Tissue Reaction Research Articles

Safety and tissue remodeling assay of small intestinal submucosa meshes using a modified porcine surgical hernia model

In studies to date, meshes based on extracellular matrix (ECM) have been extensively used in clinical applications. Unfortunately, little is known about the function of the immunogenic residual, absorbable profile during the tissue repair process. Moreover, there needs to be a recognized preclinical animal model to investigate the safety and efficacy of extracellular matrix meshes. Herein, we designed and fabricated a kind of SIS mesh followed by a scanned electron micrograph characterization and tested α-Gal antigen clearance rate and DNA residual. In order to prove the biocompatibility of the SIS mesh, cell viability, chemotaxis assay and local tissue reaction were assessed by MTT and RTCA cytotoxicity test in vitro as well as implantation and degradation experiments in vivo. Furthermore, we developed a stable preclinical animal model in the porcine ventral hernia repair investigation, which using laparoscopic plus open hybridization method to evaluate tissue adhesion, explant mechanical performance, and histologic analysis after mesh implantation. More importantly, we established a semi-quantitative scoring system to examine the ECM degradation, tissue remodeling and regeneration in the modified porcine surgical hernia model for the first time. Our results highlight the application prospect of the improved porcine ventral hernia model for the safety and efficacy investigation of hernia repair meshes.

Effects of Parallel Contact Cooling on Pulsed-Type, Bipolar Radiofrequency-Induced Tissue Reactions in an in vivo Porcine Model.

Skin cooling during laser or radiofrequency (RF) treatments is a method to minimize thermal damage to the epidermis, reduce pain, and decrease post-treatment downtime. We evaluated the effect of parallel contact cooling (PCC) on RF-induced thermal reactions in minipig skin in vivo after bipolar microneedling RF treatment. RF treatments were administered at frequencies of 0.5, 1, and 2 MHz with single (500 ms), six (1000 ms), and ten (5000 ms) sub-pulse packs to minipig skin with or without PCC. Subsequently, thermometric imaging and histology were used to analyze skin reactions to RF. Thermometric images showed that PCC promptly lowered skin temperature in the RF-treated area, with this effect persisting for over 60s. Regardless of the PCC, RF treatments lasting for 500 ms with a single pulse pack resulted in peri-electrode coagulative necrosis (PECN) zones and inter-electrode non-necrotic thermal reaction (IENT) zones in the dermis. In contrast, treatment lasting 5000 ms with 10 sub-pulse packs produced distinct IENT without notable PECN over a wide dermal area. Skin specimens obtained at 1 h and 3, 7, and 14 days after PCC-assisted RF treatments showed a higher degree of thermal tissue reactions in the deeper dermal regions compared to those after RF treatments without PCC. PCC-assisted RF treatment, utilizing an invasive bipolar microneedling device, enhanced RF-induced skin reactions in the mid to deep dermis while preserving the epidermis and upper papillary dermis from excessive thermal tissue injury.

Alpha-synuclein expression in GnRH neurons of young and old bovine hypothalami.

Context Understanding of central nervous system mechanisms related to age-related infertility remains limited. Fibril α-synuclein, distinct from its monomer form, is implicated in age-related diseases and propagates among neurons akin to prions. Aims We compared α-synuclein expression in gonadotropin-releasing hormone-expressing neurons (GnRH neurons) in the pre-optic area, arcuate nucleus, and median eminence of healthy heifers and aged cows to determine its role in age-related infertility. Methods We analysed mRNA and protein expression, along with fluorescent immunohistochemistry for GnRH and α-synuclein, followed by Congo red staining to detect amyloid deposits, and confocal microscopy. Key results Both mRNA and protein expressions of α-synuclein were confirmed by reverse transcription-polymerase chain reaction (RT-PCR) and western blots in bovine cortex, hippocampus, and anterior and posterior hypothalamus tissues. Significant differences in α-synuclein mRNA expression were observed in the cortex and hippocampus between young and old cows. Western blots showed five bands of α-synuclein, probably reflecting monomer, dimer, and oligomers, in the cortex, hippocampus, hypothalamus tissues, and there were significant differences in some bands between young and old cows. Bright-field and polarised light microscopy did not detect obvious amyloid deposition in aged hypothalami; however, higher-sensitive confocal microscopy unveiled strong positive signal of Congo red and α-synuclein in GnRH neurons in aged hypothalami. Additionally, α-synuclein expression was detected in immortalised GnRH neurons, GT1-7 cells. Conclusion Alpha-synuclein was expressed in GnRH neurons, and some differences were observed between young and old hypothalami. Implications Alpha-synuclein may play an important role in aging-related infertility.

Multiplex PCR Assay for Detection and Identification of Gnomoniopsis idaeicola, the Causal Agent of Blackberry Collapse

Blackberry collapse is an emerging disease in Oregon caused by Gnomoniopsis idaeicola. Symptoms associated with the disease include cane lesions, reduced primocane production, wilting, and plant death. Symptomatic plants are removed to reduce disease spread in the field. Unfortunately, blackberry collapse symptoms can be difficult to differentiate from those of other non-lethal cane diseases. Diagnostic procedures for blackberry collapse currently require several weeks to complete, necessitating development of a species-specific PCR assay to identify G. idaeicola in culture and in planta. The assay targets tef-1α and β -tubulin and includes primers as internal controls for PCR reactions of plant tissue or fungal cultures. This species-specific assay will provide rapid diagnosis of blackberry collapse and aid with epidemiological studies.

Pan-cancer analysis of HS6ST2: associations with prognosis, tumor immunity, and drug resistance.

In this comprehensive study spanning 33 malignancies, we explored the differential expression and prognostic significance of Heparan sulfate 6-O-sulfotransferase 2 (HS6ST2). TIMER2, UALCAN, and GEPIA2 were used for the expression analysis. cBioPortal was used for mutational analysis. CancerSEA, STRING, and DAVID, were employed for the single cell sequencing data analysis, protein-protein interaction network development, and gene enrichment analyses, respectively. GSCAlite and RT-qPCR were used for drug sensitivity and expression validation analysis. HS6ST2 exhibited significant (P < 0.05) overexpression in multiple cancers. Prognostically, elevated HS6ST2 expression was significantly associated with poor overall survival (OS) in patients with cervical squamous cell carcinoma (CESC), kidney chromophobe (KICH), lung adenocarcinoma (LUAD), and stomach adenocarcinoma (STAD), emphasizing its potential as a prognostic indicator in these cancers. Moreover, HS6ST2 expression correlated with pathological stages in CESC, KICH, LUAD, and STAD patients. Exploration of genetic alterations using cBioPortal unveiled distinct mutational landscapes, with low mutation frequencies in CESC, KICH, LUAD, and STAD. Additionally, reduced DNA methylation in CESC, KICH, LUAD, and STAD suggested a potential link between hypomethylation and heightened HS6ST2 expression. Analysis of immune cell infiltration revealed a positive correlation between HS6ST2 expression and the infiltration of CD8+ T and CD4+ T cells in CESC, KICH, LUAD, and STAD, highlighting its involvement in the tumor immunology processes. Single-cell functional states analysis demonstrated associations between HS6ST2 and diverse cellular processes. Moreover, gene enrichment analysis revealed the involvement HS6ST2 in crucial cellular activities. GSCAlite analysis underscored the potential of HS6ST2 as a therapeutic target, showing associations with drug sensitivity. Finally, experimental validation through reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and immunohistochemistry in LUAD tissues confirmed elevated HS6ST2 expression. Overall, this study provides a comprehensive understanding of HS6ST2 in CESC, KICH, LUAD, and STAD, emphasizing its potential as a prognostic biomarker and therapeutic target.

AID in non-Hodgkin B-cell lymphomas: The consequences of on- and off-target activity.

Activation induced cytidine deaminase (AID) is a key element of the adaptive immune system, required for immunoglobulin isotype switching and affinity maturation of B-cells as they undergo the germinal center (GC) reaction in peripheral lymphoid tissue. The inherent DNA damaging activity of this enzyme can also have off-target effects in B-cells, producing lymphomagenic chromosomal translocations that are characteristic features of various classes of non-Hodgkin B-cell lymphoma (B-NHL), and generating oncogenic mutations, so-called aberrant somatic hypermutation (aSHM). Additionally, AID has been found to affect gene expression through demethylation as well as altered interactions between gene regulatory elements. These changes have been most thoroughly studied in B-NHL arising from GC B-cells. Here, we describe the most common classes of GC-derived B-NHL and explore the consequences of on- and off-target AID activity in B and plasma cell neoplasms. The relationships between AID expression, including effects of infection and other exposures/agents, mutagenic activity and lymphoma biology are also discussed.

Absorption of bioactive peptides following collagen hydrolysate intake: a randomized, double-blind crossover study in healthy individuals.

Collagen hydrolysates (CH) in functional foods and supplements are dietary sources of amino acids (AAs) and di-and tripeptides linked to various health benefits. This study aimed to investigate the single-dose bioavailability of skin- and hide-derived CH from fish, porcine and bovine origin with different molecular weights (bovine 2,000 and 5,000 Da). A randomized, double-blind crossover clinical study was performed with healthy volunteers assessing the plasma concentration of free and peptide-bound hydroxyproline (Hyp) as well as selected peptides reported to be abundantly present in collagen. The pharmacokinetic endpoints demonstrated comparable uptake of free Hyp from all CH. A higher amount of total compared to free Hyp indicated the uptake of substantial amounts of Hyp-containing di- or tripeptides. Independently of source and molecular weight, all CH yielded relevant plasma concentrations of the investigated metabolites. Larger studies are needed to estimate an ideal level of selected circulating metabolites needed to trigger distinct physiological reactions in target tissues.

Clinicopathological Study of Mucormycosis in COVID-19: A Cross-sectional Study from a Tertiary Care Centre in North Kerala, India

Introduction: Mucormycosis is an angioinvasive disease associated with high morbidity and mortality caused by fungi of the order Mucorales. The rise in the incidence of mucormycosis, along with the surge of Coronavirus Disease- 2019 (COVID-19), justifies reassessment of associated risk factors and the susceptible population. The present study aims to highlight the specific clinicopathological features and risk factors of mucormycosis in COVID-19 patients. Aim: To investigate the histopathological features, key clinical findings in mucormycosis, and the predisposing factors associated with mucormycosis in post-COVID-19 patients. Materials and Methods: This descriptive cross-sectional study was conducted at the Department of Pathology, Government Medical College, Manjeri, Malappuram, Kerala, India, in the Department of Pathology. It included all histopathologically proven Mucormycosis specimens from confirmed COVID-19 positive and post-COVID-19 cases in this Medical College from January 1, 2021, to December 31, 2021, amounting to a total of 30 cases. The type of tissue reaction, fungal hyphae, angioinvasion, necrosis, and fungal co-infections were assessed. Histopathologic analysis was performed using routine Haematoxylin and Eosin (H&amp;E) slides, followed by special stains such as Periodic Acid Schiff (PAS) and Grocott Methenamine Silver (GMS). Data was collected using a proforma, and the clinical details were obtained from the request form received along with the biopsy specimen and case sheets. Age, gender, site of involvement, and risk factors were assessed and subjected to descriptive tabulation and analysis. Results: The mean age was 49.5 years with a male-to-female ratio of 1.30:1. The major risk factors observed in the present study were Diabetes Mellitus (DM) and steroid therapy, 30 all cases (100%), along with others such as chronic kidney disease 2 cases (6.67%) immune disorders, and renal transplantation 1 case each (3.33%). The most commonly involved site was sinuses 27 cases (90.00%). Multiple sinuses were affected in 22 cases (73.33%), with the ethmoid sinus being the most common site 24 cases (80.00%), followed by the maxillary sinus 21 cases (70.00%). The most common reaction pattern observed was acute inflammation 15 cases (50.00%). Angioinvasion was noticed in 19 cases (63.33%) and necrosis was present in 28 cases (93.33%). Co-infection with fungal pathogens was observed in 8 cases (26.67%), with aspergillus being the most common co-infection in all except one of the eight cases. Fungal hyphae were visible on H&amp;E slides in 28 cases (93.33%), while the remaining cases were identified only through special stains (PAS and GMS). Conclusion: Mucormycosis infection is strongly associated with DM and steroid therapy. A more even distribution between males and females was noted, deviating from the male predominance described in most studies. The histopathological appearance of angioinvasion was less frequent compared to most studies, consistent with previous studies on the Indian population. Higher rates of co-infection and the presence of granulomatous inflammation were observed. Further studies are needed to explore the relationship between host immunity, morphological patterns, and their influence on prognosis.

In Vivo Evaluation of Tissue Biocompatibility of Calcium Silicate-based and Epoxy Resin-based Sealers.

Calcium silicate-based sealers are an alternative to be used into root canal, mainly to their biological properties. However, some biological parameters need to be determined in an in vivo animal research model. So, the aim of the present study was to evaluate in vivo the tissue biocompatibility of a calcium silicate-based sealer (EndoSequence BC Sealer) and an epoxy resin-based sealer (AH-Plus). Polyethylene tubes were filled with freshly mixed sealers and implanted in connective subcutaneous tissue of 25 rats (5/euthanasia day) (Rattus norvegicus albinus). Empty tubes were used as controls and no tubes as sham. Histopathological (hematoxylin eosin) and histochemical (Picrosirius red) examinations were conducted at 3, 7, 15, 30 and 60 days (five rats/day) after the implantation procedure (n=5/group). The type/intensity of inflammation and collagenesis was analyzed statistically with Friedman or Kruskal-Wallis/Dunn tests (P<0.05). The profile of inflammation induced by AH-Plus (Median=2, Range=2-3) was significantly greater than that by Endosequence BC Sealer (Median=1, Range=1-1) during the 15-day experimentation period (P=0.018). After 30 days, both materials produced similar tissue reaction (P>0.05). AH-Plus and Endosequence BC Sealer (Median=2, Range=1-2) induced a high level of fibrosis after 60-day than control (Median=1, Range=1-1) and sham (Median=0, Range=0-0) groups (P<0.001) of fibrosis based in type I collagen increase (P=0.025 and P=0.021, respectively). Tissue necrosis was not observed and the bioceramic sealer showed significant signs of endocytosed (Median=1, Range=1-1) material after 7 days than other groups (Median=0, Range=0-0) (P<0.05). The calcium silicate-based sealer induced tissue repair faster than the epoxy resin-based sealer tested. However, both materials showed adequate biocompatibility and tolerance by subcutaneous tissues, with few differences in inflammatory profiles, formation of granulation tissue, and collagenesis. It may be concluded that calcium silicate-based sealer (EndoSequence BC Sealer) and an epoxy resin-based sealer (AH-Plus) presented suitable biocompatibility.

A Novel Prehydrated Porcine-Derived Acellular Dermal Matrix: A Histological and Clinical Evaluation.

It is well known that soft tissue quality and quantity around dental implants is of paramount importance for later peri-implant health. For this purpose, the clinical and histological outcomes of the peri-implant mucosa, following soft tissue augmentation for soft tissue improvement with a novel prehydrated porcine acellular dermal matrix graft (PPADMG) in conjunction with simultaneous implant placement, were evaluated in this case series. Twenty-two patients were included in the study. They underwent a late implant placement protocol combined with PPADMG for soft tissue augmentation. A punch biopsy was taken at the time of uncovery of the submerged healed implant after a mean of 157 days healing time. Supracrestal soft tissue height (STH) was measured at the time of implant placement and uncovery. All sites showed a clinical increase in STH. The histological structure of the biopsies resembled a similar structure as found in the healthy oral mucosa. No unexpected tissue reactions could be found. Within the limits of this clinical and histological study, it may be concluded that STH improvement with this novel porcine-derived acellular dermal matrix, in combination with simultaneous implant placement, is a viable option to create a peri-implant tissue thickness and stability.

Histopathological Spectrum of Interface Dermatitis in a Tertiary Care Center

Background: Interface dermatitis (ID) is a histomorphological tissue reaction pattern that involves dermoepidermal junction of skin. Varieties of cutaneous lesions fall under primary ID which has to be differentiated from secondary ID. Aim: This study was undertaken to evaluate the histopathological spectrum of ID and compare them in relation to age, sex and anatomical site along with clinicopathological correlation. Material and method: This is a one year prospective cross sectional study done at Department of Pathology of Tribhuvan University Teaching Hospital, which included 69 cases of skin biopsies with histological features of ID. Results: Out of 650 skin biopsies, 69 cases were diagnosed as primary ID. Most common age of presentation was 21-40 years. Male to female ratio was 1:1.5. Lichen planus and variants were the commonest ID (63.8%) with widest anatomical distribution, followed by discoid lupus erythematosus (15.9%) and pityriasis lichenoides chronica (8.7%). The most consistent histopathological findings of IDs were basal layer vacuolation and interface inflammation. Clinicopathological concordance was seen in 79.7% of cases. Conclusion: Distinctive histopathological features of basal layer vacuolation and interface inflammation involving dermoepidermal junction were valuable in arriving at diagnosis of various lesions of interface dermatitis. However, histopathological categorization of ID should be done in a clinical context because of overlapping clinical and histological features and for guiding appropriate therapy.

Dosimetric Correlation of Acute Radiation Dermatitis in Patients With Breast Cancer Undergoing Hypofractionated Proton Beam Therapy Using Pencil Beam Scanning.

Pencil-beam scanning (PBS) is a modern delivery technique used in proton beam therapy (PBT) to reduce normal tissue reactions. No dosimetric correlation between dermatitis and PBS has been reported for breast cancer. The current study aimed to investigate the factors associated with grade 2 or higher dermatitis in patients with breast cancer undergoing PBT using PBS. The medical data of 42 patients with breast cancer who underwent adjuvant radiotherapy between December 2019 and September 2023 were reviewed. All patients received hypofractionated radiotherapy (HFRT), either 26 Gy (relative biological effectiveness [RBE])/five fractions or 40.05 or 43.5 Gy (RBE)/15 fractions, for the whole breast/chest wall with or without nodal irradiation. The duration of acute radiation dermatitis was defined as within 90 days from the start of radiotherapy. The Kaplan-Meier method and Cox proportional hazards model were used for univariate and multivariate analyses of the actuarial rates of grade 2-3 dermatitis. Twenty-two (52.4%) and 20 (47.6%) patients were diagnosed with grade 1 and 2 dermatitis, respectively. Multivariate analysis revealed a clinical target volume (CTV) ≥ of 320 cc (p = 0.035) and a skin dose of D10cc ≥ 38.3 Gy (RBE) (p = 0.009) as independent factors of grade 2 dermatitis. The 10-week cumulative grade 2 dermatitis rates were 88.2%, 39.4%, and 8.3% (p < 0.001) for patients with both high, either high, and neither high CTV and D10cc, respectively. To the best of our knowledge, this is the first study on dosimetric correlations for dermatitis in patients with breast cancer who underwent hypofractionated PBT using PBS. In the era of HFRT, skin dose modulation using PBS may reduce the incidence of dermatitis.

Application experience of bioresorbable implants in correcting the volume of the pleural cavity and their biocompatibility assessment

Objective: To substantiate experimentally the possibility of using bioresorbable biopolymer pleural implants made of polylactide and polycaprolactone (PLA/PCL) to correct the volume of the chest. Materials and methods. Rabbits were used as experimental animals — mature females of the Chinchilla breed, age 1–1.5 years, weight 3500–4300 g. The number of individuals were 5. For studying changes in implants and local tissue reactions in vivo, as close as possible to clinical conditions, the method of intrapleural implantation was used. Bio-resorbable highly porous samples based on polylactide and polycaprolactone (PLA/PCL) with different polymer ratios and porosity degrees were used as implants. The implant and local tissue reactions were evaluated over five implantation periods: 7, 21, 54, 66 and 78 weeks. Results. The study of morphology in implants during a long experiment showed good biocompatibility, which was confirmed by the absence of necrosis in implants and surrounding tissues. In the first and second implantation periods minimal reactive changes were detected in the adjacent soft tissues (lung, pleura, soft tissues of the chest wall), existing as a focal fibrosis of muscle fibers, focal mononuclear infiltration of fibrous tissue. Conclusion: As a result of studying morphological changes in the implant and adjacent tissues of the chest wall, the absence of necrosis and purulent-inflammatory changes both in the implant itself and in the surrounding tissues of the chest wall and lung was confirmed. It has been proven that a highly porous pleural implant based on polylactide and polycaprolactone is a safe and promising material for correcting the volume of the chest, which can be in demand both in general thoracic surgery and for the surgical treatment of patients with advanced pulmonary tuberculosis.

Effect of Loading Frequency on the Fretting-Corrosion Degradation of the Stem-Head and Stem-Cement Interfaces in Hip Implants

Abstract Degradation by fretting-corrosion of the stem-head interface is considered the main source of the release of metal ions and debris, leading to adverse tissue reactions at the cemented total hip arthroplasty. The aim of this study was to investigate the effect of loading frequency on the fretting-corrosion degradation at the stem-head and stem-cement interfaces through electrochemical measurements during the benchtop testing. Different loading frequency conditions were investigated with the same number of cycles (1,000 cycles) to calculate the fretting current and Faraday mass loss. For both interfaces, there was a biphasic waveform response of the fretting current to the load applied, at 1 Hz, almost with phase opposition. An increase in the loading frequency (1 to 30 Hz) generated a higher fretting current for the stem-head (2.97 ± 2.04 μA to 7.66 ± 2.46 μA) and stem-cement (7.62 ± 2.26 μA to 25.48 ± 5.35 μA) interfaces. However, an increase in the loading frequency (1 to 30 Hz) reduced the Faraday mass loss of the stem-head (0.79 ± 0.54 μg to 0.07 ± 0.02 μg) and stem-cement (2.02 ± 0.62 μg to 0.32 ± 0.12 μg) interfaces because of a reduction in the overall testing time. Thus, there is a compromise relation between the fretting current and the Faraday mass loss, which must be considered when setting the loading frequencies in the fretting-corrosion benchtop testing of hip implants.

Genetic Polymorphisms of XPC, XPD, XPG Genes and their Association with Radiotherapy Induced Toxicity among Head and Neck Cancer Patients: A Hospital Based Study from Maharashtra.

The present study was planned to investigate possible association of single nucleotide polymorphisms (SNPs) of nucleotide excision repair (NER) genes such as XPC, XPD, XPG with acute radiation induced toxicities such as skin reactions and oral mucositis in normal tissue from head and neck cancer (HNC) patients receiving radiotherapy. Methods: Two hundred and fifty HNC patients receiving radiotherapy were enrolled in this study and the acute toxicity reactions and radiation response were recorded. Association of SNPs rs2228001 of XPC, rs238406, rs13181 of XPD and rs17655 of XPG gene with normal tissue reactions in the form of dermatitis and mucositis were studied by PCR-RFLP and direct DNA sequencing. The results of univariate analysis of SNPs of XPC, XPD and XPG showed that XPC polymorphism at codon 939 of exon 15 (A>C) was not associated with dermatitis (OR=0.30, 95% CI: 0.06-1.39; p=0.125), or oral mucositis (OR=1.14, 95% CI: 0.41-3.20; p=0.793). The XPD codon 156 of exon 6 (C>A) and codon 751 of exon-23 A>C) polymorphism showed no association with radiosensitivity in HNC patients (OR=1.50, 95% CI: 0.60-3.71; p=0.080) for dermatitis, (OR=1.54, 95% CI: 0.66-3.61; p=0.312) for oral mucositis. The 1104 Asp variant genotype or allele of XPG (OR=1.35 95% CI: 0.50-3.64; p=0.541) showed no association with degree of radiotherapy associated dermatitis or mucositis (OR=0.80, 95% CI: 0.32-2.03; p=0.648) in HNC patients. The variant C allele of 2920 A/C genotype of XPC gene at codon 939 of exon 15, found protective with developing skin reactions with grade >1 (OR=0.60, 95% CI: 0.36-0.97; p=0.039) in HNC patients treated with radiotherapy. The results obtained in this study concluded that the SNPs rs2228001of XPC, rs238406, rs13181 SNPs of XPD and rs17655 SNP of XPG are not associated with normal tissue toxicity in HNC patients treated with radiotherapy. Radiotherapy with high radiation dose was significantly associated with oral mucositis in response to radiotherapy.

Issues of morphological diagnosis and pathogenesis of tuberculosis

Tuberculosis remains a serious global problem of our time. The epidemiological situation regarding tuberculosis in the Russian Federation and in Moscow is quite favorable, however, many manifestations of diseases and morphological changes in tuberculosis require a serious approach to the timely diagnosis of the disease, especially intravital morphological verification of the process. The article outlines the main aspects of the pathogenesis of tuberculosis, including deep immunosuppression associated with HIV. A typical microscopic picture of tuberculosis inflammation is described with an algorithm for identifying the causative agent of tuberculosis in histological sections and cytological preparations, and species identification of mycobacteria in material from paraffin blocks. Attention is paid to the morphology of HIV-associated tuberculosis, which is characterized by the loss of signs of granulomatous inflammation in condition of deep immune suppression. The need for differential diagnosis of tuberculosis with many infectious and non-infectious granulomatous-necrotic processes is noted, which requires the morphologist to compare the cellular composition of granulomas, study perifocal tissue reactions and features of vascular damage, correctly assess the activity of inflammatory changes, etc. Attention is drawn to the features of the morphological diagnostic search in cases combined pathology of tuberculosis with other infectious diseases, incl. with Covid 19. Changes are difficult to analyze due to the combination of morphological manifestations of several diseases, each of which may have atypical microscopic manifestations, as well as the varying activity of several simultaneously occurring infectious processes.

Association between the levels of postoperative pyuria and urinary tract infection in patients undergoing Transurethral Anatomical Enucleation of Prostate (TUAEP) in Rajavithi Hospital

Objective: Pyuria is a common condition that can occur after TUAEP. One possible cause is postoperative inflammation. To limit this many physicians prescribe antibiotic prophylaxis to prevent postoperative urinary tract infections, however this can lead to the overuse of antibiotics and increase the growing problem of antibiotic resistance. Therefore the object of this study is to evaluate the association between the level of postoperative pyuria and urinary tract infections in patients undergoing TUAEP and to identify other risk factors associated with postoperative urinary tract infection facilitating appropriate antibiotic management. Materials and Methods: Data from 94 patients who underwent TUAEP in Rajavithi Hospital from 1st December 2016 to 31st March 2021 were retrospectively analyzed. The data collected from medical records included demographic data, details from operative record sheets and laboratory results. Results: A significant association was found between a level of postoperative pyuria &gt;100 WBCs/HPF and postoperative bacteriuria (46.15% vs 19.35%, p = 0.024). Diabetes mellitus and preoperative bacteriuria were also significant risk factors for postoperative bacteriuria. The bacterium which was the most frequently cultured from samples taken both preoperatively and postoperatively was Escherichia coli. Conclusion: The risk factors for postoperative bacteriuria in patients undergoing TUAEP are a level of postoperative pyuria &gt; 100/HPF, diabetes mellitus and preoperative bacteriuria. It may be concluded from the results that the most frequent cause of postoperative pyuria was more likely to be due to a tissue reaction after surgery than from a urinary tract infection. Selective antibiotic treatment in patients who have these risk factors can reduce problems of antibiotic overuse and anti- biotic resistance.

Mucormycosis: Cytomorphological Spectrum in Fine-Needle Aspiration Cytology.

Mucormycosis is a fungal infection that can affect multiple organs. The role of fine-needle aspiration cytology (FNAC) in its diagnosis is not well documented. The objective of this study was to describe the detailed cytomorphologic features of mucormycosis on FNAC samples. A retrospective analysis of all cases diagnosed as mucormycosis on FNAC between January 2014 and July 2021 was performed for detailed cytomorphological evaluation and correlation to clinical data and microbiological studies wherever available. FNA was computed tomography-guided (n = 38), ultrasonography-guided (n = 31) or palpation-guided (n = 12), and slides were reviewed in two cases. A total of 83 cases of mucormycosis were evaluated. An immunocompromised setting was observed in 48 cases. The most common site of FNA was the lung (n = 57) followed by liver, soft tissue, palate, mediastinum, orbital/ocular region, and lymph node. Isolated renal involvement, a unique feature, was seen in seven cases. The aspirates were necrotic to pus-like or blood-mixed particulate. Broad, nonseptate, foldable, ribbon-like fungal hyphae showing right-angled branching were seen. The tissue reaction was predominantly necro-inflammatory (n = 36), bland necrotic (n = 22), mixed inflammatory (n = 16), suppurative (n = 5), necrotizing granulomatous (n = 3), and granulomatous (n = 1). Immunocompromised patients showed mixed inflammatory responses more frequently. Fungal culture was positive for Rhizopus species in 2/13 cases and molecular testing in two additional cases corresponding to Rhizopus and Syncephalastrum spp. FNA provides quick and conclusive diagnosis of mucormycosis from varied anatomic sites enabling prompt institution of therapy. The tissue response is variable and to some extent dependent on the immune status of the patient.

Tectorigenin inhibits oxidative stress by activating the Keap1/Nrf2/HO-1 signaling pathway in Th2-mediated allergic asthmatic mice

Asthma is a chronic obstructive airway condition and one of the most common non-communicable illnesses worldwide. Tectorigenin (Tec) is an isoflavonoid found in plants that possesses significant antioxidative and anti-inflammatory abilities. Nevertheless, the antioxidative properties of Tec have not yet been documented in allergic asthma. In this study, we created an asthmatic BALB/c mouse model induced by ovalbumin (OVA) and used it to assess the efficacy of Tec as a possible therapy agent. Tec decreased the serum OVA-specific immunoglobulin (Ig) E and IgG1 secretion levels. The total number of cells and the distribution of inflammatory cells decreased significantly in bronchoalveolar lavage fluid (BALF), with weakened inflammatory reaction in pulmonary tissues. Additionally, Tec regulated the T helper 1(Th1)/Th2 balance by increasing the expression of Th1- related factors (interleukin (IL)-12 and T-bet) and decreasing the expression of Th2-related factors (IL-4, IL-5, IL-13, and GATA binding protein 3. In addition, the pro-inflammatory cytokines such as IL-6, tumor necrosis factor-alpha, and IL-1β were also inhibited by Tec. Tec also dramatically increased antioxidant (catalase and superoxide dismutase) concentrations while lowering the intensity of the indicators of oxidative stress such as reactive oxygen species and malondialdehyde in BALF. Finally, Tec effectively activated the Keap1/Nrf2/HO-1 signaling pathway and prevented the epithelial-mesenchymal transition. The results of the current study show that Tec may be useful in relieving the inflammatory and oxidative stress responses associated with asthma.

MicroRNA-21 and MicroRNA-125b expression in skin tissue and serum as predictive biomarkers for psoriasis.

Psoriasis is a chronic, inflammatory, and hyperproliferative skin disease. We have investigated the role of miR-21 and miR-125b in the development of psoriasis and atopic eczema and their relation with the severity of the diseases. Participants included 40 psoriasis patients, 40 healthy controls, and 40 atopic eczema patients as a positive control group. In addition, analysis of mRNA expression of miR-125b and miR-21 was carried out utilizing quantitative real-time reverse transcription polymerase chain reaction (RT-PCR) in serum samples and skin tissue. Our results have demonstrated that miR-21 was significantly overexpressed in the psoriatic and atopic eczema skin tissue and serum samples compared to controls, whereas miR-125b was significantly down-expressed in psoriatic and atopic eczema skin tissues and serum samples. There was a statistically significant positive correlation between the psoriasis area and severity index (PASI) score and miR-21 among the studied groups in both serum and tissue samples. In contrast, there was a statistically significant negative association between the miR-125b and PASI score. On the other hand, there was no significant relation between the extent of body surface area (BSA), intensity, and subjective symptoms using visual analog scale (VAS) of atopic eczema disease and miRNA-21 and miRNA-125b in both tissue and serum. In conclusion, miR-21 gene expression was significantly increased in psoriatic and atopic eczema skin samples and serum samples, whereas miR-125b was statistically lowered in psoriatic and atopic eczema patient samples. The miR-21 and miR-125b expression level has a possible predictive value as a marker for psoriasis severity but not for atopic eczema severity.