Assessment of deep learning algorithms to predict histopathological diagnosis of breast cancer: first Moroccan prospective study on a private dataset.

OBJECTIVE: Breast cancer is a critical public health issue and a leading cause of cancer-related deaths among women worldwide. Its early diagnosis and detection can effectively help in increasing the chances of survival rate. For this reason, the diagnosis and classification of breast cancer using Deep learning algorithms have attracted a lot of attention. Therefore, our study aimed to design a computational approach based on deep convolutional neural networks for an efficient classification of breast cancer histopathological images by using our own created dataset. We collected overall 328 digital slides, from 116 of surgical breast specimens diagnosed with invasive breast carcinoma of non-specific type, and referred to the histopathology department of the National Institute of Oncology in Rabat, Morocco. We used two models of deep neural network architectures in order to accurately classify the images into one of three categories: normal tissue-benign lesions, in situ carcinoma or invasive carcinoma. RESULTS: Both Resnet50 and Xception models achieved comparable results, with a small advantage to Xception extracted features. We reported high degrees of overall correct classification accuracy (88%), and sensitivity (95%) for detection of carcinoma cases, which is important for diagnostic pathology workflow in order to assist pathologists for diagnosing breast cancer with precision. The results of the present study showed that the designed classification model has a good generalization performance in predicting diagnosis of breast cancer, in spite of the limited size of the data. To our knowledge, this approach can be highly compared with other common methods in the automated analysis of breast cancer images reported in literature.

[Gliosarcomas. A case report]. / Gliosarcome. A propos d'un cas.

Gliosarcomas account for 2% of glioblastomas. We report a case of gliosarcoma in a 65-year-old man, which presented as meningioma, and discuss diagnostic, therapeutic and prognostic aspects of this particular entity.

Pharmacokinetics of antituberculosis drugs in patients.

The pharmacokinetics of rifampin, isoniazid, and ethambutol were determined in 26 ambulatory male patients (aged 49.5 +/- 9.9 yr) with tuberculosis. Rifampin and isoniazid were given individually or together, with or without ethambutol; studies were done after a single dose and after chronic administration. Under the study conditions, with large variability in the extent of disease and physical status and history of alcohol and tobacco abuse and narrow age range, the pharmacokinetics of these three antituberculosis drugs were not modified significantly by patient age. Furthermore, appreciable drug-drug interactions did not occur when the three drugs were administered concurrently. Self-induction of rifampin clearance by chronic dosing with the drug may lead to subtherapeutic levels of rifampin. Administration of isoniazid and ethambutol in two divided doses resulted in peak plasma concentrations below the accepted therapeutic levels of the two drugs. Our findings indicate that at least in the middle-aged patients with tuberculosis, the current single daily dose, multiple-drug regimen is therapeutically sound pharmacokinetically, and clinicians do not have to make adjustments in dosages of these drugs for age and the extent of disease.

Increased excretion of aromatic amino acid catabolites in animals infected with Trypanosoma brucei evansi.

Aromatic amino acid catabolism by Trypanosoma brucei evansi was investigated in vivo using C3HeB/FeJ mice. The major catabolites detected by gas chromatography in the urines of infected animals were phenylpyruvic acid, 4-hydroxyphenylpyruvic acid, and indole-3-pyruvic acid. Identity of each compound was confirmed by gas chromatography-mass spectrometry. Concentrations of catabolites in urine of infected mice were correlated with parasitemia and returned to normal following suramin treatment. Other aromatic amino acid metabolites, including indole-3-acetic acid, indole-3-lactic acid, and 4-hydroxyphenyllactic acid, were detected in urine from infected animals by gas chromatography mass spectrometry, although quantities were too low to be quantified reproducibly. Both phenylpyruvic acid and 4-hydroxyphenylpyruvic acid were also detected in urine of dogs and donkeys experimentally infected in Egypt with a recent field isolate of T. b. evansi. Tryptophan metabolites could not be assayed in dog and urine samples because formalin, which degraded the indole acids, had to be added before the samples could be imported into the U.S. Finally, concentrations of urinary catabolites during infection were correlated with the tyrosine aminotransferase activity in infected mouse sera.

[Pelvic tuberculosis mimicking bilateral ovarian tumor. A case report]. / Tuberculose pelvienne simulant une tumeur ovarienne bilatérale: à propos d'un cas.

Tuberculosis is a curable infectious disease which can mimic ovarian cancer. This case report illustrates that the association of a pelvic mass with elevated CA125 is not necessarily suggestive of ovarian malignancy. A 22-Year-old woman presenting with bilateral ovarian masses and an elevated CA 125 underwent an exploratory laparotomy to search for ovarian tumor. The final pathology diagnosis was ovarian tuberculosis without pulmonary involvement. Tuberculosis is a differential diagnosis to consider in patients with a pelvic mass because of the lack of pathognomonic clinical and biological signs.

[Solitary fibrous mediastinal tumor. A case report]. / Tumeur fibreuse solitaire du médiastin. A propos d'un cas.

Solitary fibrous tumor is a rare tumor, generally located in the pleura. Recently, new sites have been described in the literature, particularly involving the peritoneum and mediastinum, as wekk as te-the bronchopulmonary and orbital regions. The diagnosis is established at pathology, but in some cases may be difficult to differentiate from other tumors. We report the case of a 60-year-old women who had undergone surgery 25 years ago for right pulmonary hydatid cyst and who presented inspiratory dyspnea and dry cough for four months. Physical examination revealed a right cervical tumefaction in the supraclavian region. The AP chest x-ray disclosed an opacity in the right laterotracheal upper cervicomediastinal zone laminating the trachea which was displaced to the left. Thoracic computerized tomography showed a tissular process in the superior and middle mediastinum. Surgical tumor resection was performed and pathology confirmed the diagnosis of solitary fibrous tumor. The postoperative period was uneventful. Frequency of the mediastinal localisation is the same in men and women. The tumor generally develops between the 5th and 7th decades, and is most often asymptomatic. Fortuitous discovery is the rule. The clinical course is unforeseeable.

Hepatocyte growth factor in Egyptian females with breast benign lumps and cancers.

BACKGROUND: Hepatocyte growth factor (HGF) also known as scatter factor (SF) and its receptor c-met play important roles in mammary differentiation and have been implicated in mammary carcinogenesis. OBJECTIVE: Estimation of the plasma level of HGF in females with benign breast lumps or breast carcinomas and correlating levels with important prognostic parameters. SUBJECTS: Sixty eight adult premenopausal females were divided into control group of fifteen healthy volunteers and fifty-three patients subdivided into fifteen with benign breast lumps and thirty-eight with breast carcinomas. METHODS: A thorough clinical examination, plain chest x-rays, ultrasonography of the abdomen and pelvis, pre- operative fine needle aspiration cytology, estimation of fasting serum glucose, urea, creatinine and uric acid levels, alanine aminotransferase activities, C-reactive protein, HGF level and histopathological examination of the breast masses were performed. RESULTS: Significant increase in HGF levels was found in patients with benign breast lumps and in breast cancer patients when each was compared to controls and when cancer patients were compared to the benign breast lumps group. CONCLUSION: The serum level of HGF is an independent prognostic indicator for breast cancer.

Comparison of serum survivin and alpha fetoprotein in Egyptian patients with hepatocellular carcinoma associated with hepatitis C viral infection.

BACKGROUND: Survivin is specific antiapoptotic gene product expressed in a variety of human neoplasms whose overexpression might assist in early diagnosis and as a prognostic marker. OBJECTIVES: The aim was to evaluate the plasma levels of survivin and alpha fetoprotein in patients with chronic hepatitis C viral infection (HCV) with and without hepatocellular carcinoma (HCC). SUBJECTS: 70 subjects were divided into: a control group (Group I) (20 healthy volunteers) and two patients groups: Group II, HCV group (20 patients); and Group III, HCC with HCV(30 patients). METHODS: Thorough physical examination, ultrasonography of the abdomen, laboratory investigations (liver profile, anti-HCV antibodies, hepatitis B surface antigen, Alpha fetoprotein (chemiluminometry) and Survivin (ELISA)) were performed. RESULTS: There was a significant increase in survivin level in HCV patients (Group II) when compared to the control group (p=0.039), along with a significant increase in AFP in Groups II and III when compared to Group I (P<0.001 for both). AFP also distinguished between the two HCV groups. The best generated cut off value for AFP was 10.9 ng/ml and for survivin 13.7 pg/ml. Serum survivin diagnostic sensitivity was 53.3%, diagnostic specificity 62.5% and efficiency 58.6%, in contrast to 100%, 92.5% and 95.7%, respectively, for AFP. CONCLUSIONS: While survivin showed significant increase in the HCV group, its diagnostic performance was lower and it proved to be less reliable as a tumor marker for HCC than did AFP.

Catabolism of tryptophan by Trypanosoma evansi.

Trypanosoma brucei gambiense, which causes human African trypanosomiasis, catabolizes the aromatic amino acid tryptophan via an initial aminotransferase catalyzed reaction to form several indole end products, which have been suggested to contribute to the pathogenesis of trypanosomiasis. To determine if this same pathway exists in T. evansi, the closely related trypanosome pathogen of domestic animals, tryptophan catabolism was examined in vitro and in vivo. As is the case with human African trypanosomes, T. evansi catabolized tryptophan to form indole-3-pyruvic acid and smaller amounts of indole-3-acetic acid and indole-3-lactic acid. Large concentrations of indole-3-pyruvic acid are excreted in urine of trypanosome-infected mice. However, indole-3-ethanol could not be detected in incubates of T. evansi or T. b. gambiense, even though the latter species had previously been reported to form this neutral metabolite. A new, previously unreported tryptophan metabolite was isolated and partially characterized from incubates of T. evansi and T. b. gambiense. Although the functional significance of tryptophan catabolism to trypanosomatids remains obscure, the pathway is quantitatively significant in all species examined thus far.