Comparative analysis of four nutritional scores in predicting adverse outcomes in biopsy-confirmed diabetic kidney Disease.

Malnutrition is associated with adverse outcomes in patients with diabetic kidney disease (DKD). However, it is uncertain which nutritional assessment tools are most effective in predicting the adverse outcomes of DKD. This retrospective study was conducted at a single center and included 367 patients diagnosed with DKD based on biopsy results between August 2009 and December 2018. Four nutritional assessment indices, namely the Prognostic Nutritional Index (PNI), Geriatric Nutritional Risk Index (GNRI), Triglycerides (TG) × Total Cholesterol (TC) × Body Weight (BW) Index (TCBI), and Controlling Nutritional Status (CONUT) score, were selected and calculated. We aimed to assess the association between these nutritional scores and adverse outcomes, including progression to end-stage kidney disease (ESKD), cardiovascular diseases events (CVD), and all-cause mortality. Univariate and multivariate Cox regression analyses, Kaplan-Meier analysis, along with Restricted cubic spline analysis were used to examine the relationship between nutritional scores and adverse outcomes. Furthermore, the area under the curve (AUC) was calculated using time-dependent receiver operating characteristics to determine the predictive value of the four nutritional scores alone and some combinations. Lastly, ordered logistic regression analysis was conducted to explore the correlation between the four nutritional scores and different renal histologic changes. The incidence of ESKD, CVD, and all-cause mortality was significantly higher in patients with DKD who had a lower PNI, lower GNRI, and higher CONUT score. Additionally, The TCBI performed the worst in terms of grading and risk assessment. The PNI offer the highest predictive value for adverse outcomes and a stronger correlation with renal histologic changes compared to other nutritional scores. Patients diagnosed with DKD who have a worse nutritional status are more likely to experience higher rates of adverse outcomes. The PNI might offer more valuable predictive values and a stronger correlation with different renal histologic changes compared to other nutritional scores.

Effect of Esophagogastroduodenoscopy Volume and Gastric/Esophageal Pathology on the Rate of Lymphocytic Duodenosis Reporting in Children and Adolescents.

Background It is not clear if the increase in the number of esophagogastroduodenoscopies (EGDs) performed has any significant effect on the rate of lymphocytic duodenosis (LD) reporting in children and adolescents and whether it correlates with abnormal gastric and/or esophageal pathology." Methods We performed a single-center retrospective study using the Mayo Clinic electronic health record and pathology database. We reviewed all EGD procedures performed in children and adolescents (<18 years) between January 1, 2000, and December 31, 2018, and identified two groups, the LD group and matched age and sex control group (normal duodenal biopsies). We evaluated the correlation of LD rate with the yearly number of EGDs performed and the presence of abnormal gastric and/or esophageal pathology. Results Of 11,870 EGDs performed, we identified 338 (3%) individuals with LD and 390 (3%) randomly selected controls, with a mean (SD) age of 9.6 (5.3) and 11.7 (5.0) years, respectively. Based on logistic regression analysis, abnormal gastric histology was associated with the presence of LD when compared with controls (odds ratio, 2.85; 95% CI, 2.05-3.97; P < 0.001). The rate of LD-positive biopsies per year was highly correlated with the number of EGDs performed (ρ = 0.931; 95% CI, 0.826-0.974; P < 0.001). Conclusion The rate of LD reporting is correlated with the number of EGDs performed and is more likely seen in children and adolescents with abnormal gastric histology.

Effect of green synthesized ZnO nanoparticles using Paspalum scrobiculatum grains extract in biological applications.

In this report, ZnO nanoparticles were biosynthesized using Paspalum scrobiculatum grains extract for the first time. GC-MS analysis explicated that diethyl phthalate was the major phytocompound with 94.09% in aqueous extract. ZnO nanoparticles formation was confirmed by various physicochemical analyses. HR-TEM images showed the hexagonal, rectangular shaped nanoparticles in 15-30 nm size. The antioxidant, anti-inflammatory, and anti-diabetic analyses showed the effective bioactivity of ZnO nanoparticles in 80 µg/ml concentration with 95.36%, 94.08%, and 91.96%, respectively. The morphological and tissue changes witnessed in larvicidal and insecticidal activities against Culex tritaeniorhynchus and Tribolium castaneum revealed the efficient nature of ZnO nanoparticles in 100 ppm at 48 h and 100 µg/kg at 72 h, respectively. The morphological changes in antibacterial activity demonstrated the bactericidal nature of ZnO nanoparticles against Salmonella typhi and Staphylococcus aureus in 150 µg/ml concentration. The morphological observations in anticancer activity against HepG2 liver cancer cells showed the potent drug features of ZnO nanoparticles in 100 µg/ml concentration with 97.18% of cytotoxicity. The ZnO nanoparticles showed no toxicity against HDF normal cells in lower concentrations and it explicated the biocompatible features of nanoparticles. The Vigna radiata plant growth was efficiently promoted by low (60 ppm) concentration of nanoparticles. The ZnO nanoparticles divulged effective degradation of IPA, EDTA, BQ, and DPBF in 75%, 45%, 55%, and 80% through ROS formation, respectively. Thus, the synthesized ZnO nanoparticles are biocompatible and inexpensive material compared to the traditional one and can be utilized as an efficient material in biological fields. RESEARCH HIGHLIGHTS: Efficient larvicidal and insecticidal activities were evinced at low IC50 value. The ZnO nanoparticles were non-toxic to HDP (fibroblast) normal cells. Efficient plant growth was attained at 60 ppm concentration.

Significant Histologic Changes Are Not Rare in Treatment-naive Hepatitis B Patients with Normal Alanine Aminotransferase Level: A Meta-analysis.

BACKGROUND AND AIMS: Chronic hepatitis B is the main cause of liver cancer. However, the most neglected group has been treatment-naive chronic hepatitis B patients with normal alanine aminotransferase (ALT). People have tended to subjectively assume that the liver lesions of these patients are not serious and do not need antiviral treatment. However, the truth is not as optimistic as we thought. We aimed in this study to analyze the proportion of significant inflammation or fibrosis in aforementioned patients. METHODS: Medline, Embase, and Cochrane Library were searched up to January 10th 2020, to identify studies of these patients with liver biopsy. The double arcsine method was used with a random-effect model to combine the proportion of significant inflammation or fibrosis. Potential heterogeneity was explored by subgroup analysis and meta-regression. Outcome of interests included the proportion of significant inflammation or fibrosis and cirrhosis. The secondary outcome was to find the risk factors of significant histological changes. RESULTS: Nineteen eligible studies, with 2,771 participants, were included. The pooled proportion of significant inflammation or fibrosis was 35% [95% confidence interval (CI): 27 to 43] and 30% (95% CI: 25 to 36), respectively. The pooled proportion of cirrhosis was 3% [95% CI: 1 to 5, (12 studies; 1,755 participants)]. In subgroup analysis, old age [vs. young (<40 years-old), 44% vs. 26%, p=0.012] was significantly associated with higher fibrosis stage as well as cirrhosis [vs. young (<40 years-old), 4.8% vs. 1.8%, p<0.001]. CONCLUSIONS: About 1/3 of the treatment-naive chronic hepatitis B patients with normal ALT show significant histological changes, and some even have cirrhosis.

Evaluation of gingival tissue samples for predicting the time of death using histological and biochemical tests.

Thanatochemistry also known as chemistry of death and is used to determine post mortem interval (PMI). It is arguably one of the critical steps in forensic investigation. Recent addition of analyzing biochemical changes along with the traditional methods have gained importance, as they help us to record very early changes in the tissue specimens. In this view, our study aimed to correlate both histological changes and enzymatic changes in gingival tissue samples at intervals of immediate, 1 h, 5 h, 24 h and 48 h after death. Histologic changes noted were loss of epithelial architecture, chromatin clumping, nuclear vacuolation, karryopyknosis, eosinophilia and wide intercellular junctions. Two enzymes which differentiate between the autolytic phase (acid phosphatase) and putrefactive phase (ammonia) of decomposition were evaluated using UV spectrometer. Results in our study demonstrated there were variations as in gradual increase in ammonia levels (1.13±0.24-26.6±2.09) and gradual decrease in acid phosphatase levels (5.61±0.67-1.25±0.53) at different time intervals till 48 h. The cellular changes in gingival tissue could also be related to time. The result of our study helps us to identify potential of enzymatic changes which when correlated with histological reports helps us to predict the time of death accurately. Replicating this experiment in various known taphonomic conditions and other enzymes could highlight the usefulness of gingival tissue samples in determining time of death.

Endocrine disrupting chemicals, 4-nonylphenol, bisphenol A and butyl benzyl phthalate, impair metabolism of estradiol in male and female rats as assessed by levels of 15α-hydroxyestrogens and catechol estrogens in urine.

Bisphenol A (BPA), 4-nonylphenol (NP) and butyl benzyl phthalate (BBP), termed endocrine-disrupting chemicals, are known to mimic estrogen activity. The effects of these chemicals on 17ß-estradiol (E2 ) metabolism in vivo in rats were examined. Male and female rats were given NP (250 mg kg-1  day-1 ), BPA (250 µg kg-1  day-1 ) or BBP (500 mg kg-1  day-1 ) by gavage for 14 days, followed by a single intraperitoneal injection of E2 (5 mg kg-1 ) on the final day. The urinary excretion over 72 hours of 2-hydroxyestrone 1-N-acetylcysteine thioether, 2-hydroxyestrone 4-N-acetylcysteine thioether, 4-hydroxyestrone 2-N-acetylcysteine thioether, 2-hydroxy-17ß-estradiol (2-OHE2 ), 2-hydroxyestrone (2-OHE1 ), 4-hydroxy-17ß-estradiol, 4-hydroxyestrone, 15α-hydroxyestriol (E4 ), 15α-hydroxy-17ß-estradiol and 15α-hydroxyestrone was measured. Increases in urinary excretion of 2-OHE1 and decreases in E4 were observed in males treated with NP or BBP. Decreases in urinary excretion of 2-OHE2 and E4 were observed in males treated with BPA. Decreases in urinary excretion of 2-OHE1 and 2-OHE2 were observed in females treated with BBP. Normalized liver and weights were increased in both sexes treated with NP or BBP. Histologic observations revealed marked changes in the distal tubules and collecting ducts in the kidneys of rats exposed to NP and BBP, and hypertrophy in the hepatocytes of the centrilobular zone of the liver. No BPA-related effects on organ weight and on liver or kidney histopathology were found. These results suggest that the 14 day oral dosing of NP and BBP disrupted E2 metabolism, resulting from marked morphological and functional alterations in the liver and kidneys. In addition, BPA could induce metabolic and endocrine disruption.

Histologic Findings and Cytological Alterations in Thyroid Nodules After Radioactive Iodine Treatment for Graves' Disease: A Diagnostic Dilemma.

Unlike the well-documented relation between radiation to the neck and development of papillary thyroid carcinoma, a causal association between radioactive iodine treatment for Graves' disease and development of thyroid malignancy is less defined. However, patients with a background of thyroid dysfunction presenting with clinically palpable thyroid nodules are followed more closely than the average population, and fine needle aspiration is recommended in such circumstances. Cytological examination of aspirates, and histologic examination of tissue provided from patients with a known history of Graves' disease, managed by radioactive iodine therapy can create a diagnostic dilemma, as the distinction between radiation effect and a malignant primary thyroid neoplasm can be very challenging. Thus, pathologists should be aware of the existence of these changes in the setting of radiation therapy for Graves' disease. Providing pathologists with appropriate clinical history of Graves' disease treated with radioactive iodine is of paramount importance in order to prevent an overdiagnosis of malignancy.

Alterações histológicas em fígados e linfonodos de búfalos (bubalus bubalis) mantidos em pastagens de brachiaria spp / Histologic lesions in livers and lymph nodes in buffalo (bubalus bubalis) grazing in brachiaria spp. pastures

Infiltração por macrófagos espumosos e outras lesões podem ser encontradas em bovinos clinicamente sadios em pastagens de Brachiaria spp. Com o objetivo de determinar as alterações histológicas do fígado e linfonodos mesentéricos em búfalos no Pará foram estudadas as alterações histológicas de fragmentos desses órgãos de 142 búfalos da raça Murrah e de 15 bovinos da raça Nelore, coletados em frigoríficos. As coletas foram separadas em grupos de animais de acordo com sua origem e tempo de permanência na pastagem de Brachiaria spp., sendo o Grupo (G) 1 composto por 79 búfalos provenientes da Ilha de Marajó, criados em pastagens de campo nativo; o G2 composto por 17 búfalos mantidos desde o nascimento em pastagens de Brachiaria brizantha; o G3 composto por 29 búfalos adquiridos na Ilha do Marajó e introduzidos em pastagem de B. decumbens por aproximadamente 12 meses; o G4 composto por 17 búfalos adquiridos na Ilha de Marajó e introduzidos em pastagem de B. brizantha por aproximadamente 18 meses; e o G5 composto por 15 bovinos mantidos em pastagem de B. brizantha por aproximadamente 12 meses.Para avaliar a gravidade da lesão hepática foram estabelecidos graus de acordo com a quantidade e tamanho dos grupos de macrófagos espumosos, seguindo uma escala de 0 a 4. Nos animais do G1, provenientes da Ilha de Marajó, não foram observadas alterações histológicas significativas no fígado e linfonodos mesentéricos. Em todas as amostras dos grupos G2, G3 e G4 foram observados quantidades variáveis de macrófagos espumosos no fígado e linfonodos mesentéricos.Os animais dos grupos G2 e do G4, que permaneceram um período maior em pastagens de Brachiaria spp, apresentaram lesões mais acentuadas (P<0,05) de macrófagos espumosos do que os animais do G3...

Infiltration by foamy macrophages and other lesions are reported in healthy cattle held in Brachiaria spp. pastures. With the objective to study histologic lesions in the liver and mesenteric lymph nodes in buffalo in the state of Pará, samples of liver and lymph nodes of 142 buffalo Murah and 15 Nelore cattle were studied histologically. The samples were collected in an slaughterhouse and divided into groups of animals according to their origin and period of grazing Brachiaria spp. pastures. Group (G) 1 consisted of 79 buffalo from Marajó Island, raised in native pastures free of Brachiaria spp.; G2 was composed of 17 buffalo kept since birth in Brachiaria brizantha pastures; G3 was composed of 29 buffalo purchased in Marajó Island and introduced in B. decumbens pastures where they stayed for nearly 12 months; G4 consists of 17 buffalo purchased in Marajó Island and introduced in B. brizantha pastures where they stayed for nearly 18 months. G5 was composed of 15 Nelore cattle grazing B. brizantha during one year period. To assess the degree of liver injury, grades following a scale of 0 to 4 were established according to the quantity and size of groups of foamy macrophages. In G1, from the Marajó Island, there were no significant histological changes in liver and lymph nodes. Foamy macrophages and other lesions were observed in liver and lymph nodes of all samples from G1, G2, G3, and G4. The animals from G2 and G4, which remained a longer period in Brachiaria spp., showed more pronounced infiltration of foamy macrophages (P<0.05) than the animals of G3...

Histologic Changes in the Skin with Photoaging / 대한피부과학회지

BACKGROUND: In white people, a distinction between intrinsic aging and photoaging has been well documented in histologic studies. However, no histological studies to date have attempted to announce morphological changes with photoaged skin of Koreans. OBJECTIVE: Our purpose was to compare the histologic change with advancing age between exposed skin and nonexposed skin of Koreans. METHODS: Twenty-one male volunteers between 20 and 80 years of age were recruited. The histochemical and immunhistochemical studies were performed with the skin obtained from face and buttock. RESULTS: With advancing age, there was a decreasing tendency in the epidermal thickness. However, there was no difference between exposed skin and non-exposed skin. Density of dopa-positive melanocytes was much higher in the face than in the buttock at all ages. Decline of melanocyte density with advancing age is not prominent in the facial skin. In the facial skin, accumulation of thickened degraded elastic fibers and a decrease in collagen fibers are evident with advancing age. In the facial skin, increase of acid mucopolysaccharides is also found with advancing age. CONCLUSION: Koreans, the histologic changes in the skin with photoaging are distinct from those in the skin with intrinsic aging.

Anatomic and Histologic Changes of the Testis after Long-Term Estrogen Exposure in Transsexuals / 대한남성과학회지

PURPOSE: To investigate the anatomic and histologic changes of testis as a result of long-term estrogen exposure on male MATERIALS AND METHODS: Fourteen testes were harvested from 14 consecutive male-to-female transsexuals who had sex reassignment operation in Dong-A University Hospital from March 1991 to March 1997. Age at inception of estrogen therapy was 16 years to 24 years. The duration of estrogen therapy was 2-12 years (mean 7.4 years). The dose and method of estrogen treatment regimen was variable, but about 20 mg (intravenous) monthly during first year. Sperm analysis, volume of testis and histologic change of testis were compared to the duration of estrogen therapy. RESULTS: The mean volume of semen was 1.8 ml(0.5~3 ml), and oligozoospermia, azoospermia or asthenospermia were observed in 12 cases (85.7%) by means of sperm analysis. The mean volume of testis was 17.3 ml(15~23ml). In light microscopic examination of the testis, near-normal histologic finding was noted in 3 cases(21.4%), spermatocytic arrest in 8 cases(57.2%) and geminal cell aplasia in 3 cases (21.4%). CONCLUSION: As the duration of estrogen therapy was longer, there was a tendency that volume of semen, sperm count and motility were reduced and the histologic change of seminiferous tubules was severe. It was considered that the negative feedback of estrogen on hypothalamic-pituitary-gonadal axis, the down regulation of estrogen receptors and the direct effect of estrogen might produce the adverse effect on male reproductive system by testicular change with maturation arrest, germ cell aplasia, end-stage testis and peritubular fibrosis and reduced fertility after long-term estrogen exposure.

Histological Changes in the Skin with Innate Ageing / 대한피부과학회지

BACKGROUND: It is a popular notion that cutaneous ageing includes two distinct phenomenon; true ageing, a universal presumably inevitable change attributable to the passage of time alone, and photoageing, changes attributable to chronic habitual sun exposure that are neither universal nor inevitable. Numerous investigations with experimental animals, in vitro skin models have been conducted, although, few histological studies to date have attempted to announce fundamental morphological changes with innate ageing. OBJECTIVE: We compared skin derived from the breast of old and young persons using light microscopy to discern structural changes in epidermal and dermal morphology with advancing age. METHODS: The histological, immunohistochemical studies were performed with normal skin sections of thirty donors who were diagnosed with breast cancer. They were classified into three age cohort groups; nine into group I (22 to 38), twelve into group II(40 to 52), and nine into group III(54 to 87). We chose the breast as an area that might closely resemble intrinsically aged skin. This region is relatively shielded from photoageing by its anatomical location. Analysis of data was performed using the Kruskal-Wallis and ANOVA test for dermal parameters based on a 5-point rating scale, and a simple regression test for a positive rate of immunoreactants. Results : 1. Light microscopic appearance of aged skin revealed a more flattened epidermis than young skin. There was no trend for an increase in epidermal melanin content per unit area on Fontana-Masson staining. There was an age-associated decrease in the Ki-67 positive rate(p<0.001), the density of Ki-67 positive cells declined approximately 1.16% per decade in photoprotected skin(p<0.001). The number of S-100 positive cells declined approximately 4.4/mm width along the dermo-epidermal juction per decade in photoprotected skin(p<0.001). The expression of differentiation markers(keratin 1, involucrin, filaggrin, loricrin) were not different among the three age cohort groups. 2. With advancing age, there was an attenuation in the number and diameter of elastic fibers in the papillary dermis and an increase in the number and straightness of the same fibers in the reticular dermis. The collagen fibers are arranged in sparse bundles in disarray, and/or aggregates of loosely woven, straight fibers in the aged skin. There was an apparent, age-related decrease in the stainability of ground substances in the papillary dermis on colloidal iron staining. Conclusions : Our data documents semi-quantitative differences among three groups in intrinsically aged breast skin and provide the framework for future research to evaluate the ageing process.

Sequential Studies of Glomerular Crescent Formation in Rabbits with Anti-Glomerular Basement Membrane(GBM) Antibody Induced Glomerulonephritis(GN)

To investigate the mechanism of crescent formation, sequential pathologic changes from the New Zealand White rabbits with anti-GBM antibody induced GN by administration of guinea pig anti-GBM IgG were studied by light (LM), immunofluorescent (IF) and electron (EM) microscopy. Although no glomerular changes were observed in LM, swelling of the endothelial cells and the epithelial cells were noted in EM by day 2. By day 7, early and cellular crescents were evident. Proteinaceous materials and fibrins were noted in the glomerular capillary lumina (GCL) and Bowman's space (BS) associated with segmental hypercellularity. The GBM damage became progressively severe, followed by focal detachment of the visceral epithelial cells from the GBM. At day 14, fibrin strands, mononuclear cells and collagen fibrils were present between the proliferating extracapillary cells. At day 31, fibrocellular crescents were predominated. Elongated spindle cells, morphologically resembling myofibroblasts, were noted near the Bowman's capsule (BC). A degree of tubular atrophy, interstitial fibrosis, and inflammatory infiltrates increased as it did with fibrous organization of crescent. Intense linear IF staining for IgG and C3 were seen throughout the experiments along the GBM. In conclusion, the progression of crescent from an early "proteinaceous" stage through cellular, fibrocellular and fibrous stages was well documented in this study. Inflammatory cells and coagulation mechanism may activate the initiation of the GBM damage at the early stage. Activated periglomerular mononuclear cells may also cause disruption of BC which facilitates entry of activated periglomerular cells and fibroblasts into BS leading to progressive fibrous crescent formation.

Histological Changes Induced by Neurolysis: An Experimental Study on Rabbit Sciatic Nerve / 대한정형외과학회잡지

Several attempts have been made to assess the relative importance of the vasa nervorum and the intrinsic longitudinal vascular plexuses of nerve in maintaining the blood supply of a segment of nerve trunk, but the effect of mobilization on the ability of an injuried or repaired nerve to regenerate and regain function has been less certain and is the subject of these investigations. Thirty-two Korean rabbits of both sexes were used for these studies and we concluded that it is increased fibrosis with adhesion to surrounded tissues, loss of glistening and milk-like discoloration of never grossly, and increased degeneration and milk-like discoloration of nerve grossly, and increased degeneration of axons and demyelization progressively and early proliferated Schwann cells with increasing length of neurolysis. And there was no recovery of damage in nerve tissue induced by above 7 cm of neurolysis. (1:35)