Sporadic Lymphangioleiomyomatosis Disease: A Case Report

Pulmonary Lymphangioleiomyomatosis (LAM) is a rare disease of the lung and lymphatic system that primarily affects women of childbearing age. LAM is a progressive disease with a terrible prognosis, which worsens over time and is extremely difficult to treat. In this study, we discuss the case of a 31-year-old woman with LAM who was initially misdiagnosed with leiomyoma and the way that led to a true diagnosis and effective treatment. Following a precise diagnosis based on comprehensive clinical data and particular immunohistochemical tests, sirolimus treatment was initiated, and the patient entirely responded to the treatment. This case report demonstrated that LAM is an uncommon condition that is challenging to diagnose, which causes its treatment to be delayed

Bone Marrow and Karyotype Findings of Patients with Pancytopenia in Southern Iran

Background: Pancytopenia is a manifestation of a wide range of disorders. The main prognostic factor for predicting outcome and response to treatment is based on the underlying cause. To detect the root cause of this problem, depending on other accompanied signs or symptoms, the need for bone marrow examination and other advanced work ups is different at least at the practical level. This study focuses on the karyotype abnormality and to demonstrate the ability of this complimentary study in diagnosis and prognosis of such patients. Methods: In this cross sectional study, bone marrow aspiration samples of all patients with Pancytopenia underwent cytogenetic investigation on bone marrow aspiration. Gathered data were analyzed by SPSS software. Results: Among the 100 eligible patients, 67% revealed hypercellular, 19% had hypocellular and 13% had normocellular marrow. Most common causes of pancytopenia were myelodysplastic syndrome (MDS) (33%), MDS vs. megaloblastic anemia (23%) and acute leukemia (18%). Thirty one patients had karyotype abnormality in which majority (13 patients) were diagnosed as MDS followed by 11 patients with acute leukemia. Conclusion: Beside bone marrow examination, there is a need for more supplementary studies like karyotyping to detect the exact cause of pancytopenia. It is concluded that cytogenetic study on bone marrow aspiration can be a complementary test in diagnosis of pancytopenic patients. However, there are also cases where diagnosis even with implementing bone marrow examination and cytogenetic analysis is not possible. Such patients require more clinical follow-up and investigation

Two Invasive Thymomas Incidentally Found during Coronary Artery Bypass Graft Surgery

Thymoma, the most common neoplasm of the anterior mediastinum, is a rare tumor of thymic epithelium that can be locally invasive. We reported 2 cases of invasive thymoma incidentally found during routine coronary artery bypass graft (CABG) surgery at Faghihee Hospital of Shiraz University of Medical Sciences of Iran in a period of about 6 months. The 2 patients were male and above 60 years old. They had no clinical symptoms and radiological evidence of mediastinal mass before detection of the tumor during operation. For both patients mass was completely excised and sent to the laboratory. The ultimate pathological diagnosis of both masses was invasive thymoma (stage 2). There are few reports in which thymomas were found incidentally during cardiac surgery. In spite of rare coincidence, due to being asymptomatic and possibly invasive, special attention to thymus gland during cardiac surgery or other mediastinal surgery and preoperative imaging studies seem to be reasonable approach

Relationship between Non-Technical Factors and Diagnostic Accuracy of Frozen Section in Axillary Lymph Nodes in Patients with Breast Cancer

Background and purpose: Regional lymph node involvement is one of the main prognostic factors for breast cancer. Intraoperative assessment of sentinel lymph node biopsy (SLNB) by frozen section (FS) allows necessary axillary lymph node dissection (ALND) at the same time. But, false negative results are the main problems of the FS. The aim of this study was to investigate the relationship between non-technical factors and occurrence of false negative FS results in SLNB. Materials and methods: In this retrospective cross-sectional research, we studied the medical records of patients who underwent breast cancer surgery and SLNB in 2017-2018 in Shiraz Shahid Faghihi Hospital. FS and permanent pathology (standard method for examining pathology specimens) reports were compared to determine the rate of false negatives results. Results: We investigated 198 patients. The average size of breast mass was26.2 mm. Sensitivity, specificity and false negative rate were 80%, 98.4%, and 19.6%, respectively. Among the non-technical factors studied, including breast tumor diameter, type of pathology, micrometastasis, tumor grade, and lymphovascular involvement, there was a significant relationship between lymphovascular involvement and false negative results (P= 0.026). Conclusion: The present study showed that false-negative results were significantly higher in mass with lymphovascular invasion

Diagnostic Accuracy of Immunologic Biomarkers for Accurate Diagnosis of Bloodstream Infection in Patients with Malignancy: Procalcitonin in Comparison with C-Reactive Protein

Purpose. To calculate the diagnostic value of C-reactive protein (CRP) and serum procalcitonin (PCT) levels for the pathologic presence of microbes in the bloodstream of patients with malignancy, in comparison with blood culture. Methodology. Blood culture (by reference method) and assay results of PCT and CRP of febrile patients, with clinical suspicion to blood infections, were collected. Statistical aspects of PCT  and CRP tests were evaluated. Results. Data from 255 cases were gathered. The area under the curve for differentiating bacteremia from nonbacteremia for PCT (0.741) was superior to that of CRP (0.612). Amongst the different cutoffs of PCT and CRP, the cutoff of ≥1.17 ng/ml and >47 mg/l had the sensitivity of 75 and 58.3%, the best NPV of 91.5% and 81.3%, and the best specificity of 79.9% and 72.8%, respectively. Discussion. Despite statistically nonsignificant results, PCT seems to be a superior indicator to CRP for rejecting the presence of microorganism in bloodstream. For PCT, the cutoff value of 1.17 ng/ml (bacteremia from nonbacteremia) had the highest NPV value of 91.5% in malignant patients, suspicion of sepsis

Pulmonary atypical carcinoid tumor in a 15-year-old girl: a case report and review of the literature

Primary pulmonary neoplasms in children are very rare, and because of their rarity, delays in diagnosis and treatment are common. Bronchial typical carcinoid accounts for 80% of primary malignant tumors, but, there are less than 40 proven cases in children reported in literature. Atypical carcinoids (AC) are the least common type of pulmonary carcinoids among children and to the best of our knowledge less than 10 cases have been reported in the English literature so far. Herein we present an extremely rare case of AC in a 15-year-old child and review the previously reported and published cases of pulmonary AC in pediatric age group

Functionalization of Graphene Oxide Nanosheets Can Reduce Their Cytotoxicity to Dental Pulp Stem Cells

Background. The dental pulp is a heterogeneous soft tissue that supplies nutrients and acts as a biosensor to identify pathogenic stimuli. Regeneration of the dental pulp is one of the desirable topics for researchers. Graphene oxide nanosheets (nGOs) help overexpression of the genes related to odontogenic differentiation of stem cells from dental pulps and increases attachment and proliferation of dental pulp stem cells. Despite its benefits, nGO may be considered as a threat to the environment and human health. Therefore, the purpose of this study was to evaluate the biocompatibility potential of graphene oxide (nGO), chitosan functionalized graphene oxide (nGO-CS), and carboxylated graphene (nGO-COOH) when exposed to human dental pulp stem cells (hDPSCs). Material and Methods. Some different aspects of biocompatibility of nGO, nGO-CS, and nGO-COOH were synthesized, and several intracellular effects induced by different concentrations of graphene-based nanosheets, including cell viability, intracellular oxidative damages, and various factors such as LDH, GSH, SOD, MDA, and MMP, were studied on hDPSCs. Results. According to results, IC50 was determined as 232.01, 467.81, and ≥1000 μg/mL for nGO, nGO-CS, and nGO-COOH, respectively. These results demonstrated the lower toxicity and higher cytocompatibility of nGO-CS and nGO-COOH compared to nGO. nGO-COOH not only has any adverse effect on the cell membrane and mitochondrial activity but also shows slight antioxidant activity at some concentrations. Conclusion. The findings help design safe and cytocompatible nGO derivatives for biomedical applications in dental fields

Protective Effects of Hydroalcoholic Extract of Rosa canina Fruit on Vancomycin-Induced Nephrotoxicity in Rats

Vancomycin-induced nephrotoxicity (VIN) has been reported to occur in 5–35% of recipient patients. The aims of the study were to evaluate protective effects of Rosa canina (RC) on VIN in rats. Rats were randomly divided into five groups as follows: control group I, group II (received VAN 400 mg/kg/day, every 12 h at doses of 200 mg/kg/day, for 7 consecutive days), group III (VAN + RC 250 mg/kg/day, for 7 consecutive days), group IV (VAN + RC 500 mg/kg/day, for consecutive days), and group V (received RC 500 mg/kg/day, for consecutive 7 days). On the eighth day after anesthetizing the animals, blood samples were taken from the heart, and then, the kidneys were removed to investigate kidney function, oxidative stress, and histopathological marker. Also, the chemical composition of RC extract was identified by GC-MS analysis. Oral dose of 500 mg/kg RC extract significantly reduced the serum levels of blood urea nitrogen (BUN), creatinine (Cr), malondialdehyde (MDA), and nitric oxide (NO) and also the kidney tissue MDA, protein carbonyl, and NO metabolites (nitrite) levels compared to the VAN-treated group (P<0.05). Based on histopathological analysis, RC extract at the dose of 500 mg/kg inhibited the destructive effects of VAN on kidney tissues. GC-MS analysis indicated that the main compositions were found to be lactose (21.96%), 3-t-butyloxaziridine (20.91%), and 5-oxymethylfurfurole (16.75%). The results indicated that oral administration of RC was able to reduce VAN-induced nephrotoxicity in rats, possibly through antioxidant pathways