Ferulago Angulata methanolic extract ameliorates scopolamine-induced memory impairment through the inhibition of hippocampal monoamine oxidase activity.

Ferulago angulata is a medicinal herb from the Apiaceae family known for its antioxidant, anti-apoptotic, and neuroprotective properties. This study aimed to assess the effects of F. angulata extract on neurobehavioral and biochemical parameters in scopolamine-induced amnesic rats. Fifty-six male Wistar rats were divided into seven groups and orally treated with F. angulata extract (100, 200, 400 mg/kg) and Rivastigmine (1.5 mg/kg) for 10 days. Starting on the sixth day of treatment, the Morris water maze behavioral study was conducted to evaluate cognitive function, with scopolamine administered 30 min before training. Biochemical assays, including monoamine oxidase and oxidative stress measures, were performed on hippocampal tissue. Results showed that extract treatment significantly attenuated scopolamine-induced memory impairment in a dose-dependent manner. Following scopolamine administration, malondialdehyde levels and monoamine oxidase A/B activity increased, while total thiol content and catalase activity decreased compared to the control group. Pretreatment with F. angulata extracts ameliorated the scopolamine-induced impairment in all factors. Toxicological evaluation of liver, lung, heart, and kidney tissues did not indicate any side effects at high doses. The total extract of F. angulata prevents scopolamine-induced learning and memory impairment through antioxidant mechanisms and inhibition of monoamine oxidase. These results suggest that F. angulata extract is effective in the scopolamine model and could be a promising agent for preventing dementia, especially Alzheimer's disease.

Comprehensive quantitative analysis of erythrocytes and leukocytes using trace volume of human blood using microfluidic-image cytometry and machine learning.

A diagnostic test based on microfluidic image cytometry and machine learning has been designed and applied for accurate classification of erythrocytes and leukocytes, including a unique fully-automated 5-part quantitative differentiation into neutrophils, lymphocytes, monocytes, eosinophils, and basophils, using minute amounts of whole blood in a single counting chamber. A low-cost disposable multilayer microdevice for microfluidic image cytometry was developed that comprises a 1 mm × 22 mm × 70 µm (w × l × h) rectangular microchannel, allowing the analysis of trace volume of blood (20 µL) for each assay. Automated analysis of digitized binary images applying a border following algorithm was performed allowing the qualitative analysis of erythrocytes. Bright-field imaging was used for the detection of erythrocytes and fluorescence imaging for 5-part differentiation of leukocytes after acridine orange staining, applying a convolutional neural network enabling unparalleled speed for identification and automated morphology classification yielding 98.57% accuracy. Blood samples were obtained from 30 volunteers and count values did not significantly differ from data obtained using a commercial automated hematology analyzer.

Practice of IDH1, ATRX, and P53 Immunohistochemistry in Integrated Diagnosis of Adult Diffuse Gliomas: Single Center Study.

Diffuse gliomas exhibit different molecular and genetic profiles with a wide range of heterogeneity and prognosis. Recently, molecular parameters including ATRX, P53, and IDH mutation status or absence or presence of 1p/19q co-deletion have become a crucial part of the diagnosis of diffuse glioma. In the present study, we tried to analyze the routine practice of the above-mentioned molecular markers focusing on the IHC method in cases of adult diffuse gliomas to evaluate their utility in the integrated diagnosis of adult diffuse gliomas. In total, 134 cases of adult diffuse glioma were evaluated. Using the IHC method, 33,12, and 12 cases of IDH mutant Astrocytoma grade 2, 3, 4, and 45 cases of gliobalstoma, IDH wild type, were molecularly diagnosed. By adding the FISH study for 1p/19q co-deletion, 9 and 8 cases of oligodendroglioma grade 2 and 3 also were included. Two IDH mutant cases were negative for IDH1 in IHC but revealed a positive mutation in further molecular testing. Finally, we were not able to incorporate a complete integrated diagnosis in 16/134(11.94%) of cases. The main molecularly unclassified group was histologically high-grade diffuse glial tumors in patients less than 55 years old and negative IDH1 immunostaining. P53 was positive in 23/33 grade 2, 4/12 grade 3, and 7/12 grade 4 astrocytomas, respectively. Four out of 45 glioblastomas showed positive immunostain, and all oligodendrogliomas were negative. In conclusion, a panel of IHC markers for IDH1 R132H, P53, and ATRX significantly improves the molecular classification of adult diffuse gliomas in daily practice and can be used as a tool to select limited cases for co-deletion testing in the low resources area.

Respiratory Bacterial and Fungal Superinfections During the Third Surge of the COVID-19 Pandemic in Iran.

Objective: We characterized bacterial and fungal superinfection and evaluated the antimicrobial resistance profile against the most common superinfection-causing pathogens (Klebsiella pneumoniae, Acinetobacter baumannii, and Staphylococcus aureus). Methods: In a cross-sectional study, 192 respiratory samples were collected from patients with and without SARS-COV-2 admitted to a teaching hospital in Tehran. Superinfection proportions and the antibiotic resistance profile were assessed and compared with demographic, comorbidities, and other clinical factors. Results: Superinfection rate was 60% among COVID-19 patients (p = 0.629). Intensive care unit admission (p = 0.017), mortality rate (p ≤ 0.001), and antiviral and corticosteroid therapy (p ≤ 0.001) were significantly more common among patients with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). The most common superinfections were caused by K. pneumoniae (42.7%, 82/192), A. baumannii (14.6%, 28/192), and S. aureus (13%, 25/192). A. baumannii isolates exhibited greater antibiotic resistance. Forty-four percent (11/25) of S. aureus isolates were cefoxitin resistant and also confirmed as methicillin-resistant S. aureus by PCR. Conclusion: The rise of difficult-to-treat infections with a high burden of antibiotic resistance, coupled with an increase in mortality rate of SARS-COV-2 superinfected individuals, illustrates the impact of the COVID-19 pandemic on antimicrobial resistance. Post-pandemic antimicrobial resistance crisis management requires precise microbiological diagnosis, drug susceptibility testing, and prescription of antimicrobials appropriate for the patient's condition.

Determination of ß-catenin Expression in Breast Cancer and Its Relationship with Clinicopathologic Parameters.

BACKGROUND: Abnormal activation of the ß-catenin signaling pathway is involved in various malignancies, including breast carcinoma.Aberrant expression of ß-catenin has been associated with more aggressive behaviors of breast cancer in some previous studies. . In the present study, we intend to evaluate the ß-catenin expression in breast cancer specimens and study its relationship with clinicopathological parameters. MATERIALS AND METHOD: In this cross-sectional study,88 samples diagnosed as invasive ductal breast carcinoma from 2007 to 2017 were evaluated. The slides and paraffin blocks were retrieved from the archive of pathology department. Patients' clinical characteristics and other information were also extracted from medical documents. Sections from related paraffin blocks through the tissue microarray method were provided, and immunohistochemistry staining for ß-catenin was done. Then different patterns of ß-catenin expression and the relationship between different patterns and clinicopathological parameters were investigated. RESULTS: Of the 88 breast cancer samples, 94% were female, and 6% were male. In 70% of the samples, normal membrane expression of ß-catenin was observed. Whereas in 30% of them, aberrant expression of ß-catenin was observed. A close significant relationship was observed between aberrant ß-catenin expression and age over 50 years (p-value: 0.093) and negative HER2 (p-value: 0.07). CONCLUSION: In the present study, a correlation was observed between aberrant ß-catenin expression and age over 50 years in patients and HER2 negativity, although this association was not statistically significant.

Expression of PAX2 and PAX8 in Wilms Tumor: A Tissue Microarray-based Immunohistochemical Study.

BACKGROUND & OBJECTIVE: There is currently inadequate information about the expression of immunohistochemical markers in pediatric tumors. Paired box genes 2 and 8 (PAX2 and PAX8) genes have an essential role in kidney organogenesis. This study aimed to investigate the IHC expression of PAX2 and PAX8 in Wilms tumor. Such study would be helpful in diagnosis and possibly in differentiation of this tumor from other mimics, especially in those of poorly differentiated type in small needle biopsy specimens. METHODS: We performed a cross-sectional study on 45 Wilms tumor cases referred to Bahrami pediatric hospital between 2005 and 2015. Demographic data were collected from medical documents. Sections from related paraffin blocks were provided by the tissue microarray method, and immunohistochemical (IHC) staining was done for PAX8 and PAX2. RESULTS: The mean tumor size was 9.98±4.95 cm. Favorable histology was seen in 84.4% of samples. PAX2 was expressed in 41 cases (91.1%), and PAX8 in 37 patients (82.2%). PAX2 and PAX8 expression was mostly seen in both blastemal and epithelial components (77.8% and 66.6%), respectively. Tumors with favorable and unfavorable histology did not significantly differ in PAX2 and PAX8 expression (P=0.637). We found a statically significant relationship between PAX8 expression and tumor size (P=0.033). CONCLUSION: PAX2 and PAX8 markers might helpful in diagnosis of Wilms tumor and may differentiate it from other histologically similar kidney tumors. PAX8 expression may be associated with larger tumor size. Tumors with favorable and unfavorable histology may not be different in PAX2 and PAX8 expression.

Effects of mobilized peripheral blood stem cells on treatment of primary lower extremity lymphedema.

OBJECTIVE: Lymphedema is a chronic debilitating disease characterized by the accumulation of fluid in the extremities as a result of lymphatic system impairment. Current treatments fail to restore the functionality and structural integrity of the lymphatic vessels lost in this condition. In this study, autologous mobilized peripheral blood stem cell transplantation was used and its potential efficacy and safety were evaluated in treating this condition. METHODS: Ten patients with primary lymphedema in the lower extremity received granulocyte-colony stimulating factor subcutaneously for 4 days, to stimulate stem cell mobilization, after which 200 to 250 mL of blood was drawn from each patient and used to collect stem cells. Mobilized stem cells were counted by flow cytometry with International Society of Hematotherapy and Graft Engineering method. In two sessions, 3 weeks apart, these stem cells were injected subcutaneously in the affected limb at approximately 80 points, along the lymphatic vessels. Each patient was followed for 6 months, during which changes in the limb volume and circumference were measured. Lymphangiogenesis was evaluated by biopsy, the lymphoscintigraphic transport index was calculated using Lymphoscintigraphy, and quality of life was surveyed. RESULTS: In this study, patients received on average 9.5 ± 6.8 × 108 mononuclear cells (which divided into 2 × 106 CD34+ cells for each session) in two sessions. The volume of the lower limbs decreased in 60% of patients. One patient showed a slight increase in the volume of lower limbs and three showed no change. The average limb volume was 4469.41 ± 1760.71 cm3, which on average differed from the average initial limb volume by 232.88 ± 392.53 cm3. Quality of life was reported as slightly increased in 60% of patients. The lymphoscintigraphic transport index suggested improvement in 60% of the patients. Likewise, tissue samples showed a 60% increase in lymphatic vessels. CONCLUSIONS: Subcutaneous injection of autologous hematopoietic stem cells harvested from peripheral blood into patients with primary lower limb lymphedema is feasible, potentially effective, and without serious adverse effects. However, a larger scale study with more patients is needed to validate our results. Last, to increase the effectiveness of this treatment, the optimal dose of cells injected and the requirement for additional growth factors need further study.

Cervical cancer screening and Pap test non-adherence risk factors in systemic sclerosis patients.

Systemic sclerosis is a rare autoimmune disorder that potentially affects nearly every organ of the body. Malignancies are one of the most common non-systemic sclerosis related cause of mortality. There are controversial findings regarding the cervical cancer rate among these patients, but prolonged immunosuppressive medication makes them more susceptible to cervical cancer. In the present study, we have aimed to investigate the cervical cancer screening result and the Pap test non-adherence risk factors among systemic sclerosis patients. This cross-sectional study was conducted on 100 systemic sclerosis patients. The clinicodemographic variables in addition to cervical cancer risk factors were obtained from the patients. Pap test performed using the liquid-based method. The non-adherence risk factors were determined by univariate and multivariate logistic regression analysis. Benign inflammatory and atrophic changes were reported in 26 and 5%, respectively. None of the cases had abnormal cytological finding. Twenty-two percent of the participants were a routine Pap test performer. According to the multivariate model, higher age was associated with Pap test non-adherence [odds ratio (95% confidence interval): 1.058 (1.010-1.108) and P-value: 0.018]. In the present study, we have shown that compliance with Pap test performing is extremely low among Iranian systemic sclerosis patients. In addition, we have demonstrated that older age is a risk factor for non-adherence. These findings highlighted the crucial role of the physicians in motivating the patients toward cancer screening.

Heterotopic Pancreas as a Leading Point of Intussusception: A Case Report.

Heterotopic pancreas (HP) is generally asymptomatic and found incidentally. It can act very rarely as a leading point for intussusception. Thus, it should be considered as a differential diagnosis of the mass lesions leading to the intestinal intussusception. Herein, we report an unusual case of HP as a cause of ileocolic intussusception.

Dyspnea as the First Manifestation of Silent Renal Cell Carcinoma.

Renal cell carcinoma (RCC) accounts for only 3% of adult malignancies, and the lung is the most common site of metastasis of this tumor, which may be accompanied by pleural metastasis. However, solitary pleural involvement is very rare and its presentation with dyspnea as the first manifestation of RCC is extremely rare. We describe a 39-year-old male with episodes of dyspnea dating back 6 months prior to hospital admission. During paraclinical investigations, chest computed tomography (CT) demonstrated pleural effusion and multiple pulmonary nodules, raising the question of primary mesothelioma or metastasis from distant focus. Histopathology and immuno- histochemical examinations of pleural biopsy provided evidence of metastatic RCC of the clear cell type. Therefore, an abdominal contrast computed tomography (CT) was performed, revealing a 3 cm right renal mass, which was then removed by partial nephrectomy. Physicians and pathologists should be aware of unusual presentations of RCC with no symptoms attributable to the kidneys, including dyspnea as in our case.

Adrenal Collision Tumor Composed of Pheochromocytoma and Diffuse Large B-Cell Lymphoma: A Case Report.

Adrenal involvement in the course of malignant lymphoma occurs in about 4% of patients, but primary adrenal lymphoma (PAL) is extremely rare. To the best of our knowledge, only one case study reported the combination of PAL with pheochromocytoma. In the current study, we present the second case who was a 63-year-old man admitted to our hospital with hematuria and abdominal discomfort. Ultrasound imaging indicated the presence of a lesion, 5×4×3 cm in size, in the upper pole of his right kidney. Histopathologic study confirmed a collision tumor composed of pheochromocytoma and diffuse large B-cell lymphoma (DLBCL).

Association of Neo Angiogenesis by CD34 Expression and Clinicopathologic Features in Squamous Cell Carcinoma of Cervix.

Tumor angiogenesis is one of the most important factors in tumor progression. In this study, the angiogenesis of cervical squamous cell carcinoma (SCC) and its association with prognostic factors was assessed by using CD34 immunostaining marker. The microvessel density in 40 patients with cervical SCC was studied in three areas of the tumor; stromal and peripheral tumor area (combined) central stromal tumor area and peripheral tumor area and the relationship of microvascular density and survival was also evaluated. The count of CD34 is correlated with younger age, the presence of perineural invasion and metastasis to lymph nodes. High peripheral tumor angiogenesis is also correlated with lower disease-free tumor survival. According to the findings of the present study, CD34 expression, especially in peripheral tumor areas, can be used as a prognostic marker in cervical SCC.

Identification and management of right ventricular perforation using pacemaker and cardioverter-defibrillator leads: A case series and mini review.

Right ventricular perforation is a rare but serious complication of permanent pacemaker and implantable cardioverter-defibrillator implantation, with a reported prevalence rate of 0.1-6%. Generally, there is a high incidence of asymptomatic lead perforation with otherwise normal function. Some patients present with a stabbing chest pain and shortness of breath or pacemaker malfunction. However, in some cases, tamponade or adjacent tissue injury may be seen. The exact risk factors for lead perforation are not yet clear. Furthermore, there are many controversies in the management of lead perforation. Extraction of an asymptomatic, incidentally detected, chronically perforating lead does not seem to be necessary. Patients with symptoms or device malfunction will require treatment appropriate for their problem.

Pulmonary blastoma: a case report and brief review of the literature of tumor-induced hypoglycemia.

BACKGROUND: Tumor induced hypoglycemia (TIH) is a rare clinical entity that can be caused by different mechanisms such as secretion of various substances, autoimmune disorders, massive tumoral infiltration of liver, and pituitary or adrenal glands destruction by tumors. Furthermore, any type of neoplasms can cause TIH. CASE PRESENTATION: The patient presented with a case of classic biphasic pulmonary blastoma (CBPB) with hypoglycemia. Chest CT scan showed 2 huge masses in the right hemi-thorax and multiple smaller masses located in the left hemi-thorax. The patient underwent surgery, and was referred to an oncologist for adjuvant therapy. CONCLUSION: CBPB is a rare primary lung tumor with poor prognosis. They are classically large, symptomatic tumors with lymph node metastasis. Surgical resection at early stages has been more effective than other treatments; however, there is no standard treatment in unresectable cases. Adjuvant treatments have been temporarily effective.

Mucin profile expression in gastric adenocarcinoma.

BACKGROUND: The process of neoplastic transformation in the stomach has been reported to be associated with decreased expression of normal mucins of the gastric mucosa and denovo expression of mucins that are normally expressed in other organs. This association may be used as a means to bring new insights into biologic behavior and genetic pathways in the development of gastric cancer. There are controversial reports about differences in the genetic pathway and behavior of gastric cancer in younger patients in comparison with older ones. This study aims to determine if there is any difference in mucin profiles between different age groups with gastric cancer. METHODS: Over a five-year (2003-2008) period, 43 cases of gastric cancer (≤50) years were referred to our center. Of these, 40 had adequate tissue for additional study, whereas three cases lacked a sufficient amount of tumor tissue for immunohistochemistry (IHC) analysis. A group of 40 gastric cancer patients above the age of 50 years were gender-matched with the first group. Expressions of MUC-1, MUC-2, MUC-5AC, and MUC-6 were evaluated by IHC for the total 80 gastric cancer cases. RESULTS: The expressions of the mucins did not show a significant difference between the two age groups. CONCLUSION: Gastric cancer in both young and old age adults was not significantly different in terms of mucin profiles. Our results have shown that younger age is not predictive of gastric cancer phenotype, which can be an indicator of the lack of difference in the genetic pathways and molecular alterations in these two age groups.

Comparison of the Expression of Cell Adhesion Molecule Markers (E-Cadherin and Syndecan-1) between Young and Older Age Patients with Gastric Carcinoma.

AIM: The aim of this study was to evaluate the relationship between age and cell adhesion molecule markers (E-cadherin and syndecan-1). MATERIALS AND METHODS: Forty-three cases of gastric carcinoma below the age of 50 were referred to our center in the period of 5 years (2003­2008). Forty-three gastric carcinoma above the age of 50 years were sex-matched with the first group. Expression of syndecan-1 and E-cadherin were evaluated by immunohistochemistry in a total of 86 gastric carcinomas accompanying with all the clinicopathological findings in each case. RESULTS: The expression of syndecan-1 and E-cadherin did not show significant difference between two age groups; in addition, there were no significant differences in all the clinicopathological findings in these two age groups. DISCUSSION: Gastric carcinoma in young and old age adults showed no significant difference in respect of the expression of cell adhesion molecule markers. Our result shows that young age alone cannot be predictive of more metastasis and invasion potential.

Pericardial PEComa: echocardiographic features.

The patient was a 19 year old man referred to our center due to progressive effort dyspnea and left sided pleuritic chest pain for 1 month. Echocardiographic examination showed a posteriorly located, giant, well demarcated mass, that compresses the left atrium. It was encased by moderate pericardial effusion. Histhopathological analysis disclosed neoplastic cells arranged around blood vessels with immunoreactivity for HMB-45 indicative of PEComa (Perivascular Epitheloid Cell differentiation). Six month follow up was uneventful. Up to the best of our knowledge, this is the first case of pericardial PEComa reported in the literature.

'Giant fleshy leaflet myxoma'.

A 25-year-old woman was admitted to the neurology department because of sudden onset of weakness of her left upper and lower extremities. Cardiac auscultation revealed an extra sound. Transesophageal echocardiography showed a huge mobile fleshy mass on the atrial side of anterior mitral leaflet protruding into the left ventricle during diastole. A large irregularly shaped mass resembling a 'cluster of grapes' was found on the atrial side of anterior mitral leaflet. The mass was excised and mitral valve was repaired. Histology was diagnostic for myxoma. Six months clinical and echocardiographic follow-up was normal and did not show any recurrence of tumor.