The expression of monocarboxylate transporters in thyroid carcinoma can be associated with the morphological features of BRAF (V600E) mutation

BRAF (V600E) mutation, usually performed by DNA techniques, is one of the most common diagnostic markers in papillary thyroid carcinoma. Few papers have demonstrated that plump cells (eosinophilic cytoplasms and papillary thyroid carcinoma nuclei) and peculiar sickle-shaped nuclei represent morphological features of BRAF (V600E) on papillary thyroid carcinomas. These features seem to be linked to glycolytic phenotype whereby monocarboxylate transporters 1-4 are hypothesized to have a dominant role as lactate transporters. We investigated the association between these morphological features and monocarboxylate transporters 1 and 4 in 48 cyto-histological samples diagnosed as "positive for malignancy-favoring papillary thyroid carcinoma". These cases were processed with liquid-based cytology and underwent BRAF (V600E) mutational analysis (pyrosequencing) on liquid-based cytology and monocarboxylate transporters immunostaining on histology. The expression of monocarboxylate transporter 1, monocarboxylate transporter 4, glucose trasporter-1 and carbonic anhidrase were scored semi-quantitatively with expression from 0 to 3+ (strong positivity). The 33 mutated and 15 wild type cases showed 100 % cyto-histological concordance. The cytological evaluation revealed plump cells and sickle nuclear shape in 100 % mutated cases. Monocarboxylate transporter 1 yielded 76 % positivity in the mutated cases especially in both the plump cells and sickle-shaped nuclei, whereas the wild types showed 13.3 % positive monocarboxylate transporter 1 (p = 0.00013). Monocarboxylate transporter 4 resulted in 100 % positivity in mutated and 40 % in wild types (p 0.05). This is the first report analyzing the association between monocarboxylate transporter expression and the morphological features of BRAF (V600E) mutated papillary thyroid carcinomas suggesting the possible involvement of lactate in the morphological features.info:eu-repo/semantics/publishedVersio

ICAR: endoscopic skull‐base surgery

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Using an equity-based framework for evaluating publicly funded health insurance programmes as an instrument of UHC in Chhattisgarh State, India

Universal health coverage (UHC) has provided the impetus for the introduction of publicly funded health insurance (PFHI) schemes in the mixed health systems of India and many other low- and middle-income countries. There is a need for a holistic understanding of the pathways of impact of PFHI schemes, including their role in promoting equity of access. Methods: This paper applies an equity-oriented evaluation framework to assess the impacts of PFHI schemes in Chhattisgarh State by synthesising literature from various sources and highlighting knowledge gaps. Data were collected from an extensive review of publications on PFHI schemes in Chhattisgarh since 2009, including empirical studies from the first author's PhD and grey literature such as programme evaluation reports, media articles and civil society campaign documents. The framework was constructed using concepts and frameworks from the health policy and systems research literature on UHC, access and health system building blocks, and is underpinned by the values of equity, human rights and the right to health

Large Epithelial and Stromal Lesion of Breast: It’s Not Always Phyllodes!

Fibroepithelial lesions (FELs) of breast often pose a diagnostic challenge to pathologists.1 In this article, we share gross and microscopic findings of 3 large breast lesions with epithelial and spindle cell components: (1) a giant fibroadenoma (FA; Figure 1 [1A-C]), (2) a borderline phyllodes tumor (World Health Organization classification2; Figure 1 [2A-C]), and (3) a nodular pseudoangiomatous stromal hyperplasia (NPASH; Figure 1 [3A-C]). This brief report highlights histological overlap between NPASH and FELs, and describes morphological clues that can help pathologists in differentiating NPASH from FELs with PASH-like stroma

Spatio-temporal Identification of Regions with Anomalous Values of 222 Rn in Groundwater of Madurai District, Tamilnadu, India

Measurement of dissolved radon (222 Rn) activity concentration in groundwater samples from private and public hand pumps, and in bore wells located at Madurai district of Tamilnadu, India, are presented. The study attempts to identify the background value of 222 Rn in groundwater of hard rock terrain and the main aquifer contributing 222 Rn, and to determine if any correlation exists with observed field parameters. Measured parameters included pH, TDS, Temperature and 222 Rn in 42 samples for two seasons (South West Monsoon [SWM] and North East Monsoon [NEM]). The results show that the 222 Rn activity concentration of the samples ranged from 0.049 to 59.952 Bq/L in South west monsoon and 0.12 to 211.60 Bq/L in North east monsoon. The higher activity was noted in NEM and the highest 222 Rn concentrations were observed in granitic terrains in both seasons. The average values of the parameters studied shows that there is a general decrease of TDS and Temperature, but an increase in 222 Rn and pH during NEM. The spatial representation of the activity shows that maximum values are in the north eastern part of the study area. Further, correlations between the measured parameters show that temperature has a negative correlation to the samples of charnockite formation during both seasons; pH and TDS also show negative relationships to 222 Rn during SWM