bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Submucosal Eosinophilia With Blood and Bronchoalveolar Lavage Eosinophilia in Adults With Severe Refractory Asthma
Authors: Tjota Melissa , Adegunsoye Ayodeji , Husain Aliya 
Published: September 2019

Abstract

Objectives
Asthma is a chronic inflammatory disease of the lungs, and for individuals with persistently uncontrolled symptoms despite maximal medical therapy, an endobronchial biopsy and bronchoalveolar lavage (BAL) may be obtained to guide therapy. Given the invasive nature of this procedure, most patients obtain blood eosinophil counts. The goal of this study was to compare blood, BAL, and biopsy eosinophils to identify whether there is a correlation between these various approaches.

Methods
A retrospective study was conducted in adult patients (n = 220) who had been seen in the Refractory Obstructive Lung Disease clinic over a 10-year period (2008-2017). All the patients had been clinically diagnosed with severe refractory asthma. Clinical data were obtained through review of the electronic medical records.

Results
Patients with submucosal eosinophilia had a greater prevalence of intraepithelial eosinophils (50.9% vs 2.3%, P < .001), intraepithelial neutrophils (36.7% vs 9.3%, P < .001), and intraepithelial lymphocytes (52.5% vs 18.6%, P < .001). In contrast, no significant differences were noted between the samples with submucosal eosinophilia present versus submucosal eosinophilia absent for polymorphonuclear leukocyte (PMN) percent, lymphocyte percent, or macrophage percent in BAL. There was a significant difference in eosinophil percentage between the two groups (8.7% vs 1.1%, P = .004). When submucosal eosinophilia was divided into mild (1-10 eosinophils/HPF), moderate (11-20 eosinophils/HPF), and severe (>20 eosinophils/HPF), mean eosinophilia trended more with eosinophilia in the BAL than with the peripheral blood. There was poor correlation (r = 0.31, P = .0001) between eosinophil levels in the blood and BAL.

Conclusion
Compared to BAL, histopathologic data may more accurately characterize the underlying pathophysiology in severe asthmatics by providing a more detailed quantification of the airway inflammatory infiltrates. Moreover, blood eosinophilia may not be as representative of airway inflammation in patients with severe refractory asthma given the poor correlation between eosinophil levels in the blood and BAL.
Three Cases of Pyogenic Granuloma of the Gastrointestinal Tract
Authors: Nakanishi Yukihiro , Behl Preeti , Crawford Byron 
Published: September 2019

Abstract
Pyogenic granuloma also known as lobular capillary hemangioma occurs commonly in the skin and oral mucosa. This entity has been rarely reported in the gastrointestinal tract. We herein report three cases of pyogenic granuloma, located in the duodenum, ileum, and rectum, respectively. Case 1 is a 54-year-old female with a history of angioimmunoblastic T-cell lymphoma who underwent an esophagogastroduodenoscopy for severe heartburn. The endoscopy showed a 13-mm nonbleeding, pedunculated polyp in the second portion of duodenum, which was removed using a hot snare after injection of epinephrine. The patient had an episode of massive gastrointestinal bleeding postpolypectomy, with a significant drop of her hemoglobin, which was managed with blood transfusion. Case 2 is a 68-year-old male with a history of right hemicolectomy due to trauma who had a colonoscopy for chronic diarrhea. The colonoscopy revealed a 14-mm, nonbleeding, pedunculated polyp in the ileum, located 3 cm from the ileocolonic anastomosis. The polyp was removed with hot snare, without complications. Case 3 is a 44-year-old female with morbid obesity who underwent a colonoscopy for iron-deficiency anemia. The colonoscopy showed an 8-mm multilobulated sessile lesion in the distal rectum, which was completely removed using hot snare. No complications were seen postpolypectomy. Histological examination of all the three polyps showed a proliferation of capillary-sized blood vessels with a mixed inflammatory infiltrate, resembling granulation tissue. Additionally, the ileal polyp in our case had marked eosinophilic infiltrate, the etiology of which remains unknown. In conclusion, pyogenic granuloma, given its vascular nature, can be a cause of bleeding in the gastrointestinal tract. Awareness regarding this rare entity is important for its proper diagnosis and treatment.
A Case of Pseudomelanosis Duodeni: Striking Endoscopic Features With Subtle but Characteristic Pathologic Findings
Authors: Nakanishi Yukihiro , Souers Amber , Shridhar Rachna Jetly , De Felice Kara , Crawford Byron 
Published: September 2019

Abstract
A 72-year-old man was referred to the inflammatory bowel disease clinic for evaluation for possible Crohn disease. The patient was diagnosed with pan-ulcerative colitis in the late 1960s. He had medically refractory disease and required a total proctocolectomy with end ileostomy in the early 1970s. Since surgery, the patient has done well with his end ileostomy and has not required any inflammatory bowel disease medications. Over the past 14 months, he has developed intermittent foul-smelling serosanguinous drainage from his previous drained pilonidal cyst. His local gastroenterologist raised the concern for possible Crohn disease with perianal involvement. He has a significant family history of Crohn disease in his father. Past medical history includes chronic kidney disease, hypertension, diabetes, coronary artery disease, gout, and arthritis. Esophagogastroduodenoscopy (EGD) revealed diffuse brown to black speckled/tigroid spots in the entire examined duodenum. Duodenal biopsy showed scattered clusters of macrophages containing dark pigmented granules within the apical tips of the lamina propria. These pigmented granules were focally positive with iron staining. No villous blunting, intraepithelial lymphocytosis, granuloma, or significant inflammation was identified. The distinctive endoscopic and histologic features are diagnostic of pseudomelanosis duodeni. Pseudomelanosis duodeni is a rare benign entity characterized by diffuse black tigroid spots and aggregates of pigment-laden macrophages in the lamina propria. Results of iron staining are characteristically variable. Pseudomelanosis duodeni is seen in middle-aged to elderly adults. Most of the patients with pseudomelanosis duodeni are asymptomatic. Although the exact etiology remains unknown, pseudomelanosis duodeni has been reported to be associated with several medical conditions such as end-stage renal disease, hypertension, diabetes, heart failure, gastrointestinal hemorrhage, and medications, including oral iron therapy, furosemide, hydralazine, thiazide, and iron sulfate. Pathologists should be aware of this rare condition of the duodenum to make an accurate diagnosis of this rare entity.
The Histopathologic Patterns of Intracranial Neoplasms in the Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, Nigeria: A 10-Year Retrospective Study, January 2008 to December 2017
Authors: Uchime Kasiemobi , Adebayo Luqman , Anunobi Charles 
Published: September 2019

Abstract

Objectives
Intracranial neoplasms have distinct diagnostic histologic features and some are common in certain gender and age groups. The most common intracranial neoplasm worldwide is meningioma, followed by gliomas, most especially astrocytic tumors, and then pituitary adenomas. There are geographical differences in the pattern of occurrence of intracranial neoplasms. Few studies have been done in Nigeria to demonstrate the pattern of occurrence, age, and sex distributions of these neoplasms. The aim for this study is to establish the pattern of occurrence with age and sex distribution of different histologic types of intracranial neoplasm in our environment. This study may help portray the health burden of these tumors and aid in epidemiological studies.

Methods
A total of 296 patients (165 females, 131 males) diagnosed with intracranial neoplasms between January 2008 and December 2017 at Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, Nigeria, were retrospectively analyzed. Patients’ data were retrieved from the archives of the Department of Anatomic and Molecular Pathology, LUTH, Idi-Araba, Lagos. Histologic patterns with age and gender distribution were noted. The data obtained were analyzed with SPSS version 23.

Results
Majority of the patients diagnosed with intracranial neoplasm were between 41 and 50 years of age. The most frequently diagnosed intracranial neoplasm at LUTH within the study period was meningioma (105 cases, median age of 42 years, male to female ratio of 3:7), followed by pituitary adenoma (78 cases, median age of 47 years, male to female ratio of 3:2), and then gliomas (66 case), most especially the astrocytic and oligodendroglial tumors (median age of 37 years, male to female ratio of 2:3).

Conclusion
The result of the study shows that the pattern of occurrence of primary intracranial neoplasms in our environment is different from that in Caucasians, with meningiomas being the most common, followed by pituitary adenomas and then gliomas.
Mixed Neuroendocrine-Nonneuroendocrine Carcinoma Arising in the Gallbladder: A Rare Case of a Three-Component Composite Neoplasm
Authors: Alawad Mouyed , Schoninger Scott , Gupta Raavi 
Published: September 2019

Abstract

Introduction
Neuroendocrine gallbladder neoplasms are rare, comprising 0.5% of all neuroendocrine cancers and about 2% of gallbladder cancers. Interestingly, those neoplasms can also be observed along with other malignant components of epithelial origin, mostly adenocarcinomas. Herein we report an unusual case of a patient with a gallbladder neoplasm composed of a neuroendocrine carcinoma, a squamous cell carcinoma, and an adenocarcinoma.

Methods
The patient was a 62-year-old woman who presented with right upper quadrant abdominal pain with a positive Murphy’s sign on physical examination. She was clinically diagnosed with acute cholecystitis and underwent cholecystectomy. Gross examination showed a 5-cm exophytic mass at the gallbladder fundus. Histopathologic examination of the mass showed an infiltrating squamous cell carcinoma and an adjacent high-grade neuroendocrine carcinoma; each of these two components composed more than 30% of the neoplasm and infiltrated into the perimuscular connective tissue with no serosal involvement. Additionally, a superficial adenocarcinoma component was also seen composing 10% of the neoplasm. The squamous cell carcinoma showed moderate differentiation with areas of keratinization; it was positive for Ck7, p40, and p63. The neuroendocrine carcinoma showed areas of geographic necrosis, and the cells had inconspicuous nucleoli and granular chromatin, with numerous mitotic figures; it was positive for synaptophysin and chromogranin. The adenocarcinoma showed gland formation with mucicarmine stain, highlighting the mucin within the neoplastic cells; it was positive for Ck7 but negative for p40. Subsequently, the patient underwent resection of the liver bed, which was negative for metastasis, and was then referred for chemotherapy.

Conclusion
Our review of the literature revealed seven documented cases of three-component gallbladder neuroendocrine neoplasms. Generally, patients with these tumors have a poor prognosis, and due to their rarity, no specific treatment guidelines have yet been established. It has been suggested that a multipotent common stem cell is the origin of these tumors.
Improving Augmented Human Intelligence to Distinguish Burkitt Lymphoma From Diffuse Large B-Cell Lymphoma Cases
Authors: Mohlman Jeffrey , Leventhal Samuel , Pascucci Valerio , Salama Mohamed 
Published: September 2019

Abstract

Introduction
Our objective is to improve the assistive role of a deep, densely connected convolutional neural network (CNN) to hematopathologists in differentiating histologic images of Burkitt lymphoma (BL) from diffuse large B-cell lymphoma (DLBCL). We hypothesized that for the majority of cases, a CNN would accurately differentiate BL from DLBCL and attempted to identify design and input variables to improve performance.

Methods and Materials
In total, 3608 images of BL were collected from 18 cases and 2,071 images of DLBCL were collected from 20 cases using Aperio Image Scope (Leica Biosystems, Buffalo Grove, IL). Cases were randomized into training and unknowns, and three separate CNNs were trained and applied to unknown images. Networks differed by either the size in pixels of the images (network 1 used 32 × 32 while networks 2 and 3 used 224 × 224) or absence of color (in network 2). Decreased numbers of training images were used to evaluate network 3.

Results
Network 3 performed the best with 17 of 19 (89%) cases classified correctly, 10 with 100% of images correct. Overall, network 3 had 88% accuracy, 80% precision, 81% recall, and an F1 score of 0.81. Receiver operating characteristic (ROC) curve analysis showed an area under the curve (AUC) of 0.89 for DLBCL and 0.88 for BL. Networks 1 and 2 performed more poorly with F1 scores of 0.63 and 0.39, respectively. Decreasing training images by one-half and one-fourth resulted in decreased F1 scores of 0.63 and 0.60, respectively.

Conclusions
CNNs are promising augmented human intelligence tools for differentiating DLBCL from BL cases and potentially could contribute to improved workflow in the laboratory. More training images, larger image size, and color significantly improved performance of the CNN because of the added information available to the network. More research is under way to optimize the performance of CNNs’ lymphoma application.
Status of Histopathology Services in Ethiopia
Authors: Yeabyo Giorgis 
Published: September 2019

Abstract

Objectives
The main purpose of this study is to evaluate the accessibility of pathology services in Ethiopia.

Methods
Checklist was prepared for the assessment of the availability of histopathology services in Ethiopia, types of equipment, turnaround time (TAT), and intended number of population to use it.

Results
There are 13 histopathology laboratories in the Ethiopia and a survey was conducted at all facilities in the nation. Out of 13 institutions, 7 (53.8%) of them are located in the capital, Addis Ababa. Six (46.2%) of them are out of the capital located in four different regions. No service is given in regions of afar, Somali, Benishangul-gumuz, Gambella, Harari, and Diredawa city administration where 40,239,100 population resides.

Conclusion
There are very limited histopathology laboratories in the country; as a result, diagnosis and prevention of cancer diseases are inadequate throughout the country.
A Loop-Mediated Isothermal Amplification (LAMP) Assay for the Detection of Treponema pallidum subsp. pertenue
Authors: Anthony Basing Laud 
Published: September 2019

Abstract

Objectives
The eradication of yaws, a childhood disease caused by Treponema pallidum subsp. pertenue, is constrained by the lack of rapid, accurate diagnosis. We sought to develop a molecular point-of-care test for the diagnosis of yaws.

Methods
A loop-mediated isothermal amplification (LAMP) assay with primers targeting the conserved gene, tp0967, with visual detection by lateral flow test strip was developed. The assay was optimized by varying the concentrations of reagents as well as the temperature and time of the reaction. The limit of detection and selectivity of the assay were evaluated. Subsequently, 63 clinical samples from yaws-infected lesions were used to determine the sensitivity of the assay from both unextracted and DNA extracted swab samples as compared to the current molecular testing protocol (CDC PCR assay) as the gold standard. A further five clinical samples from lesions containing PCR-confirmed syphilis pathogen (Treponema pallidum subsp. pallidum) were tested to ensure specificity of the assay for yaws alone.

Results
The developed LAMP assay was found to be optimal when run at 65oC for 30 minutes. The limit of detection was 2.7*104 copies DNA per mL. Out of the 63 yaws samples tested, the CDC assay, extracted DNA LAMP assay, and unextracted DNA using the LAMP assay resulted in 12, 14, and 8 positive results, respectively. None of the syphilis samples tested positive in any of the assays.

Conclusion
We show the development of a fast and sensitive LAMP assay for Treponema pallidum subsp. pertenue detected by lateral flow test strip. Using extracted DNA, the assay sensitivity is on par with gold standard detection. Further, the assay can be adapted to minimal sample processing required for in-field detection without DNA extraction.
Evaluation of Forward Laser Light Scatter Technology as a Preculture Screen of Unpreserved Urine Specimens
Authors: Coberly Jared , Prabhakaran Nitya 
Published: September 2019

Abstract

Introduction
Urine cultures are standard of care for the diagnosis of urinary tract infections. Reflexively culturing specimens only after an effective screening test could minimize the number of samples cultured, improving laboratory efficiency. We evaluated a commercial forward laser light scatter system as a screening tool for urine cultures.

Methods
One hundred ninety (190) consecutive unpreserved urine specimens were screened by the BacterioScan 216Dx system (BacterioScan) prior to urine culture. Performance characteristics were compared against traditional culture methods.

Results
Urine specimens from 40 men and 150 women were evaluated. In total, 182 specimens were obtained by clean-catch, 7 by catheter, and 1 via nephrostomy; 134 specimens were negative by urine culture (70%). Fifty-six were positive, with the most commonly identified organism being E coli (35 specimens, 62.5%). Compared to urine culture, forward laser light scatter identified 132 positives and 58 negatives (31%) for a sensitivity of 98%, specificity of 42%, positive predictive value of 42%, negative predictive value of 98%, and an overall accuracy of 59%. Average time from collection to result for light scatter analysis was 25 hours and 28 minutes (95% CI, ±74 minutes) versus 52:37 (±280 minutes) for urine culture (P < .01). Time to negative results was 25:51 (±77 minutes) for light scatter versus 53:17 (±320 minutes) for culture (P < .01). Time to positive results was 26:36 (±66 minutes) versus 51:02 (±146 minutes) for culture (P < .01).

Conclusions
Time to negative result and assay sensitivity showed an improvement over direct urine culture and could reduce number of cultures by ~30%; however, low positive predictive value and accuracy would lead to reflexive culture in the majority of specimens tested, limiting overall utility. Cost analyses may prove the modest efficiency gains do not outweigh the additional expense.
Epithelial-to-Mesenchymal Transition (EMT) and Signal Transducers and Activators of Transcription (STAT3) Are a Novel Therapeutic Strategy for Hepatocellular Carcinoma (HCC) Prognosis
Authors: Fyala Amira , Sultan Ahmed 
Published: September 2019

Abstract

Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide and is the second most common cancer in Egypt. Poor diagnosis of HCC is correlated with vascular invasion and metastasis. Epithelial-to-mesenchymal transition (EMT) is the main step in the tumor invasion process whereby epithelial cells lose cell polarity with each other and then undergo a dramatic remodeling of the cytoskeleton. Also, EMT plays a pivotal role in metastasis when epithelial cell layers lose cell-cell contacts in tumor progression due to the loss of E-cadherin and increasing the ability of the spread into surrounding tissues. Signal transducers and activators of transcription (STAT) play a different cellular function as signal transducers in the cytoplasm and transcription activators in the nucleus. STAT3 gene plays a crucial role to affect EMT in cancer progression by promoting cell proliferation and survival through its function as a transcription factor of the tumor. The aim of our study is to investigate the gene expression of STAT3 in HCC (HepG-2) cell lines and the expression of cell differentiation and proliferation markers. Western blotting was used to examine the protein expression of STAT3, E-cadherin, and β-catenin signaling. Our results showed that STAT3 expression levels were detected, as well as a significant increase in the expression of proliferation marker as β-catenin and a significant decrease of differentiation marker as E-cadherin protein expression levels in HepG-2 cell lines.

Conclusion
Our finding provides novel evidence for using a molecular gene therapy as STAT3, which showed an effect on EMT that plays a pivotal role in the prognosis of HCC. The loss of E-cadherin expression is a hallmark of EMT, because β-catenin is associated with the cytoplasmic domain of E-cadherin. We have emphasized the significant role of EMT and STAT3 in HCC progression, which could be a potential application as a novel therapeutic strategy for HCC treatment.
Analysis of the Expression of Genes Related to Lipidic and Glycogenic Metabolism in Pleomorphic Adenomas and Carcinomas Ex Pleomorphic Adenomas
Authors: Egal Erika , Scarini Joao , Fernandes Larissa , Sabino Welligton , Souza Reydson , Tincani Alfio , Del Negro Andre , Paulo Kowaski Luiz , Campanela Debora , Altemani Albina , Mariano Fernanda 
Published: September 2019

Abstract

Introduction
The carcinoma ex pleomorphic adenoma (CXPA) arises from a pleomorphic adenoma (PA) and is supposed to gain lipogenesis and glycogenesis during its malignant transformation. Increased lipogenesis is a characteristic of cancer cells, consisting of increased fatty acid synthesis by the enzyme fatty acid synthase (FASN) and by the accumulation of cytoplasmic lipid droplets, which express adipophilin. The increase in glycolytic metabolism has been associated with the activity of glycolytic enzymes and glucose transporters (GLUTs), whose expression is induced by HIF-1 (inducing factor of hypoxia 1).

Objectives
To analyze the gene expression of FASN, adipophilin, HIF-1α, and GLUT-1 in PA and CXPA samples.

Methodology
Gene expression analysis of the FASN, adipophilin, HIF1-α, and GLUT-1 genes was performed by the real-time PCR (qPCR) method. Fourteen cases of PA and 14 cases of CXAP were evaluated.

Results
FASN, adipophilin, HIF-1α, and GLUT-1 were more expressed in CXAP than in AP, although there was no significant difference between levels of adipophilin expression in CXPA and PA.

Conclusion
Increased expression of FASN, HIF1-α, and GLUT-1 in CXAP may be associated with malignant transformation of PA, while additional studies are needed to understand the role of adipophilin in PA carcinogenesis. Moreover, this is the first study to investigate the role of these genes in the malignant transformation of PA.