Histology Of Biopsy Specimens Research Articles

A Socket Seal Technique With the Use of Autologous Dental Roots for Socket Seal: A Case Series.

The literature identified variations in socket seal surgery, each with limitations. This case series aimed to observe the outcome of using autologous dental root (ADR) for socket sealing on socket preservation (SP). A total of 9 patients with 15 extraction sockets were documented. After flapless extraction, the xenograft or alloplastic grafts were placed in the sockets. Autologous dental roots were prepared extraorally and applied to seal the socket entrance. All SP sites healed uneventfully. Cone-beam computed tomography (CBCT) scan was performed after 4-6 months of healing to evaluate ridge dimensions. The preserved alveolar ridge profiles were verified on CBCT scans and during implant surgery. Implants were placed successfully with a reduced need for guided bone regeneration. Histological biopsy specimens were examined in 3 cases. The histological examination demonstrated vital bone formation and osseointegration of graft particles. All patients completed the final restorations and were monitored for 15.56 ± 9.08 months after functional loading. The favorable clinical outcomes support the use of ADR for SP procedures. It was not only accepted to patients but also easy to perform with low complication rates. The ADR technique is thus a feasible method for socket seal surgery.

A perifériás vérben keringő szabad DNS molekuláris vizsgálata epeúti malignitásokban

Tumor-derived free-circulating DNA in peripheral blood allows the study of the molecular genetic profile in cholangiocarcinomas and even the effective monitoring of the response to chemotherapy. The use of a liquid biopsy is a favourable solution, as repeated invasive histological sampling is much more practicable and avoidable. The efficiency of liquid biopsy-based sequencing increases with tumor progression and thus with the release of larger amounts of free DNA. In the present study, clinically relevant point mutations were detected from both histological and liquid biopsy specimens of bile duct tumors. During next-generation sequencing, histological and DNA samples obtained during liquid biopsy from 33 patients were analyzed using a 67-gene solid tumor panel. In our prospective study, we present a minimally invasive approach to identify molecular genetic changes in cholangiocarcinoma and gallbladder tumors. The diagnostic application of free DNA reflects the spatial heterogeneity of tumors, making it a new approach to precision oncology treatments. Orv Hetil. 2022; 163(50): 1982-1991.

Histological pattern of bladder cancer at a tertiary hospital in North Western Nigeria: an update

Background: An update on the histopathological patterns of bladder cancer in our environment is pertinent to determine the current prevalent histological type and if there is worsening schistosomal infestation as these can guide the management of bladder cancer.Methods: This is a prospective study of patients managed for bladder cancer at the urology unit, department of surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria between 02 February 2018 and 01 February 2019. Histology of biopsy specimens were done at the histopathology department of Usmanu Danfodiyo University Teaching Hospital, Sokoto. Data was collected using a structured proforma and analyzed using statistical package for the social sciences (SPSS) version 20.0.Results: A total of 65 patients were recruited into the study with mean age of 51.9 years and standard deviation of ±14.7. The male to female ratio was 6:1 and the commonest occupation of the patients was farming (41.5%). A total of 46 patients (70.8%) had squamous cell carcinoma following histology, followed by transitional cell carcinoma seen in 9.2% of patients and adenocarcinoma seen in 3.1% of patients. Schistosoma ova was seen in 13.8% of the patients while 3.1% of the patients had cystitis cystica.Conclusions: The commonest histological type of bladder cancer in our environment is squamous cell carcinoma. In this current study, the percentage of patients with squamous cell carcinoma is higher than the previously reported percentages while the percentage of patients with transitional cell carcinoma is lower than the previously reported percentages thus revealing worsening schistosomal infestation in our environment.

MICROBIOLOGICAL AND HISTOLOGICAL PICTURE IN LOCAL CRYO IMPACT ON A SUPPURATING WOUND

Resume. In light of the significant perspectives for the use of elements of physical processing factors in the treatment of purulent diseases of soft tissues, spesial attention should be paid of local cryoinfluence in the debridement of purulent wounds. Purpose of the work: to study changes in the histological and microbiological picture during cryo-treatment of a purulent wound model. Material and methods. Superficial purulent wounds of soft tissues were modeled on 40 male Wistar rats. A dynamic microbiological study of wound smears and histological biopsy specimens was performed with cryotherapy and without interfering with the course of the wound process. Results. The treatment with cryotherapy revealed a statistically significant acceleration of the elimination of the pathogen from the wound, the rapid development of fresh connective tissue and the restoration of the microvascular bed, and the activation of the rate of epithelialization. Conclusions. Debridement and the use of local cryoprocessing contributes to the rapid elimination of the pathogen from the wound, activates the processes of granulation and epithelialization. Further clinical study and introduction into practice of local cryotherapy in purulent diseases of soft tissues is substantiated.

Use of Computed Tomography-Guided Percutaneous Biopsy of Invasive Non-Mucinous Lung Adenocarcinoma to Predict the Degree of Histological Differentiation.

Background:The International Association for the Study of Lung Cancer (IASLC) published a grading system for invasive pulmonary adenocarcinoma that is closely associated with prognosis. This study aimed to investigate the accuracy of computed tomography (CT)-guided biopsy specimen grading and surgery-guided grading systems for detecting invasive non-mucinous lung adenocarcinoma and to determine whether CT-guided biopsy can predict the degree of histological differentiation.Methods:In total, 130 patients with invasive non-mucinous lung adenocarcinoma who underwent CT-guided biopsy before surgical excision were retrospectively studied. Biopsy and surgical specimen pathologies were compared. Grading was performed according to different subtypes proposed by the International Association for the Study of Lung Cancer. Sensitivity, specificity, positive and negative predictive values (PPV/NPV), and accuracy were calculated for each subtype and grade.Results:The concordance rates of biopsy and surgical pathology subtypes and grades were 73.1% and 72.3%, respectively. Sensitivity, specificity, PPV, NPV, and accuracy of grade 3 were 54.8%, 100%, 100%, 87.6%, and 89.2%, respectively. Pathology grades were primarily discrepant with respect to two aspects of biopsy and surgical samples in the same patient. First, the biopsy and surgical specimen pathology findings indicated lepidic and acinar subtypes as the main subtypes in the same patient, respectively. Second, biopsy specimen histology did not find solid types; however, >20% of solid subtypes were identified in surgical pathology samples in the same patient.Conclusions:The preoperative CT-guided biopsy specimen grading system showed relatively high accuracy and could predict the prognosis of invasive non-mucinous lung adenocarcinoma.

Results of the Management of Gastrointestinal Stromal Tumors (GIST): About 6 Cases at the Vichy Hospital Center (France)

The aim of our study was to analyze the results of surgical management of gastrointestinal stromal tumors (GIST) at the Vichy Hospital Center. Methodology: Between 2010 and 2020, the data of 6 patients operated at the Vichy Hospital Center for GIST were analyzed. The parameters studied were: age, sex, antecedents, discovery circumstances, imagery, surgical procedure, anatomopathological data, the follow-up and the morbidity-mortality. Results: There were 5 men and one woman with an average age of 72.16 years [58 - 80 years]. The average time of evolution was 8 months (0 - 14 months). The diagnosis was fortuitous in 2 cases. Atypical abdominal pain was the main symptom in 3 cases. One case was received in a clinical picture of peritoneal irritation syndrome. Echo-endoscopy with biopsy specimen histology made it possible to make the diagnosis in 5 cases and the surgical specimen in 1 case. The fusiform type was the predominant histological form. The stomach was the most common location. The average size of GISTs was 7.3 × 4 cm with a positive C Kit in all patients. Neoadjuvant chemotherapy was performed on one patient. Surgery was curative and was done laparoscopically on 4 patients. Adjuvant chemotherapy based on Imatinib at a rate of 400 mg/d in 3 patients was initiated. One patient presented a fistula of the esophagus-jejunal anastomosis on D6 post operation controlled by a drainage and an antibiotic therapy. Mortality was zero. During the surgery, all of the patients were followed up with surgeon, oncologist. Conclusion: GISTs are the most common mesenchymal tumors of the digestive tract with a preferential gastric location. Laparoscopic surgery, with advances in molecular biology and the introduction of targeted therapy has improved the management of these tumors in terms of morbidity and mortality.

Diagnostics of colitis in dogs using additional methods of research

Digestive system pathologies make up a significant part of cases of internal non-communicable diseases in dogs, and colitis is not the least of them. The disease occurs in dogs of all breeds and ages. Colitis is accompanied by a decrease or complete lack of appetite, diarrhea, dehydration, fever, and flatulence and soreness in the intestines. The aim of this study was to show the relevance of using different instrumental and laboratory methods for diagnosing colitis in dogs. The study was carried out on dogs of various breeds and ages, which were subjected to general methods of examination, radiological and endoscopic, followed by examination of biopsies obtained using targeted biopsy. X-ray diagnostics of the intestines in dogs with colitis revealed deformation of the folds of the intestinal mucosa, as well as disturbances in peristalsis. Colonoscopy revealed changes in the mucous membrane of the colon: hyperemia, edema, reduction or complete absence of folding, changes in the vascular pattern, mucus, petechiae, superficial ulcers. The histology of biopsy specimens of the colon mucous membrane of dogs with colitis made it possible to determine the severity of inflammatory processes in the colon and to confirm the pathology found during endoscopic examination for an accurate diagnosis. In the course of the work, it was shown that the most informative method for diagnosing colitis is endoscopic examination with targeted biopsy and subsequent histological examination of the samples obtained.

Data-Driven Kidney Transplant Phenotyping as a Histology-Independent Framework for Biomarker Discovery.

In transplant medicine, clinical decision making largely relies on histology of biopsy specimens. However, histology suffers from low specificity, sensitivity, and reproducibility, leading to suboptimal stratification of patients. We developed a histology-independent immune framework of kidney graft homeostasis and rejection. We applied tailored RNA deconvolution for leukocyte enumeration and coregulated gene network analysis to published bulk human kidney transplant RNA transcriptomes as input for unsupervised, high-dimensional phenotype clustering. We used framework-based graft survival analysis to identify a biomarker that was subsequently characterized in independent transplant biopsy specimens. We found seven immune phenotypes that confirm known rejection types and uncovered novel signatures. The molecular phenotypes allow for improved graft survival analysis compared with histology, and identify a high-risk group in nonrejecting transplants. Two fibrosis-related phenotypes with distinct immune features emerged with reduced graft survival. We identified lysyl oxidase-like 2 (LOXL2)-expressing peritubular CD68+ macrophages as a framework-derived biomarker of impaired allograft function. These cells precede graft fibrosis, as demonstrated in longitudinal biopsy specimens, and may be clinically useful as a biomarker for early fibrogenesis. This study provides a comprehensive, data-driven atlas of human kidney transplant phenotypes and demonstrates its utility to identify novel clinical biomarkers.

КСАНТОГРАНУЛЕМАТОЗНЫЙ ПИЕЛОНЕФРИТ - РЕДКАЯ ФОРМА ХРОНИЧЕСКОГО КАЛЬКУЛЕЗНОГО ПИЕЛОНЕФРИТА

The article represents the authors’ own observation of the patient with xanthogranulomatous pyelonephritis (XPN). Xanthogranulomatous pyelonephritisis a rare form ofchronic bacterial calculous pyelonephritis. Factors predisposingto thedevelopmentof xanthogranulomatous pyelonephritis include the following: the impairment of theurinary flowalong theurinarytract, type II diabetes mellitus, and chronic inflammation of the kidney. XPN is an uncommon cause of chronic pyelonephritis resulting in non-functioning kidneys and poses a preoperative diagnostic dilemma which may mimic other malignant diseases of a kidney (renal cell carcinoma, leiomyosarcoma) and acute pyelonephritis as a bacterial infection causing inflammation of the kidneys (a renal carbuncle). The patient was examined at the urology clinic of .Grodno State Medical University: general clinical blood and urine tests, ultrasound examination, X-ray computed tomography - native and with contrast enhancement, magnetic resonance imaging were performed. The patient underwent nephrectomy due to the impossibility of organ-preserving surgery - removal of a volumetric formation located at the hilum of the kidney and adjacent to the vessels. Histopathologyof the specimen wasconcludedas xanthogranulomatouspyelonephritis. The patientsunderwentMR examinations, ultrasound examination and X-ray computed tomography with contrast enhancement, but adiagnosisofxanthogranulomatous pyelonephritiswas not confirmed unequivocally. The final diagnosis is usually established only after histologic examinationof biopsy specimens of removed kidney.

MORPHOLOGICAL PARALLELS OF THE STRUCTURE OF VESSEL’S WALL AT VARICOSE EXTENSION OF THE VEINS OF PELVIS AND LOWER EXTREMITIES

The histological differences in the structure of the ovarian vein and saphenous veins of the lower extremities during their varicose transformation have been insufficiently studied in the modern literature. The study aims to determine the morphological parallels of the structure of varicose veins in varicose veins of the pelvis and varicose veins of the lower extremities. Fifty histological biopsy specimens of removed veins were examined in women. Of these, 25 large saphenous veins were obtained from patients with varicose veins of the lower extremities and 25 preparations of a resected ovarian vein from 25 women with varicose veins of the pelvis. The preparation was stained with hematoxylin-eosin and by the Van Gieson method, studied by light microscopy. In the study of the preparations, significant structural changes were noted in all layers of the venous wall, both in varicose veins of the pelvis and in varicose veins of the lower extremities in the form of a combination of atrophic, fibroplastic and hypertrophic processes leading to the loss of its functional properties. Depending on the decompensation of pathological processes, 3 morphological forms of lesions of the venous wall structure were revealed. The hypertrophic form was found in 17 (34%) surgery perform women, fibrous - in 13 (26%), atrophic - in 20 (40%). In the group of patients with varicose veins of the pelvis compared with the group of patients with varicose veins of the lower extremities, the prevalence of initial forms of lesion was revealed. There was a correlation between the severity of venous vascular lesions with the duration of the disease and the patient's age, the number of risk predictors and a high body mass index, which was the determining factor in the occurrence of this phenomenon. The results of this study indicate the similarity of the pathological picture of venous lesions, both in varicose veins of the pelvis and in varicose veins of the lower extremities.

Comparison between organismal staining on histology and tissue culture in the diagnosis of cutaneous infection: A retrospective study

Ininstances of suspected cutaneous infection, the standard of care includes obtaining skin biopsy specimens for histology and tissue culture. Few studies have compared the clinical utility of each test. To assess the concordance of results between tissue culture and histology, as well as the clinicopathologic features that may influence the diagnostic yield of each test. A retrospective review of all patients who underwent skin biopsy for histology and tissue culture at New York University from 2013 through 2018. Of 179 patients, 10% had positive concordance, 21% had positive tissue culture only, and 7% had positive histology only. We calculated a kappa correlation coefficient of 0.25 between histology and tissue culture (reference, 0.21-0.39 indicates minimal agreement). Histology exhibited higher sensitivity in detecting fungi, whereas tissue culture was more sensitive in identifying Gram-negative bacteria. Antimicrobial use before biopsy led to significantly fewer positive cultures (37.5% vs 71%; P=.023) in patients ultimately diagnosed with infection. This study was conducted at a single institution, thereby restricting its broad applicability. The lack of a validated criterionstandard to diagnose infection also limits interpretation of the results. Tissue culture and histopathology often yield discordant results. Dermatologists should recognize specific limitations, yet high clinical utility in special circumstances, of tests when approaching cases of suspected infection.

POST-VAGOTOMY GASTROPARESIS – A CASE REPORT

We present Mr M.A. a 27 year old Nigerian of the Yoruba tribe who has been having recurrent dyspeptic symptoms for 5 years but not previously endoscopically evaluated for peptic ulcer disease who now presented with six days history of abdominal pain which was initially epigastric but later became generalized associated with four episodes of vomiting and a day history of abdominal distension and fever. He was acutely ill-looking and dehydrated. The Abdomen was moderately distended, does not move with respiration, generalized tenderness with guarding and rebound tenderness, intra-abdominal organs were difficult to palpate due to the guarding. Bowel sound was absent. Examination of the other systems was not remarkable. A provisional diagnosis of Generalized peritonitis likely secondary to perforated peptic ulcer was made. He had an emergency exploratory laparotomy under general anaesthesia. He was commenced on intravenous fluids and parenteral proton pump inhibitor(PPI) and antibiotics. Intra-op findings include 2 liters of bilious peritoneal fluid, Multiple fibrous adhesions, a 2.5cm x 2cm gastric perforation at the anterior wall of the antrum and a grossly normal bowel. The surgical operation performed was a Graham Omental patch closure of the gastric defect with Bilateral Truncal Vagotomy and Peritoneal lavage. Post-operative state was satisfactory and he was later discharged. He presented at the gastroenterology out-patient clinic eight months later with complaints of early satiety, feeling of indigestion and episodes of vomiting. Vomitus is usually offensive / foul smelling and contains undigested or partially digested stale food substances. Abdominal examination revealed a positive succussion splash. Other clinical examination findings were not remarkable. A Provisional Diagnosis of suspected Gastric outlet obstruction probably secondary to a chronic duodenal ulcer was made. Endoscopy findings revealed copious fluid and food debris in the stomach cavity which had an offensive smell with remnants of partially digested stale food substances seen. There was poor peristaltic activity and the stomach was poorly distensible. There were multiple areas of mucosa erosions seen in the gastric cardia and corpus. No corporal or antral lesion seen. The pyloric ring was normal and the duodenum was normal. Diagnosis- (1) Endoscopic features of Gastroparesis likely secondary to previous Bilateral Truncal Vagotomy. No evidence of mechanical obstruction of the Gastric outlet. (2) Gastric Cardia and Corporal mucosa lesions likely secondary to Stasis Gastritis. Histology of biopsy specimens showed acute on chronic non-specific gastritis and acute duodenitis. He was commenced on empirical first line Helicobacter pylori eradication triple therapy (PPI, Amoxycillin and Clarithromycin) and a prokinetic drug (Domperidone). He had made significant clinical improvement with resolution of the symptoms by the time he was seen in the clinic three weeks later. He was tolerating oral food intake adequately and he had no new complaints. He was counselled on dietary modification and placed on long term prokinetic agent (Domperidone) and long-term PPI therapy with regular clinic follow-up. The initial management of post-vagotomy gastroparesis should be conservative as many symptoms resolve with time, this occurs possibly because the enteric nervous system is able to adapt to the loss of vagal input. Modification of dietary habits, such as regular intake of small meals, and use of prokinetic drugs bring about symptomatic relief in most patients.

Investigation of 23 Bile Acids in Liver Bile in Benign and Malignant Biliary Stenosis: A Pilot Study.

Differential diagnosis between benign and malignant biliary stenosis can be difficult in clinical practice. Histology of biopsy specimens is often indeterminate. Laboratory markers (serum bilirubin > 75 μmol/L, carbohydrate antigen 19-9 > 400 U/mL) and the length of stenosis (>15 mm) can be helpful but are not specific enough. The aim of this study was to investigate bile acids in liver bile of patients with benign and malignant biliary stenosis and controls without stenosis. A total of 73 patients entered the study: 7 subjects with benign biliary stenosis (6 men, 1 woman; 68 ± 13 years old), 21 with malignant biliary stenosis (15 men, 6 women; 72 ± 14 years old), and 45 patients without biliary stenosis (22 men, 23 women; 70 ± 13 years old); out of those, 25 subjects have and 20 do not have choledocholithiasis. Twenty-three different bile acids were investigated by high-performance liquid chromatography/mass spectrometry. Serum total bilirubin was significantly higher in patients with malignant biliary stenosis compared with nonstenotic controls (p = 0.005). Significant relationship (r > 0.7) was found between several pairs of bile acids. Significantly lower bile acid concentrations in malignant biliary stenosis compared to controls without stenosis were found for GLCA (p = 0.032), GUDCA (p = 0.032), GCDCA (p = 0.006), GDCA (p = 0.031), GHCA (p = 0.005), TUDCA (p = 0.044), and TDCA (p = 0.036). Significant difference in cholic acid was found between benign and malignant stenosis (p = 0.022). Analysis of bile acids might be helpful in the differential diagnosis of malignant and benign biliary stenosis. More patients need to be enrolled in further studies so that the real diagnostic yield of bile acids can be determined.

Direct Ex Vivo Observation of Homologous Recombination Defect Reversal After DNA-Damaging Chemotherapy in Patients With Metastatic Breast Cancer.

Biomarkers that predict response to poly (ADP-ribose) polymerase inhibitors (PARPis) are required to detect PARPi sensitivity beyond germline BRCA-mutated (gBRCAm) cancers and PARPi resistance among reverted gBRCAm cancers. Therefore, we previously developed the Repair Capacity (RECAP) test, a functional homologous recombination (HR) assay that exploits the formation of RAD51 foci in proliferating cells after ex vivo irradiation of fresh primary breast cancer tissue. The aim of the current study was to validate the feasibility of this test on histologic biopsy specimens from metastatic breast cancer and to explore the utility of the RECAP test as a predictive tool for treatment with DNA-damaging agents, such as PARPis. Fresh tissue biopsies from easily accessible metastatic lesions from patients with locally advanced or metastatic breast cancer were irradiated with 5 Gy and cultured for 2 hours followed by detection of RAD51 foci presence (HR proficient) or absence (HR deficient [HRD]). HRD biopsy specimens as well as platinum/PARP-resistant specimens were subjected to BRCA1/2 sequencing. RECAP had a success rate of 93% on biopsy specimens from metastatic breast cancer lesions (n = 44). Although HRD was detected in 13 (32%) of 41 specimens, only five showed a gBRCAm. In three patients with gBRCAm, post-treatment RECAP tests showed HR phenotype reversion after in vivo progressive disease on platinum and PARPi treatment, which was explained in one patient by a secondary BRCA1 mutation. The RECAP test, which reflects real-time HR status regardless of BRCA mutations, is feasible in metastatic breast cancer biopsy specimens. Compared with gBRCA analysis, it may identify twice as many candidates for PARPi treatment.

Abrupt Dyskeratotic and Squamoid Cells in Poorly Differentiated Carcinoma: Case Study of Two Thoracic NUT Midline Carcinomas with Cytohistologic Correlation.

Cytologic diagnosis of nuclear protein in testis (NUT) midline carcinoma (NMC) is important due to its aggressive behavior and miserable prognosis. Early diagnosis of NMC can facilitate proper management, and here we report two rare cases of thoracic NMC with cytohistologic correlation. In aspiration cytology, the tumor presented with mixed cohesive clusters and dispersed single cells, diffuse background necrosis and many neutrophils. Most of the tumor cells had scanty cytoplasm and medium-sized irregular nuclei, which had fine to granular nuclear chromatin. Interestingly, a few dyskeratotic cells or squamoid cell clusters were present in each case. Biopsy specimen histology revealed more frequent squamous differentiation, and additional immunohistochemistry tests showed nuclear expression of NUT. Because this tumor has a notorious progression and has been previously underestimated in terms of its prevalence, awareness of characteristic findings and proper ancillary tests should be considered in all suspicious cases.

First-in-Human Pilot Study of Implantation of a Scaffold-Free Tissue-Engineered Construct Generated From Autologous Synovial Mesenchymal Stem Cells for Repair of Knee Chondral Lesions

Background: Articular cartilage has limited healing capacity, owing in part to poor vascularity and innervation. Once injured, it cannot be repaired, typically leading to high risk for developing osteoarthritis. Thus, cell-based and/or tissue-engineered approaches have been investigated; however, no approach has yet achieved safety and regenerative repair capacity via a simple implantation procedure. Purpose: To assess the safety and efficacy of using a scaffold-free tissue-engineered construct (TEC) derived from autologous synovial membrane mesenchymal stem cells (MSCs) for effective cartilage repair. Study Design: Case series; Level of evidence, 4. Methods: Five patients with symptomatic knee chondral lesions (1.5-3.0 cm2) on the medial femoral condyle, lateral femoral condyle, or femoral groove were included. Synovial MSCs were isolated from arthroscopic biopsy specimens and cultured to develop a TEC that matched the lesion size. The TECs were then implanted into chondral defects without fixation and assessed up to 24 months postoperatively. The primary outcome was the safety of the procedure. Secondary outcomes were self-assessed clinical scores, arthroscopy, tissue biopsy, and magnetic resonance image–based estimation of morphologic and compositional quality of the repair tissue. Results: No adverse events were recorded, and self-assessed clinical scores for pain, symptoms, activities of daily living, sports activity, and quality of life were significantly improved at 24 months after surgery. Secure defect filling was confirmed by second-look arthroscopy and magnetic resonance imaging in all cases. Histology of biopsy specimens indicated repair tissue approaching the composition and structure of hyaline cartilage. Conclusion: Autologous scaffold-free TEC derived from synovial MSCs may be used for regenerative cartilage repair via a sutureless and simple implantation procedure. Registration: 000008266 (UMIN Clinical Trials Registry number).

A one-step immune-chromatographic Helicobacter pylori stool antigen test for children was quick, consistent, reliable and specific.

This French study assessed a quick, noninvasive, immuno-chromatographic, Helicobacter pylori (H. pylori) stool antigen test for detecting infections in children. We enrolled 158 children, with a median age of 8.5 years (range eight months to 17 years), with digestive symptoms suggesting upper gastrointestinal tract disease. Upper digestive endoscopy was performed with gastric biopsy specimens for histology, a rapid urease test, culture test and quantitative real-time polymerase chain reaction. The H. pylori stool antigen test was performed twice for each child and the results were compared to the reference method. The reference methods showed that 23 (14.6%) of the 158 children tested were H. pylori positive. The H. pylori stool antigen test showed 91.3% sensitivity, with a 95% confidence interval (95% CI) of 86.9-95.6 and 97% specificity (95% CI 94.3-99.6), 30.84 positive likelihood ratio and 0.09 negative likelihood ratio. The test accuracy was 96.2% (95% CI 93.2-99.1). The two blinded independent observers produced identical H. pylori stool antigen test results and the Kappa coefficient for the H. pylori stool antigen test was one. The H. pylori stool antigen test was found to be a consistent, reliable, quick and specific test for detecting the H. pylori infection in children.

The value of NBI-ME for targeting biopsy in the follow-up of Barrett esophagus

Objective To assess the value of NBI-ME for targeting biopsy in the follow-up of Barrett esophagus. Methods A total of 96 patients with Barrett esophagus were enrolled and biopsied between September 2012 and May 2015. With paired crossover design, the patients were randomly allocated to receive a WLI or NBI-ME, who received the other examination in 1-3 months. Outcomes of NBI-ME and WLI were compared with histology of biopsy specimen, and the biopsy quantities were also compared. Results A total of 88 patients completed the study, 4 cases with non-specialized intestinal metaplasia, 55 cases with specialized intestinal metaplasia (SIM), 23 cases with low grade intraepithelial neoplasia(LGIN) and 6 cases with high grade intraepithelial neoplasia(HGIN)were detected. The biopsy number of WLI group was higher than that of NBI-ME group(5.3 VS 3.1, P<0.05). The incidence of intraepithelial neoplasia of WLI was lower than that of NBI-ME[21.6%(19/88)VS 31.8%(28/88), P<0.05]. Diagnostic accuracy of WLI was lower than that of NBI-ME[58.6%(17/26) VS 93.1%(27/29), P<0.05)]. Conclusion NBI-ME can detect more lesions of intraepithelial neoplasia than WLI in the follow-up of Barrett esophagus, and fewer biopsy specimens are needed. Key words: Barrett esophagus; Endoscopy; Follow-up studies; Narrow-band imaging

OW FREQUENCY ULTRASOUND APPLICATION IN KNEE ARTHROSCOPY

Purpose: in vitro study of ultrasound dissection devices' impact on meniscus and knee cartilage as well as comparison of outcomes with familiar arthroscopic techniques.Materials and methods. Meniscus and joint cartilage specimen obtained during total knee replacement were placed in a normal saline. All experiments were conducted no later than in 2 hours after obtaining and followed by histology of biopsy specimens. In the first series of experiment the authors performed meniscus dissection with ultrasound instrument «Scalpel», cold plasm ablator and surgical scalpel.Results. The first series of experiments demonstrated disruption of fibers orientation on meniscus rim after dissection with scalpel; necrosis depth after coblation is 0,7-0,8 mm. Ultrasound dissection devices leave necrosis depth of 0,1-0,2 mm and smooth cartilage surface. The second series of experiments proved that after shaver application cartilage surface was coarse; certain necrosis sections of 16-90 nm were observed on relatively smooth cartilage surface after coblation. Application of ultrasound «Miller» device leaves smooth cartilage surface with no fibers, no signs of cartilage thinning and necrosis not exceeding 15 nm.Conclusion. The results of experiments confirm that use of low frequency ultrasound dissection devices is advantageous as compared to mechanical and ablation cutting techniques while ensuring histologically proven atraumatic handling of biopsy specimens of meniscus and hyaline cartilage.

Dual-priming oligonucleotide-based multiplex PCR using tissue samples from the rapid urease test kit for the detection of Helicobacter pylori in bleeding peptic ulcers

BackgroundIn patients with peptic ulcer bleeding (PUB), diagnostic tests for Helicobacter pylori (H. pylori) infection have low sensitivity. The aim of our study was to investigate the diagnostic yield of dual-priming oligonucleotide-based multiplex (DPO)-PCR using tissue samples from the rapid urease test (RUT, CLO®test) kit in patients with PUB. MethodsWe prospectively enrolled patients with PUB. During second-look endoscopy, gastric biopsy specimens for histology and RUT were obtained from a total of 170 patients. DPO-PCR tests were performed on tissue samples obtained from the CLO®test kit. If testing for H. pylori was negative, endoscopy with re-biopsy was performed 8 weeks after the bleeding episode. ResultsH. pylori-associated bleeding was confirmed in 64.1% (109/170) of the patients. At the bleeding episode, the diagnostic sensitivities of RUT, histology, and DPO-PCR test were 47.7% (52/109), 71.6% (78/109) and 97.2% (106/109), respectively (p<0.01). The specificity of the DPO-PCR test was 91.8% (56/61). The positive predictive value (PPV) of the DPO-PCR test was 95.5% (106/111), and its negative predictive value (NPV) was 94.9% (56/59). ConclusionsIn patients with PUB, the DPO-PCR test could be a useful diagnostic tool for H. pylori infection. Particularly given a negative RUT result, subsequent DPO-PCR testing of tissue samples from the CLO®test kit could be of considerable benefit.