Adjunctive Tool In Diagnosis Research Articles

Syphilitic Uveitis With Diverse Clinical Presentations: Multimodal Imaging as a Useful Adjunctive Tool for Diagnosis and Treatment

Syphilitic Uveitis With Diverse Clinical Presentations: Multimodal Imaging as a Useful Adjunctive Tool for Diagnosis and Treatment

Histomorphological view of the cornea investigated by laser confocal microscopy in keratoplasty

Introduction. Corneal transplantation is the most successful and commonly performed allotransplantation procedure as compared with other organs and tissues. Over 100,000 corneal transplantations are performed worldwide every year.Purpose. This study investigated whether in vivo confocal microscopy (IVCM) can aid in the diagnosis of a graft rejection reaction by detecting changes in cellular structures and density of immune cells after penetrating keratoplasty.Materials and methods. The study included thirty-four eyes of 34 patients who underwent penetrating keratoplasty (7 eyes with corneal graft rejection, 27 without rejection). The average age of patients is 51.1 ± 13.6 years (from 23 to 76 years). The follow-up period ranged from 12 to 36 months (24.5 ± 4.84 months). Follow-up was performed at 1, 3, 6, 12 months and annually after PKP. To study the morphology of the cornea all patients underwent IVCM to assess the basal epithelium, subbasal layer, stroma and endothelium. Immune cells were identified and evaluated for the shape, length of the processes and their density.Results. Patients with corneal graft rejection demonstrated significant accumulation of corneal dendritic-like immune cells compared to patients with non-rejected grafts. In addition, the cells acquired a more mature morphology (grade 2–3). The density of dendritic cells (DC) was 809.17 ± 342.19 (p < 0.001). A positive correlation was found between DC density and graft rejection (p < 0.001). As well the patients showed signs of endothelial failure with low endothelial cell density and pleomorphism, increased light scattering and hyperreflectivity of the stroma.Conclusions. In a complex of diagnostic measures, confocal microscopy may provide a valuable clinical adjunctive tool in diagnosis and management of early corneal graft rejection.

NMR based serum metabolomics reveals a distinctive signature in patients with Lupus Nephritis.

Management of patient with Lupus Nephritis (LN) continues to remain a challenge for the treating physicians because of considerable morbidity and even mortality. The search of biomarkers in serum and urine is a focus of researchers to unravel new targets for therapy. In the present study, the utility of NMR-based serum metabolomics has been evaluated for the first time in discriminating LN patients from non-nephritis lupus patients (SLE) and further to get new insights into the underlying disease processes for better clinical management. Metabolic profiling of sera obtained from 22 SLE patients, 40 LN patients and 30 healthy controls (HC) were performed using high resolution 1D 1H-CPMG and diffusion edited NMR spectra to identify the potential molecular biomarkers. Using multivariate analysis, we could distinguish SLE and LN patients from HC and LN from SLE patients. Compared to SLE patients, the LN patients had increased serum levels of lipid metabolites (including LDL/VLDL lipoproteins), creatinine and decreased levels of acetate. Our results revealed that metabolic markers especially lipids and acetate derived from NMR spectroscopy has high sensitivity and specificity to distinguish LN among SLE patients and has the potential to be a useful adjunctive tool in diagnosis and clinical management of LN.

Physiological and Psychological Status Related to Dyspnea in Patients with Cardiopulmonary Disease

Background: Vital Capacity (VC); Force Expiratory Volume (FEV1) and Force Expiratory Volume percentage (FEV %) are useful adjunctive tool in diagnosis of cardio pulmonary dyspnea in the emergency department. Nurses' role in this department is to assess the psychological and physiological status related to dyspnea in patients with cardiopulmonary disease at an early stage and nursing management according to their conditions. Objective: to assess the physiological and psychological status related to dyspnea in patients with cardiopulmonary disease. Methodology: Pulmonary function test was carried out on (60) patients suffering from cardiopulmonary disease referred consecutively to the outpatient clinic for pulmonary function test in Baghdad Teaching Hospital, For every patients participate in this study a proper psychological review was done to know the presence of the psychological problem related to dyspnea. Results: Results of the study show that there is highly significant difference increased in FEV1% and high level of dyspnea and the results of this study also show that there is significant difference with increasing depression and anxiety status and high level of dyspnea. Conclusion: Verbal descriptors of dyspnea in cardiopulmonary disease are related to the intensity level of dyspnea, and dyspnea is influenced not only by physiological status but also by psychological status. Recommendation: The development and implantation of educational instructional program for nurses (theory and practice) for the care of patients with cardiopulmonary are very important.

Orofacial Granulomatosis: A Clinicopathologic Correlation

Orofacial granulomatosis is an uncommon disorder, but has been increasingly recognized in the past decade. It causes significant morbidity in the patient including oral ulcerations, enlargement of soft tissues which are often persistent and painful. This necessitates early medical intervention. We report one such case of a female patient who presented with a persistent upper lip enlargement. She had visited multiple general dental practitioners and general physicians but was undiagnosed. Ultrasonography proved an adjunctive tool in diagnosis. She was treated with a combination of topical and intra-lesional steroids. A 1-year follow-up did not show any evidence of recurrence.

Fine-needle aspiration biopsy as an auxiliary diagnostic tool on intraoral minor salivary gland adenoid cystic carcinoma

Fine-needle aspiration biopsy (FNAB) is useful in diagnosis of major salivary gland adenoid cystic carcinoma (ACC), but it has been rarely reported on minor salivary gland ACC. The aim of this study was to report the utility of FNAB on diagnosis of ACC involving minor salivary glands. Three patients presenting ACC involving the palate (2 cases) and buccal mucosa (1 case), with a mean age of 36 years and 2:1 female-to-male ratio, were included in the study. All of the patients were submitted to FNAB for diagnostic purposes. All smears were stained with hematoxylin-eosin, Papanicolaou, and Diff-Quik and showed the presence of small polyhedral cells with hyperchromatic nuclei and extracellular basophilic globular amorphous substance, compatible with ACC. Diagnosis of the 3 cases was subsequently confirmed through histopathology. The FNAB was easy to perform and cost-effective, and proved to be an useful adjunctive tool in diagnosis of intraoral ACC.

Detection of EWS/FLI‐1 by Immunostaining. An Adjunctive Tool in Diagnosis of Ewing′s Sarcoma and Primitive Neuroectodermal Tumour on Cytological Samples and Paraffin‐Embedded Archival Material

Purpose. Recently we showed that the 68-kDa fusion protein derived from the EWS/FLI1 hybrid gene can be specifically detected by Western blotting using a polyclonal antibody to the C-terminal of FLI1 on biopsy material from Ewing's sarcoma. The aim of this study was to investigate whether this antibody also could be used for immunocytochemistry and immunohistochemistry in diagnosis of Ewing's sarcoma. Methods. Immunostaining on paraffin-embedded archival material, fine-needle aspirates and tumour touch imprints from Ewing's sarcomas and primitive neuroectodermal tumours (PNET) for detection of the fusion protein was performed. Most cases were also analysed by Western blotting.Tumours of differential diagnostic importance were also included. Results. Eighty per cent (12/15 cases) of the Ewing tumours exhibited a positive immunoreactivity for the FLI1 antibody. The signal was mainly localised in the nuclei of the tumour cells, which seems reasonable since EWS/FLI1 is a transcription factor. The signal was found to be specific since it did not appear when the blocking peptide was added to the antibody solution.Moreover, two other types of small-round cell tumours (i.e. neuroblastoma and alveolar rhabdomyosarcoma) were negative as well as most normal tissues. Discussion. Immunostaining of histological and cytological specimens with the FLI1 antibody can be of diagnostic relevance in Ewing tumours carrying t(11;22).The absence of immunoreactivity in non-Ewing cells is most likely due to a low expression of the wild-type FLI1 protein.