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1.
J Dev Orig Health Dis ; 13(1): 61-67, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-33843571

RESUMO

Intestinal atresia (IA), a common cause of neonatal intestinal obstruction, is a developmental defect, which disrupts the luminal continuity of the intestine. Here, we investigated (i) the process of lumen formation in human embryos; and (ii) how a defective lumen formation led to IA. We performed histological and histochemical study on 6-10 gestation week human embryos and on IA septal regions. To investigate the topology of embryonic intestine development, we conducted 3D reconstruction. We showed that a 6-7th gestation week embryonic gut has no lumen, but filled with mesenchyme cells and vacuoles of a monolayer of epithelial cells. A narrow gut lumen was formed by gestation week-9, the gut was filled with numerous vacuoles of different sizes, some vacuoles were merging with the developing embryonic gut wall. At gestation week-10, a prominent lumen was developed, only few vacuoles were present and were merging with the intestine wall. At IA septal regions, vacuoles were located in the submucous layer, covered by a single layer of epithelium without glandular structure, and surrounded with fibrous tissue. The mucosal epithelium was developed with lamina propria and basement membrane, but the submucosa and the longitudinal smooth muscle layers were not properly developed. Hence, the vacuoles in IA septum could represent a remnant of vacuoles of embryonic gut. In conclusion, the fusion of vacuoles with the developing intestine wall associates with the disappearance of vacuoles and gut lumen formation in human embryos, and perturbation of these developmental events could lead to IA.


Assuntos
Embrião de Mamíferos/anormalidades , Histologia/estatística & dados numéricos , Atresia Intestinal/etiologia , Embrião de Mamíferos/patologia , Embrião de Mamíferos/fisiopatologia , Histologia/instrumentação , Humanos , Atresia Intestinal/patologia , Atresia Intestinal/fisiopatologia , Intestinos/patologia
2.
Clin Epigenetics ; 13(1): 153, 2021 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-34407868

RESUMO

BACKGROUND: Early-stage lung cancers radiologically manifested as ground-glass opacities (GGOs) have been increasingly identified, among which pure GGO (pGGO) has a good prognosis after local resection. However, the optimal surgical margin is still under debate. Precancerous lesions exist in tumor-adjacent tissues beyond the histological margin. However, potential precancerous epigenetic variation patterns beyond the histological margin of pGGO are yet to be discovered and described. RESULTS: A genome-wide high-resolution DNA methylation analysis was performed on samples collected from 15 pGGO at tumor core (TC), tumor edge (TE), para-tumor tissues at the 5 mm, 10 mm, 15 mm, 20 mm beyond the tumor, and peripheral normal (PN) tissue. TC and TE were tested with the same genetic alterations, which were also observed in histologically normal tissue at 5 mm in two patients with lower mutation allele frequency. According to the difference of methylation profiles between PN samples, 2284 methylation haplotype blocks (MHBs), 1657 differentially methylated CpG sites (DMCs), and 713 differentially methylated regions (DMRs) were identified using reduced representation bisulfite sequencing (RRBS). Two different patterns of methylation markers were observed: Steep (S) markers sharply changed at 5 mm beyond the histological margin, and Gradual (G) markers changed gradually from TC to PN. S markers composed 86.2% of the tumor-related methylation markers, and G markers composed the other 13.8%. S-marker-associated genes enriched in GO terms that were related to the hallmarks of cancer, and G-markers-associated genes enriched in pathways of stem cell pluripotency and transcriptional misregulation in cancer. Significant difference in DNA methylation score was observed between peripheral normal tissue and tumor-adjacent tissues 5 mm further from the histological margin (p < 0.001 in MHB markers). DNA methylation score at and beyond 10 mm from histological margin is not significantly different from peripheral normal tissues (p > 0.05 in all markers). CONCLUSIONS: According to the methylation pattern observed in our study, it was implied that methylation alterations were not significantly different between tissues at or beyond P10 and distal normal tissues. This finding explained for the excellent prognosis from radical resections with surgical margins of more than 15 mm. The inclusion of epigenetic characteristics into surgical margin analysis may yield a more sensitive and accurate assessment of remnant cancerous and precancerous cells in the surgical margins.


Assuntos
Adenocarcinoma de Pulmão/diagnóstico por imagem , Adenocarcinoma de Pulmão/patologia , Metilação de DNA/genética , Histologia/estatística & dados numéricos , Adenocarcinoma de Pulmão/genética , Adulto , Idoso , Biomarcadores Tumorais/análise , Feminino , Humanos , Masculino , Margens de Excisão , Pessoa de Meia-Idade
3.
J Hepatol ; 75(4): 810-819, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34126105

RESUMO

BACKGROUND & AIMS: The SALVE Histopathology Group (SHG) developed and validated a grading and staging system for the clinical and full histological spectrum of alcohol-related liver disease (ALD) and evaluated its prognostic utility in a multinational cohort of 445 patients. METHODS: SALVE grade was described by semiquantitative scores for steatosis, activity (hepatocellular injury and lobular neutrophils) and cholestasis. The histological diagnosis of steatohepatitis due to ALD (histological ASH, hASH) was based on the presence of hepatocellular ballooning and lobular neutrophils. Fibrosis staging was adapted from the Clinical Research Network staging system for non-alcoholic fatty liver disease and the Laennec staging system and reflects the pattern and extent of ALD fibrosis. There are 7 SALVE fibrosis stages (SFS) ranging from no fibrosis to severe cirrhosis. RESULTS: Interobserver κ-value for each grading and staging parameter was >0.6. In the whole study cohort, long-term outcome was associated with activity grade and cholestasis, as well as cirrhosis with very broad septa (severe cirrhosis) (p <0.001 for all parameters). In decompensated ALD, adverse short-term outcome was associated with activity grade, hASH and cholestasis (p = 0.038, 0.012 and 0.001, respectively), whereas in compensated ALD, hASH and severe fibrosis/cirrhosis were associated with decompensation-free survival (p = 0.011 and 0.001, respectively). On multivariable analysis, severe cirrhosis emerged as an independent histological predictor of long-term survival in the whole study cohort. Severe cirrhosis and hASH were identified as independent predictors of short-term survival in decompensated ALD, and also as independent predictors of decompensation-free survival in compensated ALD. CONCLUSION: The SALVE grading and staging system is a reproducible and prognostically relevant method for the histological assessment of disease activity and fibrosis in ALD. LAY SUMMARY: Patients with alcohol-related liver disease (ALD) may undergo liver biopsy to assess disease severity. We developed a system to classify ALD under the microscope by grading ALD activity and staging the extent of liver scarring. We validated the prognostic performance of this system in 445 patients from 4 European centers.


Assuntos
Histologia/normas , Fígado/patologia , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Prognóstico , Projetos de Pesquisa , Histologia/instrumentação , Histologia/estatística & dados numéricos , Humanos , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/mortalidade , Índice de Gravidade de Doença
4.
Indian J Pathol Microbiol ; 64(Supplement): S127-S135, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34135154

RESUMO

BACKGROUND: Both noncirrhotic portal fibrosis (NCPF) and extrahepatic portal venous obstruction (EHPVO) are important causes of noncirrhotic portal hypertension (PH) in the Asian region. In this study, we analyzed the histopathological changes of liver needle-core biopsies from patients with NCPF and EHPVO. PATIENTS AND METHODS: The patients were diagnosed as per the Asia Pacific Association for the Study of Liver (APASL) criteria. Minimum adequacy criteria for liver core biopsies were defined, and finally, 69 liver biopsies from patients with NCPF and 100 liver biopsies from patients with EHPVO were analyzed. All histological parameters were predefined, and three experienced pathologists analyzed the biopsies after reaching consensus. Institute ethics committee clearance was taken. RESULTS: Although some histological features were overlapping, phlebosclerosis of intra-hepatic branches of the portal vein (PV), periportal aberrant vascular channels, remnant portal tracts, and hepatic fibrosis beyond the portal tracts without the formation of complete hepatic nodules (P < 0.001 for all) were common histological characteristics of NCPF on core-needle liver biopsies; while maintained lobular architecture, nonspecific dilatation of PV branches, absence of intra-hepatic PV phlebosclerosis, aberrant vascular channels, and significant fibrosis were characteristics of EHPVO. CONCLUSIONS: Despite the considerable histological overlap between NCPF and EHPVO, careful histological evaluation, supplemented by clinical features, radiological and biochemical findings can help in making a conclusive diagnosis. Patients with NCPF and EHPVO with clinical jaundice show transaminitis, high serum alkaline phosphatase level, more variceal bleed, and histological evidences of nodular regenerative hyperplasia.


Assuntos
Hipertensão Portal/patologia , Fígado/patologia , Veia Porta/patologia , Adolescente , Adulto , Biópsia , Criança , Técnicas Histológicas , Histologia/estatística & dados numéricos , Humanos , Cirrose Hepática/patologia , Testes de Função Hepática , Pessoa de Meia-Idade , Inclusão em Parafina , Estudos Retrospectivos , Adulto Jovem
6.
Burns ; 47(1): 150-156, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33279341

RESUMO

Autologous skin transplantation is the gold standard for treatment of full-thickness skin defects such as deep burn injuries, but has the disadvantages of limited donor sites and donor site morbidities. Alternative skin replacement products, such as xenografts and allografts, are not a permanent solution. Numerous manufactured skin substitutes already show promising approaches, but have limited efficacy. Therefore, wound dressings adaptable to the physiology of wound healing are still needed. In a randomized controlled in vivo study, a newly designed biocompatible collagen nonwoven matrix was compared to the Integra® bilayer dermal substitute and untreated controls in 48 full-thickness skin defects in a swine model. The take of all templates was complete, and all the tissue-engineered products accelerated dermal wound healing compared to the untreated controls, as identified by planimetric measurements. The higher collagen dose treatments and Integra®-covered wounds developed the thickest, cell-rich neoepidermal tissue in histological examination. The innovative biocompatible collagen matrix is flexibly applicable and modifiable, and offers potential as a carrier membrane for therapeutic supplemental products such as growth factors to further develop effective wound dressings.


Assuntos
Queimaduras/tratamento farmacológico , Colágeno/administração & dosagem , Transplante de Pele/instrumentação , Pele Artificial/normas , Animais , Queimaduras/fisiopatologia , Colágeno/uso terapêutico , Modelos Animais de Doenças , Histologia/estatística & dados numéricos , Transplante de Pele/métodos , Pele Artificial/estatística & dados numéricos , Suínos , Cicatrização/efeitos dos fármacos , Cicatrização/fisiologia
7.
J Nucl Cardiol ; 28(5): 2233-2243, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-31933156

RESUMO

BACKGROUND: To evaluate the diagnostic value of 18F-FDG PET/CT in distinguishing benign versus malignant cardiac tumors as well as to assess its prognostic value. METHODS: We analyzed 38 patients with cardiac tumors who underwent 18F-FDG PET/CT and followed for median 8.5 ± 12.5 months. SUVmax and TBRmax (maximum tumor-to-background ratio) by receiver-operating characteristic (ROC) curve analysis were used to obtain threshold for the diagnosis of malignancy as defined by histology (n = 38). Survival was assessed and correlated with the dignity of the lesions and PET parameters. RESULTS: Optimal cut-off values indicating malignancy were as follows: SUVmax = 3.44, with 100% sensitivity and 92.9% specificity, and TBRmax = 1.55, with 95.8% sensitivity and 92.9% specificity. A significant difference of 18F-FDG uptake was observed between primary benign (n = 14, SUVmax = 2.35 ± 1.31, TBRmax = 1.05 ± 0.50) compared to primary malignant cardiac tumors (n = 11, SUVmax = 8.90 ± 4.23, TBRmax = 3.82 ± 1.44) as well as cardiac metastases and lymphoma (n = 13, SUVmax = 14.37 ± 8.05, TBRmax = 6.19 ±  3.38) (all P < .001). Survival rate was significantly lower in patients with malignant as compared to benign cardiac tumors (P < .05). Regression analysis revealed that the lesion dignity determined by the cut-off value of SUVmax was an independent predictor for death in patients with cardiac tumors (P < .05). CONCLUSION: 18F-FDG uptake in cardiac tumors can differentiate between benign and malignant cardiac tumors and predicts survival.


Assuntos
Coração/diagnóstico por imagem , Histologia/estatística & dados numéricos , Neoplasias/complicações , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/normas , Idoso , Feminino , Fluordesoxiglucose F18/administração & dosagem , Fluordesoxiglucose F18/uso terapêutico , Coração/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/diagnóstico por imagem , Neoplasias/patologia , Avaliação de Resultados em Cuidados de Saúde/métodos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/estatística & dados numéricos , Compostos Radiofarmacêuticos/administração & dosagem , Compostos Radiofarmacêuticos/uso terapêutico
8.
Clin Exp Dermatol ; 45(7): 818-823, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32656899

RESUMO

The effect of histological regression on patient prognosis for primary cutaneous melanoma is controversial. Some authors hypothesize that regression indicates a robust systemic immune response and may decrease risk of metastasis. Others argue that histological regression calls into question a T0 diagnosis because there may have been an invasive component of the melanoma that is no longer visible but is still active. The literature to date does not suggest that histological regression is associated with increased risk of positive sentinel lymph node status, metastasis or increased risk of mortality. Thus, the presence of histological regression should not change patient staging, evaluation or management. The criteria used for reporting regression have varied dramatically across studies, and standardized reporting is needed to foster evidence-based practices in the future.


Assuntos
Imunidade/fisiologia , Melanoma/diagnóstico , Melanoma/imunologia , Neoplasias Cutâneas/patologia , Gerenciamento Clínico , Histologia/estatística & dados numéricos , Histologia/tendências , Humanos , Linfonodos/patologia , Metástase Linfática/patologia , Melanoma/epidemiologia , Regressão Neoplásica Espontânea/patologia , Estadiamento de Neoplasias/métodos , Prognóstico , Linfonodo Sentinela/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/imunologia , Linfócitos T Reguladores/imunologia , Melanoma Maligno Cutâneo
9.
Histopathology ; 75(1): 39-53, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30801768

RESUMO

AIMS: Machine learning (ML) binary classification in diagnostic histopathology is an area of intense investigation. Several assumptions, including training image quality/format and the number of training images required, appear to be similar in many studies irrespective of the paucity of supporting evidence. We empirically compared training image file type, training set size, and two common convolutional neural networks (CNNs) using transfer learning (ResNet50 and SqueezeNet). METHODS AND RESULTS: Thirty haematoxylin and eosin (H&E)-stained slides with carcinoma or normal tissue from three tissue types (breast, colon, and prostate) were photographed, generating 3000 partially overlapping images (1000 per tissue type). These lossless Portable Networks Graphics (PNGs) images were converted to lossy Joint Photographic Experts Group (JPG) images. Tissue type-specific binary classification ML models were developed by the use of all PNG or JPG images, and repeated with a subset of 500, 200, 100, 50, 30 and 10 images. Eleven models were generated for each tissue type, at each quantity of training images, for each file type, and for each CNN, resulting in 924 models. Internal accuracies and generalisation accuracies were compared. There was no meaningful significant difference in accuracies between PNG and JPG models. Models trained with more images did not invariably perform better. ResNet50 typically outperformed SqueezeNet. Models were generalisable within a tissue type but not across tissue types. CONCLUSIONS: Lossy JPG images were not inferior to lossless PNG images in our models. Large numbers of unique H&E-stained slides were not required for training optimal ML models. This reinforces the need for an evidence-based approach to best practices for histopathological ML.


Assuntos
Aprendizado Profundo , Histologia , Patologia Clínica , Aprendizado Profundo/estatística & dados numéricos , Diagnóstico por Computador/estatística & dados numéricos , Feminino , Técnicas Histológicas/estatística & dados numéricos , Histologia/estatística & dados numéricos , Humanos , Interpretação de Imagem Assistida por Computador/estatística & dados numéricos , Aprendizado de Máquina , Masculino , Redes Neurais de Computação , Patologia Clínica/estatística & dados numéricos
10.
Rev. esp. patol ; 51(3): 147-153, jul.-sept. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-179069

RESUMO

Objetivo: Determinar la concordancia entre citología, colposcopia y biopsia cervical ante una citología alterada. Material y métodos: Se realizó un estudio observacional transversal, de base clínica, en un único centro. La población seleccionada consistió en 416 mujeres, de entre 25 y 65 años, con citología alterada, del 1 de agosto de 2014 al 30 de septiembre de 2016, y remitidas para estudio colposcópico y anatomopatológico al Hospital Reina Sofía de Córdoba. Se realizaron análisis estadísticos, utilizando el índice de Kappa para el grado de concordancia entre citología, colposcopia y biopsia. Resultados: Se encontró una concordancia insignificante entre citología y colposcopia (k=0,16; IC 95% 0,09-0,22); una concordancia moderada entre colposcopia y biopsia (k=0,57; IC 95% 0,47-0,68); y una concordancia insignificante entre citología y biopsia (k=0,21; IC 95% 0,08-0,34). Conclusiones: El grado de acuerdo fue mejor entre colposcopia y biopsia que entre citología y biopsia o entre citología y colposcopia


Objective: To determine the concordance between cytology, colposcopy and cervical biopsy in abnormal cytologies. Material and methods: An observational cross-sectional, clinically based, single center study was performed. The selected population consisted of 416 women between the ages of 25 and 65 who had undergone colposcopy for abnormal cytologies at the Reina Sofía Hospital, Córdoba, between August 1st, 2014, and September 30th, 2016. Statistical analysis was performed using the Kappa index for the degree of concordance between cytology, colposcopy and biopsy. Results: There was an insignificant concordance between cytology and colposcopy (k=0.16; 95% CI 0.09-0.22), a moderate concordance between colposcopy and biopsy (k=0.57; 95% CI 0.47-0.68) and an insignificant concordance between cytology and biopsy (k=0.21 (95% CI 0.08-0.34). Conclusions: Better concordance was found between colposcopy and biopsy than between either cytology and biopsy or cytology and colposcopy


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Colposcopia/estatística & dados numéricos , Neoplasias do Colo do Útero/patologia , Histologia/estatística & dados numéricos , Biópsia/estatística & dados numéricos , Detecção Precoce de Câncer/métodos , Estudos Transversais , Sensibilidade e Especificidade , Programas de Rastreamento/estatística & dados numéricos
11.
Surg Technol Int ; 31: 182-188, 2017 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-29029354

RESUMO

Bundled payment plans are being developed as a means to curb healthcare spending. Routine histology following total hip arthroplasties (THA) and total knee arthroplasties (TKA) is standard practice at many institutions. Recently, the value of this practice has been questioned as histologic diagnoses in THA and TKA rarely differ from the clinical diagnoses. The goal of this study is to identify discrepant and discordant diagnoses following THA and TKA at an academic medical center and to calculate the cost-saving potential in the setting of a bundled payment plan. A retrospective chart review was conducted on 1,213 primary THA and TKA performed by two orthopaedic surgeons from 2012 to 2014. The clinical and histologic diagnoses were compared and classified as concordant, discrepant, or discordant. Cost information was obtained from the institutional billing office. One thousand one hundred and sixty-six THA and TKA were analyzed in the final cohort. Nineteen (1.6%) diagnoses were classified as discrepant while none were discordant. The cost of histologic examination per specimen was estimated to be $48.56. The total cost of all arthroplasties was $14,999,512.46, of which histologic examination made up 0.31% of the total cost. The results of this study corroborate the results of previous studies and support the proposition that routine histologic examination is not cost-effective. The cost incurred to perform histologic examination will become a cost deduction from future bundled payments. The practice of sending routine histologic specimens following TJA should be decided upon by the operating orthopaedic surgeon.


Assuntos
Artroplastia do Joelho , Custos e Análise de Custo , Custos de Cuidados de Saúde , Histologia , Articulação do Joelho/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Artroplastia do Joelho/economia , Artroplastia do Joelho/estatística & dados numéricos , Feminino , Histologia/economia , Histologia/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite/diagnóstico , Osteoartrite/patologia , Osteoartrite/cirurgia , Estudos Retrospectivos , Adulto Jovem
12.
Rev. cientif. cienc. med ; 18(2): 14-17, 2015. ilus
Artigo em Espanhol | LILACS | ID: lil-785616

RESUMO

Los cánceres peritoneales primarios son una patología de baja prevalencia, dentro de los cuales el carcinoma seroso papilar primario de peritoneo es el más frecuente con una incidencia de 6,78 casos por millón de habitantes. Predomina en el sexo femenino y su principal diagnóstico diferencial es el carcinoma papilar seroso de ovario avanzado, para lo cual la inmunohistoquímica, junto a sus clasificaciones clínicas y anatomopatológicas son la forma de diferenciar en base a la clasificación de la Organización Mundial de la salud para lesiones tumorales. Objetivo: Describir los resultados inmuno-histoquímicos de una serie de casos estudiados en el Hospital Clinico de la Universidad de Chile y compararlos con la literatura médica. Material y Método: Estudio retrospectivo, descriptivo en base a análisis de 12 biopsias entre Enero 2010 y Marzo 2015 clasificándolos según edad, sexo y registro de biopsia. Se realizó técnica histológica rutinaria además de las tinciones inmunohistoquímicas para WT1, citoqueratinas y otros reactivos de acuerdo a los diagnósticos diferenciales. Resultados: La distribución etaria fue de 47 a los 75 años, media de 60 años, el 100% de los casos de sexo femenino. Los reactivos de Inmunohistoquímica predominantes fueron WT1 (53,8%), Citoqueratina-7 (38,5%). Conclusiones: Este carcinoma es una entidad poco común en la clínica, con similitudes al carcinoma seroso ovárico. Existe consenso sobre el diagnóstico de esta patología, el cual se debe orientar, según los criterios de la Gynecologic Oncology Group. Ante la sospecha clínica, el patólogo puede realizar el estudio inmunohistoquímico dirigido y así tener un diagnóstico preciso para determinar la conducta terapéutica del cirujano.


The primary peritoneal cancer is a low prevalence disease, within which primary papillary serous carcinoma of the peritoneum is the most frequent with an incidence of 6.78 cases per million inhabitants. Predominates in females and its main differential diagnosis is advanced ovarian papillary serous carcinoma, for which immunohistochemistry and clinical and pathological classifications are the way to differentiate base on the World Health Organization classification for tumor lesions. Objective: Describe the immunohistochemical results of a series of cases studied in Universidad de Chile Clinical Hospital and to compare them with the literature. Material and Methods: Descriptive retrospective study based on analysis of biopsies from 12 cases between January 2010 and March 2015 classifying them according to age, sex and biopsy register. Routine histological technique was performed in addition to the immunohistochemical staining for WT1, cytokeratin and other reagents according to the differential diagnoses. Results: The age distribution was 47 to 75 years, mean 60 years, 100% of cases female. Immunohistochemical reagents were predominant WT1 (53.8%) and cytokeratin-7 (38.5%). Conclusion: This carcinoma is a rare entity in routine clinical practice, with similarities to ovarian serous carcinoma.There is consensus on the diagnosis of this condition, which must be oriented according to the criteria of the Gynecologic Oncology Group. Clinical suspicion can lead the pathologist to perform immunohistochemical study and thus have an accurate diagnosis to determine the therapeutic approach of the surgeon.


Assuntos
Biópsia , Seroma/diagnóstico , Carcinoma , Classificações em Saúde , Histologia/estatística & dados numéricos
13.
Actas dermo-sifiliogr. (Ed. impr.) ; 102(4): 255-263, mayo 2011. ilus
Artigo em Espanhol | IBECS | ID: ibc-88855

RESUMO

En un informe rutinario dermatopatológico sobre un melanoma se recoge una significativa información pronóstica para el manejo de estos pacientes y que actualmente es empleada en la estadificación de la American Joint Committee on Cancer como el grosor tumoral, la presencia de ulceración, el número de mitosis y la presencia o no de microsatelitosis. Sin embargo, existen múltiples factores que si bien no están incluidos en esta clasificación, han demostrado tener un impacto pronóstico en diversos estudios y que son objeto del presente texto (AU)


Skin histopathology reports of melanoma routinely include important prognostic information used in the staging system of the American Joint Committee on Cancer (AJCC).This information, which influences disease management, includes tumor depth, presence of ulceration, number of mitotic figures, and presence or absence of microsatellites. However, numerous studies have found many other factors that are not included in the AJCC classification but that are nevertheless of prognostic significance. We discuss these factors in this paper (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Dermatopatias/diagnóstico , Dermatopatias/epidemiologia , Dermatopatias/patologia , Histologia/educação , Dermatopatias/etiologia , Dermatopatias/microbiologia , Dermatopatias , Histologia/estatística & dados numéricos , Histologia/tendências , Estadiamento de Neoplasias/métodos , Estadiamento de Neoplasias/estatística & dados numéricos , Estadiamento de Neoplasias , Índice Mitótico/métodos , Índice Mitótico/estatística & dados numéricos
14.
Actas dermo-sifiliogr. (Ed. impr.) ; 102(4): 289-292, mayo 2011. ilus
Artigo em Espanhol | IBECS | ID: ibc-88860

RESUMO

El hamartoma angiomatoso ecrino es un tumor benigno e infrecuente que se caracteriza por la proliferación de elementos ecrinos y vasculares. Presentamos dos casos, el de una mujer de 33 años que consultó por una lesión marronácea en la espalda, con hiperhidrosis asociada, y el de un varón de 25 años con una lesión eritematosa, asintomática, en la palma izquierda. Tras el estudio histológico ambos pacientes se diagnosticaron de hamartoma angiomatoso ecrino. El hamartoma angiomatoso ecrino generalmente se presenta al nacimiento o en la infancia. Se manifiesta habitualmente como una lesión única con presentación clínica variable, por lo que su diagnóstico es fundamentalmente histológico. La localización más frecuente es la región distal de las extremidades. Suele ser asintomático, pero puede haber dolor e hiperhidrosis asociados. No requiere tratamiento salvo en aquellos casos asociados a sintomatología recalcitrante, sudor excesivo o por motivos estéticos (AU)


Eccrine angiomatous hamartoma is a rare, benign tumor characterized by a proliferation of eccrine and vascular structures. We present 2 cases and review the characteristics of this disorder. The first patient was a 33-year-old woman who consulted for a brownish lesion on her back associated with local hyperhidrosis. The second patient was a 25-year-old man withan asymptomatic erythematous lesion on his left palm. In both patients a diagnosis of eccrine angiomatous hamartoma was made based on the histological findings. Eccrine angiomatous hamartoma is usually present at birth or develops during childhood. It is typically a solitary lesion and signs and symptoms can vary; diagnosis is therefore based on histological study. The most common site is on the distal parts of limbs. The lesions tend to be asymptomatic, but there may be associated pain and hyperhidrosis. Treatment is not usually necessary except in cases with persistent symptoms, excessive sweating, or cosmetic concern (AU)


Assuntos
Humanos , Animais , Masculino , Feminino , Adulto , Hamartoma/diagnóstico , Hamartoma/patologia , Hemangioma/diagnóstico , Hemangioma/patologia , Acrospiroma/diagnóstico , Acrospiroma/patologia , Hamartoma/etiologia , Hamartoma/psicologia , Hemangioma/psicologia , Hemangioma/cirurgia , Hiperidrose/complicações , Hiperidrose/patologia , Histologia/educação , Histologia/estatística & dados numéricos , Histologia/tendências
15.
Ars pharm ; 52(1): 12-15, ene.-mar. 2011. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-88801

RESUMO

Solid lipid microparticles (SLMs) loaded with ketoprofen were prepared by single emulsion-solvent evaporation method, in which glyceryl monostearate and Tween 80 were employed. The particle size was found to be 99.80±2.1μm. Microparticles observed by scanning electron microscope (SEM) showed spherical shape. The entrapment efficiency (EE %) and drug loading capacity (DL %) were found to be 72.60±1.6 % and 17.98±0.7% respectively. Results of stability evaluation showed relatively long term stability after storage at 4˚C for 3 months. The in-vivo study revealed slightly better per cent inhibition of pain i.e. 74% in comparison with 68% produced by plain drug(AU)


Las micropartículas lipídicas sólidas (MLS) cargadas con ketoprofeno se han preparado a través del método de evaporación del disolvente en emulsión simple, en el que se ha utilizado monoestearato de glicerilo y Tween 80. El tamaño de la partícula ha resultado ser de 99,80±2,1 μm. Las micropartículas observadas a través del microscopio electrónico de barrido (MEB) han mostrado una forma esférica. La eficacia de compresión (EC %) y la capacidad de concentración (CC %) del fármaco han resultado ser de 72,60±1,6% y 17,98±0,7% respectivamente. Los resultados de la evaluación de estabilidad han mostrado una estabilidad relativa a largo plazo después de una conservación a 4˚C durante 3 meses. El estudio in vivo ha revelado un ligero mejor porcentaje de inhibición del dolor, es decir, un 74% en comparación con un 68% producido por un fármaco corriente(AU)


Assuntos
Humanos , Masculino , Feminino , Peróxidos Lipídicos/classificação , Peróxidos Lipídicos/síntese química , Peróxidos Lipídicos/normas , Histologia/história , Histologia/legislação & jurisprudência , Histologia/estatística & dados numéricos , Histologia/normas , Peróxidos Lipídicos/química , Peróxidos Lipídicos/economia , Peróxidos Lipídicos/farmacologia , Peróxidos Lipídicos/uso terapêutico , Histologia/classificação , Histologia/economia , Histologia/educação , Histologia/ética
16.
Stat Med ; 26(26): 4808-16, 2007 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-17476651

RESUMO

Subjects in tumour studies are often misclassified with respect to histologic features that are not routinely recorded in diagnostic reports and that display heterogeneity within tumours. Pathologic analysis of the tumours may miss the feature of interest if the pathologist was not alerted to detail the microscopic feature of interest or if it is not present in the selected specimens. In this setting, only the subjects for whom the outcome is not found are potentially misclassified. Analyses of associations between the observed, potentially misclassified, outcome and a second outcome are invalid if the probability of misclassification depends on the second outcome. Three natural tests of association based on the observed data depend on different numbers of nuisance parameters. Most promising is a test based on the ratio of proportions of the observed feature. We illustrate this test using a study of the association of imaging parameters with genetic features in subjects with oligodendroglioma, a common brain tumour. In this study, calcification, a feature related to the imaging parameters, was potentially misclassified as not present.


Assuntos
Algoritmos , Histologia/estatística & dados numéricos , Oncologia , Manejo de Espécimes/classificação , Neoplasias Encefálicas/patologia , Erros de Diagnóstico/estatística & dados numéricos , Feminino , Humanos , Masculino , Oligodendroglioma/classificação , Oligodendroglioma/genética , Oligodendroglioma/patologia
17.
Med Sci Law ; 46(4): 310-20, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17191634

RESUMO

An audit was performed to determine the effectiveness of histological sampling of forensic post-mortem cases based on a review of three years' data, which comprised 638 adult autopsy cases. During the study period organs and tissues that appeared macroscopically normal and abnormal were extensively sampled. Histology was regarded as in some way contributory (providing, altering or confirming a cause of death) 53% of the time. The use of histology provided the cause of death in 49 (24%) of the 203 cases not given a cause of death after the completion of the macroscopic examination. When an interim cause of death had been supplied following the completion of the gross examination it was changed in 4.8% of cases, but there were no changes of the manner of death. The majority of the histological diagnoses or discrepancies involved the lungs and the heart. All diagnoses relevant to determining the cause of death would have been made if samples had been taken only from the left ventricle, right ventricle, coronary arteries, lungs, kidneys and brain with any tissue or organ that appeared abnormal macroscopically. A macroscopically identified abnormality that appeared to have been responsible for death was not sampled in 20 cases; consequently, more attention will be paid to sampling macroscopically abnormal tissues. As a result of this audit histology sampling practice has been revised and will be re-audited in the future.


Assuntos
Autopsia/estatística & dados numéricos , Histologia/estatística & dados numéricos , Auditoria Médica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Autopsia/normas , Encéfalo/patologia , Causas de Morte , Vasos Coronários/patologia , Atestado de Óbito , Feminino , Cardiopatias/mortalidade , Cardiopatias/patologia , Ventrículos do Coração/patologia , Técnicas Histológicas/estatística & dados numéricos , Histologia/normas , Humanos , Rim/patologia , Pulmão/patologia , Masculino , Pessoa de Meia-Idade , New South Wales , Garantia da Qualidade dos Cuidados de Saúde/normas
18.
Histopathology ; 47(6): 551-9, 2005 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16324191

RESUMO

The autopsy is in decline, despite the fact that accurate mortality statistics remain essential for public health and health service planning. The falling autopsy rate combined with the Coroners Review and Human Tissue Act have contributed to this decline, and to a falling use of autopsy histology, with potential impact on clinical audit and mortality statistics. At a time when the need for reform and improvement in the death certification process is so prominent, we felt it important to assess the value of the autopsy and autopsy histology. We carried out a meta-analysis of discrepancies between clinical and autopsy diagnoses and the contribution of autopsy histology. There has been little improvement in the overall rate of discrepancies between the 1960s and the present. At least a third of death certificates are likely to be incorrect and 50% of autopsies produce findings unsuspected before death. In addition, the cases which give rise to discrepancies cannot be identified prior to autopsy. Over 20% of clinically unexpected autopsy findings, including 5% of major findings, can be correctly diagnosed only by histological examination. Although the autopsy and particularly autopsy histology are being undermined, they are still the most accurate method of determining the cause of death and auditing accuracy of clinical diagnosis, diagnostic tests and death certification.


Assuntos
Autopsia/estatística & dados numéricos , Causas de Morte , Diagnóstico , Histologia/estatística & dados numéricos , Distribuição por Idade , Atestado de Óbito , Erros de Diagnóstico/estatística & dados numéricos , Feminino , Humanos , Masculino , Estudos Retrospectivos , Sensibilidade e Especificidade
19.
Diagn Cytopathol ; 28(1): 28-34, 2003 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-12508179

RESUMO

Much of the literature on the quality-assurance aspect of cytologic-histologic correlation (CHC) has focused on gynecologic cytology. For nongynecologic cytopathology, the process is complicated by the use of determinate (positive for malignant cells, negative for malignant cells) and indeterminate (atypical, suspicious, or follicular lesion) diagnostic categories. Here, we illustrate our routine methodology for analyzing CHC data on nongynecologic cytopathology cases by separating determinate from indeterminate cases. A focused list of determinate and indeterminate cytopathology cases with surgical pathology correlation is generated each week. The determinate cases are ascertained as true positive (TP), true negative (TN), false positive (FP), or false negative (TN). The discrepant cases (FP and FN) are investigated to determine the cause (sampling, interpretation, or screening). For indeterminate cases, the surgical pathology outcome (benign, malignant) and suitability of the cytopathology category utilized are reviewed. For the focused period of 4 mo, sensitivity was 70% and specificity was 100%. The most common reason for false-negative diagnoses was a sampling problem in the cytologic specimen; there were no false-positive diagnoses. Malignant outcomes for follicular lesion, atypical, and suspicious diagnoses were 29%, 40%, and 76%, respectively. Data derived from regularly performed CHC are useful in reviewing the diagnostic performance of the laboratory.


Assuntos
Biologia Celular/normas , Histologia/normas , Patologia/normas , Biologia Celular/estatística & dados numéricos , Diagnóstico Diferencial , Reações Falso-Negativas , Histologia/estatística & dados numéricos , Humanos , Neoplasias/diagnóstico , Patologia/métodos , Patologia/estatística & dados numéricos , Sensibilidade e Especificidade
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