A Study of Agreement between Clinicoradiological and Histopathological Diagnosis of Bone Tumours and Tumour: Like Lesions with FNAC Study in Selected Cases

BACKGROUND: Bone tumours and tumour-like lesions are rare. However, they cause significant morbidity and mortality. Histopathological examination of bone tumours is considered to be a challenging field in pathology and final diagnosis should be given only after review of clinical and radiological findings. FNAC (Fine Needle Aspiration Cytology) evaluation of bone tumours is a safe, simple and cost-effective procedure that is minimally disruptive to bone. In this era of neoadjuvant chemotherapy and limb salvage surgeries, FNAC is proving to be a valuable tool in preliminary diagnosis of bone tumours. This study aims at elaborating the various bone tumours and analysing the age and gender distribution of these tumours. The agreement between clinico-radiological and histopathological diagnosis of bone tumours has been studied. An attempt has been made to study the FNAC findings of bone tumours. Immunohistochemical markers have been used to confirm diagnosis in challenging bone tumours. METHODS: The study was carried out in the Department of Pathology, Madurai Medical College, Madurai, during the period from May 2012 to July 2014 on 90 specimens of bone tumours and tumour-like lesions received in the department after exclusion of specimens with leukaemic infiltration of marrow. After adequate fixation and decalcification, representative bits were taken, processed and stained with Haematoxlyin and Eosin. The cases were classified based on WHO classification, 2002. Cohen’s Kappa value was calculated to test the strength of agreement between clinico-radiological and histopathological diagnosis. FNAC was performed on 15 bone tumours and slides stained with H&E after fixation. The observations were compared with other studies and inferences drawn. The provisional histopathological diagnosis of two bone tumours was confirmed by immunohistochemical markers. RESULTS: Bone tumours and tumour-like lesions formed only 1.03% of all diagnosed neoplasms received in the department during the study period. Benign bone tumours formed 58.9% of the study material and 36.7% were malignant bone tumours. Among the malignant tumours, 66.7% were primary bone malignancies and 33.3% cases were metastatic deposits. Cartilage tumours formed the major category constituting 43.3%. Osteosarcoma was the most common primary bone malignancy (50%) while osteochondroma was the commonest benign tumour (66%). The incidence of tumours was maximum during second decade of life (45.6%). Osteosarcoma and osteoid osteoma showed predilection for males. Bone tumours were most commonly encountered around the knee joint (23.3%). Metastasis occurred most commonly in the femur (36.4%). 85 cases showed agreement between clinicoradiological and histopathological diagnosis. In 5 cases, the histopathological diagnosis was not in agreement with clinicoradiological diagnosis. Cohen’s Kappa value was 0.943 which showed excellent agreement between clinicoradiological and histopathological diagnosis. Out of the 12 adequate FNAC smears, categorisation was correctly done in 10 cases. However, in 2 cases of suspected osteosarcoma, a cytological diagnosis of sarcoma, not otherwise specified was given due to lack of osteiod. These two cases were later confirmed by histopathology to be osteosarcoma. IHC was used to confirm a provisional histopathological diagnosis of primary bone lymphoma using CD 45 immunostain. Also, a provisional histopathological diagnosis of metastatic deposits of follicular thyroid carcinoma to skull with occult primary was confirmed by TTF -1 and Thyroglobulin immunomarkers. CONCLUSION: There is very good agreement between clinico – radiological and histopathological diagnosis in bone tumours. However, many benign bone tumours and tumour - like lesions mimic malignant lesions radiologically. Hence, histopathological confirmation of radiological diagnosis should always be done before definitive treatment. A close co – ordination between the orthopaedician, radiologist and pathologist is the best approach to treat a patient with bone tumours. Cytology can serve as a good tool for rendering quick and cost effective diagnosis for further management. However, the results of FNAC should be cautiously interpreted and when in doubt, histopathological confirmation should be obtained before treatment. Immunohistochemistry has its own role in bone tumour diagnosis. It can be a valuable tool in categorising small round cell tumours and determining sites of occult primary in case of metastasis to bone

Ketorolac eye drop induced allergic wheal and chemosis

Ketorolac is a non-steroidal anti-inflammatory drug which is prescribed rampantly in the treatment of seasonal allergic conjunctivitis due to its clinical efficacy of providing rapid relief from symptoms of allergy. There is a potential for cross sensitivity to aspirin. Hence, a leading question on aspirin allergy must be taken before prescribing the drug ketorolac

Interactive Multi-Instrument Database of Solar Flares

The fundamental motivation of the project is that the scientific output of solar research can be greatly enhanced by better exploitation of the existing solar/heliosphere space-data products jointly with ground-based observations. Our primary focus is on developing a specific innovative methodology based on recent advances in "big data" intelligent databases applied to the growing amount of high-spatial and multi-wavelength resolution, high-cadence data from NASA's missions and supporting ground-based observatories. Our flare database is not simply a manually searchable time-based catalog of events or list of web links pointing to data. It is a preprocessed metadata repository enabling fast search and automatic identification of all recorded flares sharing a specifiable set of characteristics, features, and parameters. The result is a new and unique database of solar flares and data search and classification tools for the Heliophysics community, enabling multi-instrument/multi-wavelength investigations of flare physics and supporting further development of flare-prediction methodologies

DABCO promoted one-pot synthesis of dihydropyrano(c)chromene and pyrano[2,3-d]pyrimidine derivatives and their biological activities

AbstractA simple and efficient one-pot synthesis of heteroaryl substititued dihydropyrano(c)chromenes and pyrano[2,3-d]pyrimidines has been developed via initial Knoevenagel, subsequent Micheal and final heterocyclization reactions of heteroaryl aldehyde, malononitrile and barbituric acid/ dimedone. 1,4-Diazabicyclo [2.2.2] octane (DABCO) has been used as a catalyst. Short reaction time, environment friendly procedure and excellent yields are the main advantages of this procedure. All synthesized compounds have shown good antimicrobial activity against different microbial stains

Satellite Remote Sensing Applications in Mariculture Activities

During the last two decades the marine fisheries sector in India has undergone considerable change. The fishing fleet became larger and more energy-intensive, and the catch and trade of marine fishes increased substantially. Concern arising from the increasing fishing effort and the potential for overexploitation in Indian waters, led to scientific assessment of the status of several fish stocks. Consequently, attempts were made to shift from open to regulated access fisheries through Marine Fishing Regulation Acts (MFRAs). However, conflicts in sharing the limited resources intensified within and with other sectors and this, in turn, had high economic, social and environmental costs (Vision 2050, CMFRI). Thus, in recent years, the sector recognized the need for effective management for sustainable fisheries and a healthy marine environment through ecosystem approach and habitat restoration. Success has been achieved in mariculture, raising hopes of producing a plentiful supply of fish in future by farming marine fis

Contrasting Infection Strategies in Generalist and Specialist Wasp Parasitoids of Drosophila melanogaster

Although host–parasitoid interactions are becoming well characterized at the organismal and cellular levels, much remains to be understood of the molecular bases for the host immune response and the parasitoids' ability to defeat this immune response. Leptopilina boulardi and L. heterotoma, two closely related, highly infectious natural parasitoids of Drosophila melanogaster, appear to use very different infection strategies at the cellular level. Here, we further characterize cellular level differences in the infection characteristics of these two wasp species using newly derived, virulent inbred strains, and then use whole genome microarrays to compare the transcriptional response of Drosophila to each. While flies attacked by the melanogaster group specialist L. boulardi (strain Lb17) up-regulate numerous genes encoding proteolytic enzymes, components of the Toll and JAK/STAT pathways, and the melanization cascade as part of a combined cellular and humoral innate immune response, flies attacked by the generalist L. heterotoma (strain Lh14) do not appear to initiate an immune transcriptional response at the time points post-infection we assayed, perhaps due to the rapid venom-mediated lysis of host hemocytes (blood cells). Thus, the specialist parasitoid appears to invoke a full-blown immune response in the host, but suppresses and/or evades downstream components of this response. Given that activation of the host immune response likely depletes the energetic resources of the host, the specialist's infection strategy seems relatively disadvantageous. However, we uncover the mechanism for one potentially important fitness tradeoff of the generalist's highly immune suppressive infection strategy

Free volume study of poly(chlorotrifluoroethylene) using positron annihilation spectroscopy as a microanalytical tool

Positron lifetimes and X-ray diffraction measurements were carried out on poly(chlorotrifluoroethylene) films annealed between 25 and 215 degrees C. The positron lifetime results were used to determine the free volume and XRD data were used to determine the apparent crystallite size and crystallinity. The glass transition temperature (T-g) of 52 degrees C obtained from positron results is in agreement with that obtained by thermal analysis. The average free volume cell size is 74 Angstrom(3) in films annealed below T-g, and increases to 84 Angstrom(3) in samples annealed above T-g. Although the observed changes in positron lifetime parameters as a function of annealing temperature are small, they are significant for the kind of material investigated. Our observations are explained in terms of thermally activated chain mobility, local relaxations and long-range motions. We further estimate, for the first time, the activation energies in the amorphous and crystalline regions of the polymer using the Goldanskii kinetic relations. Copyright (C) 1996 Elsevier Science Ltd

Airflow Directed Acyclic Graph

The paper “Airflow Dags” is based on the generation of directed acyclic graphs during the creation of profiles and roles in the Enterprise management software. Profiles are facilities that are provided to the clients in organization, they are seen in the configuration view of enterprise software. Roles are the permissions and the access that is given to a client. Automation is necessary to make repetitive and difficult procedures simpler. In this case the automation is done so that the onboarding of new clients in organization is done in an easier way. Previously this was done manually which was time consuming, the development of this project has made the process simpler. It parses the data from the pod directory json file to generate client list, pod configurations. These are then stored in a config which is made for each of the pods. The details are then taken from this repository as the details cannot be hard coded into the code. This makes the program seem more discrete.The project work recorded below shows the implementation using an open source software called airflow which is used to generate directed acyclic graph

How to Block Cartel Formation and Price-Fixing

Abstract written by the AEI-Brookings Joint Center: Allowing foreign buyers of goods produced by international cartels to pursue civil antitrust damages in U.S. courts would better deter cartel formation and price-fixing than do sanctions currently imposed by global criminal and civil justice systems.Technology and Industry, Regulatory Reform, Other Topics