scholarly journals Clinicopathological study of premalignant and malignant lesions of cervix along with apoptotic index and Ki-67 expression

2020 ◽  
Vol 8 (10) ◽  
pp. 3543
Author(s):  
Bhagyalakshmi Atla ◽  
Uma Prasad ◽  
Saraswathi Samantra ◽  
Venkata Satya Kartheek Botta ◽  
Naresh Dasari ◽  
...  
Keyword(s):  
Pap Smear ◽  
Intraepithelial Neoplasia ◽  
Cost Effective ◽  
Apoptotic Index ◽  
Premalignant Lesions ◽  
Ki 67 ◽  
Significant Difference ◽  
Malignant Lesions ◽  
The Mean ◽  
Proliferative Indices

Background: Cervical cancer is known to have a good response to radiotherapy. The response and prognosis are dependent on the level of apoptosis. Pap smear and histopathology are cost-effective methods in diagnosing premalignant and malignant lesions of cervix but not accurate in classifying and estimating the progression of the disease, especially in premalignant lesions. Therefore this study was undertaken to know the role of Ki-67 expression and apoptotic index in classifying accurately the premalignant lesions for better management.Methods: The study included 540 cases diagnosed histologically as cervical intraepithelial neoplasia or carcinoma. The apoptotic index is calculated for all the 540 cases using light microscopy on Haematoxylin and Eosin stained sections. Ki-67 immunohistochemical staining was done for 100 cervical biopsies. Ki-67 expression was graded and the Ki-67 labelling index was calculated. Statistical evaluation was done using the unpaired t-test.Results: The Apoptotic index increased with increasing grade of dysplasia. There is a significant difference in the mean apoptotic index between premalignant and malignant lesions of the cervix. The ki-67 index increased with increasing grade of dysplasia. There is a significant difference in the mean Ki-67 index between premalignant and malignant lesions of the cervix.Conclusions: Apoptotic index and proliferative indices have been found useful in distinguishing between premalignant and malignant lesions of the cervix and gives an idea about the proliferative activity of the tumour for better management of the patient and to determine prognosis.

scholarly journals Apparent diffusion coefficient for differentiating between benign and malignant hepatic focal lesions

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Sherif Abugamra ◽  
Aya Yassin ◽  
Asmaa Saber Mostafa Abdel-Rehim ◽  
Dina Sayed Sheha
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Focal Lesion ◽  
Benign Lesions ◽  
Focal Lesions ◽  
Significant Difference ◽  
Apparent Diffusion ◽  
Malignant Lesions ◽  
The Mean

Abstract Background The aim of this study was to prospectively evaluate the role of diffusion weight MRI (DWI) in the characterization of hepatic focal lesions by using apparent diffusion coefficient (ADC). Thirty patients (18 women, 12 men; mean age 48.5 years) with hepatic focal lesions were included in this study. Patients underwent DW MR imaging with the SPLICE sequence. ADC of each focal lesion carcinoma was calculated from DW MR Images obtained with low and high b values. ADCs were compared among pathological types of focal lesions. Results Among the 30 patients included in the study, 46 focal lesions were detected. Twenty-four lesions were metastatic lesions from primary cancer, 7 lesions were hepatocellular carcinoma (HCC), 9 lesions were hemangiomas, and 6 lesions were simple cysts. There was highly significant difference between the mean ADC of the malignant lesions (metastasis and HCC) and the mean ADC of benign lesions (hemangiomas and cysts). The ADC of malignant lesion was much less than that of benign lesion. The mean ADC of malignant lesions (n = 31) was 0.73 ± 0.19 × 10−3 mm2/s, and the mean ADC of benign lesions (n = 15) was 1.94 ± 0.68 × 10−3 mm2/s (p value < 0.001). There was no significant difference between the cysts and hemangiomas. There was no statistically significant difference between the metastases and hepatocellular carcinoma. Conclusion ADCs values were able to differentiate benign from malignant lesions. ADC should be considered in the work up of patients with hepatic focal lesions.

Potential Markers of Tongue Tumor Progression Selected by cDNA Micro Array

2005 ◽  
Vol 18 (3) ◽  
pp. 513-524 ◽  
Author(s):  
F. Carinci ◽  
L. Lo Muzio ◽  
A. Piattelli ◽  
C. Rubini ◽  
F. Chiesa ◽  
...  
Keyword(s):  
Tumor Progression ◽  
Differentially Expressed ◽  
Premalignant Lesions ◽  
Cell Cycle Regulators ◽  
Agglomerative Clustering ◽  
Expression Levels ◽  
Extracellular Matrix Components ◽  
Significant Difference ◽  
Malignant Lesions ◽  
Tongue Tumor

Squamous cell carcinoma (SCC), the most frequent malignant tumor of the oral cavity, generally exhibits a poor prognosis and metastases are the main cause of death. This tumor often arises from pre-malignant lesions. To date, it is difficult to predict if and which pre-malignant lesions may progress into oral SCC using traditional methods. For these reasons, several studies are trying to identify markers useful in the progression of pre-malignant lesions and tumors. To define the genetic expression profile of tongue tumor progression we compared 9 dysplasias (DS), 8 tumors without metastasis (TWM), 11 metastasizing SCCs (MT) of the tongue, and a baseline of 11 normal tissues by using cDNA microarray containing 19.2 K clones. We initially applied hierarchical agglomerative clustering based on information from all 6026 clones. Results were obtained by performing a two steps analysis: a Significance Analysis of Microarray (SAM) and a Gene Ontology search. One hundred and five clones have statistically significant different expression levels (FDR <0.01) between DS and TWM, whereas 570 genes have statistically significant difference expression levels between TWM and MT (FDR <0.01) as detected by SAM. By filtering with FatiGo only 33 genes were differentially expressed in TWN, respect to DS, whereas 155 genes were differentially expressed in MT respect to TWM. We detected some genes which encode for oncogenes, transcription factors and cell cycle regulators as potential markers of DS progression. Examples are BAG4, PAX3 and CCNI, respectively. Among potential markers of metastases are some genes related to cell mobility (TSPAN-2 and SNTA1), intercellular adhesion (integrin alpha 7) or extracellular matrix components (ADAMTS2 and cathepsin O). Additionally, under-expressed genes encoded apoptosis-related proteins (PDCD4 and CASP4). In conclusion, we identified several genes differentially expressed in tumor progression which can potentially help in better classifying premalignant lesions and tongue SCCs.

scholarly journals Simultaneous Cervical and Lumbar Spine Surgery: Retrospective Analysis of 45 Cases

2019 ◽  
Vol 08 (01) ◽  
pp. 047-052 ◽  
Author(s):  
Amit Aiwale ◽  
Pankajkumar Patel ◽  
Syed Paspala ◽  
T. Murthy
Keyword(s):  
Lumbar Spine ◽  
Spinal Stenosis ◽  
Japanese Orthopaedic Association ◽  
Cost Effective ◽  
Lumbar Spine Surgery ◽  
Neurogenic Claudication ◽  
Cervical Canal ◽  
Canal Stenosis ◽  
Significant Difference ◽  
The Mean

Abstract Background The term ‘tandem spinal stenosis’ (TSS) was first introduced by Dagi et al to describe concurrent symptomatic cervical and lumbar spinal stenosis. A typical clinical picture includes intermittent neurogenic claudication, myelopathy, and polyradiculopathy in both the upper and lower extremities. The incidence of TSS ranges from 0.12 to 28%. Methods We studied patients who presented with tandem canal stenosis and operated cervicolumbar decompression with or without fusion procedures by two separate neurosurgical teams simultaneously from June 2015 to 2017 with follow-up period of minimum 6 months. Results We had 30 (66.66%) male and 15 (33.33%) female patients who underwent simultaneous cervical and lumbar spine surgeries. The average age was 57.8 years (male) and 53.9 years (female). Cervical canal stenosis was graded as per magnetic resonance imaging (MRI) morphological grades of stenosis by Kang et al and lumbar grading, was done as per Schizas et al grading system. The mean duration of complaints in cervical and lumbar compression was 29.54 ± 44.99 months and 30.55 ± 38.11 months, respectively. The mean preoperative Japanese Orthopaedic Association (JOA) score of was 10.46 ± 1.39, whereas the postoperative mean JOA score was 11.93 ± 1.28, and mean preoperative (38.59 ± 16.52) and postoperative (29.22 ± 9.38) Oswestry Disability Index (ODI) scores showed a statistically significant difference (p = 0.0001). Conclusion Patients with TSS are elderly and have associated comorbidities, still simultaneous cervical and lumbar surgery is feasible with the good outcome if you have two neurosurgical teams operating simultaneously and having good other super specialty teams’ support. It can be timesaving and cost effective for patients. Also, it avoids patients from undergoing exposure to two separate surgical and anesthetic stress.

scholarly journals Vitamin E in the treatment of primary dysmenorrhoea

2018 ◽  
Vol 7 (6) ◽  
pp. 2257
Author(s):  
Vilvapriya S. ◽  
Vinodhini S.
Keyword(s):  
Vitamin E ◽  
Cost Effective ◽  
Pain Severity ◽  
Medical College ◽  
Primary Dysmenorrhoea ◽  
Relieve Pain ◽  
Significant Difference ◽  
Before And After ◽  
Pain Duration ◽  
The Mean

Background: The objective of this study is to determine the efficacy of Vitamin E in the treatment of primary dysmenorrhoea compared to the placebo.Methods: Sixty women, aged 17-25 years old who suffered from primary dysmenorrhoea, among 1000 Women attending the gynec OPD in Kilpauk Medical College. 30 women were given 200 units of vitamin E (each tablet twice daily) and 30 were given a placebo tablets (each tablet twice daily). The treatment began two days before the beginning of menstruation and continued through the first three days of bleeding. The severity of pain and duration of pain before and after the treatment was studied. Treatment in both groups was carried out in three consecutive menstrual periods.Results: As to the findings, the mean age of the participants was 22.6 years. There was a significant difference between the pre- and post-treatment periods in terms of pain severity (P=0.72 and P=0.002, respectively) and pain duration (P=0.514 and P=0.027, respectively) in Vitamin E group. There was a significant difference observed between the Vitamin E group and placebo group regarding the mean of pain severity and duration (P=0.002 and p=0.027 respectively).Conclusions: Vitamin E helps to relieve pain in primary dysmenorrhoea. As this is a relatively easier method for control of pain with lesser amount of side effects and as it is cost effective, it can be considered as a universal drug in the treatment of primary dysmenorrhoea.

scholarly journals Ki-67 expression in anal intraepithelial neoplasia in AIDS

2001 ◽  
Vol 119 (3) ◽  
pp. 119-121 ◽  
Author(s):  
Edenilson Eduardo Calore ◽  
Carmen Ruth Manzione ◽  
Sidney Roberto Nadal ◽  
Maria José Cavalieri ◽  
Nilda Maria Perez Calore ◽  
...  
Keyword(s):  
Lower Layer ◽  
Intraepithelial Neoplasia ◽  
Cell Counting ◽  
Biological Behavior ◽  
Low Grade ◽  
High Grade ◽  
Ki 67 ◽  
Staining Techniques ◽  
The Mean ◽  
Group 2

CONTEXT: AIDS is one of the most important risk factors for progression and recurrence of anogenital condyloma. In a previous work, we observed that patients with warts and high-grade AIN (HAIN) had recurrences more frequently than did patients with warts without AIN. The mechanisms of this increased incidence of high-grade lesions in AIDS are not known. OBJECTIVE: We studied the expression of the proliferative marker Ki-67 by immunohistochemical methods, in specimens of anal condyloma from HIV+ patients to clarify whether its expression can be associated to the grade of AIN. DESIGN: A retrospective study of hiltological specimens. SETTING: University referral unit. SAMPLE: 34 patients were divided into two groups: (1) condylomas with low grade AIN (LAIN), with 25 patients; and (2) condylomas with HAIN, with 9 patients. In this latter group we examined two areas: 2A (HAIN area) and 2B (LAIN area). MAIN MEASUREMENTS: The immunohistochemical reaction for Ki-67 was done on histological sections. Slices were lightly stained with hematoxylin, to help us in Ki-67 positive cell counting. The percentage of Ki-67 marked nuclei was calculated. We applied one-way variance analysis for statistics. RESULTS: The mean number of Ki-67 positive cells in group 1 was 19.68 ± 10.99; in group 2 (area A) it was 46.73 ± 10.409; and in area B it was 36.43 ± 14.731. There were statistical differences between groups 1 and 2A and between groups 1 and 2B. Ki-67 positive cells predominated in the lower layer in LAIN. Positive Ki-67 cells were found in all layers in group 2A, and in group 2B they predominated in the two lower or in all layers of the epithelium. CONCLUSIONS: Our results suggest that LAIN areas (using routine staining techniques) in HAIN can have a biological behavior more similar to HAIN.

scholarly journals Cost Effectiveness Analysis of Candesartan Therapy in Comparison to Candesartan-Amlodipine Therapy on Hypertensive Outpatients

2019 ◽  
Vol 7 (22) ◽  
pp. 3837-3840
Author(s):  
Faridah Baroroh ◽  
Andriana Sari ◽  
Noviana Masruroh
Keyword(s):  
Blood Pressure ◽  
Cost Effectiveness ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
Significant Difference ◽  
Hypertension Therapy ◽  
The Mean ◽  
The Cost

BACKGROUND: he achievement of optimal hypertension therapy requires cost-effective medicine. The treatment of hypertensive patients needs for long-term medication have made medical costs a prime issue in health economics. AIM: This study aims to determine the cost effectiveness of candesartan therapy compared to candesartan-amlodipine therapy on hypertensive outpatients. METHODS: This is a prospective cohort study that compares candesartan therapy to candesartan-amlodipine therapy at a public hospital from payers’ perspective. The outcome is the percentage of targeted blood pressure decrease after three months of therapy. The cost effectiveness analysis uses the Incremental Cost Effectiveness Ratio (ICER) based on the ratio of cost difference to the outcome in both therapy groups. RESULTS: As many as 111 patients participated in this research, comprising 40 candesartan therapy patients and 71 patients with the combination of candesartan-amlodipine. Of the participants, 63.96% were female, 57.66% were aged 60 or older, and 56.32% had diabetes mellitus as the most common complication. Results show that the average direct medical cost per patient for a therapy of three months with candesartan was IDR 1,050,536 ± 730,007 and IDR 760,040 ± 614,290 for a candesartan-amlodipine therapy. The mean decline of systolic and diastolic blood pressure under candesartan therapy is less than that of candesartan-amlodipine, although without any significant difference (p > 0.05). It follows that the effectiveness of candesartan (85%) is greater than that of the candesartan-amlodipine combination (84.50%). Candesartan therapy is thereby more cost-effective with an ICER value of IDR 580,993/%. CONCLUSION: Hypertension therapy by candesartan is more cost-effective than candesartan-amlodipine therapy with a cost addition of IDR 580,993.

scholarly journals Plasmacytoma in patients with multiple myeloma: morphology and immunohistochemistry

2019 ◽  
Author(s):  
Maiia Firsova ◽  
Larisa Mendeleeva ◽  
Savchenko Valeri ◽  
Alla Kovrigina ◽  
Maxim Solovev
Keyword(s):  
Plasma Cells ◽  
Bone Destruction ◽  
Extramedullary Plasmacytoma ◽  
Histological Structure ◽  
Ki 67 ◽  
Mean Values ◽  
Significant Difference ◽  
High Proliferative Activity ◽  
The Mean ◽  
Tissue Specimens

Abstract Background. To study the histological structure and immunohistochemical (IHC) parameters of the plasmacytoma tumor substrate in patients with MM. Methods. The study included 21 patients (10 men/11 women) aged 23 to 73 years old with a newly diagnosed MM complicated by plasmacytoma. Bone plasmacytoma was diagnosed in 14 patients, and extramedullary plasmacytoma was diagnosed in 7 patients. Plasmacytoma tissue specimens were examined using a LEICA DM4000B microscope. Anti-CD56, CD166, CXCR4, Ki-67, c-MYC antibody panels were used for the IHC study of plasmacytoma biopsy. Results. When comparing the morphology of bone and extramedullary plasmacytoma, no significant differences were revealed, however, when the substrate of the extramedullary plasmacytoma was compared to the bone plasmacytoma substrate it was more often represented by tumor cells with immature morphology (57.1% vs. 28.6%). We founded a significant difference in the expression of CD166 in bone and extramedullary plasmacytoma. It was shown that the mean values ​​of the CD166 expression in bone plasmacytoma cells were significantly higher (p = 0.033) and amounted to 36.29 ± 7.61% versus 9.57 ± 8.46% in extramedullary plasmacytoma cells. We noticed that in the cells of the extramedullary plasmacytoma, there were higher values ​​in the Ki-67 index than observed in comparison to the cells of the bone plasmacytoma independent of the cells’morphology. Conclusion. The mechanisms involved in the dissemination of tumor plasma cells are currently unexplored. Our study revealed significant differences in the IHC parameters of the tumor substrate from extramedullary and bone plasmacytoma. Thus, the expression of the CD166 in extramedullary plasmacytoma cells is almost 4 times lower than that in bone plasmacytoma cells, which may indicate the involvement of CD166 in the mechanisms of bone destruction. A high proliferative activity of extramedullary plasmacytoma cells was shown when compared to bone plasmacytoma cells.

Effects of acupressure at the P6 and LI4 points on the anxiety level of soldiers in the Iranian military

2020 ◽  
pp. jramc-2019-001332 ◽  
Author(s):  
Saeid Amini Rarani ◽  
N Rajai ◽  
S Sharififar
Keyword(s):  
Military Service ◽  
Cost Effective ◽  
Anxiety Level ◽  
Anxiety Score ◽  
Control Group ◽  
Double Blind ◽  
Stressful Environment ◽  
Significant Difference ◽  
The Mean ◽  
Army Soldiers

IntroductionMilitary service is a stressful environment. Methods to reduce stress may result in the mental health promotion of military forces. There are various methods for relieving anxiety. Acupressure is one of them. Hence, this study was carried out to explore effects of acupressure at the P6 and LI4 acupressure points on the anxiety level of army soldiers.MethodsA randomised double-blind design was undertaken. A total of 120 Iranian army soldiers were randomly assigned to three groups, namely P6, LI4 and control. The P6 and LI4 acupressure points are effective in lowering the anxiety level. In the intervention groups, acupressure was applied at the P6 and LI4 points three times for 10 min at 30 min intervals. In the control group, the thumb pad, which is not an acupressure point, was pressed. The anxiety level of the subjects was measured before the intervention and 30 min after the last intervention. The instruments included a demographics questionnaire and the State-Trait Anxiety Inventory.ResultsThere was no significant difference between the three groups with respect to the anxiety level in the preintervention phase. However, the mean anxiety score in the P6 group decreased significantly from 53.35±9.7 to 49.02±9.3 (p=0.005). The mean anxiety score in the LI4 group also decreased significantly from 53.37±8.39 to 45.47±8.16 (p<0.001). In the control group, there was no significant difference between the preintervention and postintervention phases (p=0.16). In the postintervention phase, the analysis of variance test showed a significant difference between the three groups in terms of the anxiety level (p=0.04).ConclusionsAcupressure can reduce soldiers’ anxiety at the acupressure points, especially at the LI4 point. It is recommended that this simple and cost-effective intervention be used to relieve soldiers’ anxiety in stressful situations.Trial registration number20150715023216N4.

scholarly journals Prostatic lesions: Histopathological study in a tertiary care hospital

2018 ◽  
Vol 4 (1) ◽  
pp. 12-19
Author(s):  
S. Bhatta ◽  
S. Hirachan
Keyword(s):  
Histopathological Examination ◽  
Benign Lesion ◽  
Tertiary Care ◽  
Histopathological Study ◽  
P Value ◽  
Care Hospital ◽  
Significant Difference ◽  
Nodular Hyperplasia ◽  
Malignant Lesions ◽  
The Mean

Background: Prostatic lesions like Nodular hyperplasia of prostate, inflammation and carcinoma are common causes of morbidity and mortality in males. The incidence of these lesions increases with age. This study was conducted with the objective of evaluating histopathological pattern of prostatic lesions.Methods: This was a retrospective study conducted at KIST Medical College from Jan 2014 to Jan 2018. The study included ninety six prostatic specimens received in department of pathology. Hematoxylin and Eosin stained slides were retrieved and reviewed. The specimens and slides were analyzed according to type of specimen, age of patient, histopathological pattern and final diagnosis. Results were analyzed using Statistical Package for Social Science (SPSS, version 21) for Windows. Independent t test was used to correlate the mean age between patients with benign and malignant lesions. P value less than 0.05 was considered as statistically significant.Results: The most common benign lesion was nodular hyperplasia of prostate 86(89.58%). Malignant lesions comprised 8 (8.34%) cases of all prostatic lesions. All the cases of prostate carcinoma were adenocarcinoma. The most frequent Gleason score was 9. Mean age for benign and malignant lesions were 69.6 ± 8.1 years and 72.9 ± 5.2 years respectively. There was no significant difference in the mean age between patients with benign and malignant lesions (p value 0.27).Conclusion: Benign lesions of prostate are more common than malignant lesions. Histopathological examination of prostate specimens have important role in diagnosing various benign and malignant lesions, especially to rule out incidental carcinoma.JMMIHS.2018;4(1):12-19

scholarly journals Effects of Octreotide Treatment on the Proliferation and Apoptotic Index of GH-Secreting Pituitary Adenomas

2001 ◽  
Vol 86 (11) ◽  
pp. 5194-5200 ◽  
Author(s):  
Marco Losa ◽  
Enrica Ciccarelli ◽  
Pietro Mortini ◽  
Raffaella Barzaghi ◽  
Daniela Gaia ◽  
...  
Keyword(s):  
Monoclonal Antibody ◽  
Pituitary Adenomas ◽  
Apoptotic Index ◽  
Antiproliferative Effect ◽  
Nuclear Antigen ◽  
Terminal Deoxynucleotidyl Transferase ◽  
Growth Fraction ◽  
Ki 67 ◽  
Significant Difference ◽  
Octreotide Treatment

To investigate the effects of octreotide administration on the growth rate of GH-secreting pituitary adenomas, we measured both the Ki-67 labeling index (LI) and the apoptotic index in tumor specimens from octreotide-treated or matched untreated acromegalic patients. Thirty-nine patients who received octreotide until the day of or the day before surgery and 39 untreated patients matched for sex, age, tumor size, extension, and invasiveness were studied. Immunocytochemical analysis was performed on paraffin-embedded material using a monoclonal antibody (MIB-1) directed against a proliferation-associated nuclear antigen, Ki-67, to measure the growth fraction. Apoptosis was assessed by the terminal deoxynucleotidyl transferase-mediated deoxy-UTP nick endlabeling method, using a monoclonal antibody recognizing areas of DNA fragmentation. The Ki-67 LI and apoptosis were counted on separate slides in at least 1000 evaluable cells. Octreotide-treated patients showed a lower Ki-67 LI (1.8 ± 0.3%) than untreated controls (3.8 ± 0.7%; P &lt; 0.02). Overall, the mean Ki-67 LI of treated patients was 53% lower than that in untreated patients. The antiproliferative effect of octreotide occurred independently of tumor extension and invasiveness. Octreotide-treated and untreated patients showed similar apoptotic indexes (0.6 ± 0.2% and 0.8 ± 0.3%, respectively). There was a positive correlation between the Ki-67 LI and the apoptotic index (r = 0.29; P&lt; 0.03). Our study demonstrates that acromegalic patients receiving chronic octreotide treatment have a lower value of the proliferation marker Ki-67, but no significant difference in the apoptotic index compared with matched untreated patients. The antiproliferative effect of octreotide on GH-secreting adenomas should imply a lower risk of tumor growth during long-term chronic treatment with the drug.

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