RESUMO
Slow transit constipation (STC) has an estimated prevalence of 2-4% of the general population, and although it is the least prevalent of the chronic constipation phenotypes, it more commonly causes refractory symptoms and is associated with significant psychosocial stress, poor quality of life, and high healthcare costs. This review provides an overview of the pathophysiology, diagnosis, and management options in STC. STC occurs due to colonic dysmotility and is thought to be a neuromuscular disorder of the colon. Several pathophysiologic features have been observed in STC, including reduced contractions on manometry, delayed emptying on transit studies, reduced numbers of interstitial cells of Cajal on histology, and reduced amounts of excitatory neurotransmitters within myenteric plexuses. The underlying aetiology is uncertain, but autoimmune and hormonal mechanisms have been hypothesised. Diagnosing STC may be challenging, and there is substantial overlap with the other clinical constipation phenotypes. Prior to making a diagnosis of STC, other primary constipation phenotypes and secondary causes of constipation need to be ruled out. An assessment of colonic transit time is required for the diagnosis and can be performed by a number of different methods. There are several different management options for constipation, including lifestyle, dietary, pharmacologic, interventional, and surgical. The effectiveness of the available therapies in STC differs from that of the other constipation phenotypes, and prokinetics often make up the mainstay for those who fail standard laxatives. There are few available management options for patients with medically refractory STC, but patients may respond well to surgical intervention. STC is a common condition associated with a significant burden of disease. It can present a clinical challenge, but a structured approach to the diagnosis and management can be of great value to the clinician. There are many therapeutic options available, with some having more benefits than others.
Assuntos
Células Intersticiais de Cajal , Qualidade de Vida , Humanos , Constipação Intestinal/diagnóstico , Constipação Intestinal/terapia , Custos de Cuidados de Saúde , Técnicas HistológicasRESUMO
Proper kidney function depends highly on mitochondria homeostasis. This organelle is the primary source of ATP production in the kidney and regulates other cellular processes such as redox and calcium homeostasis. Although the mitochondria's primary recognized function is cellular energy production, through the function of the Krebs cycle, electron transport system (ETS), as well as oxygen and electrochemical gradient consumption, this function is interconnected with multiple signaling and metabolic pathways, making bioenergetics a central hub in renal metabolism. Furthermore, mitochondrial biogenesis, dynamics, and mass are also strongly related to bioenergetics. This central role is not surprising given that mitochondrial impairment, including functional and structural alterations, has been recently reported in several kidney diseases. Here, we describe assessment of mitochondrial mass, structure, and bioenergetics in kidney tissue and renal-derived cell lines. These methods allow investigation of mitochondrial alterations in kidney tissue and renal cells under different experimental conditions.
Assuntos
Metabolismo Energético , Mitocôndrias , Mitocôndrias/metabolismo , Rim/metabolismo , Técnicas Histológicas , Microscopia Eletrônica de TransmissãoRESUMO
SUMMARY: The preserved form of all components of the nerve fiber is a prerequisite for the proper conduction of the nerve impulse. various factors can change the shape of nerve fibers. In everyday practice, qualitative histological analysis is the gold standard for detecting changes in shape. Geometric morphometry is an innovative method that objectively enables the assessment of changes in nerve fibers' shape after local anesthetics action. A total of sixty sciatic nerves were used as material, which was intraneural injected with saline solution in the control group (n=30), and a solution of 1.33 % liposomal bupivacaine (n=30) in the test group. After the animals were sacrificed, nerve samples were taken and histological preparations were made. The preparations were first described and examined using a qualitative histological method, after which digital images were made. The images were entered into the MorphoJ program and processed using the method of geometric morphometry. Qualitative histological examination revealed no differences in nerve fibers after intraneurally applied physiological solution and liposomal bupivacaine. Using the method of geometric morphometry, a statistically significant change in the shape of axons was found after intraneurally applied saline solution and liposomal bupivacaine (p=0.0059). No significant differences in histological changes were found after the qualitative histological analysis of nerve fiber cross-section preparations. A statistically significant change in the shape of nerve fiber axons was observed after geometric morphometric analysis of digital images after intraneural application of saline and liposomal bupivacaine.
La forma conservada de todos los componentes de la fibra nerviosa es un requisito previo para la conducción correcta del impulso nervioso. Varios factores pueden cambiar la forma de las fibras nerviosas. En la práctica diaria, el análisis histológico cualitativo es el estándar de oro para detectar cambios de forma. La morfometría geométrica es un método innovador que permite evaluar objetivamente los cambios en la forma de las fibras nerviosas después de la acción de los anestésicos locales. Se utilizó como material un total de sesenta nervios ciáticos, que se inyectaron intraneuralmente con solución salina en el grupo control (n=30), y una solución de bupivacaína liposomal al 1,33 % (n=30) en el grupo de prueba. Después de sacrificados los animales, se tomaron muestras de nervios y se realizaron preparaciones histológicas. Primero se describieron y examinaron las preparaciones utilizando un método histológico cualitativo, después de lo cual se tomaron imágenes digitales. Las imágenes fueron ingresadas al programa MorphoJ y procesadas mediante el método de morfometría geométrica. El examen histológico cualitativo no reveló diferencias en las fibras nerviosas después de la aplicación intraneural de solución fisiológica y bupivacaína liposomal. Usando el método de morfometría geométrica, se encontró un cambio estadísticamente significativo en la forma de los axones después de la aplicación intraneural de solución salina y bupivacaína liposomal (p = 0,0059). No se encontraron diferencias significativas en los cambios histológicos después del análisis histológico cualitativo de las preparaciones de secciones transversales de fibras nerviosas. Se observó un cambio estadísticamente significativo en la forma de los axones de las fibras nerviosas después del análisis de morfometría geométrica de imágenes digitales después de la aplicación intraneural de solución salina y bupivacaína liposomal.
Assuntos
Animais , Ratos , Bupivacaína/administração & dosagem , Técnicas Histológicas/métodos , Anestésicos Locais/administração & dosagem , Fibras Nervosas/efeitos dos fármacos , Análise Discriminante , Ratos Wistar , Análise de Componente Principal , Solução Salina/administração & dosagem , Injeções , Lipossomos/administração & dosagemRESUMO
A porcine model was used to investigate the feasibility of using VIS-NIR spectroscopy to differentiate between degrees of ischemia-reperfusion injury in the small intestine. Ten pigs were used in this study and four segments were created in the small intestine of each pig: (1) control, (2) full arterial and venous mesenteric occlusion for 8 h, (3) arterial and venous mesenteric occlusion for 2 h followed by reperfusion for 6 h, and (4) arterial and venous mesenteric occlusion for 4 h followed by reperfusion for 4 h. Two models were built using partial least square discriminant analysis. The first model was able to differentiate between the control, ischemic, and reperfused intestinal segments with an average accuracy of 99.2% with 10-fold cross-validation, and the second model was able to discriminate between the viable versus non-viable intestinal segments with an average accuracy of 96.0% using 10-fold cross-validation. Moreover, histopathology was used to investigate the borderline between viable and non-viable intestinal segments. The VIS-NIR spectroscopy method together with a PLS-DA model showed promising results and appears to be well-suited as a potentially real-time intraoperative method for assessing intestinal ischemia-reperfusion injury, due to its easy-to-use and non-invasive nature.
Assuntos
Traumatismo por Reperfusão , Espectroscopia de Luz Próxima ao Infravermelho , Suínos , Animais , Traumatismo por Reperfusão/diagnóstico , Traumatismo por Reperfusão/patologia , Intestino Delgado/patologia , Isquemia/patologia , Técnicas HistológicasRESUMO
An easy, reliable, and time-efficient standardized approach for assessing lumbar intervertebral disc (IVD) degeneration with relaxation times measurements in pre-clinical and clinical studies is lacking. This prospective study aims to determine the most appropriate method for lumbar IVD degeneration (IDD) assessment in sheep by comparing three quantitative MRI sequences (variable-flip-angle T1 mapping, and multi-echo T2 and T2* mapping), correlating them with Pfirrmann grading and histology. Strong intra- and interrater agreements were found for Nucleus pulposus (NP) regions-of-interest (ROI). T1, T2, and T2* mapping correlated with Pfirrmann grading and histological scoring (p < 0.05) except for the most ventral rectangular ROI on T2 maps. Correlations were excellent for all of the T1 ROIs and the T2* NP ROIs. Highly significant differences in T1 values were found between all Pfirrmann grades except between grades I/II and between grades III/IV. Significant differences were identified in the T2 and the T2* values between all grades except between grades I/III. T1, T2, and T2* relaxation times measurements of the NP are an accurate and time-efficient tool to assess lumbar IDD in sheep. Variable-flip-angle T1 mapping may be further considered as a valuable method to investigate IDD and to assess the efficacy of regenerative treatments in longitudinal studies.
Assuntos
Degeneração do Disco Intervertebral , Animais , Técnicas Histológicas , Degeneração do Disco Intervertebral/diagnóstico por imagem , Degeneração do Disco Intervertebral/patologia , Imageamento por Ressonância Magnética/métodos , Estudos Prospectivos , Registros , OvinosRESUMO
OBJECTIVES: During septoplasty, normal cartilage and bone are often sent for pathologic examination despite benign appearance. We explored pathology results following septoplasty from April 2016 to April 2018, examining clinical value and relevance, implications, and cost analysis. STUDY DESIGN: Retrospective chart review. SETTING: Single-institution academic medical center. METHODS: A retrospective chart review was compiled by using Current Procedural Terminology code 30520 for septoplasty for indication of nasal obstruction, deviated septum, and nasal deformity. RESULTS: A total of 236 consecutive cases were identified spanning a 2-year period. Septoplasty specimens were sent for pathology evaluation in 76 (31%). The decision to send a specimen for histopathology was largely physician dependent. No cases yielded unexpected or significant pathology that changed management. The average total charges for septoplasty were $10,200 at our institution, with 2.2% of procedural charges accounting for pathology preparation and review, averaging $225. Nationally, this results in an estimated charged cost of $58.5 million. The Centers for Medicare and Medicaid Services (CMS) reimbursement for septoplasty pathology charges was $46 in 2018, accounting for 1.3% of hospital-based reimbursements and 2.2% of ambulatory center reimbursements. With CMS as a national model for reimbursement, $11.8 million is spent yearly for septoplasty histopathology. Given that CMS reimbursement is significantly lower than private insurers, national total reimbursement is likely considerably higher. CONCLUSION: Routine pathology review of routine septoplasty specimens is unnecessary, unremarkable, and wasteful. Correlation of the patient's presentation and intraoperative findings should justify the need for pathology evaluation. This value-based approach can offer significant direct and indirect cost savings. LEVEL OF EVIDENCE: 4.
Assuntos
Análise Custo-Benefício , Técnicas Histológicas/economia , Septo Nasal/patologia , Septo Nasal/cirurgia , Rinoplastia/métodos , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , New York , Estudos RetrospectivosRESUMO
OBJECTIVES: To evaluate the diagnostic performance in the assessment setting of three protocols: one-view wide-angle digital breast tomosynthesis (WA-DBT) with synthetic mammography (SM), two-view WA-DBT/SM, and two-view digital mammography (DM). METHODS: Included in this retrospective study were patients who underwent bilateral two-view DM and WA-DBT. SM were reconstructed from the WA-DBT data. The standard of reference was histology and/or 2 years follow-up. Included were 205 women with 179 lesions (89 malignant, 90 benign). Four blinded readers randomly evaluated images to assess density, lesion type, and level of suspicion according to BI-RADS. Three protocols were evaluated: two-view DM, one-view (mediolateral oblique) WA-DBT/SM, and two-view WA-DBT/SM. Detection rate, sensitivity, specificity, and accuracy were calculated and compared using multivariate analysis. Reading time was assessed. RESULTS: The detection rate was higher with two-view WA-DBT/SM (p = 0.063). Sensitivity was higher for two-view WA-DBT/SM compared to two-view DM (p = 0.001) and one-view WA-DBT/SM (p = 0.058). No significant differences in specificity were found. Accuracy was higher with both one-view WA-DBT/SM and two-view WA-DBT/SM compared to DM (p = 0.003 and > 0.001, respectively). Accuracy did not differ between one- and two-view WA-DBT/SM. Two-view WA-DBT/SM performed better for masses and asymmetries. Reading times were significantly longer when WA-DBT was evaluated. CONCLUSIONS: One-view and two-view WA-DBT/SM can achieve a higher diagnostic performance compared to two-view DM. The detection rate and sensitivity were highest with two-view WA-DBT/SM. Two-view WA-DBT/SM appears to be the most appropriate tool for the assessment of breast lesions. KEY POINTS: ⢠Detection rate with two-view wide-angle digital breast tomosynthesis (WA-DBT) is significantly higher than with two-view digital mammography in the assessment setting. ⢠Diagnostic accuracy of one-view and two-view WA-DBT with synthetic mammography (SM) in the assessment setting is higher than that of two-view digital mammography. ⢠Compared to one-view WA-DBT with SM, two-view WA-DBT with SM seems to be the most appropriate tool for the assessment of breast lesions.
Assuntos
Neoplasias da Mama , Paraganglioma , Mama/diagnóstico por imagem , Neoplasias da Mama/diagnóstico por imagem , Feminino , Técnicas Histológicas , Humanos , Mamografia , Estudos Retrospectivos , Sensibilidade e EspecificidadeRESUMO
This protocol describes the embedding and processing of Drosophila pupae in paraffin to monitor tissue changes during development. Although multiple methods are available to evaluate developmental changes in Drosophila embryos, imaging detailed changes during metamorphosis is challenging as the animal is enclosed in the cuticle, rendering it inaccessible to whole mount imaging. Here, we present a protocol that focuses on developmental clearance of the larval salivary glands in Drosophila pupae that can be extended to examine other tissues/stages for similar purposes. For complete details on the use and execution of this protocol, please refer to Velentzas et al. (2018).
Assuntos
Morte Celular/fisiologia , Drosophila/embriologia , Técnicas Histológicas/métodos , Pupa/citologia , Animais , Feminino , Larva/citologia , Masculino , Glândulas Salivares/citologiaRESUMO
BACKGROUND: Many practices require tissues from hip and knee arthroplasty procedures to be sent for pathologic examination. These examinations rarely provide information beyond the clinical or radiologic diagnosis and rarely alter clinical management. We aimed to determine the rate at which histologic diagnoses based on gross assessment alone or gross plus microscopic assessment correspond with reported clinical diagnoses in patients undergoing total joint arthroplasties and whether the histologic diagnoses alter patient management. METHODS: We retrospectively reviewed arthroplasty cases performed at a high-volume teaching hospital in Manitoba, Canada. The clinical diagnosis was compared with the final pathology report based on gross examination, with or without histologic assessment. The results of the comparison were classified into 3 categories: concordant (same diagnosis), discrepant (different diagnoses without alterations in management) and discordant (different diagnoses resulting in management change). The overall provincial cost for pathologic examination was determined by multiplying the total examination cost by the estimated number of arthroplasty cases. RESULTS: There were 773 patients in our study sample. The concordant rate was 98.3% (95% confidence interval [CI] 97.1%-99.1%), the discrepant rate was 1.7% (95% CI 0.9%-2.9%) and the discordant rate was 0.0% (95% CI 0%-0.5%) for 773 cases. The pathology diagnosis did not alter patient management in any case. A total of 91.5% of specimens did not require full histologic review and received gross descriptions only. The discrepancy rate was higher in cases that included microscopic examination than in those that received only gross descriptions (15.2% v. 0.4%, p < 0.001). The overall provincial cost for pathologic examination was estimated at Can$304 556. CONCLUSION: Submitting routine tissue from arthroplasty procedures to pathology does not affect patient management and therefore provides no value for the health care resources expended in doing so.
CONTEXTE: Beaucoup d'établissements exigent que des tissus soient envoyés pour un examen anatomopathologique après une arthroplastie de la hanche et du genou. Ces examens n'apportent généralement pas d'information nouvelle quant au diagnostic clinique ou radiologique et modifient rarement la prise en charge. Notre objectif était de déterminer le pourcentage de correspondance entre les diagnostics histologiques fondés sur l'inspection grossière uniquement ou sur l'inspection grossière et l'examen au microscope, et les diagnostics cliniques des patients qui subissent des arthroplasties totales. Nous cherchions également à savoir si les diagnostics histologiques modifient la prise en charge. MÉTHODES: Nous avons procédé à une analyse rétrospective d'arthroplasties effectuées dans un grand hôpital universitaire du Manitoba, au Canada. Le diagnostic clinique était comparé au rapport final de pathologie fondé sur une inspection grossière, avec ou sans examen histologique. Les résultats de cette comparaison étaient classés en 3 catégories : concordance (même diagnostic), divergence (diagnostics différents, sans modification de la prise en charge) et discordance (diagnostics différents entraînant une modification de la prise en charge). Le coût global pour la province associé aux examens pathologiques a été établi en multipliant le coût total d'un examen par le nombre estimé de cas d'arthroplastie. RÉSULTATS: Notre échantillon comprenait 773 patients. Le taux de concordance était de 98,3 % (intervalle de confiance [IC] de 95 % 97,1 %99,1 %), le taux de divergence était de 1,7 % (IC de 95 % 0,9 %2,9 %) et le taux de discordance de 0,0 % (IC de 95 % 0 %0,5 %). Dans tous les cas, le diagnostic pathologique n'a pas modifié la prise en charge. Au total, 91,5 % des spécimens ne nécessitaient pas d'examen histologique complet et n'ont fait l'objet que d'une inspection grossière. Le pourcentage d'anomalie était plus élevé pour les spécimens analysés au microscope que pour ceux ayant uniquement subi une inspection grossière (15,2 % c. 0,4 %, p < 0,001). Le coût total des examens pathologiques pour la province a été estimé à 304 556 $ CA. CONCLUSION: L'analyse pathologique systématique de tissus prélevés lors d'arthroplasties n'entraîne pas une modification de la prise en charge du patient; il n'y a donc pas de valeur associée aux ressources de santé utilisées pour ces examens.
Assuntos
Artroplastia de Quadril/normas , Artroplastia do Joelho/normas , Técnicas Histológicas/normas , Osteoartrite do Quadril/diagnóstico , Osteoartrite do Joelho/diagnóstico , Artroplastia de Quadril/economia , Artroplastia do Joelho/economia , Tomada de Decisão Clínica/métodos , Análise Custo-Benefício , Articulação do Quadril/patologia , Articulação do Quadril/cirurgia , Técnicas Histológicas/economia , Humanos , Articulação do Joelho/patologia , Articulação do Joelho/cirurgia , Manitoba , Osteoartrite do Quadril/etiologia , Osteoartrite do Quadril/patologia , Osteoartrite do Quadril/cirurgia , Osteoartrite do Joelho/etiologia , Osteoartrite do Joelho/patologia , Osteoartrite do Joelho/cirurgia , Guias de Prática Clínica como Assunto , Estudos Prospectivos , Estudos RetrospectivosRESUMO
The National Toxicology Program (NTP) now uses an extended longitudinal sectioning protocol for the uterus to better evaluate female rodent reproductive tract toxicity for all developmental and reproductive toxicology and 2-year toxicity and carcinogenicity bioassays. The previous protocol for toxicity/carcinogenicity studies involved 1 cross section midway through each uterine horn and collection of uterine cervix and vagina only if gross lesions were present. Here we compare the histological findings of the original cross sections with the additional longitudinal sections of residual uterine tissues of 7 chronic NTP rat bioassays. The goal of this study was to determine whether there might be any advantages to examining additional uterine tissue. The longitudinal protocol allowed for 10 to 20 times more uterine tissue for evaluation. Results indicate that the potential advantages of a more complete evaluation of female reproductive tract tissue include increased detection of reproductive targets, increased detection of neoplastic and nonneoplastic lesions, improved detection of tissue origin of neoplasms, less reliance on gross identification of lesions, improved accuracy in the application of severity grades, and increased detection of preneoplastic or subtle lesions.
Assuntos
Neoplasias , Reprodução , Animais , Bioensaio , Testes de Carcinogenicidade , Feminino , Técnicas Histológicas , Ratos , ÚteroRESUMO
Macrovesicular steatosis (MS) is a major risk factor for liver graft failure after transplantation and pathological microscopic examination of a frozen tissue section remains the gold standard for its assessment. However, the latter requires an experienced in-house pathologist for correct and rapid diagnosis as well as specific equipment that is not always available. Smartphones, which are must-have tools for everyone, are very suitable for incorporation into promising technology to generate moveable diagnostic tools as for telepathology. The study aims to compare the microscopic assessment of nonalcoholic fatty liver disease (NAFLD) spectrum in liver allograft biopsies by a smartphone microscopy platform (DIPLE device) to standard light microscopy. Forty-two liver graft biopsies were evaluated in transmitted light, using an iPhone X and the microscopy platform. A significant correlation was reported between the two different approaches for graft MS assessment (Spearman's correlation coefficient: r = .93; p < .001) and for steatohepatitis feature (r = .56; p < .001; r = .45; p < .001). Based on these findings, a smartphone integrated with a cheap microscopy platform can achieve adequate accuracy in the assessment of NAFLD in liver graft and could be used as an alternative to standard light microscopy when the latter is unavailable.
Assuntos
Aloenxertos/patologia , Técnicas Histológicas/instrumentação , Técnicas Histológicas/métodos , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Hepatopatia Gordurosa não Alcoólica/patologia , Smartphone , Biópsia , Secções Congeladas , Humanos , Fígado/patologia , Transplante de Fígado , Microscopia/instrumentação , Microscopia/métodos , Doadores de TecidosRESUMO
BACKGROUND: Post-mortem Computed Tomography (PMCT) allows non-invasive or minimally invasive detection of findings that may or may not be visible during conventional autopsy, however, it does not allow the investigator to draw any conclusions regarding patency of the vessel's lumen. To address this deficiency, Post-mortem Computed Tomography Angiography (PMCTA) utilizing different contrast media and techniques have been introduced with various studies looking at the correlation between PMCTA, autopsy (gross) findings and coronary artery histology in diagnosing coronary artery disease. OBJECTIVES: The aim of this study is to investigate the sensitivity and specificity of PMCTA in diagnosing coronary artery stenosis using water-based contrast media introduced though the vessels of the neck, compared to the gold standard of diagnosis i.e. gross and histological evaluation of the coronary artery. METHOD: This was a cross sectional study of 158 arterial sections involving 37 subjects recruited from the National Institute of Forensic Medicine (IPFN), Hospital Kuala Lumpur (HKL). An unenhanced PMCT was performed followed by PMCTA using water-based contrast media introduced though the vessels of the neck. Coronary artery stenosis was determined using multiplanar reconstructionD while the degree of stenosis was determined by calculating the percentage of luminal diameter divided by the diameter of the vessel internal elastic. RESULTS: The analysis of PMCTA and histopathology examinations revealed a sensitivity of 61.5%, specificity of 91.7%; positive predictive value (PPV) of 40.0% and negative predictive value (NPV) of 96.4%. CONCLUSION: PMCTA utilizing water-based contrast introduced though the vessels of the neck yielded similar results as other methods and techniques of PMCTA. We would therefore conclude that PMCTA utilizing this technique could be used to assess the degree of calcification and the presence of significant stenosis.
Assuntos
Autopsia/métodos , Angiografia por Tomografia Computadorizada/métodos , Meios de Contraste/administração & dosagem , Estenose Coronária/diagnóstico , Artérias Carótidas/química , Patologia Legal , Técnicas Histológicas , Humanos , Veias Jugulares/química , Sensibilidade e EspecificidadeRESUMO
Histological assessment of esophageal squamous malignancies is crucial for management of patients with the cancer as well as working in research on the cancer. The squamous malignancies in the esophagus comprise squamous dysplasia and squamous cell carcinoma. Current classification of squamous dysplasia in the esophagus is to divide it into low grade and high grade. Most of the esophageal squamous cell carcinomas are of conventional type and divided into well, moderately, and poorly differentiated. The variants of esophageal squamous cell carcinoma include basaloid squamous carcinoma, spindle cell carcinoma, and verrucous carcinoma. Preoperative chemoradiation is used commonly in the treatment of esophageal squamous cell carcinoma and induces changes in morphology. Tumor regression grading systems based on the percentage of the remaining carcinoma cells are used to assess the response to the neoadjuvant therapy in the cancer. Additional histological parameters including lymphovascular invasion, perineural invasion, clearance of resection margins, and carcinoma in the nodal and distant metastatic sites provide essential information for the management of the patient with the cancer.
Assuntos
Carcinoma de Células Escamosas do Esôfago/classificação , Carcinoma de Células Escamosas do Esôfago/patologia , Técnicas Histológicas/métodos , Carcinoma de Células Escamosas/patologia , Quimiorradioterapia , Neoplasias Esofágicas/patologia , Esôfago/patologia , Feminino , Hematoxilina , Humanos , Masculino , Neoplasias Bucais/patologia , Terapia NeoadjuvanteRESUMO
Anterior resection (AR), especially low anterior resection (LAR), for low rectal cancer and colorectal anastomosis is a technical challenge to surgeons. But by using circular stapling devices now it is possible make more LARs technically feasible. A stapled end-to-end colorectal anastomosis is increasingly adopted following a low anterior resection for low rectal cancer. This descriptive cross-sectional study was carried out in the department of Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from December 2015 to December 2016. The ensuing doughnuts created from the stapling device are routinely sent for histological analysis. However, its efficacy remains debatable. This study aims to determine the role of sending distal doughnut for histological examination following a stapled end-to-end colorectal anastomosis done in low anterior resection for low rectal cancers.
Assuntos
Adenocarcinoma/cirurgia , Técnicas Histológicas , Neoplasias Retais/cirurgia , Reto/patologia , Grampeamento Cirúrgico , Adenocarcinoma/patologia , Anastomose Cirúrgica/métodos , Bangladesh , Estudos Transversais , Humanos , Neoplasias Retais/patologia , Reto/cirurgia , Grampeamento Cirúrgico/efeitos adversosRESUMO
BACKGROUND: The relative proportion of inflammation and fibrosis in a stricture is highly relevant in defining the clinical approach for Crohn's disease [CD] patients. Whereas transmural inflammation in CD can be accurately estimated by cross-sectional imaging, evaluating the extent and severity of fibrosis still requires surgical pathology of intestinal resection specimens. This study systematically reviewed all existing transmural histopathological scoring systems developed for the assessment of inflammation and/or fibrosis in CD. METHODS: A systematic review of histopathological scoring systems for the assessment of transmural inflammation and/or fibrosis in CD, focusing on originally developed scoring systems. Risk of bias, methodological quality, and operating or psychometric properties [validity, reliability, responsiveness, and feasibility] of each histological scoring system were analysed. RESULTS: A total of 29 original scoring systems were included in this review. Three scoring systems were highlighted as the most widely reproduced, one aimed at assessing inflammation only and two aimed at assessing inflammation and fibrosis. These scores were more widely reproduced probably due to their ease of application in clinical studies. Two highly comprehensive scores were identified, showing good operating properties and high methodological quality, as well as the lowest risk of bias; these should, therefore, be further validated in clinical research studies. CONCLUSIONS: This study reviewed all existing transmural histopathological scoring systems for the assessment of inflammation and/or fibrosis in CD and identified the most reliable and accurate scores for clinical research and clinical practice settings.
Assuntos
Doença de Crohn , Constrição Patológica/etiologia , Constrição Patológica/patologia , Doença de Crohn/complicações , Doença de Crohn/patologia , Fibrose/patologia , Técnicas Histológicas , Humanos , Inflamação/patologia , Seleção de Pacientes , Reprodutibilidade dos Testes , Projetos de Pesquisa/normas , Índice de Gravidade de DoençaRESUMO
The aim of this study was to evaluate the toxicity of titanium dioxide nanoparticles (TiO2 NPs) by short-term toxicity tests in Apis mellifera, considered an excellent bioindicator organism mainly due to its sensitivity. Bees have been exposed to several concentrations of TiO2 NPs (1 × 10-3 , 1 × 10-4 , 1 × 10-5 , 1 × 10-6 mg/10 ml) for 10 days. Morphostructural and histological assays were done on gut and honey sac. The research of exposure biomarkers like metallothioneins 1 (MT1) and Heat Shock Protein 70 (HSP70) was performed to verify if a detoxification mechanism has been activated in the exposed animals. No histological alteration on the epithelium of the gut and honey sac were observed in exposed samples. A significant positivity for anti-MT1 antibody was observed only in the honey sac cells. A weak positivity for HSP70 was observed in both structures analyzed. In several studies have shown the non-toxicity of TiO2 NPs on other model organisms, in our study, titanium dioxide nanoparticles was proven to be highly toxic at the highest concentration tested (100% of lethality to 1 × 10-3 mg/10 ml) and moderately toxic at lower concentrations. Honey bees proved to be excellent models for study of NPs toxicity and for monitoring environment.
Assuntos
Abelhas/efeitos dos fármacos , Nanopartículas/toxicidade , Titânio/toxicidade , Animais , Abelhas/citologia , Bioensaio , Biomarcadores , Proteínas de Choque Térmico HSP72/metabolismo , Técnicas Histológicas , Imuno-Histoquímica , Metalotioneína/metabolismo , Testes de ToxicidadeRESUMO
AIMS: To assess pathological changes associated with natural infections of the trematode Odhneriotrema incommodum in wild-caught American alligators Alligator mississippiensis and assess potential first intermediate hosts. MATERIALS AND METHODS: Tongues from two wild-caught alligators were obtained from a commercial alligator processor in Port Gibson, Mississippi, USA. Tongues were subjected to gross parasitological examination and routine histological assessment. Eggs were expressed from adult trematodes collected from these tongues into distilled water, where they hatched into infectious miracidia. The snails Planorbella trivolvis, Physa gyrina, and Biomphalaria havanensis were exposed to these miracidia and observed for cercarial emergence for 200 days post-exposure. RESULTS: Histological assessment of alligator tongues revealed marked hemorrhage, necrosis, presence of bacteria, and inflammation at sites of Odhneriotrema incommodum attachment, differing from previous histological reports from controlled experimental studies. Cercarial emergence was not observed in snails exposed to infectious miracidia. CONCLUSIONS: Wild-caught alligators infected with Odhneriotrema incommodum exhibit more severe pathology than was previously noted from experimentally infected alligators. This adverse pathology may be associated with microbes present in eutrophic natural habitats that are absent from controlled environments used in experimental exposures. Impacts of this parasite in wild alligator populations are likely underestimated and damage associated with parasite attachment could increase host susceptibility to secondary infections. Given the importance of alligators as game animals and sustained demand for alligator products, further study into the role of O. incommodum on alligator health is warranted. Results of snail exposures to miracidia suggest these snail species are not suitable first intermediate hosts for this trematode and the true first intermediate host of O. incommodum remains unknown.
Assuntos
Jacarés e Crocodilos/parasitologia , Biomphalaria/parasitologia , Trematódeos/fisiologia , Infecções por Trematódeos/veterinária , Animais , Cercárias , Ecossistema , Técnicas Histológicas , Mississippi , Contagem de Ovos de Parasitas , Língua/parasitologia , Trematódeos/isolamento & purificação , Infecções por Trematódeos/parasitologiaRESUMO
Simulating a clinical condition of intracerebral hemorrhage (ICH) in animals is key to research on the development and testing of diagnostic or treatment strategies for this high-mortality disease. In order to study the mechanism, pathology, and treatment for hemorrhagic stroke, various animal models have been developed. Measurement of hematoma volume is an important assessment parameter to evaluate post-ICH outcomes. However, due to tissue preservation conditions and variables in digitization, quantification of hematoma volume is usually labor intensive and sometimes even subjective. The objective of this study is to develop an automated method that can accurately and efficiently obtain unbiased cerebral hematoma volume. We developed an application (MATLAB program) that can delineate the brain slice from the background and use the Hue information in the Hue/Saturation/Value (HSV) color space to segment the hematoma region. The segmentation threshold of Hue is calculated based on the Bayes classifier theorem so that the minimum error is mathematically ensured and automated processing is enabled. To validate the developed method, we compared the outcomes from the developed method with the hemoglobin content by the spectrophotometric assay method. The results were linearly correlated with statistical significance. The method was also validated by digital phantoms with an error less than 5% compared with the ground truth from the phantoms. Hematoma volumes yielded by the automated processing and those obtained by the operator's manual operation are highly correlated. This automated segmentation approach can be potentially used to quantify hemorrhagic outcomes in rodent stroke models in an unbiased and efficient way.
Assuntos
Hematoma/patologia , Acidente Vascular Cerebral Hemorrágico/patologia , Técnicas Histológicas/métodos , Processamento de Imagem Assistida por Computador/métodos , Animais , Teorema de Bayes , Ratos Sprague-DawleyRESUMO
Bone histology grants substantial insight into the growth and biology of fossil vertebrates. Many of the major non-avian dinosaurian clades have been extensively sampled for bone histologic data allowing reconstruction of their growth as well as the assessment of the evolution of growth changes along phylogenies. However, horned ceratopsians are poorly represented in paleohistologic studies. Further, the ceratopsian taxa that have been examined are unevenly sampled phylogenetically with very basal forms and highly derived forms making up the majority of studied taxa. In order to rectify this, we have histologically sampled Avaceratops from Montana and Yehuecauhceratops from northern Mexico to assess how mid-sized basal centrosaurines grew relative to more basal and derived forms. Based on results from these taxa, basal centrosaurines present a mosaic of growth characters intermediate between those seen in basal ceratopsians and more derived centrosaurines. Further, Yehuecauhceratops has many lines of arrested growth preserved, suggesting that the large number of lines of arrested growth found in a high-latitude Pachyrhinosaurus specimen may be a result of phylogeny rather than geography. Since lines of arrested growth are not preserved in long bones of many ceratopsians, especially chasmosaurines, we also histologically sampled ribs of Avaceratops and Pachyrhinosaurus. However, the largest ribs were highly remodeled obscuring lines of arrested growth, making it unlikely that rib histology will clarify growth trends in ceratopsians. These centrosaurines add to the growing ceratopsian histological database and demonstrate that basal centrosaurines grew in a manner intermediate between non-ceratopsid taxa and derived centrosaurines. Anat Rec, 303:935-948, 2020. © 2019 Wiley Periodicals, Inc.