by immunochemistry are desirable. Promising factors in this context are components of the human telomerase enzyme complex. Telomerase repairs and extend telomeres, which when eroded beyond a critical limit trigger a senescence checkpoint. Accordingly, while absent in normal somatic cells, telomerase activity has been detected in the great majority of malignant tumor specimens tested, and so has potential value for the recognition of malignant cells in clinical specimens. Methods In this study, we investigated whether the immunohistochemical detection of the catalytic subunit of telomerase (hTERT can aid cytology in the diagnosis of bladder lesions. Findings from the retrospective evaluation of over 100 cell blocks, including urine sediments from confirmed malignant and benign conditions, were compared with routine urine cytology data. Results The presence of hTERT protein was indicative of the transformation of urothelia to a malignant phenotype. Nucleolar hTERT was expressed in 27 (93% of 29 samples obtained from patients with confirmed primary bladder cancer. Conversely, hTERT was detectable in only 3 (0.8% of 39 samples from benign conditions. The hTERT assay showed higher diagnostic sensitivity (84.8% than published urine cytology data (~65% for confirmed bladder carcinoma, however, the hTERT assay was less specific than cytology (65.2% vs. ~95% respectively. Conclusion As a highly sensitive marker, immunohistochemical hTERT detection in urine sediments represents a reliable adjunct to cytology in the accurate diagnosis of urothelial neoplasms.

  4. [Clinical importance and diagnostic methods of minimal hepatic encephalopathy].

    Science.gov (United States)

    Stawicka, Agnieszka; Zbrzeźniak, Justyna; Świderska, Aleksandra; Kilisińska, Natalia; Świderska, Magdalena; Jaroszewicz, Jerzy; Flisiak, Robert

    2016-02-01

    Minimal hepatic encephalopathy (MHE) encompasses a number of neuropsychological and neurophysiological disorders in patients suffering from liver cirrhosis, who do not display abnormalities during a medical interview or physical examination. A negative influence of MHE on the quality of life of patients suffering from liver cirrhosis was confirmed, which include retardation of ability of operating motor vehicles and disruption of multiple health-related areas, as well as functioning in the society. The data on frequency of traffic offences and accidents amongst patients diagnosed with MHE in comparison to patients diagnosed with liver cirrhosis without MHE, as well as healthy persons is alarming. Those patients are unaware of their disorder and retardation of their ability to operate vehicles, therefore it is of utmost importance to define this group. The term minimal hepatic encephalopathy (formerly "subclinical" encephalopathy) erroneously suggested the unnecessity of diagnostic and therapeutic procedures in patients with liver cirrhosis. Diagnosing MHE is an important predictive factor for occurrence of overt encephalopathy - more than 50% of patients with this diagnosis develop overt encephalopathy during a period of 30 months after. Early diagnosing MHE gives a chance to implement proper treatment which can be a prevention of overt encephalopathy. Due to continuing lack of clinical research there exist no commonly agreed-upon standards for definition, diagnostics, classification and treatment of hepatic encephalopathy. This article introduces the newest findings regarding the importance of MHE, scientific recommendations and provides detailed descriptions of the most valuable diagnostic methods.

  5. Immunohistochemical expression of type VI collagen in superficial fibromatoses.

    Science.gov (United States)

    Magro, G; Colombatti, A; Lanzafame, S

    1995-10-01

    The expression of type VI collagen was studied immunohistochemically in 26 cases of superficial fibromatoses (palmar, plantar and penile) using an immunoperoxidase method for light microscopic visualization. The polyclonal antibody against type VI collagen used in this study was isolated from human placenta and its specifity was tested by immunoblotting assay. All cases consisted of multiple nodules showing a variable degree of cellularity and fibrosis. Depending on the predominant histological appearance of these nodules, each case was assigned to the three following phases: proliferative, involutional and residual. Morphologically normal palmar and plantar aponeuroses were included as controls. Immunohistochemical findings showed that type VI collagen was present as longitudinal thin fibers in normal palmar and plantar aponeuroses. A differential expression of this collagen was found in the different stages of superficial fibromatoses. Type VI collagen was markedly expressed as a distinct fibrillar network in the extracellular matrix (ECM) surrounding proliferating stromal cells in proliferative and involutional phases. Its expression completely disappeared from the connective tissue undergoing fibrotic transformation during involutional and residual phases. The results of the present study suggest that type VI collagen is an extracellular marker of stromal tissue proliferation and is involved in the early phases of tissue remodelling occurring in the superficial fibromatoses.

  6. Currently available useful immunohistochemical markers of renal pathology for the diagnosis of renal allograft rejection.

    Science.gov (United States)

    Kanzaki, Go; Shimizu, Akira

    2015-07-01

    Renal allograft dysfunction may be induced by various causes, including alloimmune rejection, viral infection, urinary tract obstruction, calcineurin inhibitor nephrotoxicity and/or recurrent renal disease. In order to determine the underlying cause, a renal biopsy is performed and the renal transplant pathology is diagnosed using the internationally consensus Banff classification. Although a progressive understanding of allograft rejection has provided numerous immunohistochemical markers, only the C4d is regarded to be a sufficiently useful marker for antibody-mediated allograft rejection according to the Banff classification. This review summarizes currently available useful immunohistochemical markers of renal transplant pathology, including C4d, with diagnostic implications for human renal allograft rejection. In particular, we discuss immunohistochemical markers in the following three categories: immunohistochemical markers of renal pathology used to (i) analyze the mechanisms of alloimmune rejection, (ii) monitor cell injury and/or inflammation associated with rejection and (iii) identify renal components in order to improve the diagnosis of rejection. In addition, recent progress in the field of renal transplant pathology includes the development of a new method for assessing molecular pathology using OMICS analyses. As the recent findings of various studies in patients undergoing renal transplantation are very encouraging, novel immunohistochemical markers must be also developed and combined with new technologies for the diagnosis of human renal allograft rejection.

  7. Human vomeronasal epithelium development: An immunohistochemical overview.

    Science.gov (United States)

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

    2015-06-01

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

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

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    Dipshikha Bajracharya

    2014-01-01

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

  9. Immunohistochemical study in dural arteriovenous fistula and possible role of ephrin-B2 for development of dural arteriovenous fistula

    Institute of Scientific and Technical Information of China (English)

    Wuttipong Tirakotai 王宝隆; BIAN Liu-guan 卞留贯; Helmut Bertalanffy; Siegfried Bien; Ulrich Sure

    2004-01-01

    Background Although there were several clinical and experimental studies discussing the pathogenesis of dural arteriovenous fistula (DAVF), the pathological process leading to intracranial DAVF so far remains unknown. In this study, we investigated the expression of vascular growth factors in order to elucidate the possible role of these factors for the development of DAVF and to study the biological activity of this uncommon lesion.Methods We examined the histological features, proliferative and angiogenic capacities of the tissue specimens obtained from 6 patients who underwent surgery at our institution. Immunohistochemical staining for vascular endothelial growth factor (VEGF), its receptors Flk-1 and Flt-1, ephrin-B2, MIB-1 and proliferating cell nuclear antigen (PCNA) was performed using standard immunohistochemical techniques. Results A positive immunostaining was found for all antibodies studied except MIB-1, whereas nuclear endothelial expression of PCNA was observed in only 3/6 cases. VEGF stained positive in all of the available specimens (6/6). Flk-1 showed a positive immunoreaction in only 2/6 cases and Flt-1 in 4/6 cases. Ephrin-B2 was expressed in the majority (5/6) of the cases.Conclusions These results support the hypothesis that DAVFs might be acquired dynamic vascular malformations with low biological activity. Vascular growth factors like VEGF and ephrin-B2 might play a pivotal role in the formation of DAVF.

  10. TP53 Staining in Tissue Samples of Chronic Lymphocytic Lymphoma Cases: An Immunohistochemical Survey of 51 Cases

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    İbrahim Kulaç

    2017-03-01

    Full Text Available Objective: Chronic lymphocytic leukemia (CLL is the most common lymphoproliferative disease in adults. The aim of this study is to find out if the extent of proliferation centers or the immunohistochemical expression of p53 is related to disease prognosis. Materials and Methods: In the scope of this study, 54 biopsy specimens from 51 patients (50 of lymph nodes; the others of spleen, tonsil, orbit, and liver diagnosed with CLL at the Hacettepe University Department of Pathology in 2000-2013 were reevaluated. The clinical and demographic data of the patients were obtained from our patient database. Biopsy samples were assessed semi-quantitatively for the percentage of proliferation center/total biopsy area (PC/TBA and an immunohistochemical study was performed on representative blocks of tissues for p53 expression. Results: When the patients were divided into two categories according to Rai stage as high and low (stages 0, 1, and 2 vs. stages 3 and 4, it was seen that patients with low Rai stage had a better prognosis than those with high stages (p=0.030. However, there was no statistically significant correlation between overall survival and PC/TBA ratio or p53 expression levels. Conclusion: In our cohort, PC/TBA ratio and immunopositivity of p53 did not show correlations with overall survival.

  11. Impact of Histopathological Diagnosis with Ancillary Immunohistochemical Studies on Lung Cancer Subtypes Incidence and Survival: A Population-Based Study

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    Andrea Bordoni

    2011-01-01

    Full Text Available Purpose. The aim of this study was to assess the impact of immunohistochemical- (IHC- studies on incidence and survival of lung cancer histotypes. Patients and Methods. Lung cancers occurred in southern Switzerland between 1996 and 2010 were selected by the Ticino Cancer Registry and categorised into adenocarcinoma (AC, squamous-cell-carcinoma (SqCC, small-cell-carcinoma (SmCC, and large-cell carcinoma/non-small-cell lung cancer (LCC/NSCLC. Incidence rates, annual-percentage-change (APC, and two-year overall survival (OS (follow-up: 31.12.2010 were performed. Results. 2467 cases were selected: 997 (40.4% AC; 522 (21.2% LCC/NSCLC, 378 (15.3% SmCC, and 570 (23.1% SqCC. Trend-analysis showed significant increase in AC (APC: 4.6; 95% CI: 3.1; 6.0 and decrease of LCC/NSCLC, with significant joinpoint in 2003 (APC: −14.7; 95% CI: −21.6; −7.1. Improved OS and decreased OS were detected in SqCC and LCC/NSCLC, respectively. Conclusions. This study highlights that diagnosis with ancillary immunohistochemical studies will change incidence and survival of precisely defined lung cancer subtypes. It calls attention to the need for cautious interpretation of studies and clinical trials, where the diagnosis was based on histology unaccompanied by IHC studies, and to the need of standardised diagnostic procedures.

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

    Science.gov (United States)

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

    1994-06-01

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

  13. [A study on clinical teaching method in nursing education--focusing on teaching method of touching].

    Science.gov (United States)

    Okazaki, M

    1997-06-01

    The purpose of this study is the development of effective clinical teaching methods of nursing education using touching in hospital nursing care. The clinical teaching-learning process was designed based on the Steinaker, N.W. & R. Bell's experiential learning model (1979), in which teaching-learning process was divided into five steps-exposure, participation, identification, internalization, and dissemination. Three hypotheses were postulated as follows: 1-1. Guidance given to nursing students to use touching in nursing care will make them conscious of the efficiency of touching. 1-2. Nursing students will grasp the efficiency of their nursing action by "cause and effect" relations. 2-0. Guidance given to nursing students to use touching in their nursing care will allay and soften their anxiety and tension toward such nursing practices. 3-0. Nursing intervention by touching will heighten the clinical judgement ability of nursing students. The teaching-learning plan was carried out in a nursing school in Kitakyushu-shi. Fifteen nursing students studied by this plan. The results was as follows: a. Hypotheses 1-1, 1-2, 2-0, were confirmed. b. Hypothesis 3-0, was not confirmed.

  14. Immunohistochemical detections of EGFR status in NSCLC

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    Jie WANG

    2015-04-01

    Full Text Available Background and objective Patients with non-small cell lung cancer (NSCLC harboring mutations of the epidermal growth factor receptor (EGFR respond well to EGFR-tyrosine kinase inhibitor therapy. Immunohistochemistry (IHC is a simple and widely used technique in clinical pathology laboratories. IHC also features cost effectiveness and rapid detection of EGFR mutations compared with molecular methods. This study aims to determine the accuracy of IHC for EGFR mutation detection in NSCLC. Methods Specimens (obtained from surgery or biopsy from 97 NSCLC cases were stained through IHC with mutation-specific antibodies. The clinicopathological features of patients with positive immunostaining results were analyzed. Positive specimens were subjected to liquid chip technology to detect the actual EGFR status. Forty NSCLC specimens obtained from surgery and confirmed to have EGFR mutations through liquid chip technology were collected. These specimens were then subjected to IHC analyses with mutation-specific antibodies. The sensitivity of IHC in detecting EGFR mutations was calculated. Results Seventeen of the 97 NSCLC specimens were stained positive, and positive results were mostly observed in females, patients with adenocarcinoma, and non-smokers. About 76.9% of specimens with positive IHC results harbored mutations. The sensitivity of IHC was 40% among the 40 cases identified as containing EGFR mutations through liquid chip technology. Conclusion The strong positive immunostaining result is accurate, but the sensitivity of the method may not be optimal and significantly varies in different studies. The widespread application of IHC in clinics must be further investigated.

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

    Science.gov (United States)

    Amaechi, Bennett T.

    2009-02-01

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

  16. Scrub typhus hepatitis confirmed by immunohistochemical staining

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  17. Immunohistochemical demonstration of glial markers in retinoblastomas

    DEFF Research Database (Denmark)

    Schrøder, H D

    1987-01-01

    Twenty retinoblastomas were studied immunohistochemically in order to visualize glial cells. In the retina, the glial cells in the ganglion cell layer and the Müller cells were GFAP positive, while only the glial cells of the ganglion cell layer expressed S-100 reactivity. In the tumours S-100/GFAP...... positive glial cells were found in areas near the retina and along many tumour vessels. Some S-100 reactive cells previously interpreted as tumour cells were refound in a few tumours. In areas with Flexner-Winterstein rosettes and in areas with light cells showing photoreceptor-like differentiation, glial...... cells reactive for both S-100 and GFAP were demonstrated. The latter findings may represent differentiation in a glial direction in the more mature parts of retinoblastoma....

  18. Immunohistochemical detection of human intestinal spirochetosis.

    Science.gov (United States)

    Ogata, Sho; Shimizu, Ken; Oda, Tomohiro; Tominaga, Susumu; Nakanishi, Kuniaki

    2016-12-01

    Human intestinal spirochetosis (HIS) is a colorectal infection by Brachyspira species of spiral bacteria. Immunohistochemical cross-reaction to an antibody for Treponema pallidum aids its histologic diagnosis. This study's aim was to analyze the immunohistochemical characteristics of HIS. In this analysis, on 223 specimens from 83 HIS cases, we focused on so-called fringe formation (a histologic hallmark of HIS), spiral organisms within mucus or within crypts, and strong immunopositive materials in the mucosa, together with their location and the types of lesions. Fringe formation was found in 81.6% of all specimens and spiral organisms within mucus or within crypts in 97.3% and 57.0%, respectively. Strong immunopositive materials were observed in the surface epithelial layer in 87.9%, in the subepithelial layer in 94.6%, and in deeper mucosa in 2.2% of all specimens. The positive rates in conventional adenomas (24.0%, n = 146) and hyperplastic nodules (100%, n = 17) were each different from that found in inflammation (70.8%, n = 24), and spiral organisms were seen more frequently in the right-side large intestine than in the left (within mucus, 100%, n = 104 versus 95.0%, n = 119; within crypts, 65.4%, n = 104 versus 49.6%, n = 119). Thus, immunohistochemistry was effective not only in supporting the diagnosis of HIS but also in highlighting spiral organisms within mucus or crypts that were invisible in routine histology. Possibly, these spiral organisms may spread throughout the entire large intestine, although there is a potential problem with antibody specificity.

  19. A method for clinical and physiological event stream processing.

    Science.gov (United States)

    Kamaleswaran, Rishikesan; McGregor, Carolyn; Eklund, J

    2010-01-01

    This paper proposes a methodology for the event stream processing of synchronous (physiological) and asynchronous (clinical) health data streams. The purpose is to illustrate the feasibility of Artemis, our extension of IBM's InfoSphere Streams, to appropriately deliver notifications from an initial clinical hypothesis within the critical care environment. We demonstrate that an positive alert can be delivered that is indicative of an onset of instability in critically ill newborns. Artemis, is also tested for its potential to allow clinicians the ability to interact directly with the rule-based system to prove certain hypothesis. We begin this methodology with a model of the clinical case study, and then transform that model into Stream's SPADE code. Subsequently, it is compiled and executed within the Streams environment to deliver notifications in real-time of the newborns health state.

  20. 全自动免疫组化筛查ALK基因融合非小细胞肺癌及其病理特征%Screen of Non-small Cell Lung Cancer with Anaplastic Lymphoma Kinase Fusion Gene by Automatic Immunohistochemical Method and Its Pathological Features

    Institute of Scientific and Technical Information of China (English)

    冯强; 彭森; 刘霞

    2016-01-01

    目的 探讨全自动免疫组化筛查间变性淋巴瘤激酶(ALK)基因融合非小细胞肺癌的临床特点及病理特征.方法 选取经病理检查确诊的554例非小细胞肺癌组织,采用Ventana抗ALK试剂和全自动免疫组化(IHC)染色检测ALK状态,分析ALK基因融合非小细胞肺癌的临床特点和病理特征.结果 本次研究的554例非小细胞肺癌患者组织中,共筛选出34例ALK阳性,占6.14%;年龄0.05).组织形态学方面,34例ALK阳性非小细胞肺癌中28例为肺腺癌,6例为非肺腺癌.16例实体型为主腺癌合并黏液产生,7例腺泡型为主腺癌,1例为乳头型为主腺癌,4例为浸润性黏液腺癌,4例为鳞状细胞癌.EGFR基因突变检测显示:仅有1例合并该基因突变,其余均为野生型.9例IHC阳性样本,9例ALK基因融合非小细胞肺癌,9例IHC阴性样本经荧光原位杂交技术检测和RT-PCR检测均为阴性结果,6例IHC染色可能为阳性,经荧光原位杂交技术检测均显示为ALK融合阴性.结论 ALK基因融合肺癌是非小细胞肺癌一新的分子亚型,具有独特的临床表现和病理形态;Ventana抗ALK试剂和IHC染色是检测ALK阳性非小细胞肺癌首选方法,对提高该类型肺癌的检出率及个体化治疗具有重要意义.%Objective To explore the automatic immunohistochemical method for the screen of non-small cell lung cancer with anaplastic lymphoma kinase( ALK) and its clinical pathological features.Methods 554 cases of non-small cell lung cancer diagnosed by pathological examination were enrolled in this study.The status of ALK was detected by Ventana anti ALK reagent and IHC staining, and the clinical characteristics and pathological features of ALK gene were analyzed.Results Among of 554 patients with non-small cell lung cancer,34 cases showed positive ALK(6.14%).The positive rate of the patients under 60 years old(8.69%) was significantly higher than that of the elder patients ( 3 .62%) ( P0.05).The results of

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

    Directory of Open Access Journals (Sweden)

    Hussam Hasson Ali

    2011-07-01

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

  2. Parvovirus infection: an immunohistochemical study using fetal and placental tissue.

    Science.gov (United States)

    Li, Jing Jing; Henwood, Tony; Van Hal, Sebastian; Charlton, Amanda

    2015-01-01

    Parvovirus B19 infection causes 5% to 15% of cases of nonimmune hydrops fetalis. The aim of our study was to evaluate the use of immunohistochemistry in diagnosing parvovirus infection in fetal and placental tissue during routine fetal and perinatal autopsies. Histology slides of 20 cases of confirmed parvovirus infection were reviewed, and immunohistochemistry was applied to selected blocks of fetal and placental tissue. Immunohistochemistry was positive in all 20 cases, and histologic viral inclusions were seen in 19 cases. Immunohistochemical staining was closely correlated with histology and was more sensitive than histology in detecting virally infected cells, especially in autolyzed tissue. All cases also had confirmatory evidence of parvovirus infection by polymerase chain reaction of fetal liver and positive maternal serology, where it was available. We conclude that parvovirus immunohistochemistry is a reliable method for diagnosing parvovirus infection, especially in autolyzed tissue where histologic assessment may be suboptimal.

  3. Immunohistochemical detection of brain tissue in heated meat products.

    Science.gov (United States)

    Tersteeg, M H G; Koolmees, P A; van Knapen, F

    2002-05-01

    Immunohistochemical methods were used to determine whether brain tissue could be detected in test batches of meat products prepared with known levels of this tissue (0, 1, 5, 10, or 20% bovine brain tissue or 5% porcine brain tissue). Four different, commercially-available antibodies were examined: anti-Neurofilament (anti-NF), anti-MyelinBasicProtein (anti-MBP), anti-NeuronSpecificEnolase (anti-NSE) and anti-GlialFibrillaryAcidicProtein (anti-GFAP). Results obtained with the four antibodies differed with the heat treatment applied to the products (pasteurisation or sterilisation). The amount of immunoreaction product in the raw meat product varied with the antibody, even when the sample contained the same amount of brain tissue. The staining pattern also varied with the antibody. Overall, the anti-MBP antibody proved to be most useful in detecting brain tissue in finely comminuted heated meat products.

  4. Immunohistochemical studies of the periodontal membrane in primary teeth

    DEFF Research Database (Denmark)

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

    2009-01-01

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

  5. Methods to improve the efficiency of confirmatory clinical trials

    NARCIS (Netherlands)

    Boessen, R.

    2013-01-01

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    BACKGROUND: The reliability of immunohistochemically-determined biomarkers using tissue microarrays (TMAs) of clinical specimens has long been open to question. Heterogeneity related to tumor biology might compromise determination of accurate biomarker expression in tumors, especially in small core...... samples. However, the optimal number of cores required for biomarkers with functional properties varied from 1 to > 4 cores. The results indicate that the optimal number of biopsies required to compensate for potential biomarker heterogeneity should be determined individually for each biomarker used...

  7. [Immuno-histochemical study of medullary thyroid carcinoma].

    Science.gov (United States)

    Bessho, T

    1987-07-01

    Five peptide hormones including calcitonin (CT) and gastrin-releasing peptide (GRP), serotonin (5HT), CEA, nervous tissue specific proteins and monoclonal antibody Leu-7 were immuno-histochemically studied on 60 cases of medullary thyroid carcinoma (MTC). In addition, localization of varied products in the tumor cells and its relations with the clinical features in some cases were evaluated. MTC contains a variety of products in many cases, and CT and CEA were positive in all cases. In 50 of the 57 cases (87.7%), GRP was positive, which suggested that GRP could be a novel tumor marker for this tumor. Furthermore, in tumor cells and C-cell hyperplastic foci, identical cells were sometimes revealed to possess both CT and GRP. Existence of somatostatin (SS), substance-P (SP), beta-MSH, 5 HT, Leu-7 and NSE in the tumor cells were confirmed. NSE was positive in 32 of the 47 cases (61.8%) which could confirm that MTC possesses neuroendocrine nature. In two cases of autopsy in which the tumors were highly malignant in clinical course and undifferentiated in histology, most tumor cells showed poor stainability for peptide hormones, suggesting that specific qualities as neuroendocrine tumor had been lost. In familial cases, the tumor tended to contain multiple substances.

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

    Science.gov (United States)

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

    2014-08-01

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

  9. Morphological and immunohistochemical characterisation of seminomas in Norwegian dogs

    Directory of Open Access Journals (Sweden)

    Thorvaldsen Tor

    2012-09-01

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

  10. Epithelial ovarian tumors: Clinicopathological correlation and immunohistochemical study

    Directory of Open Access Journals (Sweden)

    Pooja S Naik

    2015-01-01

    Full Text Available Background: Ovarian cancer is the third leading site of cancer among women, trailing behind cervix and breast cancer. Aim: This study was undertaken to analyze the immunohistochemical (IHC profile of estrogen receptors (ER, progesterone receptors (PR, Ki-67, and p53 in various ovarian epithelial tumors and attempt correlation with clinical and histopathological findings. Materials and Methods: The present study was conducted over a period of 4 years. A technique of manual tissue array was employed for cases subjected for IHC. The primary antibodies used were ER, PR, p53, and Ki-67. A correlation was attempted between histopathological and IHC findings. Results were subjected to statistical analysis. Software program "the primer of biostatistics 5.0" was used for calculation of interrelationships between the analyzed ER, PR, p53, and Ki-67 expression and histological factors by Pearson′s Chi-square test. The results were considered to be significant when the P < 0.05. Results: There were 110 cases of surface epithelial ovarian tumors (SEOT encountered over the period of 4 years. The expression of ER was more in malignant tumors (13/16, 81.25% than borderline (9/12, 75% and benign (20/82, 24.39%. As compared to ER, the expression of PR was more in benign (51/82, 62.19% than borderline (8/12, 66.67% and malignant tumors (9/16, 56.25%. The expression of PR was more in benign tumors than borderline and malignant tumors. However, this was not statistically significant (Chi-square = 0.335 with 2 degrees of freedom; P = 0.846. The expression of p53 was less in benign (5/82, 6.1% than borderline (9/12, 75% and malignant tumors (13/16, 81.25%. The expression of Ki-67 was more in malignant (4/82, 4.88% than borderline (10/12, 83.33% and benign tumors (15/16, 93.75%. In all the above cases, the difference was statistically significant (P < 0.05. There was statistically significant difference in the expression of ER, PR, p53, and Ki-67 in the patients with

  11. Applications of mixed-methods methodology in clinical pharmacy research.

    Science.gov (United States)

    Hadi, Muhammad Abdul; Closs, S José

    2016-06-01

    Introduction Mixed-methods methodology, as the name suggests refers to mixing of elements of both qualitative and quantitative methodologies in a single study. In the past decade, mixed-methods methodology has gained popularity among healthcare researchers as it promises to bring together the strengths of both qualitative and quantitative approaches. Methodology A number of mixed-methods designs are available in the literature and the four most commonly used designs in healthcare research are: the convergent parallel design, the embedded design, the exploratory design, and the explanatory design. Each has its own unique advantages, challenges and procedures and selection of a particular design should be guided by the research question. Guidance on designing, conducting and reporting mixed-methods research is available in the literature, so it is advisable to adhere to this to ensure methodological rigour. When to use it is best suited when the research questions require: triangulating findings from different methodologies to explain a single phenomenon; clarifying the results of one method using another method; informing the design of one method based on the findings of another method, development of a scale/questionnaire and answering different research questions within a single study. Two case studies have been presented to illustrate possible applications of mixed-methods methodology. Limitations Possessing the necessary knowledge and skills to undertake qualitative and quantitative data collection, analysis, interpretation and integration remains the biggest challenge for researchers conducting mixed-methods studies. Sequential study designs are often time consuming, being in two (or more) phases whereas concurrent study designs may require more than one data collector to collect both qualitative and quantitative data at the same time.

  12. Immunohistochemical detection of disease-associated prion protein in the intestine of cattle naturally affected with bovine spongiform encephalopathy by using an alkaline-based chemical antigen retrieval method.

    Science.gov (United States)

    Okada, Hiroyuki; Iwamaru, Yoshihumi; Imamura, Morikazu; Masujin, Kentaro; Yokoyama, Takashi; Mohri, Shirou

    2010-11-01

    An alkaline-based chemical antigen retrieval pretreatment step was used to enhance immunolabeling of disease-associated prion protein (PrP(Sc)) in formalin-fixed and paraffin-embedded tissue sections from cattle naturally affected with bovine spongiform encephalopathy (BSE). The modified chemical method used in this study amplified the PrP(Sc) signal by unmasking PrP(Sc) compared with the normal cellular prion protein. In addition, this method reduced nonspecific background immunolabeling that resulted from the destruction of the residual normal cellular form of prion protein, and reduced the treatment time compared with the usual autoclave pretreatment step. Immunolabeled PrP(Sc) was thereby clearly detected in the myenteric plexus of the ileum in naturally occurring BSE cattle.

  13. The assessment of irritation using clinical methods and questionnaires

    DEFF Research Database (Denmark)

    Kjærgaard, Søren K.; Hogdson, M.

    2001-01-01

    Sensory irritant responses to chemical exposures are measured by a variety of methods; however, studies can be influenced from biases associated with study design and subject responses. This article reviews the different methods used to quantitate irritation. These methods primarily focus on eye......, and hyperemia. Methods for detecting nasal mucosa irritation include measuring swelling of the nasal mucosa, peak airflows through the nose, acoustic rhinometry, and rhinostereometry, which measures thickness of the anterior nasal turbinate. Questionnaires are useful for defining a set of symptoms in an attempt...... to characterize dose-response relationships from controlled exposure studies or field studies, to compare rates of events in field studies, or to screen for disease. However, it is important to consider carefully the study design, goal of utilization, and constraints surrounding their application. Whichever...

  14. Fas/FasL expression in colorectal cancer. An immunohistochemical study.

    Directory of Open Access Journals (Sweden)

    Katarzyna Guzińska-Ustymowicz

    2010-11-01

    Full Text Available The objective of the current study was to assess the expression of Fas ligand (FasL and Fas receptor (FasR as the proteins of the post-mitochondrial apoptotic pathway in colorectal carcinoma and to investigate correlations between their expression and chosen clinico-pathological parameters. The protein expression was analyzed in 50 colorectal carcinoma patients, using the immunohistochemical method. Reaction for FasR was weak in 75.5% and strong in 24.5% of the study patients, as compared to normal glandular epithelium where FasR expression was strong in 100% of cases. On the other hand, FasL expression was found to be weak in 30% and strong in 70% of colorectal cancer patients, as compared to its lack in 100% of normal colorectal epithelium. Statistical analysis showed strong expression of FasL was found to correlate statistically significantly with vascular invasion (p = 0.005. No correlations of FasL and FasR expression in the main mass of tumor was found between other clinic-pathological parameters. Fas ligand and Fas receptor appeared to be of little usefulness as prognostic factors for different groups of colorectal carcinoma patients. However, these proteins could become good therapeutic targets for colorectal carcinoma since their expression differs distinctly between normal intestinal epithelium and cancer cells, and known is the mechanism by which cancer cells escape death via apoptosis-inducing Fas/FasL pathway disorders.

  15. IMMUNOHISTOCHEMICAL OBSERVATION OF MACROPHAGE COLONY STIMULATING FACTOR AND ITS RECEPTOR IN BREAST CANCER AND HEPATOMA TISSUES

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

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

  16. An immunohistochemical study of the antinociceptive effect of calcitonin in ovariectomized rats

    Directory of Open Access Journals (Sweden)

    Sekiguchi Miho

    2008-12-01

    Full Text Available Abstract Background Calcitonin is used as a treatment to reduce the blood calcium concentration in hypercalcemia and to improve bone mass in osteoporosis. An analgesic effect of calcitonin has been observed and reported in clinical situations. Ovariectomaized (OVX rats exhibit the same hormonal changes as observed in humans with osteoporosis and are an animal model of postmenopousal osteoporosis. The aim of this study to investigate antinociceptive effect of calcitonin in OVX rats using the immunohistochemical study. Methods We assessed the antinociceptive effects of calcitonin in an ovariectomized (OVX rat model, which exhibit osteoporosis and hyperalgesia, using the immunohistochemical method. Fifteen rats were ovariectomized bilaterally, and ten rats were received the same surgery expected for ovariectomy as a sham model. We used five groups: the OVX-CT (n = 5, the sham-CT (n = 5, and the OVX-CT-pcpa (n = 5 groups recieved calcitonin (CT: 4 U/kg/day, while OVX-vehi (n = 5 and the sham-vehi (n = 5 groups received vehicle subcutaneously 5 times a week for 4 weeks. The OVX-CT-pcpa-group was given traperitoneal injection of p-chlorophenylalanine (pcpa; an inhibitor of serotonin biosynthesis (100 mg/kg/day in the last 3 days of calcitonon injection. Two hours after 5% formalin (0.05 ml subcutaneously into the hind paw, the L5 spinal cord were removed and the number of Fos-immunoreactive (ir neurons were evaluated using the Mann-Whitney-U test. Results The numbers of Fos-ir neurons in the OVX-CT and sham-CT groups were significantly less than in the OVX-vehi and sham-vehi groups, respectively (p = 0.0090, p = 0.0090. The number of Fos-ir neurons in the OVX-CT-pcpa-group was significantly more than that of the OVX-CT-group (p = 0.0283, which means pcpa inhibits calcitonin induced reduction of c-Fos production. Conclusion The results in this study demonstrated that 1 the increase of c-Fos might be related to hyperalgesia in OVX-rats. 2 Calcitonin has

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

  18. Pancreatic neuroendocrine tumor and solid-pseudopapillary neoplasm: Key immunohistochemical profiles for differential diagnosis

    Science.gov (United States)

    Ohara, Yusuke; Oda, Tatsuya; Hashimoto, Shinji; Akashi, Yoshimasa; Miyamoto, Ryoichi; Enomoto, Tsuyoshi; Satomi, Kaishi; Morishita, Yukio; Ohkohchi, Nobuhiro

    2016-01-01

    AIM To reveal better diagnostic markers for differentiating neuroendocrine tumor (NET) from solid-pseudopapillary neoplasm (SPN), focusing primarily on immunohistochemical analysis. METHODS We reviewed 30 pancreatic surgical specimens of NET (24 cases) and SPN (6 cases). We carried out comprehensive immunohistochemical profiling using 9 markers: Synaptophysin, chromogranin A, pan-cytokeratin, E-cadherin, progesterone receptor, vimentin, α-1-antitrypsin, CD10, and β-catenin. RESULTS E-cadherin staining in NETs, and nuclear labeling of β-catenin in SPNs were the most sensitive and specific markers. Dot-like staining of chromogranin A might indicate the possibility of SPNs rather than NETs. The other six markers were not useful because their expression overlapped widely between NETs and SPNs. Moreover, two cases that had been initially diagnosed as NETs on the basis of their morphological features, demonstrated SPN-like immunohistochemical profiles. Careful diagnosis is crucial as we actually found two confusing cases showing disagreement between the tumor morphology and immunohistochemical profiles. CONCLUSION E-cadherin, chromogranin A, and β-catenin were the most useful markers which should be employed for differentiating between NET and SPN.

  19. A method to adjust radiation dose-response relationships for clinical risk factors

    DEFF Research Database (Denmark)

    Appelt, Ane Lindegaard; Vogelius, Ivan R

    2012-01-01

    Several clinical risk factors for radiation induced toxicity have been identified in the literature. Here, we present a method to quantify the effect of clinical risk factors on radiation dose-response curves and apply the method to adjust the dose-response for radiation pneumonitis for patients...

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

    Science.gov (United States)

    Duxbury, Mark

    2004-01-01

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

  1. [Combination analysis of new drug discovery with "Xiaohe Silian" method and traditional Chinese medicine clinical pharmacy].

    Science.gov (United States)

    Liu, Yang; Zhai, Hua-Qiang; Xiang, Jia-Mei; Wang, Jing-Juan; Zhao, Bao-Sheng; Wang, Gang; Dong, Hong-Huan; Ouyang, Guo-Qing

    2014-07-01

    With the kernel of efficacy, "Xiaohe Silian" was a pattern and method for new drug discovery which was constituted with "metabolism-efficacy, toxicity-efficacy, quality-efficacy and structure-efficacy". Its connotation was in keeping with traditional Chinese medicine (TCM) clinical pharmacy. This paper systematically summarized the research method of new drug discovery practice process for TCM. To avoid western drug like in TCM new drug discovery, we carried out combination analysis with TCM clinical pharmacy. The correlation analysis between basic elements of "Xiaohe Silian(n) and TCM clinical pharmacy was studied to guarantee this method could integrate closely with TCM clinic from all angles. Hence, this method aimed to provide a new method for TCM new drug discovery on the basis of TCM clinical pharmacy with insisting on holistic view of multicomponent study, kinetic view of metabolic process when the curative effect occurred and molecular material view of quality control and structure-activity exposition.

  2. Cutaneous epithelioid cell histiocytoma: immunohistochemical and ultrastructural findings suggesting endothelial origin.

    Science.gov (United States)

    Manente, L; Schmitt, I; Onetti, A M; Peris, K; Caracciolo, E; Chimenti, S

    1997-10-01

    A 13-year-old boy presented with a polypoid nodule localized in the groin. Although the clinical and histopathological features corresponded to previously described diagnostic criteria of epithelioid cell histiocytoma, immunohistochemical and ultrastructural findings suggested vascular differentiation of the epithelioid cells. In particular, the immunohistochemical negativity of the epithelioid cell elements for Factor XIIIa failed to substantiate the previously forwarded hypothesis that this lesion represents a dendrocytoma. Instead, the presence of histiocytoid, vacuolated cells occasionally containing sparse red blood cells, positive staining for Factor VIII-related antigen, and ultrastructural evidence of endothelial characteristics in epithelioid neoplastic cells favor the hypothesis that "epithelioid cell histiocytoma" is of endothelial origin. We suggest the descriptive term cutaneous histiocytoid hemangioendothelioma for this lesion.

  3. Digital squamous cell carcinoma in dogs: epidemiological, histological, and immunohistochemical study.

    Science.gov (United States)

    Belluco, S; Brisebard, E; Watrelot, D; Pillet, E; Marchal, T; Ponce, F

    2013-11-01

    Squamous cell carcinoma represents 47.4% of all malignant canine digital lesions, but despite its frequency, there are few published studies available. Pathology submission records of 154 cases and follow-up of 49 animals were analyzed. On the 49 cases, histological evaluation was performed of the differentiation degree, mitotic index, presence of emboli, and immunohistochemical expression of vimentin and E-cadherin. The mean (SD) age of affected animals was 10.2 (2.3) years; no sex predisposition was recorded. Beauceron and Briard were 2 new overrepresented breeds. Dark-haired animals comprised 97 of 105 (92%); 94 dogs of 125 (75.2%) belonged to large and giant breeds. The forelimb was affected twice more than the hind limb. Probable metastases were observed in 4 dogs; new tumor development was recorded in 11 of 49 (22.4%). Epidemiologic factors, histological grade, mitotic index, and expression of immunohistochemical markers seemed not to be related to the clinical outcome.

  4. Immunohistochemical investigation of wound healing in response to fractional photothermolysis

    Science.gov (United States)

    Helbig, Doris; Bodendorf, Marc Oliver; Grunewald, Sonja; Kendler, Michael; Simon, Jan C.; Paasch, Uwe

    2009-11-01

    Despite growing clinical evidence of ablative fractional photothermolysis (AFP), little is known about the spatiotemporal molecular changes within the targeted compartments. Six subjects received three different single AFP treatments using a scanned 250 μm CO2-laser beam. Spatiotemporal changes of skin regeneration were estimated by immunohistochemical investigation (HSP70, HSP72, HSP47, TGFβ, procollagen III, CD3, CD20, and CD68) in skin samples 1 h, 3 days, and 14 days postintervention. The remodeling was uniformly started by regrowth of the epidermal compartment followed by partial to complete replacement of the microscopic ablation zones (MAZ) by newly synthesized condensed procollagen III. From day 3 to 14, the number of macrophages as well as giant cells surrounding the MAZ increased. TGFβ expression was highest 1 h to 3 days following AFP. HSP70 and HSP72 expressions were highest 3-14 days postintervention in the spinocellular layer leading to an upregulation of HSP47. AFP performed by a scanned CO2-laser results in an early epidermal remodeling, which is followed by a dermal remodeling leading to a replacement of the MAZ with newly synthesized (pro)-collagen. During this, an inflammatory infiltrate with CD3+ and CD20+ cells surrounds the MAZ. The count of macrophages and giant cells involved in the replacement of the necrotic zones seems to be crucial for wound healing.

  5. Cellular and Subcellular Immunohistochemical Localization and Quantification of Cadmium Ions in Wheat (Triticum aestivum)

    OpenAIRE

    Wei Gao; Tiegui Nan; Guiyu Tan; Hongwei Zhao; Weiming Tan; Fanyun Meng; Zhaohu Li; Li, Qing X.; Baomin Wang

    2015-01-01

    The distribution of metallic ions in plant tissues is associated with their toxicity and is important for understanding mechanisms of toxicity tolerance. A quantitative histochemical method can help advance knowledge of cellular and subcellular localization and distribution of heavy metals in plant tissues. An immunohistochemical (IHC) imaging method for cadmium ions (Cd2+) was developed for the first time for the wheat Triticum aestivum grown in Cd2+-fortified soils. Also, 1-(4-Isothiocyanob...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-10-01

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

  7. [Methods and clinical applications of positron emission tomography in endocrinology].

    Science.gov (United States)

    De Landsheere, C; Lamotte, D

    1990-01-01

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

  8. Epileptic neuronal networks: methods of identification and clinical relevance.

    Science.gov (United States)

    Stefan, Hermann; Lopes da Silva, Fernando H

    2013-01-01

    The main objective of this paper is to examine evidence for the concept that epileptic activity should be envisaged in terms of functional connectivity and dynamics of neuronal networks. Basic concepts regarding structure and dynamics of neuronal networks are briefly described. Particular attention is given to approaches that are derived, or related, to the concept of causality, as formulated by Granger. Linear and non-linear methodologies aiming at characterizing the dynamics of neuronal networks applied to EEG/MEG and combined EEG/fMRI signals in epilepsy are critically reviewed. The relevance of functional dynamical analysis of neuronal networks with respect to clinical queries in focal cortical dysplasias, temporal lobe epilepsies, and "generalized" epilepsies is emphasized. In the light of the concepts of epileptic neuronal networks, and recent experimental findings, the dichotomic classification in focal and generalized epilepsy is re-evaluated. It is proposed that so-called "generalized epilepsies," such as absence seizures, are actually fast spreading epilepsies, the onset of which can be tracked down to particular neuronal networks using appropriate network analysis. Finally new approaches to delineate epileptogenic networks are discussed.

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

    Directory of Open Access Journals (Sweden)

    Luis Alberto Corona Martínez

    2007-04-01

    Full Text Available The use of a systemic approach in the theoretical analysis of the clinical method has allowed the elaboration of an schematic and synthetic representation of the new model of clinical diagnostic- therapeutic method developed from the conception of the medical assistance as a taking decisions process. The identification of the main components of the clinical method system, as well as of the interrelations established among these, facilitate the understanding of the medical attention process, and also allows the establishment of some of the regularities whose knowledge by the student is of great importance for the learning and application of the method by our Medicine students.

  10. Reporting and methods in clinical prediction research: a systematic review.

    Directory of Open Access Journals (Sweden)

    Walter Bouwmeester

    Full Text Available BACKGROUND: We investigated the reporting and methods of prediction studies, focusing on aims, designs, participant selection, outcomes, predictors, statistical power, statistical methods, and predictive performance measures. METHODS AND FINDINGS: We used a full hand search to identify all prediction studies published in 2008 in six high impact general medical journals. We developed a comprehensive item list to systematically score conduct and reporting of the studies, based on recent recommendations for prediction research. Two reviewers independently scored the studies. We retrieved 71 papers for full text review: 51 were predictor finding studies, 14 were prediction model development studies, three addressed an external validation of a previously developed model, and three reported on a model's impact on participant outcome. Study design was unclear in 15% of studies, and a prospective cohort was used in most studies (60%. Descriptions of the participants and definitions of predictor and outcome were generally good. Despite many recommendations against doing so, continuous predictors were often dichotomized (32% of studies. The number of events per predictor as a measure of statistical power could not be determined in 67% of the studies; of the remainder, 53% had fewer than the commonly recommended value of ten events per predictor. Methods for a priori selection of candidate predictors were described in most studies (68%. A substantial number of studies relied on a p-value cut-off of p<0.05 to select predictors in the multivariable analyses (29%. Predictive model performance measures, i.e., calibration and discrimination, were reported in 12% and 27% of studies, respectively. CONCLUSIONS: The majority of prediction studies in high impact journals do not follow current methodological recommendations, limiting their reliability and applicability.

  11. Immunohistochemical features of progesterone receptors expression of placental barrier in women with multiple pregnancies resulting from assisted reproduction

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    T. D. Zadorozhna

    2016-01-01

    Full Text Available Hormonal disorders are one of the main known causes of miscarriage and preterm birth in multiple pregnancies resulting from assisted reproductive technology (ART. Progesterone and the number of its receptors play an important role in the preservation and prolongation of pregnancy and it is the pressing issue of our time. The study of placentas, as the main site of synthesis of progesterone, has high informative potential and it is the most important diagnostic object, and information received by its research is essential for the full conclusion on the causes, mechanisms, close and long-term effects of multiple pregnancy pathology. Aim. The aim of our study was to investigate immunohistochemical features of placentas from women with dichorionic diamniotic twin pregnancies in spontaneous fertilization and after use of assisted reproductive technology (ART. Methods and results. According to this goal we examined 94 women, 44 of whom had multiple pregnancies due to ART, 42 with separate multiple pregnancy and 38 women with a singleton pregnancy. We carried out clinical and statistical analysis of the course of pregnancy and childbirth in the studied groups. During the study it was found that multiple pregnancies due to assisted reproduction belong to the high risk of gestation, at which premature births occur much more frequently than in singleton pregnancies. We were the first to carry out the immunohistochemical study of placentas in which the highest expression of progesterone receptors in the nuclei of cells of decidua (45% related to the parent structure of the placenta from women with multiple pregnancies caused by ART is found. It is also found that with increasing gestational age, there has been a significant decrease in the expression of the activity of progesterone receptors (from 45 to 2.5%, regardless of the method of conception and the number of fetuses. Conclusions. The results of the study point to the definitive link of structures of

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Robert A.Beckman; Cong Chen

    2013-01-01

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

  14. EGFR, p53, IDH-1 and MDM2 immunohistochemical analysis in glioblastoma: therapeutic and prognostic correlation

    Directory of Open Access Journals (Sweden)

    Richard Murdoch Montgomery

    2015-07-01

    Full Text Available We studied 36 glioblastoma cases at HC-UNICAMP from 2008 to 2012 and classified the immunohistochemical distribution of the wild-type epidermal growth factor receptor (EGFR, mutated forms of p53 protein and isocitrate dehydrogenase-1 (IDH-1 and murine double protein 2 (MDM2. Immunostaining findings were correlated with clinical data and response to treatment (surgery, chemotherapy and radiotherapy. About 97% of the tumors were primary, most of them localized in the frontal lobe. Mean time free of clinical or symptomatic disease and free time of radiological disease were 7.56 and 7.14 months, respectively. We observed a significant positive correlation between expressions of p53 and MDM2, EGFR and MDM2. Clinical, radiological and overall survivals also showed a significant positive correlation. p53 staining and clinical survival showed a significant negative correlation. The current series provides clinical and histopathological data that contribute to knowledge on glioblastoma in Brazilians.

  15. Chapter 15: Jean-Martin Charcot and the anatomo-clinical method of neurology.

    Science.gov (United States)

    Goetz, Christopher G

    2010-01-01

    Jean-Martin Charcot (1825-1893) was the premier clinical neurologist of the 19th century. Charcot's research was anchored in the anatomo-clinical method, a two-part methodology that linked clinical signs with anatomical lesions. The first step of this method involved the careful documentation of clinical signs with longitudinal observation. At the time of death, the second step involved autopsy examination of the brain and spinal cord. With combined clinical and anatomical data, Charcot was able to suggest concrete clinical-anatomical correlations. This method helped to define the tracts and nuclei responsible for normal and abnormal neurological signs and was pivotal to a new classification of neurological diseases based on anatomy. The best-developed example of this method was Charcot's work with motor system degenerative disorders, specifically amyotrophic lateral sclerosis. These studies led to the international designation of amyotrophic lateral sclerosis as Charcot's disease. Other examples of the fruits of the anatomo-clinical method included several stroke syndromes and the linkage of specific signs to specific lesions in multiple sclerosis. The discipline fostered cortical localization theory, which moved neurologists away from the concept of the brain as a homogenous organ in preference to the concept that brain regions controlled specific motor, sensory and language functions. Charcot's attempts to apply his anatomo-clinical method to the knotty neurological diagnosis of hysteria led him to experiments and conclusions that drew criticism and even scorn from colleagues. These events tarnished Charcot's reputation at the close of his career. In the context of Charcot's extensive discoveries and lasting contributions, the anatomo-clinical method remains the anchor of modern neurological diagnosis and is Charcot's most important contribution to clinical neurology.

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

    Directory of Open Access Journals (Sweden)

    Boulze Isabelle

    2006-02-01

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

  17. Sonic hedgehog in oral squamous cell carcinoma: An immunohistochemical study

    Science.gov (United States)

    Srinath, Sahana; Iyengar, Asha R; Mysorekar, Vijaya

    2016-01-01

    Background: Recent studies have revealed the involvement of hedgehog (Hh) signaling component in proliferation and invasive behavior of many carcinomas. Aim: This study aims to identify the expression of sonic Hh (SHH) protein of SHH pathway in oral epithelial dysplasia and oral squamous cell carcinoma (OSCC) using SHH (H-160) (Santa Cruz, sc-9042) which could have therapeutic implication in future. Materials and Methods: A total of 250 cases comprising 50 normal oral mucosa, 50 cases of oral epithelial dysplasia, 50 well, 50 moderate and 50 poorly differentiated OSCCs were included in the study. Immunohistochemical evaluation of SHH protein expression was conducted using monoclonal antibody. Interpretation of the expression was done by immunoreactive score of Remmele and Stegner (IRS) scoring method. Statistical Analysis: Chi-Square test was used to analyze the results. Results: The study showed that SHH signaling molecules are highly expressed in OSCC, and their expression was mainly in the cytoplasm of epithelial cells. Conclusion: The SHH signaling component is associated with the pathological parameter in OSCC and oral epithelial dysplasia. PMID:27721600

  18. IMMUNOHISTOCHEMICAL ANALYSIS OF UROTHELIAL BLADDER CANCERS

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    Katarina Bevizova

    2013-01-01

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

  19. Gliosarcoma: report of four cases with immunohistochemical findings Gliossarcoma: relato de quatro casos com achados imuno-histoquímicos

    OpenAIRE

    Tiago Noguchi Machuca; Daniel Monte-Serrat Prevedello; Leonora Zozula Blind Pope; Salo Semelman Haratz; João Cândido Araújo; Luiz Fernando Bleggi Torres

    2004-01-01

    Gliosarcoma (GSa) is a rare primary central nervous system neoplasm (CNS) characterized by biphasic histological pattern with both glial and sarcomatous components. Our objective is to describe the clinical, morphological and immunohistochemical features of four cases of GSa and to discuss its pathogenetic mechanisms. The male:female ratio was 3:1. The mean age was 39 years, ranging from 19 to 48. Headache was the commonest clinical symptom. All patients underwent craniotomy with microsurgery...

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

    Science.gov (United States)

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

    2009-11-15

    West Nile virus (WNV) can cause encephalitis or meningitis that affects brain tissue, which can also lead to permanent neurological damage that can be fatal. To our knowledge, no consistent double immunohistochemical staining of neurons, neuroglia cells, and WNV has yet been reported. To establish a method for performing double-label immunohistochemical detection of neurons, neuroglia cells and WNV, examining the pathological characteristics of WNV-infected neurons, neuroglia cells, and investigating distribution of WNV in monkey brain, paraffin-embedded monkey brain tissue were retrospectively studied by immunohistochemical staining of neurons, neuroglia cells and WNV. Antibodies against neuron-specific enolase (NSE), glial fibrillary acidic protein (GFAP) and WNV were used to develop the method of double-label immunohistochemical staining, which allowed independent assessment of neuron status and WNV distribution. A range of immunohistochemical WNV infection in monkey brain was observed in both neurons and neuroglia cells in terms of the thickness of lesion staining, and the WNV staining was slightly higher in neuroglia cells than in neurons. All these findings suggest that WNV invasion in the brain plays a crucial role in neurological damage by inducing central nervous system (CNS) cell dysfunction or cell death directly.

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

    Science.gov (United States)

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

    2013-01-01

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

  2. Expression of NF-κB and IL-6 in oral precancerous and cancerous lesions: An immunohistochemical study

    Science.gov (United States)

    Nikitakis, Nikolaos; Sfakianou, Aikaterini; Avgoustidis, Dimitrios; Sklavounou-Andrikopoulou, Alexandra

    2016-01-01

    Background The purpose of this study was to evaluate the immunohistochemical expression of NF-κB and IL-6 in oral premalignant and malignant lesions and to investigate their possible correlation with the presence of subepithelial inflammation. Material and Methods Thirty two oral premalignant lesions, clinically compatible with leukoplakia or erythroplakia, were investigated. Microscopically, 11 of them showed hyperkeratosis and acanthosis (epithelial hyperplasia) and 21 showed dysplasia of varying degrees. Nine cases of OSCC and four control cases of normal oral mucosa were also included in the study. Immunohistochemical staining with NF-κB (p65) and IL-6 was performed. IL-6 and nuclear NF-κB staining were assessed as positive or negative. For cytoplasmic localization of NF-κB, a total score combining intensity and percentage of positive epithelial cells was additionally calculated. The presence of inflammation was also recorded. Results Intensity and total scores for NF-κΒ cytoplasmic immunostaining showed a statistically significant gradual increase from normal mucosa to OSCC (p=0.012 and p=0.026 respectively). Non-statistically significant increased NF-κΒ nuclear localization was detected in dysplasias and OSCCs. Positive statistical correlation was detected between the presence of inflammation and IL-6 expression (p=0.015). No correlation between NF-κΒ and IL-6 was detected. Conclusions NF-κΒ is activated in the early stages of oral carcinogenesis. IL-6 may have an NF-κΒ-independent role, possibly through regulation of the inflammatory response. Key words:NF-κB, IL-6, immunohistochemistry, oral squamous cell carcinoma, oral precancerous lesion. PMID:26595830

  3. An Assessment of the Learning Method of Clinical Skills from the Viewpoint of Midwifery Graduates

    Directory of Open Access Journals (Sweden)

    Sh Mojahed

    2008-01-01

    Full Text Available Introduction: The promotion of clinical education quality requires the continuous investigation of the current status, identifying its strong potentialities, and modifying its weak points. The purpose of this study was to determine the clinical education status at Tehran University of Medical Sciences form the viewpoint of students of nursing and midwifery. Method : In this descriptive study, all the senior BS students of nursing and senior post diploma students of midwifery studying in the last semester including a total of 250 subjects were asked to fill in a self-administered 36-item questionnaire. The data were analyzed by SPSS using frequency distribution. Results : The most important strong points of clinical education were: instructors' proper treatment and approach toward students, punctual attendance of trainers, instructors and students, observing the prerequisites for practical training, following the stages of clinical education, instructors' complete support of students, and sufficient supervision on the course of clinical education, respectively. The most significant weak points of clinical education included: lack of use of teaching aids in the clinical environment, lack of sufficient facilities, lack of instructors clinical evaluation by students, lack of harmony between theoretical and practical courses. Conclusion : Though some aspects of clinical education are in an excellent state, reinforcing and improving the strong positive points and removing the weak points can function as an effective step in promoting the quality of clinical education. Through frequent assessments of the clinical setting and comparing the present status to the past, the strong and weak points can be determined and enumerated.

  4. [On the indiciary nature of the clinical method: an anthropological view of a published case study].

    Science.gov (United States)

    Quadrelli, Andrea; Cardoso, María Helena Cabral de Almeida; Castiel, Luis David

    2014-08-01

    In this article we present a published case study as an object of reflection. On this basis, we carried out a partial reconstruction of the process of study and diagnostic elaboration of the Uruguay syndrome, showing the circumstances of the case, the selection and interpretation of "clues," and some of the details relevant to the clinical reasoning. Our starting point is the recognition of the narrative nature of clinical knowledge and of the clinical method as an indiciary method. The manuscript of the Uruguay syndrome has a narrative structure adjusted to the conventions of a scientific article, which gives lesser importance to the clinical method. We carried out diverse methodical encounters, mainly involving in-depth interviews with the authors of the manuscript and observation in their workplace. The text seeks to recover the histories of work based on the indiciary or semiotic model of knowledge, and recognize the importance of this model in medical practice.

  5. Contraceptive Method Choice Among Women Attending at Amtullabhai Family Planning Clinic in Dar es salaam

    OpenAIRE

    Mbando, Apaisaria Humphrey

    2011-01-01

    Contraceptive prevalence in Tanzania is low despite high knowledge of contraception. In order to understand the existing barriers, it is important to find out reasons affecting contraceptive method choices. The objective of this study was to assess contraceptive method choice among women attending at Amtullabhai family planning clinic in Dar es Salaam. A cross- sectional study was conducted between October and November, 2010 at Amtullabhai family planning clinic, Ilala District in Dar es Sala...

  6. Immunohistochemical staining of radixin and moesin in prostatic adenocarcinoma

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    Becich Michael J

    2011-01-01

    Full Text Available Abstract Background Some members of the Protein 4.1 superfamily are believed to be involved in cell proliferation and growth, or in the regulation of these processes. While the expression levels of two members of this family, radixin and moesin, have been studied in many tumor types, to our knowledge they have not been investigated in prostate cancer. Methods Tissue microarrays were immunohistochemically stained for either radixin or moesin, with the staining intensities subsequently quantified and statistically analyzed using One-Way ANOVA or nonparametric equivalent with subsequent Student-Newman-Keuls tests for multiple comparisons. There were 11 cases of normal donor prostates (NDP, 14 cases of benign prostatic hyperplasia (BPH, 23 cases of high-grade prostatic intraepithelial neoplasia (HGPIN, 88 cases of prostatic adenocarcinoma (PCa, and 25 cases of normal tissue adjacent to adenocarcinoma (NAC analyzed in the microarrays. Results NDP, BPH, and HGPIN had higher absolute staining scores for radixin than PCa and NAC, but with a significant difference observed between only HGPIN and PCa (p = Conclusions To our knowledge, these studies represent the first reports on the expression profiles of radixin and moesin in prostatic adenocarcinoma. The current study has shown that there were statistically significant differences observed between HGPIN and PCa and HGPIN and NAC in terms of radixin expression. The differences in the moesin profiles by tissue type were not statistically significant. Additional larger studies with these markers may further elucidate their potential roles in prostatic neoplasia progression.

  7. Mechanism of benign biliary stricture: A morphological and immunohistochemical study

    Institute of Scientific and Technical Information of China (English)

    Zhi-Min Geng; Ying-Min Yao; Qing-Guang Liu; Xin-Jie Niu; Xiao-Gong Liu

    2005-01-01

    AIM: To explore the mechanism of benign biliary stricture.METHODS: A model of trauma of bile duct was established in 28 dogs. The anastomosed tissues were resected and examined by light and electron microscopes on day 3, in wk 1, 3 and mo 3, 6 after operation. CD68, TGF-β1 and α-SMA were examined by immunohistochemical staining, respectively.RESULTS: The mucosal epithelium of the bile duct was slowly recovered, chronic inflammation lasted for a long time,fibroblasts proliferated actively, extracellular matrix was over-deposited. Myofibroblasts functioned actively and lasted through the whole process. The expression of macrophages in lamina propria under mucosa, TGF-β1 in granulation tissue,fibroblasts and endothelial cells of blood vessels, α-SMA in myofiroblasts were rather strong from the 1st wk to the 6th mo after operation.CONCLUSION: The type of healing occurring in bile duct belongs to overhealing. Myofibroblasts are the main cause for scar contracture and stricture of bile duct. High expressions of CD68, TGF-β1 and α-SMA are closely related to the active proliferation of fibroblasts, extracellular matrix overdeposition and scar contracture of bile duct.

  8. Immunohistochemical correlates of TP53 somatic mutations in cancer.

    Science.gov (United States)

    Murnyák, Balázs; Hortobágyi, Tibor

    2016-10-04

    Despite controversy on the correlation between p53 accumulation and TP53 mutational status, immunohistochemical (IHC) detection of overexpressed protein has long been used as a surrogate method for mutation analysis. The aim of our study was to characterise the IHC expression features of TP53 somatic mutations and define their occurrence in human cancers. A large-scale database analysis was conducted in the IARC TP53 Database (R17); 7878 mutations with IHC features were retrieved representing 60 distinct tumour sites. The majority of the alterations were immunopositive (p TP53 mutations were divided into three IHC groups according to mutation frequency and IHC positivity. Each group had female dominance. Among the IHC groups, significant correlations were observed with age at diagnosis in breast, bladder, liver, haematopoietic system and head & neck cancers. An increased likelihood of false negative IHC associated with rare nonsense mutations was observed in certain tumour sites. Our study demonstrates that p53 immunopositivity largely correlates with TP53 mutational status but expression is absent in certain mutation types.Besides, describing the complex IHC expression of TP53 somatic mutations, our results reveal some caveats for the diagnostic practice.

  9. Immunohistochemical detection of P53 and Mdm2 in vitiligo

    Science.gov (United States)

    Bakry, Ola A.; Hammam, Mostafa A.; Wahed, Moshira M. Abdel

    2012-01-01

    Background: Vitiligo is a common depigmented skin disorder that is caused by selective destruction of melanocytes. It is generally accepted that the main function of melanin resides in the protection of skin cells against the deleterious effect of ultraviolet rays (UVRs). Association of vitiligo and skin cancer has been a subject of controversy. Occurrence of skin cancer in long-lasting vitiligo is rare despite multiple evidences of DNA damage in vitiliginous skin. Aim: To detect the expression of P53 and Mdm2 proteins in both depigmented and normally pigmented skin of vitiligo patients and to compare it to control subjects suffering from nonmelanoma skin cancer (NMSC). Materials and Methods: Thirty-four patients with vitiligo and 30 age and sex-matched patients with nodulo-ulcerative basal cell carcinoma (BCC) as a control group were selected. Both patients and control subjects had outdoor occupations. Skin biopsies were taken from each case and control subjects. Histopathological examination of Hematoxylin and eosin-stained sections was done. Expression of P53 and Mdm2 proteins were examined immunohistochemically. Results: Both P53 and Mdm2 were strongly expressed in depigmented as well as normally pigmented skin of vitiligo patients. This expression involved the epidermis, skin adnexa and blood vessels with significant differences between cases and controls. Conclusions: The overexpression of P53 and Mdm2 proteins in both normally pigmented and depigmented skin of patients with vitiligo could contribute to the decreased occurrence of actinic damage and NMSC in these patients. PMID:23189248

  10. Pathology of post-kala-azar dermal leishmaniasis: a light microscopical, immunohistochemical, and ultrastructural study of skin lesions and draining lymph nodes

    DEFF Research Database (Denmark)

    Ismail, Ahmed; Gadir, A Fattah A; Theander, Thor G

    2006-01-01

    BACKGROUND: Whereas the clinical manifestations and treatment of post-kala-azar dermal leishmaniasis (PKDL) have been adequately described before, the pathology received little attention, particularly the African form of PKDL which shows some clinical differences from the disease in India...... leishmaniasis: a light microscopical, immunohistochemical, and ultrastructural study of skin lesions and draining lymph nodes....

  11. Research methods to change clinical practice for patients with rare cancers.

    Science.gov (United States)

    Billingham, Lucinda; Malottki, Kinga; Steven, Neil

    2016-02-01

    Rare cancers are a growing group as a result of reclassification of common cancers by molecular markers. There is therefore an increasing need to identify methods to assess interventions that are sufficiently robust to potentially affect clinical practice in this setting. Methods advocated for clinical trials in rare diseases are not necessarily applicable in rare cancers. This Series paper describes research methods that are relevant for rare cancers in relation to the range of incidence levels. Strategies that maximise recruitment, minimise sample size, or maximise the usefulness of the evidence could enable the application of conventional clinical trial design to rare cancer populations. Alternative designs that address specific challenges for rare cancers with the aim of potentially changing clinical practice include Bayesian designs, uncontrolled n-of-1 trials, and umbrella and basket trials. Pragmatic solutions must be sought to enable some level of evidence-based health care for patients with rare cancers.

  12. Effect of Multi Mentoring Educational Method on Clinical Competence of Nursing Students

    Directory of Open Access Journals (Sweden)

    R Hosseinabadi

    2015-09-01

    Full Text Available Introduction: Mentoring, as a strategy, plays an important role in professional development of nursing students . Hence, this study was aimed to determine the effect of multi-mentoring educational method on clinical competencies of 8th term nursing students.   Methods: In this intervention study, all of 8th term nursing students of Khorramabad school of nursing in two consecutive term were selected through census method and divided into two groups of mentorship and control(routine trough simple random method. The subjects in the mentorship group completed their field training with corporation of two mentors. The subjects in the control group done their training in the presence of a full-time instructor. Nursing student's clinical competence was measured before and 10 weeks after the intervention using the 6-dimension scale of clinical competencies. Furthermore, the mentor-ship group in regard with the study date were analyzed using descriptive statistics and T-test.   Findings: The results of paired t-test demo instructed a significant difference in the sub-score of teaching-collaboration and total score of clinical competence (p0.05. Moreover, significant difference was reported in the scores of planning/evaluation of nursing care, interpersonal relationship s well as total score of clinical competence between the two groups (p<0.05.   Conclusion: The finding of this study revealed that implementing multi-mentoring method can result in promoting nursing student’s clinical competence and increasing their satisfaction with the course.

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

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    Trohimovych O.V.

    2015-03-01

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

  14. An immunohistochemical study of Flexibacter psychrophilus infection in experimentally and naturally infected rainbow trout (Oncorhynchus mykiss) fry

    DEFF Research Database (Denmark)

    Evensen, O.; Lorenzen, Ellen

    1996-01-01

    was compared in naturally and experimentally (intraperitoneal injections) infected fry by use of immunohistochemistry. This study showed that F. psychrophilus could be detected in paraffin-wax-embedded tissue of rainbow trout fry by immunohistochemistry. The principal immunohistochemical findings in naturally......An immunohistochemical method is described for the detection of Flexibacter psychrophilus in formalin-fixed, parafiin-wax-embedded fry of rainbow trout. Rabbit antiserum as well as rainbow trout hyperimmune serum were used in the study. The distribution and tissue localization of the bacterium...

  15. Use of the experience sampling method in the context of clinical trials

    Science.gov (United States)

    Verhagen, Simone J W; Hasmi, Laila; Drukker, Marjan; van Os, J; Delespaul, Philippe A E G

    2016-01-01

    Objective The experience sampling method (ESM) is a structured diary technique to appraise subjective experiences in daily life. It is applied in psychiatric patients, as well as in patients with somatic illness. Despite the potential of ESM assessment, the improved logistics and its increased administration in research, its use in clinical trials remains limited. This paper introduces ESM for clinical trials in psychiatry and beyond. Methods ESM is an ecologically valid method that yields a comprehensive view of an individual's daily life. It allows the assessment of various constructs (eg, quality of life, psychopathology) and psychological mechanisms (eg, stress-sensitivity, coping). These constructs are difficult to assess using cross-sectional questionnaires. ESM can be applied in treatment monitoring, as an ecological momentary intervention, in clinical trials, or in single case clinical trials. Technological advances (eg, smartphone applications) make its implementation easier. Results Advantages of ESM are highlighted and disadvantages are discussed. Furthermore, the ecological nature of ESM data and its consequences are explored, including the potential pitfalls of ambiguously formulated research questions and the specificities of ESM in statistical analyses. The last section focuses on ESM in relation to clinical trials and discusses its future use in optimising clinical decision-making. Conclusions ESM can be a valuable asset in clinical trial research and should be used more often to study the benefits of treatment in psychiatry and somatic health. PMID:27443678

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

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    Scardino Peter T

    2009-03-01

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

  17. COMPARATIVE STUDY FOR ESTIMATION OF FETAL WEIGHT BY CLINICAL & ULTRASONOGRAPHICAL METHODS IN TERM PATIENTS

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    Karuna

    2014-03-01

    Full Text Available BACKGROUND: Accurate determination of fetal birth weight prior to delivery can have significant bearing on management decision in labor, thereby markedly improving perinatal outcome. OBJECTIVE: To assess fetal weight in term pregnancy by different clinical and ultrasonographical methods. MATERIALS AND METHODS: The study was conducted in Obstetrics and Gynecology department of Dr. D.Y. Patil Medical College, Pimpri, Pune. Two hundred (200 women were selected and studied for a period of one year based on convenience sampling from October 2011 to September 2013.The fetal weight was estimated a week prior to the delivery by both ultrasound and clinical examination. Various formulae’s for estimation of fetal weight were applied based on Ultrasound and clinical parameters. All results arising from different formulas were studied and suitable statistics was applied and compared to have clear idea regarding results. RESULTS: All results arising from different formulas were studied by Descriptive statistics and compared with Actual weight at the time of delivery (gold standard. A box plot was used to differentiate various methods used for estimation of fetal weight, It shows that Johnson, Dawn formula and weight in gms (Dare’s formula corresponds with the base line indicating that they can predict birth weight correctly and among these Johnson showed promising results, whereas formulas like Campbell, Comb’s, Hadlock and Warsof didn’t predict birth weight as accurately as the three clinical methods used, thus in our study it can be seen that clinical methods are better predictors of birth weight than ultrasonographic methods. CONCLUSIONS: In our study it was observed that Clinical methods used for estimation of fetal birth weight was found to be by far simple and reliable methods in estimation of fetal birth weight than Ultrasonographic estimation methods and thus holds importance in day to day practice especially in countries like us where still

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    analysis) is rarely available in the clinic, the clinician needs applicable assessment tools to characterise scapular alterations.The aims were to compile a schematic overview of the available clinical scapular assessment methods and critically appraise the methodological quality of the involved studies...... an exhaustive list of scapular assessment methods on the basis of an initial search; 2) Additionally search for studies including clinimetric outcome measures of the identified assessment methods; 3) Critically appraise the methodological quality of the identified measurement properties in each study; and 4...

  19. [Theory analysis and clinical application of spirit-regulating and pain-relieving acupuncture method].

    Science.gov (United States)

    Chen, Liang; Tang, Lewei; Du, Huaibin; Zheng, Hui; Liang, Fanrong

    2015-04-01

    The theoretical foundation and scientific connotation of spirit-regulating and pain-relieving acupuncture method as well as its clinical application for pain are discussed. During spirit regulation, attention should be paid on regulating heart and brain, while acupoints should be selected mainly from the Heart Meridian, Pericardium Meridian and Governor Vessel. It has significant efficacy for refractory pain in clinical treatment. Spirit-regulating and pain-relieving acupuncture method is development of acupuncture treating spirit, and it is an important method for pain in clinic. Improvement on sensitization of pain center and brain function is considered as one of the mechanisms in spirit-regulating and pain-relieving acupuncture method.

  20. Methodical principles of assessment of financial compensation for clinical trial volunteer participants

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    V. Ye. Dobrova

    2013-10-01

    Full Text Available Introduction. Due to the necessity to obtain the reliable results of a clinical trial and to distribute it to the general population of patients the problem of recruiting the adequate number of individuals to participate in the study as objects of observation in the group receiving the investigational medicinal product or as a member of the control group should to be solved. Aim of study. The aim of our study was to research and to justify practically the methodological approaches to determining financial compensation for participation of volunteers in the clinical trials and the appropriate methods of its calculation. Material and methods. For the purpose of determining the baseline factors for calculating the hourly compensation the survey of healthy volunteers and of expert professionals as well as the analysis of its results have been done. Questioning healthy volunteers regarding their attitudes towards inconvenience and discomfort during participation in clinical trials was held at the Ukrainian clinical research centers. Survey participants number was 99, they were healthy volunteers who took part in the first phase clinical trial or bioequivalence studies. The expert survey included questioning of the 193 professionals from Ukrainian clinical research centers, CRO, pharmaceutical manufacturers – research sponsors and collaborators State Expert Center Ministry of Health of Ukraine, who were involved in the planning, organization, implementation and evaluation of clinical trials as well as their regulatory control. Results of study. Using the method of pairwise comparisons and iterative refinement procedures the collective estimate of experts questionnaire results has been performed, by the results of which the nine indicators have been identified and the importance of each of them as units of discomfort have been established. Motivational factors of voluntary participation in clinical trials have been studied. Motivation system for

  1. Online survey system for image-based clinical guideline studies using the Delphi method.

    Science.gov (United States)

    Harper, Todd M; Teng, Chia-Chi

    2011-01-01

    The increasing use of health information technology (HIT) is due to a rising interest in improving the quality of health care. HIT has the potential to reduce cost and transform services. Proper clinical support systems will contribute to the meaningful use of HIT systems by providing a wide array of data to clinicians for the diagnosis and treatments. Clinical guidelines, created by a consensus of experts, can be put in place to assist physicians in making clinical decisions. Delphi methods are commonly used to create consensus from surveys completed by a team of experts. Image based studies could create guidelines that standardize severity, deformity or other clinical classifications. As these studies were traditionally conducted using paper based media, the cost and time requirement often make the process impractical. Ware proposing a web based system to aid medical researchers in conducting image based Delphi studies for improved clinical guidelines and decision support.

  2. Collagenous gastritis: a morphologic and immunohistochemical study of 40 patients.

    Science.gov (United States)

    Arnason, Thomas; Brown, Ian S; Goldsmith, Jeffrey D; Anderson, William; O'Brien, Blake H; Wilson, Claire; Winter, Harland; Lauwers, Gregory Y

    2015-04-01

    Collagenous gastritis is a rare condition defined histologically by a superficial subepithelial collagen layer. This study further characterizes the morphologic spectrum of collagenous gastritis by evaluating a multi-institutional series of 40 patients (26 female and 14 male). The median age at onset was 16 years (range 3-89 years), including 24 patients (60%) under age 18. Twelve patients (30%) had associated celiac disease, collagenous sprue, or collagenous colitis. Hematoxylin and eosin slides were reviewed in biopsies from all patients and tenascin, gastrin, eotaxin, and IgG4/IgG immunohistochemical stains were applied to a subset. The distribution of subepithelial collagen favored the body/fundus in pediatric patients and the antrum in adults. There were increased surface intraepithelial lymphocytes (>25 lymphocytes/100 epithelial cells) in five patients. Three of these patients had associated celiac and/or collagenous sprue/colitis, while the remaining two had increased duodenal lymphocytosis without specific etiology. An eosinophil-rich pattern (>30 eosinophils/high power field) was seen in 21/40 (52%) patients. Seven patients' biopsies demonstrated atrophy of the gastric corpus mucosa. Tenascin immunohistochemistry highlighted the subepithelial collagen in all 21 specimens evaluated and was a more sensitive method of collagen detection in biopsies from two patients with subtle subepithelial collagen. No increased eotaxin expression was identified in 16 specimens evaluated. One of the twenty-three biopsies tested had increased IgG4-positive cells (100/high power field) with an IgG4/IgG ratio of 55%. In summary, collagenous gastritis presents three distinct histologic patterns including a lymphocytic gastritis-like pattern, an eosinophil-rich pattern, and an atrophic pattern. Eotaxin and IgG4 were not elevated enough to implicate these pathways in the pathogenesis. Tenascin immunohistochemistry can be used as a sensitive method of collagen detection.

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

    DEFF Research Database (Denmark)

    Poulsen, Steen Seier; Nexø, Ebba

    1986-01-01

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

  4. Clinicopathological and immunohistochemical features of lung invasive mucinous adenocarcinoma based on computed tomography findings

    Directory of Open Access Journals (Sweden)

    Shimizu K

    2016-12-01

    Full Text Available Katsuhiko Shimizu, Riki Okita, Shinsuke Saisho, Ai Maeda, Yuji Nojima, Masao Nakata Department of General Thoracic Surgery, Kawasaki Medical School, Kurashiki, Okayama, Japan Background: We performed an analysis to clarify differences in clinicopathological and molecular features of lung invasive mucinous adenocarcinoma (IMA based on computed tomography (CT findings and their impact on prognosis.Patients and methods: On the basis of CT findings, we divided lung IMA into three subtypes: solid, bubbling, and pneumonic. We then investigated differences in clinicopathological characteristics, prognosis, and the expressions of well-identified biomarkers, including cyclooxygenase-2 (Cox-2, excision repair cross-complementation group 1 (ERCC1, ribonucleotide reductase M1 (RRM1, class III beta-tubulin, thymidylate synthase (TS, secreted protein acidic and rich in cysteine (SPARC, programmed cell death-1 ligand-1 (PD-L1, and epidermal growth factor receptor mutation, among the three subtypes.Results: A total of 29 patients with resected lung IMA were analyzed. Compared with the solid or bubbling type, the pneumonic type had a higher proportion of symptoms, a larger tumor size, a higher pathological stage, and a significantly worse prognosis. The immunohistochemical findings tended to show high expression of RRM1, class III beta-tubulin, and Cox-2 in the tumor and of SPARC in the stroma, but not of ERCC1, TS, and PD-L1 in the tumor. None of the biomarkers with high expression levels in the tumor were prognostic biomarkers, but the expression of SPARC in the stroma was correlated with a poor outcome.Conclusion: Clinical and pathological features, in conjunction with molecular data, indicate that IMA should be divided into different subgroups. In our results, the pneumonic type was correlated with a significantly worse outcome. Further studies should be performed to confirm our conclusion and to explore its molecular implications. Keywords: non-small cell

  5. Immunohistochemical characterization of molecular classification of breast carcinoma and its relation with Ki-67

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    Shabnam Karangadan

    2016-01-01

    Full Text Available Background: Breast carcinoma is the leading cause of cancer deaths in women. Molecular classification of breast carcinoma along with Ki-67 index is considered a better predictive factor for prognosis and treatment than routine histopathology. Aims: To classify breast carcinoma into the four molecular subtypes defined by immunohistochemical expression of triple markers: Luminal A (estrogen receptor/progesterone receptor-positive [ER/PR+] and human epidermal growth factor receptor 2 HER2/neu, luminal B (ER/PR + and HER2/neu+, triple negative (ER/PR − and HER2/neu−, and HER2 positive (ER/PR−, HER2/neu+, and to correlate the expression of ER, PR, HER2/neu, and classification with Ki-67. Materials and Methods: The present study includes sixty breast carcinoma cases studied over a 3-year period. The expression patterns of ER, PR, HER2/neu, and Ki-67 were studied. Clinical features, pathologic features such as size, grade, and lymph node status, and correlation with Ki-67 of the four subtypes were compared. Results: Out of sixty cases, most common molecular subtype was triple negative (40.00% followed by luminal B (23.33%. Most of the tumors showed low proliferative index (low Ki-67; however, triple negative and HER2 positive subtype showed high proliferative index. Most common histological subtype was ductal carcinoma which was mainly triple negative. All medullary carcinoma cases were triple negative. One case of lobular carcinoma and mucinous carcinoma each was HER2 positive and luminal B, respectively. Single case of carcinoma of male breast was luminal B subtype. Conclusion: Correlation of molecular classification with age, histological grade, and Ki-67 was statistically significant (P < 0.05. ER/PR also correlated with histological grade and Ki-67 (P < 0.01. These results emphasize the fact that molecular subtypes correlate with prognosis and aid in targeted therapy.

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

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

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

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

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    Almir Galvão Vieira Bitencourt

    2014-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Uchiyama Chieko

    2012-06-01

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

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

    Science.gov (United States)

    Hart, Curtis W

    2002-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ruby Yadav

    2016-08-01

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

  11. Differences in quantitative methods for measuring subjective cognitive decline - results from a prospective memory clinic study

    DEFF Research Database (Denmark)

    Vogel, Asmus; Salem, Lise Cronberg; Andersen, Birgitte Bo

    2016-01-01

    influence reports of cognitive decline. METHODS: The Subjective Memory Complaints Scale (SMC) and The Memory Complaint Questionnaire (MAC-Q) were applied in 121 mixed memory clinic patients with mild cognitive symptoms (mean MMSE = 26.8, SD 2.7). The scales were applied independently and raters were blinded...... decline are not interchangeable when used in memory clinics and the application of different scales in previous studies is an important factor as to why studies show variability in the association between subjective cognitive decline and background data and/or clinical results. Careful consideration...

  12. [Results of toothlessness treatment by calottic method in the Cracow modification. Clinical studies].

    Science.gov (United States)

    Majewski, S; Wiśniewska, G; Wencel, T

    1988-11-01

    The purpose of the paper was to control the new method of teeth positioning in complete dentures based on the modification of callottic method in clinical practice. Clinical studies depended on occlusion and articulation estimation, examination of denture statics, control of occlusion height and registration of the patients' subjective experiences. They concerned 81 toothless patients divided into 2 groups according to the specific classification and wearing complete dentures in which the teeth had been positioned according to the modified method and Gysi-Fischer' method. In the groups of patients under examination that had teeth positioned according to the modified method significantly better results of the values estimated than in comparative groups have been achieved. It has been found that using the modified method smooth OA surface of artifical teeth is obtained without necessity of its correction satisfactory denture statics is obtained and rehabilitation of mastication function and adaptation to the dentures take place in a short period of time.

  13. [Molecular and immunohistochemical diagnostics in melanoma].

    Science.gov (United States)

    Schilling, B; Griewank, K G

    2016-07-01

    To provide appropriate therapy and follow-up to patients with malignant melanoma, proper diagnostics are of critical importance. Targeted therapy of advanced melanoma is based on the molecular genetic analyses of tumor tissue. In addition, sequencing of genes and other genetic approaches can provide insight into the origin of melanocytic tumors and can aid in distinguishing benign from malignant lesions. In this regard, spizoid neoplasms remain a challenging entity. Aside from genetic analyses of tumor tissue, immunohistochemistry remains an essential tool in melanoma diagnostics and TNM classification. With new immunotherapies being approved for advanced melanoma, immunohistochemistry to determine PD-L1 expression has gained clinical interest. While PD-L1 expression is associated with response to PD-1 blockade, a substantial number of patients without PD-L1 expression can still experience tumor remission upon treatment. In this review, current and future developments in melanoma diagnostics with regard to molecular genetics and immunohistochemistry are summarized. The utilization of such analyses in clinical decision making is also discussed.

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

    Directory of Open Access Journals (Sweden)

    A. ISLAS

    2001-01-01

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

  15. Klapp method effect on idiopathic scoliosis in adolescents: blind randomized controlled clinical trial

    OpenAIRE

    Dantas, Diego de Sousa; Assis, Sanderson José Costa de; Baroni, Marina Pegoraro; Lopes, Johnnatas Mikael; Cacho, Enio Walker Azevedo; Cacho,Roberta de Oliveira; Pereira, Silvana Alves

    2017-01-01

    [Purpose] To estimate the effect of Klapp method on idiopathic scoliosis in school students. [Subjects and Methods] A single-blind randomized clinical trial with 22 students randomly divided into intervention group (n=12) and inactive control group (n=10). Exercise protocol consisted of Klapp method, 20 sessions, three times a week for intervention group, and inactivity for control group. Dorsal muscle strength was measured by dynamometer; body asymmetries and gibbosity angles were measured b...

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

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    Vardosanidze S.L.

    2010-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Luis Alberto Corona Martínez

    2006-12-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

  19. Expression and clinical significance of vascular endothelial growth factor-C and nm23-H1 in stage Ⅱ and Ⅲ colorectal carcinomas

    Institute of Scientific and Technical Information of China (English)

    耿倩倩

    2013-01-01

    Objective To discuss the expression and clinical significance of VEGF-C and nm23-H1 in stageⅡandⅢcolorectal carcinomas.Methods SP immunohistochemical staining was employed to determine the expression of vascular endothelial growth factor-C (VEGF-C) and nm23-H1 in the tumor tissues of 110 cases of stageⅡ

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

    Directory of Open Access Journals (Sweden)

    Carlos Esteban Zerquera Álvarez

    2010-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Afreenish Hassan

    2011-08-01

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

  2. Marrying content and process in clinical method teaching: enhancing the Calgary-Cambridge guides.

    Science.gov (United States)

    Kurtz, Suzanne; Silverman, Jonathan; Benson, John; Draper, Juliet

    2003-08-01

    Communication skills training is now internationally accepted as an essential component of medical education. However, learners and teachers in communication skills programs continue to experience problems integrating communication with other clinical skills, ensuring that clinical faculty support and teach communication beyond the formal communication course, extending communication training coherently into clerkship and residency, and applying communication skills in medical practice at a professional level of competence. One factor contributing to these problems is that learners confront two apparently conflicting models of the medical interview: a communication model describing the process of the interview and the "traditional medical history" describing the content of the interview. The resulting confusion exacerbates the above dilemmas and interferes with learners using communication skills training to advantage in real-life practice. The authors propose a comprehensive clinical method that explicitly integrates traditional clinical method with effective communication skills. To implement this more comprehensive approach, they have modified their own Calgary-Cambridge guides to the medical interview by developing three diagrams that visually and conceptually improve the way communication skills teaching is introduced and that place communication process skills within a comprehensive clinical method; devising a content guide for medical interviewing that is more closely aligned with the structure and process skills used in communication skills training; and incorporating patient-centered medicine into both process and content aspects of the medical interview. These enhancements help resolve ongoing difficulties associated with both teaching communication skills and applying them effectively in medical practice.

  3. The summer institute in clinical dental research methods: still going and growing after twenty years.

    Science.gov (United States)

    Derouen, Timothy A; Wiesenbach, Carol

    2012-11-01

    The first Summer Institute in Clinical Dental Research Methods, a faculty development program at the University of Washington, was offered in the summer of 1992 for sixteen participants. The primary objective of the program was to give clinical faculty members in dentistry an introduction to and an understanding of the fundamental principles and methods used in good clinical research. In the twentieth offering of the institute in 2011, there were thirty-five participants, and over the twenty institutes, there has been a cumulative total of 463 participants who have come from thirty U.S. states as well as forty-three countries outside the United States. The curriculum has expanded from the initial offering of biostatistics, clinical epidemiology, behavioral research methods, and ethics in clinical research to now include clinical trials, grantsmanship, data analysis, an elective in molecular biology, and a team project that provides participants with hands-on experience in research proposal development as members of an interdisciplinary team. Enrollment has doubled since the first year, yet exit evaluations of the program content have remained consistently high (rated as very good to excellent). One of the indicators of program quality is that at least 50 percent of recent participants indicated that they attended because the program was recommended by colleagues who had attended. There seems to be an ever-increasing pool of dental faculty members who are eager to learn more about clinical research methodology through the institute despite the intensive demands of full-time participation in a six-week program.

  4. Papillary microcarcinomas of the thyroid gland and immunohistochemical analysis of expression of p53 protein in papillary microcarcinomas

    Directory of Open Access Journals (Sweden)

    Uysal Ali R

    2006-07-01

    Full Text Available Abstract Background Thyroid papillary microcarcinoma (TPM is defined according to WHO criteria as a thyroid tumor smaller than 1–1.5 cm. TPMs are encountered in 0.5–35.6 % of autopsies or surgical specimens where carcinoma had been unsuspected. The purpose of the present study was to evaluate patients who had TPMs in terms of clinical findings, histopathological features and immunohistochemical evidence of expression of the tumor suppressor gene p53. Methods A total of 44 patients with TPMs less than 1.0 cm in diameter were included in the study. The patients were evaluated clinically and the tumors were evaluated in terms of their histopathological and immunohistochemical features, including expression of p53. Results The female/male ratio was 2.8/1, and the median age at time of diagnosis was 49 years (range 20–71 years. The maximum diameter of the smallest focus was 0.1 mm, and that of the largest was 10 mm microscopically. The mean diameter of all tumors was 5.7 mm. There was no correlation between tumor size and age or gender. Of the TPMs, 72 % were found in the right lobe, 24 % in the left lobe and 4 % in the isthmus. Fine-needle aspiration biopsy provided the diagnosis of TPM in only 43.2 % of the patients. All patients were treated with surgery, with 20 undergoing conservative surgery, i.e. lobectomy or isthmusectomy, and 24 undergoing total thyroidectomy. Frozen section provided the diagnosis of TPM in only 56.8 % of the patients. We found lymphocytic thyroiditis in 13.6% of patients, follicular variants in 11.9%, capsular invasion in 26.8%, lymph node involvement in 11.9%, soft tissue metastases in the neck in 12.1% and multifocality in 31.7 %, and none of these were related to age or gender (p > 0.05. No distant metastases were observed during approximately 10 years of follow up. We found p53 positivity in 34.5 % of TPM tumors. However, p53 expression was not statistically related to age or gender. Conclusion Our findings imply

  5. Method to integrate clinical guidelines into the electronic health record (EHR) by applying the archetypes approach.

    Science.gov (United States)

    Garcia, Diego; Moro, Claudia Maria Cabral; Cicogna, Paulo Eduardo; Carvalho, Deborah Ribeiro

    2013-01-01

    Clinical guidelines are documents that assist healthcare professionals, facilitating and standardizing diagnosis, management, and treatment in specific areas. Computerized guidelines as decision support systems (DSS) attempt to increase the performance of tasks and facilitate the use of guidelines. Most DSS are not integrated into the electronic health record (EHR), ordering some degree of rework especially related to data collection. This study's objective was to present a method for integrating clinical guidelines into the EHR. The study developed first a way to identify data and rules contained in the guidelines, and then incorporate rules into an archetype-based EHR. The proposed method tested was anemia treatment in the Chronic Kidney Disease Guideline. The phases of the method are: data and rules identification; archetypes elaboration; rules definition and inclusion in inference engine; and DSS-EHR integration and validation. The main feature of the proposed method is that it is generic and can be applied toany type of guideline.

  6. [The Cracow modification of the Calotte method of teeth placement in clinical evaluation].

    Science.gov (United States)

    Majewski, S; Wiśniewska, G

    1990-01-01

    The purpose of the paper was checking of theoretical principles and assessment of the clinical usefulness of the calotte method of teeth placement in Cracow modification. In 110 patients this study was carried out according to the following schema: prosthetic treatment using complete prostheses with teeth placed by the modified method or by the Gysi-Fischer method, for comparison, and periodically repeated clinical examinations considering such elements as: articulation and occlusion, fixation and statics of prostheses, masticatory function and speech, and aesthetic result and adaptation process. In all these parameters good results were obtained by the modified method. It is concluded that the modification is particularly useful in therapeutically difficult cases, with unfavourable anatomic-physiological conditions of the denture bearing area.

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

    DEFF Research Database (Denmark)

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

    2009-01-01

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

  8. Patients recording clinical encounters: a path to empowerment? Assessment by mixed methods

    NARCIS (Netherlands)

    Elwyn, G.; Barr, P.J.; Grande, S.W.

    2015-01-01

    OBJECTIVE: To examine the motivations of patients recording clinical encounters, covertly or otherwise, and why some do not wish to record encounters. DESIGN: Mixed-methods analysis of survey data and nested semistructured interviews. SETTING: Survey to UK audience, using social media and radio broa

  9. Radiographic aluminum equivalent value of bone : the development of a registration method and some clinical applications

    NARCIS (Netherlands)

    W.T. Trouerbach (Willem)

    1982-01-01

    textabstractThe aim of this thesis is to establish and develop a method suitable for obtaining an objective analysis of bone as registered on a radiographic image. This analysis concerns determination of the quantity of bone mineral present. The system has been tested in-vitro and in a clinical stud

  10. TRANSPLANTATION OF HEPATOCYTES AS THE METHOD OF TREATMENT OF LIVER FAILURE: EXPERIMENTAL AND CLINICAL EXPERIENCE

    Directory of Open Access Journals (Sweden)

    M. Y. Shagidulin

    2010-01-01

    Full Text Available For correction and treatment of liver failure before liver transplantation were proposed severe methods such as: extracorporal devices, transplantation of hepatocytes and implanted tissue-engineering units. The function of healthy hepatocytes presumes to stabilize the state of patients with chronic liver diseases and to wait a donor organ transplantation. In this review the results of experimental and clinical therapy of liver diseases by method of hepatocyte transplantation were summarized. 

  11. Clinical Application of the Reinforcing and Reducing Methods of Acupuncture and Moxibustion

    Institute of Scientific and Technical Information of China (English)

    Mi Deping; Wang Xinzhong

    2006-01-01

    @@ The reinforcing and reducing are the two major methods used in the acupuncture-moxibustion treatment.Based on Internal Classic, Elementary Medicine and Great Compendium of Acupuncture and Moxibustion,this essay introduces the various manipulation techniques of reinforcing and reducing in acupuncture-moxibustion treatment, and the indicated acupoints. Clinically, according to the specific conditions of the patient, specific methods and points should be adopted and selected in the treatment of various kinds of diseases.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  14. Statistical methods to estimate treatment effects from multichannel electroencephalography (EEG) data in clinical trials.

    Science.gov (United States)

    Ma, Junshui; Wang, Shubing; Raubertas, Richard; Svetnik, Vladimir

    2010-07-15

    With the increasing popularity of using electroencephalography (EEG) to reveal the treatment effect in drug development clinical trials, the vast volume and complex nature of EEG data compose an intriguing, but challenging, topic. In this paper the statistical analysis methods recommended by the EEG community, along with methods frequently used in the published literature, are first reviewed. A straightforward adjustment of the existing methods to handle multichannel EEG data is then introduced. In addition, based on the spatial smoothness property of EEG data, a new category of statistical methods is proposed. The new methods use a linear combination of low-degree spherical harmonic (SPHARM) basis functions to represent a spatially smoothed version of the EEG data on the scalp, which is close to a sphere in shape. In total, seven statistical methods, including both the existing and the newly proposed methods, are applied to two clinical datasets to compare their power to detect a drug effect. Contrary to the EEG community's recommendation, our results suggest that (1) the nonparametric method does not outperform its parametric counterpart; and (2) including baseline data in the analysis does not always improve the statistical power. In addition, our results recommend that (3) simple paired statistical tests should be avoided due to their poor power; and (4) the proposed spatially smoothed methods perform better than their unsmoothed versions.

  15. Reducing the blame culture through clinical audit in nuclear medicine: a mixed methods study

    Science.gov (United States)

    Ross, P; Hubert, J

    2017-01-01

    Objectives To identify the barriers and facilitators of doctors’ engagement with clinical audit and to explore how and why these factors influenced doctors’ decisions to engage with the NHS National Clinical Audit Programme. Design A single-embedded case study. Mixed methods sequential approach with explorative pilot study and follow-up survey. Pilot study comprised 13 semi-structured interviews with purposefully selected consultant doctors over a six-month period. Interview data coded and analysed using directed thematic content analysis with themes compared against the study’s propositions. Themes derived from the pilot study informed the online survey question items. Exploratory factor analysis using STATA and descriptive statistical methods applied to summarise findings. Data triangulation techniques used to corroborate and validate findings across the different methodological techniques. Setting NHS National PET-CT Clinical Audit Programme. Participants Doctors reporting on the Audit Programme. Main Outcome measures Extent of engagement with clinical audit, factors that influence engagement with clinical audit. Results Online survey: 58/59 doctors responded (98.3%). Audit was found to be initially threatening (79%); audit was reassuring (85%); audit helped validate professional competence (93%); participation in audit improved reporting skills (76%). Three key factors accounted for 97.6% of the variance in survey responses: (1) perception of audit’s usefulness, (2) a common purpose, (3) a supportive blame free culture of trust. Factor 1 influenced medical engagement most. Conclusions The study documents performance feedback as a key facilitator of medical engagement with clinical audit. It found that medical engagement with clinical audit was associated with reduced levels of professional anxiety and higher levels of perceived self-efficacy. PMID:28210493

  16. [Method for direct generation data for formatted case report forms based on requirement for data authenticity in actual clinical conditions].

    Science.gov (United States)

    Shao, Ming-Yi; Liu, Bao-Yan; He, Li-Yun; Zhang, Run-Shun

    2013-04-01

    Data authenticity is the basic requirement of clinical studies. In actual clinical conditions how to establish formatted case report forms (CRF) in line with the requirement for data authenticity is the key to ensure clinical data quality. On the basis of the characteristics of clinical data in actual clinical conditions, we determined elements for establishing formatted case report forms by comparing differences in data characteristics of CRFs in traditional clinical studies and in actual clinical conditions, and then generated formatted case report forms in line with the requirement for data authenticity in actual clinical conditions. The data of formatted CRFs generated in this study could not only meet the requirement for data authenticity of clinical studies in actual clinical conditions, but also comply with data management practices for clinical studies, thus it is deemed as a progress in technical methods.

  17. Molecular and immunohistochemical profiling of invasive micropapillary carcinoma of the breast

    Directory of Open Access Journals (Sweden)

    Thomas A

    2014-10-01

    Full Text Available Alexandra Thomas,1 Ryan W Askeland,2 Natalya V Guseva,2 Ramakrishna Sompallae,2,3 Deqin Ma2 1Department of Internal Medicine, 2Department of Pathology, 3Bioinformatics Division, Iowa Institute of Human Genetics, University of Iowa Hospitals and Clinics, Iowa City, IA, USABackground: In this study, molecular and immunohistochemical profiling of invasive micropapillary carcinoma of the breast was used to identify potentially useful markers for targeted therapies with a focus on BRAF V600E mutation.Methods: Formalin-fixed, paraffin-embedded tumor blocks from seven patients were identified from the archives at our institution and tumor registry from 1997 to 2012. Massively parallel (Next-generation sequencing was performed using the Ion AmpliSeq™ Cancer Hotspot Panel version 2 (Life Technologies, Carlsbad, CA, USA. Mutation analysis for BRAF V600E was performed using a single nucleotide primer extension assay. Immunohistochemistry studies for estrogen receptor (ER, progesterone receptor (PR, Her2/Neu, phosphatase and tensin homolog (PTEN, and non-metastatic protein 23 homologue 1 (NM23H1 were performed using the same tumor blocks. Staining for ER, PR, and Her2/Neu was scored according to American Society of Clinical Oncology/College of American Pathologists guidelines, and a four-tier system, ie, strong homogenous, heterogeneous, positive with negative foci, reduced in more than 50%, and lost in all or majority was used for PTEN and NM23H1 staining.Results: No pathogenic mutations were identified in the tumors by next-generation sequencing. The lack of BRAF V600E mutation was confirmed by single nucleotide primer extension assay. All tumors were positive for ER and PR, and showed no overexpression of Her2/Neu. Loss of or reduced PTEN expression was observed in six of seven cases and was associated with lymph node metastasis. Reduced NM23H1 expression was observed in three of seven cases, all of which had concurrent PTEN loss.Conclusion: No somatic

  18. Investigating Immunohistochemical Expression of cyclooxygenase-2 in oral lichen planus

    Directory of Open Access Journals (Sweden)

    Maryam Seyedmajidi

    2016-06-01

    Full Text Available Background and goal: (cox2 Cyclooxygenase -2 as an enzyme is not present in normal tissues and in fact is a type of inductive enzyme during pathological phenomena such as inflammation and cancer are significantly increased. Increased expression of cox-2 in gastric carcinoma, pancreatic, lung and oral squamous cell carcinoma has been shown and seems to be one of the performance mechanisms of the inhibition of apoptosis in tumor cells. Regarding the role of cox-2 in apoptosis mechanisms and the creation of dysplastic changes and malignant, the study aimed to evaluate the immunohistochemical expression of cox-2 in oral lichen planus and were compared with normal mucosa and gingivitis. Methods: The study was performed on 30 paraffin blocks related to patients referred to oral and maxillofacial pathology department in Dental School of Babol with confirmed diagnosis of oral lichen planus was done. The same number of samples of normal mucosa and samples of gingivitis were studied. Slices prepared from the above blocks bycoloring immunostaining cox-2 were stained and after reviewing the slides obtained, data using statistical software spss20 and x2 tests, Mann-Whitney and parametric tests such as T test was analyzed and P ˂0.05 was considered significant Results: In this study, significantly percentage of stained cells and staining intensity of cells in the basal layer of lichen planus was higher than normal mucosa (p <0.001. In parabasal layer the results were similar (p <0.001. This results in comparison to lichen planus and gingivitis in basal layer (p <0.001 and parabasal was seen (p <10.0. On the other hand, significantly the percentage of stained cells and staining intensity of cells in the basal layer of gingivitis was more than normal mucosa (p <0.001. In above comparison, similar result in the parabasal layer was seen (p <0.001. The percentage of stained cells and staining intensity of cells in lymphocytic infiltration was significantly higher

  19. Immunohistochemical study on gastrointestinal endocrine cells of four reptiles

    Institute of Scientific and Technical Information of China (English)

    Xu-Gen Huang; Xiao-Bing Wu

    2005-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sema Timurkaan

    2011-09-01

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

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

    Science.gov (United States)

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

    2014-11-01

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

  2. The mass angular scattering power method for determining the kinetic energies of clinical electron beams

    Energy Technology Data Exchange (ETDEWEB)

    Blais, N.; Podgorsak, E.B. (Montreal General Hospital, PQ (Canada). Dept. of Medical Physics)

    1992-10-01

    A method for determining the kinetic energy of clinical electron beams is described, based on the measurement in air of the spatial spread of a pencil electron beam which is produced from the broad clinical electron beam. As predicted by the Fermi-Eyges theory, the dose distribution measured in air on a plane, perpendicular to the incident direction of the initial pencil electron beam, is Gaussian. The square of its spatial spread is related to the mass angular scattering power which in turn is related to the kinetic energy of the electron beam. The measured spatial spread may thus be used to determine the mass angular scattering power, which is then used to determine the kinetic energy of the electron beam from the known relationship between mass angular scattering power and kinetic energy. Energies obtained with the mass angular scattering power method agree with those obtained with the electron range method. (author).

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    %) to "poor" (43%), with only one study rated as "good". The reliability domain was most often investigated. Few of the assessment methods in the included studies that had "fair" or "good" measurement property ratings demonstrated acceptable results for both reliability and validity. We found a substantially...... larger number of clinical scapular assessment methods than previously reported. Using the COSMIN checklist the methodological quality of the included measurement properties in the reliability and validity domains were in general "fair" to "poor". None were examined for all three domains: (1) reliability......Abstract The aims were to compile a schematic overview of clinical scapular assessment methods and critically appraise the methodological quality of the involved studies. A systematic, computer-assisted literature search using Medline, CINAHL, SportDiscus and EMBASE was performed from inception...

  4. Clinical methods for the assessment of the effects of environmental stress on fish health

    Science.gov (United States)

    Wedemeyer, Gary A.; Yasutake, William T.

    1977-01-01

    Clinical methods are presented for biological monitoring of hatchery and native fish populations to assess the effects of environmental stress on fish health. The choice of methods is based on the experience of the authors and the judgment of colleagues at fishery laboratories of the U.S. Fish and Wildlife Service. Detailed analysis methods, together with guidelines for sample collection and for the interpretation of results, are given for tests on blood (cell counts, chloride, cholesterol, clotting time, cortisol, glucose, hematocrit, hemoglobin, lactic acid, methemoglobin, osmolality, and total protein); water (ammonia and nitrite content); and liver and muscle (glycogen content).

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

    DEFF Research Database (Denmark)

    Christoffersen, S.

    2011-01-01

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

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

    DEFF Research Database (Denmark)

    Primdahl, Hanne; Maase, Hans von der; Sørensen, Flemming B.

    2002-01-01

    PURPOSE: The cell cycle is known to be deregulated in cancer. We therefore analyzed the expression of the cell cycle related proteins p21, p27, p16, Rb, and L-myc by immunohistochemical staining of bladder tumors. METHODS: The tissue material consisted of bladder tumors from three groups......(kip1) ( P=0.03), Rb ( P=0.00002), and L-myc ( P=0.00000007) in muscle invasive tumors compared to noninvasive tumors. Tumors presenting as muscle invasive at first diagnosis had significantly lower levels of p16/CDKN2A ( P=0.01) when compared to muscle invasive tumors that followed Ta or T1 precursor...

  7. Immunohistochemical Study of HLA-DR Antigen in Endometrial Tissue of Patients with Endometriosis

    Institute of Scientific and Technical Information of China (English)

    刘义; 罗丽兰; 赵海波

    2002-01-01

    In order to evaluate the expression of HLA-DR antigen in glandular cells in eutopic and ectopic endometrium in patients with endometriosis, 19 infertile patients with endometriosis were analyzed immunohistochemically by labelled streptavidin biotin (LSAB) method. Nineteen infertile patients without endometriosis were studied as controls. The results showed that the expression of HLA-DR antigen in the glandular cells in both eutopic and ectopic endometrium was increased significantly as compared with that in the controls (P<0.01). It is likely that aberrant expression of HLADR antigen in endometriotic tissue is involved in abormal immunogenesis of endometriosis.

  8. Cartilage canals in newborn dogs: histochemical and immunohistochemical findings

    Directory of Open Access Journals (Sweden)

    A. Di Giancamillo

    2016-09-01

    Full Text Available Cartilage canals (CCs are microscopic structures involved in secondary ossification centers (SOCs development. The features of CCs were investigated in the humeral and femoral proximal epiphyses of small-sized newborn dogs (from premature to 28 days after birth with histochemical and immunohistochemical approaches. Masson’s Trichrome revealed a ring-shaped area around CCs, which changes in colour from green (immature collagen to red (mature collagen as ossification progresses; perichondrium staining always matched the ring colour. Safranin-O was always negative. Immunohistochemical analysis revealed immunopositivity for both collagen type I and V around the CCs; collagen type II was negative. CCs count showed a tendency to be higher in the humerus than in the femur. This work enlightened for the first time changes in composition of CCs surrounding matrix during SOCs development in dogs, paving the way to further investigations.

  9. Quantitative nucleic acid amplification methods and their implications in clinical virology.

    Science.gov (United States)

    Singh, Mini P; Galhotra, Shipra; Saigal, Karnika; Kumar, Archit; Ratho, Radha Kanta

    2017-01-01

    Recently, a number of techniques have been approved for quantification of viral nucleic acids in clinical samples. Viral load (VL) tests have considerable importance in the management of patients and are widely used in routine diagnosis. In clinical virology, VL testing are important to monitor the antiviral treatment, to initiate preemptive therapy, to understand pathogenesis, and to evaluate the infectivity. These tests have now become a part of many diagnostic and treatment guidelines. Considering the various challenges for in-house viral testing related to the standardization, validation, and precision; they are gradually being replaced by the United States Food and Drug Administration (US FDA) cleared tests. This review summarizes the various viral quantification methods and also discusses the clinical applicability of these in human immunodeficiency virus, Hepatitis B virus, Hepatitis C virus, Cytomegalovirus, and Epstein Barr virus infected patients. Further the challenges and future perspectives of VL testing have also been discussed.

  10. Quantitative nucleic acid amplification methods and their implications in clinical virology

    Science.gov (United States)

    Singh, Mini P; Galhotra, Shipra; Saigal, Karnika; Kumar, Archit; Ratho, Radha Kanta

    2017-01-01

    Recently, a number of techniques have been approved for quantification of viral nucleic acids in clinical samples. Viral load (VL) tests have considerable importance in the management of patients and are widely used in routine diagnosis. In clinical virology, VL testing are important to monitor the antiviral treatment, to initiate preemptive therapy, to understand pathogenesis, and to evaluate the infectivity. These tests have now become a part of many diagnostic and treatment guidelines. Considering the various challenges for in-house viral testing related to the standardization, validation, and precision; they are gradually being replaced by the United States Food and Drug Administration (US FDA) cleared tests. This review summarizes the various viral quantification methods and also discusses the clinical applicability of these in human immunodeficiency virus, Hepatitis B virus, Hepatitis C virus, Cytomegalovirus, and Epstein Barr virus infected patients. Further the challenges and future perspectives of VL testing have also been discussed.

  11. Wet autoclave pretreatment for immunohistochemical demonstration of oestrogen receptors in routinely processed breast carcinoma tissue.

    Science.gov (United States)

    Bier, B; Bankfalvi, A; Grote, L; Blasius, S; Ofner, D; Böcker, W; Jasani, B; Schmid, K W

    1995-02-01

    The immunohistochemical demonstration of oestrogen receptor (OR) was performed on 32 randomly selected and routinely processed breast carcinomas after wet autoclave pretreatment of sections. The autoclave method was compared to the OR status found on frozen sections as well as to alternative pretreatment methods such as enzymatic predigestion and microwave irradiation. Using four different monoclonal antibody clones (H222, LH1, CC4-5, 1D5.26), the OR status was evaluated for each of the various pretreatment methods applied. All cases with a high OR content on frozen sections (n = 11) also showed a high OR status on wet autoclave-pretreated paraffin tissues using antibody clones 1D5.26 and CC4-5; in cases with low OR content on frozen sections, no false-negative cases were recorded using only the antibody 1D5.26 neither after wet autoclave nor microwave pretreatment. In addition, with this antibody, OR was detectable after autoclave pretreatment in two cases which were considered to be OR-negative even on frozen sections. When the primary antibody was omitted, no false-positive cases were observed after wet autoclave pretreatment. Thus, in our hands, wet autoclave pretreatment, in combination with the antibody 1D5.26, offers a highly sensitive method for the immunohistochemical demonstration of OR in routinely formalin-fixed, paraffin-embedded sections of breast carcinomas.

  12. The immunohistochemical characterization of sarcomatoid malignant mesothelioma of the pleura.

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    Chirieac, Lucian R; Pinkus, Geraldine S; Pinkus, Jack L; Godleski, John; Sugarbaker, David J; Corson, Joseph M

    2011-01-01

    The immunohistochemical characteristics of epithelioid malignant mesothelioma are well described. However, immunohistochemical analyses of sarcomatoid mesothelioma, the less common type, are limited and its distinction from other tumors of the chest wall, lung and pleura is often problematic. We evaluated 24 patients with pleural sarcomatoid mesothelioma who had surgery (12 extrapleural pneumonectomies, 9 pleurectomies and 3 large biopsies) between 1989 and 2005. Clinicopathologic features and demographic data were recorded. We describe immunohistochemical results for 10 antibodies: AE1/AE3, CAM5.2 and MNF-116 keratins, calretinin, WT-1 protein, bcl-2, CD34, desmin, D2-40 and podoplanin. The patients were 23 men and one woman with a median age at diagnosis of 64.7 years (range 47 to 76). Tumor cells were positive for the keratin proteins AE1/AE3 in 18/24 cases, CAM 5.2 in 23/24 cases and MNF-116 in 21/21 cases. Calretinin was positive in 6/24 cases, WT-1 (nuclear) in 8/24 cases, bcl-2 in 0/24 cases, CD34 in 0/24 cases, desmin in 0/24 cases, D2-40 in 24/24 cases and podoplanin in 24/24 cases. This panel of antibodies may be helpful in establishing a pathologic diagnosis of sarcomatoid mesothelioma. In our study, D2-40 and podoplanin are highly sensitive immunohistochemical markers for sarcomatoid mesothelioma. Additional studies are required to define their role in the differential diagnosis of other spindle cell tumors.

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

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    Ferrández Oscar

    2012-07-01

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

  14. Adult Onset of BRAFV600E-Mutated Langerhans Cell Histiocytosis with Cutaneous Involvement Successfully Diagnosed by Immunohistochemical Staining

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    Tono, Hisayuki; Fujimura, Taku; Kakizaki, Aya; Furudate, Sadanori; Ishibashi, Masaya; Aiba, Setsuya

    2015-01-01

    Langerhans cell histiocytosis (LCH) is characterized by the clonal proliferation of Langerhans cells; it is categorized as a single-system disease with single or multifocal lesions, and as a multi-system disease with or without the risk of organ involvement. Although the skin is not categorized as a risk organ, the precise diagnosis of skin lesions is necessary to determine the protocol for the treatment of LCH. In this report, we describe a 28-year-old Japanese man with adult onset of BRAFV600E-mutated LCH with cutaneous involvement successfully diagnosed by immunohistochemical staining. Our report suggests that immunohistochemical staining for the BRAFV600E gene could be a diagnostic tool to determine the clinical type of LCH. PMID:26500535

  15. Adult Onset of BRAFV600E-Mutated Langerhans Cell Histiocytosis with Cutaneous Involvement Successfully Diagnosed by Immunohistochemical Staining

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    Hisayuki Tono

    2015-09-01

    Full Text Available Langerhans cell histiocytosis (LCH is characterized by the clonal proliferation of Langerhans cells; it is categorized as a single-system disease with single or multifocal lesions, and as a multi-system disease with or without the risk of organ involvement. Although the skin is not categorized as a risk organ, the precise diagnosis of skin lesions is necessary to determine the protocol for the treatment of LCH. In this report, we describe a 28-year-old Japanese man with adult onset of BRAFV600E-mutated LCH with cutaneous involvement successfully diagnosed by immunohistochemical staining. Our report suggests that immunohistochemical staining for the BRAFV600E gene could be a diagnostic tool to determine the clinical type of LCH.

  16. Clinical course teaching in transport of critically ill patients: Small group methods

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    Mohammad Taghi Beigmohammadi

    2016-10-01

    Full Text Available Critically ill patient transfer is potentially risky and may be lead to morbidity and mortality. Physicians' skill is very important for safe transport. We want to evaluate the effect of clinical course teaching on the promotion of physicians' abilities in the transport of critically ill patients. In an interventional study, 320 interns, male and female, were taught about patient transfer in two groups include in one day clinical course as the small group system (n=160 and other group the lecture base learning (n=160. In the clinical course, each participant under observation of an anesthesiologist in the operation room and ICU was acquainted with mask ventilation, intubation and learned to work with a defibrillator, infusion pump, portable ventilator and pulse oximeter. In lecture group, the anesthesiologist explained the topics by video and dummy. At the end of education course, the interns’ abilities were evaluated based on checklist method and scored by the project colleague in all educational items. Three hundred twenty interns, 122 males, and 198 females; were enrolled, two groups. The clinical course training caused improvements in the interns’ knowledge and abilities in intubation and use of the defibrillator and portable ventilator vs.lecture group significantly (P<0.005. The males were better than females in laryngoscopy, but the progress of the females was significantly better than males (P=0.003. The rate of adverse events was reduced significantly after clinical course teaching (P=0.041 Clinical course teaching could promote interns' clinical competencies in the transport of critically ill patients.

  17. The clinical method in geriatrics El método clínico en geriatría

    OpenAIRE

    Ángel Julio Romero Cabrera; Alfredo Darío Espinosa Brito

    2010-01-01

    Population aging and the distinctive characteristics of elderly require a particular implementation of the clinical method. Taking into account the special health problems of elderly, the geriatric evaluation is the cornerstone for the medical attention of these patients in the implementation of a global dimension of the clinical method. This article addresses the particular features of the clinical method and the steps to be followed when assisting the elderly.El envejecimiento poblacional y...

  18. Dendritic cells in melanoma - immunohistochemical study and research trends.

    Science.gov (United States)

    Nedelcu, Roxana Ioana; Ion, Daniela Adriana; Holeab, Cosmin Adrian; Cioplea, Mirela Daniela; Brînzea, Alice; Zurac, Sabina Andrada

    2015-01-01

    Cutaneous dendritic cells play multiple physiological roles and are involved in various pathophysiological processes. Research studies of dendritic cells abound in the medical literature. Nevertheless, the role of dendritic cells in melanoma regression phenomenon is not completely understood. We conducted a scientometric analysis in order to highlight the current state on research regarding dendritic cells and melanoma. We also performed an immunohistochemical study, using specific markers for dendritic cells (CD1a, langerin). We evaluated the frequency and distribution of dendritic cells in areas of tumor regression compared to the areas of inflammatory infiltrate of melanoma without regression. The immunohistochemical study we performed revealed that dendritic cells are more frequent in the regressed areas, comparing with non-regressed ones. In regressed areas, dendritic cells have a predominant nodular pattern (19 cases), followed by diffuse isolate pattern (eight cases) and mixed pattern (diffuse and nodular) (three cases). In melanoma without regression, most cases presented a diffuse pattern (27 cases) of dendritic cells distribution. In conclusion, our immunohistochemical study stressed differences between frequency and distribution of dendritic cells located in the melanoma with regression and melanoma without regression. These data suggest that dendritic cells are involved in the regression phenomenon. Following the literature analysis we obtained, we observed that dendritic cells profile in melanoma with regression was poorly studied. Insights into antitumor immune response and dendritic cells may be essential for the understanding of the potential prognostic role of dendritic cells in melanoma and for the development of new promising therapeutic strategies for melanoma.

  19. Immunohistochemical investigation of the coma blister and its pathogenesis.

    Science.gov (United States)

    Kashiwagi, Masayuki; Ishigami, Akiko; Hara, Kenji; Matsusue, Aya; Waters, Brian; Takayama, Mio; Tokunaga, Itsuo; Nishimura, Akiyoshi; Kubo, Shin-ichi

    2013-01-01

    The erythematous patches and vesicles that are observed in coma patients, usually from an overdose of medication, are known as coma blisters. However, it is unknown whether the degenerated sweat gland is a necrosis or apoptosis. We immunohistochemically examined such skin lesions to investigate the characteristics and pathogenesis of the coma blister. Skin lesions were obtained from a forensic autopsy case, a woman in her thirties, of caffeine intoxication. Those lesions were observed in the left femoral, the lower left thigh, and the right knee. Histologically, the skin lesions showed that the keratinocytes had necrosed and the epidermis was thin in some areas. Eccrine sweat gland degeneration was observed. Obvious inflammatory cell infiltrations were not detected. Immunohistochemically, we stained each skin lesion against CD3, CD8, CD45RO, cytokeratin, 70 kD heat shock protein, ubiquitin, 150 kD oxygen regulated protein, and caspase-cleaved keratin 18 neo-epitope M30. They were also stained with an in situ apoptosis detection kit. Degenerated sweat glands featured CD45RO and M30 immunoreactivity. Immunohistochemical staining for CD45RO, CK-L, and M30 might be useful to observe sweat gland degeneration in the coma blister. Therefore, the apoptosis might be related to coma blisters and sweat gland degenerations.

  20. Histological and Immunohistochemical Revision of Hepatocellular Adenomas: A Learning Experience

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    S. Fonseca

    2013-01-01

    Full Text Available Light has been shed on the genotype/phenotype correlation in hepatocellular adenoma (HCA recognizing HNF1α-inactivated HCA (H-HCA, inflammatory HCA (IHCA, and β-catenin-activated HCA (b-HCA. We reviewed retrospectively our surgical HCA series to learn how to recognize the different subtypes histopathologically and how to interpret adequately their immunohistochemical staining. From January 1992 to January 2012, 37 patients underwent surgical resection for HCA in our institution. Nine had H-HCA (25% characterized by steatosis and loss of L-FABP expression; 20 had IHCA (55.5% showing CRP and/or SAA expression, sinusoidal dilatation, and variable inflammation; and 1 patient had both H-HCA and IHCA. In 5 patients (14%, b-HCA with GS and β-catenin nuclear positivity was diagnosed, two already with hepatocellular carcinoma. Two cases (5.5% remained unclassified. One of the b-HCA showed also the H-HCA histological and immunohistochemical characteristics suggesting a subgroup of β-catenin-activated/HNF1α-inactivated HCA, another b-HCA exhibited the IHCA histological and immunohistochemical characteristics suggesting a subgroup of β-catenin-activated/inflammatory HCA. Interestingly, three patients had underlying vascular abnormalities. Using the recently published criteria enabled us to classify histopathologically our retrospective HCA surgical series with accurate recognition of b-HCA for which we confirm the higher risk of malignant transformation. We also underlined the association between HCA and vascular abnormalities.

  1. Reduced immunohistochemical expression of adhesion molecules in vitiligo skin biopsies.

    Science.gov (United States)

    Reichert Faria, Adriane; Jung, Juliana Elizabeth; Silva de Castro, Caio César; de Noronha, Lucia

    2017-03-01

    Because defects in adhesion impairment seem to be involved in the etiopathogenesis of vitiligo, this study aimed to compare the immunohistochemical expression of several adhesion molecules in the epidermis of vitiligo and non lesional vitiligo skin. Sixty-six specimens of lesional and non lesional skin from 33 volunteers with vitiligo were evaluated by immunohistochemistry using anti-beta-catenin, anti-E-cadherin, anti-laminin, anti-beta1 integrin, anti-collagen IV, anti-ICAM-1 and anti-VCAM-1 antibodies. Biopsies of vitiligo skin demonstrated a significant reduction in the expression of laminin and integrin. The average value of the immunohistochemically positive reaction area of the vitiligo specimens was 3053.2μm(2), compared with the observed value of 3431.8μm(2) in non vitiligo skin (p=0.003) for laminin. The immuno-positive area was 7174.6μm(2) (vitiligo) and 8966.7μm(2) (non lesional skin) for integrin (p=0.042). A reduction in ICAM-1 and VCAM-1 expression in the basal layer of the epidermis in vitiligo samples was also observed (p=0.001 and pskin. Our results suggest that an impairment in adhesion exists in vitiligo skin, which is supported by the diminished immunohistochemical expression of laminin, beta1 integrin, ICAM-1 and VCAM-1.

  2. Prostatic tissue in testicular teratoma. A clinicopathologic and immunohistochemical study.

    Science.gov (United States)

    Roma, Andres A; Humphrey, Peter A

    2013-02-01

    The presence of prostatic differentiation as part of teratoma is very unusual and has been reported less than 20 times in the literature; however, all but 1 case were described in ovarian teratomas. We reviewed 45 specimens of germ cell tumors with teratoma component in postpuberal male patients. Original hematoxylin and eosin review failed to identify glands morphologically consistent with prostatic differentiation. Immunohistochemical stains performed on 10 specimens from 10 patients with small glandular and/or tubular structures revealed 1 case with glands positive for prostatic-specific antigen, prostatic-specific acid phosphatase, and prostein/P501S, whereas high-molecular-weight cytokeratin and p63 highlighted only basal cells. The glands were irregular in size and shape and contained mostly cuboidal to columnar luminal-type cells with occasional basal-type cells. Re-review of all the specimens revealed a second block from the same testis as well as 1 retroperitoneal lymph node with metastatic teratoma in the same patient, also immunohistochemically confirmed. These glands were seen in a smooth muscle stromal background, adjacent to classic gastrointestinal and tracheobronchial teratoma components. Our findings show immunohistochemically confirmed prostatic differentiation in 2 specimens from 1 patient with teratoma. This study raises the possibility that prostatic differentiation, difficult to recognize on morphology alone, might not be that unusual and that immunostains can help detect it over the several different epithelial components of teratoma.

  3. Molecular and Immunohistochemical Characterization of Historical Long-Term Preserved Fixed Tissues from Different Human Organs.

    Science.gov (United States)

    Hühns, Maja; Röpenack, Paula; Erbersdobler, Andreas

    2015-01-01

    University and museum collections are very important sources of biological samples that can be used to asses the past and present genetic diversity of many species. Modern genetic and immunohistochemical techniques can be used on long-term preserved fixed tissues from museum specimens to answer epidemiological questions. A proof of principle was established to apply modern molecular genetics and immunohistochemical methods to these old specimens and to verify the original diagnosis. We analysed 19 specimens from our university collection including human organs that had been in fixative for more than 80 years. The tissues originated from lung, colon, brain, heart, adrenal gland, uterus and skin. We isolated amplifiable DNA from these wet preparations and performed mutational analysis of BRAF, KRAS and EGFR. The tissues were also embedded in paraffin and used for modern histology and immunohistochemistry. Our data show that amplifiable DNA is extractable and ranged from 0.25 to 22.77 μg of total DNA. In three specimens BRAFV600E or KRASG12D mutations were found. Additionally, expression of different proteins like vimentin and GFAP was detected immunohistochemical in six investigated specimens. On the basis of our results the original diagnosis was altered in three specimens. Our work showed that it is possible to extract amplifiable DNA suitable for sequence analysis from long-term fixed tissue. Furthermore, histology and immunohistochemistry is feasible in specimens fixed long time ago. We conclude that these old preparations are suitable for further epidemiological research and that our methods open up new opportunities for future studies.

  4. Immunohistochemical localization of human papilloma virus in conjunctival neoplasias: A retrospective study

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    Sen Seema

    2007-01-01

    Full Text Available Background: The extent of association of human papilloma virus (HPV in human conjunctival neoplasias has been debated in studies originating from different parts of the world, but no substantial evidence has been generated on Indian subjects. This prompted us to carry out a retrospective study on conjunctival neoplasias diagnosed over the past 12 years. Materials and Methods: Histopathological and immunohistochemical analysis of 65 specimens of ocular neoplasias and 30 normal controls diagnosed between 1991 and 2002 at a tertiary eye care hospital, was undertaken. Formalin-fixed, paraffin-embedded tissues were reviewed for confirming histopathological diagnosis, presence of koilocytosis and changes related to actinic keratosis. Immunohistochemical analysis was done using HPV-specific monoclonal antibodies. Clinicopathological correlation and the association of HPV antigen with the histopathological features were performed. Results: Out of the 65 cases analyzed, 35 were papillomas and 30 were ocular surface squamous neoplasias (OSSN. The mean age was 48 years with a male preponderance. Histologically, koilocytosis was observed in 17.1% of papillomas and 36.6% of OSSN. Actinic keratosis was present in 33% of OSSN. Immunohistochemically 17.1% conjunctival papillomas stained positive for HPV antigen, all cases of OSSN were negative for HPV. There was no correlation between koilocytosis or actinic keratosis and the detection of HPV antigen. Conclusions: The association between HPV and conjunctival neoplasias is variable in different geographical areas and also depends on the methods of detection used. This study warrants the need for applying more advanced techniques at a molecular level to determine the possible etiology of HPV in conjunctival neoplasias among Asian-Indians.

  5. WRN protein as a novel erythroblast immunohistochemical marker with applications for the diagnosis of Werner syndrome.

    Science.gov (United States)

    Sadahira, Yoshito; Sugihara, Takashi; Fujiwara, Hideyo; Nishimura, Hirotake; Suetsugu, Yoshimasa; Takeshita, Morishige; Okamura, Seiichi; Goto, Makoto

    2015-03-01

    Genetic testing for mutations in the WRN gene is critical for the diagnosis of Werner syndrome (WS); however, these tests cannot be performed in a clinical setting. Nearly all of the WRN mutations result in expression of truncated WRN proteins that are missing the C-terminal nuclear localization signal. We evaluated the use of WRN protein immunohistochemistry for diagnosing WS using paraffin-embedded bone marrow sections. Using a well-defined commercially available polyclonal antibody against the C terminus of WRN, we found that of all the cell types tested, bone marrow erythroid precursors showed the strongest nuclear expression of WRN. Immunohistochemical analysis of bone marrow samples from 120 patients with non-WS hematological disorders (age range, 7 days-90 years) revealed WRN staining of the nuclei of CD71-positive early and late erythroid precursors. Erythroblasts negative for WRN immunostaining were only observed in two patients, both of whom were diagnosed with WS: one with concomitant myelodysplastic syndrome and the other with erythroleukemia with overexpression of TP53. Western blot analysis and immunocytochemistry indicated WRN was localized in the nuclei of the four positive control cell lines from non-WS patients but not in the five cell lines from WS patients, who had three different types of WRN mutations. Thus, immunohistochemical detection of WRN in erythroblasts from bone marrow paraffin sections could be useful in screening of WS cases and worthy of further molecular confirmation.

  6. Succinate Dehydrogenase B Subunit Immunohistochemical Expression Predicts Aggressiveness in Well Differentiated Neuroendocrine Tumors of the Ileum

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    Milione, Massimo [Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan I-20133 (Italy); Pusceddu, Sara [Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan I-20133 (Italy); Gasparini, Patrizia [Molecular Cytogenetics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan I-20133 (Italy); Melotti, Flavia [Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan I-20133 (Italy); Maisonneuve, Patrick [Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan 20141 (Italy); Mazzaferro, Vincenzo [Division of Gastrointestinal Surgery and Liver Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan I-20133 (Italy); Braud, Filippo G. de [Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan I-20133 (Italy); Pelosi, Giuseppe, E-mail: giuseppe.pelosi@unimi.it [Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan I-20133 (Italy); Department of Medicine, Surgery and Dentistry, Università degli Studi, Facoltà di Medicina, Milan 20122 (Italy)

    2012-08-16

    Immunohistochemical loss of the succinate dehydrogenase subunit B (SDHB) has recently been reported as a surrogate biomarker of malignancy in sporadic and familial pheocromocytomas and paragangliomas through the activation of hypoxia pathways. However, data on the prevalence and the clinical implications of SDHB immunoreactivity in ileal neuroendocrine tumors are still lacking. Thirty-one consecutive, advanced primary midgut neuroendocrine tumors and related lymph node or liver metastases from 24 males and seven females were immunohistochemically assessed for SDHB. All patients were G1 tumors (Ki-67 labeling index ≤2%). SDHB immunohistochemistry results were expressed as immunostaining intensity and scored as low or strong according to the internal control represented by normal intestinal cells. Strong positivity for SDHB, with granular cytoplasmatic reactivity, was found in 77% of primary tumors (T), whilst low SDHB expression was detected in 90% of metastases (M). The combined analysis (T+M) confirmed the loss of SDHB expression in 82% of metastases compared to 18% of primary tumors. SDHB expression was inversely correlated with Ki-67 labeling index, which accounted for 1.54% in metastastic sites and 0.7% in primary tumors. A correlation between SDHB expression loss, increased Ki-67 labeling index and biological aggressiveness was shown in advanced midgut neuroendocrine tumors, suggesting a role of tumor suppressor gene.

  7. Immunohistochemical features of multifocal melanoacanthoma in the hard palate: a case report

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    das Chagas e Silva de Carvalho Luis Felipe

    2013-01-01

    Full Text Available Abstract Background Melanoacanthoma (MA has been described in the oral mucosa as a solitary lesion or, occasionally, as multiple lesions. MA mainly affects dark skinned patients and grows rapidly, showing a plane or slightly raised appearance and a brown to black color. The differential diagnosis includes oral nevi, amalgam tattoos, and melanomas. We report here the case of a 58-year-old black woman who presented multiple pigmented lesions on the hard palate. Case presentation Based on the differential diagnosis of melanoma, a punch biopsy (4 mm in diameter was performed. The material was fixed in 10% formalin, embedded in paraffin, and stained with hematoxylin-eosin or submitted to immunohistochemical analysis. Immunohistochemistry using antibodies against protein S-100, melan-A, HMB-45, MCM-2, MCM-5, Ki-67 and geminin was performed. Immunohistochemical analysis revealed strong cytoplasmic immunoreactivity of dendritic melanocytes for proteinS-100, HMB-45 and melan-A.Positive staining for proliferative markers (MCM-2, MCM-5, Ki-67 was only observed in basal and suprabasal epithelial cells, confirming the reactive etiology of the lesion. The diagnosis was oral Melanoacanthoma (MA. Conclusion The patient has been followed up for 30 months and shows no clinical alterations. MA should be included in the differential diagnosis of pigmented lesions of the oral cavity.

  8. Dynamic measurements and uncertainty estimation of clinical thermometers using Monte Carlo method

    Science.gov (United States)

    Ogorevc, Jaka; Bojkovski, Jovan; Pušnik, Igor; Drnovšek, Janko

    2016-09-01

    Clinical thermometers in intensive care units are used for the continuous measurement of body temperature. This study describes a procedure for dynamic measurement uncertainty evaluation in order to examine the requirements for clinical thermometer dynamic properties in standards and recommendations. In this study thermistors were used as temperature sensors, transient temperature measurements were performed in water and air and the measurement data were processed for the investigation of thermometer dynamic properties. The thermometers were mathematically modelled. A Monte Carlo method was implemented for dynamic measurement uncertainty evaluation. The measurement uncertainty was analysed for static and dynamic conditions. Results showed that dynamic uncertainty is much larger than steady-state uncertainty. The results of dynamic uncertainty analysis were applied on an example of clinical measurements and were compared to current requirements in ISO standard for clinical thermometers. It can be concluded that there was no need for dynamic evaluation of clinical thermometers for continuous measurement, while dynamic measurement uncertainty was within the demands of target uncertainty. Whereas in the case of intermittent predictive thermometers, the thermometer dynamic properties had a significant impact on the measurement result. Estimation of dynamic uncertainty is crucial for the assurance of traceable and comparable measurements.

  9. Integrating economic evaluation methods into clinical and translational science award consortium comparative effectiveness educational goals.

    Science.gov (United States)

    Iribarne, Alexander; Easterwood, Rachel; Russo, Mark J; Wang, Y Claire

    2011-06-01

    With the ongoing debate over health care reform in the United States, public health and policy makers have paid growing attention to the need for comparative effectiveness research (CER). Recent allocation of federal funds for CER represents a significant move toward increased evidence-based practice and better-informed allocation of constrained health care resources; however, there is also heated debate on how, or whether, CER may contribute to controlling national health care expenditures. Economic evaluation, in the form of cost-effectiveness or cost-benefit analysis, is often an aspect of CER studies, yet there are no recommendations or guidelines for providing clinical investigators with the necessary skills to collect, analyze, and interpret economic data from clinical trials or observational studies. With an emphasis on multidisciplinary research, the Clinical and Translational Science Award (CTSA) consortium and institutional CTSA sites serve as an important resource for training researchers to engage in CER. In this article, the authors discuss the potential role of CTSA sites in integrating economic evaluation methods into their comparative effectiveness education goals, using the Columbia University Medical Center CTSA as an example. By allowing current and future generations of clinical investigators to become fully engaged not only in CER but also in the economic evaluations that result from such analyses, CTSA sites can help develop the necessary foundation for advancing research to guide clinical decision making and efficient use of limited resources.

  10. Device and methods for "gold standard" registration of clinical 3D and 2D cerebral angiograms

    Science.gov (United States)

    Madan, Hennadii; Likar, Boštjan; Pernuš, Franjo; Å piclin, Žiga

    2015-03-01

    Translation of any novel and existing 3D-2D image registration methods into clinical image-guidance systems is limited due to lack of their objective validation on clinical image datasets. The main reason is that, besides the calibration of the 2D imaging system, a reference or "gold standard" registration is very difficult to obtain on clinical image datasets. In the context of cerebral endovascular image-guided interventions (EIGIs), we present a calibration device in the form of a headband with integrated fiducial markers and, secondly, propose an automated pipeline comprising 3D and 2D image processing, analysis and annotation steps, the result of which is a retrospective calibration of the 2D imaging system and an optimal, i.e., "gold standard" registration of 3D and 2D images. The device and methods were used to create the "gold standard" on 15 datasets of 3D and 2D cerebral angiograms, whereas each dataset was acquired on a patient undergoing EIGI for either aneurysm coiling or embolization of arteriovenous malformation. The use of the device integrated seamlessly in the clinical workflow of EIGI. While the automated pipeline eliminated all manual input or interactive image processing, analysis or annotation. In this way, the time to obtain the "gold standard" was reduced from 30 to less than one minute and the "gold standard" of 3D-2D registration on all 15 datasets of cerebral angiograms was obtained with a sub-0.1 mm accuracy.

  11. 3D-2D registration of cerebral angiograms: a method and evaluation on clinical images.

    Science.gov (United States)

    Mitrovic, Uroš; Špiclin, Žiga; Likar, Boštjan; Pernuš, Franjo

    2013-08-01

    Endovascular image-guided interventions (EIGI) involve navigation of a catheter through the vasculature followed by application of treatment at the site of anomaly using live 2D projection images for guidance. 3D images acquired prior to EIGI are used to quantify the vascular anomaly and plan the intervention. If fused with the information of live 2D images they can also facilitate navigation and treatment. For this purpose 3D-2D image registration is required. Although several 3D-2D registration methods for EIGI achieve registration accuracy below 1 mm, their clinical application is still limited by insufficient robustness or reliability. In this paper, we propose a 3D-2D registration method based on matching a 3D vasculature model to intensity gradients of live 2D images. To objectively validate 3D-2D registration methods, we acquired a clinical image database of 10 patients undergoing cerebral EIGI and established "gold standard" registrations by aligning fiducial markers in 3D and 2D images. The proposed method had mean registration accuracy below 0.65 mm, which was comparable to tested state-of-the-art methods, and execution time below 1 s. With the highest rate of successful registrations and the highest capture range the proposed method was the most robust and thus a good candidate for application in EIGI.

  12. Circulating tumour cells as tumour biomarkers in melanoma: detection methods and clinical relevance.

    Science.gov (United States)

    Khoja, L; Lorigan, P; Dive, C; Keilholz, U; Fusi, A

    2015-01-01

    Circulating tumour cells (CTCs) are cells of solid tumour origin detectable in the peripheral blood. Their occurrence is considered a prerequisite step for establishing distant metastases. Metastatic melanoma was the first malignancy in which CTCs were detected and numerous studies have been published on CTC detection in melanoma at various stages of disease. In spite of this, there is no general consensus as to the clinical utility of CTCs in melanoma, largely due to conflicting results from heterogeneous studies and discrepancies in methods of detection between studies. In this review, we examine the possible clinical significance of CTCs in cutaneous, mucosal and ocular melanoma, focusing on detection methods and prognostic value of CTC detection.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    ). There is a scarcity of head-to-head comparisons that can inform the choice of which clustering method might be suitable for particular clinical datasets and research questions. Therefore, the aim of this study was to perform a head-to-head comparison of three commonly available methods (SPSS TwoStep CA, Latent Gold......'s ease of use and interpretability of the presentation of results.We analysed five real datasets of varying complexity in a secondary analysis of data from other research projects. Three datasets contained only MRI findings (n = 2,060 to 20,810 vertebral disc levels), one dataset contained only pain...... intensity data collected for 52 weeks by text (SMS) messaging (n = 1,121 people), and the last dataset contained a range of clinical variables measured in low back pain patients (n = 543 people). Four artificial datasets (n = 1,000 each) containing subgroups of varying complexity were also analysed testing...

  14. Circulating tumor cells in lung cancer:Detection methods and clinical impact

    Institute of Scientific and Technical Information of China (English)

    Minghui Zhang; Decai Chi; Co-first author Shu Zhao; Yan Wang; Maopeng Yang; Yan Wang

    2014-01-01

    Circulating tumor cels (CTCs) are tumor cels that enter the blood circulation after detaching from the primary tumor and can migrate to reach distant organs, where they can give rise to aggressive metastasis. Clinical studies have revealed that the presence of CTCs in peripheral blood is correlated with disease progression in lung cancer. However, as CTCs are rare cancer cels released from tumors into the bloodstream, both enrichment and sensitive detection methods are technicaly chalenging. In order to best understand how CTCs are currently being deployed, this review mainly focuses on the diferent detection methods for CTCs. Furthermore, we wil describe the clinical impact of circulating tumor cels in lung cancer and discuss their potential use as biomarker to guide the prognosis.

  15. Studying children's religious knowledge: contributions of ethnography and the clinical-critical method.

    Science.gov (United States)

    García Palacios, Mariana; Castorina, José Antonio

    2014-12-01

    We analyze different methodological and conceptual contributions of anthropology and psychogenetic theory to the research of children's religious knowledge. We argue that for the study of children's points of view it is possible to build an approach that links aspects studied by both disciplinary fields. With this aim, we revise some of their basic theoretical assumptions and recent reviews as well as their methodological proposals. Then we review the core characteristics of ethnography and the clinical-critical method-proposed by Piaget's psychogenetic theory-with the goal of stressing their potentialities as well as their limitations in research. We argue that within an ethnographic approach, we must establish certain restrictions on the clinical-critical method following basic premises of social anthropology. This approach lets us demonstrate the importance of understanding children's constructions by placing them within social relations that children produce and update in everyday interactions.

  16. Immunohistochemical localization of glutathione S-transferase-pi in human colorectal polyps

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    AIM: To investigate the distribution of the placental form of glutathione-S-transferase (GST) in colon polyps in order to evaluate the role of GST-pi in these tissues. METHODS: Sixteen polyp tissues removed at colon- oscopy were examined. Tissues were investigated his- tologicaUy and ultrastructurally. GST-pi expression was also analysed immunohistochemically, using peroxidase anti-peroxidase (PAP) method and immunogold label- ling method, for light and electron microscope respec- tively. RESULTS: All polyp tissues examined were adenoma of low, mild and high- grade dysplasia as shown in the histopathological reports. Nevertheless, the examina- tion of the above specimens with electron microscope revealed that 3 of 9 adenoma of mild dysplasia had ultrastuctural features similar to high-grade dysplasia adenoma. GST-pi was variably expressed in adenoma, with the lowest relative levels occurring in low-grade adenoma and the highest levels found in high-grade adenoma. GST-pi was located mainly in undifferentiat- ed epithelial cells. GST-pi positive particles were found in the cytoplasm and especially in the nucleus adjacent to the nuclear membrane of these cells. CONCLUSION: The overexpression of GST-pi in mild- grade adenomas with significant subcellular changes and in the majority of high-grade dysplasia adenoma suggests that this might be related to the carcinogenetic proceeding. Immunohistochemical localization of GST-pi in combination with ultrastructural changes indicate that GST-pi might be a sensitive agent for the detection of preneoplastic transformations in adenoma.

  17. Using mixed methods to identify and answer clinically relevant research questions.

    Science.gov (United States)

    Shneerson, Catherine L; Gale, Nicola K

    2015-06-01

    The need for mixed methods research in answering health care questions is becoming increasingly recognized because of the complexity of factors that affect health outcomes. In this article, we argue for the value of using a qualitatively driven mixed method approach for identifying and answering clinically relevant research questions. This argument is illustrated by findings from a study on the self-management practices of cancer survivors and the exploration of one particular clinically relevant finding about higher uptake of self-management in cancer survivors who had received chemotherapy treatment compared with those who have not. A cross-sectional study generated findings that formed the basis for the qualitative study, by informing the purposive sampling strategy and generating new qualitative research questions. Using a quantitative research component to supplement a qualitative study can enhance the generalizability and clinical relevance of the findings and produce detailed, contextualized, and rich answers to research questions that would be unachievable through quantitative or qualitative methods alone.

  18. Prognostic value of immunohistochemical surfactant protein A expression in regenerative/hyperplastic alveolar epithelial cells in idiopathic interstitial pneumonias

    Directory of Open Access Journals (Sweden)

    Kajiki Akira

    2011-03-01

    Full Text Available Abstract Background It is difficult to predict survival in patients with idiopathic pulmonary fibrosis. Recently, several proteins, such as surfactant protein (SP and KL-6, have been reported to be useful biologic markers for prediction of prognosis for interstitial pneumonias. It is not clear whether there is any relationship between expression of these proteins in regenerative/hyperplastic alveolar epithelial cells and prognosis of idiopathic interstitial pneumonias (IIPs. Objectives This study aimed to elucidate the clinical significance of the expression of such lung secretory proteins as SP-A and KL-6 in lung tissues of patients with IIPs. Methods We retrospectively investigated the immunohistochemical expression of SP-A, KL-6, cytokeratin (CK, and epithelial membrane antigen (EMA in alveolar epithelial cells in lung tissues obtained from surgical lung biopsy in 43 patients with IIPs, and analyzed the correlation between expression of these markers and the prognosis of each IIP patient. CK and EMA were used as general markers for epithelial cells. Results In patients with usual interstitial pneumonia (UIP, the ratio of SP-A positive epithelial cells to all alveolar epithelial cells (SP-A positive ratio in the collapsed and mural fibrosis areas varied, ranging from cases where almost all alveolar epithelial cells expressed SP-A to cases where only a few did. On the other hand, in many patients with nonspecific interstitial pneumonia (NSIP, many of the alveolar epithelial cells in the diseased areas expressed SP-A. The SP-A positive ratio was significantly lower in patients who died from progression of UIP than in patients with UIP who remained stable or deteriorated but did not die. In NSIP patients, a similar tendency was noted between the SP-A positive ratio and prognosis. Conclusions The results suggest that the paucity of immunohistochemical SP-A expression in alveolar epithelial cells in diseased areas (i.e. regenerative

  19. A mixed methods evaluation of a patient care clinic located within a pharmacy school.

    Science.gov (United States)

    Jorgenson, Derek J; Landry, Eric J L; Lysak, Katherine J

    2016-08-01

    Background The Medication Assessment Center is a faculty and student run patient care clinic located within the pharmacy school at the University of Saskatchewan (Canada). It was created as a novel experiential education site for pharmacy students and to provide clinical pharmacist services for complex patients who have trouble accessing services elsewhere. Objective To determine if the clinical services provided by faculty and students at the Medication Assessment Center are valuable to patients who are referred to the program. Setting The Medication Assessment Center, which is faculty and student run patient care clinic. Method Convergent mixed methods design comprised of a retrospective patient chart audit and a paper based patient experience survey. All patients who attended at least one appointment at the Medication Assessment Center between March 1, 2014 and July 31, 2015 were included in the chart audit. All new patients who were referred between April 1, 2015 and October 26, 2015 were included in the survey. Main outcome measures Recommendations made by the pharmacist and patient experience survey indicators. Results 173 patients were included in the chart audit, which found that patients were elderly (64.8 years), highly medically complex (13.8 medications and 6.5 diagnoses each), and had a large number of recommendations made by the pharmacist to adjust drug therapy (6.2 per patient). 121 questionnaires were mailed to patients with a response rate of 66.9 % (n = 81). The survey found high levels of support and satisfaction for the program, including more than half of patients (59.2 %) who reported that their health had improved as a result of the Medication Assessment Center. Conclusion The patient care and experiential education program offered by the Medication Assessment Center provides a valuable service to patients who are referred to the clinic.

  20. Immunohistochemical Study to Evaluate the Prognostic Significance of Four Biomolecular Markers in Radiotherapy of Nasopharyngeal Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yeon Joo; Lee, Seung Hee; Wu, Hong Gyun; Go, Heoun Jeong; Jeon, Yoon Kyung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2010-11-15

    We performed an immunohistochemical study with pre-treatment biopsy specimens to evaluate the prognostic significance of four biomolecular markers which can be used as a predictive assay for radiotherapy (RT) treatment of nasopharyngeal carcinoma (NPC). From January 1998 through December 2006, 68 patients were histologically diagnosed as non-metastatic NPC and treated by RT. Only 38 patients had the paraffin block for the immunohistochemical study. Thirty-one patients had undifferentiated carcinoma and 7 patients had squamous cell carcinoma. Thirty two patients (84%) had advanced stage NPC (2002 AJCC Stage III{approx}IV). Immunohistochemical staining was performed for Met, COX-2, nm23-H1, and epidermal growth factor receptor (EGFR) expression using routine methods. The median follow-up time was 30 months (range, 11 to 83 months) for all patients, and 39 months (range, 19 to 83 months) for surviving patients. The 5-year overall survival (OS) rate of the patients with high Met extent ({>=}50%) was significantly lower than that of the patients with low Met extent (48% vs. 84%, p=0.02). In addition, Met extent was also a significant prognostic factor in multivariate analysis (p=0.01). No correlation was observed between Met extent and T stage, N stage, stage group, gender, age, and the response to chemotherapy or RT. Met extent showed moderate correlation with COX-2 expression (Pearson coefficient 0.496, p<0.01), but COX-2 expression did not affect OS. Neither nm23-H1 or EGFR expression was a prognostic factor for OS in this study. High Met extent ({>=}50%) might be an independent prognostic factor that predicts poor OS in NPC treated with RT.

  1. Determining nurses\\' clinical competence in hospitals of Bushehr University of Medical Sciences by self assessment method

    Directory of Open Access Journals (Sweden)

    Masood mahreini

    2008-09-01

    Full Text Available Background: Nurses’ self awareness of their own level of clinical competence is essential in maintaining high standards of care and identifying areas of educational need and professional development. Self-assessment is a method for measuring clinical competence, and encourages nurses to use reflective thinking and take an active part in the learning process. Although nurse competence may vary between hospitals, very few studies have been done on this subject. Methods: In this cross sectional study, we analyzed clinical competency of 190 registered nurses working in different hospitals in Bushehr by self assessment method. The instrument for data collection was a valid and reliable questionnaire consisting of 73 items from seven categories which were devised from Benner's “from Novice to Expert” framework. The level of competence was assessed on a scale of 0-100 and the frequency of using the competencies was assessed on a Likert scale. Results: the nurses reported their overall level of competence as “good” (51-75. They felt more competent in the categories of “managing situations” and “helping role” (with maximum score of 79.54 and least competent in “teaching – coaching” and “ensuring quality” categories (with minimum score of 61.15. The frequency of practicing competencies had a positive correlation with the level of nursing clinical competence. Conclusion: The level of nursing competence and frequency of using competencies varied in different hospitals. Although the nurses reported their overall level of competence as good, we should be concerned about 24% of competencies which are not used by the nurses, especially in "teaching – coaching" and "ensuring quality" categories.

  2. Crisis of the clinical method Crisis del método clínico.

    Directory of Open Access Journals (Sweden)

    Miguel Moreno Rodríguez

    2010-12-01

    Full Text Available This is an opinion paper. The author identifies an universal crisis of the clinical method, with dangerous consequences in the practice of medicine. Among its main causes, there are discussed: a deterioration in the doctor-patient relationship, the undervaluation of clinics, the overvaluation of technology, and the indifference for general medicine. A call for attention is made for the restoration of clinical method values and to permanent seed its principles in all medical students and young doctors.Este es un artículo de opinión donde el autor, a partir de la identificación de una crisis universal del método clínico, que tiene consecuencias preocupantes en el ejercicio de la medicina, identifica las que considera sus causas principales: el deterioro de la relación médico-paciente, el menosprecio de la clínica, la sobrevaloración de la tecnología y el desinterés por el generalismo. Se hace un llamado a restablecer todos los valores del método clínico y a sembrar permanentemente sus principios en todos los médicos en formación.

  3. Near-infrared methods for the identification of tablets in clinical trial supplies.

    Science.gov (United States)

    Dempster, M A; Jones, J A; Last, I R; MacDonald, B F; Prebble, K A

    1993-01-01

    Near-infrared reflectance analysis (NIR) methods have been developed for the confirmation of the identity of blister-packed tablets for clinical trial supplies. Three approaches are described: (1) presentation of single exposed tablets from blisters directly to the optical window; (2) presentation of unopened opaque blister-packed tablets directly to the optical window of the NIR instrument; and (3) use of a fibre-optic accessory to examine tablets through unopened opaque blister packs. For clinical purposes, all tablets in this trial were manufactured to match the appearance of one another. Tablets containing four strengths of an experimental drug (2, 5, 10 and 20% w/w of the active), a marketed product as a clinical comparator (80% w/w of the active), and a placebo were investigated. The NIR methods were developed by chemometrically building a library with second derivative spectra for each tablet type. Library validation and test data are presented along with a comparison of the three sample presentation techniques. The scope and limitation of each sample presentation technique are discussed.

  4. Liver fibrosis in human immunodeficiency virus/hepatitis C virus coinfection: Diagnostic methods and clinical impact

    Institute of Scientific and Technical Information of China (English)

    Caterina; Sagnelli; Salvatore; Martini; Mariantonietta; Pisaturo; Giuseppe; Pasquale; Margherita; Macera; Rosa; Zampino; Nicola; Coppola; Evangelista; Sagnelli

    2015-01-01

    Several non-invasive surrogate methods have recently challenged the main role of liver biopsy in assessing liver fibrosis in hepatitis C virus(HCV)-monoinfected and human immunodeficiency virus(HIV)/HCV-coinfected patients, applied to avoid the well-known side effects of liver puncture. Serological tests involve the determination of biochemical markers of synthesis or degradation of fibrosis, tests not readily available in clinical practice, or combinations of routine tests used in chronic hepatitis and HIV/HCV coinfection. Several radiologic techniques have also been proposed, some of which commonly used in clinical practice. The studies performed to compare the prognostic value of noninvasive surrogate methods with that of the degree of liver fibrosis assessed on liver tissue have not as yet provided conclusive results. Each surrogate technique has shown some limitations, including the risk of over- or under-estimating the extent of liver fibrosis. The current knowledge on liver fibrosis in HIV/HCVcoinfected patients will be summarized in this review article, which is addressed in particular to physicians involved in this setting in their clinical practice.

  5. An overview of the design and methods for retrieving high-quality studies for clinical care

    Directory of Open Access Journals (Sweden)

    Haynes R Brian

    2005-06-01

    Full Text Available Abstract Background With the information explosion, the retrieval of the best clinical evidence from large, general purpose, bibliographic databases such as MEDLINE can be difficult. Both researchers conducting systematic reviews and clinicians faced with a patient care question are confronted with the daunting task of searching for the best medical literature in electronic databases. Many have advocated the use of search filters or "hedges" to assist with the searching process. The purpose of this report is to describe the design and methods of a study that set out to develop optimal search strategies for retrieving sound clinical studies of health disorders in large electronics databases. Objective To describe the design and methods of a study that set out to develop optimal search strategies for retrieving sound clinical studies of health disorders in large electronic databases. Design An analytic survey comparing hand searches of 170 journals in the year 2000 with retrievals from MEDLINE, EMBASE, CINAHL, and PsycINFO for candidate search terms and combinations. The sensitivity, specificity, precision, and accuracy of unique search terms and combinations of search terms were calculated. Conclusion A study design modeled after a diagnostic testing procedure with a gold standard (the hand search of the literature and a test (the search terms is an effective way of developing, testing, and validating search strategies for use in large electronic databases.

  6. Integrated support for medical image analysis methods: from development to clinical application.

    Science.gov (United States)

    Olabarriaga, Sílvia D; Snel, Jeroen G; Botha, Charl P; Belleman, Robert G

    2007-01-01

    Computer-aided image analysis is becoming increasingly important to efficiently and safely handle large amounts of high-resolution images generated by advanced medical imaging devices. The development of medical image analysis (MIA) software with the required properties for clinical application, however, is difficult and labor-intensive. Such development should be supported by systems providing scalable computational capacity and storage space, as well as information management facilities. This paper describes the properties of distributed systems to support and facilitate the development, evaluation, and clinical application of MIA methods. First, the main characteristics of existing systems are presented. Then, the phases in a method's lifecycle are analyzed (development, parameter optimization, evaluation, clinical routine), identifying the types of users, tasks, and related computational issues. A scenario is described where all tasks are performed with the aid of computational tools integrated into an ideal supporting environment. The requirements for this environment are described, proposing a grid-oriented paradigm that emphasizes virtual collaboration among users, pieces of software, and devices distributed among geographically dispersed healthcare, research, and development enterprises. Finally, the characteristics of the existing systems are analyzed according to these requirements. The proposed requirements offer a useful framework to evaluate, compare, and improve the existing systems that support MIA development.

  7. Maxillofacial Prosthesis in Dentofacial Traumas: A Retrospective Clinical Study and Introduction of New Classification Method

    Directory of Open Access Journals (Sweden)

    Edoardo Brauner

    2017-01-01

    Full Text Available Background. Maxillofacial trauma represents a field of common interest as regards both the maxillofacial surgery and prosthodontics, especially for the functional and aesthetic stomatognathic rehabilitation. This condition necessitates relationship between maxillofacial surgeon and prosthodontist, to achieve the ultimate treatment goal. Purpose. The purpose of this study is to make predictable patients outcomes classifying their clinical data, using certain parameters and introducing a new classification method. Materials and Methods. We have chosen 7 parameters to classify the entity of the damage of these patients and to make their treatment and their prognosis predictable: number of teeth lost (T1–T4, upper/lower maxilla (U/L, alveolar/basal bone (Alv/B, gingival tissues (G, soft tissues (S, adult/child (a/c, and reconstructed patient (R. Results and Conclusions. The multidisciplinary approach and the collaboration between multiple clinical figures are therefore critical for the success of the treatment of these patients. The presence and quantification of above parameters influence the treatment protocol; patients undergo different levels of treatment depending on the measured data. The recognition of certain clinical parameters is fundamental to frame diagnosis and successful treatment planning.

  8. Maxillofacial Prosthesis in Dentofacial Traumas: A Retrospective Clinical Study and Introduction of New Classification Method

    Science.gov (United States)

    Brauner, Edoardo; Pompa, Giorgio; Jamshir, Sara; Di Carlo, Stefano; Valentini, Valentino

    2017-01-01

    Background. Maxillofacial trauma represents a field of common interest as regards both the maxillofacial surgery and prosthodontics, especially for the functional and aesthetic stomatognathic rehabilitation. This condition necessitates relationship between maxillofacial surgeon and prosthodontist, to achieve the ultimate treatment goal. Purpose. The purpose of this study is to make predictable patients outcomes classifying their clinical data, using certain parameters and introducing a new classification method. Materials and Methods. We have chosen 7 parameters to classify the entity of the damage of these patients and to make their treatment and their prognosis predictable: number of teeth lost (T1–T4), upper/lower maxilla (U/L), alveolar/basal bone (Alv/B), gingival tissues (G), soft tissues (S), adult/child (a/c), and reconstructed patient (R). Results and Conclusions. The multidisciplinary approach and the collaboration between multiple clinical figures are therefore critical for the success of the treatment of these patients. The presence and quantification of above parameters influence the treatment protocol; patients undergo different levels of treatment depending on the measured data. The recognition of certain clinical parameters is fundamental to frame diagnosis and successful treatment planning. PMID:28337459

  9. A Quality Assurance Method that Utilizes 3D Dosimetry and Facilitates Clinical Interpretation

    Energy Technology Data Exchange (ETDEWEB)

    Oldham, Mark, E-mail: mark.oldham@duke.edu [Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Thomas, Andrew; O' Daniel, Jennifer; Juang, Titania [Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Ibbott, Geoffrey [University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Adamovics, John [Rider University, Lawrenceville, New Jersey (United States); Kirkpatrick, John P. [Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States)

    2012-10-01

    Purpose: To demonstrate a new three-dimensional (3D) quality assurance (QA) method that provides comprehensive dosimetry verification and facilitates evaluation of the clinical significance of QA data acquired in a phantom. Also to apply the method to investigate the dosimetric efficacy of base-of-skull (BOS) intensity-modulated radiotherapy (IMRT) treatment. Methods and Materials: Two types of IMRT QA verification plans were created for 6 patients who received BOS IMRT. The first plan enabled conventional 2D planar IMRT QA using the Varian portal dosimetry system. The second plan enabled 3D verification using an anthropomorphic head phantom. In the latter, the 3D dose distribution was measured using the DLOS/Presage dosimetry system (DLOS = Duke Large-field-of-view Optical-CT System, Presage Heuris Pharma, Skillman, NJ), which yielded isotropic 2-mm data throughout the treated volume. In a novel step, measured 3D dose distributions were transformed back to the patient's CT to enable calculation of dose-volume histograms (DVH) and dose overlays. Measured and planned patient DVHs were compared to investigate clinical significance. Results: Close agreement between measured and calculated dose distributions was observed for all 6 cases. For gamma criteria of 3%, 2 mm, the mean passing rate for portal dosimetry was 96.8% (range, 92.0%-98.9%), compared to 94.9% (range, 90.1%-98.9%) for 3D. There was no clear correlation between 2D and 3D passing rates. Planned and measured dose distributions were evaluated on the patient's anatomy, using DVH and dose overlays. Minor deviations were detected, and the clinical significance of these are presented and discussed. Conclusions: Two advantages accrue to the methods presented here. First, treatment accuracy is evaluated throughout the whole treated volume, yielding comprehensive verification. Second, the clinical significance of any deviations can be assessed through the generation of DVH curves and dose overlays on

  10. Klapp method effect on idiopathic scoliosis in adolescents: blind randomized controlled clinical trial.

    Science.gov (United States)

    Dantas, Diego De Sousa; De Assis, Sanderson José Costa; Baroni, Marina Pegoraro; Lopes, Johnnatas Mikael; Cacho, Enio Walker Azevedo; Cacho, Roberta De Oliveira; Pereira, Silvana Alves

    2017-01-01

    [Purpose] To estimate the effect of Klapp method on idiopathic scoliosis in school students. [Subjects and Methods] A single-blind randomized clinical trial with 22 students randomly divided into intervention group (n=12) and inactive control group (n=10). Exercise protocol consisted of Klapp method, 20 sessions, three times a week for intervention group, and inactivity for control group. Dorsal muscle strength was measured by dynamometer; body asymmetries and gibbosity angles were measured by biophotogrammetry. Data were obtained by Generalized Estimated Equation, with 5% significance level. Clinical impact for dependent variables was estimated by "d" Cohen. [Results] There was no change in intragroup analysis and intergroup for all postural symmetry variables. However, it was detected intergroup difference in extensor muscle strength and intergroup difference with marginal significance of gibbosity angles. Regarding extensor muscle strength, intervention group produced average improvement of 7.0 kgf compared to control group. Gibbosity angles progressed less in intervention group, with 5.71° average delay compared to control group. [Conclusion] Klapp method was effective for gibbosity stabilization and it improves spine extensor muscle strength.

  11. Evaluation of different methods for detection of metallo-beta-lactamases in Pseudomonas aeruginosa clinical isolates.

    Science.gov (United States)

    Bogiel, Tomasz; Deptuła, Aleksander; Gospodarek, Eugenia

    2010-01-01

    Metallo-beta-lactamases (MBLs) produced by Pseudomnonas aeruginosa are a serious threat due to their ability to be transmitted between the same as well as different bacterial species. Different methods are applied in the clinical laboratory to detect MBLs. The aim of this study was to compare 4 phenotypic methods and a PCR assay for their ability to detect MBLs in clinical isolates of carbapenem-resistant P. aeruginosa strains. The study embraced a total of 70 carbapenem-resistant P. aeruginosa strains isolated in The Department of Microbiology of Dr. A. Jurasz University Hospital in Bydgoszcz. The highest percentage (42.9%) of the strains were isolated from Intensive Care Unit patients, mainly from urine samples (31.4%). Methods used in this study were: double-disc synergy tests in two combinations: using ceftazidime with 2-mercaptopropionic acid and imipenem with EDTA, differences in inhibition zone diameters between discs with imipenem/EDTA and imipenem, Etest MBL (AB Biodisk) and molecular amplification of bla(IMP) and bla(VIM) genes responsible for producing MBLs, using PCR assay. The lowest percentage (1.4%) of positive results in detection of MBLs was obtained using PCR assay, the highest (72.9%) by double-disc synergy tests with imipenem and EDTA, but the specificity of this method may be low.

  12. Klapp method effect on idiopathic scoliosis in adolescents: blind randomized controlled clinical trial

    Science.gov (United States)

    Dantas, Diego De Sousa; De Assis, Sanderson José Costa; Baroni, Marina Pegoraro; Lopes, Johnnatas Mikael; Cacho, Enio Walker Azevedo; Cacho, Roberta De Oliveira; Pereira, Silvana Alves

    2017-01-01

    [Purpose] To estimate the effect of Klapp method on idiopathic scoliosis in school students. [Subjects and Methods] A single-blind randomized clinical trial with 22 students randomly divided into intervention group (n=12) and inactive control group (n=10). Exercise protocol consisted of Klapp method, 20 sessions, three times a week for intervention group, and inactivity for control group. Dorsal muscle strength was measured by dynamometer; body asymmetries and gibbosity angles were measured by biophotogrammetry. Data were obtained by Generalized Estimated Equation, with 5% significance level. Clinical impact for dependent variables was estimated by “d” Cohen. [Results] There was no change in intragroup analysis and intergroup for all postural symmetry variables. However, it was detected intergroup difference in extensor muscle strength and intergroup difference with marginal significance of gibbosity angles. Regarding extensor muscle strength, intervention group produced average improvement of 7.0 kgf compared to control group. Gibbosity angles progressed less in intervention group, with 5.71° average delay compared to control group. [Conclusion] Klapp method was effective for gibbosity stabilization and it improves spine extensor muscle strength.

  13. Issues in Selecting Methods of Evaluating Clinical Competence in the Health Professions: Implications for Athletic Training Education

    Science.gov (United States)

    Middlemas, David A.; Hensal, Carleton

    2009-01-01

    Objectives: To examine methods used to evaluate the clinical competence and proficiency of students in medicine and allied health professions. To identify factors that would be valuable to educators in athletic training and other medical and allied health professions in the development and use of clinical assessment methods. Data Sources: We…

  14. A Leydig Cell Tumour in a Cat: Histological and Immunohistochemical Findings

    Directory of Open Access Journals (Sweden)

    Pietro Asproni

    2013-01-01

    Full Text Available A 13-year-old intact male cat was submitted to castration after the finding of the enlargement of the right testis during the clinical visit. Macroscopically, a nodule of 2 cm of diameter was observed on the cut surface of the enlarged testis. Histologically, the nodule was composed by polyhedral to elongated cells with a large, eosinophilic, and vacuolated cytoplasm and small, round, and dark nuclei. These cells were arranged in acinar structures and solid sheets. The tumour was diagnosed as a Leydig cell tumour. Immunohistochemical analysis revealed that neoplastic cells were vimentin, calretinin, and melan-A positive, whereas a lack of immunoreactivity to cytokeratins confirmed the diagnosis. To our knowledge, this is the first description of a feline Leydig cells tumour without any concurrent testicular neoplasm or in a nonretained testis.

  15. Immunohistochemical analyses of a case of extralobar pulmonary sequestration with chest pain in an adult

    Directory of Open Access Journals (Sweden)

    Yuji Ohtsuki

    2013-01-01

    Full Text Available Computed tomography of a Japanese man in his mid-forties with a complaint of right-side chest pain showed a dome-shaped smooth-surfaced mediastinal mass, which was extirpated. The cut surface was highly hemorrhagic and necrotic and not related to the original pulmonary tissues. Although routine sectioning detected bronchial cartilage, immunohistochemical analyses clearly showed the presence of alveolar type II cells; only the alveolar type II cells located at the periphery of this mass showed positive staining for cytokeratins, thyroid transcription factor 1, surfactant protein A, epithelial membrane antigen and Krebs von den Lungen-6. Thus, these analyses are useful for the detection of pulmonary components, even in severely hemorrhagic and necrotic tissues with marked sequestration. The clinical diagnosis was a rare, adult type of extralobar pulmonary sequestration accompanied by chest pain.

  16. Immunohistochemical testing for Helicobacter Pylori existence in neoplasms of the colon

    Directory of Open Access Journals (Sweden)

    Yasar Nurgul

    2008-08-01

    Full Text Available Abstract Background Helicobacter pylori is a common pathogen, and its prevalence varies with socioeconomic conditions (10–80%. It has recently been recognized as a class I carcinogen in relation to gastric cancer. The aim of this study was to investigate the presence of Helicobacter pylori in neoplasms of the colon by immunohistochemical methods. Methods The polypectomy materials of 51 patients (19 male and 32 female who had undergone colonoscopic polypectomy were retrieved for retrospective examination. The endoscopic size and colonic localization of the polyps were recorded. Hematoxylin and eosin stains were evaluated according to histological type and grade of dysplasia. Biopsy stains were immunohistochemically treated with Helicobacter pylori antibodies by the streptavidine-biotin immunoperoxidase technique. Helicobacter pylori staining in the gastric mucosa was used as the control for the immunohistochemical method. Specimens were classified according to the presence of Helicobacter pylori under an optical microscope, and Helicobacter pylori positive specimens were stratified according to the respective staining pattern. Results Mean age was 61.88 ± 10.62 (40–82 years. Polyp sizes were 1.45 ± 0.92 (1–4 cm; and 25.5% of polyps were localized in the right colon, 68.6% in the left colon and 5.9% in the transverse colon. Presence of Helicobacter pylori was not correlated with localization (p > 0.05 or size of the polyps (p > 0.05. Eleven (21.6% of all specimens included in the study were Helicobacter pylori positive by immunohistochemical methods. Of the Helicobacter pylori positive specimens, the staining pattern was diffuse: Equivocal in 90.9%, nonspecific with a finely granular type concentrated on the luminal surface in 90.9%, dot-like granular in 54.5%, and spiral in 9.1%. Of the tubular polyps, 17.9% were H. pylori positive, and the staining pattern was equivocal in 100%, luminal in 85.7%, and dot-like granular in 57.1%. Of the

  17. Clinical impact of evaluation of cardiovascular control by novel methods of heart rate dynamics.

    Science.gov (United States)

    Huikuri, Heikki V; Perkiömäki, Juha S; Maestri, Roberto; Pinna, Gian Domenico

    2009-04-13

    Heart rate variability (HRV) has been conventionally analysed with time- and frequency-domain methods, which measure the overall magnitude of RR interval fluctuations around its mean value or the magnitude of fluctuations in some predetermined frequencies. Analysis of heart rate dynamics by novel methods, such as heart rate turbulence after ventricular premature beats, deceleration capacity of heart rate and methods based on chaos theory and nonlinear system theory, have gained recent interest. Recent observational studies have suggested that some indices describing nonlinear heart rate dynamics, such as fractal scaling exponents, heart rate turbulence and deceleration capacity, may provide useful prognostic information in various clinical settings and their reproducibility may be better than that of traditional indices. For example, the short-term fractal scaling exponent measured by the detrended fluctuation analysis method has been shown to predict fatal cardiovascular events in various populations. Similarly, heart rate turbulence and deceleration capacity have performed better than traditional HRV measures in predicting mortality in post-infarction patients. Approximate entropy, a nonlinear index of heart rate dynamics, which describes the complexity of RR interval behaviour, has provided information on the vulnerability to atrial fibrillation. There are many other nonlinear indices which also give information on the characteristics of heart rate dynamics, but their clinical usefulness is not as well established. Although the concepts of nonlinear dynamics, fractal mathematics and complexity measures of heart rate behaviour, heart rate turbulence, deceleration capacity in relation to cardiovascular physiology or various cardiovascular events are still far away from clinical medicine, they are a fruitful area for research to expand our knowledge concerning the behaviour of cardiovascular oscillations in normal healthy conditions as well as in disease states.

  18. A Standardized Method of Isolating Adipose-Derived Stem Cells for Clinical Applications.

    Science.gov (United States)

    Raposio, Edoardo; Caruana, Giorgia; Petrella, Maira; Bonomini, Sabrina; Grieco, Michele P

    2016-01-01

    White adipose tissue is the most abundant and accessible source of stem cells in the adult human body. In this paper, we present a standardised and safe method of isolating and maximizing the number of adipose-derived stem cells (ASCs) from conventional liposuction for clinical applications, which was carried out through both mechanical (centrifuge) and enzymatic (collagenase) means. Isolated cells were characterized through flow cytometry assay. Gathered data showed a greater amount (9.06 × 10(5) ASCs from 100 mL of adipose tissue) of isolated ASCs compared to previous protocol, also with high (99%) cell vitality; the procedure we presented is easy and fast (80 minutes), allowing collecting a significative number of mesenchymal stem cells, which can be used for clinical purposes, such as wound healing.

  19. IndexFinder: a method of extracting key concepts from clinical texts for indexing.

    Science.gov (United States)

    Zou, Qinghua; Chu, Wesley W; Morioka, Craig; Leazer, Gregory H; Kangarloo, Hooshang

    2003-01-01

    Extracting key concepts from clinical texts for indexing is an important task in implementing a medical digital library. Several methods are proposed for mapping free text into standard terms defined by the Unified Medical Language System (UMLS). For example, natural language processing techniques are used to map identified noun phrases into concepts. They are, however, not appropriate for real time applications. Therefore, in this paper, we present a new algorithm for generating all valid UMLS concepts by permuting the set of words in the input text and then filtering out the irrelevant concepts via syntactic and semantic filtering. We have implemented the algorithm as a web-based service that provides a search interface for researchers and computer programs. Our preliminary experiment shows that the algorithm is effective at discovering relevant UMLS concepts while achieving a throughput of 43K bytes of text per second. The tool can extract key concepts from clinical texts for indexing.

  20. C4d staining as immunohistochemical marker in inflammatory myopathies.

    Science.gov (United States)

    Pytel, Peter

    2014-10-01

    The diagnosis of an inflammatory myopathy is often established based on basic histologic studies. Additional immunohistochemical studies are sometimes required to support the diagnosis and the classification of inflammatory myopathies. Staining for major histocompatibility complex 1 (MHC1) often shows increased sarcolemmal labeling in inflammatory myopathies. Endomysial capillary staining C5b-9 (membrane attack complex) is a feature that is reported as frequently associated with dermatomyositis. Immunohistochemical staining for C4d is widely used for various applications including the assessment of antibody-mediated rejection after solid organ transplantation. In the context of dermatomyositis, C4d staining has been described in skin biopsies but not in muscle biopsies. A total of 32 muscle biopsy specimens were examined. The hematoxylin and eosin-stained slides were reviewed, and immunohistochemical studies for MHC1, C5b-9, and C4d were conducted. The staining observed for C5b-9 and C4d was compared. Overall, the staining pattern for C4d mirrored the one observed for C5b-9 in the examined muscle biopsy specimens. There was high and statistically significant (P<0.0001) correlation between the staining seen with these 2 antibodies. Both antibodies labeled the cytoplasm of degenerating necrotic myofibers. In addition, both antibodies showed distinct endomysial capillary labeling in a subset of dermatomyositis. Areas with perifascicular atrophy often exhibited the most prominent vascular labeling for C4d and C5b-9. In conclusion, C4d and C5b-9 show similar expression patterns in muscle biopsies of patients with inflammatory myopathies and both highlight the presence of vascular labeling associated with dermatomyositis. C4d antibodies are widely used and may offer an alternative for C5b-9 staining.

  1. Immunohistochemical markers of distant metastasis in laryngeal and hypopharyngeal squamous cell carcinomas.

    Science.gov (United States)

    Rodrigo, Juan P; Martínez, Patricia; Allonca, Eva; Alonso-Durán, Laura; Suárez, Carlos; Astudillo, Aurora; García-Pedrero, Juana María

    2014-03-01

    Metastasis remains a major cause of mortality in head and neck squamous cell carcinoma (HNSCC). Current clinicopathological features have shown limited predictability for the risk of distant metastasis in individual patients, and therefore more accurate and reliable markers are needed. The aim of this study was to investigate the ability of various molecular markers present in primary tumors to predict the risk of developing distant metastasis. Restrictive clinical criteria were applied for patient selection in order to carry out a case-control study with comparable clinical features on a group-wide basis and a similar risk of metastasis. All patients were surgically treated (with postoperative radiotherapy when appropriate) and classified as stage IV disease. Immunohistochemical analysis was performed for a panel of proteins known to participate in cellular processes relevant to metastatic dissemination (E-cadherin, annexin A2, cortactin, FAK, EGFR, p53, and p-AKT). Results showed that the loss of E-cadherin expression was significantly correlated with the risk of distant metastasis (P = 0.002; log-rank test), while the loss of annexin A2 expression was nearly statistically significant (P = 0.06). None of the other protein markers assessed were associated with the development of distant metastasis. Therefore, according to our data the loss of epithelial adhesion seems to play a central role in the development of metastasis in HNSCC, and more importantly, immunohistochemical assessment of key proteins involved in cell adhesion regulation, such as E-cadherin could represent a useful tool to evaluate easily and routinely the metastatic potential of these carcinomas.

  2. Impact of white matter hyperintensities scoring method on correlations with clinical data: the LADIS study

    DEFF Research Database (Denmark)

    van Straaten, EC; Fazekas, F; Rostrup, Egill;

    2006-01-01

    between groups with and without symptoms. METHODS: We used data of 618 independently living elderly with WMH collected in the Leukoaraiosis And DISability (LADIS) study. Subjects with and without symptoms of depression, gait disturbances, urinary incontinence, and memory decline were compared with respect......BACKGROUND AND PURPOSE: White matter hyperintensities (WMH) are associated with decline in cognition, gait, mood, and urinary continence. Associations may depend on the method used for measuring WMH. We investigated the ability of different WMH scoring methods to detect differences in WMH load...... and Mann-Whitney tests. In addition, the punctate and confluent lesion type with comparable WMH volume were compared with respect to the clinical data using Student t test and chi2 test. Direct comparison of visual ratings with volumetry was done using curve fitting. RESULTS: Visual and volumetric...

  3. Circulating tumor cells in lung cancer: detection methods and clinical applications.

    Science.gov (United States)

    Yu, Na; Zhou, Jia; Cui, Fang; Tang, Xiaokui

    2015-04-01

    Circulating tumor cells (CTCs) are tumor cells that have disseminated from primary and metastatic sites, and circulate in the bloodstream. Advanced immunological and molecular-based methods can be used to detect and analyze the cells with the characteristics of tumor cells, and can be detected and analyzed in the blood of cancer patients. The most commonly used methods in lung cancer combine the processes of immunomagnetic enrichment and immunocytochemical detection, morphology-based enrichment coupled with reverse transcriptase polymerase chain reaction (RT-PCR), and RT-PCR alone. CTC analysis is considered a liquid biopsy approach for early diagnosis, risk stratification, evaluation of curative efficacy, and early detection of lung cancer relapse. In this review, we discuss the present techniques for analyzing CTCs, and the restrictions of using these methods in lung cancer. We also review the clinical studies in lung cancer and discuss the underlying associations between these studies and their future applications to this disease.

  4. Applying Process Improvement Methods to Clinical and Translational Research: Conceptual Framework and Case Examples.

    Science.gov (United States)

    Daudelin, Denise H; Selker, Harry P; Leslie, Laurel K

    2015-12-01

    There is growing appreciation that process improvement holds promise for improving quality and efficiency across the translational research continuum but frameworks for such programs are not often described. The purpose of this paper is to present a framework and case examples of a Research Process Improvement Program implemented at Tufts CTSI. To promote research process improvement, we developed online training seminars, workshops, and in-person consultation models to describe core process improvement principles and methods, demonstrate the use of improvement tools, and illustrate the application of these methods in case examples. We implemented these methods, as well as relational coordination theory, with junior researchers, pilot funding awardees, our CTRC, and CTSI resource and service providers. The program focuses on capacity building to address common process problems and quality gaps that threaten the efficient, timely and successful completion of clinical and translational studies.

  5. Epidemiological typing of clinical isolates of Achromobacter xylosoxidans: comparison of phenotypic and genotypic methods.

    Science.gov (United States)

    Kaur, M; Ray, P; Bhatty, M; Sharma, M

    2009-09-01

    The purpose of this paper is to evaluate the utility of different typing methods for Achromobacter xylosoxidans clinical isolates. Ninety-two blood culture isolates of A. xylosoxidans subsp. xylosoxidans were collected over a 25-month period. The typeability, discriminatory power and reproducibility of commonly used phenotypic and genotypic methods, such as resistotyping, plasmid profiling, whole-cell protein fingerprinting, random amplification of polymorphic DNA (RAPD) and pulsed-field gel electrophoresis (PFGE), were compared. All 92 isolates were typeable by all of the methods used, with comparable reproducibility. PFGE showed the highest discriminatory power (98.9%), but whole-cell protein profiling showed better correlation with epidemiological data without significant loss in discriminatory power (94%). Whole-cell protein profiling is a reliable epidemiological tool for the analysis of A. xylosoxidans; PFGE is the most discriminatory.

  6. 针灸临床研究方法分析%Research methods of clinical acupuncture

    Institute of Scientific and Technical Information of China (English)

    任丽娜; 马文珠

    2014-01-01

    Through retrieving Chinese bibliographic databases, the characteristics and main corresponding diseases of the research methods of clinical acupuncture documents [including randomized controlled trial (RCT), cohort study, retrospective analysis, case sequence study, single case study and clinical inspection] were summed up and analyzed. Research methods of clinical acupuncture, at present, are flexible and diverse, and RCT and case sequence study are dominated. There is no significant difference in the kinds of disease studied by different methods and main diseases are nervous ones. The application directions of these research methods are optional, for example, RCT are used for therapeutic studies and retrospective analysis, for etiological studies. RCT, as a golden criterion, can be used for reviewing the effectiveness of interventional measures, while retrospective analysis and case sequence study also have significant values to clinical acupuncture. At the same time, the research methods of acupuncture decision effects should be developed, that is real word study.%通过检索中文文献数据库,对针灸临床文献中研究方法(随机对照试验、队列研究、回顾性分析、病例序列研究、单个病例研究、临床核查)的特点及主要应用疾病进行总结和分析。目前,针灸临床研究方法灵活多样,以随机对照试验和病例序列研究为主,各方法研究的疾病种类并无很大偏差,大多以神经系统疾病为主。但其应用方向具有选择性,如随机对照试验适用于治疗性研究,而回顾性分析适用于病因学研究。随机对照试验作为临床研究方法的金标准,可用于评价干预措施的有效性,但回顾性分析、病例序列研究等方法对针灸临床也有重要的应用价值。同时,应努力研究并开展关于针灸决定效应性的研究方法,即真实世界研究。

  7. Choices on contraceptive methods in post-abortion family planning clinic in the northeast Brazil

    Directory of Open Access Journals (Sweden)

    Braga Cynthia

    2010-05-01

    Full Text Available Abstract Background In Brazil, a Ministry of Health report revealed women who underwent an abortion were predominantly in the use of contraceptive methods, but mentioned inconsistent or erroneously contraceptive use. Promoting the use of contraceptive methods to prevent unwanted pregnancies is one of the most effective strategies to reduce abortion rates and maternal morbidity and mortality. Therefore, providing post-abortion family planning services that include structured contraceptive counseling with free and easy access to contraceptive methods can be suitable. So the objective of this study is to determine the acceptance and selection of contraceptive methods followed by a post-abortion family planning counseling. Methods A cross-sectional study was carried out from July to October 2008, enrolling 150 low income women to receive post-abortion care at a family planning clinic in a public hospital located in Recife, Brazil. The subjects were invited to take part of the study before receiving hospital leave from five different public maternities. An appointment was made for them at a family planning clinic at IMIP from the 8th to the 15th day after they had undergone an abortion. Every woman received information on contraceptive methods, side effects and fertility. Counseling was individualized and addressed them about feelings, expectations and motivations regarding contraception as well as pregnancy intention. Results Of all women enrolled in this study, 97.4% accepted at least one contraceptive method. Most of them (73.4% had no previous abortion history. Forty of the women who had undergone a previous abortion, 47.5% reported undergoing unsafe abortion. Slightly more than half of the pregnancies (52% were unwanted. All women had knowledge of the use of condoms, oral contraceptives and injectables. The most chosen method was injectables, followed by oral contraceptives and condoms. Only one woman chose an intrauterine device. Conclusion The

  8. Massive retinal gliosis: An unusual case with immunohistochemical study

    Directory of Open Access Journals (Sweden)

    Sanjay D Deshmukh

    2011-01-01

    Full Text Available Massive retinal gliosis (MRG is a rare, benign intraocular condition that results from the proliferation of well-differentiated glial cells. Immunohistochemically, these cells show positivity for glial fibrillary acid protein (GFAP, neuron specific enolase (NSE, and S-100 protein. We encountered a case of a 45-year-old female with loss of vision in the left eye. She had a history of trauma to that eye two years ago. Enucleation was carried out, because malignancy was suspected due to retinal calcification. On the basis of light microscopy and immunohistochemistry (IHC performed on the enucleated eye, it was diagnosed as massive retinal gliosis.

  9. Calcifying Odontogenic Cyst with Complex Odontoma: Histological and Immunohistochemical Features

    Directory of Open Access Journals (Sweden)

    Nooshin Mohtasham

    2013-01-01

    Full Text Available The calcifying odontogenic cyst (COC is a rare odontogenic cyst. Only 2% of all odontogenic cysts and tumors are COC. COC associated with odontoma (COCaO reported in 24% of COCs. COCaO presents a greater incidence in female, with a ratio of 2 to 1. The highest incidence of COCaO occurs during the second decade with a mean age of 16 years, most frequently occurring in the maxilla (61.5%. Here, we describe a classic case of COCaO of the maxillary incisor-canine region in 17-year-old girl, and discuss the clinicopathological features and immunohistochemical finding of this tumor.

  10. Calcifying Odontogenic Cyst with Complex Odontoma: Histological and Immunohistochemical Features

    Directory of Open Access Journals (Sweden)

    Mohsen Merati

    2012-09-01

    Full Text Available The calcifying odontogenic cyst (COC is a rare odontogenic cyst. Only 2% of all odontogenic cysts and tumors are COC. COC associated with odontoma (COCaO reported in 24% of COCs. COCaO presents a greater incidence in female, with a ratio of 2 to 1. The highest incidence of COCaO occurs during the second decade with a mean age of 16 years, most frequently occurring in the maxilla (61.5%. Here, we describe a classic case of COCaO of the maxillary incisor-canine region in 17-year-old girl, and discuss the clinicopathological features and immunohistochemical finding of this tumor.

  11. Validation of the tool assessment of clinical education (AssCE): A study using Delphi method and clinical experts.

    Science.gov (United States)

    Löfmark, Anna; Mårtensson, Gunilla

    2017-03-01

    The aim of the present study was to establish the validity of the tool Assessment of Clinical Education (AssCE). The tool is widely used in Sweden and some Nordic countries for assessing nursing students' performance in clinical education. It is important that the tools in use be subjected to regular audit and critical reviews. The validation process, performed in two stages, was concluded with a high level of congruence. In the first stage, Delphi technique was used to elaborate the AssCE tool using a group of 35 clinical nurse lecturers. After three rounds, we reached consensus. In the second stage, a group of 46 clinical nurse lecturers representing 12 universities in Sweden and Norway audited the revised version of the AssCE in relation to learning outcomes from the last clinical course at their respective institutions. Validation of the revised AssCE was established with high congruence between the factors in the AssCE and examined learning outcomes. The revised AssCE tool seems to meet its objective to be a validated assessment tool for use in clinical nursing education.

  12. Conventional rapid latex agglutination in estimation of von Willebrand factor: method revisited and potential clinical applications.

    Science.gov (United States)

    Mahat, Marianor; Abdullah, Wan Zaidah; Hussin, Che Maraina Che

    2014-01-01

    Measurement of von Willebrand factor antigen (VWF : Ag) levels is usually performed in a specialised laboratory which limits its application in routine clinical practice. So far, no commercial rapid test kit is available for VWF : Ag estimation. This paper discusses the technical aspect of latex agglutination method which was established to suit the purpose of estimating von Willebrand factor (VWF) levels in the plasma sample. The latex agglutination test can be performed qualitatively and semiquantitatively. Reproducibility, stability, linearity, limit of detection, interference, and method comparison studies were conducted to evaluate the performance of this test. Semiquantitative latex agglutination test was strongly correlated with the reference immunoturbidimetric assay (Spearman's rho = 0.946, P agglutination test and the reference assay. Using the scoring system for the rapid latex test, no agglutination is with 0% VWF : Ag (control negative), 1+ reaction is equivalent to 150% VWF : Ag (when comparing with immunoturbidimetric assay). The findings from evaluation studies suggest that latex agglutination method is suitable to be used as a rapid test kit for the estimation of VWF : Ag levels in various clinical conditions associated with high levels and low levels of VWF : Ag.

  13. Would Socrates Have Actually Used the "Socratic Method" for Clinical Teaching?

    Science.gov (United States)

    Stoddard, Hugh A; O'Dell, David V

    2016-09-01

    Medical students and residents are familiar with clinical teaching methods in which a faculty member poses a series of questions to them. This technique is often called the "Socratic method," but it is frequently perceived by learners as an attempt to demean them, a practice that is colloquially known as "pimping." The distinction between Socratic teaching and pimping lies in the perception of "psychological safety." Psychological safety allows learners to answer questions or ask for help without threats to their dignity or worthiness. In a psychologically safe clinical teaching context, learners recognize that questions posed by attending physicians probe their current understanding and guide them to expand their knowledge. In pimping, questions are posed to embarrass the learner and to reinforce the teacher's position of power over them. Absent a threat of disparagement or condemnation, learners are able to focus on building schema for knowledge, skills, and attitudes, rather than worrying about shielding their self-worth. This article presents the proper Socratic method, as intended by Socrates, and contrasts it with pimping. This perspective defines psychological safety as the pivotal factor distinguishing Socratic teaching from pimping, and establishes the foundation for empirical studies of these common practices in medical education.

  14. Quantifying mast cells in bladder pain syndrome by immunohistochemical analysis

    DEFF Research Database (Denmark)

    Larsen, M.S.; Mortensen, S.; Nordling, J.;

    2008-01-01

    OBJECTIVES To evaluate a simple method for counting mast cells, thought to have a role in the pathophysiology of bladder pain syndrome (BPS, formerly interstitial cystitis, a syndrome of pelvic pain perceived to be related to the urinary bladder and accompanied by other urinary symptoms, e. g....... frequency and nocturia), as > 28 mast cells/mm(2) is defined as mastocytosis and correlated with clinical outcome. PATIENTS AND METHODS The current enzymatic staining method (naphtolesterase) on 10 mu m sections for quantifying mast cells is complicated. In the present study, 61 patients had detrusor...... sections between, respectively. Mast cells were counted according to a well-defined procedure. RESULTS The old and the new methods, on 10 and 3 mu m sections, showed a good correlation between mast cell counts. When using tryptase staining and 3 mu m sections, the mast cell number correlated well...

  15. [Effect of retroauricular galvanic stimulation on the central vestibular system--immunohistochemical evaluation of GABA].

    Science.gov (United States)

    Okami, K; Sekitani, T

    1990-03-01

    The changes of the neurotransmitter (GABA) distribution in the brain stem of the rats by retroauricular galvanic stimulation were investigated using immunohistochemical method. Twenty-one rats were divided into two groups: the control group which received no galvanic stimulation, and the galvanically stimulated group which received anodal galvanic stimulation (unipolar monoauricular, 5 mA in intensity, 500 msec of duration, 1 Hz in frequency) for 30 minutes. The specimens obtained as usual strict procedure for histological investigation were stained immunohistochemically using antisera against GABA. The results were as follows: 1. In the control group, GABA-like immunoreactivity was observed in all four main vestibular nuclei. In the superior, medial, and descending vestibular nuclei GABA-like immunoreactivity was found in the small cells and the terminals. Giant cells in the lateral vestibular nucleus were surrounded by GABA immunoreactive terminals. 2. In the galvanically stimulated group GABA-like immunoreactivity showed recognizable laterality in the lateral vestibular nucleus where GABA-like immunoreactivity surrounding giant cells showed more intensive on the side ipsilateral to the stimulation compared with the opposite side. On the other hand GABA-like immunoreactivity showed no laterality in the superior, medial, and descending vestibular nuclei. 3. It can be concluded that the retroauricular galvanic stimulation cause some changes in the inhibitory activity of the lateral vestibulo-spinal tract and of the spinal motor neuron.

  16. Immunohistochemical expression of cathepsin L in atopic dermatitis and lichen planus

    Directory of Open Access Journals (Sweden)

    Zeinab A El Ashmawy

    2015-01-01

    Full Text Available Background: Cathepsin L is a member of papain superfamily. It seems to promote T-cell survival, selection maturation in the thymus and enhance the antigen presentation. Cathepsin L plays an important role in tumor necrosis factors (TNF-α induced cell death. Also it degrades the tight junction between cornedesomses in the epidermis. Elevated expression of cathepsin L has been found in many inflammatory and neoplastic diseases. Objective: The aim of this study was to determine immunohistochemical expression of cathepsin L in atopic dermatitis (AD and lichen planus (LP patients in order to evaluate its role in the pathogenesis of both diseases. Materials and Methods: This study included 15 patients with AD (Group I, 15 patients with LP (Group II, in addition to 10 healthy skin specimens served as controls (Group III. Punch biopsies were taken from lesional skin of the patients and controls for immunohistochemical detection of cathepsin L expression. Results: Highly significant increase was found in cathepsin L expression in AD and LP patients compared to controls [P = 0.001]. Conclusion: Cathepsin L could be implicated as an important protease in the pathogenesis of AD and LP. It could be a useful marker for assessing AD severity.

  17. Immunohistochemical Expression of Myeloperoxidase in Placental Samples of Systematic Lupus Erythematosus Pregnancies

    Directory of Open Access Journals (Sweden)

    Zahra Heidari

    2016-08-01

    Full Text Available Objective: Reports of increased level of Myeloperoxidase (MPO in plasma and placental extracts of Systematic Lupus Erythematosus (SLE has been proposed that MPO may have an important role in this pregnancy complication. In present study immunohistochemical MPO expression was investigated in placental samples of SLE women compared with normal controls.Materials and methods: Ten patients with SLE were recruited as case group. Control group was selected from mothers with normal uncomplicated pregnancies. A monoclonal antibody specific for MPO was used for immunohistochemical staining and then the staining was quantified and differences between groups were compared using Mann-Whitney U test.Results: There were significant differences in the expression levels of MPO in the syncytiotrophoblast cells and the extravillous trophoblast cells between the control and SLE groups (p < 0.05. There were no significant differences in the expression level of MPO in the vascular endothelium and the relative number of the MPO-positive leukocytes in placental tissue between SLE and control groups (p > 0.05.Conclusion: The present study showed that MPO expression is increased in syncytiotrophoblast cells and the extravillous trophoblast cells of SLE placentas compared to healthy subjects. It seems that these changes are able to impress structure and function of placenta and survival of the fetus.

  18. Papulo-pustulosis form rosacea – results of immunohistochemical research of the condition of the lesions

    Directory of Open Access Journals (Sweden)

    Sviatenko T.V.

    2012-01-01

    Full Text Available Studying and the analysis of links pathogenesis papulo-pus tulosis forms of rosacea by means of a wide spectrum of immunohistochemical markers became a research problem. For the decision of tasks in view by the author it is used biopsy a material of 11 diagnosed cases papulo-pus tulosis forms of rosacea at me at the age from 32 till 59 years. Use of immunohis-tochemical methods of research has allowed to reveal new links in pathogenesis of rosacea and to establish a role of some cellular populations of a skin and cages of immune system in progressing of disease and development papulo-pustulosis forms of rosacea. Authors have come to a conclusion that is possible, strengthening of pathological changes at papulo-pustulosis forms of rosacea is caused by presence of pincers which are capable to cause migration in skin CD68+ cages while quantity CD138+ plasmocytes was insignificant and didn't exceed 5-10 % in infiltrates. К i-67+ cages in a considerable quan-tity were as a part of sebaceous glands that specified in progressing hyperplastic changes in these appendages of a skin. Be-sides, the quantity of cages, pos itive on this marker, correlated wi th expressiveness of defeat of sebaceous glands in a greate r degree, than with a disease stage.

  19. Immunohistochemical expression of PTEN in normal, hyperplastic and endometrial carcinoma of endometrium

    Directory of Open Access Journals (Sweden)

    IzadiMood

    2008-08-01

    Full Text Available "nBackground: Endometrial carcinoma is the most common malignancy of the female genital tract. Different molecular alterations have been described in endometrioid endometrial carcinoma that, the most frequently altered gene is mutations of PTEN. Up to 50-83% of endometrioid carcinoma reveal altered PTEN characterized by loss of expression. In endometrial hyperplasia, which are precursors of endometrioid carcinoma, loss of PTEN expression is 30-63%."n"nMethods: Immunohistochemical staining was performed on 90 cases of endometrial curettage including: 30 proliferative endometrium, 30 hyperplastic endometrium and 30 endometroid carcinoma."n"nImmunohistochemical specimens were graded semiquatitatively by considering the percentage of staining with two cut-point 10% & 50% on the whole section for each specimen."n"nResults: loss of PTEN expression was observed 0%, 0%, 30% of 51.7% in proliferative, simple hyperplasia, complex hyperplasia and endometrioid carcinoma respectively with cut-point 10% and 0%, 5.3%, 30%, 52.2% in endometrioid carcinoma respectively with cut-point 50%. Also there was no difference in PTEN expression between atypical complex hyperplasia and endometrioid carcinoma but there was significant difference between simple hyperplasia and proliferative with endometrioid carcinoma & atypical complex hyperplasia."n"nConclusion: These results show loss of PTEN expression in endmetrioid carcinoma and no differences between endometrioid carcinoma and atypical complex hyperplasia. Therefore, assessment of PTEN expression by negative immunostaining and matched with routine hematoxylin and eosin stained can be a new tool for diagnosis of endometrioid carcinoma.

  20. Immunohistochemical diagnosis of Alport's syndrome in paraffin-embedded renal sections: antigen retrieval with autoclave heating.

    Science.gov (United States)

    Naito, Ichiro; Ninomiya, Yoshifumi; Nomura, Shinsuke

    2003-03-01

    Alport's syndrome (AS) is a hereditary renal disease caused by mutations in the genes encoding collagen type IV. Immunohistochemical analysis of the alpha chains of collagen type IV has been found to be useful for the diagnosis of this disease. The monoclonal antibodies (mAbs) generated by us recognize alpha 1(IV) through alpha 6(IV) chains of collagen type IV on fresh-frozen sections but not on paraffin-embedded sections. Antigen retrieval by autoclave heating has been found to restore the epitopes recognized by the mAbs; however the heating conditions had not been well established. In this study, the heating conditions were carefully examined using renal sections obtained from AS and non-AS patients. The heating was performed in an autoclave, at 105 degrees -127 degrees C for 6-8 min. During the heating, the sections were immersed in 0.2 N HCl solution (pH 0.9). Then, the mAbs were applied for 30 min, and the bound mAbs were detected using the LSAB kit. The optimal temperature for the antigen retrieval varied among specimens, and was dependent on the type of basement membrane examined. Thus, it was considered that heating at two or three different temperatures could be helpful for the precise diagnosis of AS. Adopting the antigen retrieval method could extend the possibility of immunohistochemical diagnosis of AS to cases without using fresh-frozen sections.

  1. Use of immunohistochemical markers can refine prognosis in triple negative breast cancer

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    Cheang Maggie CU

    2007-07-01

    Full Text Available Abstract Background Basal-like breast cancer has been extensively characterized on the basis of gene expression profiles, but it is becoming increasingly common for these tumors to be defined on the basis of immunohistochemical (IHC staining patterns, particularly in retrospective studies where material for expression profiling may not be available. The IHC pattern that best defines basal-like tumors is under investigation and various combinations of ER, PR, HER2-, CK5/6+ and EGFR+ have been tested. Methods Using datasets from two different hospitals we describe how using different combinations of immunohistochemical patterns has different effects on estimating prognosis at different time intervals after diagnosis. As our baseline, we used two IHC patterns ER-/PR-/HER2-("triple negative phenotype", TNP and ER-/HER2-/CK5/6+ and/or EGFR+ ("core basal phenotype", CBP. Results There was no overall difference in survival between the two hospital-based series, but there was a difference between the TNP and non-TNP groups which was most marked at 3 years (76.8% vs 93.5%, p Conclusion Our findings suggests that CK5/6 and/or EGFR expressing tumor types have a persistently poorer prognosis over the longer term, an observation that may have important therapeutic implications as drugs that target the EGFR are currently being evaluated in breast cancer.

  2. Rare Giant Granular Cell Ameloblastoma: A Case Report and an Immunohistochemical Study

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    Santosh Hunasgi

    2013-01-01

    Full Text Available Aims. The aim is to present a case of rare giant granular cell ameloblastoma and to review the pertinent literature highlighting the molecular aspects of its pathogenesis by analyzing the expression of CD-68, Bcl-2, and β-catenin. Methods. H and E stained sections showed large odontogenic islands showing peripheral ameloblast-like cells and central stellate reticulum-like cells with extensive granular cell transformation surrounded by fibrous stroma. Polyclonal rabbit anti-CD 68, anti-Bcl2, and anti-β-catenin were stained immunohistochemically. Results. CD-68 showed a moderate to strong staining intensity in granular cells. Moderate staining of Bcl-2 was expressed by the peripheral columnar cells of tumor islands and negative in the granular cells. Expression of β-catenin was generally weak, except for only the focal areas that showed a moderate staining intensity and weak in peripheral cells. Conclusion. The present case of giant granular cell ameloblastoma is a rare entity. Development of monstrous size is indicative of ameloblastomas persistent growth. Granular cell transformation in ameloblastomas probably occurs as a consequence of extensive molecular changes. Immunohistochemical studies help us to know the pathogenesis of this granular cell ameloblastoma. Therefore, an effort has been made here to study the expression of Bcl-2, CD-68, and β-catenin.

  3. The Histological and Immunohistochemical Aspects of Bile Reflux in Patients with Gastroesophageal Reflux Disease

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    Andreas Nakos

    2011-01-01

    Full Text Available Introduction. The pathogenesis of GERD is strongly related with mixed acid and bile reflux. Benign and malignant esophageal and gastric lesions have been associated with synergetic activity between those parameters. Bile reflux causes reactive gastropathy evaluated with Bile Reflux Index (BRI. The aim was to investigate if the sequence: bile reflux-intestinal metaplasia-GERD-esophagitis, is associated with apoptotic/oncogenetic disturbances. Materials/Methods. Fifteen asymptomatic subjects and 53 GERD patients underwent gastroscopy with biopsies. The specimens examined histologically and immunohistochemically for p53, Ki-67, Bax, and Bcl-2. Results. Elevated BRI score detected in 47% (25/53 of patients with GERD and in 13% (2/15 of controls (=0.02. Severe esophageal lesions were significantly more common in BRI (+ patients (14/25 compared to BRI (− ones (=0.0049. Immunohistochemical analysis did not show associations between BRI score and biomarker expression. Conclusions. Bile reflux gastropathy is associated with GERD severity, but not with oncogene expression or apoptotic discrepancies of the upper GI mucosa.

  4. The histological and immunohistochemical aspects of bile reflux in patients with gastroesophageal reflux disease.

    Science.gov (United States)

    Nakos, Andreas; Kouklakis, Georgios; Pitiakoudis, Michail; Zezos, Petros; Efraimidou, Eleni; Giatromanolaki, Alexandra; Polychronidis, Alexandros; Liratzopoulos, Nikolaos; Sivridis, Efthimios; Simopoulos, Konstantinos

    2011-01-01

    Introduction. The pathogenesis of GERD is strongly related with mixed acid and bile reflux. Benign and malignant esophageal and gastric lesions have been associated with synergetic activity between those parameters. Bile reflux causes reactive gastropathy evaluated with Bile Reflux Index (BRI). The aim was to investigate if the sequence: bile reflux-intestinal metaplasia-GERD-esophagitis, is associated with apoptotic/oncogenetic disturbances. Materials/Methods. Fifteen asymptomatic subjects and 53 GERD patients underwent gastroscopy with biopsies. The specimens examined histologically and immunohistochemically for p53, Ki-67, Bax, and Bcl-2. Results. Elevated BRI score detected in 47% (25/53) of patients with GERD and in 13% (2/15) of controls (P = 0.02). Severe esophageal lesions were significantly more common in BRI (+) patients (14/25) compared to BRI (-) ones (P = 0.0049). Immunohistochemical analysis did not show associations between BRI score and biomarker expression. Conclusions. Bile reflux gastropathy is associated with GERD severity, but not with oncogene expression or apoptotic discrepancies of the upper GI mucosa.

  5. Immunohistochemical profiles of claudin-3 in primary and metastatic prostatic adenocarcinoma

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    Becich Michael J

    2011-01-01

    Full Text Available Abstract Background Claudins are integral membrane proteins that are involved in forming cellular tight junctions. One member of the claudin family, claudin-3, has been shown to be overexpressed in breast, ovarian, and pancreatic cancer. Here we use immunohistochemistry to evaluate its expression in benign prostatic hyperplasia (BPH, prostatic intraepithelial neoplasia (PIN, normal tissue adjacent to prostatic adenocarcinoma (NAC, primary prostatic adenocarcinoma (PCa, and metastatic prostatic adenocarcinoma (Mets. Methods Tissue microarrays were immunohistochemically stained for claudin-3, with the staining intensities subsequently quantified and statistically analyzed using a one-way ANOVA with subsequent Tukey tests for multiple comparisons or a nonparametric equivalent. Fifty-three cases of NAC, 17 cases of BPH, 35 cases of PIN, 107 cases of PCa, and 55 cases of Mets were analyzed in the microarrays. Results PCa and Mets had the highest absolute staining for claudin-3. Both had significantly higher staining than BPH (p Conclusions To our knowledge, this represents one of the first studies comparing the immunohistochemical profiles of claudin-3 in PCa and NAC to specimens of PIN, BPH, and Mets. These findings provide further evidence that claudin-3 may serve as an important biomarker for prostate cancer, both primary and metastatic, but does not provide evidence that claudin-3 can be used to predict risk of metastasis.

  6. Extra-tongue oral granular cell tumor: Histological and immunohistochemical aspect

    Science.gov (United States)

    Pigatti, Fernanda-Mombrini; Martins-Mussi, Maria-Carolina; Sedassari, Bruno-Tavares; Orsini-Machado de Sousa, Suzana-Cantanhede

    2017-01-01

    Background Granular cell tumor (GCT) is an uncommon benign tumor founded in any part of the body but mainly in the tongue. Extra-tongue oral granular cell tumor (ETOGCT) is rare with few cases reported. Here we describe seven cases of oral GCT located in sites other then the tongue and discuss histopathological and immunohistochemical differences between differential diagnoses. Material and Methods We retrieved all cases diagnosed with oral granular cell tumor, from the Oral Pathology Service at the School of Dentistry/ University of São Paulo, and excluded the ones sited in the tongue. Immunohistochemical staining anti-S100 was also performed. Results The presented cases of Extra-tongue Oral Granular Cell Tumor (ETOGT) are composed by granular cells with intimately association with the adjacent tissue. Atypia and mitoses were not seen, and in most cases, the typical pseudoepitheliomatous hyperplasia was not observed. Conclusions The importance of an adequate attention is to avoid misdiagnoses, since ETOGT is rare and the tricking histopathological findings could induce to it. All the cases can be differentiated from the tumors that has a granular cell proliferation through a morphological analysis and when needed, immunohistochemistry stain. Key words:Abrikossoff`s tumor, granular cell tumor, oral cavity. PMID:27918739

  7. CLINICAL OBSERVATION ON TREATMENT OF PERIPHERAL FACIAL PARALYSIS WITH DIFFERENT NEEDLING METHODS

    Institute of Scientific and Technical Information of China (English)

    HU Youping; YANG Yunkuan

    2002-01-01

    Purpose: To observe the clinical theraputic effect of different neeling methods in the treatment of peripheral faclal pelalysis. Methods: A total if 158 caese of peripheral facial palsy patients are randomly divided into treatment group (n=116 cases, who are treated by penetration needling method) and control group (n= 42 cases,who are treated with traditional acupuncture method). In treatment group, main acupoint pairs for penetration needling are Yangbai (GB 14) - Yuyao (EX-HN 4), Tongziliao (GB 1) - Taiyang (EX+IN 5), Jiache (ST 6) - Dicang (ST 4)and Chengjing (CV 24) - Jiachegjiang (EX-HN) on the affected side, and in control group, the main acupoints used are Yifeng (TE 17), Yangbai (GB 14), Sibai (ST 2), Dicang (ST 4), Jiache (ST 6), Jingming (BL 1) and Chengjiang (CV 24). The treatment is given once daily with 10 sessions being a therapeutic course. Results: After 3 courses of treatment, tth cure rates of treatment group and control group are 81.8% and 66.7% separately, showing a significant difference between two groups (P<0.05). The total effective rates of treatment and control groups are 96. 5 % and 88.1% separately, presenting a significant difference between two groups ( P < 0.01 ). Conclusion: The therapeutic effect of penetration needling method is better than that of traditional acupuncture method.

  8. Review of radiological scoring methods of osteoporotic vertebral fractures for clinical and research settings

    Energy Technology Data Exchange (ETDEWEB)

    Oei, Ling [Erasmus Medical Center, Department of Internal Medicine, Rotterdam (Netherlands); Erasmus Medical Center, Department of Epidemiology, P.O. Box 2040 Ee21-75, CA, Rotterdam (Netherlands); Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Rotterdam (Netherlands); Erasmus Medical Center, Departments of Internal Medicine and Epidemiology, P.O. Box 2040 Ee21-83, CA, Rotterdam (Netherlands); Rivadeneira, Fernando [Erasmus Medical Center, Department of Internal Medicine, Rotterdam (Netherlands); Erasmus Medical Center, Department of Epidemiology, P.O. Box 2040 Ee21-75, CA, Rotterdam (Netherlands); Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Rotterdam (Netherlands); Erasmus Medical Center, Departments of Internal Medicine and Epidemiology, P.O. Box 2040 Ee5-79, CA, Rotterdam (Netherlands); Ly, Felisia; Breda, Stephan J. [Erasmus Medical Center, Department of Internal Medicine, Rotterdam (Netherlands); Erasmus Medical Center, Department of Epidemiology, P.O. Box 2040 Ee21-75, CA, Rotterdam (Netherlands); Erasmus Medical Center, Departments of Internal Medicine and Epidemiology, P.O. Box 2040 Ee21-83, CA, Rotterdam (Netherlands); Zillikens, M.C. [Erasmus Medical Center, Department of Internal Medicine, Rotterdam (Netherlands); Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Rotterdam (Netherlands); Erasmus Medical Center, Department of Internal Medicine, ' s Gravendijkwal 230, CE, Rotterdam (Netherlands); Hofman, Albert [Erasmus Medical Center, Department of Epidemiology, P.O. Box 2040 Ee21-75, CA, Rotterdam (Netherlands); Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Rotterdam (Netherlands); Uitterlinden, Andre G. [Erasmus Medical Center, Department of Internal Medicine, Rotterdam (Netherlands); Erasmus Medical Center, Department of Epidemiology, P.O. Box 2040 Ee21-75, CA, Rotterdam (Netherlands); Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Rotterdam (Netherlands); Erasmus Medical Center, Departments of Internal Medicine and Epidemiology, P.O. Box 2040 Ee5-75B, CA, Rotterdam (Netherlands); Krestin, Gabriel P.; Oei, Edwin H.G. [Erasmus Medical Center, Department of Radiology, ' s Gravendijkwal 230, CE, Rotterdam (Netherlands)

    2013-02-15

    Osteoporosis is the most common metabolic bone disease; vertebral fractures are the most common osteoporotic fractures. Several radiological scoring methods using different criteria for osteoporotic vertebral fractures exist. Quantitative morphometry (QM) uses ratios derived from direct vertebral body height measurements to define fractures. Semi-quantitative (SQ) visual grading is performed according to height and area reduction. The algorithm-based qualitative (ABQ) method introduced a scheme to systematically rule out non-fracture deformities and diagnoses osteoporotic vertebral fractures based on endplate depression. The concordance across methods is currently a matter of debate. This article reviews the most commonly applied standardised radiographic scoring methods for osteoporotic vertebral fractures, attaining an impartial perspective of benefits and limitations. It provides image examples and discusses aspects that facilitate large-scale application, such as automated image analysis software and different imaging investigations. It also reviews the implications of different fracture definitions for scientific research and clinical practice. Accurate standardised scoring methods for assessing osteoporotic vertebral fractures are crucial, considering that differences in definition will have implications for patient care and scientific research. Evaluation of the feasibility and concordance among methods will allow establishing their benefits and limitations, and most importantly, optimise their effectiveness for widespread application. (orig.)

  9. An application of business process method to the clinical efficiency of hospital.

    Science.gov (United States)

    Leu, Jun-Der; Huang, Yu-Tsung

    2011-06-01

    The concept of Total Quality Management (TQM) has come to be applied in healthcare over the last few years. The process management category in the Baldrige Health Care Criteria for Performance Excellence model is designed to evaluate the quality of medical services. However, a systematic approach for implementation support is necessary to achieve excellence in the healthcare business process. The Architecture of Integrated Information Systems (ARIS) is a business process architecture developed by IDS Scheer AG and has been applied in a variety of industrial application. It starts with a business strategy to identify the core and support processes, and encompasses the whole life-cycle range, from business process design to information system deployment, which is compatible with the concept of healthcare performance excellence criteria. In this research, we apply the basic ARIS framework to optimize the clinical processes of an emergency department in a mid-size hospital with 300 clinical beds while considering the characteristics of the healthcare organization. Implementation of the case is described, and 16 months of clinical data are then collected, which are used to study the performance and feasibility of the method. The experience gleaned in this case study can be used a reference for mid-size hospitals with similar business models.

  10. Developing clinical knowledge through a narrative-based method of interpretation.

    Science.gov (United States)

    Ekman, Inger; Skott, Carola

    2005-09-01

    The results of research using a narrative analysis provide new clinical knowledge, but the methods used are unknown to many readers. In this paper we present an example of how an analysis may be performed in practice. The purpose of the interpretation of this specific story was to develop clinical knowledge of how it is to live with chronic heart failure from a daily life perspective. The steps in the interpretation process, within the framework of Paul Ricoeur's Interpretation theory, were: (1) general or naïve reading, (2) distancing, (3) examination of discourse, (4) conjectures and questions, and (5) reflection over the whole. The demonstrated interpretation of the interview resulted in a theme called: "Struggling to comprehend medical information". This systematic way of working with narratives makes implicit assumptions about the relationship between meaning and language explicit. These themes can be used in everyday practice as clinical tools. Because of the interpretative nature of human understanding the experienced health professional will be capable of integrating evidence-based research findings and individual illness experience.

  11. Detection methods and clinical significance of free peritoneal tumor cells found during colorectal cancer surgery

    Institute of Scientific and Technical Information of China (English)

    Simone; Sibio; Cristina; Fiorani; Carmine; Stolfi; Andrea; Divizia; Roberto; Pezzuto; Fabrizio; Montagnese; Giulia; Bagaglini; Paolo; Sammartino; Giuseppe; Sigismondo; Sica

    2015-01-01

    Peritoneal washing is now part of the standard clinical practice in several abdominal and pelvic neoplasias. However, in colorectal cancer surgery, intra-peritoneal free cancer cells(IFCC) presence is not routinely investigated and their prognostic meaning is still unclear. When peritoneal washing results are positive for the presence of IFCC a worse outcome is usually expected in these colorectal cancer operated patients, but it what is not clear is whether it is associated with an increased risk of local recurrence. It is authors’ belief that one of the main reasons why IFCC are not researched as integral part of the routine staging system for colon cancer is that there still isn’t a diagnostic or detection method with enough sensibility and specificity. However, the potential clinical implications of a routine research for the presence IFCC in colon neoplasias are enormous: not only to obtain a more accurate clinical staging but also to offer different therapy protocols, based on the presence of IFCC. Based on this, adjuvant chemotherapy could be offered to those patients found to be positive for IFCC; also, protocols of proactive intraperitoneal chemotherapy could be applied. Although presence of IFCC appears to have a valid prognostic significance, further studies are needed to standardize detection and examination procedures, to determine if there are and which are the stages more likely to benefit from routine search for IFCC.

  12. Sparse Reconstruction Techniques in Magnetic Resonance Imaging: Methods, Applications, and Challenges to Clinical Adoption.

    Science.gov (United States)

    Yang, Alice C; Kretzler, Madison; Sudarski, Sonja; Gulani, Vikas; Seiberlich, Nicole

    2016-06-01

    The family of sparse reconstruction techniques, including the recently introduced compressed sensing framework, has been extensively explored to reduce scan times in magnetic resonance imaging (MRI). While there are many different methods that fall under the general umbrella of sparse reconstructions, they all rely on the idea that a priori information about the sparsity of MR images can be used to reconstruct full images from undersampled data. This review describes the basic ideas behind sparse reconstruction techniques, how they could be applied to improve MRI, and the open challenges to their general adoption in a clinical setting. The fundamental principles underlying different classes of sparse reconstructions techniques are examined, and the requirements that each make on the undersampled data outlined. Applications that could potentially benefit from the accelerations that sparse reconstructions could provide are described, and clinical studies using sparse reconstructions reviewed. Lastly, technical and clinical challenges to widespread implementation of sparse reconstruction techniques, including optimization, reconstruction times, artifact appearance, and comparison with current gold standards, are discussed.

  13. Factors affecting the clinical use of non-invasive prenatal testing: a mixed methods systematic review.

    Science.gov (United States)

    Skirton, Heather; Patch, Christine

    2013-06-01

    Non-invasive prenatal testing has been in clinical use for a decade; however, there is evidence that this technology will be more widely applied within the next few years. Guidance is therefore required to ensure that the procedure is offered in a way that is evidence based and ethically and clinically acceptable. We conducted a systematic review of the current relevant literature to ascertain the factors that should be considered when offering non-invasive prenatal testing in a clinical setting. We undertook a systematic search of relevant databases, journals and reference lists, and from an initial list of 298 potential papers, identified 11 that were directly relevant to the study. Original data were extracted and presented in a table, and the content of all papers was analysed and presented in narrative form. Four main themes emerged: perceived attributes of the test, regulation and ethical issues, non-invasive prenatal testing in practice and economic considerations. However, there was a basic difference in the approach of actual or potential service users, who were very positive about the benefits of the technology, compared with other research participants, who were concerned with the potential moral and ethical outcomes of using this testing method. Recommendations for the appropriate use of non-invasive prenatal testing are made.

  14. Time-Frequency Analysis of Clinical Percussion Signals Using Matrix Pencil Method

    Directory of Open Access Journals (Sweden)

    Moinuddin Bhuiyan

    2015-01-01

    Full Text Available This paper discusses time-frequency analysis of clinical percussion signals produced by tapping over human chest or abdomen with a neurological hammer and recorded with an air microphone. The analysis of short, highly damped percussion signals using conventional time-frequency distributions (TFDs meets certain difficulties, such as poor time-frequency localization, cross terms, and masking of the lower energy features by the higher energy ones. The above shortcomings lead to inaccurate and ambiguous representation of the signal behavior in the time-frequency plane. This work describes an attempt to construct a TF representation specifically tailored to clinical percussion signals to achieve better resolution of individual components corresponding to physical oscillation modes. Matrix Pencil Method (MPM is used to decompose the signal into a set of exponentially damped sinusoids, which are then plotted in the time-frequency plane. Such representation provides better visualization of the signal structure than the commonly used frequency-amplitude plots and facilitates tracking subtle changes in the signal for diagnostic purposes. The performance of our approach has been verified on both ideal and real percussion signals. The MPM-based time-frequency analysis appears to be a better choice for clinical percussion signals than conventional TFDs, while its ability to visualize damping has immediate practical applications.

  15. Occurrence of trichoepithelioma in a cat: Histopathologic and immunohistochemical study.

    Science.gov (United States)

    Tavasoli, Abbas; Golshahi, Hannaneh; Rad, Maryam Nobakht; Taymouri, Afra

    2013-05-01

    Trichoepitheliomas are benign follicular appendage tumors with differentiation to all three segments of the hair follicle. A 2 years old female domestic short hair cat presented with a mass on the tail. The mass was surgically excised and for histopathologic and immunohistochemical studies, was sent to Department of Pathology. Histologically, the tumor was encapsulated and consisted of many islands of follicular epithelium and also cysts structures which varied in size and shape. The cells of epithelium islands were round to oval and had variable amounts of slightly, eosinophilic cytoplasm and euchromatic nuclei. The cystic structures were lined by a complex layer of squamous epithelium. Often, cells under went an abrupt transition between basal layers and keratinization without the development of a granular cell layer. No tendency of malignancy was seen in this case. According to mentioned characteristics, trichoepithelioma was diagnosed. By immunohistochemical study it was confirmed that this tumor had epithelial origin because squamous tumor cells reacted with the pan-cytokeratin antibody. The expression of β-catenin was predominately cytoplasmic and also together with numerous positive nuclei but membranous expression was inconsistenet. Distribution of neoplastic cells with β-catenin expression was more than 75% and labeling intensity was strong in both cytoplasm and nuclei. According to author's knowledge, this is the first report of trichoepithelioma in cat in Iran and also investigation of β-catenin expression in feline trichoepithelioma in veterinary literature.

  16. Histochemical and Immunohistochemical Study of Peripolar Cells in Sheep

    Directory of Open Access Journals (Sweden)

    Passos Joana

    2013-01-01

    Full Text Available Peripolar cells are granulated cells located in the vascular pole of the renal corpuscle. Even though these cells have already been described, there are still many unknown histological and physiological characteristics. We carried out histochemical and immunohistochemical analyses of peripolar cells in sheep and compared their number in both normal and injured kidneys, discriminating according to the age of the animal. We tested HE, Toluidine Blue, PAS, and Masson's Trichrome stains to select the best stain for identification and quantification. Masson Trichrome yielded the best results and was selected for this purpose. We identified the cells by the presence of cytoplasmatic granules and by their position in the vascular pole. We found no statistically significant association between the number of peripolar cells and the age of the animal or the occurrence of lesions. In the immunohistochemical analysis, we found that the cells were positive to α-smooth muscle actin and less consistently positive to NSE and S100 protein. Chromogranin A, cyclooxygenase-2, AE1/AE3, and Wide Spectrum Cytokeratin and desmin yielded negative results. We conclude that although there was evidence of a contractile function, there was no evidence to support that peripolar cells have either a neuroendocrine or an epithelial nature.

  17. Hepatocellular Tumors: Immunohistochemical Analyses for Classification and Prognostication

    Institute of Scientific and Technical Information of China (English)

    Regina Cheuk-Lam Lo; Irene Oi-Lin Ng

    2011-01-01

    Following the classification of hepatocellular nodules by the International Working Party in 1995 and further elaboration by the International Consensus Group for Hepatocellular Neoplasia in 2009,entities under the spectrum of hepatocellular nodules have been better characterized.Research work hence has been done to answer questions such as distinguishing high-grade dysplastic nodules from early hepatocellular carcinoma (HCC),delineating the tumor cell origin of HCC,identifying its prognostic markers,and subtyping hepatocellular adenomas.As a result,a copious amount of data at immunohistochemical and molecular levels has emerged.A panel of immunohistochemical markers including glypican-3,heat shock protein 70 and glutamine synthetase has been found to be of use in the diagnosis of small,well differentiated hepatocellular tumors and particularly of HCC.The use of liver fatty acid binding protein (L-FABP),β-catenin,glutamine synthetase,serum amyloid protein and C-reactive protein is found to be helpful in the subtyping of hepatocellular adenomas.The role of tissue biomarkers for prognostication in HCC and the use of biomarkers in subclassifying HCC based on tumor cell origin are also discussed.

  18. Immunohistochemical demonstration of airway epithelial cell markers of guinea pig.

    Science.gov (United States)

    Li, Yong; Wang, Jing; He, Hai Yan; Ma, Ling Jie; Zeng, Jin; Deng, Guang Cun; Liu, Xiaoming; Engelhardt, John F; Wang, Yujiong

    2011-10-01

    The guinea pig (Cavea porcellus) is a mammalian non-rodent species in the Caviidae family. The sensitivity of the respiratory system and the susceptibility to infectious diseases allows the guinea pig to be a useful model for both infectious and non-infectious lung diseases such as asthma and tuberculosis. In this report, we demonstrated for the first time, the major cell types and composition in the guinea pig airway epithelium, using cell type-specific markers by immunohistochemical staining using the commercial available immunological reagents that cross-react with guinea pig. Our results revealed the availability of antibodies cross-reacting with airway epithelial cell types of basal, non-ciliated columnar, ciliated, Clara, goblet and alveolar type II cells, as well as those cells expressing Mucin 5AC, Mucin 2, Aquaporin 4 and Calcitonin Gene Related Peptide. The distribution of these various cell types were quantified in the guinea pig airway by immunohistochemical staining and were comparable with morphometric studies using an electron microscopy assay. Moreover, this study also demonstrated that goblet cells are the main secretory cell type in the guinea pig's airway, distinguishing this species from rats and mice. These results provide useful information for the understanding of airway epithelial cell biology and mechanisms of epithelial-immune integration in guinea pig models.

  19. Collagenase-3 expression in periapical lesions: an immunohistochemical study.

    Science.gov (United States)

    Bhalla, G; Astekar, M S; Ramesh, G; Kaur, P; Sowmya, G V

    2014-08-01

    Collagenase-3 (matrix metalloproteinase-13) is a metalloproteinase (MMP) that is associated with bone lesions and exhibits variable expression patterns in odontogenic cysts; it may play a role in regulating focal proliferation and maturation of jaw cyst epithelium. We studied the localization, staining intensity and distribution of collagenase-3 in 13 periapical granulomas with epithelium, 16 periapical granulomas without epithelium and 10 radicular cysts using archived formalin fixed, paraffin embedded tissues. A monoclonal antibody against human collagenase-3 was used to evaluate its expression. Immunohistochemical staining intensities of collagenase-3 in all periapical lesions were (-), 4 (10%); (+), 1 (3%); (++), 22 (56%) and (+++), 12 (31%); differences were not statistically significant. Immunohistochemical distribution of collagenase-3 in epithelial cells was (-), 17 (44%); (+), 17 (44%); (++), 5 (13%); in fibroblasts it was (-), 8 (20%); (+), 23 (59%); (++), 8 (21%); in plasma cells it was (-), 7 (18%); (+), 22 (56%); (++), 10 (26%); in macrophages it was (-), 7 (18%); (+), and 15 (38%); and (++), 17 (44%). Statistically significant differences were found in epithelial cells (p = 0.00) and fibroblasts (p = 0.02), whereas differences were not statistically significant for plasma cells and macrophages. Collagenase-3 may play a role in the conversion of a periapical granuloma with epithelium to radicular cyst. MMP's influence not only epithelial rest cell migration, but also invasion of various stromal cells into granulomatous tissue.

  20. Nurse-led hepatocellular carcinoma surveillance clinic provides an effective method of monitoring patients with cirrhosis.

    Science.gov (United States)

    Nazareth, Saroj; Leembruggen, Nadine; Tuma, Rhoda; Chen, Sook-Ling; Rao, Samarth; Kontorinis, Nick; Cheng, Wendy

    2016-06-01

    The aim of this study is to examine the acceptability and effectiveness of a nurse-led hepatocellular carcinoma (HCC) surveillance clinic in high-risk patients with cirrhosis/advanced fibrosis. Early detection of HCC is associated with better treatment outcomes and improved survival. International guidelines recommend 6-monthly surveillance of patients at risk of developing HCC. A nurse-led HCC surveillance protocol was established to support patients in adherence to surveillance protocols. The design used was retrospective document analysis. Retrospective analysis of healthcare records of patients referred to the clinic between August 2009 and December 2015. Extracted data included attendance of clinic visits, blood testing, ultrasound or other imaging, and outcomes. Ultrasound was attended within 6 months in 30.3% of cases and within 7 months in 71.2% of cases. The median time between Nurse-Led Clinic appointments, ultrasound scans and blood testing did not exceed 9 months. First year FibroScans were attended by 82.9% (63/76) patients; endoscopy was indicated for 42 and attended by 35 (83.3%) patients. Lesions were identified in 16 patients (21.5%) and HCC diagnosed in two patients. One patient died because of HCC and one to sub-dural haematoma. Nurse-led HCC surveillance was an effective method of monitoring patients with cirrhosis at high risk of developing HCC. Well-defined protocols enable timely identification of patients with HCC or hepatic decompensation so that management strategies can be implemented without delay. The potential benefits identified by this study warrant further, rigorous evaluation.

  1. Recent advances in computational methods and clinical applications for spine imaging

    CERN Document Server

    Glocker, Ben; Klinder, Tobias; Li, Shuo

    2015-01-01

    This book contains the full papers presented at the MICCAI 2014 workshop on Computational Methods and Clinical Applications for Spine Imaging. The workshop brought together scientists and clinicians in the field of computational spine imaging. The chapters included in this book present and discuss the new advances and challenges in these fields, using several methods and techniques in order to address more efficiently different and timely applications involving signal and image acquisition, image processing and analysis, image segmentation, image registration and fusion, computer simulation, image based modeling, simulation and surgical planning, image guided robot assisted surgical and image based diagnosis. The book also includes papers and reports from the first challenge on vertebra segmentation held at the workshop.

  2. Selectively starving cancer cells through dietary manipulation: methods and clinical implications.

    Science.gov (United States)

    Simone, Brittany A; Champ, Colin E; Rosenberg, Anne L; Berger, Adam C; Monti, Daniel A; Dicker, Adam P; Simone, Nicole L

    2013-07-01

    As the link between obesity and metabolic syndrome and cancer becomes clearer, the need to determine the optimal way to incorporate dietary manipulation in the treatment of cancer patients becomes increasingly important. Metabolic-based therapies, such as caloric restriction, intermittent fasting and a ketogenic diet, have the ability to decrease the incidence of spontaneous tumors and slow the growth of primary tumors, and may have an effect on distant metastases in animal models. Despite the abundance of preclinical data demonstrating the benefit of dietary modification for cancer, to date there are few clinical trials targeting diet as an intervention for cancer patients. We hypothesize that this may be due, in part, to the fact that several different types of diet modification exist with no clear recommendations regarding the optimal method. This article will delineate three commonly used methods of dietary manipulation to assess the potential of each as a regimen for cancer therapy.

  3. Clinical Observation on Simple Obesity Treated by Acupuncture plus Ear Point-Sticking Method

    Institute of Scientific and Technical Information of China (English)

    CAO Xue-mei; PI Min; YU Lei; TAO Jia-ping; YU Hai-bo; HUANG Guo-qi

    2007-01-01

    Objective: In order to observe the clinical therapeutic effect of acupuncture plus ear point-sticking for simple obesity. Methods: Fifty-two cases of the patients with simple obesity were treated by acupuncture and ear point-sticking method for one course. Results:After the treatments, the results showed remarkable effect in 22 cases, effect in 25 cases and failure in 5 cases, and the total effective rate was 90.4%. There was no obvious change in various indexes of the body in the male and female patients before and after the treatment.Conclusion: Acupuncture plus ear point-sticking for simple obesity is stable in the therapeutic effect, simple and safe in application, without side effects, and cheap in cost and needs to be greatly popularized.

  4. A novel method for the measurement of linear body segment parameters during clinical gait analysis.

    Science.gov (United States)

    Geil, Mark D

    2013-09-01

    Clinical gait analysis is a valuable tool for the understanding of motion disorders and treatment outcomes. Most standard models used in gait analysis rely on predefined sets of body segment parameters that must be measured on each individual. Traditionally, these parameters are measured using calipers and tape measures. The process can be time consuming and is prone to several sources of error. This investigation explored a novel method for rapid recording of linear body segment parameters using magnetic-field based digital calipers commonly used for a different purpose in prosthetics and orthotics. The digital method was found to be comparable to traditional in all linear measures and data capture was significantly faster with the digital method, with mean time savings for 10 measurements of 2.5 min. Digital calipers only record linear distances, and were less accurate when diameters were used to approximate limb circumferences. Experience in measuring BSPs is important, as an experienced measurer was significantly faster than a graduate student and showed less difference between methods. Comparing measurement of adults vs. children showed greater differences with adults, and some method-dependence. If the hardware is available, digital caliper measurement of linear BSPs is accurate and rapid.

  5. Dichoptic viewing methods for binocular rivalry research: prospects for large-scale clinical and genetic studies.

    Science.gov (United States)

    Law, Phillip C F; Paton, Bryan K; Thomson, Richard H; Liu, Guang B; Miller, Steven M; Ngo, Trung T

    2013-12-01

    Binocular rivalry (BR) is an intriguing phenomenon that occurs when two different images are presented, one to each eye, resulting in alternation or rivalry between the percepts. The phenomenon has been studied for nearly 200 years, with renewed and intensive investigation over recent decades. The rate of perceptual switching has long been known to vary widely between individuals but to be relatively stable within individuals. A recent twin study demonstrated that individual variation in BR rate is under substantial genetic control, a finding that also represented the first report, using a large study, of genetic contribution for any post-retinal visual processing phenomenon. The twin study had been prompted by earlier work showing BR rate was slow in the heritable psychiatric condition, bipolar disorder (BD). Together, these studies suggested that slow BR may represent an endophenotype for BD, and heralded the advent of modern clinical and genetic studies of rivalry. This new focus has coincided with rapid advances in 3D display technology, but despite such progress, specific development of technology for rivalry research has been lacking. This review therefore compares different display methods for BR research across several factors, including viewing parameters, image quality, equipment cost, compatibility with other investigative methods, subject group, and sample size, with a focus on requirements specific to large-scale clinical and genetic studies. It is intended to be a resource for investigators new to BR research, such as clinicians and geneticists, and to stimulate the development of 3D display technology for advancing interdisciplinary studies of rivalry.

  6. Combining numerical and clinical methods to assess aortic valve hemodynamics during exercise.

    Science.gov (United States)

    Bahraseman, Hg; Hassani, K; Khosravi, A; Navidbakhsh, M; Espino, Dm; Fatouraee, N; Kazemi-Saleh, D

    2014-07-01

    Computational simulations have the potential to aid understanding of cardiovascular hemodynamics under physiological conditions, including exercise. Therefore, blood hemodynamic parameters during different heart rates, rest and exercise have been investigated, using a numerical method. A model was developed for a healthy subject. Using geometrical data acquired by echo-Doppler, a two-dimensional model of the chamber of aortic sinus valsalva and aortic root was created. Systolic ventricular and aortic pressures were applied as boundary conditions computationally. These pressures were the initial physical conditions applied to the model to predict valve deformation and changes in hemodynamics. They were the clinically measured brachial pressures plus differences between brachial, central and left ventricular pressures. Echocardiographic imaging was also used to acquire different ejection times, necessary for pressure waveform equations of blood flow during exercise. A fluid-structure interaction simulation was performed, using an arbitrary Lagrangian-Eulerian mesh. During exercise, peak vorticity increased by 14.8%, peak shear rate by 15.8%, peak cell Reynolds number by 20%, peak leaflet tip velocity increased by 47% and the blood velocity increased by 3% through the leaflets, whereas full opening time decreased by 11%. Our results show that numerical methods can be combined with clinical measurements to provide good estimates of patient-specific hemodynamics at different heart rates.

  7. Clinical Observations on 30 Cases of Chronic Simple Pharyngitis Treated by Acupuncture plus Cupping Method

    Institute of Scientific and Technical Information of China (English)

    程玲; 张春燕; 甘志豪

    2006-01-01

    Objective:In order to investigate the clinical efficacy of acupuncture plus cupping method for treating chronic pharyngitis. Methods: Sixty patients with chronic simple pharyngitis were randomly divided into two groups. Thirty cases in the treatment group were treated by acupuncture plus cupping method and 30 cases in the control group by routine anti-inflammatory and antiviral therapy. The clinical effects were observed in the two groups. Results: The total effective rate was 93.3% in the treatment group and 80.0% in the control group. The therapeutic effect was significantly better in the treatment group than in the control group (P<0.05). Conclusion: Acupuncture plus cupping method has a good effect for chronic simple pharyngitis.%目的:观察针刺加拔罐治疗慢性咽炎的临床疗效.方法:将慢性咽炎患者60例随机分为两组,治疗组30例,采用针罐治疗;对照组30例,采用常规的抗炎、抗病毒治疗.观察两组的临床疗效.结果:治疗组总有效28/30,对照组为24/30.治疗组疗效明显优于对照组(P《0.05).结论:针刺加拔罐治疗慢性咽炎的疗效好.

  8. Analysis of clinicopathological and immunohistochemical features of 15 cases with olfactory neuroblastoma%嗅神经母细胞瘤15例临床病理及免疫组化分析

    Institute of Scientific and Technical Information of China (English)

    Xianglan Ying; lun Lin; Youping Yang

    2009-01-01

    Objective: We studied the clinicopathological and immunohistochemical features of olfactory neuroblastoma (ONB). Methods: The clinic pathological data and immunohistochemical features of 15 cases with ONB were analyzed ret- rospectively, and the related literatures were reviewed. Results: The tumors were all located in the nasal cavity in 15 cases. According to Kadish's staging system, 7 cases were in stage A, 5 cases in stage B, and 3 cases in stage C. The morphological features showed small round or ovoid tumor cells divided into pieces or trabeculae by connective tissues which were rich in capillaries. The tumor cells had round or oval nuclei and fine chromatins and lack of cytoplasma. Flexner rosette and Homer- Wright rosette were found in some cases. Acidophilic fibrins were composed of cytoplasmic projection among tumor cells. All cases were positive for NSE, Syn, CgA, 1 case was positive for Vimentin, 2 cases were positive for S-100, while CKpan, LCA and HMB45 were all negative. Conclusion: ONB is a type of very rare malignant tumors, which could be diagnosed by pathology, and immunohistochemistry is helpful in the diagnosis and differential diagnosis.

  9. Primary exploration of the application of case based learning method in clinical probation teaching of the integrated curriculum of hematology

    Institute of Scientific and Technical Information of China (English)

    Zi-zhen XU; Ye-fei WANG; Yan WANG; Shu CHENG; Yi-qun HU; Lei DING

    2015-01-01

    Objective To explore the application and the effect of the case based learning(CBL)method in clinical probation teaching of the integrated curriculum of hematology among eight-year-program medical students.Methods The CBL method was applied to the experimental group,and the traditional approach for the control group.After the lecture,a questionnaire survey was conducted to evaluate the teaching effect in the two groups.Results The CBL method efficiently increased the students’interest in learning and autonomous learning ability,enhanced their ability to solve clinical problems with basic theoretic knowledge and cultivated their clinical thinking ability.Conclusion The CBL method can improve the quality of clinical probation teaching of the integrated curriculum of hematology among eight-year-program medical students.

  10. Clinical correlative evaluation of an iterative method for reconstruction of brain SPECT images

    Energy Technology Data Exchange (ETDEWEB)

    Nobili, Flavio E-mail: fnobili@smartino.ge.it; Vitali, Paolo; Calvini, Piero; Bollati, Francesca; Girtler, Nicola; Delmonte, Marta; Mariani, Giuliano; Rodriguez, Guido

    2001-08-01

    Background: Brain SPECT and PET investigations have showed discrepancies in Alzheimer's disease (AD) when considering data deriving from deeply located structures, such as the mesial temporal lobe. These discrepancies could be due to a variety of factors, including substantial differences in gamma-cameras and underlying technology. Mesial temporal structures are deeply located within the brain and the commonly used Filtered Back-Projection (FBP) technique does not fully take into account either the physical parameters of gamma-cameras or geometry of collimators. In order to overcome these limitations, alternative reconstruction methods have been proposed, such as the iterative method of the Conjugate Gradients with modified matrix (CG). However, the clinical applications of these methods have so far been only anecdotal. The present study was planned to compare perfusional SPECT data as derived from the conventional FBP method and from the iterative CG method, which takes into account the geometrical and physical characteristics of the gamma-camera, by a correlative approach with neuropsychology. Methods: Correlations were compared between perfusion of the hippocampal region, as achieved by both the FBP and the CG reconstruction methods, and a short-memory test (Selective Reminding Test, SRT), specifically addressing one of its function. A brain-dedicated camera (CERASPECT) was used for SPECT studies with {sup 99m}Tc-hexamethylpropylene-amine-oxime in 23 consecutive patients (mean age: 74.2{+-}6.5) with mild (Mini-Mental Status Examination score {>=}15, mean 20.3{+-}3), probable AD. Counts from a hippocampal region in each hemisphere were referred to the average thalamic counts. Results: Hippocampal perfusion significantly correlated with the MMSE score with similar statistical significance (p<0.01) between the two reconstruction methods. Correlation between hippocampal perfusion and the SRT score was better with the CG method (r=0.50 for both hemispheres, p<0

  11. Development of Microcomputer Methods for Analysis and Simulation of Clinical Pharmacokinetic Data Relevant to New Drug Development.

    Science.gov (United States)

    1985-08-02

    applications of new microcomputer graphics techonology to the analysis and interpretation of clinical pharmacological data. This involves continuing...COF AD DEVELOPMENT OF MICROCOMPUTER METHODS FOR ANALYSIS AND SIMULATION OF CLINICAL PHARMACOKINETIC DATA RELEVANT TO NEW DRUG DEVELOPMENT ANNUAL/FINAL...Simulation of Clinical Pharmacokinetic Data ERING ORG. TU Relevant to New Drug Development 6. PERFORMiNG ORG. REPORT NUMBER 7. AUTHOR(*) 5. CONTRACT OR

  12. Immunohistochemical analysis of immune response in breast cancer and melanoma patients after laser immunotherapy

    Science.gov (United States)

    Nordquist, Robert E.; Bishop, Shelly L.; Ferguson, Halie; Vaughan, Melville B.; Jose, Jessnie; Kastl, Katherine; Nguyen, Long; Li, Xiaosong; Liu, Hong; Chen, Wei R.

    2011-03-01

    Laser immunotherapy (LIT) has shown great promise in pre-clinical studies and preliminary clinical trials. It could not only eradicate treated local tumors but also cause regression and elimination of untreated metastases at distant sites. Combining a selective photothermal therapy with an active immunological stimulation, LIT can induce systemic anti-tumor immune responses. Imiquimod (IMQ), a toll-like receptor agonist, was used for the treatment of late-stage melanoma patients and glycated chitosan (GC), a biological immunological modulator, was used for the treatment of late-stage breast cancer patients, in combination of irradiation of a near-infrared laser light. To observe the immunological changes before and after LIT treatment, the pathological tissues of melanoma and breast cancer patients were processed for immunohistochemical analysis. Our results show that LIT changed the expressions of several crucial T cell types. Specifically, we observed significant decreases of CD3+ T-cells and a significant increase of CD4+,CD8+, and CD68+ T-cells in the tumor samples after LIT treatment. While not conclusive, our study could shed light on one the possible mechanisms of anti-tumor immune responses induced by LIT. Further studies will be conducted to identify immunological biomarkers associated with LIT-induced clinical response.

  13. Gingival juvenile xanthogranuloma in an adult patient: case report with immunohistochemical analysis and literature review.

    Science.gov (United States)

    Consolaro, Alberto; Sant'Ana, Eduardo; Lawall, Melaine A; Consolaro, Maria Fernanda M O; Bacchi, Carlos Eduardo

    2009-02-01

    Juvenile xanthogranuloma (JXG) is a non-Langerhans cell histiocytosis (nonLCH). It is a benign and self-healing disorder that generally affects infants and children. Oral lesions in adult patients are rare, although the microscopic findings are similar to those observed in other locations. A 56-year-old white man presented with a chief complaint of a gingival mass that had appeared 6 months before and had grown slowly. An intraoral examination revealed the presence of a solitary, softened gingival mass affecting the mandibular lingual gingiva at the right central incisor area. A biopsy of the lesion showed multiple large macrophages and numerous giant cells of Touton type. The immunohistochemistry positivity for CD68, fascin, factor XIIIa, alpha-antitrypsin and negativity for S-100, beta-actin, CD1a, and desmin confirmed the diagnosis of JXG. The occurrence of adult oral JXG is extremely rare. It is a nonLCH that may present variable clinical and microscopic aspects, which leads to a diversity of clinical misdiagnoses. A precise diagnosis of these lesions requires an accurate evaluation of clinical, microscopic, and immunohistochemical features.

  14. Clinical Characteristics and Low Vision Rehabilitation Methods for Partially Sighted School-Age Children

    Science.gov (United States)

    Özen Tunay, Zuhal; Çalışkan, Deniz; İdil, Aysun; Öztuna, Derya

    2016-01-01

    Objectives: To determine the clinical features and the distribution of diagnosis in partially sighted school-age children, to report the chosen low vision rehabilitation methods and to emphasize the importance of low vision rehabilitation. Materials and Methods: The study included 150 partially sighted children between the ages of 6 and 18 years. The distribution of diagnosis, accompanying ocular findings, visual acuity of the children both for near and distance with and without low vision devices, and the methods of low vision rehabilitation (for distance and for near) were determined. The demographic characteristics of the children and the parental consanguinity were recorded. Results: The mean age of children was 10.6 years and the median age was 10 years; 88 (58.7%) of them were male and 62 (41.3%) of them were female. According to distribution of diagnoses among the children, the most frequent diagnosis was hereditary fundus dystrophies (36%) followed by cortical visual impairment (18%). The most frequently used rehabilitation methods were: telescopic lenses (91.3%) for distance vision; magnifiers (38.7%) and telemicroscopic systems (26.0%) for near vision. A significant improvement in visual acuity both for distance and near vision were determined with low vision aids. Conclusion: A significant improvement in visual acuity can be achieved both for distance and near vision with low vision rehabilitation in partially sighted school-age children. It is important for ophthalmologists and pediatricians to guide parents and children to low vision rehabilitation.

  15. A method to relate StarTrack(®) measurements to R50 variations in clinical linacs.

    Science.gov (United States)

    de la Vega, J M; Ruiz-Arrebola, S; Tornero-López, A M; Vilches, M; Guerrero, R; Guirado, D; Lallena, A M

    2014-11-01

    The relation between the data recorded with any device for the daily checking of the behavior of a clinical linac and the reference magnitudes to be monitored may be unknown. An experimental method relating the energy stability of the electron beam measured with StarTrack(®) to the R50 beam quality index is proposed. The bending magnet current is varied producing a change in the exit energy window and, therefore, a modification of the R50 value. For different values of this current, the output data of StarTrack(®) and the R50, obtained from depth doses measured in a water phantom are determined. A linear fit between both sets of data allows the identification of the StarTrack(®) output that provides the best way to obtain the quality index R50, for each beam nominal energy. Using these fits, an historical datum series is used to analyze the method proposed in the daily quality control. The ouput data of the StarTrack(®) and the R50 values show a good linear correlation. It is possible to establish a methodology that allows the monitoring of R50 by direct use of the daily quality control data measured with StarTrack(®). A method to monitor R50 in the daily quality control using the StarTrack(®) device has been developed. The method may be applied to similar devices in which the statistical control variable does not show a linear behavior with R50.

  16. Clinical Characteristics and Low Vision Rehabilitation Methods for Partially Sighted School-Age Children

    Directory of Open Access Journals (Sweden)

    Zuhal Özen Tunay

    2016-04-01

    Full Text Available Objectives: To determine the clinical features and the distribution of diagnosis in partially sighted school-age children, to report the chosen low vision rehabilitation methods and to emphasize the importance of low vision rehabilitation. Materials and Methods: The study included 150 partially sighted children between the ages of 6 and 18 years. The distribution of diagnosis, accompanying ocular findings, visual acuity of the children both for near and distance with and without low vision devices, and the methods of low vision rehabilitation (for distance and for near were determined. The demographic characteristics of the children and the parental consanguinity were recorded. Results: The mean age of children was 10.6 years and the median age was 10 years; 88 (58.7% of them were male and 62 (41.3% of them were female. According to distribution of diagnoses among the children, the most frequent diagnosis was hereditary fundus dystrophies (36% followed by cortical visual impairment (18%. The most frequently used rehabilitation methods were: telescopic lenses (91.3% for distance vision; magnifiers (38.7% and telemicroscopic systems (26.0% for near vision. A significant improvement in visual acuity both for distance and near vision were determined with low vision aids. Conclusion: A significant improvement in visual acuity can be achieved both for distance and near vision with low vision rehabilitation in partially sighted school-age children. It is important for ophthalmologists and pediatricians to guide parents and children to low vision rehabilitation

  17. Image De-Identification Methods for Clinical Research in the XDS Environment.

    Science.gov (United States)

    Aryanto, K Y E; van Kernebeek, G; Berendsen, B; Oudkerk, M; van Ooijen, P M A

    2016-04-01

    To investigate possible de-identification methodologies within the Cross-Enterprise Document Sharing for imaging (XDS-I) environment in order to provide strengthened support for image data exchange as part of clinical research projects. De-identification, using anonymization or pseudonymization, is the most common method to perform information removal within DICOM data. However, it is not a standard part of the XDS-I profiles. Different methodologies were observed to define how and where de-identification should take place within an XDS environment used for scientific research. De-identification service can be placed in three locations within the XDS-I framework: 1) within the Document Source, 2) between the Document Source and Document Consumer, and 3) within the Document Consumer. First method has a potential advantage with respect to the exposure of the images to outside systems but has drawbacks with respect to additional hardware and configuration requirements. Second and third method have big concern in exposing original documents with all identifiable data being intact after leaving the Document Source. De-identification within the Document Source has more advantages compared to the other methods. On the contrary, it is less recommended to perform de-identification within the Document Consumer since it has the highest risk of the exposure of patients identity due to the fact that images are exposed without de-identification during the transfers.

  18. Histochemical and immunohistochemical analyses of the myocardial scar fallowing acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Tatić Vujadin

    2012-01-01

    Full Text Available Background/Aim. The heart has traditionally been considered as a static organ without capacity of regeneration after trauma. Currently, the more and more often asked question is whether the heart has any intrinsic capacities to regenerate myocytes after myocardial infarction. The aim of this study was to present the existence of the preserved muscle fibers in the myocardial scar following myocardial infarction as well as the presence of numerous cells of various size and form that differently reacted to the used immunohistochemical antibodies. Methods. Histological, histochemical and immunohistochemical analyses of myocardial sections taken from 177 patients who had died of acute myocardial infarction and had the myocardial scar following myocardial infarction, were carried out. More sections taken both from the site of acute infarction and scar were examined by the following methods: hematoxylin-eosin (HE, periodic acid schiff (PAS, PAS-diastasis, Masson trichrom, Malory, van Gieson, vimentin, desmin, myosin, myoglobin, alpha actin, smoth muscle actin (SMA, p53, leukocyte common antigen (LCA, proliferating cell nuclear antigen (PCNA, Ki-67, actin HHF35, CD34, CD31, CD45, CD45Ro, CD8, CD20. Results. In all sections taken from the scar region, larger or smaller islets of the preserved muscle fibers with the signs of hypertrophy were found. In the scar, a large number of cells of various size and form: spindle, oval, elongated with abundant cytoplasm, small with one nucleus and cells with scanty cytoplasm, were found. The present cells differently reacted to histochemical and immunohistochemical methods. Large oval cells showed negative reaction to lymphocytic and leukocytic markers, and positive to alpha actin, actin HHF35, Ki-67, myosin, myoglobin and desmin. Elongated cells were also positive to those markers. Small mononuclear cells showed positive reaction to lymphocytic markers. Endothelial and smooth muscle cells in the blood vessel walls

  19. Clinicopathological and immunohistochemical features of primary central nervous system germ cell tumors: a 24-years experience.

    Science.gov (United States)

    Gao, Yuping; Jiang, Jiyao; Liu, Qiang

    2014-01-01

    Primary central nervous system (CNS) germ cell tumors (GCTs) are a rare heterogeneous group of lesions, which the clinicopathological features have a marked degree of heterogeneity comparing with that of gonadal GCTs. Accurately diagnosing CNS GCTs might be extremely difficult and requires immunohistochemical verification. This study was to investigate the biological feature of CNS GCTs and diagnostic value of immunohistochemical markers OCT3/4, C-kit, PLAP, and CD30 in CNS GCTs. A retrospective study was performed on 34 patients with CNS germ cell tumors between 1990 and 2014. 34 CNS GCTs account for 9.2% of all primary CNS neoplasms. The sellar region (35.3%) and pineal gland (17.6%) were the most common sites of intracranial GCTs. Hydrocephalus (82.4%) and diplopia (46.9%) were the two most common clinical presentations. The most common histological subtypes were germinoma (67.6%). PLAP, c-kit, OCT3/4 were highly expressed in gernimomas. CD30 and CK AE1/3 stainings were positive in embryonal carcinoma. Yolk sac tumor component showed positive staining for AFP and CK AE1/3. β-HCG staining was positive in choriocarcinoma and STGC. Patients with mature teratomas and germinomas had a better prognosis (a 5-year survival rate) than those with embryonal carcinoma and choriocarcinoma (a 5-year survival rates were 0). Our finding suggest that the incidences of primary CNS GCTs are higher in South China than in the West, but mixed GCTs are uncommon in our study. The judicious use of a panel of selected markers is helpful in diagnosing and predicting the prognosis for CNS GCTs.

  20. EGFR and gastrointestinal stromal tumor: an immunohistochemical and FISH study of 82 cases.

    Science.gov (United States)

    Lopes, Lisandro F; Bacchi, Carlos E

    2007-09-01

    Gastrointestinal stromal tumor is the most common mesenchymal neoplasm of the gastrointestinal tract. Mutually exclusive KIT or platelet-derived growth factor receptor-alpha mutations are key events in gastrointestinal stromal tumor pathogenesis, and specific treatment targeting KIT/platelet-derived growth factor receptor-alpha activation is available. Epidermal growth factor receptor plays an important role in cancer biology and also constitutes a promising molecular target of therapy. Very few reports have been published in the literature about the relationship between gastrointestinal stromal tumor and epidermal growth factor receptor. The aim of this study was to investigate epidermal growth factor receptor immunohistochemical expression and epidermal growth factor receptor gene amplification in 82 consecutive gastrointestinal stromal tumor cases using tissue microarray technique. Hematoxylin- and eosin-stained sections and clinical information were reviewed, and expression of CD117 (KIT), CD34 and epidermal growth factor receptor was investigated by immunohistochemistry. Epidermal growth factor receptor gene copy number was determined using fluorescence in situ hybridization. Immunohistochemistry revealed that CD117 and CD34 were expressed in 96 and 57% of tumors, respectively. Variable epidermal growth factor receptor protein immunohistochemical overexpression was detected in 96% of gastrointestinal stromal tumor cases, but none of the 75 cases with represented tumor tissue cores and countable fluorescence signals exhibited epidermal growth factor receptor gene amplification by fluorescence in situ hybridization. These results show that there is no correlation between epidermal growth factor receptor protein overexpression by immunohistochemistry and epidermal growth factor receptor gene amplification by fluorescence in situ hybridization. Considering that the mechanisms of epidermal growth factor receptor protein overexpression are not well understood and

  1. Clinical Self-Efficacy in Senior Nursing Students: A Mixed- Methods Study

    OpenAIRE

    Abdal; Masoudi Alavi; Adib-Hajbaghery

    2015-01-01

    Background Clinical education has a basic role in nursing education, and effective clinical training establishes a sense of clinical self-efficacy in senior nursing students. Self-efficacy is a key component for acting independently in the nursing profession. Objectives This study was designed to outline senior nursing students’ views about clinical self-efficacy and to determine its level in nursing students. ...

  2. The influence of digital filter type, amplitude normalisation method, and co-contraction algorithm on clinically relevant surface electromyography data during clinical movement assessments.

    Science.gov (United States)

    Devaprakash, Daniel; Weir, Gillian J; Dunne, James J; Alderson, Jacqueline A; Donnelly, Cyril J

    2016-12-01

    There is a large and growing body of surface electromyography (sEMG) research using laboratory-specific signal processing procedures (i.e., digital filter type and amplitude normalisation protocols) and data analyses methods (i.e., co-contraction algorithms) to acquire practically meaningful information from these data. As a result, the ability to compare sEMG results between studies is, and continues to be challenging. The aim of this study was to determine if digital filter type, amplitude normalisation method, and co-contraction algorithm could influence the practical or clinical interpretation of processed sEMG data. Sixteen elite female athletes were recruited. During data collection, sEMG data was recorded from nine lower limb muscles while completing a series of calibration and clinical movement assessment trials (running and sidestepping). Three analyses were conducted: (1) signal processing with two different digital filter types (Butterworth or critically damped), (2) three amplitude normalisation methods, and (3) three co-contraction ratio algorithms. Results showed the choice of digital filter did not influence the clinical interpretation of sEMG; however, choice of amplitude normalisation method and co-contraction algorithm did influence the clinical interpretation of the running and sidestepping task. Care is recommended when choosing amplitude normalisation method and co-contraction algorithms if researchers/clinicians are interested in comparing sEMG data between studies.

  3. An Automated Recording Method in Clinical Consultation to Rate the Limp in Lower Limb Osteoarthritis

    Science.gov (United States)

    Barrois, R.; Gregory, Th.; Oudre, L.; Moreau, Th.; Truong, Ch.; Aram Pulini, A.; Vienne, A.; Labourdette, Ch.; Vayatis, N.; Buffat, S.; Yelnik, A.; de Waele, C.; Laporte, S.; Vidal, P. P.; Ricard, D.

    2016-01-01

    For diagnosis and follow up, it is important to be able to quantify limp in an objective, and precise way adapted to daily clinical consultation. The purpose of this exploratory study was to determine if an inertial sensor-based method could provide simple features that correlate with the severity of lower limb osteoarthritis evaluated by the WOMAC index without the use of step detection in the signal processing. Forty-eight patients with lower limb osteoarthritis formed two severity groups separated by the median of the WOMAC index (G1, G2). Twelve asymptomatic age-matched control subjects formed the control group (G0). Subjects were asked to walk straight 10 meters forward and 10 meters back at self-selected walking speeds with inertial measurement units (IMU) (3-D accelerometers, 3-D gyroscopes and 3-D magnetometers) attached on the head, the lower back (L3-L4) and both feet. Sixty parameters corresponding to the mean and the root mean square (RMS) of the recorded signals on the various sensors (head, lower back and feet), in the various axes, in the various frames were computed. Parameters were defined as discriminating when they showed statistical differences between the three groups. In total, four parameters were found discriminating: mean and RMS of the norm of the acceleration in the horizontal plane for contralateral and ipsilateral foot in the doctor’s office frame. No discriminating parameter was found on the head or the lower back. No discriminating parameter was found in the sensor linked frames. This study showed that two IMUs placed on both feet and a step detection free signal processing method could be an objective and quantitative complement to the clinical examination of the physician in everyday practice. Our method provides new automatically computed parameters that could be used for the comprehension of lower limb osteoarthritis. It may not only be used in medical consultation to score patients but also to monitor the evolution of their

  4. Design and methods for a randomized clinical trial treating comorbid obesity and major depressive disorder

    Directory of Open Access Journals (Sweden)

    Crawford Sybil

    2008-09-01

    Full Text Available Abstract Background Obesity is often comorbid with depression and individuals with this comorbidity fare worse in behavioral weight loss treatment. Treating depression directly prior to behavioral weight loss treatment might bolster weight loss outcomes in this population, but this has not yet been tested in a randomized clinical trial. Methods and design This randomized clinical trial will examine whether behavior therapy for depression administered prior to standard weight loss treatment produces greater weight loss than standard weight loss treatment alone. Obese women with major depressive disorder (N = 174 will be recruited from primary care clinics and the community and randomly assigned to one of the two treatment conditions. Treatment will last 2 years, and will include a 6-month intensive treatment phase followed by an 18-month maintenance phase. Follow-up assessment will occur at 6-months and 1- and 2 years following randomization. The primary outcome is weight loss. The study was designed to provide 90% power for detecting a weight change difference between conditions of 3.1 kg (standard deviation of 5.5 kg at 1-year assuming a 25% rate of loss to follow-up. Secondary outcomes include depression, physical activity, dietary intake, psychosocial variables and cardiovascular risk factors. Potential mediators (e.g., adherence, depression, physical activity and caloric intake of the intervention effect on weight change will also be examined. Discussion Treating depression before administering intensive health behavior interventions could potentially boost the impact on both mental and physical health outcomes. Trial registration NCT00572520

  5. Reporting on methods of subgroup analysis in clinical trials: a survey of four scientific journals

    Directory of Open Access Journals (Sweden)

    E.D. Moreira Jr.

    2001-11-01

    Full Text Available Results of subgroup analysis (SA reported in randomized clinical trials (RCT cannot be adequately interpreted without information about the methods used in the study design and the data analysis. Our aim was to show how often inaccurate or incomplete reports occur. First, we selected eight methodological aspects of SA on the basis of their importance to a reader in determining the confidence that should be placed in the author's conclusions regarding such analysis. Then, we reviewed the current practice of reporting these methodological aspects of SA in clinical trials in four leading journals, i.e., the New England Journal of Medicine, the Journal of the American Medical Association, the Lancet, and the American Journal of Public Health. Eight consecutive reports from each journal published after July 1, 1998 were included. Of the 32 trials surveyed, 17 (53% had at least one SA. Overall, the proportion of RCT reporting a particular methodological aspect ranged from 23 to 94%. Information on whether the SA preceded/followed the analysis was reported in only 7 (41% of the studies. Of the total possible number of items to be reported, NEJM, JAMA, Lancet and AJPH clearly mentioned 59, 67, 58 and 72%, respectively. We conclude that current reporting of SA in RCT is incomplete and inaccurate. The results of such SA may have harmful effects on treatment recommendations if accepted without judicious scrutiny. We recommend that editors improve the reporting of SA in RCT by giving authors a list of the important items to be reported.

  6. Improving function in age-related macular degeneration: design and methods of a randomized clinical trial.

    Science.gov (United States)

    Rovner, Barry W; Casten, Robin J; Hegel, Mark T; Massof, Robert W; Leiby, Benjamin E; Tasman, William S

    2011-03-01

    Age-Related Macular Degeneration (AMD) is the leading cause of severe vision loss in older adults and impairs the ability to read, drive, and live independently and increases the risk for depression, falls, and earlier mortality. Although new medical treatments have improved AMD's prognosis, vision-related disability remains a major public health problem. Improving Function in AMD (IF-AMD) is a two-group randomized, parallel design, controlled clinical trial that compares the efficacy of Problem-Solving Therapy (PST) with Supportive Therapy (ST) (an attention control treatment) to improve vision function in 240 patients with AMD. PST and ST therapists deliver 6 one-hour respective treatment sessions to subjects in their homes over 2 months. Outcomes are assessed masked to treatment assignment at 3 months (main trial endpoint) and 6 months (maintenance effects). The primary outcome is targeted vision function (TVF), which refers to specific vision-dependent functional goals that subjects highly value but find difficult to achieve. TVF is an innovative outcome measure in that it is targeted and tailored to individual subjects yet is measured in a standardized way. This paper describes the research methods, theoretical and clinical aspects of the study treatments, and the measures used to evaluate functional and psychiatric outcomes in this population.

  7. Comparison of different methods involved in the planning of clinical crown lengthening surgery

    Directory of Open Access Journals (Sweden)

    Fabricio Batistin Zanatta

    2010-12-01

    Full Text Available There is little material in the literature that compares biological width measurements in periapical and bite-wings radiographs with clinical measurements. The purpose of this study was to compare measurements of biological width taken by three different methods which are frequently used for planning periodontal surgery - periapical radiograph, bite-wing radiograph and transperiodontal probing - with the trans-surgical measurements. Thirty-four sites from twenty-one subjects were analyzed. The intra-class correlation coefficients between measurements obtained trans-surgically (gold standard and those obtained by transperiodontal probing, periapical radiography and bite-wing radiography were determined. Average measurements were compared using the Wilcoxon test at a significance level of 0.05. Also, the frequency distribution of differences between test measurements and the gold standard was calculated. The results showed that transperiodontal probing (mean 2.05 mm was the most accurate measurement, as compared to the gold standard (mean 1.97 mm, with no statistically significant difference observed. On the other hand, periapical and bite-wing radiographic mean values (1.56 mm and 1.72 mm, respectively were smaller than the gold standard, with statistically significant differences (p < 0.05. It was concluded that transperiodontal probing was the most accurate measurement, as compared to the gold standard, followed by that obtained with the bite-wing radiograph. The clinical relevance of these results could be that planning for crown lengthening surgery should, preferably, include transperiodontal probing.

  8. Experimental Maedi Visna Virus Infection in sheep: a morphological, immunohistochemical and PCR study after three years of infection

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    S Preziuso

    2009-06-01

    Full Text Available A morphological, immunohistochemical and polymerase chain reaction (PCR study was performed on eight ewes experimentally infected with an Italian strain of Maedi-Visna Virus (MVV in order to evaluate the lesions and the viral distribution after three years of infection. At the moment of euthanasia, seven sheep were seropositive for MVV, while one sheep in poor body conditions was seronegative since one year. Lungs, pulmonary lymph nodes, udder, supramammary lymph nodes, carpal joints, the CNS, spleen and bone marrow of the eight infected sheep were collected for histology, for immunohistochemical detection of the MVV core protein p28 and for PCR amplification of a 218 bp viral DNA sequence of the pol region. The most common histological findings consisted of interstitial lymphoproliferative pneumonia and lymphoproliferative mastitis of different severity, while no lesions were observed in the CNS. MVV p28 antigen was immunohistochemically labelled in lungs, udder, pulmonary lymph nodes, spleen and bone marrow but not in the CNS of all the eight infected sheep. A 218 bp sequence of MVV pol region was detected in lung of a seropositive and of the seroconverted negative sheep. The results suggest that (i MVV causes heterogeneous lesions in homogeneously reared ewes, (ii MVV p28 antigen is detectable not only in inflammed target organs, but also in pulmonary lymph nodes, spleen and bone marrow, and (iii immunohistochemistry and PCR are useful methods for Maedi-Visna diagnosis in suspected cases, also when serological tests are negative.

  9. COTA (colon-ovarian tumor antigen). An immunohistochemical study.

    Science.gov (United States)

    Pant, K D; Fenoglio-Preiser, C M; Berry, C O; Zamora, P O; Ram, M D; Fulks, R M; Rhodes, B A

    1986-07-01

    A goat anti-serum was prepared against mucinous ovarian cyst fluid and absorbed with normal colon and a variety of normal tissues until the only residual immunoreactivity was directed against colon cancer and ovarian tumor mucin. The set of antigenic determinants defined by this anti-serum has been called COTA, standing for colon-ovarian-tumor-antigen. This highly absorbed anti-serum (anti-COTA) was used for immunohistochemical staining of 42 different tissues in parallel with staining with a goat anti-CEA, which was also highly absorbed. The results suggest that COTA is a highly sensitive and specific antigen for colon carcinoma and may have potential for the early detection of malignant changes predictive of cancer of the colon.

  10. A Histopathological and Immunohistochemical Analysis of Ameloblastic Fibrodentinoma

    Directory of Open Access Journals (Sweden)

    Ronell Bologna-Molina

    2013-01-01

    Full Text Available Ameloblastic fibrodentinoma (AFD is considered a mixed odontogenic tumor that is characterized by conserved epithelial and ectomesenchymal neoplastic components. AFD is composed of long narrow cords and islands of odontogenic epithelium; the epithelial strands lie in a myxoid cell-rich ectomesenchymal tissue with stellate-shaped fibroblasts that exhibit long slender cytoplasmic extensions that resemble dental papilla. The lesions show the presence of dysplastic dentin. Although AFD is a rare entity and its very existence is not completely accepted, based on the extent of histodifferentiation, it is considered to represent a stage between ameloblastic fibroma and ameloblastic fibroodontoma. This study aimed to provide a histopathological and immunohistochemical characterization of this infrequent tumor. A large panel of antibodies including amelogenin, Ck 19, calretinin, syndecan-1, E-cadherin, MSH2, histone H3, and Ki-67 was used to illustrate the nature of the tumor.

  11. Immunohistochemical Characteristics of Bone Forming Cells in Pleomorphic Adenoma

    Directory of Open Access Journals (Sweden)

    Keisuke Nakano, Takehiro Watanabe, Takako Shimizu, Toshiyuki Kawakami

    2007-01-01

    Full Text Available Histopathological and immunohistochemical examinations were carried out in a case of pleomorphic adenoma with bone formation, occurring in the chin of a 34-year-old Japanese man. Examination results showed the modified neoplastic myoepithelial cells reacted positively to S-100 protein. The S-100-positive modified neoplastic myoepithelial cells were proliferated in the closely related area of the bone tissue. Furthermore, positive reaction was detected in the bone forming cells: osteoblasts and osteocytes. These cells also reacted positively to Runx2 as a marker of bone forming cells. These results suggest that the origin of the bone forming cells in this case of pleomorphic adenoma was modified neoplastic myoepithelial cells.

  12. Clinical and Pathological Features of Riedel's Thyroiditis

    Institute of Scientific and Technical Information of China (English)

    Lin Lu; Feng Gu; Wei-xin Dai; Wu-yi Li; Jie Chen; Yu Xiao; Zheng-pei Zeng

    2010-01-01

    Objective To evaluate the clinical and pathological features of Riedel's thyroiditis (RT), and current diagnostic and treatment methods for that disease.Methods Five RT cases identified by surgery and pathological examinations at Peking Union Medi-cal College Hospital from 1985 to 2009 were analyzed and compared with the cases reported in the litera-ture in terms of clinical and pathological features. Immunohistochemical staining of kappa and lambda light chains was carried out for RT tissues from all the five patients.Results All the five cases were females, aged 45-55 years. Elevation of serum thyroid autoantibodies was found in only one patient, who had longer disease duration than the others. Pathological examination re-vealed invasive fibrosclerosis of the thyroid follicles, thyroid capsule, and the surrounding tissues. In RT tis-sues, the number of cells containing lambda chains was a little higher than those containing kappa chains.Conclusions RT is a rare disease which might be more common in middle-aged females than in other populations. Pathological features include the destruction of thyroid follicle, extension into surround-ing tissues by inflammatory cells and fibrous tissues. Immunohistochemical staining of kappa and lambda chains could help diagnose RT.

  13. Perception of nursing students toward integrated methods of teaching the ENT clinical examination in south India

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    Sivaraman Ganesan

    2012-01-01

    Full Text Available Context: Assessment of integrated teaching methods are lacking in Indian setup of nursing education. AIM: To assess the perception of nursing students towards integrated methods of teaching ENT Clinical Examination. Materials and Methods: Large group teaching was carried out for teaching ENT examination in a theory class of nursing students. This large group teaching included facilitations such as dividing the one hour session into three short sessions of 20 minutes each, group activity, five minute evaluation, and usage of video. The impact was assessed by scoring the group generated checklist, individual response on a short answer question and obtaining a feedback on video teaching and group activity. Results: At the end of the class after three assessments, the overall mean group score was 85.4%. The students showed positive reaction when they were allowed to solve a specific task in groups as reflected by their feedbacks. Authors found that these factors promoted most of the aspects of the cognitive domain in the students, improved the clarity of the student for a complex topic and improved the attention span of the students. Conclusion: These integrated systems worked out well in our setup and can be used regularly in nursing students teaching.

  14. Development of pyrosequencing methods for the rapid detection of RAS mutations in clinical samples.

    Science.gov (United States)

    Cortes, Ulrich; Guilloteau, Karline; Rouvreau, Mélanie; Archaimbault, Céline; Villalva, Claire; Karayan-Tapon, Lucie

    2015-10-01

    In advanced colorectal carcinoma (CRC) patients, extended RAS mutations testing (KRAS exons 2 to 4 and NRAS exons 2 to 4) is a prerequisite for patient stratification to anti-EGFr therapy. Accurately distinguishing mutant patients from potential responders has a clinically critical impact, and thus effective and low cost methods are needed for identification of the mutation status. We have developed quantitative pyrosequencing assays for sensitive and rapid detection of mutant RAS alleles in formalin-fixed, paraffin-embedded tissues. Exons 2 to 4 of KRAS and NRAS genes were PCR amplified and analyzed by pyrosequencing. For validation, PCR products were sequenced by conventional Sanger sequencing. Analytical sensitivity of these assays was determined by calculating the limit of detection. The results showed that low levels of mutant RAS alleles (2-13%) can be detected with pyrosequencing assays.

  15. Thresholds for statistical and clinical significance in systematic reviews with meta-analytic methods

    DEFF Research Database (Denmark)

    Jakobsen, Janus Christian; Wetterslev, Jørn; Winkel, Per;

    2014-01-01

    BACKGROUND: Thresholds for statistical significance when assessing meta-analysis results are being insufficiently demonstrated by traditional 95% confidence intervals and P-values. Assessment of intervention effects in systematic reviews with meta-analysis deserves greater rigour. METHODS......: Methodologies for assessing statistical and clinical significance of intervention effects in systematic reviews were considered. Balancing simplicity and comprehensiveness, an operational procedure was developed, based mainly on The Cochrane Collaboration methodology and the Grading of Recommendations...... Assessment, Development, and Evaluation (GRADE) guidelines. RESULTS: We propose an eight-step procedure for better validation of meta-analytic results in systematic reviews (1) Obtain the 95% confidence intervals and the P-values from both fixed-effect and random-effects meta-analyses and report the most...

  16. Impact of white matter hyperintensities scoring method on correlations with clinical data: the LADIS study

    DEFF Research Database (Denmark)

    van Straaten, EC; Fazekas, F; Rostrup, Egill;

    2006-01-01

    to WMH load measured qualitatively using 3 widely used visual rating scales (Fazekas, Scheltens, and Age-Related White Matter Changes scales) and quantitatively with a semiautomated volumetric technique and an automatic lesion count. Statistical significance between groups was assessed with the chi2...... between groups with and without symptoms. METHODS: We used data of 618 independently living elderly with WMH collected in the Leukoaraiosis And DISability (LADIS) study. Subjects with and without symptoms of depression, gait disturbances, urinary incontinence, and memory decline were compared with respect...... and Mann-Whitney tests. In addition, the punctate and confluent lesion type with comparable WMH volume were compared with respect to the clinical data using Student t test and chi2 test. Direct comparison of visual ratings with volumetry was done using curve fitting. RESULTS: Visual and volumetric...

  17. Application of PCR-based methods for diagnosis of intestinal parasitic infections in the clinical laboratory.

    Science.gov (United States)

    Verweij, Jaco J

    2014-12-01

    For many years PCR- and other DNA-based methods of pathogen detection have been available in most clinical microbiology laboratories; however, until recently these tools were not routinely exploited for the diagnosis of parasitic infections. Laboratories were initially reluctant to implement PCR as incorporation of such assays within the algorithm of tools available for the most accurate diagnosis of a large variety of parasites was unclear. With regard to diagnosis of intestinal parasitic infections, the diversity of parasites that one can expect in most settings is far less than the parasitological textbooks would have you believe, hence developing a simplified diagnostic triage is feasible. Therefore the classical algorithm based on population, patient groups, use of immuno-suppressive drugs, travel history etc. is also applicable to decide when to perform and which additional techniques are to be used, if a multiplex PCR panel is used as a first-line screening diagnostic.

  18. Interrater reliability of the Koppitz Developmental Scoring method in the clinical evaluation of the single case.

    Science.gov (United States)

    Svensson, P W; Hill, M A

    1990-04-01

    Using the Koppitz method, Bender-Gestalt protocols of three patients (8-12 yr.), representing three commonly occurring disorders, and of one normal child were evaluated by 12 raters of varying experience with this system. Raters were asked to make provisional diagnoses based on Bender protocols alone, and these were compared with actual clinical diagnoses. Despite significant interrater reliability of Koppitz Total Developmental Scores and emotional indices, no significant agreement was found in subscores or in diagnoses made, although the effect of raters' experience was noted. Results suggest that the type of dysfunction present is a factor in raters' reliability. Results are seen, however, to support the potential of the Bender-Gestalt for use in relatively subtle diagnosis of children and highlight the differentiation of "organic" versus "developmental" factors as an area for further study.

  19. [High-resolution distortion-product otoacoustic emissions: method and clinical applications].

    Science.gov (United States)

    Janssen, T; Lodwig, A; Müller, J; Oswald, H

    2014-10-01

    Unlike pure tone thresholds that assess both peripheral and central sound processing, distortion-product otoacoustic emissions (DPOAEs) selectively mirror the functioning of the cochlear amplifier. High resolution DPOAEs are missing in the toolbox of routine audiometry due to the fact that high resolution DPOAE measurements are more time-consuming when compared to normal clinical DP grams with rough frequency resolution. Measurements of high resolution DPOAEs allow an early assessment of beginning sensory cell damage due to sound overexposure or administration of ototoxic drugs. When using a rough grid, sensory cell damage would be overlooked as in the early state damage only appears at some distinct cochlear sites. A review is given on the method and application of high resolution DPOAEs.

  20. A survey of immunohistochemical biomarkers for basal-like breast cancer against a gene expression profile gold standard.

    Science.gov (United States)

    Won, Jennifer R; Gao, Dongxia; Chow, Christine; Cheng, Jinjin; Lau, Sherman Y H; Ellis, Matthew J; Perou, Charles M; Bernard, Philip S; Nielsen, Torsten O

    2013-11-01

    Gene expression profiling of breast cancer delineates a particularly aggressive subtype referred to as 'basal-like', which comprises ∼15% of all breast cancers, afflicts younger women and is refractory to endocrine and anti-HER2 therapies. Immunohistochemical surrogate definitions for basal-like breast cancer, such as the clinical ER/PR/HER2 triple-negative phenotype and models incorporating positive expression for CK5 (CK5/6) and/or EGFR are heavily cited. However, many additional biomarkers for basal-like breast cancer have been described in the literature. A parallel comparison of 46 proposed immunohistochemical biomarkers of basal-like breast cancer was performed against a gene expression profile gold standard on a tissue microarray containing 42 basal-like and 80 non-basal-like breast cancer cases. Ki67 and PPH3 were the most sensitive biomarkers (both 92%) positively expressed in the basal-like subtype, whereas CK14, IMP3 and NGFR were the most specific (100%). Among biomarkers surveyed, loss of INPP4B (a negative regulator of phosphatidylinositol signaling) was 61% sensitive and 99% specific with the highest odds ratio (OR) at 108, indicating the strongest association with basal-like breast cancer. Expression of nestin, a common marker of neural progenitor cells that is also associated with the triple-negative/basal-like phenotype and poor breast cancer prognosis, possessed the second highest OR at 29 among the 46 biomarkers surveyed, as well as 54% sensitivity and 96% specificity. As a positively expressed biomarker, nestin possesses technical advantages over INPP4B that make it a more ideal biomarker for identification of basal-like breast cancer. The comprehensive immunohistochemical biomarker survey presented in this study is a necessary step for determining an optimized surrogate immunopanel that best defines basal-like breast cancer in a practical and clinically accessible way.

  1. Net benefits: assessing the effectiveness of clinical networks in Australia through qualitative methods

    Directory of Open Access Journals (Sweden)

    Cunningham Frances C

    2012-11-01

    Full Text Available Abstract Background In the 21st century, government and industry are supplementing hierarchical, bureaucratic forms of organization with network forms, compatible with principles of devolved governance and decentralization of services. Clinical networks are employed as a key health policy approach to engage clinicians in improving patient care in Australia. With significant investment in such networks in Australia and internationally, it is important to assess their effectiveness and sustainability as implementation mechanisms. Methods In two purposively selected, musculoskeletal clinical networks, members and stakeholders were interviewed to ascertain their perceptions regarding key factors relating to network effectiveness and sustainability. We adopted a three-level approach to evaluating network effectiveness: at the community, network, and member levels, across the network lifecycle. Results Both networks studied are advisory networks displaying characteristics of the ‘enclave’ type of non-hierarchical network. They are hybrids of the mandated and natural network forms. In the short term, at member level, both networks were striving to create connectivity and collaboration of members. Over the short to medium term, at network level, both networks applied multi-disciplinary engagement in successfully developing models of care as key outputs, and disseminating information to stakeholders. In the long term, at both community and network levels, stakeholders would measure effectiveness by the broader statewide influence of the network in changing and improving practice. At community level, in the long term, stakeholders acknowledged both networks had raised the profile, and provided a ‘voice’ for musculoskeletal conditions, evidencing some progress with implementation of the network mission while pursuing additional implementation strategies. Conclusions This research sheds light on stakeholders’ perceptions of assessing clinical

  2. Comparison of different methods of platelet count and its clinical application

    Institute of Scientific and Technical Information of China (English)

    Bin Li; Chuan Wang

    2016-01-01

    Objective:To compare the results of different platelet mean volume (MPV) with the method of instrument and manual counting of platelet and its application in clinical practice.Method:According to prompts Sysmex xn (10) B4 detection results MPV. The 246 samples divided for four groups, with Sysmex xn (10) B4, Mindray BC6800 blood cell analyzer, artificial bovine Bao counting plate platelet count number. The detection results are paired t-test.Results:When 5.4 fL≤MPV≤7.4 fL, 2 instruments and artificial platelet count results showed no significant difference; When 7.5 fL≤MCV≤9.0 fL, 2 instruments and artificial platelet count results showed no significant difference, Sysmex XN (10) B4 slightly lower test results, Mindray BC6800 test results closer to the true value; When 9.1 fL≤MCV≤12.0 fL, Sysmex XN (10) B4 and artificial platelet count results were significantly, and manual counting Mindray BC6800 platelet count was no significant difference; When MPV≧ 12.1 fL, 2 instrument testing platelet counting and artificial platelets results difference had statistical significance, platelet test results between two instruments are low.Conclusion:MPV is the main factors of effect of platelet count by apparatus, when the MPV increase should be the manual assay of platelet count in order to ensure accuracy, more realistically reflect the actual situation in the patient, and provide more valuable diagnostic basis for clinical.

  3. Radiation dose to children in diagnostic radiology. Measurements and methods for clinical optimisation studies

    Energy Technology Data Exchange (ETDEWEB)

    Almen, A.J.

    1995-09-01

    A method for estimating mean absorbed dose to different organs and tissues was developed for paediatric patients undergoing X-ray investigations. The absorbed dose distribution in water was measured for the specific X-ray beam used. Clinical images were studied to determine X-ray beam positions and field sizes. Size and position of organs in the patient were estimated using ORNL phantoms and complementary clinical information. Conversion factors between the mean absorbed dose to various organs and entrance surface dose for five different body sizes were calculated. Direct measurements on patients estimating entrance surface dose and energy imparted for common X-ray investigations were performed. The examination technique for a number of paediatric X-ray investigations used in 19 Swedish hospitals was studied. For a simulated pelvis investigation of a 1-year old child the entrance surface dose was measured and image quality was estimated using a contrast-detail phantom. Mean absorbed doses to organs and tissues in urography, lung, pelvis, thoracic spine, lumbar spine and scoliosis investigations was calculated. Calculations of effective dose were supplemented with risk calculations for special organs e g the female breast. The work shows that the examination technique in paediatric radiology is not yet optimised, and that the non-optimised procedures contribute to a considerable variation in radiation dose. In order to optimise paediatric radiology there is a need for more standardised methods in patient dosimetry. It is especially important to relate measured quantities to the size of the patient, using e g the patient weight and length. 91 refs, 17 figs, 8 tabs.

  4. The first clinical treatment with kilovoltage intrafraction monitoring (KIM): A real-time image guidance method

    Energy Technology Data Exchange (ETDEWEB)

    Keall, Paul J., E-mail: paul.keall@sydney.edu.au; O’Brien, Ricky; Huang, Chen-Yu [Radiation Physics Laboratory, Sydney Medical School, University of Sydney, Camperdown, New South Wales 2006 (Australia); Aun Ng, Jin [Radiation Physics Laboratory, Sydney Medical School, University of Sydney, Camperdown, New South Wales 2006, Australia and School of Physics, University of Sydney, Camperdown, New South Wales 2006 (Australia); Colvill, Emma [Radiation Physics Laboratory, Sydney Medical School, University of Sydney, Camperdown, New South Wales 2006, Australia and Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales 2065 (Australia); Rugaard Poulsen, Per; Fledelius, Walther [Department of Oncology, Aarhus University Hospital, 8000 Aarhus C, Denmark and Institute of Clinical Medicine, Aarhus University, 8000 Aarhus C (Denmark); Juneja, Prabhjot; Booth, Jeremy T. [School of Physics, University of Sydney, Camperdown, New South Wales 2006, Australia and Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales 2065 (Australia); Simpson, Emma; Bell, Linda; Alfieri, Florencia; Eade, Thomas; Kneebone, Andrew [Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales 2065 (Australia)

    2015-01-15

    Purpose: Kilovoltage intrafraction monitoring (KIM) is a real-time image guidance method that uses widely available radiotherapy technology, i.e., a gantry-mounted x-ray imager. The authors report on the geometric and dosimetric results of the first patient treatment using KIM which occurred on September 16, 2014. Methods: KIM uses current and prior 2D x-ray images to estimate the 3D target position during cancer radiotherapy treatment delivery. KIM software was written to process kilovoltage (kV) images streamed from a standard C-arm linear accelerator with a gantry-mounted kV x-ray imaging system. A 120° pretreatment kV imaging arc was acquired to build the patient-specific 2D to 3D motion correlation. The kV imager was activated during the megavoltage (MV) treatment, a dual arc VMAT prostate treatment, to estimate the 3D prostate position in real-time. All necessary ethics, legal, and regulatory requirements were met for this clinical study. The quality assurance processes were completed and peer reviewed. Results: During treatment, a prostate position offset of nearly 3 mm in the posterior direction was observed with KIM. This position offset did not trigger a gating event. After the treatment, the prostate motion was independently measured using kV/MV triangulation, resulting in a mean difference of less than 0.6 mm and standard deviation of less than 0.6 mm in each direction. The accuracy of the marker segmentation was visually assessed during and after treatment and found to be performing well. During treatment, there were no interruptions due to performance of the KIM software. Conclusions: For the first time, KIM has been used for real-time image guidance during cancer radiotherapy. The measured accuracy and precision were both submillimeter for the first treatment fraction. This clinical translational research milestone paves the way for the broad implementation of real-time image guidance to facilitate the detection and correction of geometric and

  5. Immunohistochemical detection of growth hormone (GH) in canine hepatoid gland tumors.

    Science.gov (United States)

    Petterino, Claudio; Martini, Marco; Castagnaro, Massimo

    2004-05-01

    The aim of this study was to detect immunohistochemically means growth hormone (GH) in 24 hepatoid gland adenomas and 5 hepatoid gland carcinomas and to compare the difference of immunoreactivity between types of tumors. The tumors were classified according to the WHO standards. Tissue sections which were prepared from formalin-fixed, paraffin wax-embedded tissues from 25 male and 4 female dogs were carried out immunostaining using polyclonal primary anti-hGH and EnVision method. Of 24 hepatoid gland adenomas (perianal gland adenomas) 23 (95.8%) were positive. All 5 hepatoid gland carcinomas (perianal gland carcinomas) were positive. No statistically significant differences in percentage of labelled cells between malignant and benign tumors were seen. The present demonstration of GH in hepatoid gland tumors adds new data on GH in extra-pituitary tissues and hormon-dependent tumors.

  6. Immunohistochemical detection of a very high density lipoprotein (VHDL) in ovarian follicles of Triatoma infestans.

    Science.gov (United States)

    González, M S; Ronderos, J R; Rimoldi, O J; Brenner, R R

    2001-04-01

    The ability of Triatoma infestans ovarian follicles to synthesize a very high-density lipoprotein (VHDL) has been examined by immunohistochemical methods. This kind of lipoprotein can be envisaged as a storage hexameric protein present in the hemolymph of some insect species. VHDL immunoreactivity is observed in oocytes at different stages of maturation. The antigen is present in the oocyte cytoplasm as well as in the follicular epithelial cells. The immunopositive reaction in the apical surface of follicle cells suggests both a VHDL synthesis and a secretion process. Furthermore, VHDL seems to be stored into oocyte in yolk granules. On the contrary, no immunopositive reaction is observed in the intracellular spaces between follicle cells, suggesting that VHDL is not incorporated from hemolymph into the oocyte.

  7. Immunohistochemical distribution of leptin in kidney tissues of melatonin treated diabetic rats.

    Science.gov (United States)

    Elis Yildiz, S; Deprem, T; Karadag Sari, E; Bingol, S A; Koral Tasci, S; Aslan, S; Nur, G; Sozmen, M

    2015-05-01

    We examined using immunohistochemistry the distribution of leptin in kidney tissues of melatonin treated, streptozotocin (STZ) diabetic rats. The animals were divided into five groups: control, sham, melatonin-treated, diabetic and melatonin-treated diabetic. Kidney sections were prepared and stained with hematoxylin and eosin, and Crossman's triple staining for histological examination. The immunohistochemical localization of leptin in the kidney tissue was determined using the streptavidin-biotin-peroxidase method. We determined that on days 7 and 14, the leptin immunoreactivity of the diabetic and melatonin-treated diabetic groups was weaker than for the other groups. Weak immunoreactivity was found in the proximal and distal tubules of the kidney in the diabetic and melatonin-treated diabetic groups on days 7 and 14, and strong immunoreactivity was found in the control, sham and melatonin groups. Melatonin application had no significant effect on leptin production in the kidney tissues of diabetic rats.

  8. Immunohistochemical changes in the expression of HSP27 in exercised human vastus lateralis muscle

    DEFF Research Database (Denmark)

    Folkesson, M; Mackey, Abigail; Holm, L;

    2008-01-01

    . METHODS: Two different exercise protocols were used: (1) one-leg ergometer cycling (EC, n = 6) consisting of two 30-min bouts at 40% and 75% of peak oxygen uptake, respectively, and (2) leg extension resistance exercise (RE, n = 9) including 10 sets of eight repetitions at a load corresponding to 70......AIM: The role of HSP27 in the adaptive process of skeletal muscle to exercise, especially in humans, is not well understood. The objective of this study was to investigate immunohistochemical changes in HSP27 expression in human vastus lateralis muscle following resistance and endurance exercises......% of one maximal repetition (1RM). Immunohistochemistry using specific monoclonal antibodies was used to determine the location of HSP27 protein in muscle biopsies from human vastus lateralis. RESULTS: Our results show that RE, but not EC, induced a significant appearance of scattered accumulations of HSP...

  9. Immunohistochemical evaluation of proliferation, apoptosis and steroidogenic enzymes in the ovary of rats with polycystic ovary

    Directory of Open Access Journals (Sweden)

    Leonardo Augusto Lombardi

    2014-07-01

    Full Text Available Objective: to evaluate the immunohistochemical expression of proliferative, apoptotic and steroidogenic enzyme markers in the ovaries of rats with polycystic ovary syndrome (PCOS. Methods: twenty rats were divided into two groups: GCtrl - estrous phase, and PCOS - with polycystic ovaries. The GCtrl animals were subjected to a lighting period from 7 am to 7 pm, while the animals with PCOS group remained with continuous lighting for 60 days. Subsequently, the animals were anesthetized, the ovaries were removed and fixed in 10% formaldehyde, prior to paraffin embedding. Sections were stained using H.E. or subjected to immunohistochemical methods for the detection of Ki-67, cleaved caspase-3, CYP11A1, CYP17A1 and CYP19A1. The results were analyzed using Student's t-test (p < 0,05. Results: morphological results showed evidence of interstitial cells originating from the inner theca cells of degenerating ovarian cysts in PCOS. Immunoexpression of Ki-67 was higher in the granulosa cells in GCtrl, and the theca interna cells in PCOS, while cleaved caspase-3 was higher in granulosa cells of ovarian cysts from PCOS and in the theca interna cells of GCtrl. Immunoreactivity of CYP11A1 in the theca interna, granulosa and interstitial cells was similar between the two groups, while CYP17A1 and CYP19A1 were higher in the granulosa and interstitial cells in the PCOS group. Conclusion: the results indicate that the interstitial cells are derived from the theca interna and that enzymatic changes occur in the theca interna and interstitial cells in ovaries of rats with PCOS, responsible for the high levels of androgens and estradiol.

  10. Histopathological and immunohistochemical diagnosis of infectious bursal disease in poultry birds

    Directory of Open Access Journals (Sweden)

    J. Singh

    2015-11-01

    Full Text Available Aim: The aim of the present study was to diagnose infectious bursal disease (IBD using gross, histopathological, and immunopathological approaches and to compare efficacy of immunohistochemical techniques with conventional diagnostic techniques. Materials and Methods: A total of 33 samples were collected from the six different poultry farms from Ludhiana and the nearby districts. Upon gross analysis of the necropsied birds, the relevant tissue samples such as bursa, kidney, junction of proventriculus and gizzard, heart, and muscles were then processed for histopathological and immunohistochemical studies. Results: Varied macroscopic changes were noted in bursa, characterized as swollen, hemorrhages to atrophy in size. Nonetheless, hemorrhages over thigh muscles were rarely seen. Histologically, the bursa showed prominent fibrotic and atrophic changes. Rarefaction of bursal follicles with intermittent infiltration of lympho-mononuclear cells with chronic cystic changes was additional changes, considered to be paramount for IBD. Expression and localization of IBD specific viral antigens were noticed mainly intracellular to the rarefied areas of bursal follicle section(s, in conjunction to inner lining of the cystic cavities of affected follicles. In addition, the junction of proventriculus and gizzard, the heart muscle, respiratory ciliated epithelium, and proventriculus also revealed positive expression to IBD virus (IBDV antigen. Advanced immunopathological techniques, i.e., immunofluorescence further testified the evidence of antigen as positive green signal within affected follicles. Further consideration to the reliability of various techniques employed, positive correlation (r=0.64623 was emerged out with conventional pathological scoring. Conclusion: It is concluded that the bursa acts as an organ of choice for demonstrating IBDV antigen for specific diagnosis of disease using immunohistochemistry (IHC, and IHC staining is a precise

  11. [Epi-Bowman Keratectomy: Clinical Evaluation of a New Method of Surface Ablation].

    Science.gov (United States)

    Taneri, S; Kießler, S; Rost, A; Schultz, T; Elling, M; Dick, B

    2017-02-10

    Purpose A new device for epithelial abrasion before excimer laser surface ablation or corneal cross-linking (CXL) has recently been introduced (Epi-Clear™, Orca Surgical, Kiryat-Shmona, Israel). We have reviewed the literature on the clinical results, potential benefits and drawbacks of this instrument, compared to other methods of epithelial removal. Method Literature search for "Epi-Bowman Keratectomy", "Epi-clear", and "Epikeratome" yielded 1 peer-review publication, 1 non-peer-review publication, 18 posters and presentations at international conferences (European Society of Cataract and Refractive Surgeons [ESCRS] and American Society of Cataract and Refractive Surgery [ASCRS]) on the use of the Epi-Clear™ device before surface ablation, 2 posters on the use of Epi-Clear before corneal crosslinking and 1 presentation on the experimental use of Epi-Clear for removal of a pterygium. Results Comparison of laser ablation after epithelial removal with the Epi-Clear device (Epi-Bowman Keratectomy™, EBK™) to other established methods of surface ablation, i.e. alcohol-assisted PRK or PRK with a metallic scraper, EBK, suggests that the results are generally similar. Pain perception, haze formation, and epithelial healing are reported to be better than with conventional surface ablation methods. Studies evaluating the use of the Epi-Clear device before CXL report that the healing time is significantly reduced and that less pain is perceived. Conclusion The Epi-Clear device seems to be a promising new option for epithelial removal before refractive laser ablation, although a convincing explanation for its potential superiority is still missing. In contrast, when the Epi-Clear device is used before CXL, then the Bowman's layer remains intact; this may provide an adequate explanation for the reported benefits of this application. However, currently available studies are of low level of evidence, so that more prospective randomised trials are needed for a robust

  12. Clinical study on thermography, as modern investigation method for Candida-associated denture stomatitis.

    Science.gov (United States)

    Iosif, Laura; Preoteasa, Cristina Teodora; Murariu-Măgureanu, Cătălina; Preoteasa, Elena

    2016-01-01

    Candida-associated denture stomatitis is an infectious inflammatory condition of the oral mucosa, with frequent recurrences. The aim of this study was to assess the use of infrared thermography as investigation method for Candida-associated denture stomatitis (as inflammatory disorder of the maxillary denture bearing area), by comparing disease and non-disease groups. An observational study was conducted on maxillary edentulous patients treated by acrylic dentures, with and without Candida-associated denture stomatitis. Diagnostic test methods used were clinical examination for denture stomatitis and conventional microbiological culture method for oral candidiasis. Thermography analysis of the maxillary denture bearing area was made using the ThermaCAM PM350 infrared camera (Inframetrics, Flir Systems) and ThermaGram Pro 95 software, data being acquired by usage of standard protocol of thermographic registrations. The sample included 52 patients, 21 with and 31 without Candida-associated denture stomatitis. The temperature of the maxillary mucosa corresponding to the denture bearing area was found to be statistically significantly higher in Candida-associated denture stomatitis (mean 36.20°C), compared to healthy oral mucosa (mean 34.85°C). The thermal threshold value of 35.44°C was identified as best differentiating a pathological from normal state of the maxillary mucosa corresponding to the denture bearing area. In conclusion, infrared thermography, a rapid non-invasive investigation method, has the premises to bring valuable data in inflammatory disorders of the maxillary denture bearing area, as Candida-associated denture stomatitis that may be used for screening, diagnostic or monitoring purposes.

  13. Alternate calibration method of radiochromic EBT3 film for quality assurance verification of clinical radiotherapy treatments

    Science.gov (United States)

    Park, Soah; Kang, Sei-Kwon; Cheong, Kwang-Ho; Hwang, Taejin; Yoon, Jai-Woong; Koo, Taeryool; Han, Tae Jin; Kim, Haeyoung; Lee, Me Yeon; Bae, Hoonsik; Kim, Kyoung Ju

    2016-07-01

    EBT3 film is utilized as a dosimetry quality assurance tool for the verification of clinical radiotherapy treatments. In this work, we suggest a percentage-depth-dose (PDD) calibration method that can calibrate several EBT3 film pieces together at different dose levels because photon beams provide different dose levels at different depths along the axis of the beam. We investigated the feasibility of the film PDD calibration method based on PDD data and compared the results those from the traditional film calibration method. Photon beams at 6 MV were delivered to EBT3 film pieces for both calibration methods. For the PDD-based calibration, the film pieces were placed on solid phantoms at the depth of maximum dose (dmax) and at depths of 3, 5, 8, 12, 17, and 22 cm, and a photon beam was delivered twice, at 100 cGy and 400 cGy, to extend the calibration dose range under the same conditions. Fourteen film pieces, to maintain their consistency, were irradiated at doses ranging from approximately 30 to 400 cGy for both film calibrations. The film pieces were located at the center position on the scan bed of an Epson 1680 flatbed scanner in the parallel direction. Intensity-modulated radiation therapy (IMRT) plans were created, and their dose distributions were delivered to the film. The dose distributions for the traditional method and those for the PDD-based calibration method were evaluated using a Gamma analysis. The PDD dose values using a CC13 ion chamber and those obtained by using a FC65-G Farmer chamber and measured at the depth of interest produced very similar results. With the objective test criterion of a 1% dosage agreement at 1 mm, the passing rates for the four cases of the three IMRT plans were essentially identical. The traditional and the PDD-based calibrations provided similar plan verification results. We also describe another alternative for calibrating EBT3 films, i.e., a PDD-based calibration method that provides an easy and time-saving approach

  14. Resting energy expenditure in critically ill patients: Evaluation methods and clinical applications

    Directory of Open Access Journals (Sweden)

    Ana Cláudia Soncini Sanches

    Full Text Available Summary Patients on intensive care present systemic, metabolic, and hormonal alterations that may adversely affect their nutritional condition and lead to fast and important depletion of lean mass and malnutrition. Several factors and medical conditions can influence the energy expenditure (EE of critically ill patients, such as age, gender, surgery, serious infections, medications, ventilation modality, and organ dysfunction. Clinical conditions that can present with EE change include acute kidney injury, a complex disorder commonly seen in critically ill patients with manifestations that can range from minimum elevations in serum creatinine to renal failure requiring dialysis. The nutritional needs of this population are therefore complex, and determining the resting energy expenditure is essential to adjust the nutritional supply and to plan a proper diet, ensuring that energy requirements are met and avoiding complications associated with overfeeding and underfeeding. Several evaluation methods of EE in this population have been described, but all of them have limitations. Such methods include direct calorimetry, doubly labeled water, indirect calorimetry (IC, various predictive equations, and, more recently, the rule of thumb (kcal/kg of body weight. Currently, IC is considered the gold standard.

  15. Resting energy expenditure in critically ill patients: Evaluation methods and clinical applications.

    Science.gov (United States)

    Sanches, Ana Cláudia Soncini; Góes, Cassiana Regina de; Bufarah, Marina Nogueira Berbel; Balbi, André Luiz; Ponce, Daniela

    2016-10-01

    Patients on intensive care present systemic, metabolic, and hormonal alterations that may adversely affect their nutritional condition and lead to fast and important depletion of lean mass and malnutrition. Several factors and medical conditions can influence the energy expenditure (EE) of critically ill patients, such as age, gender, surgery, serious infections, medications, ventilation modality, and organ dysfunction. Clinical conditions that can present with EE change include acute kidney injury, a complex disorder commonly seen in critically ill patients with manifestations that can range from minimum elevations in serum creatinine to renal failure requiring dialysis. The nutritional needs of this population are therefore complex, and determining the resting energy expenditure is essential to adjust the nutritional supply and to plan a proper diet, ensuring that energy requirements are met and avoiding complications associated with overfeeding and underfeeding. Several evaluation methods of EE in this population have been described, but all of them have limitations. Such methods include direct calorimetry, doubly labeled water, indirect calorimetry (IC), various predictive equations, and, more recently, the rule of thumb (kcal/kg of body weight). Currently, IC is considered the gold standard.

  16. Overlapping Morphologic and Immunohistochemical Features of Hashimoto Thyroiditis and IgG4-Related Thyroid Disease.

    Science.gov (United States)

    Raess, Philipp W; Habashi, Arlette; El Rassi, Edward; Milas, Mira; Sauer, David A; Troxell, Megan L

    2015-05-01

    Immunoglobulin G4-related disease (IgG4-RD) is an emerging clinicopathologic entity characterized by both IgG4+ plasma cell infiltration and fibrosis in one or more organs, prototypically pancreas or salivary/lacrimal glands. IgG4-RD in the thyroid (IgG4-RTD) is an area of active study, and the relationship between IgG4-RTD and Hashimoto thyroiditis is not fully delineated due to their overlapping histologic features. Retrospective review was performed of all thyroidectomy cases demonstrating lymphocytic inflammation at a single institution over a 4-year period. Approximately half (23/38) of patients had a clinical diagnosis of Hashimoto thyroiditis (HT). Nine of the 38 patients had increased absolute and relative numbers of IgG4+ plasma cells. Patients with a clinical diagnosis of HT had increased lymphoplasmacytic inflammation, but the relative proportion of IgG4+ plasma cells was not increased compared to patients without HT. There was no correlation between IgG4 levels and the amount of fibrosis in patients with or without HT. Patients identified as having the fibrosing variant of HT were not more likely to have increased levels of IgG4+ plasma cells than those without. There is significant morphologic and immunohistochemical overlap between HT and IgG4-RTD. Future studies to identify specific characteristics of IgG4-RTD involving the thyroid are necessary to accurately define this entity.

  17. Prognostic Significance of Immunohistochemical Phenotypes in Patients Treated for High-Grade Cervical Intraepithelial Neoplasia

    Directory of Open Access Journals (Sweden)

    Massimo Origoni

    2013-01-01

    Full Text Available Strong evidence exists that the host’s immune system plays a crucial role for the development of human papillomavirus-related cervical premalignant and malignant lesions. In particular, effective cell-mediated immunity (CMI promotes spontaneous infection clearance and cancer precursors regression in healthy subjects, while immunosuppressed individuals are more likely to experience infection persistence, cervical intraepithelial neoplasia (CIN lesions, and cervical cancer. In this study, the prognostic significance of immunohistochemical profiling of CD4+ T-cells, CD8+ T-cells, dendritic cells (CD11c+, T-bet+, and GATA-3+ transcription factors has been studied in surgical specimens of 34 consecutive women affected by high-grade cervical intraepithelial neoplasia (CIN2-3 submitted to cervical conization. Results have been correlated with the clinical outcomes at 24 months after treatment and statistically analyzed. Higher rates of CD4+ T-cells, CD11c+ dendritic cells, and T-bet+ transcription factor positivity showed a strong statistically significative correlation with favourable clinical outcomes (P≤0.0001. These data reinforce the evidence of the relevance of the host’s immune status in the natural history of HPV-related cervical disease and add a prognostic significance of the cervical immunological profile in terms of predicting significant lower recurrence rates.

  18. Automated Methods to Extract Patient New Information from Clinical Notes in Electronic Health Record Systems

    Science.gov (United States)

    Zhang, Rui

    2013-01-01

    The widespread adoption of Electronic Health Record (EHR) has resulted in rapid text proliferation within clinical care. Clinicians' use of copying and pasting functions in EHR systems further compounds this by creating a large amount of redundant clinical information in clinical documents. A mixture of redundant information (especially outdated…

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

    Directory of Open Access Journals (Sweden)

    José Arteaga Herrera

    2010-12-01

    Full Text Available This paper is the chapter dedicated to the scientific method and the clinical method in the authors’ Handbook “Teaching of Clinics”. Philosophycal principles of the scientific method and its stages are presented as well as the clinical method as a scientific one and its stages. A relationship between the clinical method and the medical record is established, the role of technology in the clinical method is stated and the most frequent mistakes when applying it in clinical practice are provided. Finally, the teaching of the clinical method and the appropriate settings to do it are discussed.Este trabajo forma parte del Manual de la “Enseñanza de la Clínica” de los autores, y de hecho es el capitulo dedicado al método científico y al método clínico en esa publicación. Se presentan los fundamentos filosóficos del método científico y sus etapas, así como el método clínico como método científico y también sus etapas. Se vincula el método clínico con el expediente clínico, se plantea el papel de la tecnología con el método clínico y se ilustran los errores más frecuentes que se cometen en la aplicación del método en la práctica clínica. Por último, se trata la enseñanza del método clínico y la necesidad de un escenario formativo adecuado.

  20. [Application of the immunohistochemical detection of PGP 9.5 protein for the study of rat and human heart innervation].

    Science.gov (United States)

    Korzhevskiy, D E; Sukhorukova, Ye G; Petrova, Ye S; Tzukanova, A F; Chumasov, Ye I

    2013-01-01

    In this paper we describe the modern immunohistochemical method detecting the neuronal marker PGP 9.5. The application of this method for the study of the innervation of rat and human heart, the detailed examination of the topography of the cardiac nervous apparatus, as well as their changes in pathological states, is demonstrated. Structural organization and the nature of the terminal branches of nerve apparatus suggest that they have afferent function. Protocol of the reaction demonstrating PGP 9.5 on paraffin sections is presented.

  1. Improving patient experience in a pediatric ambulatory clinic: a mixed method appraisal of service delivery

    Directory of Open Access Journals (Sweden)

    Soeteman M

    2015-03-01

    Full Text Available Marijn Soeteman,1 Vera Peters,2 Jamiu O Busari1,3 1Department of Pediatrics, Atrium Medical Center, Heerlen, 2Faculty of Health, Medicine and Life Sciences, 3Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, University of Maastricht, Maastricht, the Netherlands Objective: In 2013, customer satisfaction surveys showed that patients were unhappy with the services provided at our ambulatory clinic. In response, we performed an appraisal of our services, which resulted in the development of a strategy to reduce waiting time and improve quality of service. Infrastructural changes to our clinic’s waiting room, consultation rooms, and back offices were performed, and schedules were redesigned to reduce wait time to 10 minutes and increase consultation time to 20 minutes. Our objective was to identify if this would improve 1 accessibility to caregivers and 2 quality of service and available amenities. Design: We conducted a multi-method survey using 1 a patient flow analysis to analyze the flow of service and understand the impact of our interventions on patient flow and 2 specially designed questionnaires to investigate patients’ perceptions of our wait time and how to improve our services. Results: The results showed that 79% of our respondents were called in to see a doctor within 20 minutes upon arrival. More patients (55% felt that 10–20 minutes was an acceptable wait time. We also observed a perceived increase in satisfaction with wait time (94%. Finally, a large number of patients (97% were satisfied with the quality of service and with the accessibility to caregivers (94%. Conclusion: The majority of our patients were satisfied with the accessibility to our ambulatory clinics and with the quality of services provided. The appraisal of our operational processes using a patient flow analysis also demonstrated how this strategy could effectively be applied to investigate and improve quality of

  2. Clinical Holistic Medicine: Teaching Orgasm for Females with Chronic Anorgasmia using the Betty Dodson Method

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    Pia Struck

    2008-01-01

    Full Text Available The objective of this study was to test the Betty Dodson method of breaking the female orgasm barrier in chronic anorgasmic women. The aim was sexual and existential healing (salutogenesis through direct confrontation and integration of both the repressed shame, guilt, and other negative feelings associated with body, genitals, and sexuality, and the repressed sexual pleasure and desire. We conducted a retrospective analysis of clinic data from holistic sexological manual therapeutic intervention, an intensive subtype of clinical holistic medicine (CHM. The patients received 3 × 5 h of group therapy, integrating short-term psychodynamic psychotherapy (STPP and complementary medicine (CAM bodywork, manual sexology similar to the “sexological examination”. The therapy used the advanced tools of reparenting, genital acceptance, acceptance through touch, and direct sexual clitoral stimulation. A clitoral vibrator was used. Participants were 500 female patients between 18 and 88 years of age (mean of 35 years with chronic anorgasmia (for 12 years on average who were participating in the “orgasm course for anorgasmic women”; 25% of the patients had never experienced an orgasm. Our results show that 465 patients (93% had an orgasm during therapy, witnessed by the therapist, and 35 patients (7% did not. Postmenopausal women were as able to achieve orgasm as fertile women, as were women who never had an orgasm. No patients had detectable negative side effects or adverse effects. NNT: 1.04 500. Therapeutic value: TV = NNH/NNT > 446. Our conclusions are that holistic sexological manual therapy may be rational, safe, ethical, and efficient.

  3. Clinical holistic medicine: teaching orgasm for females with chronic anorgasmia using the Betty Dodson method.

    Science.gov (United States)

    Struck, Pia; Ventegodt, Søren

    2008-09-21

    The objective of this study was to test the Betty Dodson method of breaking the female orgasm barrier in chronic anorgasmic women. The aim was sexual and existential healing (salutogenesis) through direct confrontation and integration of both the repressed shame, guilt, and other negative feelings associated with body, genitals, and sexuality, and the repressed sexual pleasure and desire. We conducted a retrospective analysis of clinic data from holistic sexological manual therapeutic intervention, an intensive subtype of clinical holistic medicine (CHM). The patients received 3 "e 5 h of group therapy, integrating short-term psychodynamic psychotherapy (STPP) and complementary medicine (CAM bodywork, manual sexology similar to the inverted exclamation mark section signsexological examination inverted exclamation mark ). The therapy used the advanced tools of reparenting, genital acceptance, acceptance through touch, and direct sexual clitoral stimulation. A clitoral vibrator was used. Participants were 500 female patients between 18 and 88 years of age (mean of 35 years) with chronic anorgasmia (for 12 years on average) who were participating in the inverted exclamation mark section signorgasm course for anorgasmic women inverted exclamation mark ; 25% of the patients had never experienced an orgasm. Our results show that 465 patients (93%) had an orgasm during therapy, witnessed by the therapist, and 35 patients (7%) did not. Postmenopausal women were as able to achieve orgasm as fertile women, as were women who never had an orgasm. No patients had detectable negative side effects or adverse effects. NNT: 1.04 500. Therapeutic value: TV = NNH/NNT > 446. Our conclusions are that holistic sexological manual therapy may be rational, safe, ethical, and efficient.

  4. Healthcare information systems: data mining methods in the creation of a clinical recommender system

    Science.gov (United States)

    Duan, L.; Street, W. N.; Xu, E.

    2011-05-01

    Recommender systems have been extensively studied to present items, such as movies, music and books that are likely of interest to the user. Researchers have indicated that integrated medical information systems are becoming an essential part of the modern healthcare systems. Such systems have evolved to an integrated enterprise-wide system. In particular, such systems are considered as a type of enterprise information systems or ERP system addressing healthcare industry sector needs. As part of efforts, nursing care plan recommender systems can provide clinical decision support, nursing education, clinical quality control, and serve as a complement to existing practice guidelines. We propose to use correlations among nursing diagnoses, outcomes and interventions to create a recommender system for constructing nursing care plans. In the current study, we used nursing diagnosis data to develop the methodology. Our system utilises a prefix-tree structure common in itemset mining to construct a ranked list of suggested care plan items based on previously-entered items. Unlike common commercial systems, our system makes sequential recommendations based on user interaction, modifying a ranked list of suggested items at each step in care plan construction. We rank items based on traditional association-rule measures such as support and confidence, as well as a novel measure that anticipates which selections might improve the quality of future rankings. Since the multi-step nature of our recommendations presents problems for traditional evaluation measures, we also present a new evaluation method based on average ranking position and use it to test the effectiveness of different recommendation strategies.

  5. A method for developing standardised interactive education for complex clinical guidelines

    Directory of Open Access Journals (Sweden)

    Vaughan Janet I

    2012-11-01

    Full Text Available Abstract Background Although systematic use of the Perinatal Society of Australia and New Zealand internationally endorsed Clinical Practice Guideline for Perinatal Mortality (PSANZ-CPG improves health outcomes, implementation is inadequate. Its complexity is a feature known to be associated with non-compliance. Interactive education is effective as a guideline implementation strategy, but lacks an agreed definition. SCORPIO is an educational framework containing interactive and didactic teaching, but has not previously been used to implement guidelines. Our aim was to transform the PSANZ-CPG into an education workshop to develop quality standardised interactive education acceptable to participants for learning skills in collaborative interprofessional care. Methods The workshop was developed using the construct of an educational framework (SCORPIO, the PSANZ-CPG, a transformation process and tutor training. After a pilot workshop with key target and stakeholder groups, modifications were made to this and subsequent workshops based on multisource written observations from interprofessional participants, tutors and an independent educator. This participatory action research process was used to monitor acceptability and educational standards. Standardised interactive education was defined as the attainment of content and teaching standards. Quantitative analysis of positive expressed as a percentage of total feedback was used to derive a total quality score. Results Eight workshops were held with 181 participants and 15 different tutors. Five versions resulted from the action research methodology. Thematic analysis of multisource observations identified eight recurring education themes or quality domains used for standardisation. The two content domains were curriculum and alignment with the guideline and the six teaching domains; overload, timing, didacticism, relevance, reproducibility and participant engagement. Engagement was the most

  6. Evaluation of the clinical process in a critical care information system using the Lean method: a case study

    Directory of Open Access Journals (Sweden)

    Yusof Maryati Mohd

    2012-12-01

    Full Text Available Abstract Background There are numerous applications for Health Information Systems (HIS that support specific tasks in the clinical workflow. The Lean method has been used increasingly to optimize clinical workflows, by removing waste and shortening the delivery cycle time. There are a limited number of studies on Lean applications related to HIS. Therefore, we applied the Lean method to evaluate the clinical processes related to HIS, in order to evaluate its efficiency in removing waste and optimizing the process flow. This paper presents the evaluation findings of these clinical processes, with regards to a critical care information system (CCIS, known as IntelliVue Clinical Information Portfolio (ICIP, and recommends solutions to the problems that were identified during the study. Methods We conducted a case study under actual clinical settings, to investigate how the Lean method can be used to improve the clinical process. We used observations, interviews, and document analysis, to achieve our stated goal. We also applied two tools from the Lean methodology, namely the Value Stream Mapping and the A3 problem-solving tools. We used eVSM software to plot the Value Stream Map and A3 reports. Results We identified a number of problems related to inefficiency and waste in the clinical process, and proposed an improved process model. Conclusions The case study findings show that the Value Stream Mapping and the A3 reports can be used as tools to identify waste and integrate the process steps more efficiently. We also proposed a standardized and improved clinical process model and suggested an integrated information system that combines database and software applications to reduce waste and data redundancy.

  7. The Clinical and Experimental Research on Billings Ovulation Method During Breastfeeding

    Institute of Scientific and Technical Information of China (English)

    金碧华; 姜国珠; 吴靖川; 申屠敏; 朱志宾; 郑玲珍; 张逸; 颜洁敏

    2002-01-01

    Objective The effectiveness and acceptability of Billings Ovulation Method (BOM)during breast feeding were studied. At the same time, the monitoring indexes of fertil-ity return vere studied.Methods It was a clinical comparative study of BOM and IUD containing copper(200 mm2). The annual rate of pregnancy, discontinuation rate and continuation ratein the two groups was determined. The serum prolactin and estradiol in 90 breast feed-ing mothers and urine estrogen and pregnanediol in different feeding mothers weremeasured.Results There were 219 subjects in the BOM group and 200 in the IUD group. Thepregnancy rate in this two groups was 1. 43% and 1. 54% respectively. The rates ofdiscontinuation and continuation in the IUD group were8. 87% and 91.35% as well asin the BOM group were 8. 53% and 90. 17% respectively. Neither result was statisti-cally significant (P> 0. 05). The experimtal research showed that menses return waswell estimated by 0. 35 ratio of serum prolactin vs. estrodiol. Sensitivity and specifici-ty was 94. 61% and 84. 61% respectively. It also indicated that (1) the levels of urinehormone were closely related to the patterns of cervical mucus and (2) the incidence ofovulating before the second return of menses in partially breast feeding mothers wasmuch lower than that of bottle-feeding mothers (47.05% vs. 94. 20% ).Conclusion BOM is a simple, reliable and well accepted contraceptive method of dur-ing breastfeeding. If it can be combined with the measurement of serum prolactin/estradiol, the date of menses return will be determined more easily. Encouragingmothers to breast-feed will be beneficial to the health of both babies and mothers anddelay the fertility return of mothers.

  8. Detecting the apoptosis of dopamine neurons with immunohistochemical staining and double-staining technique

    Institute of Scientific and Technical Information of China (English)

    Jiguo Zhang; Jing Zhang; Feng Zhang; Yunsheng Gao

    2006-01-01

    BACKGROUND: It is proved that the onset of Parkinson disease companies with neuronal apoptosis of dopamine in substantia nigra of midbrain. Previous researches on neuronal apoptosis of dopamine were analyzed on their consecutive tissue sections with immunohistochemical single-labeling method, immunofluorescence and electron microscope, and there are significant differences.OBJECTIVE: To observe the feasibility of neuronal apoptosis of dopamine with in situ end labeling and tyrosine-hydroxylase antibody immunohistochemical double-labeling staining technique.DESIGN: Controlled study.SETTING: College of Pharmacology of Taishan Medical College; College of Management of Taishan Medical College.MATERIALS: Wistar rats with 2 weeks old and of clean grade were provided by the Animal Center of Taishan Medical College. In situ end labeling kit (terminal deoxynucleotidyl transferase, mixed reactive solution of nucleotide, transfusion-POD), monoclonal antibody of rat antibody against tyrosine hydroxylase (Boehriuser).METHODS: The experiment was completed at the Pharmacological Laboratory of Taishan Medical College from February to December 2005. Tissue from midbrain of rats was taken out to make paraffin sections to observe the neuronal apoptosis of dopamine under microscope with in situ end labeling and tyrosine-hydroxylase antibody immunohistochemical double-labeling staining technique.MAIN OUTCOME MEASURES: Neuronal apoptosis of dopamine with in situ end labeling and tyrosine-hydroxylase antibody immunohistochemical double-labeling staining technique.RESULTS:① After double-labeling staining,two kinks of positive products were observed in neurons of dopamine which were suffered from apoptosis. One stained with tyrosine hydroxylase was hyacinthine, and the other stained with in situ end labeling was buffy. Cells of positive products stained with in situ end labeling shaped as strap and bend and was distributed in clustering.Cytoplasm was hyacinthine, staining was symmetrical

  9. Clinicopathological, immunohistochemical, and ultrastructural study of 13 cases of melanotic schwannoma

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hong-ying; ZHANG Yuan-heng; YANG Guang-hua; CHEN Hui-jiao; WEI Bing; KE Qi; GUO Hua; YE Lü; BU Hong; YANG Ke

    2005-01-01

    Background Melanotic schwannoma is a rare variant of schwannoma composed of melanin-producing cells with ultrastructural features of schwann cells. The description of the course of the tumors differs somewhat, but it is generally considered as a benign lesion. We investigated the clinicopathologic features, immunophenotypes, and ultrastructural features of 13 patients with nonpsammomatous melanotic schwannoma (NPMS).Methods Tumor specimens of each patient were sectioned and stained with hematoxylin-eosin, Fontana-Masson, Prussian blue, and periodic acid-Schiff (PAS). Immunohistochemical markers such as S-100, Leu-7, HMB-45, Melan-A, CK, EMA, vimentin, GFAP, laminin, collagen Ⅳ and MIB-1 were detected with the Envision immunohistochemical staining method. Four of the cases were observed by electron microscopy.Results Of the 13 patients, 8 were male and 5 female, aged from 11 to 92 years (mean, 38.6 years). The tumor sites included the spinal nerve root (5 patients), cranial nerve (1), greater omentum (1), subcutaneous tissue (3), mesentery (1), bone (1) and mediastinum (1). Eleven patients were followed up for over 2 years, with a mean of 5.9 years. One patient (9.1%) with a primary tumor in the greater omentum developed another primary tumor of the same type in the subcutaneous tissue of the abdominal wall after the first operation. Local recurrence of the tumor was seen in 2 patients (18.2%). One patient (9.1%) showed the local recurrence and metastasis. Seven patients (63.6%) showed no evidence of the recurrence or metastasis. Grossly, all tumors were well-circumscribed and the gross findings were suggestive of melanin-containing tumors. The tumor was composed of spindled and epithelioid cells with abundant intracytoplasmic melanin pigments. Nuclei were round and contained delicate, evenly distributed chromatins as well as small, distinct nucleoli. In some areas, the nucleoli were large and prominent. Rare mitoses were seen in most lesions except the larger

  10. Expanding the Aperture of Psychological Assessment: Introduction to the Special Section on Innovative Clinical Assessment Technologies and Methods

    Science.gov (United States)

    Trull, Timothy J.

    2007-01-01

    Contemporary psychological assessment is dominated by tried-and-true methods like clinical interviewing, self-report questionnaires, intellectual assessment, and behavioral observation. These approaches have served as the mainstays of psychological assessment for decades. To be sure, these methods have survived over the years because clinicians…

  11. Optimal Methods to Screen Men and Women for Intimate Partner Violence: Results from an Internal Medicine Residency Continuity Clinic

    Science.gov (United States)

    Kapur, Nitin A.; Windish, Donna M.

    2011-01-01

    Contradictory data exist regarding optimal methods and instruments for intimate partner violence (IPV) screening in primary care settings. The purpose of this study was to determine the optimal method and screening instrument for IPV among men and women in a primary-care resident clinic. We conducted a cross-sectional study at an urban, academic,…

  12. Clinical Observation on Treatment of Osteoarthritis of Knee by Needle-Warming Method and Functional Training

    Institute of Scientific and Technical Information of China (English)

    吴立红; 朱国祥; 龚艳菲

    2007-01-01

    Purpose: To observe the long-term and recent clinical effect of needle-warming method plus functional training in the treatment of osteoarthritis of the knee joint. Methods:After 106 cases of the patients were divided into the needle-warming group and comprehensive group by the order of their first visit, the needle-warming group was treated by the needle-wanning method and the comprehensive group was treated by the needle-warming method plus functional training. After ten treatments, the clinical data in the two groups were evaluated upon Lequesne scale before and after the treatments. Three months later, follow-up survey was given to process the statistic management of the reoccurrence rate of the symptoms.Results: In the two groups after the treatment, the symptoms of the knee joint and daily life ability were obviously improved than the respective conditions before the treatment, and the integral decreased (P<0.05), with no significant difference (P>0.05) between the two groups. In the follow-up survey, there was a difference (P<0.05) between the two groups in the positive rate of the recurrent symptoms. Conclusion: Certain therapeutic effect exists in the treatment of osteoarthritis of the knee joint by the needle-warming method. If functional training is combined,the therapeutic effect would be more stable, without easy reoccurrence.%目的:观察温针配合功能训练治疗膝骨性关节炎的远、近期临床疗效.方法:将106例患者按首诊顺序分成温针组和综合组.温针组只采用温针治疗,综合组采用温针治疗及功能训练.治疗10次后参照Lequesne的评估法对两组临床指标进行治疗前、后评分;3个月后随访,对症状复发率进行统计处理.结果:治疗后两组膝关节症状及日常生活能力均比各自治疗前明显改善,积分值减少(P<0.05),两组积分比无明显差异(P>0.05);3个月后随访,两组症状复发的阳性率有差异(P<0.05).结论:温针治疗膝骨性关

  13. Immunohistochemical Expression Of Estrogen And Progesterone Receptors In Endometrial Hyperplasia And Endometrioid Carcinoma

    Directory of Open Access Journals (Sweden)

    N Izadi-Mood

    2012-06-01

    Full Text Available Background: Endometrial carcinoma (EC is the most common gynecologic malignancy; however, mechanisms underlying its pathogenesis remain obscure.Endometrial carcinoma has been classified into two major categories: type I (related to estrogen or endometrioid adenocarcinomaand type II (unrelated to estrogen.Estrogen is the main trigger for the abnormal proliferation in the endometrial epithelium but progesterone can inhibit this process. The aim of this study was to analyze the expression of estrogen and progesterone receptors in all types of endometrial hyperplasia in comparison to endometrioid adenocarcinoma of endometrium. Methods: Forty-seven specimens including 23 cases of histopathologically confirmed hyperplastic endometrium (12 simple hyperplasia, 5 complex hyperplasia without atypia, and 6 complex hyperplasia with atypia and 24 cases of endometrial carcinoma were studied. Immunohistochemical staining of estrogen and progesterone receptors was performed in paraffin-embedded blocks and expression of estrogen and progesterone receptors were scored according to the proportion of positive staining cells. Results: Overexpression of progesterone receptors was seen in 18 (75% out of 24 cases of endometrial carcinoma and 23 (100% of all types of endometrial hyperplasia. The aforesaid differences were statistically significant (P=0.023. 70.8% of cases with endometrial carcinoma were 3+ for immunohistochemical staining of progesterone receptors as were 85.7% of the cases with endometrial hyperplasia; the difference being also statistically significant (P=0.02.Conclusion: Considering the increased proportion of progesterone receptor expression in all types of hyperplastic endometrium in comparison to endometrial carcinoma, hormonal therapy by progestinal agents is recommended as a treatment of choice.

  14. Immunohistochemical characterization of oral mucosal lesions in cats with chronic gingivostomatitis.

    Science.gov (United States)

    Harley, R; Gruffydd-Jones, T J; Day, M J

    2011-05-01

    Histological and immunohistochemical studies were performed on samples of the glossopalatine mucosa from 30 cats with feline chronic gingivostomatitis (FCGS). Immunohistochemical labelling and computer-assisted morphometric analysis were used to identify expression of CD3, CD4, CD8, CD79a, IgG, IgM, IgA, leucocyte antigen 1 (L1) and class II molecules of the major histocompatibility complex (MHC) in tissue sections. Mast cells were detected by toluidine blue staining. The microscopical lesions were graded by severity of inflammation and although this grading correlated significantly with the severity of mucosal inflammation assessed at clinical examination, sites assessed as clinically normal or mildly inflamed were poorly predictive of the histopathological grade in the corresponding tissue sample. The number of CD79a+ cells (mostly plasma cells), L1+ cells (mostly neutrophils) and CD3+ T cells, and the level of MHC class II expression, tended to correlate with the severity of the inflammation. In general, CD8+ T cells were more numerous than CD4+ T cells. The majority of the plasma cells were of the IgG isotype and fewer IgA+ and IgM+ plasma cells were present. In some cases MHC class II expression by mucosal epithelium, salivary duct epithelium or skeletal muscle fibres was observed. Relative to equivalent oral mucosal samples from healthy cats, the number of cells labelled for CD3, CD4, CD8, CD79a, IgG, IgM, IgA or L1, and the number of mast cells, within the lamina propria/submucosa were significantly increased. Limited analysis of the epithelial compartment also found more CD3+ T cells compared with healthy cats. These findings indicate that the glossopalatine mucosal lesions in FCGS represent a complex, chronic and destructive inflammatory process affecting the epithelium and lamina propria, with frequent extension into submucosal tissues. The predominance of CD8+ cells over CD4+ cells suggests the induction of an underlying cytotoxic cell-mediated immune

  15. 沉渣包埋切片及免疫组化检测在胸水诊断中的应用价值%Application Value of Sediment Embedding Biopsy And Immunohistochemical Detection In Hydrothorax

    Institute of Scientific and Technical Information of China (English)

    林建龙; 钟国栋; 王婷; 林晶; 魏霖; 程焰红

    2015-01-01

    Objective To explore the application value of Liquid based cytology combine with sediment embedding biopsy and immunohistochemical detection in the diagnosis of hydrothorax.MethodsTo detecte liquid based cytology of 368 cases of hydrothorax and we found that 65 cases were malignant or suspicious malignant,and we further diagnosis and trace their organization sources by the means of sediment embedding biopsy combined with immunohistochemical staining.Results By the method of liquid based cytology ,we found that 49 cases (75.38%) were positive and 16 cases were suspicious positive . On the other hand ,by the method of sediment embedding biopsy conbined with immunohistochemical detection , 61 cases were positive,with the positive rate of 93.85%,and the difference was statistically significant (p < 0.05). Immunohistochemical markers results Confirmed that 41 cases of patients were lung adenocarcinoma, 2 cases were lung squamous carcinoma,1case was pulmonary neuroendocrine carcinoma, 2 cases were malignant mesothelioma, 9 cases were gastrointestinal carcinoma, 2 cases were breast cancer ,1 case was bile duct carcinoma , 3 cases were ovarian cancer and 4 cases were reactive mesothelium hyperplasia.Conclusion By using Liquid based cytology combined with sediment embedding biopsy and immunohistochemical detection can improve the accuracy of hydrothorax cytology diagnosis and positive detection rate,and be of great clinical application value in estimate the source of tumor cell tissue.%目的:探讨液基细胞学联合沉渣包埋切片及免疫组化检测在胸水诊断中的应用价值.方法:对368例胸水进行液基细胞学检测,其中65例恶性及可疑恶性胸水进行沉渣包埋切片,并联合应用免疫组化染色,进一步明确诊断及追溯其组织来源.结果:65例胸水液基细胞学检测阳性49例(75.38%),可疑阳性16例,经沉渣包埋切片及免疫组化检测出阳性61例,阳性率93.85%,差异有统计学意义(P<0.05);

  16. Diagnostic accuracy comparison between clinical signs and hemoglobin color scale as screening methods in the diagnosis of anemia in children

    OpenAIRE

    Leal,Luciana Pedrosa; Mônica M. Osório

    2006-01-01

    OBJECTIVES: to compare the validity and reproducibility of clinical signs with the World Health Organization hemoglobin color scale. METHODS: Two hundred six children in the age range of 6-23 months, at the Instituto Materno Infantil Prof. Fernando Figueira, IMIP, were assessed. Two examiners evaluated the clinical signs and the hemoglobin color scale of each child at the different times. The hemoglobin value was used as a standard for validation. RESULTS: in more than 90% of cases the agreem...

  17. Improved Methods for the Clinical Manufacture of Proteins Used In Cancer Immunotherapy | NCI Technology Transfer Center | TTC

    Science.gov (United States)

    Interleukin-15 (IL-15) is an immune system modulating protein (cytokine) that stimulates the proliferation and differentiation of T- lymphocytes.  In the clinical context, IL-15 is being investigated for use in the treatment of diseases such as cancer.  Manufacture of IL-15 for clinical use can be problematic. The National Cancer Institute seeks partners to co-develop or license methods that facilitate pharmaceutical purification and processing of Interleukin-15 (IL-15).

  18. The Clinical and Medicolegal Analysis of Electrical Shocked Rats: Based on the Serological and Histological Methods

    Science.gov (United States)

    Wang, Qiaofeng; Zhao, Ze; Xie, Yanan; Ding, Suzhen

    2016-01-01

    This research was aimed at discovering the serological and histological changes in cardiac and hepatic tissue after electric shock. The CK-MB, ALT, and AMS indexes were tested with serological methods. Moreover, the Bcl-2, Bax, and Hsp-60 expression levels were carefully measured. An electrical injury model was established by giving rats electric shocks at 110 V with alternating electric current. Blood samples from the rats were analyzed for the biochemical indexes. The degrees of pathological changes in the heart and liver were evaluated using IHC staining for Bcl-2, Bax, and Hsp-60. The levels of CK-MB in the electrical injury group rapidly peaked at 0.5 hours after the electric shock. Additionally, the levels of Bcl-2, Bax, and Hsp-60 in the cardiac and hepatic tissues changed regularly after the electrical injury and exhibited apparent differences from the levels in the control group. CK-MB, ALT, and AMS were altered regularly after electric shock, and these results provide significant information for clinical and medicolegal practice. This research has shed light on the assessment of electrical injury without obvious electrical burns. Furthermore, the findings obtained for Bcl-2/Bax and Hsp-60 can also facilitate pathological diagnosis and the identification of antemortem and postmortem electrical injury. PMID:27648446

  19. [Thinking about vertigo effectiveness evaluation methods in clinical research of Chinese medicine].

    Science.gov (United States)

    Liu, Hong-mei; Li, Tao

    2014-10-01

    Vertigo is a kind of patients' subjective feelings. The severity of vertigo is closely related to many factors. But we are short of a well accepted quantitative evaluation method capable of accurately and comprehensively evaluating vertigo in clinics. Reducing the onset of vertigo, enhancing the re- covery of equilibrium function, and improving the quality of life of vertigo patients should be taken as the focus of evaluating therapeutic effects. As for establishing a Chinese medical effectiveness evaluation system for vertigo, we believe we should distinguish different "diseases". We could roughly identify it as systemic vertigo and non-systemic vertigo. For systemic vertigo, the efficacy of vertigo could be comprehensively evaluated by UCLA vertigo questionnaire or dizziness handicap inventory combined with equilibrium function testing indices. But for non-systemic vertigo, the efficacy of vertigo could be comprehensively evaluated by taking UCLA vertigo questionnaire or dizziness handicap inventory as main efficacy indices. Secondly, we should analyze different reasons for vertigo, choose symptoms and signs in line with vertigo features as well as with Chinese medical theories, and formulate corresponding syndrome effectiveness standards according to different diseases. We should not simply take syndrome diagnosis standards as efficacy evaluation standards.

  20. Comparison of different methods involved in the planning of clinical crown lengthening surgery.

    Science.gov (United States)

    Zanatta, Fabricio Batistin; Giacomelli, Bruno Rodrigues; Dotto, Patricia Pasquali; Fontanella, Vânia Regina Camargo; Rosing, Cassiano Kuchenbecker

    2010-01-01

    There is little material in the literature that compares biological width measurements in periapical and bite-wings radiographs with clinical measurements. The purpose of this study was to compare measurements of biological width taken by three different methods which are frequently used for planning periodontal surgery - periapical radiograph, bite-wing radiograph and transperiodontal probing - with the trans-surgical measurements. Thirty-four sites from twenty-one subjects were analyzed. The intra-class correlation coefficients between measurements obtained trans-surgically (gold standard) and those obtained by transperiodontal probing, periapical radiography and bite-wing radiography were determined. Average measurements were compared using the Wilcoxon test at a significance level of 0.05. Also, the frequency distribution of differences between test measurements and the gold standard was calculated. The results showed that transperiodontal probing (mean 2.05 mm) was the most accurate measurement, as compared to the gold standard (mean 1.97 mm), with no statistically significant difference observed. On the other hand, periapical and bite-wing radiographic mean values (1.56 mm and 1.72 mm, respectively) were smaller than the gold standard, with statistically significant differences (p crown lengthening surgery should, preferably, include transperiodontal probing.

  1. Methods for clinical evaluation of noise reduction techniques in abdominopelvic CT.

    Science.gov (United States)

    Ehman, Eric C; Yu, Lifeng; Manduca, Armando; Hara, Amy K; Shiung, Maria M; Jondal, Dayna; Lake, David S; Paden, Robert G; Blezek, Daniel J; Bruesewitz, Michael R; McCollough, Cynthia H; Hough, David M; Fletcher, Joel G

    2014-01-01

    Most noise reduction methods involve nonlinear processes, and objective evaluation of image quality can be challenging, since image noise cannot be fully characterized on the sole basis of the noise level at computed tomography (CT). Noise spatial correlation (or noise texture) is closely related to the detection and characterization of low-contrast objects and may be quantified by analyzing the noise power spectrum. High-contrast spatial resolution can be measured using the modulation transfer function and section sensitivity profile and is generally unaffected by noise reduction. Detectability of low-contrast lesions can be evaluated subjectively at varying dose levels using phantoms containing low-contrast objects. Clinical applications with inherent high-contrast abnormalities (eg, CT for renal calculi, CT enterography) permit larger dose reductions with denoising techniques. In low-contrast tasks such as detection of metastases in solid organs, dose reduction is substantially more limited by loss of lesion conspicuity due to loss of low-contrast spatial resolution and coarsening of noise texture. Existing noise reduction strategies for dose reduction have a substantial impact on lowering the radiation dose at CT. To preserve the diagnostic benefit of CT examination, thoughtful utilization of these strategies must be based on the inherent lesion-to-background contrast and the anatomy of interest. The authors provide an overview of existing noise reduction strategies for low-dose abdominopelvic CT, including analytic reconstruction, image and projection space denoising, and iterative reconstruction; review qualitative and quantitative tools for evaluating these strategies; and discuss the strengths and limitations of individual noise reduction methods.

  2. Contribution of laboratory methods in diagnosing clinically suspected ocular toxoplasmosis in Brazilian patients.

    Science.gov (United States)

    Mattos, Cinara C B; Meira, Cristina S; Ferreira, Ana I C; Frederico, Fábio B; Hiramoto, Roberto M; Almeida, Gildásio C; Mattos, Luiz C; Pereira-Chioccola, Vera L

    2011-07-01

    This prospective study evaluated the value of laboratorial diagnosis in ocular toxoplasmosis analyzing peripheral blood samples from a group of Brazilian patients by immunologic and molecular methods. We analyzed blood samples from 184 immunocompetent patients with ocular disorders divided into 2 groups: Group I, composed of samples from 49 patients with ocular toxoplasmosis diagnosed by clinical features; Group II, samples from 135 patients with other ocular diseases. Samples were assayed by conventional polymerase chain reaction (cnPCR), real-time PCR (qPCR) for Toxoplasma gondii, indirect immunofluorescence reaction (IF), avidity test (crude tachyzoite lysate as antigen), and excreted-secreted tachyzoite proteins as antigen (ESA-ELISA). cnPCR and qPCR profiles were concordant in all samples. Positive PCR was shown in 40.8% of group I patients. The majority of the positive blood samples (75%) were taken from patients with toxoplasmic retinochoroiditis scars, and the others (25%), from patients with retinal exudative lesions. Despite that 86 of the 135 patients from Group II had asymptomatic toxoplasmosis, all DNA blood samples had negative PCR. Concordant results were shown in the data obtained by serologic methods. Around 24% of the patients with ocular toxoplasmosis had high antibody titers determined by ESA-ELISA and IF. Anti-ESA antibodies are shown principally in patients with active infection. Collectively, these data demonstrate the presence of tachyzoites in the blood of patients with chronic infection, supporting the idea of recurrent disease. Circulating parasites in blood of immunocompetent individuals may be associated with the reactivation of the ocular disease.

  3. A peripheral ameloblastic fibro-odontoma in a 3-year-old girl: case report, immunohistochemical analysis, and literature review.

    Science.gov (United States)

    Lin, Yi-Chun; Hsu, Hsiu-Ming; Liu, Chiang-Shin; Yuan, Kuo

    2014-01-01

    Ameloblastic fibro-odontoma (AFO) predominantly occurs in the jaw bones of children and young adults. Extraosseous AFO is extremely rare. We describe a peripheral ameloblastic fibro-odontoma in the maxillary gingiva of a 3-year-old girl. The clinical appearance resembled fiery red reactive gingival lesions. The histopathological examination of the excised lesion showed small islands and cords of odontogenic epithelium with cellular myxoid stroma in the subepithelial tissue. The mass contained calcified material and an enamel-like deposit. Many small blood vessels appeared in the connective tissue surrounding the odontogenic epithelium. The immunohistochemical assays showed strong reactivity for amelogenin, β-catenin, CD44, and CD31 in the tissue sections. There was no recurrence after the 1-year follow-up. Because this lesion clinically resembles other nonneoplastic lesions and is very rare in gingiva, establishing a correct diagnosis is achieved only based on specific histological characteristics. Conservative excision of the tumor is the treatment of choice.

  4. Immunohistochemical localization of sex hormone receptors in two Raillietina tapeworms.

    Science.gov (United States)

    Chen, L; Sun, Y M; Mu, L; Zeng, Y; Li, H Y; Yang, T H

    2017-03-08

    Sex hormone receptors play critical roles in development and reproduction. However, it is not known whether they exist in Raillietina tapeworms, and if they do, whether they have a similar function to that in vertebrates. We examined the immunohistochemical distributions of androgen receptors (ARs), estrogen receptors (ERs), and progesterone receptors (PRs) in the tissues of two tapeworm species: Raillietina echinobothrida and Raillietina tetragona. Immunopositive ARs were found in the entire reproductive system of R. echinobothrida, including the testes, ovaries, and oocysts, and weakly immunopositive ERs and PRs were found in the testes, ovaries, and oocysts. Immunopositive ARs were also found throughout the entire reproductive system of R. tetragona, including the testes, ovaries, and oocysts, and weakly immunopositive ERs were in the testes and oocysts; the PRs were distributed in an immunonegative manner. The results show that androgens and their receptors play critical roles in reproductive system development in the two tapeworms. The immunoreactivity and tissue localizations of the sex hormone receptors suggest that, in both species, they have similar functions as in vertebrates, and modulate reproduction.

  5. Immunohistochemical study of subepidermal connective of molluscan integument

    Directory of Open Access Journals (Sweden)

    S Corbetta

    2010-01-01

    Full Text Available Sections of integument from gastropod, bivalve and cephalopod species were studied immunohistochemically to determine reactivity to antibody against the type I-like collagen from Sepia cartilage and antibodies against components of the extracellular matrix (ECM of vertebrate connective tissue: type I, III, IV, V, and VI collagens, laminin, nidogen and heparan sulphate. All samples exhibited similar reactivities to the antibodies, although differences in the intensity and localization of the immunostaining were found that were clearly correlated with between-species differences in integumental ultrastructure. These findings indicate that the composition of the integumental ECM is similar in the three classes of molluscs examined and that several types of collagen are present. However molluscan subepidermal connective tissue differs from the ECM of vertebrate dermis: molluscan integumental ECM contains collagens similar to type I, V and VI collagens but has no type III-similar collagen. Furthermore molecules similar to the type IV collagen, laminin, nidogen and heparan sulphate of vertebrates were present ubiquitously in molluscan basement membrane, confirming the statement that the structure and composition of basement membrane have remained constant throughout the evolution of all animal phyla.

  6. Immunohistochemical Analysis of P63 Expression in Odontogenic Lesions

    Directory of Open Access Journals (Sweden)

    Saede Atarbashi Moghadam

    2013-01-01

    Full Text Available P63 may have a role in tumorigenesis and cytodifferentiation of odontogenic lesions. We investigated the immunohistochemical expression of P63 in a total of 30 cases of odontogenic cysts and tumors. The percentage of positive cells was calculated in the lining of odontogenic cysts and islands of ameloblastoma. P63 expression was evident in all types of odontogenic lesions. P63 was expressed throughout the lining epithelium of odontogenic keratocyst except surface parakeratinized layer. In addition, calcifying odontogenic cyst showed P63 expression in all layers. In almost all radicular and dentigerous cysts, the basal and parabasal layers were immunoreactive. Peripheral cells of ameloblastoma expressed P63; however, stellate reticulum had weaker immunostaining. No significant difference in P63 expression was observed between studied lesions (. Expression of P63 in odontogenic lesions suggests that this protein is important in differentiation and proliferation of odontogenic epithelial cells. However, it seems that it could not be a useful marker to differentiate between aggressive and nonaggressive lesions. P63 also represents a progenitor or basal cell marker, and it is not expressed in mature differentiated cells.

  7. Hepatic metastasis of thymoma: case report and immunohistochemical study

    Science.gov (United States)

    Speisky, Daniela; de Davila, María Teresa García; Vigovich, Felix; Mendez, Julian; Maurette, Rafael; Ejarque, Marcos García; Spina, Juan Carlos; Iotti, Alejandro; Dezanzo, Pablo

    2016-01-01

    Thymomas are rare tumours characterised by their slow growth and capacity to invade directly by contiguity. While distant dissemination is infrequent, all sub-types of thymoma have the capacity to metastasise to extrathoracic organs. We present here the case of a female patient with a liver mass discovered 13 years after the removal of a mediastinal thymoma and after ten years from thyroidectomy for papillary carcinoma. The histopathological study showed that the lesion contained an epithelial component, which was immunohistochemically positive for pankeratin. It was accompanied by numerous small lymphocytes testing positive for TdT, CD3, CD4, CD5, CD8, CD99, and CD43. The result was consistent with hepatic metastatic thymoma sub-type B1, according to the World Health Organisation classification (WHO). Our case highlights the importance of morphological and immunohistological examinations in the differential diagnosis of visceral masses in patients with a history of thymoma. Given the infrequency of its metastasis and the increased risk of developing other primary tumours that these patients have, these studies play a significant role. PMID:28101136

  8. Immunohistochemical distribution of myotonic dystrophy kinase (DNK) in muscle

    Energy Technology Data Exchange (ETDEWEB)

    Whiting, E.J.; Tamai, K. [Univ. of Ottawa (Canada); Waring, J.D. [Chilrdren`s Hospital of Eastern Ontario, Ottawa (Canada)] [and others

    1994-09-01

    Myotonic dystrophy (DM) is the most common form of inherited neuromuscular disease in adults and is characterized by progressive muscle wasting and myotonia. The mutation responsible for DM has been identified as the expansion of a polymorphic (CTG)n repeat in the 3{prime} untranslated region of a gene encoding a putative serine/threonine kinase (DMK). We have raised a polyclonal raised a polyclonal rabbit antisera against a fusion protein encoding exons 11-15 of DMK. The antisera detects both the full length and a truncated isoform (missing amino acids corresponding to exons 13-15) of the human DMK expressed in a recombinant baculovirus system. In addition, it recognizes a 69 kDA protein on Western blots of both human and mouse myoblasts. Use of this antiserum in immunohistochemical studies of human tissue demonstrates that DMK is expressed in the cytoplasm of both skeletal and smooth muscle and is expressed postsynaptically (as determined by codistribution with acetylcholinesterase and acetylcholine receptors) within the vicinity of neuromuscular junction of skeletal muscle. Further, no obvious differences in DMK localization were observed between muscle tissues from normal and DM-affected individuals.

  9. Histochemical and immunohistochemical analyses of primary carcinoma of the liver.

    Directory of Open Access Journals (Sweden)

    Sacho,Masanori

    1991-12-01

    Full Text Available Hematoxylin and eosin (H-E stained liver sections of 47 autopsy cases of hepatic malignancies were examined. There were 43 cases of hepatocellular carcinoma (subtypes of 30 trabecular, 7 solid, 5 pseudoglandular, and one scirrhous carcinoma, 3 of cholangiocellular carcinoma and one of mixed carcinoma. After immunohistochemical staining, benign hepatocytes reacted positively with anti-epithelial membrane antigen (EMA. Hepatocellular carcinoma cells reacted more weakly than benign hepatocytes. It was noted that the microtubular structure, which could not be demonstrated even by alcian blue or cationic ferric hydroxide colloid stabilized with cacodylate (Fe-CaC, was clearly detected with anti-EMA. The EMA-positive microtubular structures may indicate terminal cholangiolar differentiation. Based on EMA, seven more cases formerly classified as hepatocellular carcinoma by H-E were reclassified as mixed carcinoma, totaling eight (17.0%. The histologic classification of "mixed carcinoma" has been 1.5 to 2.0% of primary liver cancers in Japan, but we suggest there may be more cases of "mixed carcinoma" identified in the future. In conclusion, we emphasize that EMA staining is useful for more accurate classification of hepatic tumors.

  10. Evaluation of new oxidation methods for the measurement of bilirubin on the aeroset clinical chemistry analyzer and comparison with methods on the Hitachi 717.

    Science.gov (United States)

    Sturm, Ernhard; Albrecht-Groos, Ragnhild; Seyfarth, Michael

    2002-01-01

    We evaluated analytical and performance quality of the new oxidation methods for direct and total bilirubin on the Abbott Aeroset clinical chemistry analyzer. Within-day imprecisions for Abbott Aeroset assays ranged from 0.7 to 2.9% and between-day imprecisions from 2.1 to 7.3%. Inaccuracies as compared with the control "target values" for the Jendrassik-Gróf method showed deviations of -18.2 to +4.2%. Limits of detection were determined and showed very low values of 300 micromol/l. A method comparison for 100 patient samples with established Jendrassik-Gróf and DPD methods on the Roche Hitachi 717 showed good linearities between the investigated methods (r > or = 0.995). Due to slopes that ranged from 0.829 to 0.950, reference ranges for the oxidation methods differ slightly from those of established Roche Jendrassik-Gróf methods, but results can be adapted by the introduction of converting factors. In conclusion, the oxidation bilirubin assays revealed convincing analytical and performance qualities for medical needs that were similar or even better than for established methods. Application of the oxidation methods on the Aeroset clinical chemistry analyzer also improves laboratory efficiency by increasing throughput, speed of obtaining results and lowered sample and reagent volumes compared to established methods.

  11. Agreement in the diagnosis of dental fluorosis in central incisors performed by a standardized photographic method and clinical examination.

    Science.gov (United States)

    Martins, Carolina Castro; Chalub, Loliza; Lima-Arsati, Ynara Bosco; Pordeus, Isabela Almeida; Paiva, Saul Martins

    2009-05-01

    The aim of this study was to assess agreement in the diagnosis of dental fluorosis performed by a standardized digital photographic method and a clinical examination (gold standard). 49 children (aged 7-9 years) were clinically evaluated by a trained examiner for the assessment of dental fluorosis. Central incisors were evaluated for the presence or absence of dental fluorosis and were photographed with a digital camera. Photographs were presented to three pediatric dentists, who examined the images. Data were analyzed using Cohen's kappa and validity values. Agreement in the diagnosis performed by the photographic method and clinical examination was good (0.67) and accuracy was 83.7%. The prevalence of dental fluorosis was reported to be higher in the clinical examination (49%) compared with the photographic method (36.7%). The photographic method presented higher specificity (96%) than sensitivity (70.8%), a positive predictive value (PPV) of 94.4% and a negative predictive value (NPV) of 77.4%. The diagnosis of dental fluorosis performed using the photographic method presented high specificity and PPV, which indicates that the method is reproducible and reliable for recording dental fluorosis.

  12. Current concepts in the diagnosis of blood stream infections. Are novel molecular methods useful in clinical practice?

    Science.gov (United States)

    Huttunen, Reetta; Syrjänen, Jaana; Vuento, Risto; Aittoniemi, Janne

    2013-11-01

    The decision on the right empirical treatment in bacteremia places particular demands on the clinician. As long as no microbiological diagnosis can be immediately drawn, the clinical diagnosis together with knowledge of local antimicrobial resistance must determine the antimicrobial choice. The use of several amplification, hybridization, and mass spectrometry methods has been studied in patient cohorts in comparison with blood culture-based conventional techniques. However, no clinical outcome trials have been conducted in which the use of these novel methods would guide antimicrobial therapy. Local differences in bacterial antimicrobial resistance cause differences in the regional need for molecular methods for the early detection of resistance mechanisms. The implementation of novel methods in clinical use requires active discussion between laboratory experts and clinicians. Providing rapid susceptibility results using conventional methods can lead to timely changes to appropriate antimicrobial therapy and the costs are lower than with the molecular methods. Gram-stain information in combination with clinical data is an underestimated, underused, rapid, and economical means of assessing the etiology of blood stream infection.

  13. A Comparison of In-service Teaching Methods on Clinical Aspesis for Dental Personnel.

    Science.gov (United States)

    Fotos, Pete G.; And Others

    1990-01-01

    Results of a study with dental assistants and hygienists, clinic clerks, supply and sterilization personnel, receptionists, and housekeeping and secretarial staff (n=80) suggest that inservice training programs on infection control and clinical asepsis procedures may be better accomplished by practical demonstration than by lecture or seminar.…

  14. Aggressive Epidermotropic Cutaneous CD8+ Lymphoma:A cutaneous lymphoma with distinct clinical and pathological features Report of an EORTC Cutaneous Lymphoma Task Force Workshop

    OpenAIRE

    A. Robson; Assaf, C; Bagot, M; G. Burg; Calonje, Je; CASTILLO C.; CERRONI, L.; Chimenti, N; Dechelotte, P; Franck, F.; Geerts, M; Gellrich, S; Goodlad, John; Kempf, W; Knobler, R.

    2014-01-01

    AIMS: Aggressive epidermotropic cutaneous CD8+ lymphoma is currently afforded provisional status in the WHO classification of lymphomas. An EORTC Workshop was convened to describe in detail the features of this putative neoplasm and evaluate its nosological status with respect to other cutaneous CD8+ lymphomas.METHODS & RESULTS: Sixty-one CD8+ cases were analysed at the workshop; clinical details, often with photographs, histological sections, immunohistochemical results, treatment and pa...

  15. How have research questions and methods used in clinical trials published in Clinical Rehabilitation changed over the last 30 years?

    Science.gov (United States)

    Mayo, Nancy E; Kaur, Navaldeep; Barbic, Skye P; Fiore, Julio; Barclay, Ruth; Finch, Lois; Kuspinar, Ayse; Asano, Miho; Figueiredo, Sabrina; Aburub, Ala’ Sami; Alzoubi, Fadi; Arafah, Alaa; Askari, Sorayya; Bakhshi, Behtash; Bouchard, Vanessa; Higgins, Johanne; Hum, Stanley; Inceer, Mehmet; Letellier, Marie Eve; Lourenco, Christiane; Mate, Kedar; Salbach, Nancy M; Moriello, Carolina

    2016-01-01

    Research in rehabilitation has grown from a rare phenomenon to a mature science and clinical trials are now common. The purpose of this study is to estimate the extent to which questions posed and methods applied in clinical trials published in Clinical Rehabilitation have evolved over three decades with respect to accepted standards of scientific rigour. Studies were identified by journal, database, and hand searching for the years 1986 to 2016. A total of 390 articles whose titles suggested a clinical trial of an intervention, with or without randomization to form groups, were reviewed. Questions often still focused on methods to be used (57%) rather than what knowledge was to be gained. Less than half (43%) of the studies delineated between primary and secondary outcomes; multiple outcomes were common; and sample sizes were relatively small (mean 83, range 5 to 3312). Blinding of assessors was common (72%); blinding of study subjects was rare (19%). In less than one-third of studies was intention-to-treat analysis done correctly; power was reported in 43%. There is evidence of publication bias as 83% of studies reported either a between-group or a within-group effect. Over time, there was an increase in the use of parameter estimation rather than hypothesis testing and there was evidence that methodological rigour improved. Rehabilitation trialists are answering important questions about their interventions. Outcomes need to be more patient-centred and a measurement framework needs to be explicit. More advanced statistical methods are needed as interventions are complex. Suggestions for moving forward over the next decades are given. PMID:27496695

  16. Reporting of missing data and methods used to accommodate them in recent analgesic clinical trials: ACTTION systematic review and recommendations.

    Science.gov (United States)

    Gewandter, Jennifer S; McDermott, Michael P; McKeown, Andrew; Smith, Shannon M; Williams, Mark R; Hunsinger, Matthew; Farrar, John; Turk, Dennis C; Dworkin, Robert H

    2014-09-01

    Missing data in clinical trials can bias estimates of treatment effects. Statisticians and government agencies recommend making every effort to minimize missing data. Although statistical methods are available to accommodate missing data, their validity depends on often untestable assumptions about why the data are missing. The objective of this study was to assess the frequency with which randomized clinical trials published in 3 major pain journals (ie, European Journal of Pain, Journal of Pain, and Pain) reported strategies to prevent missing data, the number of participants who completed the study (ie, completers), and statistical methods to accommodate missing data. A total of 161 randomized clinical trials investigating treatments for pain, published between 2006 and 2012, were included. Approximately two-thirds of the trials reported at least 1 method that could potentially minimize missing data, the most common being allowance of concomitant medications. Only 61% of the articles explicitly reported the number of patients who were randomized and completed the trial. Although only 14 articles reported that all randomized participants completed the study, fewer than 50% of the articles reported a statistical method to accommodate missing data. Last observation carried forward imputation was used most commonly (42%). Thirteen articles reported more than 1 method to accommodate missing data; however, the majority of methods, including last observation carried forward, were not methods currently recommended by statisticians. Authors, reviewers, and editors should prioritize proper reporting of missing data and appropriate use of methods to accommodate them so as to improve the deficiencies identified in this systematic review.

  17. [Comparison of clinical results between LASIK method and ICL implantation in high myopia].

    Science.gov (United States)

    Hrubá, H; Vlková, E; Horácková, M; Svacinová, J

    2004-05-01

    In a retrospective study the authors evaluate clinical results of the LASIK (laser in situ keratomileusis) and the implantation of the implantable posterior chamber contact lens phakic IOL (ICL) (STAAR Surgical) to correct high myopia. The purpose of the study was to assess which of those two methods is more reliable in patients to correct myopia in the range -10.0 to -23.0 diopters. The LASIK method was presented of a group of 70 eyes of 48 patients with preoperative spherical equivalent average of -12.9 +/- 3.8 diopters (Dsf) and average astigmatism of -0.99 +/- 1.2 cylindrical diopters (Dcyl). The group was divided into two parts: one part was with the desired postoperative emmetropia--46 eyes (65.7%), and part two was with the desired postoperative residual myopia up to -3.0 Dsf--24 eyes (34.3%). The method of ICL implantation was presented of a group of 36 eyes of 21 patients with preoperative spherical equivalent average of -15.21 +/- 4.0 Dsf and average astigmatism of -0.92 +/- 0.69 Dcyl. Also this group was divided into two parts: One part was with the desired postoperative emmetropia--25 eyes (69.4%), and part two was with the desired postoperative residual myopia up to -3.0 Dsf--11 eyes (30.6%). The developments of postoperative refraction in time (1 week to 3 years after the surgery), the final postoperative refraction and its stability and (6 months to 3 years after the surgery) as well as the occurrence of complications in both studied groups were evaluated. In the assessment of the postoperative refraction development in groups of desired emmetropia, the average uncorrected visual acuity (UCVA), average postoperative spherical equivalent and astigmatism were evaluated. In the groups with desired residual myopia the average best-corrected visual acuity (BCVA), average postoperative spherical equivalent, and astigmatism were followed. Three years after the surgery in groups with desired emmetropia, the average postoperative spherical equivalent was -0

  18. How to develop, validate, and compare clinical prediction models involving radiological parameters: Study design and statistical methods

    Energy Technology Data Exchange (ETDEWEB)

    Han, Kyung Hwa; Choi, Byoung Wook [Dept. of Radiology, and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Song, Ki Jun [Dept. of Biostatistics and Medical Informatics, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-06-15

    Clinical prediction models are developed to calculate estimates of the probability of the presence/occurrence or future course of a particular prognostic or diagnostic outcome from multiple clinical or non-clinical parameters. Radiologic imaging techniques are being developed for accurate detection and early diagnosis of disease, which will eventually affect patient outcomes. Hence, results obtained by radiological means, especially diagnostic imaging, are frequently incorporated into a clinical prediction model as important predictive parameters, and the performance of the prediction model may improve in both diagnostic and prognostic settings. This article explains in a conceptual manner the overall process of developing and validating a clinical prediction model involving radiological parameters in relation to the study design and statistical methods. Collection of a raw dataset; selection of an appropriate statistical model; predictor selection; evaluation of model performance using a calibration plot, Hosmer-Lemeshow test and c-index; internal and external validation; comparison of different models using c-index, net reclassification improvement, and integrated discrimination improvement; and a method to create an easy-to-use prediction score system will be addressed. This article may serve as a practical methodological reference for clinical researchers.

  19. Grey Matter Atrophy in Multiple Sclerosis: Clinical Interpretation Depends on Choice of Analysis Method.

    Directory of Open Access Journals (Sweden)

    Veronica Popescu

    Full Text Available Studies disagree on the location of grey matter (GM atrophy in the multiple sclerosis (MS brain.To examine the consistency between FSL, FreeSurfer, SPM for GM atrophy measurement (for volumes, patient/control discrimination, and correlations with cognition.127 MS patients and 50 controls were included and cortical and deep grey matter (DGM volumetrics were performed. Consistency of volumes was assessed with Intraclass Correlation Coefficient/ICC. Consistency of patients/controls discrimination was assessed with Cohen's d, t-tests, MANOVA and a penalized double-loop logistic classifier. Consistency of association with cognition was assessed with Pearson correlation coefficient and ANOVA. Voxel-based morphometry (SPM-VBM and FSL-VBM and vertex-wise FreeSurfer were used for group-level comparisons.The highest volumetry ICC were between SPM and FreeSurfer for cortical regions, and the lowest between SPM and FreeSurfer for DGM. The caudate nucleus and temporal lobes had high consistency between all software, while amygdala had lowest volumetric consistency. Consistency of patients/controls discrimination was largest in the DGM for all software, especially for thalamus and pallidum. The penalized double-loop logistic classifier most often selected the thalamus, pallidum and amygdala for all software. FSL yielded the largest number of significant correlations. DGM yielded stronger correlations with cognition than cortical volumes. Bilateral putamen and left insula volumes correlated with cognition using all methods.GM volumes from FreeSurfer, FSL and SPM are different, especially for cortical regions. While group-level separation between MS and controls is comparable, correlations between regional GM volumes and clinical/cognitive variables in MS should be cautiously interpreted.

  20. Yoga for veterans with chronic low back pain: Design and methods of a randomized clinical trial.

    Science.gov (United States)

    Groessl, Erik J; Schmalzl, Laura; Maiya, Meghan; Liu, Lin; Goodman, Debora; Chang, Douglas G; Wetherell, Julie L; Bormann, Jill E; Atkinson, J Hamp; Baxi, Sunita

    2016-05-01

    Chronic low back pain (CLBP) afflicts millions of people worldwide, with particularly high prevalence in military veterans. Many treatment options exist for CLBP, but most have limited effectiveness and some have significant side effects. In general populations with CLBP, yoga has been shown to improve health outcomes with few side effects. However, yoga has not been adequately studied in military veteran populations. In the current paper we will describe the design and methods of a randomized clinical trial aimed at examining whether yoga can effectively reduce disability and pain in US military veterans with CLBP. A total of 144 US military veterans with CLBP will be randomized to either yoga or a delayed treatment comparison group. The yoga intervention will consist of 2× weekly yoga classes for 12weeks, complemented by regular home practice guided by a manual. The delayed treatment group will receive the same intervention after six months. The primary outcome is the change in back pain-related disability measured with the Roland-Morris Disability Questionnaire at baseline and 12-weeks. Secondary outcomes include pain intensity, pain interference, depression, anxiety, fatigue/energy, quality of life, self-efficacy, sleep quality, and medication usage. Additional process and/or mediational factors will be measured to examine dose response and effect mechanisms. Assessments will be conducted at baseline, 6-weeks, 12-weeks, and 6-months. All randomized participants will be included in intention-to-treat analyses. Study results will provide much needed evidence on the feasibility and effectiveness of yoga as a therapeutic modality for the treatment of CLBP in US military veterans.

  1. Translating Research on Myoelectric Control into Clinics-Are the Performance Assessment Methods Adequate?

    Science.gov (United States)

    Vujaklija, Ivan; Roche, Aidan D; Hasenoehrl, Timothy; Sturma, Agnes; Amsuess, Sebastian; Farina, Dario; Aszmann, Oskar C

    2017-01-01

    Missing an upper limb dramatically impairs daily-life activities. Efforts in overcoming the issues arising from this disability have been made in both academia and industry, although their clinical outcome is still limited. Translation of prosthetic research into clinics has been challenging because of the difficulties in meeting the necessary requirements of the market. In this perspective article, we suggest that one relevant factor determining the relatively small clinical impact of myocontrol algorithms for upper limb prostheses is the limit of commonly used laboratory performance metrics. The laboratory conditions, in which the majority of the solutions are being evaluated, fail to sufficiently replicate real-life challenges. We qualitatively support this argument with representative data from seven transradial amputees. Their ability to control a myoelectric prosthesis was tested by measuring the accuracy of offline EMG signal classification, as a typical laboratory performance metrics, as well as by clinical scores when performing standard tests of daily living. Despite all subjects reaching relatively high classification accuracy offline, their clinical scores varied greatly and were not strongly predicted by classification accuracy. We therefore support the suggestion to test myocontrol systems using clinical tests on amputees, fully fitted with sockets and prostheses highly resembling the systems they would use in daily living, as evaluation benchmark. Agreement on this level of testing for systems developed in research laboratories would facilitate clinically relevant progresses in this field.

  2. Feline peripheral nerve sheath tumors: histologic, immunohistochemical, and clinicopathologic correlation (59 tumors in 53 cats).

    Science.gov (United States)

    Schulman, F Y; Johnson, T O; Facemire, P R; Fanburg-Smith, J C

    2009-11-01

    Feline peripheral nerve sheath tumors are uncommonly reported, and their clinical behavior has not been well documented. Fifty-nine peripheral nerve sheath tumors were collected from 53 cats. All of the tumors involved skin, subcutis, skeletal muscle, and/or mucous membranes. Histologically, the tumors were composed of compact to loosely arranged streams and fascicles of spindled cells with eosinophilic, often wavy cytoplasmic processes; small to occasionally moderate amounts of collagenous to myxoid matrix; and nuclear palisading. Immunohistochemically, all tumors were positive for vimentin and S-100 protein, 44 of 59 were positive for glial fibrillary acidic protein (GFAP), and all were negative for muscle specific actin. The tumors fell into 3 histologic categories: 34 benign tumors with Antoni A areas that were S-100 protein and GFAP positive, 9 benign tumors that lacked Antoni A areas and were S-100 protein positive and GFAP negative, and 16 tumors with features of malignancy. Seventy-five percent of these cases involved the head, neck, or limbs. Recurrent tumors were submitted or tumors were reported to have recurred in 9 cases. Tumor recurrence was reported for all 3 of the histologic subtypes. None was documented as having metastasized.

  3. Spindle cell carcinoma of maxilla: Histomorphological and immunohistochemical analysis of a case

    Directory of Open Access Journals (Sweden)

    Rachna Rath

    2014-01-01

    Full Text Available The intriguing array of spindle cell lesions occurring, especially in the head and neck region, poses a critical diagnostic challenge not only to the histopathologist but also ultimately to the clinicians for planning an appropriate treatment protocol. Overlapping spectrum of clinico-radiographic and microscopic features further compounds this problem. In such situations, the aid of ancillary techniques like immunohistochemistry (IHC is sought to clinch the diagnosis. But is the diagnosis based on IHC most decisive? Probably the answer lies in the Pandora′s Box. This paper analyzed the potential doubts, apprehensions and the reliability that is singularly based on the morphological spindle appearance of an abnormal cell that has deviated from the usual clinical and microscopic presentation and thus posed a diagnostic dilemma warranting more questions than the answers. We review the etiopathogenesis of this entity and its differential diagnosis from few other spindle cell lesions of head and neck with special reference to use of immunohistochemical markers, with a case study.

  4. Primary Acinic Cell Carcinoma of the Breast: A Clinicopathological and Immunohistochemical Study

    Directory of Open Access Journals (Sweden)

    Kiyoshi Shingu

    2013-01-01

    Full Text Available Acinic cell carcinoma of the breast is an extremely rare, malignant neoplasm characterized by widespread acinar cell-like differentiation and clinically low-grade malignancy. Herein, we report a case of acinic cell carcinoma of the breast in a 41-year-old woman. The tumor was poorly demarcated but had a firm consistency. It was removed with lumpectomy, and sentinel lymph node biopsy was performed to check for metastasis. Microscopically, the tumor showed an infiltrative growth pattern with a combination of solid, trabecular, and microglandular areas. Many of the tumor cells had abundant clear vacuolated cytoplasm containing zymogen-typed granules which resemble acinar cells of the salivary glands. The immunohistochemical profile of the tumor was also similar to that of salivary gland acinic cell carcinoma: the tumor cells were positive for amylase, lysozyme, α-1-antichymotrypsin, S-100 protein, and epithelial membrane antigen and negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2. She received postoperative chemoradiation therapy and has been well for 3 years since surgery. As studies on large series are lacking, further studies are needed to elucidate the biological characteristics of acinic cell carcinoma of the breast.

  5. Immunohistochemical expression of basement membrane proteins of verrucous carcinoma of the oral mucosa.

    Science.gov (United States)

    Arduino, Paolo G; Carrozzo, Marco; Pagano, Marco; Broccoletti, Roberto; Scully, Crispian; Gandolfo, Sergio

    2010-06-01

    Squamous cell carcinoma (SCC) of the oral cavity is an extremely invasive tumour of stratified squamous epithelium that spreads throughout degradation of the basement membrane (BM) and extra-cellular matrix. Oral verrucous carcinoma (VC) is a rare low-grade variant of oral SCC that penetrates into the subepithelial connective tissue. It also has a different clinical behaviour from classical oral SCC. We investigated the immunohistochemical expression of laminin, laminin-5, collagen IV and fibronectin in VC, severe epithelial dysplasia (SED) and SCC in order to analyse if the pattern of these molecules expression contributes to the differences in the biological behaviour of these diseases. The staining pattern of laminin was less intensive in SCC compared with SED and VC, and collagen IV expression was increased in VC compared with SED. Discontinuities of laminin, collagen IV and fibronectin were more evident in SED than in VC. This study indicates that VC has a biological behaviour different from SED or SCC, observable by immunohistochemistry in the BM zone.

  6. Cytokeratin expression in gastrointestinal stromal tumor: a clinicopathologic and immunohistochemical study of 687 cases.

    Science.gov (United States)

    Lopes, Lisandro F; Bacchi, Carlos E

    2012-01-01

    Gastrointestinal stromal tumor is the most common clinically significant mesenchymal neoplasm of the gastrointestinal tract. The expression of the intermediate filament cytokeratin in gastrointestinal stromal tumor is not frequently reported in the literature. The aim of this study was to investigate the immunohistochemical expression of several types of cytokeratin in a large number of cases (n=687), including a pan-cytokeratin marker (AE1/AE3 cocktail antibodies), high-molecular weight cytokeratins (34ßE12 antibody), and individual cytokeratins 8 (35ßH11 and CAM5.2 antibodies), 7, 14, and 20. Ki-67 antigen was used for the determination of cell proliferation index, and the correlation between Ki-67 and cytokeratin expression was evaluated. Cytokeratin expression was also correlated with several clinicopathologic parameters. The expression of pan-cytokeratin was observed in 24 (3.5%) cases, with variable intensity. Only 1 of 687 (0.1%) cases showed cytokeratin 14 expression. All 687 cases revealed no expression of high-molecular weight cytokeratins, cytokeratins 7, 8, and 20. No significant statistical association was found between AE1/AE3 immunoreactivity and several clinicopathologic parameters, including sex, tumor location and size, cell morphology, mitotic count, risk of aggressive behavior, and Ki-67 antigen cell proliferation index. However, statistical correlation between AE1/AE3 immunoreactivity and a higher age at diagnosis was detected. These results show that cytokeratin expression is not frequent in gastrointestinal stromal tumor, but caution is necessary to avoid erroneous diagnoses.

  7. Prognostic significance of new immunohistochemical markers in refractory classical Hodgkin lymphoma: a study of 59 cases.

    Directory of Open Access Journals (Sweden)

    Danielle Canioni

    Full Text Available Although most classical Hodgkin lymphoma patients are cured, a significant minority fail after primary therapy and may die as result of their disease. To date, there is no consensus on biological markers that add value to usual parameters (which comprise the International Prognostic Score used at diagnosis to predict outcome. We evaluated 59 patients (18 with primary refractory or early relapse disease and 41 responders for bcl2, Ki67, CD20, TiA1 and c-kit expression by semi-quantitative immunohistochemical study and correlated the results with the response to treatment.The results showed that expression of bcl2 and CD20 in Hodgkin and Reed Sternberg cells, and expression of TiA1 in micro-environmental lymphocytes, and c-kit positive mast cells in microenvironment, were independent prognostic markers. These novel cHL markers could be used in association with clinical parameters to identify newly diagnosed patients with favorable or unfavorable prognosis and to better tailor treatment for different risk groups.

  8. Expression of PPARγ and PTEN in human colorectal cancer: An immunohistochemical study using tissue microarray methodology.

    Science.gov (United States)

    Lin, Mao Song; Huang, Jun Xing; Chen, Wei Chang; Zhang, Bao Feng; Fang, Jing; Zhou, Qiong; Hu, Ying; Gao, Heng Jun

    2011-11-01

    Although aberrations of peroxisome proliferator-activated receptor γ (PPARγ) and phosphatase and tensin homolog (PTEN) expression have been identified in several other cancer types, certain previous studies have revealed that PPARγ is abundant in normal and malignant tissue in the colon. The question of whether aberrant PTEN is involved in the initial stage or is a later event during colorectal carcinogenesis remains controversial. Relatively few studies have focused on the correlation of expression of PPARγ and PTEN in various tissues. In the present study, paraffin-embedded blocks from 139 patients with CRC, 18 adenomatous polyps and 50 paired paracancerous benign mucosas were selected and analysed in 4 tissue microarray (TMA) blocks comprising 104, 72, 130 and 54 cores, respectively. Expression of PPARγ and PTEN was examined using immunohistochemical staining on TMAs. There were no significant differences in the expression of PPARγ (P=0.055) and PTEN (P=0.100) between the colorectal cancers, adenomas and paracancerous mucosas. However, correlations of PPARγ expression with clinical stage (P=0.004) and PTEN expression with histological grade (P=0.006) and distant metastasis (P=0.015) were demonstrated in the CRC specimens. Although the differences in PPARγ and PTEN protein expression in human colorectal cancer may not be considered as early diagnostic markers, our results indicate that CRCs with a low expression or deletion of PTEN may progress towards invasion and even metastasis; thus, PTEN may have potential as a prognostic marker in human CRC.

  9. Lipomas of the oral cavity: clinicopathological and immunohistochemical study of 24 cases and review of the literature.

    Science.gov (United States)

    Naruse, Tomofumi; Yanamoto, Souichi; Yamada, Shin-Ichi; Rokutanda, Satoshi; Kawakita, Akiko; Takahashi, Hidenori; Matsushita, Yuki; Hayashida, Saki; Imayama, Naomi; Morishita, Kota; Yamashita, Kentaro; Kawasaki, Goro; Umeda, Masahiro

    2015-03-01

    Although lipomas are common soft tissue tumors, few cases of lipoma or its variants have been reported in the oral cavity. We here described the clinical, histological, and immunohistochemical features of 24 cases of oral lipoma obtained from medical records at Nagasaki University Hospital between 1977 and 2010, and also retrospectively reviewed 603 cases of oral lipoma reported in the English literatures. The patients examined comprised 11 men and 13 women with a mean age of 59 years, ranging from 31 to 90 years. The main sites involved were the buccal mucosa (n = 9), followed by the tongue (n = 4), lip and retromolar area (n = 3), floor of the mouth (n = 2), and gingiva (n = 1). The mean tumor size was 2.0 cm, ranging from 0.2 to 5 cm. Histological analysis revealed 20 cases of lipoma, 2 cases of fibrolipoma, and one case each of intramuscular lipoma and spindle cell lipoma. Twenty-three cases were treated surgically while one case underwent biopsy and follow-up. Recurrence was not observed in any case. We reviewed the English literatures, and similar results were obtained. In immunohistochemical analysis, PCNA and ki-67 expression indices were higher in intramuscular lipoma cases than in its variants. Especially, it showed that a long time follow-up may be necessary in ki-67 positive cases.

  10. Evaluation and clinical application of a new method for detecting ADAMTS13 activity

    Institute of Scientific and Technical Information of China (English)

    WANG An-you; DONG Ning-zheng; MA Zhen-ni; ZHANG Jing-yu; SU Jian; RUAN Chang-geng

    2010-01-01

    Background A severe deficiency of ADAMTS13 activity contributes to the pathogenesis of thrombotic thrombocytopenic purpura (TTP). Measuring the activity of ADAMTS13 is helpful for the diagnosis of TTP and the prognostic monitor in TTP patients. Most available assays are cumbersome and costly, so not easily adapted to routine laboratories. ADAMTS13 cleaves von Willebrand factor (VWF) within the domain A2., located between domains A1 and A3. Therefore, specific assays for ADAMTS13 activity could be based on the different structures of VWF before and after the cleavage. Using this hypothesis we try to establish a new and simple method to determine ADAMTS13 activity.Methods First, plasma samples were exposed in denaturing condition to allow cleavage of VWF by ADAMTS13. Then, the A