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This comprehensive review explores the complex terrain of stem cell therapies as a potential therapeutic frontier in the healing of complicated burn wounds. Serious tissue damage, impaired healing processes, and possible long-term consequences make burn wounds a complex problem. An in-depth review is required since, despite medical progress, existing methods for treating severe burn wounds have significant limitations. Burn wounds are difficult to heal because they cause extensive tissue damage. The challenges of burn injury-induced tissue regeneration and functional recovery are also the subject of this review. Although there is a lot of promise in current stem cell treatments, there are also some limitations with scalability, finding the best way to transport the cells, and finding consistent results across different types of patients. To shed light on how to improve stem cell interventions to heal severe burn wounds, this review covers various stem cell applications in burn wounds and examines these obstacles. To overcome these obstacles, one solution is to enhance methods of stem cell distribution, modify therapies according to the severity of the burn, and conduct more studies on how stem cell therapy affects individual patients. Novel solutions may also be possible through the combination of cutting-edge technologies like nanotechnology and biotechnology. This review seeks to increase stem cell interventions by analyzing present challenges and suggesting strategic improvements. The goal is to provide a more effective and tailored way to repair serious burn wounds.
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Amidst the present healthcare issues, diabetes is unique as an emerging class of affliction with chronicity in a majority of the population. To check and control its effects, there have been huge turnover and constant development of management strategies, and though a bigger part of the health care area is involved in achieving its control and the related issues such as the effect of diabetes on wound healing and care and many of the works have reached certain successful outcomes, still there is a huge lack in managing it, with maximum effect yet to be attained. Studying pathophysiology and involvement of various treatment options, such as tissue engineering, application of hydrogels, drug delivery methods, and enhancing angiogenesis, are at constantly developing stages either direct or indirect. In this review, we have gathered a wide field of information and different new therapeutic methods and targets for the scientific community, paving the way toward more settled ideas and research advances to cure diabetic wounds and manage their outcomes.
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Materiales Biocompatibles , Diabetes Mellitus , Hidrogeles , Neovascularización Fisiológica , Cicatrización de Heridas , Cicatrización de Heridas/efectos de los fármacos , Humanos , Materiales Biocompatibles/uso terapéutico , Materiales Biocompatibles/química , Neovascularización Fisiológica/efectos de los fármacos , Hidrogeles/química , Hidrogeles/uso terapéutico , Diabetes Mellitus/tratamiento farmacológico , Diabetes Mellitus/fisiopatología , Animales , Ingeniería de Tejidos/métodos , Sistemas de Liberación de Medicamentos/métodos , AngiogénesisRESUMEN
Background: Pediatric central nervous system (CNS) tumors have a different histological spectrum as compared to adults with the infantile group having even more varied and distinct histological profiles. Intra-operative diagnosis is especially important as it guides the neurosurgeon to tailor an approach which is best suited for a particular case. The aim of the study was to evaluate the diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value of frozen section (FS) and squash cytology and to find out the degree of correlation (kappa value) between the two procedures. Materials and Methods: A prospective study was conducted on 55 pediatric patients with clinicoradiologically diagnosed CNS lesions for a period of 2.5 years. Intra-operative squash smears and FS were made and stained with hematoxylin and eosin stain. Diagnosis made subsequently on paraffin embedded sections was taken as the gold standard. Results: Although the specificity (90%) and positive predictive value (96%) were comparable between the two procedures, sensitivity (91.4%) and negative predictive value (75%) of FS was more as compared to squash cytology. Both the diagnostic modalities showed substantial agreement (k = 0.728). Conclusion: Even though the histological spectrum of pediatric CNS tumors is more varied than adults, FS gives a reasonable intra-operative diagnosis and better results when compared to squash alone.
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Neoplasias del Sistema Nervioso Central , Secciones por Congelación , Adulto , Neoplasias del Sistema Nervioso Central/diagnóstico , Neoplasias del Sistema Nervioso Central/patología , Niño , Citodiagnóstico/métodos , Secciones por Congelación/métodos , Humanos , Valor Predictivo de las Pruebas , Estudios ProspectivosRESUMEN
Clear cell meningioma (CCM) is a rare histological variant of meningioma. It is commonly located at the cerebellopontine angle and the spine particularly around the cauda equina. Squash cytology finding of meningioma is well-established, however there is sparse literature available on squash cytology of CCM. Here we describe a case of CCM occurring in the lumbar spine in a young woman. Initially, on squash cytology a diagnosis of a low grade glioma favouring an ependymoma was considered. Eventually histopathological examination along with immunohistochemistry helped us reach the diagnosis of a CCM. In this article we discuss the cytomorphology of CCM along with its cytological differentials and the hurdles to an accurate diagnosis.
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Ependimoma , Neoplasias Meníngeas , Meningioma , Citodiagnóstico , Ependimoma/diagnóstico , Ependimoma/patología , Femenino , Humanos , Inmunohistoquímica , Neoplasias Meníngeas/diagnóstico , Neoplasias Meníngeas/patología , Meningioma/diagnóstico , Meningioma/patologíaRESUMEN
BACKGROUND: Squash cytology is of significant importance in intraoperative consultation of central nervous system (CNS) pathology. There are several studies on squash cytology of CNS lesions, and only a few of them deal with spinal lesions alone. AIMS: (1) To evaluate intraoperative squash cytology of spinal lesions. (2) To correlate cytological diagnosis with histopathological diagnosis and assess the diagnostic accuracy. (3) To study Ki67 expression on squash smears and determine whether it can assist in grading spinal tumours on cytology. MATERIALS AND METHODS: A prospective study was conducted on 68 patients with clinico-radiologically diagnosed lesions of the spine. Intraoperative squash smears were stained with haematoxylin-eosin (H&E) stain, Papanicolaou (Pap) stain, and May-Grünwald-Giemsa (MGG) stain. Subsequently, histological diagnosis was made. Ki67 immunostaining was performed on squash smears and histology sections. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of squash cytology in spinal lesions were 84.6, 100, 100, 23.1, and 80.88%, respectively. On immunocytochemistry, the mean Ki67 labelling indices for grade I, II, and III tumours were 0, 0.33 and 9%, respectively. CONCLUSION: Squash smear cytology is a rapid intraoperative technique for diagnosing spinal lesions, with high specificity and high positive predictive value. It is more effective in diagnosing neoplasms than non-neoplastic lesions. Ki67 immunostaining can be done on cytology smears to effectively differentiate between WHO grade I and grade II spinal tumours.
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Citodiagnóstico/métodos , Inmunohistoquímica , Cuidados Intraoperatorios/métodos , Antígeno Ki-67/análisis , Manejo de Especímenes/métodos , Neoplasias de la Columna Vertebral/química , Adolescente , Adulto , Anciano , Niño , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Valor Predictivo de las Pruebas , Pronóstico , Estudios Prospectivos , Reproducibilidad de los Resultados , Neoplasias de la Columna Vertebral/diagnóstico por imagen , Neoplasias de la Columna Vertebral/patología , Neoplasias de la Columna Vertebral/cirugía , Adulto JovenRESUMEN
Papillary ependymoma is a rare variant of ependymoma. It has been included in Grade II tumors of updated 2016 WHO classification of central nervous system tumors. Only a handful of cases of spinal papillary ependymomas have been reported so far. The differential diagnoses include choroid plexus papilloma, papillary meningioma, metastatic carcinoma, and papillary tumor of the pineal region. Here, we take the opportunity of reporting a rare case of spinal papillary ependymoma along with its squash cytological features and a summary of prior published cases.
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BACKGROUND: Role of squash cytology in intraoperative diagnosis of central nervous system lesions has been well established. Intraoperative diagnosis is especially important in paediatric CNS lesions as decision regarding gross total resection or near total resection or subtotal resection is crucial and radiotherapy and chemotherapy are best avoided in this age group. The aim of this study was to evaluate the utility of squash cytology of CNS lesions in paediatric age group and to assess its diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value. MATERIALS AND METHODS: A prospective study was conducted on 42 paediatric patients with clinico-radiologically diagnosed CNS lesions. Intraoperative squash smears were stained with haematoxylin and eosin (H&E) stain. Diagnosis made subsequently on paraffin sections was taken as gold standard. RESULTS: The overall diagnostic accuracy of intraoperative squash cytology of CNS lesions in paediatric age group was 73.80%. The sensitivity, specificity, positive predictive value and negative predictive value of this modality were 92.31%, 87.50%, 96.00% and 77.78%, respectively. CONCLUSIONS: The spectrum of CNS lesions in paediatric age group is different from that in adults. Though the sensitivity and specificity of squash cytology in paediatric tumours are less than that of adults, it is an important tool for intraoperative diagnosis that guides regarding the extent of resection.
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Neoplasias del Sistema Nervioso Central/patología , Adolescente , Biopsia/métodos , Biopsia/normas , Neoplasias del Sistema Nervioso Central/cirugía , Niño , Femenino , Humanos , Periodo Intraoperatorio , Masculino , Sensibilidad y EspecificidadRESUMEN
Tanycytic ependymoma is a rare variant of ependymoma which has a predilection for the spinal cord. It is a WHO grade II tumour with favourable outcome. Although squash cytology of ependymoma is well described, there is sparse literature available on squash cytomorphology of tanycytic variant. Here we present two cases of squash cytology of tanycytic ependymoma. In the first case the diagnosis of tanycytic ependymoma was considered. However, in the second case a diagnosis of usual ependymoma was offered. Subsequently histopathology confirmed tanycytic nature in both the cases. In this article we discuss the squash cytological features of tanycytic ependymoma along with its differential diagnosis. Diagn. Cytopathol. 2017;45:270-273. © 2016 Wiley Periodicals, Inc.
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Ependimoma/diagnóstico por imagen , Neoplasias de la Médula Espinal/diagnóstico por imagen , Adulto , Neoplasias del Tronco Encefálico , Citodiagnóstico , Células Ependimogliales/patología , Ependimoma/patología , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Médula Espinal/patologíaRESUMEN
Bangur Institute of Neurosciences is one of India's oldest teaching institutions in the field of neurosciences. It has contributed richly over four decades in training and research in Neurology and Neurosurgery. Situated in Kolkata, the City of Joy and the Cultural Capital of India, and run under the aegis of the Government of West Bengal's Ministry of Health and Family Welfare, it remains one of the highest-volume neurological and neurosurgical centers in the country. This is a humble attempt to illustrate the history of this Institute and to provide a vignette of the many illustrious neurologists and neurosurgeons who were intimately involved in the setting up practice of Clinical Neurosciences in Eastern India.