Histological Tracking into the Third Dimension: Evolution of Early Tumorigenesis in VHL Kidney

Using a novel three-dimensional (3D) approach, we tracked histological changes to elucidate the earliest stages of renal clear cell neoplasia in normal kidney tissue of patients with von Hippel-Lindau (VHL) disease. Tissue blocks of interest were procured, serially sectioned, and 3D reconstruction of the entirety of pathologic events was performed. The results reveal an abundance of foci with aberrant clear cell proliferation that initially develop along the tubular lining, but have the potential to aggregate within individual tubules. This stage is followed by the extension of clear cell aggregates beyond the tubular basement membrane, which allows for the recruitment of angiogenesis derived from interstitial vasculature. The results suggest that the most frequent pathologic event in VHL kidneys is the presence of isolated or aggregated clear cells within the tubular epithelium, potentially developing further into a protracted process of neoplasia. The abundance of independent pathologic events in VHL kidneys confirms developmental mechanisms to precede tumor initiation. To our knowledge, this is the first report demonstrating that tracking of histologic changes in the 3rd dimension enables the confirmation of the sequence of events from the earliest pathologic change in the VHL kidney to the neoplastic stage. This approach is not only useful for visualization and quantification of pathologic changes but also for targeted sampling allowing selective analysis of the earliest stages of clear cell carcinogenesis

Characterization of Microscopic Multicellular Foci in Grossly Normal Renal Parenchyma of Von Hippel-Lindau Kidney

Background and Objectives: This study aims to describe the earliest renal lesions in patients with von Hippel-Lindau (VHL) disease, especially the multicellular microscopic pathologic events, to get information into the genesis of renal neoplasms in this condition. Materials and Methods: Multicellular events were identified, and 3dimensional reconstruction was performed in grossly normal kidney parenchyma from VHL disease patients by using H&E-stained slides previously prepared. Results: The lesions were measured and the volume of clusters was calculated. Immunohistochemistry was performed for downstream HIF-target protein carbonic anhydrase 9 (CAIX) as well as CD34 for assessment of angiogenesis. We divided lesions into four types according to lesion height/size. The number of lesions was markedly decreased from lesion 1 (smallest) to lesion 2, then from lesions 2 to 3, and again from lesion 3 to 4. Distribution was highly consistent in the four cases, and the same decrement pattern was seen in all blocks studied. The volumes of clusters were measured and divided into three categories according to their volume. The most frequent pathologic event in VHL kidneys was category 1 (smallest volume), then category 2, and then category 3. Conclusion: We demonstrate that tracking histologic and morphologic changes in 3 dimensions of multicellular microscopic pathologic events enabled us to confirm a protracted sequence of events from smaller to larger cellular amplification events in VHL kidney

The effectiveness of a cognitive-behavioral therapy program in reducing the risk of relapse for recovering addicts

The study aimed to identify the effectiveness of the cognitive-behavioral therapy program in reducing the risk of relapse for recovering addicts. The study applied the quasi-experimental approach, where the study sample consisted of (10) individuals addicted to the substance (Ceptagon and Synthetic cannabinoids), who are present in the addiction treatment center / Arjan. They were divided into two equal groups, an experimental group consisting of (5) drug addicts, and a control group consisting of (5) drug addicts. The criteria for evaluating the factors of addict’s relapse were applied to them, in addition to the treatment program. Moreover, the study found the effectiveness of the program in reducing the risk of relapse for the recovering addicts, the research sample. It showed the presence of statistically significant differences between the ranks of the degrees of the two measurements, pre and post tests, for the experimental group, and also showed that there were no statistically significant differences between the ranks of the degrees of the two measurements. It also reflected that there were no statistically significant differences between the ranks of the dimensional and follow-up measurement degrees for the experimental group on the relapse scale and its dimensions for the research sample of recovering addicts

The effectiveness of a cognitive-behavioral therapy program in reducing the risk of relapse for recovering addicts

The study aimed to identify the effectiveness of the cognitive-behavioral therapy program in reducing the risk of relapse for recovering addicts. The study applied the quasi-experimental approach, where the study sample consisted of (10) individuals addicted to the substance (Ceptagon and Synthetic cannabinoids), who are present in the addiction treatment center / Arjan. They were divided into two equal groups, an experimental group consisting of (5) drug addicts, and a control group consisting of (5) drug addicts. The criteria for evaluating the factors of addict’s relapse were applied to them, in addition to the treatment program. Moreover, the study found the effectiveness of the program in reducing the risk of relapse for the recovering addicts, the research sample. It showed the presence of statistically significant differences between the ranks of the degrees of the two measurements, pre and post tests, for the experimental group, and also showed that there were no statistically significant differences between the ranks of the degrees of the two measurements.&nbsp