Investigating The Frequency of Serrated Polyps/Adenomas and Their Subtypes in Colonic Polyp Samples.

BACKGROUND: The purpose of this study was to determine the frequency of Serrated polyps of colonic polyps samples in Hazrat_e Rasoul_e Akram Hospital over ten years. MATERIALS: The target group in this study was patients with colonic polyps in Hazrat_e Rasoul_e Akram Hospital. Pathologic evaluation of these patients was done. Serrated polyps, by location, gender, age and type of polyps were divided and frequency of them were determined separately. RESULTS: Of 381 patients studied, 224 (58.79%) and 157(41.20%) were males and females, respectively. Mean age of patients was 59.25 years. In initial diagnosis, frequency of Adenomatous polyp, Hyperplastic polyp and Mixed polyp were 92.44% and 5.33%, and 2.22%, respectively. In final diagnosis (Second evaluation), frequency of Adenomatous polyp, Hyperplastic polyp, Mixed polyp, Sessile Serrated Adenoma/ Polyp, Traditional Serrated Adenoma and SPU (Serrated Polyp Unclassifiable) were 90.44%, 4.88%, 2.44%, 1.11%, 0.66% and 0.44%, respectively. 72.13% and 27.86% of polyps were low grade dysplasia and high grade dysplasia, respectively. According to the results of this study, the incidence of all types of polyps detected was more in men than women. Rectum and sigmoid were most abundant in the area polyp in both initial and final diagnosis. CONCLUSION: Despite the low prevalence of Serrated polyps in patients, early diagnosis is the best action to reduce morbidity and mortality. Probability of the risk of progression from low grade to high grade dysplasia and transforming into Adenocarcinoma is high in Serrated polyps.

Diagnostic Accuracy of Fine Needle Aspiration Cytology versus Concurrent Core Needle Biopsy in Evaluation of Intrathoracic Lesions: a Retrospective Comparative Study.

BACKGROUND: Transthoracic fine needle aspiration (FNA) cytology and core needle biopsy (CNB) are two commonly used approaches for the diagnosis of suspected neoplastic intrathoracic lesions. This study compared the diagnostic accuracy of FNA cytology and concurrent CNB in the evaluation of intrathoracic lesions. MATERIALS AND METHODS: We studied FNA cytology and concurrent CNB specimens of 127 patients retrospectively, using hematoxylin and eosin (H and E), immunohistochemistry, and, on certain occasions cytochemistry. Information regarding additional tissue tests was derived from the electronic archives of the Department of Pathology and Laboratory Medicine as well as patient records. Diagnostic accuracy was calculated for each test. RESULTS: Of 127 cases, 22 were inconclusive and excluded from the study. The remaining 105 were categorized into 73 (69.5%) malignant lesions and 32 (30.5%) benign lesions. FNA and CNB findings were in complete agreement in 63 cases (60%). The accuracy and confidence intervals (CIs) of FNA and CNB for malignant tumors were 86.3% (CI: 79.3-90.7) and 93.2% (CI: 87.3- 96.0 ) respectively. For epithelial malignant neoplasms, a definitive diagnosis was made in 44.8% of cases by FNA and 80.6% by CNB. The diagnostic accuracy of CNB for nonepithelial malignant neoplasms was 83.3% compared with 50% for FNA. Of the 32 benign cases, we made specific diagnoses in 16 with diagnostic accuracy of 81.3% and 6.3% for CNB and FNA, respectively. CONCLUSIONS: Our findings suggest that FNA is comparable to CNB in the diagnosis of malignant epithelial lesions whereas diagnostic accuracy of CNB for nonepithlial malignant neoplasms is superior to that for FNA. Further, for histological typing of tumors and examining tumor origin, immunohistochemical work up plays an important role.

Detection of mucosal type human papillomavirus in cutaneous squamous cell carcinoma in Iran.

Squamous cell carcinoma (SCC) is the second most common non-melanoma skin cancer. The oncogenic role of human papilloma virus (HPV) in cutaneous SCC has been suggested by several studies performed on immunosuppresed patients. However, the role of mucosal type HPV in SCC patients with normal immunity has not been studied extensively. Sixty skin biopsies from immunocompetent SCC patients and 60 benign skin specimens were evaluated for mucosal type HPV DNA using polymerase chain reaction (PCR) and immunohistochemistry (IHC). Mucosal type HPV DNA was detected in 18 of 60 cases (30%) and in 7 of 60 controls (11.6%) using PCR. HPV immunostain was positive in 16 of 60 cases (26.6%) and in 15 of 60 controls (25%). Mixed infection with HPV 18, 11, 6 was found in half of the SCC cases. The most prevalent subtype was HPV 18 followed by HPV 6 and 11. The frequency of HPV DNA was significantly elevated in our cases compared to controls (P value <0.01, OR=16.8, 95% CI: 3.3-74.9). Our findings suggest an association of mucosal type HPV, especially HPV 18, with skin SCC in Iranian patients with normal immunity.

Group B streptococci urine isolates and their antimicrobial susceptibility profiles in a group of Iranian females: prevalence and seasonal variations.

Streptococcus agalactiae is one of the uropathogens responsible for urinary tract infections (UTI) in children, pregnant women, and elderly people with chronic underlying diseases. This study was performed to determine the prevalence of urinary tract isolates of group B streptococci (GBS) in a group of females referred to a referral University Hospital in Iran. In this retrospective cross-sectional study, urine analysis and urine culture results of all female subjects referred to the laboratory of the Rasoul-e-Akram Hospital, Tehran, Iran in 2010 were reviewed. Bacteriuria, colony count, pyuria and demographic data of patients were also evaluated. In this study, 10,256 females were investigated; 2061 (20.1%) of them had positive urine cultures. GBS was the isolated microorganism in 184 (8.92%) cases, yielding a prevalence of 1.79% in total study population. The mean age of subjects with positive GBS cultures was 48.24 +/- 18.8 years, with a higher prevalence recorded in the 51-60 and 21-30 age groups. The highest rates of cultures positive for GBS were seen in December and January. GBS was found to be sensitive to the following antibiotics: cephalothin (100%), norfloxacin (96.9%), ampicillin (96%), nitrofurantoin (95.5%), and vancomycin (95%). In this study, GBS showed greatest resistance to tetracycline (81.6%) and co-trimoxazole (68.9%). In conclusion, the prevalence of GBS in females with suspected UTI is relatively low; however, attention to the age and susceptibility pattern of antibiotic treatment for UTI caused by this microorganism is necessary.

Epidermodysplasia verruciformis associated with plasmablastic lymphoma and hepatitis B virus infection.

Epidermodysplasia verruciformis is a rare genodermatosis characterized by inherited susceptibility to infection with certain papillomaviruses, which leads to the development of disseminated plane wart-like lesions. In some patients, lesions resembling pityriasis versicolor appear. Epidermodysplasia verruciformis has also been reported in immunosuppressed patients, most notably those with HIV infection. The affected patients are predisposed to development of skin and mucosal malignancies. We describe the rare occurrence of plasmablastic lymphoma in a patient with long lasting epidermodysplasia verruciformis and hepatitis B virus infection.

Platelet count and MPV, routinely measured but ignored parameters used in conjunction with the diagnosis of acute coronary syndrome: single study center in Iranian population, 2010.

BACKGROUND: Myocardial infarction is the major cause of morbidity and mortality in industrialized countries. Platelet count and the mean platelet volume (MPV), a simple and reliable indicator of platelet size which correlates with platelet activation, might associate with troponin in acute chest pain. METHODS: We analyzed MPV of 851 patients who were admitted to Rasoul-e-Akram Hospital with acute chest pain during the year 2010. Two blood samples were taken from each patient within 4 hours of their arrival for routine hematology, including platelet count and MPV, and cardiac troponin T. Also, electrocardiograms of the patients were recorded. Association of MPV and platelet count with troponin was observed. RESULTS: The patients in troponin positive group, who had also ischemic electrocardiographic changes, had higher MPV values than non- acute coronary syndrome (ACS) patients with normal cardiac troponin T levels (9.9 vs 9.5 fl with p< 0.001). In troponin negative group, the mean of platelet count was higher than that in the positive group (221683 vs 198814/µl with p< 0.001). CONCLUSION: MPV and platelet count are inexpensive laboratory tests which can be measured in association with other laboratory biomarkers in patients presenting with acute chest pain. This could help to lower hospitalization rates and also avoid misdiagnosis and having complications of patients with ACS.

Clinicopathologic comparison of radiofrequency versus scalpel incision for upper blepharoplasty.

PURPOSE: To compare the sensation recovery, scar formation, and histopathologic aspects of upper blepharoplasty eyelid incision performed with radiofrequency or scalpel. METHODS: In a prospective, randomized, blind, comparative, interventional study, 46 eyelids from 23 subjects underwent upper blepharoplasty using radiofrequency incision on one side and a scalpel on the other side. Exclusion criteria were diseases resulting in peripheral neuropathy such as diabetes mellitus, previous upper eyelid surgery or trauma, and history of skin disease. Eyelid sensation was measured preoperatively and 1 week, 1 month, and 6 to 7 months after surgery by a masked observer. Eyelid scar was evaluated by 2 masked observers at final follow-up. Histologic examination for zone and depth of tissue damage, hemorrhage, and inflammatory cell reaction was performed in a masked fashion on 16 eyelids. RESULTS: The mean patient age was 52 years (SD, 5.48 years). Mean aesthesiometry reading significantly decreased in both groups at all follow-up visits in comparison with preoperative measurement (p = 0.000). Mean sensation recovery was insignificantly (0.2 < p < 0.6) higher in the radiosurgery group at all follow-up visits. Mean scar score was insignificantly (p = 0.055 for observer 1, and 0.241 for observer 2) less in the radiosurgery group. The scar score was not significantly different between Fitzpatrick skin types 3 and 4, scored by either observer. The zone and depth of tissue damage on histopathologic examination was greater in the radiofrequency group. However, the hemorrhage and infiltration of inflammatory cells were the same. CONCLUSION: There was no significant difference between radiofrequency and scalpel incision in upper blepharoplasty with regard to sensation recovery and scar formation. Histologic zone and depth of tissue damage were greater in the radiofrequency group.