Role of FNAC in Early Detection and Diagnosis of Lung Lesions with Histo-radiological Correlation and Clinical Insights in a Tertiary Care Centre

Background: Carcinoma of lung has now become increasingly frequent during the last 60 years; this increase is seen in males and especially in the females. Cytological evaluation from respiratory tract is the initial investigation along with radiological investigations in patients suspected to have pulmonary diseases. The various cytological samples included transbronchial needle aspiration, guided fine needle aspiration cytology (FNAC) smears and pleural fluid. Present study was undertaken to study the spectrum of lesions diagnosed by cytomorphological analysis of various cytological samples and correlation of the histopathology, cytology and radiology of lung lesions. Materials and Methods: Centrifuged and direct smears from received samples were stained with MGG and PAP stain. Cytohistological correlation was done when biopsy was available with radiological correlation & comparison of topographic display. Results: Present study was carried out during the period of December 2018 to November 2019. During this period, of total 52 cases, 36 (69.2%) were males and 16 (30.8%) were females. Their age ranged from 26 years to 73 years, most patients (53.8) belonged to the age group of 56 – 65 years. The literacy status of the patients was assessed. 2 out of 52 (3.8%) patients were illiterate, 8 out of 52 (15.4%) patients were educated above H.S. level. Adenocarcinoma was seen to be the most prevalent 29 (55.7%) followed by squamous cell carcinoma 12 (23.0%) among the cases studied. Smoking was seen to be the most common addiction i.e. 34 out of 52 cases (65.4%). Among non-smokers 66.7% presented with adenocarcinoma and 16.6% cases with squamous cell carcinoma. The topography of the neoplasms within the lungs was assessed radiologically. On chest X ray (82.6%) lung lesions were identified; (48%) of patients were found to have pleural effusion. By using CT SCAN, all masses were located definitely. Conclusion: A good correlation between cytology and histopathology is revealed in our study. Guided FNAC helps in early detection and diagnosis of lung lesions and facilitates appropriate management of patients. Keywords: Lung, Carcinoma, Detection, Diagnosis, Fine needle aspiration, Cytology, Histopathology, Radiology, Correlatio

Fibrinogen inhibits sonic hedgehog signaling and impairs neonatal cerebellar development after blood-brain barrier disruption.

Cerebellar injury in preterm infants with central nervous system (CNS) hemorrhage results in lasting neurological deficits and an increased risk of autism. The impact of blood-induced pathways on cerebellar development remains largely unknown, so no specific treatments have been developed to counteract the harmful effects of blood after neurovascular damage in preterm infants. Here, we show that fibrinogen, a blood-clotting protein, plays a central role in impairing neonatal cerebellar development. Longitudinal MRI of preterm infants revealed that cerebellar bleeds were the most critical factor associated with poor cerebellar growth. Using inflammatory and hemorrhagic mouse models of neonatal cerebellar injury, we found that fibrinogen increased innate immune activation and impeded neurogenesis in the developing cerebellum. Fibrinogen inhibited sonic hedgehog (SHH) signaling, the main mitogenic pathway in cerebellar granule neuron progenitors (CGNPs), and was sufficient to disrupt cerebellar growth. Genetic fibrinogen depletion attenuated neuroinflammation, promoted CGNP proliferation, and preserved normal cerebellar development after neurovascular damage. Our findings suggest that fibrinogen alters the balance of SHH signaling in the neurovascular niche and may serve as a therapeutic target to mitigate developmental brain injury after CNS hemorrhage

Continuous Glucose Monitors and Automated Insulin Dosing Systems in the Hospital Consensus Guideline.

This article is the work product of the Continuous Glucose Monitor and Automated Insulin Dosing Systems in the Hospital Consensus Guideline Panel, which was organized by Diabetes Technology Society and met virtually on April 23, 2020. The guideline panel consisted of 24 international experts in the use of continuous glucose monitors (CGMs) and automated insulin dosing (AID) systems representing adult endocrinology, pediatric endocrinology, obstetrics and gynecology, advanced practice nursing, diabetes care and education, clinical chemistry, bioengineering, and product liability law. The panelists reviewed the medical literature pertaining to five topics: (1) continuation of home CGMs after hospitalization, (2) initiation of CGMs in the hospital, (3) continuation of AID systems in the hospital, (4) logistics and hands-on care of hospitalized patients using CGMs and AID systems, and (5) data management of CGMs and AID systems in the hospital. The panelists then developed three types of recommendations for each topic, including clinical practice (to use the technology optimally), research (to improve the safety and effectiveness of the technology), and hospital policies (to build an environment for facilitating use of these devices) for each of the five topics. The panelists voted on 78 proposed recommendations. Based on the panel vote, 77 recommendations were classified as either strong or mild. One recommendation failed to reach consensus. Additional research is needed on CGMs and AID systems in the hospital setting regarding device accuracy, practices for deployment, data management, and achievable outcomes. This guideline is intended to support these technologies for the management of hospitalized patients with diabetes

CEOs\u27 understanding of blockchain technology and its adoption in export-oriented companies in West Sweden: a survey

Purpose The purpose of this paper is to study current practices in adopting blockchain technology amongst export companies in West Sweden and to capture their CEOs\u27 knowledge of and attitudes towards blockchains. Design/methodology/approach Factors enabling or hindering the adoption of blockchains were identified from a comprehensive literature review and a survey of 72 chief executive officers (CEOs) of export-oriented firms in West Sweden, all with turnovers exceeding euro2m, regarding their knowledge of and attitudes towards blockchains. Findings Blockchain technology is not currently perceived to provide benefits that would outweigh the costs of introducing it into West Sweden\u27s export firms. Nevertheless, the findings suggest that such technology, though currently too immature to meet today\u27s industrial requirements, could experience more widespread use if certain key factors (i.e. lower cost, traceability, improved security or trustworthiness and new blockchain-enabled business models) are prioritised. Research limitations/implications Answered by 72 CEOs, the survey achieved a response rate of 6%, meaning that the findings are only exploratory. Even so, they offer new insights into CEOs\u27 attitudes towards blockchain technology. Practical implications The CEOs reported comparatively limited knowledge of and experience with implementing blockchains, the lack of which has hampered their large-scale implementation in multi-actor supply chains. Social implications Negative sentiment amongst CEOs towards blockchain technology may lower on-the-job satisfaction amongst tech personnel aspiring to develop and implement blockchain applications in their firms. Originality/value Knowledge of and attitudes towards blockchain technology amongst top-level managers, as well as about factors enabling or hindering its adoption, guide managers in crafting strategies for implementing blockchains in their organisations and maximising the benefits therein. Unlike past studies focussing on technological aspects or views of experts and middle-management, the study was designed to capture the views of CEOs

Osteosarcoma cell proliferation and survival requires mGluR5 receptor activity and is blocked by Riluzole.

Osteosarcomas are malignant tumors of bone, most commonly seen in children and adolescents. Despite advances in modern medicine, the poor survival rate of metastatic osteosarcoma has not improved in two decades. In the present study we have investigated the effect of Riluzole on a human and mouse metastatic osteosarcoma cells. We show that LM7 cells secrete glutamate in the media and that mGluR5 receptors are required for the proliferation of LM7 cells. Riluzole, which is known to inhibit glutamate release, inhibits proliferation, induces apoptosis and prevents migration of LM7 cells. This is also seen with Fenobam, a specific blocker of mGluR5. We also show that Riluzole alters the phosphorylation status of AKT/P70 S6 kinase, ERK1/2 and JNK1/2. Thus Riluzole is an effective drug to inhibit proliferation and survival of osteosarcoma cells and has therapeutic potential for the treatment of osteosarcoma exhibiting autocrine glutamate signaling

Riluzole prevents migration of LM7 cells.

<p>Scratch assay was performed to measure migration of LM7 cells. Cells were either treated with vehicle for control or treated with 100 μM Riluzole, scratched and images of the gap created were captured at 0 time, 8 and 24 hours using phase contrast inverted scope. <b>A.</b> Representative images of the scratch in samples at 0 h and 24 hr. <b>B.</b> The gap distance was measured from 3 scratches in each image at 0, 8 and 24 hours. <b>C.</b> The distance travelled by the cells in the images was measured at 8 and 24 hrs.</p

Knockdown of mGluR5 slows growth of LM7 cells.

<p>Colonies stained by Cresyl Violet are shown from WT, control ShRNA and mGluR5 KO samples. <b>B.</b> The number of colonies in each sample from three independent experiments. <b>C.</b> Western blot of whole cells extracts from WT, control ShRNA and mGluR5 KO using anti mGluR5 antibody. μ-Tubulin is used as a loading control.</p

Schematic of mechanism of action of Riluzole.

<p>Glutamate released from LM7 cells binds and activates mGluR receptor signaling that in turn induces the activation of genes involved in proliferation. Riluzole treatment inhibits glutamate release thereby preventing the activation of glutamate receptors. Similarly, blocking of mGluR receptors with Fenobam also prevents mGluR5 activation and signaling thereby blocking activation of proliferation genes.</p

Blocking metabotropic receptors inhibits LM7 growth.

<p><b>A.</b> Specific inhibitor of mGluR1, CPCCOEt (CCPD) 40 μM or mGluR5 inhibitor, Fenobam 300 μM, were used to measure total number of cell by DAPI staining. <b>B.</b> Proliferation was measured using Ki-67 staining after blocking with specific mGluR inhibitor. <b>C.</b> Apoptosis was performed using TUNEL in LM7 cells in the presence of specific mGluR1 or mGluR5 inhibitors. <b>D.</b> Percent apoptosis was calculated based on DAPI numbers for samples in Fig 5A. <b>E.</b> LM7 cells express mGluR5. Whole cell extracts from LM7 cells were analyzed by Western blot using mGluR5 antibodies. P value <0.01 = **, P value < 0.001 = ****.</p