The Utility of Phosphohistone H3 in Inter-Observer Variability of Mitotic Count in Meningioma, is There Any Benefit?

OBJECTIVE: One of the most reliable and decisive histologic parameters with negative prognostic impact is tumor proliferation capacity . Quantification of mitosis in H&E stained slides could be problematic and is limited by poor reproducibility and lack of objectivity. This study was designed to evaluate inter-observer variability in mitotic count using Phosphohistone H3(PHH3). METHODS: Totally, 60 specimens with histologic diagnosis of meningioma were selected including 50 grade I, 7 grdae II and 3 grade III tumors. Mitotic figures were counted both in H&E stained sections and slides prepared by immunohistochemistry using Anti-Phosphohistone H3 Anti body by three observers with various level of expertise, independently. RESULTS: Mean mitotic count by PHH3 method was higher than H&E staining for all three observers. Observer 1 and 2 revealed good correlation in mitotic count using H&E method, while observer 3 showed disagreement with both of them. However, all of them had good correlation in mitotic count using PHH3 method (cc=0.956,0.947,0.909). CONCLUSION: Based on our findings, PHH3 revealed good agreement between pathologists with various level of expertise and has the capability for further contribution in meningioma grading classification and specially could be beneficial for less experienced pathologists.

Low-level laser for treatment of tinnitus: a self-controlled clinical trial.

BACKGROUND: Despite the high prevalence and morbidity, tinnitus still remains an obscure symptom. We assessed the efficacy of low-level laser for treatment of tinnitus. METHODS: It was a self controlled clinical trial study on 61 outpatients with subjective tinnitus. The patients were irradiated with a 650-nm, 5-mW soft laser for twenty days and twenty minutes per day. The sensation of tinnitus was measured on a Visual Analog Scale (VAS) before and two weeks after treatment and they were compared by means of Wilcoxon signed ranktest. RESULTS: Thirty-eight (62.3%) patients were men and twenty-three (37.7%) were women. Fourteen patients (31.8%) worked in noisy environment. The VAS mean difference before and after the treatment was statistically significant (p < 0.0001). The best treatment effect was in the youngest group and there were significant differences between this group and the middle age and older groups (p = 0.018 and 0.001, respectively). The mean VAS score reduction was not statistically significant between male and female patients (p = 0.23). Also, the treatment outcome according to the noise level in patient's workplaces was not significantly different in women (p = 0.693), but it was significant in men (p = 0.029). CONCLUSIONS: Transmeatal low-level laser irradiation is effective for the treatment of tinnitus and some variables like age and job can affect the treatment outcome.