Preoperative serum thyroglobulin levels as a predictor of thyroid carcinoma

Background: Incidence of thyroid nodules varies according to the methods of diagnosis, 4-7% by palpation and 17-67% by high resolution ultrasound. The gold standard of diagnosis for thyroid nodules is fine needle aspiration (FNA); however, fine needle aspiration cytology (FNAC) alone is insufficient to detect cancer because of inadequate cytology (5-15%) and in cases of follicular neoplasm (15-25%) where only surgery is diagnostically conclusive. Therefore, other factors in addition to FNA should be considered to predict malignancy. This study was done to evaluate the association between elevated pre-operative thyroglobulin levels and histopathologically proven thyroid carcinoma.Methods: This retrospective study was conducted in Bowring and Lady Curzon Hospital, from December 2017 to November 2018. All patients above 18 years, undergoing total thyroidectomy, with normal antithyroglobulin levels and with indeterminate thyroid nodules or disease on FNAC were included. Patients proven to have malignancy by FNAC, who underwent hemithyroidectomy and patients with thyroglossal cyst or ectopic thyroid swellings were excluded.Results: A total of 50 patients were included. The Fischer’s exact test shows significant value of 0.037 and also the two-tailed test showed a p value <0.05, hence it is significant to conclude that the mean value of thyroglobulin levels among histopathologically proven malignant thyroid cancers is significantly higher compared to the benign thyroid disease.Conclusions: In addition to thyroid-stimulating hormone, thyroid nodules with elevated thyroglobulin levels were independently associated with the presence of thyroid cancer; therefore, the evaluation of pre-operative thyroglobulin level in patients with indeterminate FNAC might give additional information to predict malignancy.

Histopathological Analysis of Sealant Infiltration in White Spot Enamel Lesions (WSEL) / Análisis Histopatológico de Infiltración de Sellante en Lesiones de Mancha Blanca en Esmalte (LMBE)

ABSTRACT: The use of resin sealants has shown partial infiltration of White-Spot Enamel Lesions in vitro (WSEL). The aim of the present study was to perform a morphological evaluation of natural WSEL when infiltrated using a commercially available sealant (Concise, 3M- ESPE). 20 bicuspids extracted for orthodontic reasons from patients ranging 18 to 30 years old, which had WSEL, were used in this study. The patients agreed to donate their teeth by signing a written consent. Every WSEL was assessed microscopically (Stereo Zeiss Axiscop) and then photographed (ProScope HR microscope). Prior to applying the sealant the lesion was etched using phosphoric acid at 37 % (3M-ESPE, St Paul, MN, USA.) for 30 seconds, washed for 40 seconds and then air-dried. The sealant was marked with rhodamine B (1mg/ml) and was applied according to the manufacturer directions. A specimen of approximately 100 mm was obtained for every WSEL by cutting perpendicularly through the lesion (Isomet 1000, Buehler Co.) and grinding (600 grit). The specimens were evaluated using: clear camp, polarized light, and epifluorescence microscopy. Images were taken of each specimen for every microscopic evaluation using a slide film (Kodak Ektachrome film 400 ASA). The images were digitalized by scanning at 1200 dpi resolution (Epson Filmscan 200) and then saved as JPEG and TIFF files. The sealant infiltration into The WSEL was assessed by means of analysis, processing and digital superimposing using Adobe Photoshop 7.0 and Matrox Inspector 1.07. It was concluded that the sealant infiltrated the whole body zone of the lesion. The depth of penetration of sealants into White Spot Enamel Lesion plays an important role in the control of caries lesion progression.

RESUMEN: El uso de sellantes de resina ha demostrado lograr la infiltración parcial de lesiones de mancha blanca en esmalte in vitro (LMBE). El objetivo del presente estudio fue realizar una evaluación morfológica de la infiltración a LMBE naturales utilizando un sellante disponible comercialmente (Concise, 3M-ESPE). Se utilizaron en este estudio, 30 bicúspides extraídos por razones de ortodoncia en pacientes que tenían entre 18 a 30 años de edad, y presentaban LMBE. Los pacientes aceptaron donar sus dientes firmando un consentimiento informado. Cada LMBE se evaluó microscópicamente (Stereo Zeiss Axiscop) y luego se fotografió (microscopio ProScope HR). Antes de aplicar el sellante, la lesión se grabó usando ácido fosfórico al 37 % (3M-ESPE, St Paul, MN, EE. UU.) durante 20 segundos, luego se lavó durante 40 segundos y finalmente se secó con aire de jeringa triple. El sellante se marcó con rodamina B (1 mg / ml) y se aplicó siguiendo las instrucciones del fabricante. Se obtuvo una muestra de aproximadamente 100 mm para cada LMBE cortando perpendicularmente a través de la lesión (Isomet 1000, Buehler Co.) y trituración (grano 600). Las muestras se evaluaron usando: campo claro, luz polarizada y microscopía de epifluorescencia. Se tomaron imágenes de cada espécimen para la evaluación microscópica usando una película deslizante (Kodak Ektachrome film 400 ASA). Las imágenes se digitalizaron escaneando a una resolución de 1200 ppp (Epson Filmscan 200) y luego se guardaron como archivos JPEG y TIFF. La infiltración del sellante en las LMBE se evaluaron mediante análisis, procesamiento y superposición digital utilizando Adobe Photoshop 7.0 y Matrox Inspector 1.07. Se concluyó que el sellante infiltró toda la zona del cuerpo de la lesión. La capacidad de penetración en profundidad de los sellantes en Lesiones de Mancha Blanca del Esmalte desempeñan un rol importante en el control de la progresión de las lesiones de caries.

Different processing methods change the oral toxicity induced by Sophora alopecuroides seeds and the contents of five main toxic alkaloids from the ethanol extracts determined by a validated UHPLC-MS/MS assay

Abstract This study investigated the influence of different processing methods on the oral toxicity of Sophora alopecuroides L., Fabaceae, seeds in mice and on the contents of five known toxic-effective quinolizidine alkaloids from the ethanol extracts quantified by ultra-performance liquid chromatography coupled to tandem quadrupole mass spectrometry. It provides an evidence to elucidate the possible reasons why vinegar-processing and parching methods significantly decrease the acute oral toxicity induced by S. alopecuroides and why wine-processing method increases it instead (demonstrated by measurement of LD50 and histopathological analysis). The analytical performance for the determination of the five analytes was evaluated by linearity, stability, repeatability, precision and accuracy, and recovery test. The lowest limit of quantification was determined to be 5 ng/ml for each substance and the precision and accuracy at lowest limit of quantification were below 20%. Cytisine, the most toxic alkaloid among the five alkaloids, declined 11.26, 3.98, and 2.73 folds after being vinegar-processed and fried in a ceramic or iron pan, respectively and had a very close correlation with the toxicity of S. alopecuroides seeds (r = 0.8589). Other matrine-type alkaloids with lower toxicity including matrine, sophcarpine, and sophoridine decreased after being wine-processed and fried in a ceramic pan, but increased 4.44, 7.20, and 7.23 folds when being processed by vinegar. Oxymatrine declined in all groups. It, therefore, reveals that vinegar-processing method reduces the oral toxicity of S. alopecuroides mainly due to a sharp decrease of cytisine, thus improves its clinical safety.

Toxicological evaluation of ethanolic extract of Lychnophora trichocarpha, Brazilian arnica

The species of the genus Lychnophora, Asteraceae, are popularly known as "arnica" and are native from Brazilian savana (Cerrado). They are widely used in Brazilian folk medicine as anti-inflammatory, to treat bruise, pain, rheumatism and for insect bites. For evaluation of acute toxicity, the ethanolic extract was given to albino female and male mice. In open-field test, the extract of Lychnophora trichocarpha (Spreng.) Spreng. (0.750 g/kg) induced a significant inhibition of the spontaneous locomotor activity and exploratory behavior of the animals were observed 1 and 4 h after administration. In traction test, the same dose reduced the muscular force 1 h after administration. The exploratory behavior reduced significantly in the group that received 0.50 g/kg, 1 and 4 h after administration of the extract. The animals that received the doses of 0.25, 0.50 and 0.75 g/kg did not show any change of blood biochemical parameters comparing to control group and showed some histopathological changes such as congestion and inflammation of kidney and liver. The dose of 1.5 g/kg caused the most serious signs of toxicity. Histopathological changes observed was hemorrhage in 62.5% and pulmonary congestion in 100% of the animals. Brain and liver congestion was found in 62.5% of the animals.

Estudos comportamentais e das alterações histopatológicas em camundongos pré-tratados com Bellis perennis no modelo de convulsão induzido por pilocarpina / Behavioral studies and histopathological changes in mice pretreated with Bellis perennis in pilocarpine-induced seizures

The aim of this study was to investigate the potential neuroprotective and anticonvulsant effects of ethanolic extract from flowers (EEF) of B. perrenis in adult Swiss mice (2 months old) after seizures induced by pilocarpine. The animals were divided into 8 groups. The first group was treated with vehicle (0.05 percent Tween 80 dissolved in 0.9 percent saline) and the second with pilocarpine (400 mg/kg, P400 group). The third, fourth and fifth group were pretreated with EEF (50, 100 or 150 mg/kg) and 30 min later received P400 (EEF 50, EEF 100 or EEF 150 plus P400 groups), respectively. In turn, the remaining groups were treated with EEF alone (50, 100 or 150 mg/kg EEF 50, EEF 100 or EEF 150 groups), respectively. After treatment, the groups were observed for 24 h and then euthanized and their brains removed for histopathological analysis. All P400 group animals showed seizures that progressed to status epilepticus. Pre-treatment with EEF produced a significant reduction in those indices. P400 and EEF 50 plus P400 groups showed 87.5 percent and 37.5 percent of animals with brain damage in the hippocampus, respectively. In P400 group, the damage rate in striatum was 75 percent. In turn, this region has seen a reduction of 46.99 percent neuronal damage of those of EEF 50 plus P400 group. According to our results we suggest that the EEF may modulate epileptogenesis and promote anticonvulsant and neuroprotective mechanisms in model of seizures induced by pilocarpine.

O objetivo desse estudo foi investigar o potencial efeito neuroprotetor e anticonvulsivante do extrato etanólico das flores de B. perrenis (EEF) em camundongos Swiss adultos (2 meses) após convulsão induzida por pilocarpina. Os animais foram divididos em 8 grupos. O primeiro grupo foi tratado com veículo (Tween 80 0,05 por cento dissolvido em salina 0,9 por cento) e o segundo com pilocarpina (400 mg/kg, grupo P400). Já o terceiro, quarto e quinto grupo foram tratados com EEF (50, 100 ou 150 mg/kg), e 30 min depois receberam P400 (grupos EEF 50, EEF 100 ou EEF 150 plus P400), respectivamente. Por sua vez, os demais grupos foram tratados somente com EEF (50, 100 ou 150 mg/kg; grupos EEF 50, EEF 100 ou EEF 150), respectivamente. Após os tratamentos, os grupos foram observados durante 24 h e em seguida eutanasiados e seus cérebros removidos para as análises histopatológicas. Todos os animais do grupo P400 apresentaram convulsões que progrediram para o estado de mal epiléptico. O pré-tratamento com EEF produziu uma redução significativa nesses índices. Os grupos P400 e EEF 50 plus P400 apresentaram 87,5 por cento e 37,5 por cento de animais com lesão cerebral no hipocampo, respectivamente. No corpo estriado dos animais do grupo P400 houve um comprometimento de 75 por cento. Por sua vez, nessa região foi vista uma redução de 46,99 por cento nesse comprometimento nos animais do grupo EEF 50 plus P400. De acordo com nossos resultados podemos sugerir que o EEF pode modular a epileptogênese e promover ação neuroprotetora e anticonvulsivante no modelo das convulsões induzidas por pilocarpina.

Study about Histopathological Diagnosis of Lung Cancer by X-ray and CT / 医疗卫生装备

Objective To study the co-relation of radiological and histopathological features of lung cancer. Methods X-ray CT and histopathological features of 36 cases of lung cancer were analyzed retrospectively. Results High-density mass with strengthened edge was found to be paralleled with lung atery at lung gate in 6 cases. As a result, bronchial tubes became narrow with mucus in it. Squamous carcinoma tissues of 22 cases were showed growing within bronchial tubes. Local lung emphysema in early stage obstructive pneumonia and 19 cases of lung collapse in mid/late stage(86.4%) were brought out because of narrow cavity of bronchi. Megaly lymph nodes were seen by mediastina window in 12 cases. Peripheral mass with leaf-like edge were found in 8 cases,and the diameter of each was less than 2cm,while irregular deviated cavitative was seen in one case. Conlusion It is suggested that close combination of X-ray CT and histopathological can improve the accurate rate of diagnosis in lung cancer.

Histopathologic Analysis of Helicobacter Pylori Associated Gastritis

Gastric mucosa shows continuous changes in surface epithelium as well as inflammatory reaction by various substances from the outside and their metabolic products. Gastric mucosal lesions are proven to be associated with bacterial infection by the discovery of Heliobacter pylori(H. pylori) and many studies about histopathologic changes of gastric mucosa associated H. pylori infection has been advanced. It is known that H. pylori associated gastritis displays surface foveolar epithelial changes, such as cytoplasmic vacuolation, mucin loss, juxtaluminal cytoplasm erosion, epithelial denudation, and mucosal irregularity. There have been many studies that H. pylori infection is associated with intestinal metaplasia, gastric dysplasia, and carcinoma. Also chronic H. pylori infection with its induction of gastric lymphoid follicle has been implicated as a precursor of gastric lymphoma of the unique B-cell type that arises from mucosa-associated lymphoid tissue(MALT). However, these gastric mucosal changes are also observed in gastritis with other causes. In this study, we aimed to define specific histopathiologic findings associated with H. pylori infection. A total of 463 gastric biopsy specimens were reviewed. They were Helicobacter-associated gastritis and were divided as many (MH), a few (AH), and no (NH), according to the number of H. pylori. 210 (MH), 131 (AH), and 122 (NH) biopsy specimens were included. Lymphocytes, plasma cells in lamina propria, eosinophils and neutrophils in surface epithelium and crypt as well as lamina propria were graded from 0 to 3. Surface epithelial changes including cytoplasmic vacuolation, mucin loss, juxtaluminal erosion, epithelial denudation and mucosal irregrarity were observed in 200 of 210 cases(95%) in MH group, 34 of 131 cases(26%) in AH group, and 6 of 122 cases(5%) in NH group. This result indicates there is significant difference in surface epithelial changes according to the number of H. pylori(p<0.001). Severity of eosinophil, neutrophil, lymphocyte, and plasma cell infiltration is increased in proportion to the number of H. pylori. Especially, neutrophilic infiltration is not identified in 95 of 122 cases(78%) in NH group, whereas MH group shows severe infitration (grade 3) in 127 of 210 cases(61%), and no (grade 0) in 11 of 210 cases(5%). This data well explains that the severity of neutrophil infiltration is associated with, the degree of H. pylori infection in chronic active gastritis, with statistical significance. The prevalence of lymphoid follicle formation was 17 of 120 cases(14%) in NH group, 24 of 131 cases(18%) in AH group, and 52 of 210 cases(25%) in MH group. This shows that lymphoid follicle formation correlates with the number of H. pylori, but without statistical significance. The prevalence of intestinal metaplasia in NH, AH, and MH was 43 of 122 cases(35%), 46 of 131 cases(35%), and 69 of 210 cases(33%), showing no association between intestinal metaplasia and H. pylori. In summary, H. pylori associated gastritis dispays characteristic histopathological changes in gastric mucosa, in which surface epithelial changes and various inflammatory infiltrates are increased in proportion to the number of H. pylori. Especially vacuolization of surface foveolar epithelium, cryptitis, and crypt abscess are specific findings of H. pylori associated gastritis.

Histopathological Differences between Silicone Granuloma and Paraffinoma

During the past two decades, silicone (polydimethylsiloxane) has become one of the most extensively applied biomaterials. Although pure silicone is relatively inert and usually causes only minimal tissue reactions, it has been reported to evoke a definite foreign body reaction. We studied five cases of silicone-induced granulomas in various sites; two in the breast, one in the breast and axillary lymph nodes, one in the subcutis of the abdomen, back and extremities and one in the eyeball, to illustrate the salient histopathologic features of reactions to silicone with particular emphasis to its differences from paraffin granuloma. For this, 17 paraffinomas were also studied. Tissue reaction to silicone liquid and gel was characterized by numerous round to oval empty cystic vacuoles, mild to moderate fat necrosis, foreign body reaction, a variable degree of mononuclear inflammatory cell infiltration and mild focal fibrosis. The cystic spaces were relatively uniform and showed a snow-man like appearance. In contrast to the silicone granulomas, the paraffinomas, also refered to as sclerosing lipogranulomas showed diffuse sclerosis and frequent calcification around the cystic vacuoles. The cystic spaces in paraffinomas were swiss cheese-like configuration, and the content of the cystic spaces was dirty and frequently calcified. However, there were certain similarities between these two types of granulomas particularly in the early phases of the reaction, therefore, the history of silicone injection or implant, is sometimes critical to the diagnosis of silicone granuloma. Despite great technologic advances in the manufacturing of prostheses and medical equipment, droplets and/or particles of silicone still escape into the body tissues in a variety of ways; therefores, the pathologist should always wonder whether the histologic reaction observed is due to silicone or to some other foreign material including paraffin.

A Histopathological Analysis on 73 Cases of Enucleated Eyeballs

A total of 73 enucleated eyeballs is reviewed and analyzed clinicopthologically. These eyeballs were selected among the enucleated spceimens that had been removed at the Yeungnam University Hospital during a period of 10 years beginning from 1983 to 1992. Following results were obtained. 1) When the eyeballs were classified according to me direct cause of removal, the neoplasm was the most common single cause accounting for 26 cases(35.6%) out of 73 cases, followed by phthisis bulbi l6 cases(21.9%), trauma 10 cases(13.7%), glaucoma 8 cases(10.9%), inflammation 5 cases(6.8%), staphyloma 4 cases(5.5%), retinal detachment 1 cases(1.4%), Coat's disease 1 cases(1.4%), corneal disease 1 cases(1.4%) and choroidal hemorrhage 1 cases(1.4%). 2) 39 cases(53.4%) were male and 34(46.6%) were female. 23 cases(31.5%) were below 10 years of age, which was the highest rate. 3) The neoplastic lesion included retinoblastoma 20 cases(76.9%) in 26 neoplasms, malignant melanoma 4 cases(15.3%), hemagioblastoma of optic disc 1 cases(3.9%), adenocarcinoma of Meibomian gland 1 cases(3.9%). 4) Retinoblastoma was the commonest intraocular tumor accounting for 20 out of 26 cases, In growth pattern, 80.0% of the tumor grew endophtytically. True rosette were seen 60% of the retinoblastoma.