The Effect of PT Link and Waterbath Antigenic Retrieval Procedures On The Expression of Common Receptors In Breast Cancer Cases

Background: Antigen retrieval (AR) techniques play a major role in determining the quality and functional state of tissue proteins recovered from formalin fixed paraffin embedded blocks (FFPEB). Different techniques are used each with its merits and drawbacks.Materials and Method: FFPEB from cases diagnosed as breast cancer were examined for the expression of estrogen- receptor (ER), progesterone receptor (PR) and HER2 by immunohistochemical techniques using two different AR methods.Results: Fifty cases, 49 were from females, the age ranged from 28–85 years were examined. The expression of ER using water bath and PT link (pretreatment system) as antigen retrieval methods was equal, both methods showed 20(40%) positive cases and 30(60%) negative cases, whereas, the expression of PR was found positive in 18 cases (36%) and negative in 32 (64%) when water bath was used, in comparison to10 positive (20%) and 40 negative (80%) when PT link was used (P value 0.312).The expression of HER2 was as follows; water bath HER2 weak positive 20 cases (40%), moderate expression 10 cases (20%), overexpression 2 cases (4%). PT link weak expression 13 cases (26%), moderate expression 15 cases (30%), overexpression 4cases (8%); yet, the total number of negative cases and positive cases was equal for both methods (p-value 0.035).Conclusion: Antigen retrieval methods were found to affect the expression of common receptors in breast cancer. The magnitude of this effect was found to be significant in PR and HER2 receptors, however, the different methods of antigen retrieval did not affect the expression of ER. The appropriate and suitable retrieval methods have to be chosen individually for each receptor.Keywords: Antigen retrieval, ER, PR, HER2 expression, PT link, waterbath

First Case Report of Primary Testicular Diffuse Large B-Cell Lymphoma from the Western Region of Saudi Arabia

Primary testicular lymphoma (PTL) represents 1-2% of all types of non-Hodgkin lymphomas (NHLs) and 1-10% of testicular neoplasms. Up to the best of my knowledge, this is the first case of PTL of the diffuse large B-cell lymphoma (DLBCL) in a 60-year-old man presented with a painless mass in the left testis as revealed by physical examination in a tertiary care hospital in Al-Madinah Al-Munwarah in the western region of the Kingdom of Saudi Arabia (KSA). Radiological examination revealed a large well-defined heterogeneous predominantly hypo-echoic mass with increased vascularity in the upper portion of the testis. On the other hand, histopathological examination revealed a tumor involving the whole left testis, which was large (measuring 6 3.5  3.3 cm), solid and dark red with focal areas of hemorrhage and epididymal infiltration. Immunohistochemistry showed positivity of leucocyte common antigen (LCA), pan B-cell marker (CD20) and negativity of pan T-cell marker (CD3). Other immunohistochemical markers such as CD10, placental alkaline phosphatase (PLAP), cytokeratin, vimentin, desmin and S100 protein were also negative. However, there was a marked expression of Ki67 and Bcl2 markers. Accordingly, the diagnosis of DLBCL was established. The tumor was classified as stage I according to the Ann Arbor system. The case was treated by orchiectomy followed by prophylactic anthracycline-based chemotherapy and irradiation of the contralateral testis and central nervous system

Evaluation of new scoring system predicting the occurrence of deep infection in open fractures patients

Background: Open fractures of long bones incidence is 11.5 per 100,000 person per year. The management of open fractures had been improved by early adequate surgical debridement and various types of fracture fixation. The Gustilo classification is commonly used for treatment decisions and comparison. Although it had a good prediction power for deep infection but the variability among the inter observer was a problem. Yokoyama et al., 2009 he had advised a new scoring system based on three items of HFS-98 to predicting significant deep infections in open upper and lower extremity fractures.Methods: This study was conducted at Emergency Department Suez Canal University Hospital on 233 Patients with open fractures of long bones from April 2014 till November 2015. The patients were classified according to the criteria proposed by Gustilo classification & Yokoyama’s new scoring system. The relationship between the new score three items were investigated by categorical regression multivariate analysis.Results: In this study, we had 233 Patients with open fractures of long bones. Road traffic accidents were the mechanism of injury in (44.6%). Deep infection was positive in 70/233 patients with Gustilo GI. The cut-off point of application of Yokoyama’s new scoring system was 30, Sensitivity; 63.3%, Specificity; 89%, significant P-value <0.001.Conclusions:The cut-off point of the new Yokoyama’s new scoring application in this study was slit different from the reported applicable values before. This revised scoring system was thought to be useful for predicting deep. Further prospective trial is needed for advising new scoring system.

Comparative evaluation of cardiac health in patients with chronic liver disease secondary to HCV, HBV, and NASH

Background: There is a documented relationship between chronic liver disease and cardiac dysfunction. The current investigation aims to compare the cardiac health in patients with chronic liver disease secondary to HCV, HBV, and NASH. Patients and Methods: This prospective study included 150 patients divided into three groups; Group I (50 HCV cases), Group II (50 HBV cases), and Group III (50 NASH cases). Each group was subdivided into two equal subgroups; the A subgroup included patients without liver cirrhosis, and the B subgroup included patients with liver cirrhosis. The assessment included laboratory biomarkers, transabdominal ultrasound, fibroscan, echocardiography, and carotid doppler. Results: EF had mean values of 62.58, 62.8, and 64.14%, whereas prolonged QT interval was noted in 30%, 40%, and 37% of patients in the three groups, respectively. E/A ratios > 1 were detected in 70%, 66%, and 72% of patients, while carotid atherosclerosis was detected in 28%, 28%, and 32% in the same three groups, respectively. All of the previous parameters were comparable between the three main groups. On comparing subgroups A to B, prolonged QT intervals, carotid atherosclerosis, and decreased EF were more noticed in the latter.&nbsp

ASOCIERE ÎNTRE AgRON ȘI EXPRESIA IMUNOHISTOCHIMICĂ A COX2 şi iNOS ÎN CANCERUL VEZICII URINARE

OBJECTIVE: The objective of this study was to find out if there is correlation between AgNORs (Argyrophilic Nucleolar Organizer Region-associated proteins), COX2 and iNOS expression in bladder cancerMETHODOLOGY: The present study investigated the relationship between means AgNORs count and immunohistochemical expression of COX2 and iNOS in bladder carcinomas in serial paraffin sections from 155 bladder carcinomas. Thirty nine control cases of benign bladder cystitis lesions were included.RESULTS: Mean AgNOR counts correlated significantly with COX2 and iNOS, denoting P values of 0.000 for all three markers. Mean AgNOR count was significantly correlated with tumor type; the mean was 5.94 for SCC, 4.94 for TCC and 3.72 for benign bladder cystitis.CONCLUSION: Strong link between cell proliferation and cellular proliferative activity. Thus the three investigated markers (AgNORs, COX2 and iNOS) can be used as pre-warning factors of bladder cancers among patients at risk of bladder cancer.Keywords: Ag NORs, COX2. iNOS, Bladder cancer.OBIECTIV: Obiectivul acestui studiu a fost de a afla dacă există corelație între AgRON (proteinele organizator argyrofilic nucleolar regional asociate) şi COX2 și iNOS, în cancerul vezicii urinare.METODOLOGIE: Studiul a investigat relatia dintre valorile medii de AgRONs și expresia imunohistochimică de COX2 și iNOS în carcinoamele vezicii urinare în secțiuni seriale de parafină de la 155 de carcinoame ale vezicii urinare. Au fost incluse treizeci și nouă de cazuri- control de leziuni de cistita benignă a vezicii urinare.REZULTATE: valorile medii de AGRON se corelează în mod semnificativ cu COX2 și iNOS, rezultând valori ale P de 0.000 pentru toţi cei trei markeri. Media AgRON a fost corelată semnificativ cu tipul tumorii, media a fost de 5,94 pentru SCC, 4,94 pentru TCC și 3,72 pentru cistita benignă a vezicii urinare. CONCLUZIE: Există o legătură puternică între proliferarea celulelor și activitatea proliferativă celulară. Astfel, cei trei markeri investigaţi (AgRONs, COX2 și iNOS) pot fi utilizaţi ca factori de pre-avertizare de cancer al vezicii urinare la pacienții cu risc de cancer de vezică urinară.Cuvinte cheie : AgRON, COX2, iNOS , cancer de vezica urinară

Predictive value of S100B and brain derived neurotrophic factor for radiofrequency treatment of lumbar disc prolapse

Abstract Background This work aimed to analyze serum S100B levels and brain-derived neurotrophic factor (BDNF) in patients with lumbar disc prolapse to test their predictive values concerning the therapeutic efficacy of pulsed radiofrequency. Methods This prospective interventional study was carried out on 50 patients candidates for radiofrequency for treating symptomatic lumbar disc prolapse. Pain severity and functional disability were assessed using the Numeric Rating Scale (NRS) and Functional rating index (FRI) before as well as two weeks, 1, 3, and 6 months after the radiofrequency. Quantitative assessment of serum S100B level and BDNF was done for all the included patients one day before radiofrequency. Results The scores of NRS and FRI were significantly improved at two weeks, 1, 3, and 6 months following radiofrequency (P-value < 0.001 in all comparisons). Statistically significant positive correlations were found between duration of pain, NRS, and S100B serum level before radiofrequency, and both NRS (P-value = 0.001, 0.035, < 0.001 respectively) and FRI (P-value = < 0.001, 0.009, 0.001 respectively) 6 months following radiofrequency. Whereas there were statistically significant negative correlations between BDNF serum level before radiofrequency and both NRS and FRI 6 months following radiofrequency (P-value = 0.022, 0.041 respectively). NRS and S100B serum levels before radiofrequency were found to be independent predictors of NRS 6 months following radiofrequency (P-value = 0.040. <0.001, respectively). Conclusion Serum level of S100B is a promising biomarker that can predict functional outcomes after pulsed radiofrequency in patients with lumbar disc prolapse

A non-invasive AI-based system for precise grading of anosmia in COVID-19 using neuroimaging

COVID-19 (Coronavirus), an acute respiratory disorder, is caused by SARS-CoV-2 (coronavirus severe acute respiratory syndrome). The high prevalence of COVID-19 infection has drawn attention to a frequent illness symptom: olfactory and gustatory dysfunction. The primary purpose of this manuscript is to create a Computer-Assisted Diagnostic (CAD) system to determine whether a COVID-19 patient has normal, mild, or severe anosmia. To achieve this goal, we used fluid-attenuated inversion recovery (FLAIR) Magnetic Resonance Imaging (FLAIR-MRI) and Diffusion Tensor Imaging (DTI) to extract the appearance, morphological, and diffusivity markers from the olfactory nerve. The proposed system begins with the identification of the olfactory nerve, which is performed by a skilled expert or radiologist. It then proceeds to carry out the subsequent primary steps: (i) extract appearance markers (i.e., 1st and 2nd order markers), morphology/shape markers (i.e., spherical harmonics), and diffusivity markers (i.e., Fractional Anisotropy (FA) & Mean Diffusivity (MD)), (ii) apply markers fusion based on the integrated markers, and (iii) determine the decision and corresponding performance metrics based on the most-promising classifier. The current study is unusual in that it ensemble bags the learned and fine-tuned ML classifiers and diagnoses olfactory bulb (OB) anosmia using majority voting. In the 5-fold approach, it achieved an accuracy of 94.1%, a balanced accuracy (BAC) of 92.18%, precision of 91.6%, recall of 90.61%, specificity of 93.75%, F1 score of 89.82%, and Intersection over Union (IoU) of 82.62%. In the 10-fold approach, stacking continued to demonstrate impressive results with an accuracy of 94.43%, BAC of 93.0%, precision of 92.03%, recall of 91.39%, specificity of 94.61%, F1 score of 91.23%, and IoU of 84.56%. In the leave-one-subject-out (LOSO) approach, the model continues to exhibit notable outcomes, achieving an accuracy of 91.6%, BAC of 90.27%, precision of 88.55%, recall of 87.96%, specificity of 92.59%, F1 score of 87.94%, and IoU of 78.69%. These results indicate that stacking and majority voting are crucial components of the CAD system, contributing significantly to the overall performance improvements. The proposed technology can help doctors assess which patients need more intensive clinical care