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Histopathologic Evidence (histopathologic + evidence)
Selected AbstractsHistopathologic evidence of the nondermatophytic mould Scopulariopsis brevicaulis masking the presence of dermatophytes in a toenail infectionJOURNAL OF CUTANEOUS PATHOLOGY, Issue 2009Catherine M. Stefanato Nondermatophytic toenail infection with Scopulariopsis brevicaulis is rare, but may occur often in association with dermatophytes. We report a case of an 84-year-old man who presented with onychomycosis of the big toenail. Histopathologic examination of the avulsed nail showed evidence of S.brevicaulis coinfection with a dermatophyte, despite negative mycology results for the latter. Our case underscores the importance of histopathologic examination of nail specimens as an additional invaluable tool in the diagnosis of onychomycosis, as it may unmask false-negative mycology findings. [source] Repair of transected facial nerve with mesenchymal stromal cells: Histopathologic evidence of superior outcome,THE LARYNGOSCOPE, Issue 11 2009Bulent Satar MD Abstract Objectives/Hypothesis: Despite advanced surgical techniques, clinical results of the transected facial nerve are still far from the desired outcome. Mesenchymal stromal cells (MSCs) were shown to transdifferentiate into Schwann cells and express some growth factors beneficial in peripheral nerve injury. We aimed to document histopathological improvement obtained from application of the homograft bone marrow-derived MSCs immediately after conventional anastomosis of a transected facial nerve branch in rats, and to compare the results with those nerves anastomosed only. Study Design: Animal, prospective, and controlled study. Methods: The study was performed in 15 rats. The right buccal branch was completely transected and repaired with epineural sutures. The right-side anastomosis was additionally treated with MSCs thereafter. The right marginal mandibular branch was kept intact, but in contact with MSCs. The left buccal branch was transected and repaired in a similar fashion except for MSC application. The left-side marginal mandibular branch was left intact. Rats were sacrificed at month 1, 3, and 6. Four branches of each rat were sampled, and nerve segments distal to the anastomosis were histopathologically examined. Results: The examination revealed that intact nerve segments and nerve segments in contact with MSCs had completely normal appearance regardless of the time interval. Samples from the nerves anastomosed and treated with MSCs did better than those nerves anastomosed only in terms of axonal organization and myelin thickness. Conclusions: This preliminary report witnessed beneficial effects of MSCs application onto the injured facial nerve as evidenced by the histopathological examination. Laryngoscope, 2009 [source] Clinical model for distinguishing nonalcoholic steatohepatitis from simple steatosis in patients with nonalcoholic fatty liver diseaseLIVER INTERNATIONAL, Issue 2 2006Nicole A. Palekar Abstract: Nonalcoholic fatty liver disease (NAFLD) encompasses both simple steatosis and nonalcoholic steatohepatitis (NASH). Differentiation of these two entities requires histopathologic evaluation. The aim of this study was to establish a reliable diagnostic model for differentiating steatosis from steatohepatitis utilizing both clinical characteristics and a panel of biochemical markers of lipid peroxidation and fibrosis. Eighty subjects with biopsy proven NAFLD were enrolled, 39 with simple steatosis and 41 with histopathologic evidence of NASH. Demographic and laboratory data to include serologic testing for 8-epi-PGF2,, transforming growth factor-, (TGF-,), adiponectin, and hyaluronic acid (HA) were obtained and compared between the two groups. There were significant differences between the two groups with respect to age (P=0.004), female gender (P=0.024), aspartate aminotransferase (AST) (P=0.028), body mass index (BMI) (P=0.003), fasting insulin (0.018), AST/alanine aminotransferase (ALT) ratio (AAR) (P=0.017), quantitative insulin sensitivity check index (QUICKI) (P=0.002), and HA (P=0.029). A composite index for distinguishing steatosis from NASH was calculated by summing the risk factors of age ,50 years, female gender, AST,45 IU/l, BMI ,30 mg/kg2, AAR,0.80, and HA,55 mcg/l, and its accuracy was determined by receiver operating characteristic (ROC) analysis to be 0.763 (95% CI: 0.650,0.876). The presence of three or more risk factors had a sensitivity, specificity, PPV, and NPV of 73.7%, 65.7%, 68.2%, and 71.4%, respectively. In addition, HA at a cutoff of 45.3 mcg/l was a good predictor of advanced fibrosis. In conclusion, we propose a noninvasive screening model for distinguishing simple steatosis from NASH. Identifying patients at risk for NASH will allow clinicians to more accurately determine who may benefit from liver biopsy. [source] Safety of Magnetic Resonance Imaging of Stapes Prostheses,THE LARYNGOSCOPE, Issue 3 2005Mark James Syms MD Abstract Objective: Assess the safety of performing magnetic resonance imaging (MRI) on patients with stapes prostheses. Study Design: Survey and animal model. Methods: A survey regarding implant usage, MRI procedures, and adverse outcomes after MRI in patients previously undergoing stapes procedures. Guinea pigs implanted with ferromagnetic 17 to 4 stainless steel, 316L nonferromagnetic stainless steel, titanium, and fluoroplastic stapes prostheses underwent a MRI in a 4.7 Tesla MR system. Results: Three adverse outcomes were reported on the clinical survey. One adverse event occurred during an MRI performed on a recalled ferromagnetic prosthesis. The other two adverse events were probably not secondary to MRI exposure. No damage or inflammation was observed in the region of the oval window or vestibule of implanted guinea pigs exposed to a 4.7 Tesla MR system. Conclusions: The combination of prior studies, the clinical survey, and the absence of histopathologic evidence of damage in the guinea pigs is compelling evidence that MRI for patients with stapes prostheses is safe. Implanting physicians should feel comfortable clearing a patient for a MRI in a 1.5 Tesla or 3.0 Tesla MRI. It is imperative for the physician to qualify the field strength when clearing a patient to undergo a MRI. [source] Clinical and histologic evidence of salivary gland restoration supports the efficacy of rituximab treatment in Sjögren's syndrome,ARTHRITIS & RHEUMATISM, Issue 11 2009J. Pijpe Objective To assess the effect of rituximab (anti-CD20 antibody) therapy on the (immuno)histopathology of parotid tissue in patients with primary Sjögren's syndrome (SS) and the correlation of histologic findings with the flow rate and composition of parotid saliva. Methods In a phase II study, an incisional parotid biopsy specimen was obtained from 5 patients with primary SS before and 12 weeks after rituximab treatment (4 infusions of 375 mg/m2). The relative amount of parotid parenchyma, lymphocytic infiltrate, and fat, and the presence/quantity of germinal centers and lymphoepithelial duct lesions were evaluated. Immunohistochemical characterization was performed to analyze the B:T cell ratio of the lymphocytic infiltrate (CD20, CD79a, CD3) and cellular proliferation in the acinar parenchyma (by double immunohistologic labeling for cytokeratin 14 and Ki-67). Histologic data were assessed for correlations with the parotid flow rate and saliva composition. Results Four patients showed an increased salivary flow rate and normalization of the initially increased salivary sodium concentration. Following rituximab treatment, the lymphocytic infiltrate was reduced, with a decreased B:T cell ratio and (partial) disappearance of germinal centers. The amount and extent of lymphoepithelial lesions decreased in 3 patients and was completely absent in 2 patients. The initially increased proliferation of acinar parenchyma in response to inflammation was reduced in all patients. Conclusion Sequential parotid biopsy specimens obtained from patients with primary SS before and after rituximab treatment demonstrated histopathologic evidence of reduced glandular inflammation and redifferentiation of lymphoepithelial duct lesions to regular striated ducts as a putative morphologic correlate of increased parotid flow and normalization of the salivary sodium content. These histopathologic findings in a few patients underline the efficacy of B cell depletion and indicate the potential for glandular restoration in SS. [source] Takayasu arteritis: Utility and limitations of magnetic resonance imaging in diagnosis and treatmentARTHRITIS & RHEUMATISM, Issue 6 2002Elisa Tso Objective Previous studies have confirmed the poor correlation of symptoms, signs, and levels of acute-phase reactants with disease activity in ,50% of all patients with Takayasu arteritis (TA). Invasive angiographic studies demonstrate vessel lumen anatomy, but do not provide qualitative information about the vessel wall. Moreover, sequential invasive angiographic studies expose patients to high-dose ionizing radiation and catheter/procedure-related morbidity. The aim of the present study was to determine the utility of new developments in vascular magnetic resonance (MR) technology in patients with TA. Methods Electrocardiogram-gated "edema-weighted" MR was used to evaluate the aorta and its primary branches with regard to the vascular lumen, vessel wall anatomy, and vessel wall edema in 24 TA patients (77 studies). Inclusion criteria were age <50 years and features of TA on both clinical examination and invasive angiographic studies. Patients were stratified based on clinical and laboratory indications of having either unequivocally active disease, inactive disease, or uncertain disease status. Results MR revealed vessel wall edema in 94% (17 of 18), 81% (13 of 16), and 56% (24 of 43) of studies obtained during periods of unequivocally active disease, uncertain disease activity, and apparent clinical remission, respectively. Westergren erythrocyte sedimentation rate and C-reactive protein values did not correlate with either the clinical assessment of disease activity or MR evidence of vascular edema. The frequency of presumed vascular inflammation (edema), as assessed by MR, in patients who appeared to be in remission was similar to the reported frequency of new angiographic lesions and histopathologic evidence of active disease in surgical specimens from patients thought to be in remission. However, the presence of edema within vessel walls did not consistently correlate with the occurrence of new anatomic changes found on subsequent studies. Conclusion Inconsistencies in the presence or absence of vessel edema and subsequent anatomic changes have cast doubt on the utility of edema-weighted MR imaging as a sole guide to disease activity and treatment in TA. In this study, the greatest utility of MR was in providing a safe, noninvasive means of assessing changes in vascular anatomy. [source] | ||||||||||