Areas Of Pathology Research Articles

Numerical study of the mechanical behavior of the hip joint under therapeutic acoustic impact

Degenerative diseases are one of the main causes of disability in the middle-aged and older population. One of the most common diseases is osteoporosis and osteonecrosis of the femoral head. For the prevention and treatment of osteoporosis, osteopenia, and osteonecrosis, external mechanical stimulation based on ultrasound and shock wave exposure is used, based on local ultrasonic or shock wave exposure in the area of pathology. The effect of external mechanical action is based on mechanobiological principles, the essence of which is that a certain level of pressure (mechanical stress) and deformation leads to the growth and differentiation of various types of biological tissue. To obtain a therapeutic effect, it is necessary to correctly choose the parameters of exposure and the place of its application. Usually, these problems are solved empirically. In this work, the possibility of creating conditions for bone tissue regeneration under external acoustic impact on a healthy hip joint and a joint affected by osteonecrosis was studied numerically. The study was carried out using the method of mobile cellular automata. The results obtained showed the effectiveness of the use of medium- and high-intensity ultrasound exposure for the prevention of osteopenia and osteoporosis. When exposed to ultrasound on a joint with osteonecrosis of the head, the creation of conditions for osteogenesis and chondrogenesis in the affected area is observed only with high-intensity loading. Thus, the hypothesis that low-intensity ultrasound therapy is effective only in combination with other methods of treatment was con-firmed. It was found that shock-wave action of low intensity promotes the division of biological cells and their transfer, thereby creating conditions for the regeneration of bone tissues. This conclusion is consistent with the results of most experimental studies.

Top 10 Significant Spindled Head and Neck Lesions to Scrutinze.

Spindled lesions are a challenging area in head and neck pathology. This is particularly true in the sinonasal tract, where several uncommon entities with both unique and overlapping morphologic, immunophenotypic, and/or molecular features can occur. Review. The clinicopathologic characteristics of biphenotypic sinonasal sarcoma and nine important differential diagnostic considerations with one or more overlapping feature are summarized to establish a practical framework for approaching spindled lesions of the sinonasal tract. Morphologic evaluation is central to the work up of sinonasal spindle cell lesions-in particular, cellular morphology, tumor architecture and growth pattern, and the presence of admixed epithelial elements - however, focused immunohistochemical analysis of neural, myogenic, rhabdomyoblastic, epithelial, and/or melanocytic marker expression and/or ancillary tests for tumor-specific molecular alterations may be necessary for definitive diagnosis.

Quantitative Imaging Analysis Fluorescence In Situ Hybridization Validation for Clinical HER2 Testing in Breast Cancer.

Quantitative imaging is a promising tool that is gaining wide use across several areas of pathology. Although there has been increasing adoption of morphologic and immunohistochemical analysis, the adoption of evaluation of fluorescence in situ hybridization (FISH) on formalin-fixed, paraffin-embedded tissue has been limited because of complexity and lack of practice guidelines. To perform human epidermal growth factor receptor 2 (HER2) FISH validation in breast carcinoma in accordance with the American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) 2018 guideline. Clinical validation of HER2 FISH was performed using the US Food and Drug Administration-approved dual-probe HER2 IQFISH (Dako, Carpinteria, California) with digital scanning performed on a PathFusion (Applied Spectral Imaging, Carlsbad, California) system. Validation parameters evaluated included z-stacking, classifier, accuracy, precision, software, and hardware settings. Finally, we evaluated the performance of digital enumeration on clinical samples in a real-world setting. The accuracy samples showed a final concordance of 95.3% to 100% across HER2 groups 1 to 5. During clinical implementation for HER2 groups 2, 3, and 4, we achieved a final concordance of 76% (95 of 125). Of these cases, only 8% (10 of 125) had discordances with clinical impact that could be identified algorithmically and triaged for manual review. Digital FISH enumeration is a useful tool to improve the efficacy of HER2 FISH enumeration and capture genetic heterogeneity across HER2 signals. Excluding cases with high background or poor image quality and manual review of cases with ASCO/CAP group discordances can further improve the efficiency of digital HER2 FISH enumeration.

Abstract P5-14-08: Machine learning based histopathology images analysis reveals cancer stemness in TNBC patient with 17p loss

Abstract Background: The area of computational pathology has made huge progresses due to advances in artificial intelligence (AI) and machine learning technologies. It has been applied to many research and translational tasks which provide great improvement on medical diagnosis and treatment. Cancer stem-like cells (CSC) have been consistently reported for its key role in Triple negative breast cancer (TNBC) . Given the large amount of existing H&E stained histological slides of TNBC, digital identification of CSC could benefit the evaluation of tumor status and prediction of patients’ response to chemotherapy. Here we proposed an AI framework based on Convolutional Neural Network (CNN) to predict CSC from the histological images of TNBC patient. And our preliminary work suggested that chromosome 17p loss, a common genetic variations in breast cancer, is linked to cancer stemness. Methods: A modified GoogleNet model was adopted as our CNN classifier. Consecutive breast cancer tissue microarrays (TMA), which stained with H&E ,SOX2, OCT4 and NANOG antibodies respectively by IHC, were used as training dataset for the CNN model. Gene expression data from the TCGA and METABRIC datasets were used to identify gene signatures associated with CSC. The connectivity map (CMAP) and Cancer Cell Line Encyclopedia (CCLE) were used for screening compounds that target stemness in cancer cell lines with chromosomal 17p loss. HS578T and EO771 cells with or without heterozygous 17p loss (11b in EO771) were used for in vitro experiments. Female immunodeficient nude (Nu/J) mice were used for animal studies. Results: The well trained GoogleNet model was applied to TNBC patient diagnosis images in TCGA BRCA dataset. By analyzing patient genomic alteration on chromosomal level, we found that loss of chromosome 17p associate with high cancer stemness in TNBC. Flow cytometry assays also demonstrated higher ALDH1 activity and higher CD44+/CD24−/low cell population in HS578T cells with 17p loss. RNA-seq of HS578T cells revealed that most CSC marker genes were located in the unregulated differentially expressed genes (DEGs) of 17p loss cells. We next compared the cytotoxicity of chemotherapy drugs including doxorubicin, paclitaxel, docetaxel and cisplatin on 17p loss and 17p intact HS578T cells, 11b loss and 11b intact EO771 cells, in terms of IC50 value. The IC50 value of indicated drug on 17p loss HS578T cells with were 3-6 fold higher than their IC50 on 17p intact HS578T cells. Similar result was observed in EO771 cells. Next, 17p loss and 17p intact HS578T cells were orthotopically implanted into the Nu/J mice. Under the doxorubicin treatment, mice bearing 17p loss HS578T derived tumors had larger and heavier tumors in compare to mice bearing 17p intact tumors. Next, we did a computational drug screening to identify compounds that can target the cancer stemness in 17p loss cells. Screened out compounds were tested for their cytotoxicity on 17p loss and 17p intact HS578T cells and FK866 showed the most pronounced efficacy on inhibiting the viability of 17p loss cells, compared to 17p intact cells. Followup experiments demonstrated that FK866 can decrease the CSC features induced by doxorubicin, both in vitro and in vivo. FK866 also potentiates the effect of doxorubicin on treating TNBC cells with 17p loss, which provide a drug combination potential for TNBC patient with 17p loss. Conclusions: A CNN based model was developed to identify CSC from TNBC histopathology images. The images analysis combined with patient genomic data revealed that chromosome 17p loss associated with cancer stemness in TNBC. This result was confirmed using assays on TNBC cells with or without 17p loss. A computational drug screening was performed to identify candidates that targeting stemness in 17p loss cells. FK866 was identified and it potentiates the anti-tumor effect of doxorubicin on treating TNBC cells with 17p loss. Our study provides a novel strategy on applying AI to precision treatment for cancers. Citation Format: tianhan dong, jiannan liu, yuanzhang Fang, Ziyu Liu, Xiongbin Lu, kun huang. Machine learning based histopathology images analysis reveals cancer stemness in TNBC patient with 17p loss [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-14-08.

ИССЛЕДОВАНИЕ МИНЕРАЛИЗАЦИИ ТВЕРДЫХ ТКАНЕЙ ЗУБОВ, ПОРАЖЕННЫХ ЛУЧЕВЫМ КАРИЕСОМ, С ПОМОЩЬЮ МЕТОДА РАМАН-ФЛЮОРЕСЦЕНТНОЙ ДИАГНОСТИКИ

Subject. Mineralization of hard tissues of teeth affected by radiation caries in patients after radiation therapy of malignant neoplasms.
 Objectives. To develop a digital method for diagnosing radiation caries based on Raman fluorescence technology.
 Methodology. The study was conducted at the Department of Orthopedic Dentistry and Orthodontics of South Ural State Medical University. The study was conducted on two groups of people (cohorts) comparable in sex and age, who voluntarily agreed to take part in it. The main group consisted of 20 people (patients with radiation caries), the comparison group – 20 people (without radiation caries). The main research method was the study of Raman fluorescence of tooth areas using the «InSpectr» hardware-software complex with diagnostic sensitivity according to the integral concentration of aerobic-anaerobic microbial suspension up to 109 KOE/ml. A study was made of teeth in the pathological area in patients of the main group, and in the intact area in patients of the comparison group.
 Results. Raman fluorescent diagnostics of the intact tooth surface and the surface with a pathological focus made it possible to clearly see the difference in mineralization in digitized indicators. So, for example, according to the indicators of patients with damage to the teeth by radiation caries, it can be concluded that the indicators of mineralization in the focus affected by radiation caries ( y = 172 ± 0.04, x = 963 cm-1) are lower than those of the intact area (y = 1174 ± 0.071, x = 963 cm-1)
 Conclusion. The method of Raman fluorescence diagnostics can be used in the diagnosis of radiation caries, since there is a potential difference between the healthy and the affected areas of the hard tissues of the tooth. On the basis of the study, the author recommends using the «InSpectr» hardware-software complex for diagnosing radiation caries.

Application of Phage Therapy in a Case of a Chronic Hip-Prosthetic Joint Infection due to Pseudomonas aeruginosa: An Italian Real-Life Experience and In Vitro Analysis.

Prosthetic joint infection (PJI) caused by Pseudomonas aeruginosa represents a severe complication in orthopedic surgery. We report the case of a patient with chronic PJI from P. aeruginosa successfully treated with personalized phage therapy (PT) in combination with meropenem. A 62-year-old woman was affected by a chronic right hip prosthesis infection caused by P. aeruginosa since 2016 . The patient was treated with phage Pa53 (I day 10 mL q8h, then 5 mL q8h via joint drainage for 2 weeks) in association with meropenem (2gr q12h iv) after a surgical procedure. A 2-year clinical follow up was performed. An in vitro bactericidal assay of the phage alone and in combination with meropenem against a 24-hour-old biofilm of bacterial isolate was also carried out. No severe adverse events were observed during PT. Two years after suspension, there were no clinical signs of infection relapse, and a marked leukocyte scan showed no pathological uptake areas. In vitro studies showed that the minimum biofilm eradicating concentration of meropenem was 8 µg/mL. No biofilm eradication was observed at 24 hours incubation with phages alone (108 plaque-forming units [PFU]/mL). However, the addition of meropenem at suberadicating concentration (1 µg/mL) to phages at lower titer (103 PFU/mL) resulted in a synergistic eradication after 24 hours of incubation. Personalized PT, in combination with meropenem, was found to be safe and effective in eradicating P. aeruginosa infection. These data encourage the development of personalized clinical studies aimed at evaluating the efficacy of PT as an adjunct to antibiotic therapy for chronic persistent infections.

Petrographic Microscopy with Ray Tracing and Segmentation from Multi-Angle Polarisation Whole-Slide Images

‘Slide scanners’ are rapid optical microscopes equipped with automated and accurate x-y travel stages with virtual z-motion that cannot be rotated. In biomedical microscopic imaging, they are widely deployed to generate whole-slide images (WSI) of tissue samples in various modes of illumination. The availability of WSI has motivated the development of instrument-agnostic advanced image analysis software, helping drug development, pathology, and many other areas of research. Slide scanners are now being modified to enable polarised petrographic microscopy by simulating stage rotation with the acquisition of multiple rotation angles of the polariser–analyser pair for observing randomly oriented anisotropic materials. Here we report on the calibration strategy of one repurposed slide scanner and describe a pilot image analysis pipeline designed to introduce the wider audience to the complexity of performing computer-assisted feature recognition on mineral groups. The repurposed biological scanner produces transmitted light plane- and cross-polarised (TL-PPL and XPL) and unpolarised reflected light (RL) WSI from polished thin sections or slim epoxy mounts at various magnifications, yielding pixel dimensions from ca. 2.7 × 2.7 to 0.14 × 0.14 µm. A data tree of 14 WSI is regularly obtained, containing two RL and six of each PPL and XPL WSI (at 18° rotation increments). This pyramidal image stack is stitched and built into a local server database simultaneously with acquisition. The pyramids (multi-resolution ‘cubes’) can be viewed with freeware locally deployed for teaching petrography and collaborative research. The main progress reported here concerns image analysis with a pilot open-source software pipeline enabling semantic segmentation on petrographic imagery. For this purpose, all WSI are post-processed and aligned to a ‘fixed’ reflective surface (RL), and the PPL and XPL stacks are then summarised in one image, each with ray tracing that describes visible light reflection, absorption, and O- and E-wave interference phenomena. The maximum red-green-blue values were found to best overcome the limitation of refractive index anisotropy for segmentation based on pixel-neighbouring feature maps. This strongly reduces the variation in dichroism in PPL and interference colour in XPL. The synthetic ray trace WSI is then combined with one RL to estimate modal mineralogy with multi-scale algorithms originally designed for object-based cell segmentation in pathological tissues. This requires generating a small number of polygonal expert annotations that inform a training dataset, enabling on-the-fly machine learning classification into mineral classes. The accuracy of the approach was tested by comparison with modal mineralogy obtained by energy-dispersive spectroscopy scanning electron microscopy (SEM-EDX) for a suite of rocks of simple mineralogy (granulites and peridotite). The strengths and limitations of the pixel-based classification approach are described, and phenomena from sample preparation imperfections to semantic segmentation artefacts around fine-grained minerals and/or of indiscriminate optical properties are discussed. Finally, we provide an outlook on image analysis strategies that will improve the status quo by using the first-pass mineralogy identification from optical WSI to generate a location grid to obtain targeted chemical data (e.g., by SEM-EDX) and by considering the rock texture.

Tumor volume definitions in head and neck squamous cell carcinoma – Comparing PET/MRI and histopathology

Background and purposeIn cancer treatment precise definition of the tumor volume is essential, but despite development in imaging modalities, this remains a challenge. Here, pathological tumor volumes from the surgical specimens were obtained and compared to tumor volumes defined from modern PET/MRI hybrid imaging. The purpose is to evaluate mismatch between the volumes defined from imaging and pathology was estimated and potential clinical impact. Methods and MaterialsTwenty-five patients with head and neck squamous cell carcinoma were scanned on an integrated PET/MRI system prior to surgery. Three gross tumor volumes (GTVs) from the primary tumor site were delineated defined from MRI (GTVMRI), PET (GTVPET) and one by utilizing both anatomical images and clinical information (GTVONCO). Twenty-five primary tumor specimens were extracted en bloc, scanned with PET/MRI and co-registered to the patient images. Each specimen was sectioned in blocks, sliced and stained with haematoxylin and eosin. All slices were digitalized and tumor delineated by a head and neck pathologist. The pathological tumor areas in all slices were interpolated yielding a pathological 3D tumor volume (GTVPATO). GTVPATOwas compared with the imaging GTV’s and potential mismatch was estimated. ResultsThirteen patients were included. The mean volume of GTVONCOwas larger than the GTV’s defined from PET or MRI. The mean mismatch of the GTVPATOcompared to the GTVPET, GTVMRIand GTVONCOwas 31.9 %, 54.5 % and 27.9 % respectively, and the entire GTVPATO was only fully encompassed in GTVONCO in 1 of 13 patients. However, after the addition of a clinical 5 mm margin the GTVPATO was fully encompassed in GTVONCO in 11 out of 13 patients. ConclusionsDespite modern hybrid imaging modalities, a mismatch between imaging and pathological defined tumor volumes was observed in all patients.A 5 mm clinical margin was sufficient to ensure inclusion of the entire pathological volume in 11 out of 13 patients.

Oxidation Responsive PEGylated Polyamino Acid Bearing Thioether Pendants for Enhanced Anticancer Drug Delivery.

Reactive oxygen species (ROS) in biological tissues are in a state of dynamic balance. However, many diseases such as cancer and inflammation, are accompanied by a long-term increase in ROS. This situation inspires researchers to use ROS-sensitive nanocarriers for a site-specific release of cargo in pathological areas. Polyamino acid materials with good biodegradability, biocompatibility, and regular secondary structure are widely used in the biomedical field. Herein, a new oxidation responsive PEGylated polyamino acid is synthesised for anticancer drug delivery by ring-opening polymerisation of N-carboxyanhydrides bearing thioether pendants. The obtained block copolymer mPEG-b-PMLG self-assembles into spherical nanoparticles (NPs) in water with diameter ≈68.3nm. NMR measurement demonstrated that the hydrophobic thioether pendants in the NPs can be selectively oxidised to hydrophilic sulfoxide groups by H2 O2 , which will lead to the disassociation of NPs. In vitro drug release results indicated that the encapsulated Nile red is selectively released in the trigger of 10mM H2 O2 in PBS. Finally, anticancer drug doxorubicin (DOX) is encapsulated to the NPs, and the obtained NPs/DOX exhibits an improved antitumor efficacy in 4T1 tumour-bearing mice and lower cardiotoxicity than free DOX. These results indicates that the mPEG-b-PMLG NPs are promising for anticancer drug delivery.

Mesenteric Teratoma in Adult Female: a Rare Case

Mesenteric teratomas are considered rare intra-abdominal tumors with minimum clinical symptoms, which turn difficult their preoperative diagnosis. They represent a poorly studied pathology that has been established with 1 in 26,794 to 250,000 frequency of hospital admissions. It is not frequent to think about this kind of lesion in a preoperative period, and the symptoms it presents can be very ambiguous. Therefore, in this study, we present a case of acute abdomen, in a 65-year-old Mexican woman, in which a mesenteric teratoma was obtained as a surgical finding. Sixty-five-year-old woman who presented a clinical picture of abdominal pain and distention, nausea and constipation, and absence of gas channelling in the last 24 h. After 48 h of conservative management, without favorable results and with a diagnosis of acute abdomen, surgery was entered to perform exploratory laparotomy and an intraoperative finding of mesenteric teratoma was made. Two ovoid specimens were extracted and sent to the pathology area, who confirms the diagnosis of mature cystic teratoma. Teratoma is commonly a germ cell tumor that originates in the gonads and is detected in women of reproductive age. This is extremely rare, with an estimated 21 cases reported to date. Despite the low frequency, it is suggested to consider these teratomas in the differential diagnosis against other pathologies, especially if they do not show a very clear data.

Efficacy of autologous mesenchymal stromal cell treatment for chronic degenerative musculoskeletal conditions in dogs: A retrospective study.

The objective of this study was to retrospectively analyze clinical data from a referral regenerative medicine practice, to investigate the efficacy of autologous mesenchymal stromal cells (MSC) in 245 dogs deemed unresponsive to conventional treatment by their referring vet. Diagnostic imaging [radiology and musculoskeletal ultrasound (MSK-US)] identified musculoskeletal pathology holistically. MSCs, produced according to current guidelines, were initially administered with PRP by targeted injection to joints and/or tendons, with a second MSC monotherapy administered 12 weeks later to dogs with severe pathology and/or previous elbow arthroscopic interventions. Dogs with lumbosacral disease received epidural MSCs with additional intravenous MSCs administered to dogs with spondylosis of the cervical, thoracic and lumbar spine. All dogs received laser therapy at 10 J/cm2 at the time of treatment and for 5 sessions thereafter. Objective outcome measures (stance analysis, range of joint motion, pressure algometry) and validated subjective outcome measures (owner reported VetMetrica HRQL™ and veterinary pain and quality of life impact scores) were used to investigate short and long-term (6-104 weeks) efficacy. Outcome data were collected at predetermined time windows (0-6, 7-12, 13-18, 19-24, 25-48, 49-78, 79-104) weeks after initial treatment. There were statistically significant improvements in post compared with pre-treatment measures at all time windows in stance analysis, shoulder and hip range of motion, lumbosacral pressure algometry, and to 49-78 weeks in carpus and elbow range of motion. Improvements in 4 domains of quality of life as measured by VetMetricaTM were statistically significant, as were scores in vet-assessed pain and quality of life impact. In dogs receiving one initial treatment the mean time before a second treatment was required to maintain improvements in objective measures was 451 days. Diagnostic imaging confirmed the regenerative effects of MSCs in tendinopathies by demonstrating resolution of abnormal mineralization and restoration of normal fiber patterns. This represents the first study using "real-world" data to show that cell-based therapies, injected into multiple areas of musculoskeletal pathology in a targeted holistic approach, resulted in rapid and profound positive effects on the patient's pain state and quality of life which was maintained with repeat treatment for up to 2 years.

Qualitative and Quantitative Evaluation of Morpho-Metabolic Changes in Bone Cartilage Complex of Knee Joint in Osteoarthritis Using Simultaneous 18F-NaF PET/MRI-A Pilot Study.

Background Articular cartilage (AC) loss and deterioration, as well as bone remodeling, are all symptoms of osteoarthritis (OA). As a result, an ideal imaging technique for researching OA is required, which must be sensitive to both soft tissue and bone health. Objective The aim of this study was to assess the potential of simultaneous 18F sodium fluoride (18F-NaF) positron emission tomography/magnetic resonance imaging (PET/MRI) to identify as well as classify osseous metabolic abnormalities in knee OA and to see if degenerative changes in the cartilage and bone on MRI might be correlated with subchondral 18F-NaF uptake on PET. Methods Sixteen (32 knees) volunteers with no past history of knee injury, with or without pain, were enrolled for the research from January to July 2021. The images of both knees were taken utilizing an molecular magnetic resonance (mMR) body matrix coil on a simultaneous PET/MRI biograph mMR. The acquisition was conducted after 45 minutes of intravenous infusion of 18F-NaF 185-370 MBq (5-10 mCi) over one PET bed for 40 minutes, while MRI sequences were performed simultaneously. Results All pathologies showed significantly higher maximum standardized uptake value (SUV max ) than the background. Thirty-four subchondral magic spots were identified on 18F-NaF PET without any structural alteration on MRI. Bone marrow lesions (BMLs) and osteophytes with higher MRI osteoarthritis knee score (MOAKS) score showed higher 18F-NaF uptake (grade1˂grade2˂grade3). BMLs had corresponding AC degeneration. There was discordance between grade 1 osteophytes (86.6%), sclerosis (53.7%) and grade 1 BML in cruciate ligament insertion site (91.66%); they did not have high uptake of 18F-NaF. In case of cartilage, there was significant difference between AC grades and average subchondral SUV max and T2* relaxometry (grade0˂grade1˂grade2˂grade3˂grade4). BMLs are much more metabolically active than other pathologies, while sclerosis is the least. We also found that the subchondral uptake was statistically increased in the areas of pathology: Conclusion 18F-NaF PET/MRI was able to detect knee abnormalities unseen on MRI alone and simultaneously assessed metabolic and structural markers of knee OA across multiple tissues in the joint. Thus, it is a promising tool for detection of early metabolic changes in OA.

Mesotherapy using Vitamin C and platelet-rich plasma as an antiinflammatory agent in persistent gingival inflammation: A pilot study

Introduction: In mesotherapy, the recipient receives minor dosages of biologically active substances in an area of pathology, which are delivered into the skin through local intradermal therapy (LIT). In addition to its anti-inflammatory properties, Vitamin C and platelet-rich plasma (PRP) can improve tissue repair and reduce inflammation. Aim: This study examined whether local injections of Vitamin C and PRP could be used to treat persistent gingival inflammation. Materials and Methods: Following Phase I therapy, 15 patients with chronic persistent gingival inflammation underwent PRP and Vitamin C injections, respectively, into the gingiva. Each patient underwent a weekly evaluation to see if the inflammation had subsided. Results: During recall visits, the inflammation of the injected sites showed a significant improvement in postclinical pictures. Conclusions: LIT with Vitamin C and PRP has a synergistic interaction along with scaling and root planing in the treatment of persistent gingival inflammation.

Inspection of plant pathologies through pseudocolored images based on polarimetric basis

The study of the interaction of biological tissue with polarized light leads to relevant information of physical properties (dichroism, retardance and depolarization) of samples. Polarimetric analysis of different characteristics in tissues is useful for applications such us tissue classification, contrast enhancement or pathology detection. By means of polarimetric imaging techniques we can characterize the polarimetric signature of biological samples in a noninvasive and nondestructive way. We have found that depolarization information is of special interest in turbid media such as plant tissue. In this manuscript we use polarimetric observables for plant inspection. In particular, we provide enhanced visualization of certain plant pathologies by constructing depolarization based pseudocolored images of pathological leaves where the pathological areas are revealed.

EAL/D or an additional need? A cycle of learning, teaching and assessment to discern if an EAL/D student has additional needs to learning English

Classroom teachers concerned with the academic or literacy progress of their English as an Additional Language/ Dialect (EAL/D) learners may ask the question: Does my EAL/D learner have additional needs to learning English? As young EAL/D learners are still in the process of learning English as well as developing their home language/s, deciding whether a student has a learning difficulty additional to English language learning needs can be difficult. A search of available information about assessment and identification of EAL/D learners with additional needs reveals information from a variety of sources and educational jurisdictions. These include EAL/D specialists and researchers as well as from the areas of Speech Pathology and Psychology. Approaches to assessment and identification vary with the different fields of expertise offering different perspectives. This has led to a tension in schools with teachers wanting a quick definitive answer to whether a student has an additional need to learning English and what must be done to remedy the situation. This report describes a cycle of teaching learning and assessment that offers a response to this dilemma. It involves planning for language growth, rather than for a deficit, and monitoring the everyday teaching and learning of the classroom for the learner in question before referring onto another professional.

Intravascular Large B-Cell Lymphoma (IVLBCL) Presenting with CNS Involvement in Patient with Chronic Lymphocytic Leukemia

Background: Intravascular lymphoma (IVL) is a rare, often fatal disease characterized by intraluminal proliferation of lymphoid cells within blood vessels. Intravascular Large B-Cell Lymphoma (IVLBCL) is frequently found in different organs, but the skin and central nervous system (CNS) are the most affected ones. Routine radiological examination and additional diagnostic tools, such as high-resolution, three-dimensional (3D) FLAIR sequence, T2-weighted (T2W) and T1-weighted (T1W) contrast-enhanced magnetic resonance imaging (MRI), MRI diffusion and perfusion imaging studies are useful to confirm the diagnosis in cases where it is not easy to perform histopathological examinations [1]. 1.2. Case Report: We present a clinical case of a 63-year-old female patient who presented with progressive cognitive deficit as mild motor aphasia, acalculia, agraphia, dyslexia and mild ideomotor apraxia without any signs of other organ involvement. It was known that the patient had 5-year anamnesis of chronic lymphocytic leukemia, stage II and splanchnic venous thrombosis 2 months ago. Blood biochemical analysis without any significant change, except leukocytosis in full blood count (leukocytes 15,2 x 10*9/L, where neutrophils were in normal range, but lymphocytes were increased). Head magnetic resonance imaging (MRI) showed pathological signal areas on the left parietal lobe with hypointense signal on contrast-enhanced T1-weighted, hyperintense signal on contrast-enhanced T2-weighted and FLAIR-weighted MRI images with restricted diffusion and slightly lower ADC value. Magnetic resonance perfusion imaging studies did not show an increase in cerebral blood flow or in cerebral blood volume. In this case, the patient’s diagnosis was made based on typical radiological features. 1.3. Conclusions: Intravascular large B-cell lymphoma is a rare subtype of extra nodal large B-cell lymphoma with an aggressive clinical course. The diagnosis is challenging, as it presents without any obvious tumour mass or lymphadenopathy. [2] As the clinical presentation is variable without specific characteristics, mostly biopsy or even autopsy confirms the definite diagnosis. But in some cases, the diagnosis can be made by typical radiological findings in the restricted availability of brain biopsy.

A STUDY OF CONVENTIONAL SEPTOPLASTY VERSUS ENDOSCOPIC SEPTOPLASTY

Introduction:Adeviated septum can be asymptomatic or can cause functional and cosmetic abnormalities. Different studies have been proposed for the correction of deviated septum, but septoplasty has been the treatment of choice. Septoplasty is a more conservative surgery and endoscopic septoplasty has become increasingly popular over the past few decades. Materials and Methods: The study was carried out to compare the postoperative results among patients of conventional and endoscopic septoplasty and to assess the efcacy of endoscopic septoplasty with other surgeries. The present study was conducted among 40 patients of deviated nasal septum admitted in the Department of Otolaryngology of Patna Medical College & Hospital , Patna for 12 months. Patients were selected by simple random sampling and were divided into Groups Aand B, with 20 patients in each group. Group A underwent conventional septoplasty and Group B underwent endoscopic septoplasty. Results: The male-tofemale ratio in the present study was 3:1. Deviated nasal septum was commonly associated with inferior turbinate hypertrophy (44%) and concha bullosa (28%). Postoperatively, a signicant relief from the symptoms of nasal obstruction (80%), nasal discharge (30%), headache (30%), and postnasal drip (55%) was observed in endoscopic septoplasty. Complication rate was higher in conventional septoplasty. The endoscopic approach facilitates proper alignment by limited and precise resection of pathological areas. Conclusion: Endoscopic septoplasty provides precise resection of the pathological areas and better illumination with limited ap dissection and exposure.

Immunohistochemical expression of CD8, CTLA4, and PD-L1 in NSCLC of smokers versus non smokers and its effect on prognosis

ABSTRACT Background Identifying hig- risk non-small cell lung cancer (NSCLC) patients is the most contentious area in lung pathology for reducing cancer-related morbidity and mortality. Aim of the work Was to investigate the immunohistochemical expression of CD8, CTLA4, and PD-L1 among different NSCLC histopathological variants and it’s correlation with different clinicopathological variables. Material and Methods Expression of CD8, CTLA4, & PD-L1 was evaluated immunohistochemically in 45 NSCLC cases. Results Higher expression of CD8 tumor infiltrating lymphocytes (TILs) was significantly associated with better progression-free survival (PFS). The expression of CTLA4&PD-L1 on tumor cells was significantly associated with lower PFS. However, smoking status of the studied cases showed no statistically significant correlation with expression of any of the studied immunohistochemical markers. Conclusions Immunostaining for CD8, CTLA4, and PD-L1 could have a major role in the anticipation of PFS of NSCLC cases regardless of their smoking status.

Posterior Segment Optical Coherence Tomography in Uncooperative Paediatric Patients Using Exo-Illumination and Microscope-Integrated Optical Coherence Tomography.

To describe a non-invasive technique for the acquisition of retinal optical coherence tomography (OCT) scans in paediatric patients undergoing examination under general anaesthesia (EUA) using microscope-integrated OCT (MIOCT). Prospective observational study Methods and Material: The study included 10 paediatric patients undergoing EUA for posterior segment pathology. These patients underwent OCT using MIOCT. No sclerotomy was made during imaging. The fundus was externally illuminated with a 25 gauge endoilluminator probe placed at the limbus and directed towards the posterior pole to aid in image acquisition by MIOCT (exo-illumination). Imaging for all patients was done by two trained vitreoretinal surgeons independently. Acquisition time was recorded for each surgeon. Interobserver variability in acquisition time and image quality was assessed to estimate the reliability of the novel imaging technique. In nine cases (90%), MIOCT successfully imaged the posterior segment pathology while in one case (10%) of X-linked retinoschisis, it failed to detect an inner retinal break located anteriorly at the equator. The mean acquisition time for surgeons one and two was 211.75 ± 26.00 and 212.58 ± 23.47 seconds, respectively. There was no significant difference in total image acquisition time between the two surgeons (P = 1.0) and the findings of both surgeons were comparable for structural morphology. 4x4 mm-sized scans provided the best delineation in macular pathology, while a 16x16 mm scan size was best suited for localising the area of interest and post-equatorial pathology. Using this technique acquisition of posterior segment OCT scans can be achieved non-invasively, using exo-illumination and MIOCT in paediatric patients undergoing EUA.

Biokinetic Model Development of 177Lu-labeled Methylene Diphosphonate as a Radiopharmaceutical Treatment

177Lu is a lanthanide radionuclide. In recent years, the possibility of applying a drug based on the 177Lu radionuclide as a palliative treatment for bone metastases has increased. 177Lu has many prospects in terms of its applications in nuclear medicine. The high-energy beta particles and the relatively short half-life of the radionuclide are used to provide an effective treatment. In this work, a comparison of organ and tissue doses is performed with two different drugs: 177Lu in an ionic radionuclide form and 177Lu labeled methylene diphosphonate (177Lu-MDP). 177Lu in an ionic form actively accumulates in the liver and bones. Phosphonate compounds form stable radio-labeled complexes. This suggests that 177Lu-MDP is a non-dissociated form of the drug. The distribution and elimination of the drug occur according to the kinetics of the carrier, i.e., methylene diphosphonate. It is shown that the use of an osteotropic complex (describing any drug that is attracted to and targets bone) allows for the concentration of a large dose in pathological areas and minimizes damage to healthy organs and tissues.