Utility of Wnt family member 9b (Wnt9b) immunohistochemistry in the cytologic diagnosis of metastatic breast carcinoma.

Wnt family member 9b (Wnt9b) has been demonstrated as a valuable marker for breast cancer diagnosis in surgical pathology. In this study, we examined the utility of Wnt9b in diagnosing metastatic breast carcinoma in cytology samples. Cell blocks from fine needle aspirations (FNA) and fluid specimens of 96 metastatic breast carcinomas and 123 primary and metastatic non-breast neoplasms from various organ systems were evaluated by Wnt9b and GATA3 immunohistochemistry (IHC). Wnt9b and GATA3 were positive in 81.3% and 92.7% of metastatic breast carcinomas, respectively. Conversely, 93.5% and 90.0% of non-breast, non-urothelial carcinomas were negative for Wnt9b and GATA3, respectively. Wnt9b expression was positive in rare gastrointestinal, gynecological, lung, pancreas, and salivary gland tumors. All twenty-eight urothelial carcinomas were negative for Wnt9b, while twenty-six (92.9%) were positive for GATA3. Wnt9b was slightly less sensitive but more specific than GATA3 in diagnosing metastatic breast cancer in cytology samples. Particularly, Wnt9b shows higher specificity in differentiating breast and urothelial primaries. The combined use of Wnt9b and GATA3 may increase diagnostic accuracy.

A simple and portable vacuum assisted headspace solid phase microextraction device coupled to gas chromatography based on covalent organic framework/metal organic framework hybrid for simultaneous analysis of volatile and semi-volatile compounds in soil.

Various microextraction methods have demonstrated a positive effect when assisted by vacuum. However, working with such systems is often laborious, they often require expensive and non-portable vacuum pumps, and may even suck off some sample vapor or solid particles during the evacuation process. To address these issues, a simple, and affordable vacuum-assisted headspace solid-phase microextraction (HS-SPME) device was developed in this study. The device, named In Syringe Vacuum-assisted HS-SPME (ISV-HS-SPME), utilizes an adjustable 40 mL glass syringe as a vacuum provider and sampling vessel. A new fiber coating, made from a hybrid of covalent triazine-based frameworks and metal-organic frameworks (COF/MOF), was prepared and characterized by Fourier transform infrared spectrometry, field emission scanning electron microscopy, energy dispersive X-ray, X-ray diffraction, thermogravimetric analysis, and Brunauer-Emmett-Teller techniques for use in the ISV-HS-SPME. By optimizing parameters such as extraction temperature, extraction time, desorption temperature, desorption time, and, humidity using a simplex method, the ISV system was found to increase the extraction efficiency of polycyclic aromatic hydrocarbons (PAHs) and benzene, toluene, ethylbenzene, and xylenes (BTEX) in solid samples by up to 175%. The determinations were followed by GC-FID measurements. Compared to three commercially available fibers, the ISV-HS-SPME device with the COF/MOF (2DTP/MIL-101-Cr) fiber exhibited significantly higher peak areas for PAHs and BTEX. The linear dynamic ranges for BTEX and PAHs were 7.1-9000 ng g-1 and 0.23-9000 ng g-1, respectively, with limits of detection ranging from 2.1-5 ng g-1 for BTEX and 0.07-1.6 ng g-1 for PAHs. The relative standard deviation of the method was 2.6-7.8% for BTEX and 1.6-6.7% for PAHs. The ISV-HS-SPME was successfully used to simultaneously determine PAHs and BTEX in polluted soil samples with recoveries ranging from 80.4 to 108%.

Graphene-MoS2 polyfunctional hybrid hydrogels for the healing of transected Achilles tendon.

Healing of injured tendon is a major clinical challenge in orthopaedic medicine, due to the poor regenerative potential of this tissue. Two-dimensional nanomaterials, as versatile scaffolds, have shown a great potential to support, trigger and accelerate the tendon regeneration. However, weak mechanical properties, poor functionality and low biocompatibility of these scaffolds as well as post-surgery infections are main drawbacks that limit their development in the higher clinical phases. In this work, a series of hydrogels consisting polyglycerol functionalized reduced graphene oxide (PG), polyglycerol-functionalized molybdenum disulfide (PMoS2) and PG/PMoS2 hybrid within the gelatin matrix are formulated in new scaffolds and their ability for the healing of injured Achilles tendon, due to their high mechanical properties, low toxicity, cell proliferation enhancement, and antibacterial activities is investigated. While scaffolds containing PG and PMoS2 showed a moderate tendon regeneration and anti-inflammatory effect, respectively, their hybridization into PG/PMoS2 demonstrated a synergistic healing efficiency. Along the same line, an accelerated return of tendon function with low peritendinous adhesion and low cross-sectional area in animal group treated with scaffold containing PG/PMoS2 was observed. Taking advantage of the high biocompatibility, high strength, straightforward construction and fast tendon regeneration, PG/PMoS2 can be used as a new scaffold for the future tissue engineering.

Utility of secretagogin as a marker for the diagnosis of lung neuroendocrine carcinoma.

Small-cell lung cancers (SCLC) and large-cell neuroendocrine carcinomas (LCNEC) are two types of high-grade pulmonary neuroendocrine carcinomas (NECs). Diagnostic neuroendocrine markers commonly include synaptophysin, chromogranin A, CD56, and insulinoma-associated protein 1 (INSM1). In this study, the utility of secretagogin (SCGN) was examined in the context of pulmonary NEC diagnosis. The study included 71 pulmonary NEC cases (18 SCLCs, 13 combined-SCLCs, 23 LCNECs, and 17 combined-LCNECs). Immunohistochemical stains of SCGN, synaptophysin, chromogranin A, CD56, and INSM1 were performed on whole tumor sections. The stains were evaluated based on combined staining intensity and the proportion of positive tumor cells. At least mild staining intensity in at least 1% of the cells was considered positive. Bioinformatic studies showed specific SCGN expression in neuroendocrine cells and NECs. SCGN showed diffuse nuclear and cytoplasmic staining in NECs with intra-tumoral heterogeneity. The non-neuroendocrine components were negative. The sensitivity of SCGN was no better than the other established neuroendocrine markers based on all NECs combined or LCNECs/c-LCNECs only. However, the sensitivity of SCGN (71%) was higher than chromogranin A (68%) for SCLCs/c-SCLCs only. The average proportion of SCGN positive tumor cells was 8% higher than chromogranin A (22% versus 14%, P = 0.0332) in all NECs and 18% higher for SCLC and c-SCLC cases only (32% versus 13%, P = 0.0054). The above data showed that SCGN could be used as a supplemental neuroendocrine marker to diagnose SCLC.

Computer-Based Tools Unmask Critical Mineral Nutrient Interactions in Hoagland Solution for Healthy Kiwiberry Plant Acclimatization.

The aim of this study was to better understand the response of ex vitro acclimatized plants grown to a set of mineral nutrient combinations based on Hoagland solution. To reach that, two computer-based tools were used: the design of experiments (DOE) and a hybrid artificial intelligence technology that combines artificial neural networks with fuzzy logic. DOE was employed to create a five-dimensional IV-design space by categorizing all macroelements and one microelement (copper) of Hoagland mineral solution, reducing the experimental design space from 243 (35) to 19 treatments. Typical growth parameters included hardening efficiency (Hard), newly formed shoot length (SL), total leaf number (TLN), leaf chlorophyll content (LCC), and leaf area (LA). Moreover, three physiological disorders, namely, leaf necrosis (LN), leaf spot (LS), and curled leaf (CL), were evaluated for each treatment (mineral formulation). All the growth parameters plus LN were successfully modeled using neuro-fuzzy logic with a high train set R 2 between experimental and predicted values (72.67 < R 2 < 98.79). The model deciphered new insights using different sets of "IF-THEN" rules, pinpointing the positive role of Mg2+ and Ca2+ to improve Hard, SL, TLN, and LA and alleviate LN but with opposite influences on LCC. On the contrary, TLN and LCC were negatively affected by the addition of NO3 - into the media, while NH4 + in complex interaction with Cu2+ or Mg2+ positively enhanced SL, TLN, LCC, and LA. In our opinion, the approach and results achieved in this work are extremely fruitful to understand the effect of Hoagland mineral nutrients on the healthy growth of ex vitro acclimatized plants, through identifying key factors, which favor growth and limit physiological abnormalities.

Sporadic uterine Lymphangioleiomyomatosis (LAM): Report of a unique case arising in the lower uterine segment with short review.

•Extrapulmonary lymphangioleiomyomatosis is rare and can be associated with tuberous sclerosis.•Recognition of lymphangioleiomyomatosis is important for early disease screening and genetic testing.•Lymphangioleiomyomatosis in lower uterine segment is very rare and can be overlooked.

Differentiating Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features from Classic Papillary Thyroid Carcinoma: Analysis of Cytomorphologic Descriptions Using a Novel Machine-Learning Approach.

BACKGROUND: Recent studies show various cytomorphologic features that can assist in the differentiation of classic papillary thyroid carcinoma (cPTC) from noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Differentiating these two entities changes the clinical management significantly. We evaluated the performance of support vector machine (SVM), a machine learning algorithm, in differentiating cases of NIFTP and encapsulated follicular variant of papillary thyroid carcinoma with no capsular or lymphovascular invasion (EFVPTC) from cases of cPTC with the use of microscopic descriptions. SVM is a supervised learning algorithm used in classification problems. It assigns the input data to one of two categories by building a model based on a set of training examples (learning) and then using that learned model to classify new examples. METHODS: Surgical pathology cases with the diagnosis of cPTC, NIFTP, and EFVPTC, were obtained from the laboratory information system. Only cases with existing fine-needle aspiration matching the tumor and available microscopic description were included. NIFTP cases with ipsilateral micro-PTC were excluded. The final cohort consisted of 59 cases (29 cPTCs and 30 NIFTP/EFVPTCs). RESULTS: SVM successfully differentiated cPTC from NIFTP/EFVPTC 76.05 ± 0.96% of times (above chance, P < 0.05) with the sensitivity of 72.6% and specificity of 81.6% in detecting cPTC. CONCLUSIONS: This machine learning algorithm was successful in distinguishing NIFTP/EFVPTC from cPTC. Our results are compatible with the prior studies, which show cytologic features are helpful in differentiating these two entities. Furthermore, this study shows the power and potential of this approach for clinical use and in developing data-driven scoring systems, which can guide cytopathology and surgical pathology diagnosis.

Knowledge, attitude and practices of farmers about pesticide use, risks, and wastes; a cross-sectional study (Kermanshah, Iran).

This study was aimed to investigate the knowledge, attitude, and behavior of farmers about the pesticide use and wastes, and to determine the factors affecting the use of pesticides and their health effects, in agricultural lands located in Kermanshah province, western Iran. Three hundred eleven (311) farmers were included in this study, and filled a structured questionnaire containing questions about their basic information, their knowledge and attitude regarding pesticides, and their practices for pesticide disposal. In addition, the type and amount of pesticide consumption, and the health symptoms during the last year were recorded. Prevalence ratios and linear regression were used to evaluate the association between the different factors, and health symptoms and the amount of pesticide use, respectively. The majority of respondents had not been trained formally for the use of pesticides before. Approximately 10%, 45%, and 17% of pesticides contained highly hazardous, moderately hazardous, and slightly hazardous compounds, respectively. The farmers mainly had incorrect knowledge about pesticides and their risks, and used incorrect and high-risk methods for handling and application of pesticides and relevant wastes. Health symptoms were more associated with age ≥ 65, having no education, having income < 482 USD, not trained for pesticide use, and applying highly hazardous pesticides. In addition, the factors contributing to the amount of pesticide use included age, education level, and pesticide training. In order to reduce the amount of pesticide released to the environment, comprehensive training programs and implementing a waste management system could be effective.

Data for interventional role of training in changing the knowledge and attitudes of urban mothers towards food hygiene (A case study of Ravansar Township, Kermanshah, Iran).

Food hygiene is a key factor at the time of production and distribution of food. Therefore, the present study aimed to assess the interventional role of education in changing the knowledge and attitudes of urbane mothers towards food hygiene in Ravansar Township, Kermanshah, Iran. To this end, 200 mothers residing in Ravansar Township were selected using simple random sampling. First, the subjects' knowledge and attitudes towards food hygiene were evaluated in a pre-test, and then after holding some educational sessions, the two variables were assessed again in a post-test using a researcher-made questionnaire with 72 questions. The reliability and validity of the questionnaire were evaluated using Cronbach's alpha and content validity, respectively. After completing the questionnaires, the results were analyzed using the SPSS Statistical Software Version 21.0, and all tests were at the significance level of α = 0.05. The results of the present study demonstrated that education did not promote the knowledge of married subjects, those whose use of media was average or high, and the ones aged above 20 (P > 0.05). However, the results showed that education had significant effects on other factors (P < 0.05). In addition, it was revealed that the effects of education on promoting the attitudes of individuals aged above 60, those holding academic education and married subjects were not significant (P > 0.05), Nevertheless, the results revealed that education had significant effects on other factors (P < 0.05). Hence, it can be concluded that education plays a major role in changing the knowledge and attitudes of urban mothers towards food hygiene.

A Needle Trap Device Packed with Nanoporous Silica Sorbents for Separation and Gas Chromatographic Determination of Polycyclic Aromatic Hydrocarbons in Contaminated Soils.

SBA-15 and MCM-41 nanoporous silica sorbents were synthesized and functionalized by amine groups and used, for the first time, for packing a needle trap device (NTD). The characteristics of the synthesized SBA-15 and MCM-41 sorbents were investigated by X-ray diffraction, scanning electron microscopy and Fourier transfer infrared spectroscopy. The NTD coupling to gas chromatography with a flame ionization detector (GC-FID) was carried out to extract and determine polycyclic aromatic hydrocarbons (PAHs) in contaminated soil samples. The performances of the sorbents for the extraction of PAHs were compared under identical conditions and the NH2-SBA-15 sorbent showed superior results. Extraction temperature, extraction time, recycling gas flow rate, sample moisture, desorption time and desorption temperature were evaluated and optimized for the system. Under the optimum conditions, detection limits of 0.0004-0.0035 µg g-1, quantitation limits of 0.001-0.01 µg g-1 and relative standard deviations of 7.4-14.9% were obtained for the PAHs. The results showed the more effectiveness of this sorbent for the extraction of the PAHs compared to that of a commercial sorbent. The method was successfully applied for the extraction and determination of PAHs in polluted soil samples collected from gas stations, with recoveries ranging from 64 to 112%.

Fine-needle aspiration biopsy of prostate synovial sarcoma: A case report and review of the literature.

We describe a case of synovial sarcoma originating from prostate gland. The diagnosis was confirmed by fluorescent in situ hybridization analysis (FISH) for SYT rearrangement on the cell block. Synovial sarcoma is a high grade soft tissue malignancy with exceedingly rare involvement of genitourinary tract. However this entity should be considered in the differential diagnosis when dealing with aspiration biopsies of particularly deep seated lesions with spindle cell or small round blue cell cytomorphology. Diagn. Cytopathol. 2017;45:168-172. © 2016 Wiley Periodicals, Inc.

Invasive breast carcinoma cells from patients exhibit MenaINV- and macrophage-dependent transendothelial migration.

Metastasis is a complex, multistep process of cancer progression that has few treatment options. A critical event is the invasion of cancer cells into blood vessels (intravasation), through which cancer cells disseminate to distant organs. Breast cancer cells with increased abundance of Mena [an epidermal growth factor (EGF)-responsive cell migration protein] are present with macrophages at sites of intravasation, called TMEM sites (for tumor microenvironment of metastasis), in patient tumor samples. Furthermore, the density of these intravasation sites correlates with metastatic risk in patients. We found that intravasation of breast cancer cells may be prevented by blocking the signaling between cancer cells and macrophages. We obtained invasive breast ductal carcinoma cells of various subtypes by fine-needle aspiration (FNA) biopsies from patients and found that, in an in vitro transendothelial migration assay, cells that migrated through a layer of human endothelial cells were enriched for the transcript encoding Mena(INV), an invasive isoform of Mena. This enhanced transendothelial migration required macrophages and occurred with all of the breast cancer subtypes. Using mouse macrophages and the human cancer cells from the FNAs, we identified paracrine and autocrine activation of colony-stimulating factor-1 receptor (CSF-1R). The paracrine or autocrine nature of the signal depended on the breast cancer cell subtype. Knocking down Mena(INV) or adding an antibody that blocks CSF-1R function prevented transendothelial migration. Our findings indicate that Mena(INV) and TMEM frequency are correlated prognostic markers and CSF-1 and Mena(INV) may be therapeutic targets to prevent metastasis of multiple breast cancer subtypes.

Abnormal high-frequency burst firing of cerebellar neurons in rapid-onset dystonia-parkinsonism.

Loss-of-function mutations in the α3 isoform of the Na(+)/K(+) ATPase (sodium pump) are responsible for rapid-onset dystonia parkinsonism (DYT12). Recently, a pharmacological model of DYT12 was generated implicating both the cerebellum and basal ganglia in the disorder. Notably, partially blocking sodium pumps in the cerebellum was necessary and sufficient for induction of dystonia. Thus, a key question that remains is how partially blocking sodium pumps in the cerebellum induces dystonia. In vivo recordings from dystonic mice revealed abnormal high-frequency bursting activity in neurons of the deep cerebellar nuclei (DCN), which comprise the bulk of cerebellar output. In the same mice, Purkinje cells, which provide strong inhibitory drive to DCN cells, also fired in a similarly erratic manner. In vitro studies demonstrated that Purkinje cells are highly sensitive to sodium pump dysfunction that alters the intrinsic pacemaking of these neurons, resulting in erratic burst firing similar to that identified in vivo. This abnormal firing abates when sodium pump function is restored and dystonia caused by partial block of sodium pumps can be similarly alleviated. These findings suggest that persistent high-frequency burst firing of cerebellar neurons caused by sodium pump dysfunction underlies dystonia in this model of DYT12.

A team-based approach to autopsy education: integrating anatomic and clinical pathology at the rotation level.

CONTEXT: Pathology residency training programs should aim to teach residents to think beyond the compartmentalized data of specific rotations and synthesize data in order to understand the whole clinical picture when interacting with clinicians. OBJECTIVE: To test a collaborative autopsy procedure at Montefiore Medical Center (Bronx, New York), linking residents and attending physicians from anatomic and clinical pathology in the autopsy process from the initial chart review to the final report. Residents consult with clinical pathology colleagues regarding key clinical laboratory findings during the autopsy. This new procedure serves multiple functions: creating a team-based, mutually beneficial educational experience; actively teaching consultative skills; and facilitating more in-depth analysis of the clinical laboratory findings in autopsies. DESIGN: An initial trial of the team-based autopsy system was done from November 2010 to December 2012. Residents were then surveyed via questionnaire to evaluate the frequency and perceived usefulness of clinical pathology autopsy consultations. RESULTS: Senior residents were the most frequent users of clinical pathology autopsy consultation. The most frequently consulted services were microbiology and chemistry. Eighty-nine percent of the residents found the clinical pathology consultation to be useful in arriving at a final diagnosis and clinicopathologic correlation. CONCLUSION: The team-based autopsy is a novel approach to integration of anatomic and clinical pathology curricula at the rotation level. Residents using this approach develop a more holistic approach to pathology, better preparing them for meaningful consultative interaction with clinicians. This paradigm shift in training positions us to better serve in our increasing role as arbiters of outcomes measures in accountable care organizations.

Estrogen, progesterone, and HER-2 receptor immunostaining in cytology: the effect of varied fixation on human breast cancer cells.

The ASCO/CAP Expert Panel recommends that all invasive breast carcinomas and breast cancer recurrences be tested for ER, PR and HER-2 expression. The guidelines for testing of surgical specimens by immunohistochemistry (IHC) are well defined, whereas they are lacking for cytological samples. We evaluated various fixation protocols for optimal receptor testing by immunohistochemistry and immunocytochemistry (ICC) of human breast cancer cell lines MCF-7 (ER/PR positive) and SKBR-3 (overexpressing HER-2). The cells were fixed in 10% neutral buffered formalin or Saccomanno Fixative (SF) for various time points, and either embedded in paraffin as cell blocks or prepared as cytospins. ER and PR slides were assigned a proportion score (PS; 0-5), an intensity score (IS; 0-3) and a total score (TS = PS + IS). Standard DAKO scoring system ranging from 0 to 3+ was used for the evaluation of HER-2 staining. Human breast cancer cells stained successfully for ER, PR and HER-2 when fixed in formalin and prepared as cell blocks. The optimal fixation time for formalin-fixed cells ranged from 2 to 96 hours. Cells fixed in SF from 2 to 96 hours also stained well for ER and PR. However, SF produced variable results for HER-2 staining; particularly, SF fixation beyond 24 hours caused false negative results. The interpretation of HER-2 staining on cytospins was not feasible irrespective of the fixative and fixation time. In summary, formalin fixation from 2 to 96 hours and preparation of cells as cell blocks produces optimal results for ER, PR, and HER-2 testing in human breast cancer cells.

Lymphocytic host response to oral squamous cell carcinoma: an adaptive T-cell response at the tumor interface.

Lymphocytic host response (LHR) in the Risk Model is histologically quantified as the density of lymphocytes at the tumor interface (Brandwein-Gensler in Am J Surg Pathol, 34:676-688, 1; in, Am J Surg Pathol 29:167-178, 2). It is classified as strong, intermediate or weak, and is inversely associated with the risk of decreased time to disease progression. In this study, we test the hypothesis that strong LHR corresponds to a greater degree of adaptive cytotoxic T cell response as compared to moderate LHR. We studied resection specimens of primary oral squamous carcinoma classified as having either strong (n = 16), intermediate (n = 20) or weak (n = 4) LHR. CD20+, CD4+, & CD8+ cells were detected by immunohistochemistry and quantified at 40× with a grid; counting the 10 fields with the most lymphocytes at the tumor interface and within tumors. Mean counts/tumor were analyzed by the 2-sided T-test. Statistically significant differences were observed for interface CD8 cells with respect to strong versus moderate LHR, strong versus weak LHR, and moderate versus weak LHR, and tumor infiltrating CD8 cells with respect to strong versus weak LHR. Statistically significant differences were also observed for interface CD4 cells with respect to strong versus weak LHR, and moderate versus weak LHR. Statistically significant differences in interface B cell counts were seen with respect to strong versus weak LHR, and moderate versus weak LHR. Decreased CD8+ T cells were significantly associated with higher stage at presentation (P = 0.005); a direct, but nonsignificant correlation was seen between decreased CD8+ T cells and decreased survival time. Immune response at the tumor interface correlates with an adaptive T cell response; the degree of cytotoxic CD8+ cells infiltrate can distinguish between strong and intermediate LHR at the interface of oral carcinomas.