Histopathological Findings Research Articles

Clinical and Histopathological Characteristics of Acquired Inflammatory Blaschko-Linear Disorders.

Acquired inflammatory Blaschko-linear dermatoses have not been studied extensively. Descriptive studies on segmental vitiligo have yielded insights helpful in counseling patients. Similar insights are expected from studies on other acquired inflammatory Blaschko-linear diseases. Consecutive patients with an acquired inflammatory Blaschko-linear disease presenting to the dermatology outpatient department of the study center were recruited in a case series. Detailed history and examination, clinical photographs, and histopathological findings were recorded and analyzed. Features were compared between linear and generalized forms to look for any differences. Out of 99 patients, linear lichen planus (n = 47), linear morphea (n = 31), and lichen striatus (n = 9) were observed most commonly. Skin lesions were present in multiple lines in 52 (52.5%). In 12 (12.1%), more than one anatomical site was involved. In 10 (10.1%), two different Blaschko-linear diseases were seen, and in 3 (3.1%) both diseases occurred in the same/adjacent segments. The disease extended from one or both ends in 64 (88.9%). Nineteen (19.2%) had both linear and generalized disease, with linear lesions being more severe than the generalized lesions (P = 0.038133). Some (18/47, 38.3%) linear lichen planus cases showed prominent atrophy since the onset and formed a distinct subset, predominantly over the head and neck site (P < 0.00001). Histopathology of linear lichen planus differed from controls with generalized lesions in terms of having deeper infiltrate (P = 0.000124), and multi-focal, rather than confluent, lichenoid infiltrates. Atrophy was noted from the onset in 13/31 (41.9%) cases of linear morphea. Limitations include cross-sectional design and lack of controls with generalized nonlinear diseases. Acquired inflammatory Blaschko-linear disorders show distinct characteristics like involvement of multiple lines and sites, directional progression, and atrophic variants. These can be used for differentiating among different Blaschko-linear diseases, monitoring progression, and counseling patients.

Accurate diagnosis of hydatidiform mole cases requires integrating histopathological findings with genetic testing

Accurate diagnosis of hydatidiform mole cases requires integrating histopathological findings with genetic testing

Prepubertal phthalate exposure can cause histopathological alterations, DNA methylation and histone acetylation changes in rat brain.

Di-2-(ethylhexyl)phthalate (DEHP) is a phthalate derivative used extensively in a wide range of materials, such as medical devices, toys, cosmetics, and personal care products. Many mechanisms, including epigenetics, may be involved in the effects of phthalates on brain development. In this study, Sprague-Dawley male rats were obtained 21-23days after their birth (post-weaning) and were exposed to DEHP during the prepubertal period with low-dose DEHP (DEHP-L, 30mg/kg/day) and high-dose DEHP (DEHP-H, 60mg/kg/day, 37days) until the end of adolescence (PND 60). The rats in the study groups were sacrificed during adulthood, and histopathological changes, epigenetic changes, and oxidative stress parameters were evaluated in brain tissues. Histopathological findings indicating the presence of deterioration in brain tissue morphology were obtained, more prominently in the DEHP-H group. Examining the hippocampus under the light microscope, pyramidal neuron loss was detected only in CA1 of the DEHP-L group, while in DEHP-H rats, pyramidal neuron losses were detected in the CA1, CA2, and CA3 regions. No significant change was observed in brain lipid peroxidation levels with DEHP compared to control. Significant increases in total glutathione (GSH) in both dose groups were considered to be an adaptive response to DEHP-induced oxidative stress. The decrease in DNA methylation in the brain, although not statistically significant, and the increase in histone modification showed that exposure to DEHP may cause epigenetic changes in the brain and these epigenetic changes may also take place as one of the mechanisms underlying the damage observed in the brain. The results suggest that DEHP exposure during early development may have a significant effect on brain development.

Diagnostic utility of chest wall vessel involvement sign on ultra-high-resolution CT for primary lung cancer infiltrating the chest wall.

Chest wall infiltration in primary lung cancer affects the surgical and therapeutic strategies. This study evaluates the efficacy of the chest wall vessel involvement in subpleural lung cancer (CWVI) on ultra-high-resolution CT (UHR-CT) for detecting chest wall invasion. A retrospective analysis of lung cancer cases with confirmed pleural and chest wall invasion was conducted from November 2019 to April 2022. Seventy-seven patients (mean ± standard deviation age 70 ± 8 years, 64 males) who underwent preoperative contrast-enhanced UHR-CT were included. They were grouped into 51 non-chest wall infiltration (pl1 and pl2) and 26 chest wall infiltration (pl3). Clinical, histopathological, and UHR-CT findings were reviewed. Upper lobe tumors exhibited a higher chest wall invasion rate (p < 0.001). Rib destruction was evident in five patients with chest wall invasion but none with pleural invasion (p < 0.001). CWVI was present in 19 of 26 patients with chest wall invasion and 2 of 51 patients with pleural invasion (p < 0.001). The maximum tumor diameter (Dmax), arch distance which means the interface length between the primary tumor and the chest wall (Adist), and the ratio of Dmax to Adist were higher in chest wall invasion cases (all p < 0.001). After excluding patients with rib destruction, in multivariate logistic regression analysis, only CWVI was a significant predictor for chest wall invasion (odds ratio 29.22 (95% confidence interval 9.13-262.90), p < 0.001). CWVI on UHR-CT can help diagnose lung cancer infiltrating the chest wall, offering a potential tool for clinical decision-making. Question Chest wall infiltration in primary lung cancer has implications for the treatment plan, but diagnosis is often difficult with conventional CT. Findings Chest wall vessel involvement in subpleural lung cancer on ultra-high-resolution CT is a valuable predictor for diagnosing chest wall infiltration. Clinical relevance The delineation of chest wall vessels with contrast-enhanced ultra-high-resolution CT may improve the diagnosis of chest wall infiltration and allow accurate staging and optimal treatment options for subpleural primary lung cancer.

The degree of cross-linking of polyacrylic acid affects the fibrogenicity in rat lungs

Polyacrylic acid (PAA) with different concentrations of cross-linker was instilled into the trachea of rats to examine the effect of PAA crosslink density on lung disorders. Methods: F344 rats were intratracheally exposed to low and high doses of PAA with cross-linker concentrations of 0.1, 1.0, and 5.0% (CL0.1%, CL1.0%, and CL5.0%, respectively). Rats were sacrificed at 3 days, 1 week, 1 month, 3 months, and 6 months after exposure. PAA with different cross-linker concentrations caused an increase in neutrophil influx, cytokine-induced neutrophils, and chemotactic factor (CINC) in bronchoalveolar lavage fluid (BALF) from 3 days to 1 week after instillation. Lactate dehydrogenase (LDH) activity in BALF and heme oxygenase-1 (HO-1) release in lung tissue were higher in the CL0.1% exposure group during the acute phase. Lung histopathological findings also showed that severe fibrotic changes induced by CL0.1% were greater than those observed in CL1.0% and CL5.0% exposure during the observation period. CL0.1% was associated with more severe lung fibrosis, and a decrease in lung fibrosis was observed with increasing cross-linker concentrations, suggesting that the cross-link density of PAA is a physicochemical feature that affects lung disorders.

The role of Juniperus Macrocarpa extract as anti-inflammatory and antioxidant on methotrexate-induced acute liver injury in rat model

Background Methotrexate (MTX) is an antifolate medication indicated to treat an array of tumors and autoinflammatory maladies. MTX may exhibit harmful impacts on multiple organs, especially liver injury and cirrhosis. Juniperus macrocarpa is a medicinal herb enriched with polyphenols and flavonoids featuring robust anti-inflammatory and antioxidative benefits. Objective To evaluate the hepatoprotective effects of Juniperus macrocarpa aqueous extract on MTX-aggravated liver toxicity. Methods The study involved 20 male middle-aged albino rats, arbitrarily allocated into 4 groups of 5 animals each. Group 1 (control) were given distilled water (DW) once daily for two weeks. Group 2 (MTX) got an intraperitoneal single dose of MTX (20 mg/kg) for two weeks. Rats in groups 3 and 4 were given daily dosages of 100 mg and 200 mg of Juniperus macrocarpa aqueous extract, respectively, for two weeks before receiving a single intraperitoneal MTX injection. Results Juniperus macrocarpa extracts at both low and high doses substantially alleviated the MTX-provoked biochemical alterations, as evidenced by decreased levels of inflammatory parameters including TNF-α and IL-6 and hepatic enzymes including ALT, AST, and ALP. Juniperus macrocarpa also significantly boosted levels of the anti-oxidant enzymes like SOD and GPX. Moreover, Juniperus macrocarpa extract attenuated congestive and degenerative hepatic changes, as indicated by improved histopathological findings. Conclusion The anti-oxidative and anti-inflammatory activities of Juniperus macrocarpa extract are a promising approach for ameliorating MTX-aggravated hepatotoxicity.

The genetic landscape and classification of infantile epileptic spasms syndrome requiring surgery due to suspected focal brain malformations

Abstract Infantile epileptic spasms syndrome is a severe epilepsy of infancy that is often associated with focal malformations of cortical development. This study aimed to elucidate the genetic landscape and histopathologic aetiologies of infantile epileptic spasms syndrome due to focal malformations of cortical development requiring surgery. Fifty-nine children with a history of Infantile epileptic spasms syndrome and focal malformations of cortical development on MRI were studied. Genetic testing of resected brain tissue was performed by high coverage targeted panel sequencing or exome sequencing. Histopathology and magnetic resonance imaging (MRI) were reviewed, and integrated clinico-pathological diagnoses were established. A genetic diagnosis was achieved in 47 children (80% of cohort). Germline pathogenic variants were identified in 27/59 (46%) children, in TSC2 (x19), DEPDC5 (x2), CDKL5 (x2), NPRL3 (x1), FGFR1 (x1), TSC1 (x1), and one child with both a TUBB2A/TUBB2B deletion and a pathogenic variant in COL4A1 (x1). Pathogenic brain somatic variants were identified in 21/59 (36%) children, in SLC35A2 (x9), PIK3CA (x3), AKT3 (x2), TSC2 (x2), MTOR (x2), OFD1 (x1), TSC1 (x1) and DEPDC5 (x1). One child had “two-hit” diagnosis, with both germline and somatic pathogenic DEPDC5 variants in trans. Multimodal data integration resulted in clinical diagnostic reclassifications in 24% of children, emphasizing the importance of combining genetic, histopathologic, and imaging findings. Mammalian target of rapamycin (mTOR) pathway variants were identified in most children with tuberous sclerosis or focal cortical dysplasia type II. All nine children with somatic SLC35A2 variants in brain were reclassified to mild malformation of cortical development with oligodendroglial hyperplasia in epilepsy. Somatic mosaicism was a major cause of focal cortical dysplasia type II/hemimegalencephaly (81%) and mild malformation of cortical development with oligodendroglial hyperplasia (100%). The genetic landscape of infantile epileptic spasms syndrome due to focal malformations comprises germline and somatic variants in a range of genes, with mTORopathies and SLC35A2-related mild malformation of cortical development with oligodendroglial hyperplasia being the major causes. Multimodal data integration incorporating genetic data aids in optimizing diagnostic pathways and can guide surgical decision-making and inform future research and therapeutic interventions.

Sudden death due to right fallopian tube tear in ectopic pregnancy: An autopsy-based case report

Background: Ectopic pregnancy complications, particularly when they cause rupture, can lead to a sudden and critical situation. In cases of sudden death, it is important to approach it as an unnatural death until proven otherwise through scientific means. Autopsy, conducted by a forensic and medicolegal pathologist, is a key method for establishing the cause of death. Case presentation: We have reported a suspected case of unnatural death being investigated by the police. A young, unmarried woman living alone was found dead in her room, with no clear medical history. The forensic autopsy was performed to establish the cause of death in this case. The findings revealed an enlarged uterus, a tear in the right fallopian tube, and a blood β-hCG level of 5,224.07 mIU/mL. Supported by histopathological findings in the form of an overview that supports the existence of tubal ectopic pregnancy. There is severe internal bleeding in the abdominal cavity due to a tear in the right fallopian tube, leading to hemorrhagic shock because of a loss of 1,946.7 ml of blood. As a result, the patient experiences Multiple Organ Failure (MOF), indicated by lung edema and kidney and stomach necrosis observed in the histopathological examination. Conclusions: The victim's sudden death was a result of a natural cause. The cause of death is determined after eliminating other possibilities.

Adalimumab induced psoriasis in Crohn’s disease and treatment with ustekinumab: case report and special histopathological findings

This case report presents an instance of Tumor Necrosis Factor-α Inhibitor-induced psoriasis (TNFiIP), also known as paradoxical psoriasis, in a 30-year-old male with fistulizing Crohn’s disease. The patient developed extensive erythematous and scaly lesions on the palms, lower limbs, ankles, and soles after 4 months of adalimumab monotherapy. Histopathological analysis revealed a pattern of psoriasiform dermatitis with notable dermal neutrophil and eosinophil infiltration, distinguishing TNFiIP from idiopathic psoriasis. The patient’s condition significantly improved following the transition from adalimumab to ustekinumab, which highlights the importance of alternative therapeutic strategies for patients who exhibit paradoxical reactions to TNF-α inhibitors.

Frontal Fibrosing Alopecia: A Comprehensive Review with Recent Updates

Abstract Frontal fibrosing alopecia (FFA) is a progressive scarring alopecia affecting postmenopausal women. FFA is a primary lymphocytic scarring alopecia and is considered a variant of LPP due to similar histopathology findings in both conditions. The exact etiopathogenesis of FFA is not known. However, some genetic, autoimmunity, hormonal and environmental factors are implicated. However, the loss of the immune privilege of hair follicles and the role of cosmetics and sunscreen have been postulated. The disease is characterised by frontal and temporoparietal hairline recession with shiny, atrophic skin with sideburn involvement. The common trichoscopic findings include perifollicular erythema, follicular hyperkeratosis and loss of follicular openings. The histopathology is characterised by lichenoid lymphocytic infiltrate around the upper part of the hair follicle including the bulge area and concentric perifollicular lamellar fibrosis. There are two diagnostic criteria proposed by Tolkachjov et al. and the International FFA Cooperative Group. Many topical and systemic treatment options are available, but none have shown satisfactory results. Recently, many biological agents have been tried including tofacitinib and tildrakizumab.

Aggressive angiomyxoma of the vagina: A case report and literature review.

Aggressive angiomyxoma (AAM) is an exceptionally rare mesenchymal tumor that predominantly manifests in the female genital organs during the reproductive age. Its rarity alone makes it a fascinating subject for study. The diagnosis of AAM necessitates differentiation from other benign or mesenchymal tumors and can be confirmed through immunohistochemistry (IHC) staining. Surgical resection is the primary treatment, and adjuvant treatment can be used as hormonal therapy with gonadotropin-releasing hormone agonists, selective estrogen receptor modulators, and aromatase inhibitors. A 44-year-old premenopausal Korean woman presented with a growing perineal mass and frequent urination. Histopathological findings confirmed AAM, with IHC staining showing estrogen receptor, progesterone receptor, actin and desmin positivity, and CD34 and S100 negativity. The mass was excised transvaginally under general anesthesia. The patient showed no signs of recurrence 6 months postoperatively. AAM in the vagina is a rare tumor that requires differential diagnosis using IHC staining. Previously, we reviewed reported cases and confirmed the feasibility and effectiveness of surgery as the main treatment. This might reassure us about the potential successful treatment of AAM. Adjuvant hormonal therapy with gonadotropin-releasing hormone agonists, selective estrogen receptor modulators, and aromatase inhibitors can further reduce the risk of recurrence.

Renal Impairment Caused by Statins in Rats Can Be Restored by Thymoquinone.

Atorvastatin (ATO) is an HMG-CoA reductase inhibitor used to lower blood cholesterol, but it causes renal injury in high doses. Thymoquinone (TQ), is a natural antioxidant that has been shown to protect the kidney through its anti-inflammatory, antioxidant, & antiapoptotic, effects. The current study aimed to investigate whether posttreatment TQ could reverse ATOinduced renal injury, and the possible mechanism of action by which TQ produced such an effect. Forty adult male rats were divided into 4 groups: (control; TQ-treated; ATO-treated; ATO plus TQ-treated). Blood and kidney tissue samples were tested for kidney functions, oxidative stress and apoptosis markers, and morphometric analyses of the histopathological and ultrastructural evaluations. Statistical analyses were done using JASP, Shapiro-Wilk, and Levene's test. ANOVA and Kruskal-Wallis tests were done to determine differences between groups. The significance level was set at p<.05. The ATO-treated group showed abnormal outcome measures including kidney functions, oxidative stress and apoptotic markers, and morphometric analyses of the histopathological and ultrastructural findings. Post-treatment TQ improved all outcome measures. Posttreatment TQ could reverse oxidative stress-induced renal injury produced by highdose ATO, suggesting a potential clinical application in patients with renal insufficiency with hypercholesterolemia.

Gestational Pemphigoid: A Comprehensive Review of Clinical Features, Differential Diagnosis, and Management Strategies with Case Report

Gestational pemphigoid (GP) is a rare autoimmune blistering disorder that typically occurs in the second or third trimester of pregnancy. Characterized by pruritic, tense blisters primarily affecting the abdomen and extremities, GP can lead to significant discomfort and potential complications for both the mother and fetus. The condition is caused by the production of autoantibodies against basement membrane proteins, resulting in subepithelial blister formation. Differential diagnoses include other pregnancy-related dermatoses, such as pruritic urticarial papules and plaques of pregnancy (PUPPP) and drug-induced bullous eruptions. Histopathological findings typically reveal subepidermal vesicles and lympho-eosinophilic infiltrates, although direct immunofluorescence may be negative in some cases. Management primarily involves symptomatic treatment with corticosteroids and antihistamines, leading to favorable outcomes for most patients. This review highlights the clinical features, differential diagnoses, and management strategies for gestational pemphigoid, emphasizing the importance of early recognition and intervention to ensure maternal and fetal health

OP34 Mirikizumab demonstrates rapid improvements in bowel urgency severity, bowel urgency frequency, and stool deferral time in patients with moderately-to-severely active Ulcerative Colitis: 12-week interim results from the phase 3b LUCENT-URGE trial

Abstract Background Bowel urgency (BU) is a common, under-recognized and debilitating symptom among patients with ulcerative colitis (UC). LUCENT-URGE is a Phase 3b, open-label, single-arm 28-week (W) study in adults with moderately-to-severely active UC and BU (Urgency Numeric Rating Scale [UNRS] ≥3) at baseline treated with mirikizumab (MIRI) (NCT05767021). BU was assessed using the validated UNRS1 and 2 new BU assessments: BU Frequency (BUF) and Stool Deferral Time (SDT). These 3 BU measures (UNRS, BUF, SDT) and clinical endpoints provide a more comprehensive understanding of BU and the impact of MIRI treatment. Here, we report W12 interim analysis results. Methods Patients were treated with intravenous (IV) MIRI 300 mg at W 0, 4 and 8, followed by 200 mg subcutaneous at W12 and every 4 weeks up to W28. The primary endpoint, BU severity (UNRS) at W12, was assessed by change from baseline. BUF improvement was assessed by change from baseline at W12. SDT was reported in minutes and categorized as (4) Severe: &amp;lt;1 min; (3) Moderate-Severe: 1-2 min: (2) Moderate: 2-5 min; (1) Mild: 5-15 min; (0) None: ≥15 minutes. Results 172 patients were enrolled from 8 countries. At baseline, mean (± standard deviation [SD]) modified Mayo score [MMS]) was 6.8±1.3; 64% of patients had severe disease activity (MMS 7-9), mean duration of UC was 8.0±8.2 years, mean UNRS score was 6.9 ±1.6, mean BUF was 6.9±3.7. UNRS, BUF, and SDT improved from baseline to W12 (Figure 1). At W12, 63% patients achieved clinical response and 44% achieved both clinical response and UNRS clinically meaningful improvement (≥3 point decrease). Correlations between UNRS and BUF, and between UNRS and SDT at baseline, W12, and W12 change from baseline were of similar magnitude (Spearman correlation coefficient range: 0.43-0.68). The safety profile of MIRI observed in LUCENT-URGE was consistent with the profile previously reported. Conclusion In patients with moderately-to severely active UC and BU, MIRI demonstrated improvement in BU measures with a decrease by more than 50% in BUF after 12W of treatment. Selecting patients with urgency and targeting BU improvement is a novel strategy to assess response to therapy for UC. Broader associations between BU and quality of life, UC symptoms, histopathologic findings, and gene expression data will be explored upon completion of the W28 LUCENT-URGE study.

Peripheral Giant Cell Granuloma of Maxilla: A Case Report

Peripheral giant cell granuloma is a benign and reactive hyperplastic lesion originating from the periosteum and resulting from local stimulation or trauma. It is more aggressive due to its high growth potential and may involve the cortical plate. Diagnosis is based on histopathological findings. It occurs mostly in the lower jaw, but can also occur in the upper jaw. It often appears as a nodular purple mass on the gums or mucosa of the edentulous alveolar ridge. we report a case of maxillary peripheral giant cell granuloma with bone resorption in a 46-year-old male patient, who was treated with an excisional biopsy.

Retrospective analysis of criteria for oncological completion surgery of neuroendocrine tumors of the appendix

PurposeNeuroendocrine neoplasms of the appendix (aNET) are rare tumors that are often diagnosed by pathology as an incidental finding after appendectomy for acute appendicitis. Several guidelines proposed risk criteria to indicate oncological completion surgery after appendectomy. The aim of this study was to evaluate the reliability of proposed criteria for completion surgery of aNET.MethodsPatients with aNET treated at ENETS center of excellence Marburg between 2002 and 2022 were retrieved from a prospective data base. Demographic data, histopathological findings, including formerly proposed criteria to indicate oncological completion surgery, histological results of the completion resection and disease-free survival were evaluated.Results82 patients with a median age of 35 (range 8–82) years were analysed. 72 (88%) patients underwent an emergency appendectomy because of acute appendicitis. 11 (13%) patients received an ileocecal resection or right hemicolectomy. Seven (8.5%) patients had lymph node metastases and three (3.6%) patients had distant metastases at the initial operation. 27 (33%) patients underwent completion surgery by right hemicolectomy according to guideline criteria, but postoperative histology detected lymph node and distant metastases in only six (22%) and zero patients resulting in an overtreatment of 21 (75%) patients. A tumor size of > 2 cm was the only significant criterion which was associated with lymph node metastases (p < 0.05). After a median follow-up of 62 months (range 2-264) 76 (96%) of the patients in stages I to III were alive with no evidence of disease.ConclusionaNET have an excellent prognosis in stages I-III and distant metastases are rare. Formerly proposed criteria for oncological completion surgery have to be adopted and discussed for every patient, as they might result in an overtreatment in at least 75% of patients.

SD-OCT-histopathologic correlation in Schnabel's cavernous optic nerve atrophy.

Until now, Schnabel's cavernous optic nerve atrophy (SCONA) has solely been a histopathological diagnosis exhibiting variable degrees of optic nerve (ON) atrophy with characteristic cavernous spaces filled with acid mucopolysaccharides. We report the first correlation of histopathologic findings with spectral domain-optical coherence tomography (SD-OCT) imaging in SCONA. We examined the eye of an index patient with histopathologically identified SCONA who had undergone multimodal imaging before enucleation for iris ring melanoma. The extent of SCONA in the index patient and three other enucleated eyes with SCONA were determined histopathologically. The histopathological findings of our index patient were correlated with in vivo SD-OCT images before enucleation and compared to representative images from eyes with a normal versus glaucomatous optic disc. Histopathologic examination of our index patient showed a pre- and intralaminar extension of SCONA. Atrophy of the inner retinal layers was observed corresponding to the extent of SCONA. Correlation with SD-OCT showed small intralaminar hyporeflective pseudocysts which were detected in multiple scans corresponding to the histologically affected areas. These changes were neither visible in scans of patients with glaucomatous atrophy nor those with a normal ON. We present the first correlation of clinical and pathological findings in SCONA and were able to identify distinct SD-OCT characteristics for this condition. These findings may help to detect SCONA in vivo and to study this rare entity clinically with regard to its clinical course, risk factors, and pathogenesis. However, more cases of SCONA are needed to confirm our findings.

Septicemic omphalophlebitis by Streptococcus equi subsp. zooepidemicus in a southern right whale calf (Eubalaena australis).

Southern right whales (Eubalaena australis) are mysticete cetaceans commonly observed in the coastal waters of Brazil, particularly in Santa Catarina State. There is limited understanding of the causes of calf mortality in this species, particularly concerning infectious diseases. We report a case of omphalophlebitis caused by Streptococcus equi subsp. zooepidemicus (S. zooepidemicus) that led to septicemia in a Southern right whale calf. Gross examination revealed an incompletely healed umbilicus with fibrin deposition and amorphous yellow material present in the lumen of the umbilical vein on the cut surface. The main histopathological findings showed fibrinosuppurative omphalophlebitis with numerous coccoid basophilic bacterial aggregates. These aggregates were also observed in the lamina propria, submucosa, and muscular layers of the small intestine and uterus, as well as in the interstitium of the kidneys and within blood vessels of the skin, skeletal muscle, heart, and ovaries. Tissue samples taken from the umbilicus and uterus were inoculated on 5% sheep blood agar and MacConkey agar. Small, transparent colonies that exhibited complete hemolysis were identified on blood agar. Gram staining revealed the presence of Gram-positive cocci arranged in chains. The bacterial isolate was analyzed using the MALDI-TOF technique, which confirmed its identity as S. zooepidemicus. The presence of S. equi antigen in the extra-umbilical aggregates was confirmed through immunohistochemistry. These findings underscore the significance of streptococcal infections in cetaceans and contribute valuable data regarding calf mortality in baleen whales. Furthermore, we provide new insights into the understanding of marine ecosystem health markers.

Investigation of the Effects of Light, Darkness, and Dim Light on Rat Brain Tissue: A Biochemical and Histological Study.

This study evaluates acetylcholinesterase (AChE) enzyme activity levels, oxidative stress parameters, histopathological findings, and serum melatonin levels in rat brain tissue. 32 male Wistar Albino rats were randomly divided into four groups: Control, Light, Dark, Dim light (n = 8 each group). After a 30 day experiment, brain tissues were collected to measure AChE, glutathione S-transferase (GST), glutathione (GSH), and malondialdehyde (MDA) levels and conduct histopathological analyses. Serum melatonin levels were also measured. In this study, we observed a significant increase in MDA levels in dim light, dark, and light groups. AChE and α-GST enzyme activity levels were significantly decreased in the dark group compared with the other groups. Additionally, there was a statistical difference in melatonin levels between the light and dark groups. In the light microscope examination of the sections stained with hematoxylin-eosin from the dark group brain tissue, mild perineuronal edema was observed in all areas. Our study is the first to compare the effects of three groups on the brain: continuous light, continuous darkness, and dim light at night. Additionally, it is the only study to examine the effects of light exposure differences on the brain AChE levels.

EP69 Real Life Assessment of Diagnostic Imaging In Acute Appendicitis. A Multi-Centre Audit from The United Kingdom

Abstract Objectives Ultra-sound scan (USS) and Computed Tomography (CT) are commonly used in the diagnosis of acute appendicitis (AA). This audit aims at assessing their sensitivity and implications on the rate of negative appendicectomy (NA) and the number of scans patients have. Methods This is a retrospective multi-centre audit from tertiary (TH) and secondary (SH) hospitals in the United Kingdom. We enrolled patients who underwent appendicectomy over the last year and compared their scans findings to the histopathological findings as the gold standard for AA. Results This is a preliminary report of the first 405 (49.4% females). 69% had USS and 51% had CT scan. USS sensitivity was 57.6%. This sensitivity did not change significantly with age, sex or the size of hospital. CT sensitivity was 95.7%. Females and SH patients tended to have more scans (p&amp;lt; 0.001 for both). 26.4% of the patients had no scans and underwent appendicectomy based on clinical diagnosis. The positive predictive value of this clinical diagnosis was 85% which is equal to USS. 12.1% of the patients had NA, of which 16.4% were females Vs 7.8% males (p= 0.008). The mean age in NA was 26.96 years old Vs 34.12 years old in positive appendicectomy (p=0.009). Conclusion USS sensitivity is low and does not improve in females or younger patients who are also more likely to have NA. Females and SH patients are more likely to have more scans. Findings of USS should be interpreted with care, especially in young and female patients.