Pathological Picture Research Articles

Osteogenesis Imperfecta : A Case Report

ABSTRACT Background: Osteogenesis imperfecta (OI) comprises a heterogeneous group of diseases characterized by susceptibility to bone fractures with variable severity and, in most cases, with presumed or proven defects in collagen type I biosynthesis and an estimated prevalence of 1/15,000 births. Management is multidisciplinary involving mainly surgery, physiotherapy, and rehabilitation Case Presentation: A young woman the age of 19 years old came to the Endocrine Polyclinic of H. Adam Malik Hospital, with a complaint of a fracture of the arm and left thigh for 4 years due to a slip. Since a small age, there was difficulty walking due to the twisted bones of the limbs, and surgery was performed. The conclusion of X-ray of right and left femur bones according to the description of osteogenesis imperfecta accompanied by a picture of fracture and osteomalasia and the conclusion of the whole body scan: pathological picture in the bones can be caused by osteogenesis imperfecta. Conclusion: A young woman the age of 19 years old has been reported may have OI type 1, management is multidisciplinary involving mainly surgery, physiotherapy, and rehabilitation.

Cyclic GAN Model to Classify Breast Cancer Data for Pathological Healthcare Task.

An algorithm framework based on CycleGAN and an upgraded dual-path network (DPN) is suggested to address the difficulties of uneven staining in pathological pictures and difficulty of discriminating benign from malignant cells. CycleGAN is used for color normalization in pathological pictures to tackle the problem of uneven staining. However, the resultant detection model is ineffective. By overlapping the images, the DPN uses the addition of small convolution, deconvolution, and attention mechanisms to enhance the model's ability to classify the texture features of pathological images on the BreaKHis dataset. The parameters that are taken into consideration for measuring the accuracy of the proposed model are false-positive rate, false-negative rate, recall, precision, and F1 score. Several experiments are carried out over the selected parameters, such as making comparisons between benign and malignant classification accuracy under different normalization methods, comparison of accuracy of image level and patient level using different CNN models, correlating the correctness of DPN68-A network with different deep learning models and other classification algorithms at all magnifications. The results thus obtained have proved that the proposed model DPN68-A network can effectively classify the benign and malignant breast cancer pathological images at various magnifications. The proposed model also is able to better assist the pathologists in diagnosing the patients by synthesizing the images of different magnifications in the clinical stage.

Speculation on the pathophysiology of musculoskeletal injury with COVID-19 infection.

Coronavirus disease 2019 (COVID-19) primarily affects the respiratory tract, but also many other organs and tissues, leading to different pathological pictures, such as those of the musculoskeletal tissues. The present study should be considered as a speculation on the relationship between COVID-19 infection and some frequent musculoskeletal pathologies, in particular sarcopenia, bone loss/osteoporosis (OP) and fracture risk and osteoarthritis (OA), to hypothesize how the virus acts on these pathologies and consequently on the tissue regeneration/healing potential. The study focuses in particular on the modalities of interaction of COVID-19 with Angiotensin-Converting Enzyme 2 (ACE2) and on the “cytokine storm.” Knowing the effects of COVID-19 on musculoskeletal tissues could be important also to understand if tissue regenerative/reparative capacity is compromised, especially in elderly and frail patients. We speculate that ACE2 and serine proteases together with an intense inflammation, immobilization and malnutrition could be the responsible for muscle weakness, altered bone remodeling, increase in bone fracture risk and inflammatory joint pathologies. Future preclinical and clinical studies may focus on the regenerative/reparative properties of the musculoskeletal tissues after COVID-19 infection, toward a personalized treatment usually based on scaffolds, cells, and growth factors.

Bilateral Radicular Cyst – A Rare Case Presentation

Radicular cyst usually originates as a sequel to a periapical inflammatory process following an injury. This report presents a case of radicular cyst with “bilateral involvement” of permanent central incisors with an atypicalradiographical finding and pathological picture that has been discussed. An extensive review of radicular cyst with rarity as seen in the present case was studied. Further importance on treatment with a long term following up of the patient was noted. A sound knowledge regarding the rarity of this lesion is necessary to aid in early diagnosis with an appropriate treatment plan for general practitioners.

Innate Lymphoid Cells - Neglected Players in Multiple Sclerosis.

Multiple sclerosis (MS) is a highly debilitating autoimmune disease affecting millions of individuals worldwide. Although classically viewed as T-cell mediated disease, the role of innate lymphoid cells (ILC) such as natural killer (NK) cells and ILC 1-3s has become a focal point as several findings implicate them in the disease pathology. The role of ILCs in MS is still not completely understood as controversial findings have been reported assigning them either a protective or disease-accelerating role. Recent findings in experimental autoimmune encephalomyelitis (EAE) suggest that ILCs infiltrate the central nervous system (CNS), mediate inflammation, and have a disease exacerbating role by influencing the recruitment of autoreactive T-cells. Elucidating the detailed role of ILCs and altered signaling pathways in MS is essential for a more complete picture of the disease pathology and novel therapeutic targets. We here review the current knowledge about ILCs in the development and progression of MS and preclinical models of MS and discuss their potential for therapeutic applications.

Eugenia pyriformis ('uvaia') intoxication of sheep / Intoxicação por Eugenia pyriformis ('uvaia') em ovinos

This study describes the clinical and pathological picture of a disease followed by death in sheep raised for subsistence, characterized by difficulty in locomotion, sternal decubitus, severe dyspnea, opisthotonos, and pedaling movements, followed by death. The disease occurred in February 2020 in the northern state of Rio Grande do Sul, Brazil, due to the consumption of the fruits of Eugenia pyriformis ('uvaia'). All sheep that became ill later died, resulting in morbidity of 68.75% and mortality of 100%. An autopsy revealed the presence of E. pyriformis fruits with or without seeds in the rumen, in addition to the diet provided to the animals. The main histological findings consisted of edema and perivascular cuffs in the frontal telencephalon, nephrosis and glomerular necrosis, in addition to glomerulosclerosis. One sheep had heightened urea and creatinine and lower levels of non-protein thiols. Deaths ceased once animals were prevented from accessing E. pyriformis. These findings confirm that this plant was responsible for the deaths of the animals and point to the possibility of E. pyriformis having neurotoxic and nephrotoxic action on sheep.

Complications after Thermal Ablation of Hepatocellular Carcinoma and Liver Metastases: Imaging Findings.

Tumour ablation is a strategy of treatment of hepatic tumours in patients with small hepatocellular carcinoma (HCC) (<3 cm) or in patients unfit for surgical resection. Moreover, tumor ablation can be used as an adjuvant therapy or may be used in association with resection in case of patients with poor functional liver disease. These types of treatment usually could be performed percutaneously under image guidance. The most clinically verified and used ablation modalities are Radiofrequency Ablation (RFA) and microwave ablation (MWA). However, despite both of them are considered minimally invasive techniques, they could be related to post-procedural complications. The International Working Group on Image-Guided Tumor and the Society of Interventional Radiology (SIR) identified major and minor post-ablative complications. Major complications, as vascular complications, occur in 2.2% to 3.1% of cases and include all the high risk pathological conditions which could increase the level of care or result in hospital admission or substantially prolonged hospital stay (SIR classifications C–E). Minor complications, as biliary complications, occur in 5% to 8.9% and include self-limiting conditions that are considered to be of low risk for the patient’s outcome. The purpose of this review is to summarise the main pathological ultrasound (US) and Computed Tomography (CT) findings, that may arise after ablative treatment. To simplify the analysis, the pathological pictures are divided according to the site of damage into vascular, biliary and extrahepatic complications.

Defining diagnostic trajectories in patients with podocytopathies.

Podocytopathies are glomerular disorders in which podocyte injury drives proteinuria and progressive kidney disease. They encompass a broad spectrum of aetiologies, resulting in pathological pictures of minimal-changes, focal segmental glomerulosclerosis, diffuse mesangial sclerosis or collapsing glomerulopathy. Despite improvement in classifying podocytopathies as a distinct group of disorders, the histological definition fails to capture the relevant biological heterogeneity underlying each case, manifesting as extensive variability in disease progression and response to therapies. Increasing evidence suggests that podocytopathies can result from a single causative factor or a combination of multiple genetic and/or environmental risk factors with different relative contributions, identifying complex physiopathological mechanisms. Consequently, the diagnosis can still be challenging. In recent years, significant advances in genetic, microscopy and biological techniques revolutionized our understanding of the molecular mechanisms underlying podocytopathies, pushing nephrologists to integrate innovative information with more conventional data obtained from kidney biopsy in the diagnostic workflow. In this review, we will summarize current approaches in the diagnosis of podocytopathies, focusing on strategies aimed at elucidating the aetiology underlying the histological picture. We will provide several examples of an integrative view of traditional concepts and new data in patients with suspected podocytopathies, along with a perspective on how a reclassification could help to improve not only diagnostic pathways and therapeutic strategies, but also the management of disease recurrence after kidney transplantation. In the future, the advantages of precision medicine will probably allow diagnostic trajectories to be increasingly focused, maximizing therapeutic results and long-term prognosis.

MO426: Elucidation of Mechanism of Low-Birth-Weight-Related Fsgs in Rats by Rna-Seq Analysis of Cultured Podocytes From Low-Birth-Weight Rats

Abstract BACKGROUND AND AIMS The pathogenesis of low-birth-weight (LBW)-related nephropathy has been considered to be the result of intra-glomerular hyperfiltration during growth due to the presence of low nephron numbers. On the other hand, we hypothesized that there may be pathogenic factor(s) other than low nephron number in LBW individuals [1]. We reported the results of proteomic analysis of the renal cortex of LBW rats to show that metabolic abnormalities should exist in the kidneys of LBW individuals [2]. However, our result of the previous study was obtained by analysis using the renal cortex, which did not allow us to interpret the mechanism of focal segmental glomerulosclerosis (FSGS) formation, the most typical pathological picture of LBW-related nephropathy. METHOD A total of 5 LBW rats (birth weight 4.38±0.08) were obtained by 55% caloric restriction to pregnant maternal rats. The normal-birth-weight (NBW) rats (birth weight 6.48±0.18) were obtained by feeding normal diets to pregnant maternal rats. Kidneys were removed at 4 weeks of age, and after isolation of the glomeruli by sieving of kidneys, primary culture of glomerular epithelial cells (podocytes) was performed. Then, mRNAs were extracted from the cultured podocytes after 7 days and RNA-seq analysis was performed using these mRNAs from LBW podocytes and NBW podocytes. RESULTS Gene expression of Nphs1 (nephrin), Nphs2 (podocin) Podxl (podocalyxin) was detected in all samples of both groups, confirming that podocytes were cultured. The number of transcripts detected was 17 967 genes. In addition, by comparison of mRNA expression levels between LBW podocytes and NBW podocytes, 107 genes (102 genes decreased in the LBW group and 5 genes increased in the LBW group) showed a False Discovery Rate (FDR) P -value (q-value) &amp;lt; 0.05 between the two groups. Furthermore, IPA (Ingenuity® Pathway Analysis) by using these 107 genes was performed. As a result, five candidates for the upstream master regulator were identified: TNF, SIRT1, SH2B1, C5 and GDF15 as shown in the Figure. The downstream of all these pathways contain TCS2. This gene has been implicated in FSGS formation, as we recently reported [3]. CONCLUSION It is possible that TCS2 is involved in the mechanism of FSGS formation in LBW-related nephropathy.

Comparison and aggregation of event sequences across ten cohorts to describe the consensus biomarker evolution in Alzheimer\u2019s disease

BackgroundPrevious models of Alzheimer’s disease (AD) progression were primarily hypothetical or based on data originating from single cohort studies. However, cohort datasets are subject to specific inclusion and exclusion criteria that influence the signals observed in their collected data. Furthermore, each study measures only a subset of AD-relevant variables. To gain a comprehensive understanding of AD progression, the heterogeneity and robustness of estimated progression patterns must be understood, and complementary information contained in cohort datasets be leveraged.MethodsWe compared ten event-based models that we fit to ten independent AD cohort datasets. Additionally, we designed and applied a novel rank aggregation algorithm that combines partially overlapping, individual event sequences into a meta-sequence containing the complementary information from each cohort.ResultsWe observed overall consistency across the ten event-based model sequences (average pairwise Kendall’s tau correlation coefficient of 0.69 ± 0.28), despite variance in the positioning of mainly imaging variables. The changes described in the aggregated meta-sequence are broadly consistent with the current understanding of AD progression, starting with cerebrospinal fluid amyloid beta, followed by tauopathy, memory impairment, FDG-PET, and ultimately brain deterioration and impairment of visual memory.ConclusionOverall, the event-based models demonstrated similar and robust disease cascades across independent AD cohorts. Aggregation of data-driven results can combine complementary strengths and information of patient-level datasets. Accordingly, the derived meta-sequence draws a more complete picture of AD pathology compared to models relying on single cohorts.

Role of magnetic resonance imaging in the pre‐surgical planning of perianal hidradenitis suppurativa, complicated by anal fistulae: A case report and review of the literature

Hidradenitis Suppurativa (HS) is a chronic inflammatory disease of the skin starting from the apocrine glands and mainly involving the axilla, perineum and perianal area. It is clinically defined by the onset of painful subcutaneous nodularities, associated with signs of local inflammation, whose progression proceeds towards the definition of true subcutaneous abscess collections from which fistulous pathways branch off. These lesions result in severe fibro-cicatricial deformities. The diagnosis of HS, which is basically clinical, is followed, due to the recurrent/relapsed nature of the disease, by a difficult therapeutic management, which makes use of different treatments depending on the severity of the pathological picture, ranging from topical or systemic medical therapy to surgical excision. Imaging examinations, although not specific enough in the diagnosis of HS, are essential to define the loco-regional extension of the disease and to exclude possible alternative diagnoses. In particular, MRI plays a key role in the study of HS with anogenital localization, both for the recognition of lesions in the active phase and for the assessment of the local extension of the disease, in particular in adequately demonstrating the entire course of the fistulas and the relationships with the neighboring anatomical structures. This allows the optimization of its treatment, in order to reduce disease recurrence. The case presented by us describes the MRI characteristics in a rare case of HS, complicated by anal fistulae.

Dr. Fig. Progressive paralysis and syphilis. Progressive Paralyse und Syphilis Correspondenzblatt f. Schweizer Aerszte, 1907

The question of the relationship of progressive paralysis to syphilis has not yet been resolved. The author asks the question: is there a histological difference between the pathological picture of syphilis and progressive paralysis? It follows from his research that progressive paralysis is a disease sui generis. The histological picture of the cerebral cortex is typical. This is a special form of cerebral syphilis. Painful process - chronic inflammation - degeneration of blood vessels stands out especially sharply.

Testicular biopsies in infertility and correlation with clinical and laboratory features

Background: With advances in assisted reproductive techniques management of infertility is changing at a very fast pace. Although minimally invasive techniques such as testicular sperm aspiration and micro-dissection testicular sperm extraction (microTESE) are gaining increased acceptance due to their minimally invasive nature the importance of testicular biopsy can not be overemphasized. Testicular biopsy provides a more accurate picture of testicular pathology and helps in identifying conditions such as hypospermatogenesis, which may not be evident on microTESE. Aims and Objectives: The aim of the study was to study the histopathology of testicular tissue in infertile males and to correlate the histopathologic findings with clinical features and relevant laboratory findings. Materials and Methods: Seventy patients with male infertility who had undergone testicular biopsies were included in this study on the basis of a predefined inclusion and exclusion criteria. The study was conducted in the department of general pathology, Christian medical college Vellore. Demographic details and history were recorded in all patients. Hormonal profile, Histopathological analysis was done in all the cases. Chromosomal analysis and Y chromosomal microdeletion studies were done in selected cases. Results: Among the 70 patients evaluated, semen analysis revealed azoospermia in all but four cases. The most commonly affected age group was found to be between 31 and 35 years (44.29%). The mean age of the patients was found to be 33.71±5.56 years. Only 37.14% of our patients had normal testicular volumes and 66 (94.29%) patients had azoospermia. The majority of the patients (64.29 %) had high FSH values (&gt;11 mIU/ml). On histopathological examination, the basement membrane was thickened (more than 0.40 microns) in 26 cases (37.14 %). On analysis of seminiferous tubules, maturation arrest was the most common abnormality (40%) followed by Sertoli cells only (30%) and hypospermatogenesis (15.71%). Maturation arrest was most commonly seen at the stage of primary spermatocyte (22.86%). Karyotyping was done only in 24 selected cases. Out of 24 patients, 23 patients had normal chromosomal numbers (95.83%) whereas one patient had a missing Y chromosome (4.17%). Y chromosome microdeletion studies showed abnormalities in three patients consisting of AZFa,b,c in two patients (8.33%) and AZFb deletion in 1 (4.77%) patient. Conclusion: Testicular biopsy is an important investigation in patients with male factor infertility. It not only does help in accurate diagnosis but also can help in sperm extraction for usage in in vitro fertilization and intracytoplasmic sperm injection.

Early Detection of Medical Image Analysis by Using Machine Learning Method.

We develop effective medical image classification techniques, with an emphasis on histopathology and magnetic resonance imaging (MRI). The trainer utilized the curriculum as a starting point for a set of data and a restricted number of samples, and we used it as a starting point for a set of data. As calibrating a machine learning model is difficult, we used alternative methods as unsupervised feature extracts or weight-conditioning factors for identifying pathological histology pictures. As a result, the pretrained models will be trained on 3-channel RGB pictures, while the MRI sample has more slices. To alter the working model using the MRI data, the convolutional neural network (CNN) must be fine-tuned. Pretrained models are placed and then used as feature snippets. However, there is a scarcity of well-done medical photos, making training machine learning models a difficult endeavor to begin with. In any case, data augmentation aids in the generation of sufficient training samples; however, it is unclear if data augmentation aids in the prediction of unknown data samples. As a result, we fine-tuned machine learning models without using any additional data. Furthermore, rather than utilizing a standard machine learning classifier for the MRI data, we created a unique CNN that uses both 3D shear descriptors and deep features as input. This custom network identifies the MRI sample after processing our representation of the characteristics from beginning to end. On the hidden MRI dataset, our bespoke CNN outperforms traditional machine learning. Our CNN model is less prone to overfitting as a result of this. Furthermore, we have given cutting-edge outcomes employing machine learning.

Investigating ways of detecting and handling findings indicating prior septicaemia in bovines

The European Union legislation prescribes that generalised cases of septicaemia must be condemned at meat inspection. In Denmark, bovine carcasses with lesions indicating septicaemia are subjected to an additional investigation to elucidate whether findings reflect a generalised or local condition. Local cases can be subjected to an officially guided, complete deboning. To investigate whether the pyaemia investigation suffices, a study was undertaken. The retrospective part included 703 bovine carcasses subjected to deboning, corresponding to 0.16% of the bovines slaughtered. Around 70% were cows and 30% young bulls. The findings detected during post-mortem inspection and the pyaemia investigation revealed different pathological pictures, mainly centred around the codes for osteomyelitis and pyaemia. All carcasses were approved after deboning. The prospective part included 146 carcasses, which were all approved after deboning. Most findings were detected during ordinary inspection and the pyaemia investigation. The few additional findings resulting from the deboning occurred at random and at a low prevalence. This suggests that the pyaemia investigation performed lege artis is sufficient, and the few remaining findings – mainly in the form of abscesses - will be detected and handled during ordinary cutting in the same way as other abscesses are dealt with by the abattoir.

Landry's rabies and paralysis

In recent years, more and more generalizations have begun to be made between clinically different diseases caused by filterable and ultramicroscopic viruses. Such Schiikrin Spatz point to the similarity of the pathological and anatomical picture between rabies and acute epidemic encephalitis, which is so great that without knowledge of the anamnesis and clinical course, it is impossible to know which disease is in question.

Corticosteroids in the prevention and treatment of infants with bronchopulmonary dysplasia: Part I. systemic corticosteroids.

Bronchopulmonary dysplasia (BPD) is the most significant respiratory complication of prematurity, and its consequences last from birth into adulthood. Unfortunately, the dramatic improvements in the management of premature infants have not led to a decreased incidence of BPD, or to breakthroughs in treatments offered for this long-lasting chronic respiratory disorder. Over recent decades the pathological picture of BPD has changed from inflammation, interstitial fibrosis and emphysema attributed to volu-, barotrauma and oxygen toxicity to larger, simplified alveoli and dysmorphic vessels related to arrested alveolarization and vasculogenesis with inflammation maintaining a central role. Corticosteroids (CSs) play a key role in the development of respiratory epithelial cells and lung maturation. These potent anti-inflammatory agents have long been used for the prevention and treatment of BPD; however, the risk/benefit ratio of their use remains unresolved. CSs administered antenatally have contributed to reduce mortality and respiratory distress syndrome, no such effect on BPD reduction has been observed. Postnatal systemic CSs reduced the rate and severity of BPD, yet their long-term neurodevelopmental and respiratory consequences markedly limit routine administration. This is the first in a two-part State-of-the-Art series that reviews the latest relevant clinical trials investigating the short-term and long-term effects of CSs in the prevention and treatment of BPD.

Segmentation of Cervical Cancer by OLHT Based DT-CWT Techniques

Every year, cervical cancer (CC) is the leading cause of death in women around the world. If detected early enough, this cancer can be treated, and patients will receive adequate care. This study introduces a novel ultrasound-based method for detecting CC. The Oriented Local Histogram Technique (OLHT) is used to improve the image corners in the cervical image (CI), and the Dual-Tree Complex Wavelet Transform (DT-CWT) is used to build a multi-resolution image (CI). Wavelet, and Local Binary Pattern are among the elements retrieved from this improved multi-resolution CI (LBP). The retrieved appearance is trained and tested using a feed-forward propagation neural network, and the ANFIS classifier is utilized to classify them. The purpose of this classifier is to distinguish between normal and pathological cervical pictures. Sensitivity is 97.52 percent, specificity is 99.46 percent, accuracy is 98.39 percent, precision is 97.48 percent, PPV is 97.38 percent, NPV is 92.27 percent, LRP is 141.81 percent, 0.0946 percent LRN, FPR is 96.82 percent, and NPR is 91.46 percent for the CC detection categorization. The proposed methodology outperforms standard CC identification and classification methodologies.

Клинико-лабораторные проявления и патологоанатомическая картина тяжелого течения новой коронавирусной инфекции (COVID-19) с летальным исходом

Клинико-лабораторные проявления и патологоанатомическая картина тяжелого течения новой коронавирусной инфекции (COVID-19) с летальным исходом

Epidemiological Overview HIV-AIDS in the Microregion of Varginha (MG)

Since the emergence of the Human Immunodeficiency Virus (HIV), with the consequent development of the Acquired Immunodeficiency Syndrome (AIDS) in the 1980s, the identification of the infection has been a milestone for science and is considered a public health problem. Currently, about 38 million people live with HIV/AIDS in the world, of which 920,000 of these people are in Brazil, in the micro-region of Varginha (Varginha, Três Corações, Três Pontas, Campos Gerais, Boa Esperança, Elói Mendes , Campanha, Guapé, Ilicínea, Carmo da Cachoeira, Campo do Meio, Coqueiral, Monsenhor Paulo, Santana da Vargem, São Thomé das Letras and São Bento Abade), with an estimated population of 478 thousand inhabitants, between 2010 and 2020, 510 people were diagnosed with HIV and 533 people living with AIDS. In this way, the present article aimed to carry out a survey of epidemiological data on HIV/AIDS in the last 10 years, on platforms made available by the Government, and to relate it to the variables of sex and age, where it was possible to observe a masculinization of cases, with higher prevalence in the age group of 30 to 39 years in the general population. The importance of understanding the infection at its beginning is essential for diagnosis, since it allows alternative therapeutic decisions to be made, avoiding exacerbated viral replication, mitigating the AIDS pathology picture and its subsequent systemic damage to the body, which promotes greater expenses for the patient's public agencies. Therefore, the epidemiological study of HIV/AIDS is of great importance, as it can assist in the development of effective programs to control the infection by governments, in addition to contributing to the control and awareness of vulnerable populations, bringing benefits to public health in the region.