Anatomic Pathology Research Articles

Cardiovascular Stroke Prevention and Management Using the Principles of Cellular Medicine

Cerebrovascular disease generally refers to the abnormality of the brain, and it is usually caused by the pathologic process of blood vessels. After heart disease and cancer, stroke is the third most common cause of death in the developed world. Stroke can be classified based on the evolution and duration of the symptoms experienced by the patient. From the perspectives of human, family, and the society, stroke is a costly disease. In 2015, the total cost of stroke in the EU was estimated at about €45 Billion. Also, in the same year, the total direct and indirect cost of stroke in the United States of America was calculated as $103.50 billion annually. Meanwhile, stroke can be conveniently classified as two processes, based on pathologic anatomy and pathophysiology. The first process is; hpoxia, ischaemia, and infarction. This is usually caused by the pathology of blood supply and the impairment of oxygenation to the central nervous system (CNS) tissue. The second process is haemorrhage, and this is usually due to the rupture of blood vessels to the CNS. Most of the thrombotic arterial occlusions are caused by atherosclerosis, while primary brain parenchymal haemorrhage is most commonly due to hypertension. Cellular medicine is an approach to healthcare which focuses on the aetiology of diseases and develops treatment for the diseases by studying; biological processes, structures and functions of biomolecules, and cell physiology, in order to understand abnormal biological function at the cellular level. Research in the field of cellular medicine have revealed that atherosclerosis, the main cause of cardiovascular and cerebrovascular diseases, can be reversed using cellular medicine. The research also showed that atherosclerosis is an early form of full blown scurvy, thus both scurvy and atherosclerosis have the same cause, which is vitamin C deficiency.

COCCIDIOSIS IN BROILER CHICKEN AGED 26 DAYS FROM A FARM IN BANJARANGKAN, KLUNGKUNG, BALI

The object of this case study is a broiler chicken from a farm located in Banjarangkan District, Klungkung Regency, Bali. This broiler chicken is 26 days old which was reported to have had diarrhea mixed with blood for 5 days. This chicken also experience weakness, pale wattles, and separate itself in the corner of the shed. This case study aims to discuss the anatomical pathology, histopathology, and laboratory examination results to obtain a definitive diagnosis of the disease that attacked this chicken. Data collection in the form of indications, anamnesis, epidemiology, with parasite examination were carried out for further descriptive qualitative analysis. Necropsy after the animal died showed bleeding, and necrosis of the cecum accompanied by enlargement from cecum to colon. Petechiae bleeding were also observed along the small intestine. Histopathological observations showed necrosis in the mucosa of the cecum and small intestine accompanied by bleeding, inflammatory cell infiltration, and clusters of Eimeria spp. with different life stages. Changes also occur in the colon where necrosis of mucosa and proliferation of Lieberkhun crypts were observed. Schizonts of Eimeria spp. were found in qualitative fecal examinations. Based on all data and laboratory examination results of this chicken, it was concluded that the chicken was infected with coccidiosis.

Cytotoxic T lymphocyte associated antigen-4 (CTLA4) expression with renal cell carcinoma subtype and staging

In Indonesia, approximately 45% of renal cell carcinoma (RCC) patients are at an advanced stage that requires checkpoint inhibition combination immunotherapy. Cytotoxic T lymphocyte associated antigen-4 (CTLA-4) is associated with poor prognosis of RCC and it is the first checkpoint developed in cancer immunotherapy. This study aimed to investigate CTLA-4 expression among RCC subtypes and staging. Formalin fixed paraffin embedded (FFPE) tissue of RCC patients from 2018-2020 were obtained from the Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta. Expression of CTLA-4 among RCC subtypes and stage was measured using quantitative reverse-transcription polymerase chain reaction (qRT-PCR) and compared. Among the 40 patients involved in this study, the CTLA-4 expression was higher in papillary RCC/pRCC (95.88 + 31.58) compared to clear cell RCC/ccRCC (90.94 + 43.05). However, no significantly different in CTL-4 expression based on histologic subtypes and tumor stage (p>0.05). In conclusion, neither the histologic subtype nor the tumor stage of RCC can be predicted by CTLA-4 expression.

Molecular profiling across histologies in lung cancer: Time to change WHO nomenclature?

8532 Background: Biomarker testing is essential for optimal therapeutic management of Non-Small lung Cancer (NSCLC). However, a not negligible percentage of patients (pts) is not tested in clinical practice for all the relevant actionable biomarkers. Biomarker testing is recommended in lung adenocarcinoma (LUAD), while in tumors with other histologies it is reserved when clinical features indicate a higher probability of an oncogenic driver. Histopathology report and biomarker testing are usually performed sequentially, which is time consuming and delays patient care. Herein we determined the distribution of actionable biomarkers across NSCLC histotypes and other clinic-demographic characteristics. Methods: This is an observational retrospective analysis on histologically confirmed NSCLC cases tested between 2014-2022 using FoundationOne/FoundationOneCDx assay. Histopathologies of all cases were centrally reviewed and confirmed by Board Certified Anatomic Pathologists. Results: 82,328 NSCLC pts were included. Actionable genomic alterations (GA) were found in 35.1% of the cases (Table). LUAD and adenosquamous (ASC) were more commonly associated with actionable GA (45.8% and 40.9%, respectively) as compared with sarcomatoid (29.1%), not otherwise specified (NOS) (27.6%), large cell (LCC) (21.1%), and squamous cell (LUSC) (6.5%) histologies. Sarcomatoid histology had the highest METex14 skipping mutations (muts) frequency (9.9% vs. 2.4% in LUAD). Tumor mutational burden (TMB) ≥10 Mut/Mb was associated with histology (50.9% in LCC, 40.8% in NOS, 39.1% in LUSC, and 36.3% in sarcomatoid vs. 31.2% in LUAD and 29.2% in ASC). Pts with actionable GA usually had a low TMB (80.9%). A significant correlation (p<0.005) between age and actionable GA was reported for BRAF/ ERBB2 muts, ALK/RET/ROS1 rearrangements (RE), and MET amplification. EGFR actionable muts and KRASG12C were more commonly observed in females, whereas no significant correlation between sex and other GA was observed. Finally, genetic ancestry analyses revealed a strong correlation between EGFR actionable muts and South/East Asian and American ancestries, but not for other GA. Conclusions: This is the largest NSCLC dataset analyzed for biomarker distribution across histologies, age, sex and genetic ancestry. This dataset confirms sufficient enough biomarker prevalence across LUAD and ASC carcinoma to be included in WHO nomenclature for lung tumors, and provides reassurance that cases with NOS, LCC and sarcomatoid histologies must be considered for biomarker workup. [Table: see text]

The histopathological spectrum and molecular changes associated with KRAS G12C mutation in non-small cell lung carcinoma

KRAS G12C is the most common KRAS mutation in non-small cell lung carcinoma (NSCLC), for which targeted therapy has recently been developed. From the 732 cases of NSCLC that underwent next-generation sequencing at the Department of Anatomical Pathology, Liverpool Hospital, between July 2021 and May 2023, we retrieved 83 (11%) consecutive cases of KRAS G12C mutated NSCLC, and analysed their clinical, pathological, and molecular features. Of the 83 cases of KRAS G12C mutated NSCLC, there were 46 (55%) men and 37 (45%) women, with mean age of 72 years. Of the 49 cases with known clinical information, 94% were current or ex-smokers, and 49% were stage IV at diagnosis with median survival of 12 months. Sixty-three percent were histology cases and the remainder were cytology cases. Eighty-two percent were non-mucinous adenocarcinomas, with conventional histology including lepidic, acinar, solid, single cells and micropapillary patterns, and 62% were poorly differentiated. There were five (6%) cases of mucinous adenocarcinoma, one case of pleomorphic carcinoma and one case of high-grade fetal adenocarcinoma. TTF1 was positive in the majority (89%) of cases. Nineteen (23%) cases had TP53 co-mutation, and these cases had trends towards higher PD-L1 expression, poor differentiation, and presentation as stage IV disease, but the differences were not statistically significant. KRAS G12C mutated NSCLCs almost exclusively occurred in smokers and were mostly non-mucinous adenocarcinomas with conventional histological patterns which ranged from well to poorly differentiated. Around a quarter had TP53 co-mutation, the histological impacts and immune profile of which need to be assessed in a larger study.

Landscape of HER2-low breast cancer: Insights from a six-year study on incidence and clinicopathological characteristics.

e13148 Background: Human epidermal growth factor receptor 2 (HER2)-low breast cancer has emerged as a subtype of breast cancer, defined by HER2 1+ or 2+ in immunohistochemistry (IHC) and the absence of the ERBB2 gene amplification on fluorescence in situ hybridization (FISH). Recent trials showed marked response of HER2 breast cancer to novel anti-HER2 antibody-drug conjugates, rising interest in the HER2-low subtype. To date, data on characteristics of HER2-low breast cancer subtype is limited. Herein, we describe the clinicopathological characteristics of HER2-low breast cancer subtype compared HER2-zero/negative breast cancer. Methods: Real-world data from the Anatomic Pathology Division of Hotel Dieu de France, spanning 2017-2022, was retrospectively collected. Patients with HER2-IHC 3+ and HER2-IHC 2+ with ISH-amplified (HER2-positive) were excluded to compare HER2-low to HER2-zero breast cancer subtypes. Patients were then categorized based on their hormone receptor (HR) status. Clinicopathological characteristics between the groups were compared using a Chi-Square and Mann–Whitney U tests. Results: Out of 1195 patients, we observed 341 (28.5%) HER2-low breast cancers cases. HER2-positive breast cancer cases (n=178; 14.9%) were subsequently excluded. There was no significant difference in age and sex between the HER2-low and the HER2-zero group (p=0.3 and 0.8, respectively). HER2-low breast cancer was associated with positive estrogen receptor (ER) status and positive progesterone receptor (PR) status (p<0.001 and p=0.01, respectively). Ductal adenocarcinomas were more frequently observed in the HER2-low group, whereas lobular and metaplastic adenocarcinomas were especially prevalent in the HER2-zero group (all p<0.001). When stratified by HR status, 87.4% of patients had HR-positive status and 12.6% were HR-negative. Furthermore, the occurrence rate of tumors with a low Ki-67 labeling index was comparable between the two groups (p=0.9). However, among the HR-negative group, HER2-low tumors tended to show lower proliferation index compared to HER2-zero tumors (p = 0.04; Table). Conclusions: In conclusion, this study showed that HER2-low is a distinct from HER2-zero and is frequently present among patients with breast cancer. Clinicopathological features such as histological type differ between HER2-zero and HER2-low breast cancer. Our findings suggest that, within HR-negative breast cancer, breast cancer with low HER2 expression exhibits a less aggressive profile when compared to HER2-zero tumors. [Table: see text]

Anterolateral Ligament Pathological Anatomy and its Associated Injuries: An Infographic.

Anterolateral Ligament Pathological Anatomy and its Associated Injuries: An Infographic.

Incidental prostate cancer after TURP or prostate adenectomy, how to proceed?

Background: During this work we will talk about incidental prostate cancer. It is defined by the presence of cancerous cells on the anatomical pathology specimens of RTUP or adenectomy in patients initially admitted for BPH management. That is, in these patients the preoperative PSA and DRE were considered normal. There is still debate about the optimal treatment for patients with incidental prostate cancer. The objective of this research is to provide a clear challenge for care this subgroup of prostate cancer. Methods: Our study was based on pubmed data, we used the terms: incidental, prostate cancer, and TURP. Then we limited the study period to the period between 1985 and 2023. Result: We have eliminated all the articles not written in English. After we have chosen that we saw that they answer well to our subject. Discussion: In a first plan we see that the classical TNM classification that divides these patients in T1a and T1b divide these patients in a heterogeneous group of patients. Currently we can see that we can base ourselves on progression factors that allow us to divide each group of these patients into a subgroup of good prognosis and a bad prognosis, the reclassification biopsy has a place only in the active surveillance. Active surveillance is the treatment of choice for PT1a patients with a GCS of 6 or less and a life expectancy of less than 10 years, Radical prostatectomy is an optional treatment for patients with long life experience and low differentiated tumors. and is the standard treatment for T1b patients with a life expectancy of more than ten years who accept surgical complications, Radiation therapy is optional in patients with stage T1a, in patients with a life expectancy of more than 10 years and with low differentiated tumors. On the other hand, it represents the treatment of choice of t1b whose life expectancy exceeds 10 years or between 5 and 10 years with low differentiated tumors, and in these patient’s surgery is not indicated. Hormonotherapy alone is indicated only for symptomatic T1b tumors for which curative treatment is not possible, Hormonotherapy combined with radiation therapy has demonstrated local control and better global survival.

Age and Luminal Type Play Important Role as Therapeutic Policies in the Management of Breast Cancer at Prof. Dr. Margono Soekarjo Regional Hospital Purwokerto

Introduction: Breast cancer (carcinoma mammae) is a malignancy originating from breast tissue, either from its ductal or lobular epithelium. Objective: This study aims to find out the characteristics of Breast Cancer at Margono Soekarjo Hospital in Purwokerto to determine the breast cancer therapy policies. Methods : This study utilized a descriptive retrospective design with the research subjects being patients with carcinoma mammae who underwent anatomical pathology and immunohistochemistry examinations at Prof. Dr. Margono Soekarjo Regional General Hospital from 2020 to 2023. Result: The characteristics age of patients with Carcinoma Mammae are divided into 76 patients (30,9%) between 50-59 years old, followed by the 40-49 age group with 68 patients (27,6%). A total of 178 (72.4%) patients are ductal type, followed by 35 patients (14,2%) are lobular type. A total of 92 patients (37,4%) are grade 2 of Ca Mammae, followed by 83 patients (33,7%) are grade 3. A total of 95 patients (38,6%) are Luminal B sub type, followed by 69 patients (28%) are Her2 Enriched. Conclusion: The majority of breast cancer patient are aged 50 – 59 years with Invasive Ductal Carcinoma type, grade 2 and Luminal B Subtype.

Integration of case-based learning and three-dimensional printing for tetralogy of fallot instruction in clinical medical undergraduates: a randomized controlled trial

BackgroundCase-based learning (CBL) methods have gained prominence in medical education, proving especially effective for preclinical training in undergraduate medical education. Tetralogy of Fallot (TOF) is a congenital heart disease characterized by four malformations, presenting a challenge in medical education due to the complexity of its anatomical pathology. Three-dimensional printing (3DP), generating physical replicas from data, offers a valuable tool for illustrating intricate anatomical structures and spatial relationships in the classroom. This study explores the integration of 3DP with CBL teaching for clinical medical undergraduates.MethodsSixty senior clinical medical undergraduates were randomly assigned to the CBL group and the CBL-3DP group. Computed tomography imaging data from a typical TOF case were exported, processed, and utilized to create four TOF models with a color 3D printer. The CBL group employed CBL teaching methods, while the CBL-3DP group combined CBL with 3D-printed models. Post-class exams and questionnaires assessed the teaching effectiveness of both groups.ResultsThe CBL-3DP group exhibited improved performance in post-class examinations, particularly in pathological anatomy and TOF imaging data analysis (P < 0.05). Questionnaire responses from the CBL-3DP group indicated enhanced satisfaction with teaching mode, promotion of diagnostic skills, bolstering of self-assurance in managing TOF cases, and cultivation of critical thinking and clinical reasoning abilities (P < 0.05). These findings underscore the potential of 3D printed models to augment the effectiveness of CBL, aiding students in mastering instructional content and bolstering their interest and self-confidence in learning.ConclusionThe fusion of CBL with 3D printing models is feasible and effective in TOF instruction to clinical medical undergraduates, and worthy of popularization and application in medical education, especially for courses involving intricate anatomical components.

Digital Cytology in Veterinary Education: A Comprehensive Survey of Its Application and Perception among Undergraduate and Postgraduate Students.

The COVID-19 pandemic accelerated technological changes in veterinary education, particularly in clinical pathology and anatomic pathology courses transitioning from traditional methods to digital pathology (DP). This study evaluates the personal effectiveness and satisfaction, as well as the advantages and disadvantages, of DP, in particular digital cytology (DC), as a teaching method among European veterinary students, both at the undergraduate and postgraduate level, who attended digital pathology courses during and before the pandemic. A further aim is to discuss the differences between the two student groups. A Google Form survey consisting of 11 multiple-choice questions was emailed to pathology teachers and distributed to their students. Results indicated that undergraduate students showed greater digital pathology training, favouring DC as the most effective learning modality. In contrast, postgraduate students reported less digital slide training, and their preference for learning cytology was split between DC alone and DC integrated with traditional microscopy. All students experienced whole slide imaging for learning cytology slides prevalently, and they stated that DC enhanced their learning experience. While DC demonstrates personal effectiveness and satisfaction as a teaching method, it is important to not replace pathology training with light microscopy completely, as almost a third of the students indicated.

Mapping Thyroid Changes in Size and Position During Enlargement in Adult Mice With Hyperthyroidism.

The thyroid in Graves' disease undergoes a considerable divergence in size and position from the normal anatomy. However, knowledge of the pathological anatomy related to the change, which is required before planned surgical or local intervention, or diagnosis, is neglected. To investigate Graves' disease, we established a model of mice that successfully mimicked all the signs presented in the clinic. Under a long-term immunization (35 weeks), the animals displayed large heterogeneity in thyroid size, such as the cases of natural occurrence. These thyroids in the model were sized into various phases and registered. A blend of the registered thyroids and the thyroid and tracheal cartilage landmarks led to the production of site-dependent incidence graphs of thyroid in the front view and on the section for each phase. The merger of the incidence graphs of all the phases resulted in thyroid phase-dependent topography. The depicted graphs illustrate the fine localization of the thyroid in various sizes and their dynamic changes during enlargement, which may facilitate currently used fine-needle aspiration biopsy and ultrasonography-guided biopsy techniques. Familiarity with this knowledge might avoid misclassifying an abnormality as normal, or vice versa, and be helpful for imaging diagnosis and local surgery therapy in Graves' disease.

Use of Artificial Intelligence Chatbots in Interpretation of Pathology Reports.

Anatomic pathology reports are an essential part of health care, containing vital diagnostic and prognostic information. Currently, most patients have access to their test results online. However, the reports are complex and are generally incomprehensible to laypeople. Artificial intelligence chatbots could potentially simplify pathology reports. To evaluate the ability of large language model chatbots to accurately explain pathology reports to patients. This cross-sectional study used 1134 pathology reports from January 1, 2018, to May 31, 2023, from a multispecialty hospital in Brooklyn, New York. A new chat was started for each report, and both chatbots (Bard [Google Inc], hereinafter chatbot 1; GPT-4 [OpenAI], hereinafter chatbot 2) were asked in sequential prompts to explain the reports in simple terms and identify key information. Chatbot responses were generated between June 1 and August 31, 2023. The mean readability scores of the original and simplified reports were compared. Two reviewers independently screened and flagged reports with potential errors. Three pathologists reviewed the flagged reports and categorized them as medically correct, partially medically correct, or medically incorrect; they also recorded any instances of hallucinations. Outcomes included improved mean readability scores and a medically accurate interpretation. For the 1134 reports included, the Flesch-Kincaid grade level decreased from a mean of 13.19 (95% CI, 12.98-13.41) to 8.17 (95% CI, 8.08-8.25; t = 45.29; P < .001) by chatbot 1 and 7.45 (95% CI, 7.35-7.54; t = 49.69; P < .001) by chatbot 2. The Flesch Reading Ease score was increased from a mean of 10.32 (95% CI, 8.69-11.96) to 61.32 (95% CI, 60.80-61.84; t = -63.19; P < .001) by chatbot 1 and 70.80 (95% CI, 70.32-71.28; t = -74.61; P < .001) by chatbot 2. Chatbot 1 interpreted 993 reports (87.57%) correctly, 102 (8.99%) partially correctly, and 39 (3.44%) incorrectly; chatbot 2 interpreted 1105 reports (97.44%) correctly, 24 (2.12%) partially correctly, and 5 (0.44%) incorrectly. Chatbot 1 had 32 instances of hallucinations (2.82%), while chatbot 2 had 3 (0.26%). The findings of this cross-sectional study suggest that artificial intelligence chatbots were able to simplify pathology reports. However, some inaccuracies and hallucinations occurred. Simplified reports should be reviewed by clinicians before distribution to patients.

Prenatal ultrasound diagnostics and sociopsychological support as rehabilitation measures in patients with congenital cleft palate complicated by anomalies of other organs and systems

BACKGROUND: Prenatal ultrasound diagnostics and sociopsychological support in the early rehabilitation of children with congenital cleft palate combined with malformations of other organs and systems complement the unified algorithm of dynamic monitoring and rehabilitation treatment of these patients. Thus, predicting the choice of techniques and the system of rehabilitation prescriptions became possible. AIM: To present the experience of prenatal ultrasound diagnostics and sociopsychological support during pregnancy for the early rehabilitation of a patient with cleft palate combined with malformations of other organs and systems. MATERIALS AND METHODS: The study was conducted in the Multiprofile Clinical Medical Center “Bonum” in Yekaterinburg. For 24 years, from the analysis of medical records of the organizational and rehabilitation process of 2,475 patients with congenital cleft lip and/or palate receiving comprehensive care (1998–2022), 823 (33.25%) patients who had with cleft palate and malformations of other organs and systems were enrolled in this study. The discharge epicrises of the pregnancy and the timing of intrauterine ultrasound diagnostics of the fetus were studied, and the history of childbirth and anamnesis of newborns and timing of their routing and registration in the specialized “Bonum” Center were analyzed. At the time of the initial outpatient appointment at the center, parents’ responses to a survey on the nature of emotional and psychological experiences during the prenatal ultrasound examination of the fetus, period of “bearing” pregnancy, and birth of a baby with a complex anatomical and physiological pathology were analyzed. RESULTS: Ultrasound examination of the fetus during uterine development registered 292 (35.48%) of 823 cases of a combination of congenital cleft palate and anomalies of other organs and systems. The main forms of malformations in the fetus were established in the second (n=99, 33.90%) and third (n=185, 63.36%) trimester pregnancy screening. Mothers who were told about the results of ultrasound diagnostics of the fetus showed anxiety and emotional lability. The use of psychocorrectional and socially significant measures during the diagnosis of fetal pathologies and at the time deciding whether to continue pregnancy, as well as the newborn period, which relieved the psycho-emotional tension of parents, was proposed. CONCLUSION: Early rehabilitation of patients with congenital cleft palate combined with malformations of other organs and systems should be provided as an integral part of the complex rehabilitation therapy. Sociopsychological support of the family from the period of prenatal diagnosis of the fetus who had multiple malformations is necessary at all stages of pregnancy and rehabilitation treatment of the child.

Landscape of HER2-low breast cancer: Insights from a six-year study on prevalence and clinicopathological characteristics

Human epidermal growth factor receptor 2 (HER2)-low breast cancer has emerged as a subtype of breast cancer, defined by HER2 1+/2+ in immunohistochemistry (IHC) and absence of ERBB2 gene amplification on fluorescence in situ hybridization (FISH). Recent trials showed marked response of HER2-low breast cancer to novel anti-HER2 antibody-drug-conjugates. Data on characteristics of HER2-low breast cancer subtype is limited. Real-world data from the Anatomic Pathology Department of Hotel-Dieu de France, spanning 2017–2023, was retrospectively collected. HER2-positive patients were excluded to compare HER2-low to HER2-zero breast cancer subtypes. Clinicopathological characteristics between the groups were compared using a Chi-Squared test. Out of 1195 patients, we observed 341 (28.5 %) HER2-low breast cancers cases. HER2-positive breast cancer cases (n = 178; 14.9 %) were excluded. There was no significant difference in age and sex between HER2-low and HER2-zero group (p = 0.33 and 0.79, respectively). HER2-low breast cancer was associated with positive estrogen receptor status and positive progesterone receptor status (p < 0.001 and p = 0.01, respectively). Ductal adenocarcinomas were more commonly observed in HER2-low group (p < 0.001). When stratified by hormone (HR) status, 87.4 % of patients had HR-positive status and 12.6 % were HR-negative. Among the HR-negative group, HER2-low tumors tended to show lower proliferation index compared to HER2-zero tumors (25%vs.10 %, p = 0.04). This study showed that HER2-low is distinct from HER2-zero and is common among patients with breast cancer. Clinicopathological features such as histological type differ between HER2-zero and HER2-low breast cancer. Within HR-negative breast cancer, those with low HER2 expression exhibit a less aggressive profile compared to HER2-zero tumors.

Correlation between the expected risk of malignancy according to FNA and the actual percentage of malignancy found on pathological anatomy in thyroidectomies and hemithyroidectomies

Correlation between the expected risk of malignancy according to FNA and the actual percentage of malignancy found on pathological anatomy in thyroidectomies and hemithyroidectomies

On Victory Day and the 80th Anniversary of the Lifting of the Siege of Leningrad. Review of the Archives of the Pathological Anatomy Laboratory of the Oncology Institute

On Victory Day and the 80th Anniversary of the Lifting of the Siege of Leningrad. Review of the Archives of the Pathological Anatomy Laboratory of the Oncology Institute

Vulva lesions seen at a tertiary health centre in southwest Nigeria

Background: Some researchers have emphasised the need for more studies on vulvar cancers. The aim of our study is to describe the vulvar lesions identified in biopsies seen in our department over a five-year period to serve as baseline data for future studies. Methods: We conducted a five-year cross-sectional study on all vulva specimens received by the department of Morbid Anatomy and Forensic medicine at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria. From the departmental records, we retrieved data on the patients' biodata, medical history, and vulva lesion diagnosis. Results: We recorded 15 vulva biopsies during the study period, with an age range of 13 to 80 years. Two cases were benign tumours, and two cases were inflammatory in nature. A case of a pre-malignant lesion was seen. Nine cases were malignant tumours, all of which are epithelial in origin. We saw two non-neoplastic lesions. These are acute on chronic inflammation and lichen sclerosus et atrophicus. Of the malignant tumours seen, five were well-differentiated squamous cell carcinoma (SCC), two were moderately differentiated SCC, and two were cases of verrucous carcinoma. One case of verrucous carcinoma and a well-differentiated SCC had a background HIV. Conclusion: Vulva lesions are rarely seen at our centre. The absence of preinvasive lesions in our study may be due to the late presentation of cases in clinics or the reluctance of gynaecologists to take biopsies of non-tumoral lesions of the vulva. HIV may be associated with an increased risk of HPV-related cancers.

Improving Patient Understanding of Femoroacetabular Impingement Syndrome With Three-Dimensional Models.

Three-dimensional (3D) printed models may help patients understand complex anatomic pathologies such as femoroacetabular impingement syndrome (FAIS). We aimed to assess patient understanding and satisfaction when using 3D printed models compared with standard imaging modalities for discussion of FAIS diagnosis and surgical plan. A consecutive series of 76 new patients with FAIS (37 patients in the 3D model cohort and 39 in the control cohort) from a single surgeon's clinic were educated using imaging and representative 3D printed models of FAI or imaging without models (control). Patients received a voluntary post-visit questionnaire that evaluated their understanding of the diagnosis, surgical plan, and visit satisfaction. Patients in the 3D model cohort reported a significantly higher mean understanding of FAIS (90.0 ± 11.5 versus 79.8 ± 14.9 out of 100; P = 0.001) and surgery (89.5 ± 11.6 versus 81.0 ± 14.5; P = 0.01) compared with the control cohort. Both groups reported high levels of satisfaction with the visit. In this study, the use of 3D printed models in clinic visits with patients with FAIS improved patients' perceived understanding of diagnosis and surgical treatment.

Direct effect of ultra diluted ethanolic extract of Apis mellifica on Escherichia coli and Staphylococcus aureus in Gallus gallus domesticus embryo model

Urinary tract infection and other infections caused by multi-drug resistance strains have increased significantly, creating a need to investigate alternative medicine for therapeutic purposes. Our aim is to determine whether Apis mellifica 6C (an alternative ultra-diluted medicine) can counteract the detrimental impact of Escherichia coli ATCC 25922, Escherichia coli MDR and Staphylococcus aureus ATCC 25923 in Gallus gallus domesticus embryos with regard to their morbid anatomical changes and cytokine alterations. Anti-microbial activity of Apis mellifica 6C against the ATCC and MDR strains was examined by Agar Disc Diffusion method. The bacterial strains were inoculated on 15th day embryonated chick egg model and the alteration in cytokine gene expressions (IL-10 and IFN-γ) was examined by RT PCR method. In disc diffusion method, Apis mellifica induced zone of inhibition which was prominent in case of all mentioned bacteria. In case of embryo model, the most notable finding is that after being challenged with Apis mellifica 6C, the IFN-γ and IL-10 gene expression of E. coli ATCC, MDR E. coli and S. aureus ATCC were all remarkably decreased than the control set. Similar interesting outcomes were also found in the morbid anatomy of the chick embryo. In cases of urinary tract infection and other infections, Apis mellifica 6C appears to be efficient and beneficial.