Head-tracking as an interface device for image control in digital pathology: a comparative study / Reconocimiento facial como interfaz de usuario para el manejo de la imagen en patología digital: un estudio comparativo

BACKGROUND: Inasmuch as the conventional mouse is not an ideal input device for digital pathology, the aim of this study was to evaluate alternative systems with the goal of identifying a natural user interface (NUI) for controlling whole slide images (WSI). DESIGN: Four pathologists evaluated three webcam-based, head-tracking mouse emulators: Enable Viacam (eViacam, CREA Software), Nouse (JLG Health Solutions Inc), and Camera Mouse (CM Solutions Inc). Twenty WSI dermatopathological cases were randomly selected and examined with Image Viewer (Ventana, AZ, USA). The NASA-TLX was used to rate the perceived workload of using these systems and time was recorded. In addition, a satisfaction survey was used. RESULTS: The mean total time needed for diagnosis with Camera Mouse, eViacam, and Nouse was 18'57", 19'37" and 22'32", respectively (57/59/68seconds per case, respectively). The NASA-TLX workload score, where lower scores are better, was 42.1 for eViacam, 53.3 for Nouse and 60.62 for Camera Mouse. This correlated with the pathologists' degree of satisfaction on a scale of 1-5: 3.4 for eViacam, 3 for Nouse, and 2 for Camera Mouse (p < 0.05). CONCLUSIONS: Head-tracking systems enable pathologists to control the computer cursor and virtual slides without their hands using only a webcam as an input device. - Of the three software solutions examined, eViacam seems to be the best of those evaluated in this study, followed by Nouse and, finally, Camera Mouse. - Further studies integrating other systems should be performed in conjunction with software developments to identify the ideal device for digital pathology

INTRODUCCIÓN: Considerando que el ratón convencional no es el controlador ideal en patología digital, el objetivo del estudio fue evaluar sistemas alternativos y tratar de identificar una interfaz natural de usuario para controlar preparaciones digitalizadas. MATERIAL Y MÉTODOS: Cuatro patólogos evaluaron tres emuladores de ratón con reconocimiento facial a través de webcam: eViacam, Nouse y Camera Mouse. Se seleccionaron 20 casos digitalizados de dermatopatología aleatoriamente para su diagnóstico, empleando el software Image Viewer (Ventana, AZ, USA). Se utilizó el sistema NASA-TLX para registrar la carga de trabajo percibida y se grabaron los tiempos. Adicionalmente, se empleó un cuestionario de satisfacción. RESULTADOS: El tiempo medio requerido para diagnosticar con Camera Mouse, eViacam y Nouse fue de 18'57", 19'37"y 22'32", respectivamente (57/59/68 segundos por caso, respectivamente). La carga de trabajo NASA-TLX, donde registros menores implican menor carga, fue de 42,1 para eViacam, 53,3 para Nouse y 60,62 para Camera Mouse, correlacionándose con el grado de satisfacción de los patólogos en una escala de 1-5: 3,4 para eViacam (3,4), Nouse (3) y Camera Mouse (2) (p < 0,05). CONCLUSIONES: El reconocimiento facial posibilita a los patólogos el control del cursor y las preparaciones virtuales sin utilizar las manos, empleando únicamente una webcam como dispositivo de entrada. - De los tres sistemas, eViacam es el mejor software evaluado en este estudio, seguido de Nouse y, finalmente, de Camera Mouse. - Deben ser desarrollados estudios adicionales, integrando otros sistemas, en conjunción con el desarrollo de software para alcanzar el sistema ideal en patología digital

Hallazgos pulmonares en un caso de muerte inesperada por infección de COVID-19 / Pulmonary findings in an unexpected COVID-19 death

El nuevo coronavirus SARS-CoV-2 ha causado miles de muertes alrededor del mundo. La mayoría de los fallecimientos ocurren en instalaciones sanitarias; sin embargo, un número indeterminado de enfermos fallecen de manera súbita, inesperada o repentina en diversos lugares y representan casos de interés médico legal. Compartimos los hallazgos del estudio microscópico de muestras de pulmón de un caso de muerte inesperada de un paciente positivo por COVID-19 que permanecía en aislamiento domiciliario. Nuestras observaciones corroboran la endotelialitis, trombosis y angiogénesis como distintivos de la patología pulmonar de esta nueva enfermedad, hallazgos con implicaciones clínicas y terapéuticas

The new SARS-CoV-2 coronavirus has caused thousands of deaths around the world. Most deaths occur in healthcare facilities. However, an undetermined number of patients die suddenly, unexpectedly in a variety of places and are cases of medical legal interest. We share the findings of the microscopic study of lung samples from a COVID-19 positive patient who died unexpectedly at home in quarantine. Our observations confirm endothelialitis, thrombosis and angiogenesis as microscopic hallmarks of the lung pathology of this new disease. These findings have clinical and therapeutic implications

Multi-organ pathological findings associated with COVID-19 in postmortem needle core biopsies in four patients and a review of the current literature / Hallazgos patológicos multiorgánicos asociados a COVID-19 a través de biopsias con aguja gruesa postmortem y revisión de la literatura actual

Coronavirus disease 2019 (COVID-19) has spread worldwide, resulting in significant morbidity and mortality. Histopathological findings are essential in understanding its pathogenesis and we present our findings from postmortem core needle biopsies in an attempt to share information that may shed some light on this severe pandemic. Different organ samples from four patients with PCR-confirmed COVID-19 at the Infanta Sofía Hospital (Madrid) were studied during the months of April and May, 2020 by six pathologists using routine stains, histochemistry and immunohistochemistry. Results were compared with other reported cases. All patients had a clinical diagnosis of pneumonia and biopsies revealed lung damage in the majority. Heart, liver, spleen and kidney were also studied and abnormalities were found in all cases and are extensively described. The histopathology of organs affected by COVID-19 is vital to the understanding of this disease and its sequelae

La enfermedad de coronavirus 2019 (COVID-19) ha afectado de forma mundial causando intensa morbimortalidad. Los hallazgos patológicos son claves para entender su patogénesis. A través de biopsias con aguja gruesa postmortem, intentamos responder a las incógnitas que giran en torno a la severidad de esta infección. Se enviaron muestras de cuatro pacientes COVID-19 positivos al servicio de Anatomía Patológica del Hospital Infanta Sofía (Madrid) en los meses de Abril y Mayo 2020. Se estudiaron a través de distintas técnicas y los resultados se compararon con la literatura, buscando similitudes y peculiaridades. Todos los pacientes tenían un diagnóstico de neumonía. Las biopsias mostraron daño pulmonar en la mayoría. El resto de los órganos estudiados fueron: corazón, hígado, bazo y riñón. Se encontraron características distintivas en muchos, las cuales fueron descritas exhaustivamente. En conclusión, el análisis microscópico de los órganos afectados por COVID-19 es importante para comprender ésta enfermedad y sus posibles consecuencias

Hysteroscopy: endometrial vascular dystrophy / Histeroscopia: ¿distrofia vascular endometrial?

Objective: The objective of the study was to analyze cases of endometrial vascular dystrophy in the Hysteroscopy Unit of Hospital Clínico San Carlos, Madrid, Spain. Review: We reviewed a total of 7,658 hysteroscopies carried out in the unit during 2011-May 2017. We identified a total of 8 cases and analyzed both the hysteroscopy and the histopathology data. Conclusion: The condition known as endometrial vascular dystrophy does not comprise vascular disorders, but rather involves tortuous secretory glands (normal) filled with retained blood. We can find no explanation for this phenomenon

Objetivo: el objetivo del trabajo es analizar los casos de "Distrofia Vascular Endometrial" encontrados en la unidad de histeroscopias del Hospital Clínico de San Carlos (UCM). Material y métodos: se revisan un total de 7.658 histeroscopias, practicadas en la unidad durante el periodo de tiempo comprendido entre 2011- mayo de 2017. Se analizan las histeroscopias, así como el estudio histopatológico e histoquimico de los 8 casos de DVE encontrados. Resultados: se encuentran un total de 8 casos de DVE, totalmente documentados con videos, desechándose otros casos que no están documentados. Conclusión: los autores llegan a la conclusión de que la llamada Distrofia Vascular Endometrial, no está constituida por alteraciones vasculares, sino que se trata de glándulas secretoras tortuosas (normales) pero llenas de sangre retenida y material de secreción. No encuentran explicación a este fenómeno

Control de calidad de la citología ginecológica: programa de calidad de la Sociedad Española de Citología. Resultados de la segunda ronda / The Spanish Society of Cytology: quality control program of gynecological cytology

Introducción. Las recomendaciones del cribado de cáncer de cérvix en España incluyen la participación en programas de control de calidad externos a los laboratorios de citología. La Sociedad Española de Citología (SEC) ha iniciado un programa de control de calidad de la citología ginecológica (CG). Objetivo. Presentar y analizar los resultados de la segunda ronda del control de calidad de la SEC. Material y métodos. Se incluyeron casos procesados mediante citología en medio líquido. Se escanearon las laminillas mediante la plataforma Aperio. Se seleccionaron 23 muestras procedentes de un banco de casos con al menos un 75% de acuerdo entre 4 expertos citopatólogos. Los diagnósticos de los casos para estudio incluyeron: uno negativo, 15 lesiones de bajo grado (4 ASCUS y 11 LSIL) y 7 lesiones de alto grado (uno ASCH y 6 HSIL). La CML correspondía a ThinPrep® en 16 casos y a SurePath® en 7. Se realizó el estudio de la correlación diagnóstica interobservador. Resultados. Participaron 16 hospitales. Las concordancias medias fueron: global 70,6% y por tipo de lesión 63,1%. En negativo 71,9%, en ASCUS 56,2%, en LSIL 69,5% y en HSIL 82,8%. Los casos discordantes correspondían con mayor frecuencia a negativos y a ASCUS. Se observó discordancia severa (HSIL/ASCH frente a negativo) en un 4,4% de los casos. Conclusiones. Nuestros resultados son similares a los descritos en la literatura, encontrando muy escasas discordancias severas (AU)

Introduction. In Spain, the guidelines for cervical cancer screening include a recommendation to enroll in external quality control programs. The Spanish Society of Cytology (SEC) has initiated its own quality control program of gynecological cytology (QCPGC). Aim. To describe and discuss the results of the second round of SEC¿s QCPGC. Material and method. The cases are selected by a group of expert cytologists. The cases with an agreement of 75% of four cytopathologists were used. The cases were scanned with Aperio. The scanned cases not available were excluded. We included a total of 23 cases, 1 negative, 15 low grade lesions (4 ASCUS and 11 LSIL) and 7 high grade lesions (1 ASCH and 6 HSIL). Sixteen cases were studied with ThinPrep™ platform and in 7 cases the SurePath™ platform was used. Results. Sixteen hospitals participated. The global mean concordance was 70.6%. The mean concordance in the type of lesion was 63.1%. The concordance was 71.9% in negative diagnoses, 56.2% in ASCUS, 69.5% in LSIL and 82.8% in HSIL The discordant cases were diagnosed more frequently as negative and ASCUS. 4.4% of cases had major discordances (HSIL or ASCH versus negatives). Conclusions: Our results are similar to those reported in the literature, with very little severe discordance. The method of exchanging slides does not allows continuous training, since the review of discordant cases can not be made. Therefore, methodological corrections are contemplated for future rounds (AU)

Anatomía patológica del trasplante renal / The pathology of renal transplants

Una valoración objetiva de la histopatología de la biopsia renal en el trasplante exige conocer todos los factores implicados. Un factor importante es tener un conocimiento de las características del órgano trasplantado sobre todo si es donante mayor de edad superior a 65años. Las características de la biopsia del donante y su afectación sobre todo vascular están relacionadas con mala función inicial del injerto. La inflamación liderada por linfocitos T es una característica de Rechazo Celular Agudo siendo importante la cuantificación del grado de tubulitis así como el área del parénquima afectada. Es importante conocer la proporción de sub-poblaciones celulares tales como células plasmáticas y macrófagos ya que pueden relacionarse con la presencia de Rechazo Humoral, mediado por anticuerpos. El estudio con inmuno-fluorescencia o inmunohistoquímica es necesario para descartar depósitos de C4d o inmunoglobulinas. La presencia de abundantes depósitos de C4d en membranas basales tubulares apoya el diagnóstico de Rechazo Humoral así como la presencia de capilaritis, glomerulitis y vasculitis son hallazgos típicos diagnósticos en casos con C4d negativo. La fibrosis intersticial, atrofia tubular y esclerosis glomerular, aunque son hallazgos inespecíficos, implican un estadío crónico. La glomerulopatía del trasplante, la multilaminación en mas de 6 capas de la membrana basal del glomérulo o del túbulo son características quasi específicas de la existencia de Rechazo Humoral crónico. La identificación de estas previas patologías así como la presencia de otras enfermedades renales glomerulares exigen el estudio con microscopio electrónico (AU)

In order to make an objective assessment of the histopathology of a renal biopsy during a kidney transplant, all the various elements involved in the process must be understood. It is important to know the characteristics of the donor organ, especially if the donor is older than 65. The histopathological features of the donor biopsy, especially its vascular status, are often related to an initial poor function of the transplanted kidney. The T lymphocyte inflammatory response is characteristic in acute cellular rejection; the degree of tubulitis, together with the amount of affected parenchyme, are important factors. The proportion of cellular sub-populations, such as plasma cells and macrophages, is also important, as they can be related to antibody-mediated humoral rejection. Immunofluorescent or immunohistochemical studies are necessary to rule out C4d deposits or immunogloblulins. The presence of abundant deposits of C4d in tubular basement membranes supports a diagnosis of humoral rejection, as does the presence of capillaritis, glomerulitis which, together with vasculitis, are typical diagnostic findings in C4d negative cases. Interstitial fibrosis, tubular atrophy and glomerular sclerosis, although non-specific, imply a chronic phase. Transplant glomerulopathy and multilamination in more than 6 layers of the tubular and glomerular basement membranes are quasi-specific characteristics of chronic humoral rejection. Electron microscopy is essential to identify of these pathologies as well as to demonstrate the presence of other glomerular renal diseases (AU)

Histopathological factors predicting response to neoadjuvant therapy in gastric carcinoma

Background. Neoadjuvant therapy (NAT) is a useful therapeutic option. However, some patients respond poorly to it and can even show tumor progression. It is important to define factors that can predict response to NAT. Materials and methods. This is a retrospective cohort study to define histopathological factors predicting response to NAT in gastric tubular carcinoma. This study has enrolled 80 patients receiving chemotherapy for locally advanced gastric carcinoma. Results. 44.5% of the patients were men; mean age was 64.49 years. Only 5.7% of the patients showed a complete response to therapy, 10% had grade 1, 21.4% grade 2, and 62.9% grade 3 regression. On follow-up, 43.8% of the patients showed recurrence of disease (57.1% distant metastasis) and 33.8% eventually died of it. We found a statistically significant association between response and prognosis. We found a statistically significant association between regression and perineural, vascular, and lymph vessel invasion. Logistic regression model showed that only lymph vessel invasion had independent influence. Lymph vessel invasion not only indicated lack of response to therapy, but also higher incidence of lymph node involvement in the gastrectomy specimen. Discussion. Our study indicates that the presence of vascular or perineural invasion in the endoscopic biopsies and high histopathological grade predict poor response to therapy. This seems peculiar, for undifferentiated tumors are supposed to have better response to therapy. Conclusion. Our study indicates that undifferentiated tumors respond worse to therapy. Furthermore, studies are necessary to define lack of response, to help avoid neoadjuvant therapy in unfavorable cases (AU)

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Análisis histopatológico e inmunohistoquímico del uso del apósito de colágeno como refuerzo de anastomosis esofágica en un modelo experimental en rata / Histopathological and Immunohistochemical Analysis of the Use of Collagen Dressing as a Reinforcement of Esophagic Anastomosis in a Rat Experimental Model

Introducción: Una de las complicaciones más graves tras la cirugía de resección esofagogástrica es la dehiscencia de la anastomosis. El uso de apósitos adhesivos podría constituir una ayuda eficaz para resolver esta complicación. Nuestro objetivo ha sido realizar un estudio experimental encaminado a estudiar dichos mecanismos en un modelo de anastomosis esofágica en rata. Métodos: Se han utilizado un total de 50 ratas Sprague-Dawley divididas en 2 grupos, grupo Tachosil(R) (n = 25) y grupo control (n = 25). Tras la sección del esófago abdominal se realizó una anastomosis esófago-gástrica monoplano, reforzando con una tira de 1cm de Tachosil(R) envolviendo la anastomosis en el primer grupo. Se realizó un estudio funcional mediante manometría, así como un estudio histopatológico e inmunohistoquímico para factores angiogénicos, fibrogénicos y proliferativos. Resultados: La mortalidad en nuestra serie alcanzó un 8% en el grupo en el que fue aplicado apósito de colágeno, frente a un 36% del grupo control. Al realizar la manometría esofágica, la presión de dehiscencia fue mayor en las anastomosis reforzadas. En el estudio microscópico, en el grupo en el que se aplicó apósito de colágeno se apreció una profusa reacción inflamatoria con abundantes PMN y macrófagos rodeados por una matriz conectiva con fibroblastos y vasos sanguíneos. La expresión de VEGF y FGF1 y FGF2 fue sensiblemente mayor en las anastomosis con apósito de colágeno. Conclusiones: Estos resultados indican que la aplicación de apósito de colágeno facilita los fenómenos de reparación tisular, por lo que podría ser de gran utilidad como refuerzo de las anastomosis esofagogástricas para la prevención de dehiscencias (AU)

Introduction: One of the most severe complications after esophaguectomy is anastomotic dehiscence. The use of collagen sponges could be an effective way to resolve this complication. Our objective was to perform an experimental model of esophageal anastomosis in rats to study these mechanisms. Methods: A total of 50 Sprague-Dawley rats were used divided into 2 groups, Tachosil(R) group (n = 25) and control group (n = 25). After the section of the abdominal esophagus a single-layer esophago-gastric anastomosis was performed reinforced with 1cm of Tachosil(R) wrapping the anastomosis in group 1. A functional study was performed using manometry as well as histopathological and immunohistochemical studies for angiogenic, fibrogenic and growth factors. Results: The mortality in our series was 8% in the collagen dressing group, compared to 36% in the control group. When esophageal manometry was performed, the dehiscence pressure was higher in the reinforced anastomosis, On microscopical analysis, in the collagen dressing group a profuse inflammatory reaction with abundant neutrophils and macrophages surrounded by a connective matrix with fibroblasts and blood vessels was observed, The expression of VEGF, FGF1 and FGF2 was noticeably higher in the collagen dressing group. Conclusions: These results show that the application of collagen dressing facilitates tissue reparation phenomena, and therefore could be very useful as a reinforcement of esophago-gastric anastomosis to prevent dehiscence (AU)

Lesiones histopatológicas en peces originadas por la exposición a contaminantes emergentes: recopilando y analizando datos / Histopathological lesions in fish caused by exposure to emerging pollutants: collecting and analysing data

Los contaminantes emergentes son compuestos de diferente origen y naturaleza química cuya presencia en el medio ambiente, o las posibles consecuencias de la misma, han pasado en gran parte inadvertidas. Son compuestos de los cuales se posee poca información sobre su impacto en los distintos compartimentos ambientales y que, por tanto, precisan investigación. El creciente énfasis en la evaluación y monitoreo de los contaminantes en los ecosistemas acuáticos ha revelado la necesidad de utilizar biomarcadores apropiados, siendo las lesiones histopatológicas una herramienta cada vez más utilizada. El presente trabajo recoge una revisión bibliográfica sobre la presencia de contaminantes emergentes en el medio acuático, así como, de las lesiones histopatológicas originadas en peces como consecuencia de la exposición a estos compuestos. Se puede indicar que los fármacos son el grupo de contaminantes emergentes mayoritariamente detectado en el compartimento acuático (incluyendo aguas superficiales y sedimentos). Son el 17α-etinilestradiol (estrógeno sintético) y el nonilfenol (surfactante) los contaminantes emergentes más ampliamente estudiados en peces desde el punto de vista Histopatológico; y también se observa que existe predominancia de ciertas lesiones en cuanto al órgano estudiado y la exposición a determinados grupos de contaminantes emergentes. Por todo ello, se puede considerar a las lesiones histopatológicas como un buen biomarcador de exposición a contaminantes emergentes y de los efectos originados por ellos. Las lesiones histopatológicas pueden: alterar las funciones reguladas por los órganos afectados, las cuales están relacionadas con procesos biológicos importantes; reflejar cambios subclínicos originados por la exposición a bajas concentraciones de tóxicos (particularmente importante en el caso de los contaminantes emergentes) así como permanecer en el tiempo si las condiciones ambientales no varían (AU)

Emerging pollutants are compounds of different origin a chemical nature, which a presence in the environment, or their posible consequences, have largely gone unnoticed. They are compounds of which relatively little is known about their impact in the different environmental compartments, therefore, they need investigation. The increasing emphasis on the assessment and monitoring of contaminants in the aquatic ecosystems has revealed the need to use appropiate biomarkers, being the histopathological lesions a tool increasingly used. In the current work a review of the literatura on the presence of the emerging pollutants in the aquatic compartment, as well as, of the histopathological lesions caused by exposure to these compounds in fish was performed. It can be indicated that pharmaceutical compounds are the group of emerging pollutants mainly detected in the quatic environment (including superficial water and sediments). 17alpha-ethinylestradiol (synthetic estrogen) and nonylphenol (surfactant) are the most widely emerging pollutants studied in fish from a Histopathological point of view; and also it is observed that there is a predominance of certain lesions in terms of the organ studied and exposure to certain groups of emerging pollutants. For all that, histopathological lesions can be considered as a good biomarker of exposure and effects of emerging pollutants. Histopathological lesions can: disturb functions regulated by the affected organs that can be related with important biological processes; reflect subclinical changes caused by exposure to low concentrations of toxics (paticularly important in the case of emerging pollutants) as well as remain in time if the environmental conditions do not vary (AU)

Uncommon oral manifestation of lichen sclerosus: critical analysis of cases reported from 1957 to 2016

Background: Lichen sclerosus is a mucocutaneous autoimmune disease which might be initiated by infectious pathogens as Borrelia Bugrdorferi and HPV. This disease shows destructive potential and is rarely diagnosed in oral mucosa. The purpose of this paper is to evaluate the characteristics of cases described in literature from 1957 to 2016, looking to provide valuable evidence about clinicopathologic features of this disease. Material and Methods: A MedLine search was performed aiming to find oral lichen sclerosus cases in literature and discuss its demographical and pathological characteristics as well as treatment methods performed for these cases. Results: 34 oral lichen sclerosus cases with histological confirmation and one clinicopathologic study linked with this disease were found in literature. Oral lichen sclerosus affected most commonly female patients, were asymptomatic and not associated to skin or genital lesions. Furthermore, affected patients in a range of 7 - 70-years old (Average age = 31.81). Conclusions: Oral lichen sclerosus is a rare pathologic process with slight predilection for prepubertal girls, for which topical corticosterois have demonstrated satisfactory therapeutic value (AU)

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Proceso neuroinflamatorio en pacientes con el virus del dengue / Neuroinflammatory processes in patients with dengue virus

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Histopathology of gastric wall in Chinese alligator Alligator sinensis infected with Ortleppascaris sinensis (Nematoda: Ascaridoidea) / Histopatología de la pared gástrica en el aligátor chino alligator sinensis infectado con Ortleppascaris sinensis (Nematodos: Ascaridoidea)

Crocodiles are susceptible to infection with a wide array of external and internal gastrointestinal helminths, yet little is known on the histopathology following infection or the effects of these parasites. The present study was aimed at evaluating the impact of infection by Ortleppascaris sinensis (Nematoda: Ascaridoidea) on the stomach of captive Alligator sinensis. The histological examination of the stomach revealed presence of superficial ulcer in mucous layer and granulomatous inflammation in submucous layer at entire gastric walls of the Alligator sinensis. Our findings also confirm that development of Ortleppascaris sinensis is in close association with the wall of the stomach (AU)

Los cocodrilos son susceptibles a la infección con una amplia gama de helmintos gastrointestinales externos e internos; sin embargo, poco se sabe sobre la histopatología tras la infección o los efectos de estos parásitos. El presente estudio pretende evaluar el impacto de la infección por Ortleppascaris sinensis (Nematodos: Ascaridoidea) sobre el estómago del Alligator sinensis en cautividad. El examen histológico del estómago reveló la presencia de úlcera superficial en la capa mucosa e inflamación granulomatosa en la capa submucosa del conjunto de las paredes gástricas del Alligator sinensis. Nuestros resultados confirman también que el desarrollo de Ortleppascaris sinensis está estrechamente relacionado con la pared del estómago (AU)

Angiofibroma nasofaríngeo juvenil: a propósito de un caso / Juvenile nasopharyngeal angiofibroma: presentation of a case

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Histological, histochemical and ultrastructural characterization of the pancreas of the grass carp (Ctenopharyngodon idella)

The purpose of this study is to describe the histological, histochemical and ultrastructural features of pancreas of the grass carp (Ctenopharyngodon idella), one of the common herbivorous freshwater fish of Egypt. The pancreas is divided into exocrine and endocrine portions. Exocrine pancreatic tissues consists of scattered serous acini, and is observed in two forms: 1) disseminated in the spleen tissue, in mesentery around intestine and intestinal bulb, and 2) intrahepatically, around the branches of the portal vein. Two alveolar cell types are present in pancreatic acini; centroacinar cells and typical pyramidal acinar cells. Pancreatic stellate cells (PSC) are demonstrated in the perivascular and the periacinar space of the pancreas. The pancreatic acini gave positive reaction to PAS, Best's carmine, and osmium tetraoxide, and negative to alcian blue. The acini also show high lipase and alkaline phosphatase activity, and moderate activity for acid phosphatase. Scanning electron microscopy show apical microvilli of the acinar cells, and branched PSC extend their processes between the pancreatic cells. Ultrastructure of pancreatic acini reveals well-developed rER, membrane-bound zymogen granules, and abundant lipid droplets. The duct system is composed of intralobular duct, interlobular pancreatic duct and main duct opened in the intestinal bulb. The endocrine parts of the pancreas are organized as lightly staining Langerhan’s islets between exocrine acinar cells found in the liver, in mesenteries around the intestinal bulb and the intestine, and consisted of three cell types. Alpha cells were the most dominant cells, and were ovoid in shape. Beta cells were polyhedral in shape, and they grouped in small clusters. Delta cells were small fusiform, argyrophilic cells. In conclusion, the present study revealed that the exocrine portion of the pancreas of the grass carp had two forms, disseminated and intrahepatic, with characteristic cellular and histochemical components, and an endocrine portion that consisted of Alpha, Beta and Delta cells

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Insight into the pathogenesis and nature of central giant cell lesions of the jaws

Central giant cell lesions of the jaws are not uncommon. While the majority of these represent single, sporadic lesions, histologically identical lesions are seen in association with a number of other bone lesions, as well as in certain syndromes. This manuscript offers a brief update on recent developments in this area that provide new insight into the pathogenesis and nature of Central Giant Cell Lesions of the Jaws

Human population studies and the World Health Organization

This essay draws attention to the role of the WHO in shaping research agendas in the biomedical sciences in the postwar era. It considers in particular the genetic studies of human populations that were pursued under the aegis of the WHO from the late 1950s to 1970s. The study provides insights into how human and medical genetics entered the agenda of the WHO. At the same time, the population studies become a focus for tracking changing notions of international relations, cooperation, and development and their impact on research in biology and medicine in the post-World War II era. After a brief discussion of the early history of the WHO and its position in Cold War politics, the essay considers the WHO program in radiation protection and heredity and how the genetic study of «vanishing» human populations and a world-wide genetic study of newborns fitted this broader agenda. It then considers in more detail the kind of support offered by the WHO for these projects. The essay highlights the role of single individuals in taking advantage of WHO support for pushing their research agendas while establishing a trend towards cooperative international projects in biology (AU)

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Tumor congénito de lengua / Congenital tumor of tongue

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Enseñanzas derivadas del estudio comparativo entre biopsia de masa renal y el análisis del espécimen quirúrgico / Lessons learned from the comparative study between renal mass biopsy and the analysis of the surgical specimen

Introducción: El papel de la biopsia de masa renal (MR) está actualmente en discusión. Ante el aumento progresivo en el diagnóstico incidental de MR (que tienen un mayor porcentaje de benignidad y cánceres bien diferenciados) surgen nuevos planteamientos como la observación, especialmente en pacientes añosos o con importante comorbilidad. La biopsia de la MR (BMR) debería proporcionar datos suficientes para tomar esa decisión, pero hasta ahora no ha sido así. Estudiamos nuestra serie prospectiva de BMR tomadas en banco tras la cirugía, comparándola con la anatomía de la pieza extirpada. Material y métodos: Se obtuvieron, prospectivamente y en banco, 4 biopsias con aguja 16 Gauge (G) de las MR operadas en nuestro servicio desde octubre de 2008 a diciembre de 2009. Estas fueron analizadas por 2 uropatólogos y comparadas con el resultado de la pieza.Resultados: Se analizaron 188 biopsias (47 MR): 12,75% «no validas». La capacidad de la biopsia para diagnosticar la malignidad o benignidad fue del 100%, y la coincidencia en el tipo histológico del 95%. El acierto en el grado tumoral fue del 100% si el tumor era de bajo grado y del 62% si era de alto grado. Ninguno de los datos estudiados (necrosis, tamaño…) influyeron de manera estadísticamente significativa en los resultados. Conclusión: La BMR con aguja 16 G permite diferenciar entre malignidad y benignidad en 100% de los casos, con una exactitud diagnóstica en el tipo tumoral muy similar. El grado tumoral sigue siendo la asignatura pendiente de la BMR

Introduction: The role of renal mass (RM) biopsy is currently under discussion. As a result of the progressive increase in the incidental diagnosis of RMs (which have a higher percentage of benignity and well-differentiated cancers), new approaches have emerged such as observation, especially with elderly patients or those with significant comorbidity. RM biopsy (RMB) should provide sufficient information for making this decision, but so far this has not been the case. We examine our prospective series of in-bench RMBs after surgery and compare them with the anatomy of the removed specimen. Material and methods: We obtained (prospectively, in-bench and with a 16-gauge needle) 4 biopsies of RMs operated on in our department from October 2008 to December 2009. These RMs were analyzed by 2 uropathologists and compared with the results of the specimen. Results: We analyzed 188 biopsies (47 RMs); 12.75% were «not valid». The ability of biopsy to diagnose malignancy or benignity was 100%, and the coincidence in the histological type was 95%. The success in determining the tumor grade was 100% when the cancer was low-grade and 62% when high-grade. None of the analyzed data (necrosis, size, etc.) influenced the results in a statistically significant manner. Conclusion: RMB with a 16-G needle enables the differentiation between malignancy and benignity in 100% of cases, with a very similar diagnostic accuracy in the tumor type. Tumor grade is still the pending issue with renal mass biopsy

Revisión sistemática sobre el diagnóstico diferencial de lesiones radiotransparentes asociadas a terceros molares / Systematic review on the differential diagnosis of radiolucent lesions associated third molar

Introducción: Los quistes dentígeros son quistes odontogénicos de malformación y origen epitelial, según la clasificación de los tumores, realizada por la Organización Mundial de la Salud (OMS). Es el más común después del quiste radicular y están asociados a la corona de un diente en desarrollo, no erupcionado o incluido. En ocasiones, la presencia de un quiste dentígero a nivel de un tercer molar no erupcionado, puede llevará un diagnóstico erróneo, pudiéndose confundir con el folículo dental de propio diente. Objetivos: Determinar qué imágenes radiotransparentes, a nivel de los terceros molares, corresponden a folículos dentales o aquistes dentígeros. Material y método: Se realizó una revisión sistemática de los artículos publicados en las bases de datos Pubmed / Medline, Cochrane Database of Systematic Reviews y Embase hasta el 1 de marzo de 2013 incluido, utilizando las palabras clave «third molar» AND «dentigerous cyst» AND «dental follicle». Los criterios de inclusión de los artículos se establecieron según el formato PICO. Resultados: Los resultados de los estudios consultados, indican que no existe un criterio estandarizado, en cuanto a las dimensiones a nivel del espacio pericoronario, que sean los utilizados por todos los autores para diferenciar el límite entre folículo dental y quiste dentígero. Conclusiones: Se ha observado que la presencia de una imagen radiotransparente a nivel de los terceros molares, no siempre es excluyente a la hora de establecer un diagnóstico final. Por ello, es necesario considerar siempre la anatomía patológica, que nos proporcionará o corroborará el diagnóstico

Introduction: The dentigerous cysts areodontogenic cysts and epithelial malformation, by classification of tumors by the World health Organization (WhO). It is most common after radicular cyst and are associated with the crown of a developing tooth, unerupted or included. Sometimes the presence of a dentigerous level of a third molar unerupted cyst can lead to misdiagnosis, and may be confused with the dental follicle of the tooth itself. Objectives: To determine what lucencies at the level of the third molars, are dental dentigerous cysts or follicles. Methods: A systematic review of published articles in the database Pubmed / Medline, Cochrane Database of Systematic Reviews, Embase and Ebsco data until March 1, 2013 inclusive was performed using keywords 'third molar' AND the words ' dentigerous cyst’ AND ‘Dental follicle’. The criteria for inclusion of articles was established according to PICO format. Results: The results of the studies consulted, indicate that there is no standardized criteria, in terms of dimensions pericoronal level space, which are used by all the authors to distinguish the boundary between dental follicle and dentigerous cyst. Conclusions: It has been observed that the presence of a radiolucent image at the level of third molars is not always exclusive to when establishing a final diagnosis. Therefore, you must always include pathology, which will provide or corroborate the diagnosis

Diagnosing organizing pneumonia: Limitations of radiology and pathology / Diagnóstico de neumonía organizada: limitaciones de la radiología y la anatomía patológica

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