MATERIALS AND METHODS: We included all HMs cases diagnosed in our centre over a six-year period. p57 immunohistochemistry stain was performed. Only nuclear immunoreactivity in >50% of cytotrophoblasts and villous stromal cells was regarded as positive for p57. DNA ploidy status was determined by fluorescence in situ hybridisation. A total of 250 cells from five chorionic villi were counted and were scored as diploid or triploid if more than 10% of nuclei demonstrated two or three signals, respectively.
RESULTS: A total of 51 cases originally diagnosed by histomorphology as complete mole (n = 18), partial mole (n = 24) and non-molar abortus (n = 9) were recruited. The cases were reclassified based on the p57 immunostaining pattern and DNA ploidy status, into 27 complete moles (p57-/diploid), 9 partial moles (p57+/triploid) and 15 non-molar abortus (p57+/diploid). The diagnostic accuracy by histomorphological features alone in each category: complete moles, partial moles and non-molar abortus was 78.4%, 70.6% and 88.2% respectively.
CONCLUSION: This study highlighted the importance of the utility of combined p57 immunostain and DNA ploidy analysis in arriving at an accurate diagnosis in HMs. An algorithmic approach utilising these ancillary techniques is advocated in routine diagnostic workup for a more refined diagnostic approach to HMs.
MATERIALS AND METHODS: All cases received by the Department of Pathology for histopathological examination between 1 July 2018 and 30 June 2019 were retrieved from the Laboratory Information System (LIS). All the IHC requests over this period were tabulated, with the exception of renal, muscle, rectal and nerve biopsies with their pre-defined algorithms for stains and cytological specimens. IHC stains performed solely for purpose of directing targeted treatment were also not included.
RESULTS: Immunohistochemistry was performed in 2044 (21.1%) of the total of 9686 cases, with a total of 5969 IHC stains performed i.e. 2.9 (5969/2044) IHC stains per case. All 91 antibodies available were used at least once during the study. 14 histopathologists (5 with < 10-years and 9 with ≥ 10-years postgraduate specialist experience) reported on the cases with no significant difference (p=0.90) in their usage of IHC stains. Among the most common IHC stains used, requests for Ki67 and MNF116 showed higher standard deviations compared with p63, CK7 and S100 among the histopathologists. From the relatively higher standard deviation for Ki67 and MNF116 it appeared that there was a greater difference in the requesting pattern between histopathologists for these two antibodies.
CONCLUSION: The rate of use of IHC in our centre seems compatible with that of an academic centre. Personal preferences of the histopathologists, rather than years of postgraduate specialist experience appeared to influence the rate of usage and choice of antibodies.
MATERIALS AND METHODS: We retrospectively analysed 691 allogeneic PBSCT patients between 2010-2017 in two centers.
RESULTS: The prevalence of cutaneous GVHD was 31.4% (217/691). No associations were detected with race, age or gender of donor and recipients. Cutaneous GVHD was associated with host cytomegalovirus (CMV) seropositivity (p<0.01), conditioning (p<0.01), GVHD prophylaxis (p=0.046) and survival (p<0.01). Majority developed the acute form (58.1%;126/217). Biopsies in 20.7% (45/217) showed 55.6% positivity for GVHD. Overall, involvement was non-severe. A majority demonstrated complete response (CR) to first-line corticosteroids (70.0%;152/217). Secondline therapies (extracorporeal phototherapy (ECP), psolaren ultraviolet A (PUVA), mycophenolate, tumour necrosis factor (TNF) inhibitors, interleukins inhibitors, or CD20 monoclonal antibodies) were required in 65/217, with 38.5% CR. Second-line therapy was associated with gender (p=0.042), extra-cutaneous GVHD (p=0.021), treatment outcomes (p=0.026) and survival (p=0.048). Mortality in cutaneous GVHD was 24.0% with severe sepsis being the leading cause at Day 100 (7.8%) and 5-years (7.8%), and relapsed disease at 2-years (32.7%). In steroid refractoriness, severe GVHD caused 30.8% mortality. In cutaneous GVHD, survival at Day 100 was 95.4%; 80.2% at 2-years and 73.1% at 5-years. The median survival in cutaneous GVHD was significantly shorter at 55 months, compared to those without GVHD at 69 months (p=0.001).
CONCLUSION: Cutaneous involvement is the commonest clinical manifestation of GVHD. A larger national study is warranted to further analyse severity and outcome of multiorgan GVHD, and factors associated with steroid refractoriness.
MATERIALS AND METHODS: This study was conducted at Chemical Pathology, Department of Pathology and Laboratory Medicine and Department of Medicine, Aga Khan University (AKU), Karachi Pakistan. Electronic medical records of all in-patients including both genders and all age groups with documented COVID-19 from March to August 2020 were reviewed and recorded on a pre-structured performa. The subjects were divided into two categories severe and non-severe COVID-19; and survivors and non-survivors. Between-group differences were tested using the Chi-square and Mann-Whitney's U-test. The receiver operating characteristic curve was plotted for serum PCT with severity and mortality. A binary logistic regression was used to identify variables independently associated with mortality. The data was analysed using SPSS.
RESULTS: 336 patients were reviewed as declared COVID-19 positive during the study duration, and 136 were included in the final analysis including 101 males and 35 females. A statistically significant difference in PCT was found between severe and non-severe COVID-19 (p value=0.01); and survivors and nonsurvivors (p value<0.0001). PCT, older age and increased duration of hospital stay were revealed as variables independently associated with mortality. On ROC analysis, an AUC of 0.76 for mortality prediction was generated for PCT.
CONCLUSION: Baseline serum PCT concentration is a promising predictor of mortality and severity in COVID-19 cases when considered in combination with clinical details and other laboratory tests.
DESIGN: Cross-sectional study.
SETTING: Pathology department of a tertiary hospital.
MATERIALS AND METHODS: The prostatectomy materials of 122 patients diagnosed with prostate adenocarcinoma between 2004 and 2017 in Zonguldak Bülent Ecevit University Faculty of Medicine, Department of Pathology were included in the study.
MAIN OUTCOME MEASURES: Clinical data were obtained from patient files and macroscopic data were obtained from surgery and pathology reports. ERG expression, age, prostate-specific antigen levels, Gleason pattern and score, Gleason grade, and pathological stage were recorded.
RESULTS: The mean age of the patients was 62.66 ± 5.81 years and overall preoperative PSA was 10.40 ± 8.88 ng/ml. ERG was positive in 52.46% of the patients. PSA levels were similar in ERG positive and negative samples (p = 0.935). There was no significant relationship between Gleason score and ERG positivity (p = 0.197). ERG expression did not change with regard to age groups (p = 0.441) or tumour stage (p = 0.371).
CONCLUSION: This study shows that the frequency of ERG positivity was high in our patients and that ERG positivity was not associated with clinical and pathological features, such as PSA levels, Gleason score, age and pathological stage.
MATERIALS AND METHODS: A total of 226 invasive breast carcinoma cases were selected and assembled into tissue microarrays (TMAs). The stromal expression of CD10 was immunohistochemically analysed.
RESULTS: Stromal CD10 was positive in 67 (29.6%) cases of invasive breast carcinoma. The frequency of positive stromal staining was significantly higher in the cases with ER-negative (P=0.000). CD10 stromal negativity was significantly higher in luminaltype cases (P=0.001). However, there was no correlation between stromal CD10 expression with tumour grade, stage, PR and HER2 status.
CONCLUSION: Positive CD10 stromal expression correlates with ER-negative invasive breast carcinomas, while negative CD10 stromal expression correlates with luminal type invasive breast carcinomas. This demonstrates that stromal CD10 expression within the TME constitutes a potential prognostic marker and therapeutic target. Future studies are necessary to evaluate other stromal markers within the TME immunohistochemically as well as its molecular basis in order to confirm the definite role of stromal CD10.
MATERIALS & METHODS: This was a single-centre retrospective study of patients (n = 19) diagnosed with cutaneous malignant melanomas in our hospital between 2011 and 2019 were included in the study. The exclusion criteria were in situ melanomas, punch or incisional biopsies and metastasis at the time of the diagnosis. Breslow density was determined by reevaluating slides obtained at the time of the initial diagnoses. The effect of Breslow density on survival was determined using univariate and multivariate Cox proportional risk analyses.
RESULTS: In terms of the overall survival, mortality risk increased as Breslow density increased (p = 0.044). Breslow density was not significantly associated with the overall survival in the multivariate model (p = 0.078). In terms of disease-free survival, the risk of metastasis or recurrence increased 1.229- fold in accordance with an increase in Breslow thickness (CI: 1.057-1.428), whereas increased Breslow density increased the metastasis or recurrence risk 1.059-fold (CI: 1.008-1.112). In the multivariate model, only Breslow density was statistically significant (p = 0.046).
CONCLUSIONS: As a semi-quantitative and subjective measurement, Breslow density is not a completely accurate representation of the invasive tumour load. However, the measurement is practical and low cost and requires no additional equipment. Therefore, Breslow density can be measured in every laboratory. Considering the value of Breslow density in predicting the prognosis in patients with cutaneous melanomas and strong inter-observer compliance observed in the present study, we believe that it would be useful to include this measurement in pathology reports.
OBJECTIVE: This study aimed to evaluate the treatment paradigm of a single dose of GSK-3 inhibitor administration at various time courses for the protection of the CNS from EAE.
MATERIALS AND METHODS: Effects of GSK-3 inhibition on intracellular cytokine levels were evaluated from in vitro naïve CD4+ T cell cultures. Immunized C57BL/6 female mice with MOG35-55 in conjunction with CFA and Ptx were used as a chronic inflammatory EAE disease model. Tideglusib (NP12), a Thiadiazolidinone class, selective, and non-ATP competitive GSK-3 inhibitor, was injected intraperitoneally at pre-EAE, same-day of immunization or disease onset. After 30 days post-immunization, brain, and spinal cord tissues were collected for inflammation and demyelination analysis by H&E and luxol fast blue staining, respectively, whereas cytokine profiles of the serum were assessed by cytokine beads array.
RESULTS: The inhibition of GSK-3 in CD4+ T cells increased IL-10 production. The administration of Tideglusib during pre-EAE and same-day, but not during disease onset, significantly reduced clinical symptoms and delayed disease onset. Histopathological analysis of spinal cord tissues showed a significant decline in the number of inflammatory cell infiltration with a concomitant reduction in demyelination through the blocking of GSK-3, especially during pre-EAE and sameday. Upregulation of IL-10 via GSK-3 inhibition coincided with the downregulation of cytokineassociated effector T cells, including IFN-γ, IL-9, IL-17A, IL-17F, IL-21, and IL-23. Increased IL-4 production, however, was only significant in the pre-EAE group.
CONCLUSION: The neuroprotective effects of Tideglusib against EAE are time-dependent. Downregulation of Th1 and Th17 hallmark cytokines by Tideglusib in EAE may be associated with IL-10 production.
METHODS: Blood samples of individuals with periodontitis (PD) (n=72) and periodontally healthy (PH) (n=62) donors were obtained from Malaysian Periodontal Database and Biobanking system (MPDBS). Genomic DNA samples were analyzed for three PTGS2 SNPs (rs5275, rs20417, rs689466,) and one DEFB1 SNP (rs1047031) using Taqman SNP genotyping assays. Notably, rs20417 and rs689466 were located in the promoter region while rs5275 and rs1047031 were located in the 3' untranslated region of the transcript. Association between the SNPs and PD were then analyzed using genotypic association analysis (additive, dominant and recessive models).
RESULTS: The allelic frequency for the rs689466-G was higher in PD group (35.2%) compared that in PH group (29.0%). However, the association of rs689466-G and other SNPs with PD was not statistically significant (at 95% CI). No associations were observed for genotypic associations between the PTGS2 and DEFB1 SNPs with PD susceptibility.
CONCLUSIONS: PTGS2 (rs5275, rs20417, and rs689466) and DEFB1 (rs1047031) polymorphism was not associated with PD in Malays, unlike the Chinese, Taiwanese & European population. This suggests that other causal variants might be involved in the development and progression of PD among Malays.
METHODS: Cross-sectional study was conducted from Jun 2018 to May 2019. Isolates from first-positive peripheral blood cultures were tested with Prolex Staph Xtra Latex agglutination test, together with routine tube coagulase and DNase test. All isolates were further confirmed with Vitek2 GP.
RESULTS: Hundred isolates were tested with Prolex Staph Xtra Latex. Twelve isolates were excluded due to incomplete medical records. Eighty-eight isolates were analysed, yielded sensitivities, specificities, positive and negative predictive values of 100%, 91.7%, 98.7%, and 100%, respectively. Of these, 76 were identified as S. aureus and 12 CoNS. Seventy-six patients were included in the SAB analysis. Fifty-nine out of 76 (78.6%) had underlying comorbidities. Thirty-four percent of the episodes were considered as primary SAB. Skin and soft tissue infection were accounted for the highest source of bacteraemia, 24(31.6%). Both MRSA and MSSA bacteraemia were seen mostly among healthcare-associated bacteraemia (HCA) (7/16, 43.8% and 28/60, 46.7%). Liver cirrhosis was significantly associated with MRSA bacteraemia (P=0.048). Metastatic infection & complicated SAB were identified in 13(17.1%) and 30(39.5%) of cases, respectively. All-cause mortality was 22.4%.
CONCLUSION: S. aureus bacteraemia is a serious infection associated with significant metastatic complications and mortality. Prolex Staph Xtra Latex agglutination test has excellent sensitivity and specificity with 100% and 91.7% respectively.