AIM:To characterize the histopathologic specifications of non-alcoholic steatohepatitis(NASH)according to age and gender.METHODS:An analytical cross-sectional study was conducted in two private gastroenterology clinic...AIM:To characterize the histopathologic specifications of non-alcoholic steatohepatitis(NASH)according to age and gender.METHODS:An analytical cross-sectional study was conducted in two private gastroenterology clinics on biopsy proven patients suffering from NASH.Biopsy histopathologic findings as well as demographic and laboratory data of the patients at the time of biopsy were gathered retrospectively from clinical records.The grading and staging of histopathologic findings were performed according to the Brunt method after reevaluation of the slides by a pathologist.Patients were divided into two groups according to age(belowand above 55 years).Mean quantitative grade of all pathologic findings were also calculated according to Brunt scoring values.RESULTS:A total number of 77 NASH patients,consisting of 58 males(75.3%)and 19(24.7%)females with a mean age of 41.99±11.80 years(range,18-70 years),were enrolled.The mean age(48.72±13.99 years vs 39.74±10.16 years,P=0.004)and aspartate aminotransferase level(75.11±29.68 U/L vs 52.78± 25.00 U/L,P=0.002)was significantly higher in female patients.Mean quantitative grade of hepatosteatosis was significantly higher in females(2.00±0.82 vs 1.59 ±0.68,P=0.031)compared to males.Fifty four percent(34/65)of young patients had mild hepatosteatosis (GradeⅠ)while only one patient(11.2%)in the older group had gradeⅠhepatosteatosis.Patients aged≥55 had significantly more severe hepatosteatosis(GradeⅢ) (44.4%vs 9.5%,P=0.007)and the mean quantitative grade of hepatosteatosis was significantly higher among them(2.33±0.71 vs 1.56±0.67,P=0.002).Multivariate analysis after omitting the confounding role of age revealed a higher grade of hepatosteatosis in female patients(P=0.010).CONCLUSION:These findings point toward the possible influence of age in the severity of steatohepatitis,portal and lobar inflammation in patients suffering from NASH while gender independently might contribute to the level of steatohepatitis.展开更多
Although COVID-19 clinical manifestations are mostly respiratory gastrointestinal manifestations may also be encountered in some instances. However, at the time of our writing, little is known about COVID-19, associat...Although COVID-19 clinical manifestations are mostly respiratory gastrointestinal manifestations may also be encountered in some instances. However, at the time of our writing, little is known about COVID-19, associated pathologic changes in the digestive system. We describe a case of COVID-19 disease with digestive manifestations that demonstrated specific pathologic changes in the gastrointestinal tract. Histological examination of endoscopic biopsy samples from duodenum was performed in combination with a review of the literature. According to our literature review, digestive histopathologic changes have been reported in 14 cases of COVID-19 patients. Pathological findings were generally nonspecific in all these cases and ranged from epithelial damage, lymphoplasmacytic and macrophages infiltrates, prominent endothelitis and ischemic enterocolitis. In our patient, histological features were more specific, characterized by several viral cytopathic effects associated with mucosal damage, numerous microthrombi and positive staining of ACE2 on various enterocytes. Histological analysis is not a practical option for the diagnosis of SARS-CoV-2 infections but could help to elucidate pathophysiology of the disease. Those changes may be specific in the GI tract and related clinical manifestations should not be overlooked. Furthermore, preventive measures for oral-fecal transmission should not be minimized.展开更多
<abstract>Aim: To determine the ultrastructural effects of sildenafil on the female genital organs. Methods: Twenty female cycling Wistar albino rats weighing 250±20 g were randomly divided into two groups ...<abstract>Aim: To determine the ultrastructural effects of sildenafil on the female genital organs. Methods: Twenty female cycling Wistar albino rats weighing 250±20 g were randomly divided into two groups of 10 each. Rats of one group were gavaged with 0.5 mg·kg-1·d-1 of sildenafil 3 days in a week for 4 weeks and the other served as the controls. After cessation of treatment animals were sacrificed by cervical dislocation under methoxyflurane anaesthesia. The clitoris, vagina, uterus and bartholin glands were taken at the estrous and were fixed with 10 % formalin solution for light microscopy and 2.5 % glutaraldehyde and osmic acid for electron microscopy. Results: Under the light microscope, the fibrocollageous tissue was found increased, the capillaries enlarged and the connecting tissue elements increased in the corpus cavernosum in the treated group. On electron microscopy, increased connective tissue, fibroblasts with notched nucleus, shorten immature collagen fibers without striation were seen. Abundant foldings and penetration with collagen bundles were observed in the basal membrane. Large connection complexes, especially gap junctions among the wide capillary endothelial cells were observed. Conclusion: There are evident histological changes due to sildenafil citrate in female rat corpus cavernosum. The clitoris and bartholin glands were the most effected organs. While the histopathological changes of clitoral tissue could be expected, an increase in the mass of bartholin gland was surprised.展开更多
Background: Anatomical and histopathologic examination of placenta in cases of abortion is crucial as to clarify the underlying causes of many adverse pregnancy outcomes. Dilation and evacuation (D&E) is the most ...Background: Anatomical and histopathologic examination of placenta in cases of abortion is crucial as to clarify the underlying causes of many adverse pregnancy outcomes. Dilation and evacuation (D&E) is the most common mode of uterine evacuation that commonly examined in pathology sections. The aim of this study is to discuss the various placental pathologies, and to demonstrate the importance of careful pathologic examination of D&E material, also to review the anatomy of placenta and to compare our findings with other publications worldwide. Material and Methods: A retrospective descriptive study for 200 placental tissues was collected in 18 months period and revised for normal anatomy and various placental pathologies. These placentas were obtained by dilation and evacuation (D&E) technique. All cases were undergone for histopathological sections that were stained by Hematoxylin and Eosin (H&E). Results: Placental infarction was observed in 25% of cases, and chorioammnitis was the most common form of placental infection and found in 12.5%. Molar changes were represented a lowered percentage of placental pathologies that found in 9% of specimens. Conclusion: Study and recognition of placental lesions among general surgical pathologists have clinical significance and awareness of deficiency, standardization of diagnostic criteria, and increased knowledge in placental pathology improve the quality of diagnosis in this area.展开更多
Background/Aim: Free radicals have a role in the development of chronic gastritis. The aim of this study to know the effect and efficacy of rebamipide on free radicals in chronic gastritis. Method: Forty five patients...Background/Aim: Free radicals have a role in the development of chronic gastritis. The aim of this study to know the effect and efficacy of rebamipide on free radicals in chronic gastritis. Method: Forty five patients in the division gastroenterology Cipto Mangunkusumo Hospital Jakarta 2009-2010 with moderate and severe gastritis endoscopically were included in this study. Before and after rebamipide treatment the patient were performed endoscopical examination and were taken 5 biopsies for histopathological examination and free radicals (MDA & Carbonyl Compound) examination. All patients were given rebamipide 100 mg three times a day for 28 days. Data were analyzed with t test or wilcoxon signed rank test. Exclusion: GERD, Peptic ulcer, PPI treatment, NSAID consumption etc. The symptoms were recorded on day-0 and day-28. The severity symptoms were measured by VAS. Result: The mucosal damage on day-0 was 2.268 ± 0.45 vs day-28 was 1.707 ± 0.78 (P < 0.001). The antrum neutrophil: day-0: 0.12 ± 0.46 vs day-28: 0.10 ± 0.37 (P = 0.710) and corpus neutrophil: day-0: 0.12 ± 0.40 vs day-28: 0.07 ± 0.26 (P = 0.421). The mean endoscopical mucosal severity score was decreased significantly on day- 28 compared to day-0 (1.707 ± 0.78 vs 2.268 ± 0.45;P < 0.05). The other histopathological appearances between day-0 and day-28 were not different. Rebamipide can reduce the mean of MDA from 5.28 ± 3.54 on day-0 to 4.15 ± 2.71 on day-28 (P = 0.047). The mean of carbonyl compound on day-0 was 4.14 ± 3.01 and on day-28 was 5.12 ± 2.71 (P = 0.642). Conclusion: Rebamipide significantly reduced the extend of symptoms associated with chronic gastritis. The improvement in symptoms was associated with the decreased of endoscopic severity score and the mean gastric mucosal malondialdehyde (MDA) significantly but not the histopathologic appearance and carbonyl compound.展开更多
Background: Mainly for economic reasons, histopathologic analysis is not a systematic practice in medical structures in Senegal, and the utility of this exam is being questioned by many authors. The purpose of this pa...Background: Mainly for economic reasons, histopathologic analysis is not a systematic practice in medical structures in Senegal, and the utility of this exam is being questioned by many authors. The purpose of this paper is to report the results of this exam, in our medical practice and try to determine if this exam should be systematic of kept only for individualized cases. Material and Methods: It was a retrospective study from January 2010 to December 2018, carried out in the Laboratory of Pathology of the Teaching Hospital of Grand Yoff in Dakar. The data were collected from the register of pathologic examinations of the laboratory. Results: We registered 543 results of histopathologic examination of products of conception from the first trimester abortion. The women mean age was 22.4 years ± 6.2 with extremes of 17 and 46 years. The routine histopathologic assessment of products of first- trimester miscarriages highlighted in our study three pathologies: hydatidiform mole (24.7%), infection (4.6%) and ectopic pregnancy (0.09%). Only 11.7% of cases of Hydatidiform mole (HM) were suspected before the histopathologic assessment. In our sample, molar pregnancy seems to be higher in anembryonic conception with a prevalence of 45%. The prevalence of Complete Hydatidiform Mole (CHM) was higher than the one of Partial Hydatidiform Mole (PHM) (14.8% vs. 9.9% of miscarriages). Indeed, both require follow up to prevent or manage at time the occurrence of choriocarcinoma. Conclusion: The results of the histologic analysis after abortion in the first trimester of pregnancy show that this exam should be practiced systematically in routine in our context because of high prevalence of hydatidiform mole.展开更多
Objective: Telemedicine is the use of telecommunication for medical diagnosis, treatment, health education and research. Telepathology is diagnostic pathology at a distance. It functions with images viewed on a video ...Objective: Telemedicine is the use of telecommunication for medical diagnosis, treatment, health education and research. Telepathology is diagnostic pathology at a distance. It functions with images viewed on a video monitor rather than directly through a microscope. Many years have passed since the evolution of telepathology. But no study has yet been done to evaluate the benefits postgraduates got through this. Therefore this study is undertaken to analyse the different impacts of telepathology on the postgraduate learning. Material and Methods: The study was done in Telemedicine Center of S. C. B. Medical College, Cuttack over a period of 9 years. The telepathology service was carried out by store and forward method using a CCD, a large computer server and a huge bandwidth network service (VSAT). The sessions with SGPGI, Lucknow were analysed and the benefits of postgraduates were studied. Results: The number of sessions held was 95. Out of which 92 sessions were with SGPGI. It included 202 cases transmitted from Lucknow and 186 cases from S. C. B. Medical College, Cuttack. The postgraduates had a chance to exposure to rare cases in renal pathology, dermatopathology and hepatopathology. The overall concordance rate with glass slide diagnosis was 87%. Conclusion: The diagnostic expertise through light microscopy and tele-images are not the same. But the telepathology system increased the ability of image analysis, histopathologic diagnosis of our postgraduates and also exposed them to many rare and interesting cases.展开更多
Background The use of post-enucleation adjuvant therapy to decrease the extraocular relapse rate is frequently considered, but there is much controversy about the indications for adjuvant therapy. The aim of this retr...Background The use of post-enucleation adjuvant therapy to decrease the extraocular relapse rate is frequently considered, but there is much controversy about the indications for adjuvant therapy. The aim of this retrospective study was to observe the treatment and prognosis for different degrees of invasion of eye tissue in retinoblastoma （RB） and identify the indications for post-enucleation adjuvant therapy. Methods We recruited 537 children who had been diagnosed with unilateral RB and had received enucleation from January 2006 to December 2012 in our hospital, and divided them into three groups according to their number of histopathologic risk factors： 0 factor, 1 factor, or 〉2 factors. Histopathologic high-risk factors included invasion of the optic nerve posterior to the ethmoid plate （including optic nerve stumps） and extensive invasions of the choroid, sclera, anterior chamber, iris, and ciliary body. Treatment was delivered accordingly, and the prognosis of different degrees of histopathologic invasion was observed. The subjects were followed up for 6 months to 7 years （average follow-up time： 35 months）. Statistical analysis was analyzed using X2 test. P 〈0.05 was considered significant. Results Of the 537 RB patients who received enucleation, 25 died （overall survival： 95.3%）. Of the 369 （68.7%） with no histopathologic risk factors, 1 died of recurrence, with a mortality rate of 0.3%, whereas of the 168 （31.3%） with histopathologic risk factors, 26 had recurrences and 24 died （mortality rate： 14.3%; P=0.000）. Of the 93 patients （17.3%）, each of whom had a single risk factor, nine had recurrences, 16 died （8.6%）. Of the 75 patients （14%） with two or more high-risk factors, 16 died （21.3%）. These differences were statistically significant between the three （P=0.000）. Conclusion Chemotherapy is recommended for patients with histopathologic risk factors, especially those with two or more histopathologic risk factors.展开更多
文摘AIM:To characterize the histopathologic specifications of non-alcoholic steatohepatitis(NASH)according to age and gender.METHODS:An analytical cross-sectional study was conducted in two private gastroenterology clinics on biopsy proven patients suffering from NASH.Biopsy histopathologic findings as well as demographic and laboratory data of the patients at the time of biopsy were gathered retrospectively from clinical records.The grading and staging of histopathologic findings were performed according to the Brunt method after reevaluation of the slides by a pathologist.Patients were divided into two groups according to age(belowand above 55 years).Mean quantitative grade of all pathologic findings were also calculated according to Brunt scoring values.RESULTS:A total number of 77 NASH patients,consisting of 58 males(75.3%)and 19(24.7%)females with a mean age of 41.99±11.80 years(range,18-70 years),were enrolled.The mean age(48.72±13.99 years vs 39.74±10.16 years,P=0.004)and aspartate aminotransferase level(75.11±29.68 U/L vs 52.78± 25.00 U/L,P=0.002)was significantly higher in female patients.Mean quantitative grade of hepatosteatosis was significantly higher in females(2.00±0.82 vs 1.59 ±0.68,P=0.031)compared to males.Fifty four percent(34/65)of young patients had mild hepatosteatosis (GradeⅠ)while only one patient(11.2%)in the older group had gradeⅠhepatosteatosis.Patients aged≥55 had significantly more severe hepatosteatosis(GradeⅢ) (44.4%vs 9.5%,P=0.007)and the mean quantitative grade of hepatosteatosis was significantly higher among them(2.33±0.71 vs 1.56±0.67,P=0.002).Multivariate analysis after omitting the confounding role of age revealed a higher grade of hepatosteatosis in female patients(P=0.010).CONCLUSION:These findings point toward the possible influence of age in the severity of steatohepatitis,portal and lobar inflammation in patients suffering from NASH while gender independently might contribute to the level of steatohepatitis.
文摘Although COVID-19 clinical manifestations are mostly respiratory gastrointestinal manifestations may also be encountered in some instances. However, at the time of our writing, little is known about COVID-19, associated pathologic changes in the digestive system. We describe a case of COVID-19 disease with digestive manifestations that demonstrated specific pathologic changes in the gastrointestinal tract. Histological examination of endoscopic biopsy samples from duodenum was performed in combination with a review of the literature. According to our literature review, digestive histopathologic changes have been reported in 14 cases of COVID-19 patients. Pathological findings were generally nonspecific in all these cases and ranged from epithelial damage, lymphoplasmacytic and macrophages infiltrates, prominent endothelitis and ischemic enterocolitis. In our patient, histological features were more specific, characterized by several viral cytopathic effects associated with mucosal damage, numerous microthrombi and positive staining of ACE2 on various enterocytes. Histological analysis is not a practical option for the diagnosis of SARS-CoV-2 infections but could help to elucidate pathophysiology of the disease. Those changes may be specific in the GI tract and related clinical manifestations should not be overlooked. Furthermore, preventive measures for oral-fecal transmission should not be minimized.
文摘<abstract>Aim: To determine the ultrastructural effects of sildenafil on the female genital organs. Methods: Twenty female cycling Wistar albino rats weighing 250±20 g were randomly divided into two groups of 10 each. Rats of one group were gavaged with 0.5 mg·kg-1·d-1 of sildenafil 3 days in a week for 4 weeks and the other served as the controls. After cessation of treatment animals were sacrificed by cervical dislocation under methoxyflurane anaesthesia. The clitoris, vagina, uterus and bartholin glands were taken at the estrous and were fixed with 10 % formalin solution for light microscopy and 2.5 % glutaraldehyde and osmic acid for electron microscopy. Results: Under the light microscope, the fibrocollageous tissue was found increased, the capillaries enlarged and the connecting tissue elements increased in the corpus cavernosum in the treated group. On electron microscopy, increased connective tissue, fibroblasts with notched nucleus, shorten immature collagen fibers without striation were seen. Abundant foldings and penetration with collagen bundles were observed in the basal membrane. Large connection complexes, especially gap junctions among the wide capillary endothelial cells were observed. Conclusion: There are evident histological changes due to sildenafil citrate in female rat corpus cavernosum. The clitoris and bartholin glands were the most effected organs. While the histopathological changes of clitoral tissue could be expected, an increase in the mass of bartholin gland was surprised.
文摘Background: Anatomical and histopathologic examination of placenta in cases of abortion is crucial as to clarify the underlying causes of many adverse pregnancy outcomes. Dilation and evacuation (D&E) is the most common mode of uterine evacuation that commonly examined in pathology sections. The aim of this study is to discuss the various placental pathologies, and to demonstrate the importance of careful pathologic examination of D&E material, also to review the anatomy of placenta and to compare our findings with other publications worldwide. Material and Methods: A retrospective descriptive study for 200 placental tissues was collected in 18 months period and revised for normal anatomy and various placental pathologies. These placentas were obtained by dilation and evacuation (D&E) technique. All cases were undergone for histopathological sections that were stained by Hematoxylin and Eosin (H&E). Results: Placental infarction was observed in 25% of cases, and chorioammnitis was the most common form of placental infection and found in 12.5%. Molar changes were represented a lowered percentage of placental pathologies that found in 9% of specimens. Conclusion: Study and recognition of placental lesions among general surgical pathologists have clinical significance and awareness of deficiency, standardization of diagnostic criteria, and increased knowledge in placental pathology improve the quality of diagnosis in this area.
文摘Background/Aim: Free radicals have a role in the development of chronic gastritis. The aim of this study to know the effect and efficacy of rebamipide on free radicals in chronic gastritis. Method: Forty five patients in the division gastroenterology Cipto Mangunkusumo Hospital Jakarta 2009-2010 with moderate and severe gastritis endoscopically were included in this study. Before and after rebamipide treatment the patient were performed endoscopical examination and were taken 5 biopsies for histopathological examination and free radicals (MDA & Carbonyl Compound) examination. All patients were given rebamipide 100 mg three times a day for 28 days. Data were analyzed with t test or wilcoxon signed rank test. Exclusion: GERD, Peptic ulcer, PPI treatment, NSAID consumption etc. The symptoms were recorded on day-0 and day-28. The severity symptoms were measured by VAS. Result: The mucosal damage on day-0 was 2.268 ± 0.45 vs day-28 was 1.707 ± 0.78 (P < 0.001). The antrum neutrophil: day-0: 0.12 ± 0.46 vs day-28: 0.10 ± 0.37 (P = 0.710) and corpus neutrophil: day-0: 0.12 ± 0.40 vs day-28: 0.07 ± 0.26 (P = 0.421). The mean endoscopical mucosal severity score was decreased significantly on day- 28 compared to day-0 (1.707 ± 0.78 vs 2.268 ± 0.45;P < 0.05). The other histopathological appearances between day-0 and day-28 were not different. Rebamipide can reduce the mean of MDA from 5.28 ± 3.54 on day-0 to 4.15 ± 2.71 on day-28 (P = 0.047). The mean of carbonyl compound on day-0 was 4.14 ± 3.01 and on day-28 was 5.12 ± 2.71 (P = 0.642). Conclusion: Rebamipide significantly reduced the extend of symptoms associated with chronic gastritis. The improvement in symptoms was associated with the decreased of endoscopic severity score and the mean gastric mucosal malondialdehyde (MDA) significantly but not the histopathologic appearance and carbonyl compound.
文摘Background: Mainly for economic reasons, histopathologic analysis is not a systematic practice in medical structures in Senegal, and the utility of this exam is being questioned by many authors. The purpose of this paper is to report the results of this exam, in our medical practice and try to determine if this exam should be systematic of kept only for individualized cases. Material and Methods: It was a retrospective study from January 2010 to December 2018, carried out in the Laboratory of Pathology of the Teaching Hospital of Grand Yoff in Dakar. The data were collected from the register of pathologic examinations of the laboratory. Results: We registered 543 results of histopathologic examination of products of conception from the first trimester abortion. The women mean age was 22.4 years ± 6.2 with extremes of 17 and 46 years. The routine histopathologic assessment of products of first- trimester miscarriages highlighted in our study three pathologies: hydatidiform mole (24.7%), infection (4.6%) and ectopic pregnancy (0.09%). Only 11.7% of cases of Hydatidiform mole (HM) were suspected before the histopathologic assessment. In our sample, molar pregnancy seems to be higher in anembryonic conception with a prevalence of 45%. The prevalence of Complete Hydatidiform Mole (CHM) was higher than the one of Partial Hydatidiform Mole (PHM) (14.8% vs. 9.9% of miscarriages). Indeed, both require follow up to prevent or manage at time the occurrence of choriocarcinoma. Conclusion: The results of the histologic analysis after abortion in the first trimester of pregnancy show that this exam should be practiced systematically in routine in our context because of high prevalence of hydatidiform mole.
文摘Objective: Telemedicine is the use of telecommunication for medical diagnosis, treatment, health education and research. Telepathology is diagnostic pathology at a distance. It functions with images viewed on a video monitor rather than directly through a microscope. Many years have passed since the evolution of telepathology. But no study has yet been done to evaluate the benefits postgraduates got through this. Therefore this study is undertaken to analyse the different impacts of telepathology on the postgraduate learning. Material and Methods: The study was done in Telemedicine Center of S. C. B. Medical College, Cuttack over a period of 9 years. The telepathology service was carried out by store and forward method using a CCD, a large computer server and a huge bandwidth network service (VSAT). The sessions with SGPGI, Lucknow were analysed and the benefits of postgraduates were studied. Results: The number of sessions held was 95. Out of which 92 sessions were with SGPGI. It included 202 cases transmitted from Lucknow and 186 cases from S. C. B. Medical College, Cuttack. The postgraduates had a chance to exposure to rare cases in renal pathology, dermatopathology and hepatopathology. The overall concordance rate with glass slide diagnosis was 87%. Conclusion: The diagnostic expertise through light microscopy and tele-images are not the same. But the telepathology system increased the ability of image analysis, histopathologic diagnosis of our postgraduates and also exposed them to many rare and interesting cases.
文摘Background The use of post-enucleation adjuvant therapy to decrease the extraocular relapse rate is frequently considered, but there is much controversy about the indications for adjuvant therapy. The aim of this retrospective study was to observe the treatment and prognosis for different degrees of invasion of eye tissue in retinoblastoma （RB） and identify the indications for post-enucleation adjuvant therapy. Methods We recruited 537 children who had been diagnosed with unilateral RB and had received enucleation from January 2006 to December 2012 in our hospital, and divided them into three groups according to their number of histopathologic risk factors： 0 factor, 1 factor, or 〉2 factors. Histopathologic high-risk factors included invasion of the optic nerve posterior to the ethmoid plate （including optic nerve stumps） and extensive invasions of the choroid, sclera, anterior chamber, iris, and ciliary body. Treatment was delivered accordingly, and the prognosis of different degrees of histopathologic invasion was observed. The subjects were followed up for 6 months to 7 years （average follow-up time： 35 months）. Statistical analysis was analyzed using X2 test. P 〈0.05 was considered significant. Results Of the 537 RB patients who received enucleation, 25 died （overall survival： 95.3%）. Of the 369 （68.7%） with no histopathologic risk factors, 1 died of recurrence, with a mortality rate of 0.3%, whereas of the 168 （31.3%） with histopathologic risk factors, 26 had recurrences and 24 died （mortality rate： 14.3%; P=0.000）. Of the 93 patients （17.3%）, each of whom had a single risk factor, nine had recurrences, 16 died （8.6%）. Of the 75 patients （14%） with two or more high-risk factors, 16 died （21.3%）. These differences were statistically significant between the three （P=0.000）. Conclusion Chemotherapy is recommended for patients with histopathologic risk factors, especially those with two or more histopathologic risk factors.
