Pathologic evaluation of appendectomy specimens in children: is routine histopatholgic examination indicated?

Acute appendicitis is the most common cause of abdominal surgery in children. Similarity between signs and symptoms of appendicitis and other common pediatric illnesses, atypical manifestations of appendicitis in young children, and children's inability to give precise explanation for their symptoms contribute to considerable delay in proper diagnosis and increased rate of perforation. Current study reports the surgical and pathological findings of appendectomies in the largest Children's Hospital in Iran. It also evaluates whether common protocol for pathologic evaluation following appendectomy is beneficial. Pathologic reports of 947 appendectomies, performed with the presumptive diagnosis of acute appendicitis, were gathered. Correlation between surgical and pathologic findings was assessed. Demographic characteristics of patients between surgical and pathological subgroups were also compared. The mean age of participants was 6.9 +/- 3.5 years. Eighty seven [25.5%] children had abnormal pathological findings and normal surgical report. None of miscellaneous findings including appendicular carcinoid tumor 3 [0.3%], oxyuriasis 2 [0.2%], and mycobacterial infection 4 [0.5%] were recognizable during the surgery. Of all pathologically confirmed cases with perforated appendicitis, 9.7% were not detected during the surgery. In current study, acute appendicitis was the most common pathological diagnosis, however, high normal appendectomy rate along with noticeable proportion of surgically missed perforated appendicitis and unusual histopathologies strongly supported routine histological examination

Plasma myeloperoxidase activity and apolipoprotein A-1 expression in chronic hepatitis B patients

Hepatitis B virus initiates a complicated cascade process leading to chronic hepatitis B, cirrhosis, and hepatocellular carcinoma. In inflammatory situations, myeloperoxidase is released in plasma and binds to apolipoprotein A-1 in high-density lipoproteins. This study aims to evaluate the level of plasma myeloperoxidase as well as the pattern of plasma proteins in patients with chronic hepatitis B. Included in this study were 30 male subjects: 19 chronic hepatitis B patients, 6 HBV-related cirrhotic patients, and 5 healthy controls. Plasma myeloperoxidase was measured using enzyme-linked immunosorbent assay. Proteomic analysis of plasma proteins was performed by two-dimensional gel electrophoresis [2-DE] and mass spectrometry. One way ANOVAwas used for data analysis. Mean plasma myeloperoxidase levels were higher in patients with liver cirrhosis [65.5 +/- 12.5; P=0.007] and chronic hepatitis B [53.7 +/- 10.6; P=0.18] when compared with healthy subjects [45 +/- 7.6]. Moreover, a positive correlation was found between plasma myeloperoxidase levels and hepatic fibrosis stage [r=0.53, P=0.002; r=0.63, P=0.000]. Proteomic analysis showed an altered plasma protein pattern in progressive hepatitis B and down-regulation of the major apolipoprotein A-1 along with the appearance of a variety of spots noted to be apolipoprotein A-1isoforms with different molecular masses. In this study, progressive liver injury due to HBV infection correlated with higher plasma myeloperoxidase and an altered plasma apolipoprotein A-1 pattern

[Detection and analysis of BTNL2 gene mutations in patients diagnosed with skin sarcoidosis]

Sarcoidosis is a non-caseous granulomatous disease that can involve several organs such as lung, kidney, liver, heart and skin. In systemic sarcoidosis, skin lesions occur in 20-35% of patients. Cutaneous sarcoidosis with no systemic involvement was found in about 25% of patients. Mutation within Butyrophilin-like 2 [BTNL2] gene, rs2076530 was reported in systemic sarcoidosis. However, there is no report of evaluation of mutation in BTNL2 gene with the diagnosis of skin sarcoidosis. In this study ten patients with skin sarcoidosis were evaluated for the mutation of rs2076530 allele in exon 5 of BTNL2 gene. This assessment was performed by the single strand conformation polymerase chain reaction [SSCP-PCR] in which the existing mutations with positive shift were deteced using directl sequence analysis. Data from sequence analysis were evaluated and blusted by means of Choroms computer software. Our results showed the BTNL2 G->A transition of rs2076530 in seven patients and three patients were normal. This pilot study concludes the presence of a mutation at rs2076530 in exon 5 of BTNL2 gene in patients with skin sarcoidosis. Larger studies are needed to evaluate the role of this finding