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Brahma D, Narang D, Chandra M, Gupta K, Singh A, Kaur G. Diagnosis of Mycobacterial infections (Tuberculosis and Paratuberculosis) in tissue samples using molecular (inhouse multiplex PCR, PCR and TaqMan real-time PCR), histopathology and immunohistochemical techniques. Trop Biomed 2017; 34:911-927. [PMID: 33592961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
An in-house multiplex PCR designed for differential detection of M. bovis, M. avium paratuberculosis (MAP) and M. smegmatis in tissue samples, besides PCR and TaqMan real-time PCR targeting esxA (ESAT-6) and esxB (CFP-10) gene of M. tuberculosis complex (MTC) and IS900 gene targeting MAP were carried out in the present study. Tissue samples comprising of lung, mediastinal lymph node, intestine and mesenteric lymph node from cattle and buffaloes (n=16) suspected to have died of tuberculosis (TB) or paratuberculosis (JD) were collected at post-mortem. Out of 16 animals, only 4 (25%) cases were positive for M. bovis by in-house designed multiplex PCR, where as 9 (56.25%) cases were positive for MTC by both conventional and real-time PCR targeting esxA (ESAT-6) and esxB (CFP-10) genes. Out of 9 TB positive animals, 2 (22.22%) had co-infection with MAP as confirmed by IS900 PCR, real-time PCR and also by in-house multiplex PCR. No samples were found positive for M. smegmatis by the in-house multiplex PCR. Analytical sensitivity of in-house multiplex primers targeting M. bovis, MAP and M. smegmatis were 170 fg/µl, 300 fg/µl and 51 fg/µl of genomic DNA respectively. Analytical sensitivity of primers for both conventional and real time PCR tareting esxA were 8 pg/µl and 800 fg/µl, esxB were 800 fg/µl and 80 fg/µl and IS900 were 30 fg/µl and 3 fg/µl of M. tuberculosis and MAP genomic DNA respectively. The tissue samples were also subjected to histopathology and Immunohistochemical (IHC) staining using ESAT-6 and CFP-10 antibodies for TB and anti-JD anti-serum (raised in rabbit) for JD. All the animals positive for TB (9 of 9) and JD (2 of 2) in PCR and real-time PCR were also positive in histopathology and IHC. Thus, combination of molecular, histopathology and IHC techniques increased the accuracy of TB and JD diagnosis, all of which had same sensitivity and specificity except the in-house multiplex PCR which was comparatively less sensitive in M. bovis detection. However, the molecular methods were found to be more convenient and rapid, capable of making the diagnosis within 6 hours. The study indicated that Real-time PCR was ten times more sensitive than the conventional PCR.
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Gupta K, Chougule A, Ramprasad V, Noronha V, Joshi A, Patil V, Veldore V, Prabhash K. Liquid biopsies in clinical oncology: Review of validation results. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx672.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gupta K, Dabas S. Oncological outcome following intensification of treatment by transoral robotic surgery (TORS) for HPV negative stage IV oropharyngeal cancer: A prospective trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx665.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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79
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Li X, Lip G, Keshishian A, Hamilton M, Horblyuk R, Gupta K, Luo X, Mardekian J, Friend K, Nadkarni A, Pan X, Deitelzweig S. P3603Effectiveness and safety of standard and lower dose apixaban compared to warfarin in non-valvular atrial fibrillation patients: a propensity score matched analysis. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Li X, Deitelzweig S, Keshishian A, Hamilton M, Horblyuk R, Gupta K, Luo X, Mardekian J, Friend K, Nadkarni A, Pan X, Lip G. P3588Effectiveness and safety of apixaban versus warfarin among high-risk subgroups of non-valvular atrial fibrillation patients: a propensity score matched analysis. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Deitelzweig S, Luo X, Gupta K, Trocio J, Mardekian J, Curtice T, Lingohr-Smith M, Menges B, Lin J. 5721Comparison of stroke and major bleeding risk of treatment with apixaban vs. rivaroxaban and dabigatran among elderly nonvalvular atrial fibrillation patients in the United States. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.5721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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82
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Masoomi R, Shah Z, Dawn B, Gupta K. P6190Incidence of peripartum cardiomyopathy diagnosed in 90-day post-delivery: insights from the nationwide readmission database. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Gupta K, Pandey A, Singh RP. Synthesis, characterization of nano-sized anatase TiO2 and its adsorption behaviour for environmental contaminant. ACTA ACUST UNITED AC 2017; 63:18-20. [PMID: 28968203 DOI: 10.14715/cmb/2017.63.6.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Indexed: 11/18/2022]
Abstract
TiO2 is one of the most studied material due to its unique properties like chemical stability, non toxicity and cost effectiveness. Nano-sized TiO2 has been prepared by sol -gel method using titanium butoxide as precursor. X- ray diffraction analysis was used to characterize the phase and crystal size of the synthesized TiO2 particles. It was found that sizes of the particles ranged from 6 to 12 nanometre. FT-IR spectrum was also recorded for the TiO2 particles to detect the remaining organic residue .Heavy metals like Cr, Cu, Fe, Ni etc are considered major environmental contaminant in water due to their non biodegradable nature and adverse health effect in living beings. In this work the adsorption behavior of heavy metals towards nano-sized TiO2 was investigated.
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Bhattacharya S, Gupta K, Ghosh UC. Synthesis, characterization and trivalent arsenic sorption potential of Ce-Al nanostructured mixed oxide. ACTA ACUST UNITED AC 2017. [DOI: 10.1088/1757-899x/188/1/012003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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85
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Deka L, Gupta S, Gupta R, Gupta K, Kaur CJ, Singh S S. Nuclear morphometry and texture analysis on cytological smears of thyroid neoplasms: a study of 50 cases. THE MALAYSIAN JOURNAL OF PATHOLOGY 2017; 39:33-37. [PMID: 28413203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Fine needle aspiration cytology (FNAC) is a reliable and reproducible diagnostic technique for thyroid lesions with certain limitations. Computed morphometric methods have been introduced with a view to improve the diagnostic yield of thyroid aspirates. However, a review of the existing literature revealed conflicting reports regarding morphometric parameters in thyroid neoplasms. MATERIALS AND METHODS This study included 50 cases of thyroid lesions (20 cases of colloid goitre, 15 of follicular adenoma, 5 of follicular carcinoma and 10 papillary carcinomas). Digital images of cytologic smears of these cases were captured using a dedicated photomicrography system and nuclear profiles traced manually. With self-designed image analysis software, nuclear morphometric measurements, including texture analysis, were performed. Discriminant analysis was performed including the morphometric parameters and percentage of correctly classified nuclei noted. RESULTS Nuclear morphometry parameters showed that papillary thyroid carcinoma had the highest perimeter, area, radius and elongation factor compared to other thyroid lesions. Discriminant analysis revealed that altogether 77.9% of cells could be correctly classified to their lesion category based on the nuclear morphometric and textural parameters. Of the neoplastic cases, 84.5% of cells of follicular neoplasms and 72.5% of papillary carcinoma were classified to the respective category. CONCLUSION Nuclear morphometry, including texture analysis, can assist in the cytologic diagnosis of thyroid lesions, considering the high degree of accuracy of classification. Further studies and methodological refinements can achieve higher accuracy.
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Abstract
Abstract
This abstract was not presented at the symposium.
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Sood I, Gupta K, Sharma AK, Gaur A, Pathania V, Thakur VBS. Assessment of knowledge and awareness among medical doctors toward emergency management of dental trauma in State of Himachal Pradesh: A survey. INDIAN JOURNAL OF DENTAL SCIENCES 2017. [DOI: 10.4103/ijds.ijds_72_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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88
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Mahajan V, Banga HS, Filia G, Gupta MP, Gupta K. Comparison of diagnostic tests for the detection of bovine brucellosis in the natural cases of abortion. IRANIAN JOURNAL OF VETERINARY RESEARCH 2017; 18:183-189. [PMID: 29163647 PMCID: PMC5674441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 03/06/2017] [Accepted: 03/11/2017] [Indexed: 06/07/2023]
Abstract
Rapid and precise diagnosis in natural field cases of bovine abortion caused by Brucella abortus warrants the use of the most sensitive and reliable diagnostic methods. In the present study, bacterial isolation, serology, gross, histopathology, immunohistochemistry and polymerase chain reaction technique(s) were applied. Sero-prevalence studies showed the rate of 28.86% positive cases using the competitive ELISA. Histopathological changes were mainly seen in the placenta, fetal lungs, kidney, liver and spleen. Immunohistochemical (IHC) staining of Brucella spp. was evident as brown, finely granular intracytoplasmic staining in trophoblasts of placental sections and in section(s) of liver, lung, kidney and spleen. Twenty-eight out of the 103 samples (17 from stomach contents, 3 from placental cotyledons, 2 from vaginal discharges and 6 from pooled fetal tissues) produced 193 bp amplicon specific for Brucella genus. Moreover, the species-specific primers amplified a 498 bp amplicon which corresponded to B. abortus. Comparison of diagnostic tests revealed PCR and IHC provide a reliable test for the diagnosis of bovine brucellosis in aborted fetal tissue and placental cotyledons whereas serology is most important for detection of Brucella positive animals in a herd.
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Gupta K, Mitra S, Kazal S, Saroa R, Ahuja V, Goel P. I.V. paracetamol as an adjunct to patient-controlled epidural analgesia with levobupivacaine and fentanyl in labour: a randomized controlled study. Br J Anaesth 2016; 117:617-622. [DOI: 10.1093/bja/aew311] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Singh K, Thukral CL, Gupta K, Singh N, Aggrawal SL, Ded KS. Role of Magnetic Resonance Imaging in the Evaluation of Spinal Dysraphism. HONG KONG JOURNAL OF RADIOLOGY 2016. [DOI: 10.12809/hkjr1615365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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91
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Gupta KK, Attri JP, Singh A, Kaur H, Kaur G. Basic concepts for sample size calculation: Critical step for any clinical trials! Saudi J Anaesth 2016; 10:328-31. [PMID: 27375390 PMCID: PMC4916819 DOI: 10.4103/1658-354x.174918] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Quality of clinical trials has improved steadily over last two decades, but certain areas in trial methodology still require special attention like in sample size calculation. The sample size is one of the basic steps in planning any clinical trial and any negligence in its calculation may lead to rejection of true findings and false results may get approval. Although statisticians play a major role in sample size estimation basic knowledge regarding sample size calculation is very sparse among most of the anesthesiologists related to research including under trainee doctors. In this review, we will discuss how important sample size calculation is for research studies and the effects of underestimation or overestimation of sample size on project's results. We have highlighted the basic concepts regarding various parameters needed to calculate the sample size along with examples.
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Charlebois M, Gupta K, Payandeh S. Shape Description of Curved Surfaces from Contact Sensing Using Surface Normals. Int J Rob Res 2016. [DOI: 10.1177/02783649922066556] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We describe a spline-based framework for incorporating both position and surface-normal information into estimates of curvaturebased shape parameters. Such position and normal data can be obtained with different types of contact sensors, for example, tactile sensors, force-moment sensors, etc. The heart of our framework is an extended B-spline formulation that incorporates the surfacenormal information into a B-spline surface fit of the position data. The surface-normal information provides additional constraints for the surface fit, and can also significantly improve the approximation of the surface. Curvature-based shape parameters applied to this B-spline surface are then used to characterize the local shape of the object surface. Preliminary experiments with simple primitives—spherical, cylindrical, and planar shapes—and an off theshelf force/moment sensor to obtain the position and surfacenormal data show that despite coarse resolution of the sensor, this approach succeeds in qualitative shape recognition.
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Gorla A, Gupta K, Sood A, Biswal C, Bhansali A, Mittal B. Adrenal tuberculosis masquerading as disseminated malignancy: A pitfall of 18 F-FDG PET/CT Imaging. Rev Esp Med Nucl Imagen Mol 2016; 35:257-9. [DOI: 10.1016/j.remn.2015.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 11/25/2015] [Accepted: 11/26/2015] [Indexed: 11/29/2022]
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Brar APS, Sood NK, Singla LD, Kaur P, Gupta K, Sandhu BS. Validation of Romanowsky staining as a novel screening test for the detection of faecal cryptosporidial oocysts. J Parasit Dis 2016; 41:260-262. [PMID: 28316422 DOI: 10.1007/s12639-016-0788-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 05/17/2016] [Indexed: 10/21/2022] Open
Abstract
Cryptosporidiosis is an emerging waterborne protozoan disease and one of the major causes of neonatal diarrhea in humans and animals. But the disease remains under diagnosed due to lack of availability of special stains in majority of laboratories at primary health centers. Therefore, it requires a rapid screening test for routine diagnosis in conventional laboratory set up. In this pursuit, the present study was planned. During this study, fecal samples from 100 representative animals randomly selected from 17 out breaks of bovine calf diarrhea, were stained with modified Ziehl Neelsen staining (mZN) and Leishman's stain to demonstrate cryptosporidial oocysts and for routine fecal examination, respectively. By mZN staining, 25 cases confirmed the presence of cryptosporidial oocysts. However, examination of Leishman's stained fecal smears revealed round hollow unstained bodies resembling cryptosporidia in 20 cases. Therefore, a comparative morphometric analysis was made between the two techniques to determine their relative efficacy in demonstrating cryptosporidia in the feces of affected animals. The analyses showed that the Leishman's stain can be effective in making a presumptive diagnosis of cryptosporidiosis with a little experience. Confirmation of cryptosporidiosis was done by histopathological examination of intestinal sections of calves died during these out breaks. The findings appear to have great clinical value for routine laboratory screening of fecal samples for cryptosporidiosis as conventional Romanowsky stains are readily available and used for multipurpose examination in most of the laboratories at grass root level. Perusal of literature proved this to be the first attempt at easy diagnostics for cryptosporidiosis.
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Gupta KK, Choi SB, Lung SF, Ibrahim A. Aerothermoelastic-Acoustics Simulation of Flight Vehicles. AIAA JOURNAL. AMERICAN INSTITUTE OF AERONAUTICS AND ASTRONAUTICS 2016; Volume 55:49-56. [PMID: 31806909 PMCID: PMC6894403 DOI: 10.2514/1.j055088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 04/16/2016] [Accepted: 04/18/2016] [Indexed: 06/10/2023]
Abstract
This paper describes a novel computational-fluid-dynamics-based numerical solution procedure for effective simulation of aerothermoacoustics problems with application to aerospace vehicles. A finite element idealization is employed for both fluid and structure domains, which fully accounts for thermal effects. The accuracies of both the fluid and structure capabilities are verified with flight- and ground-test data. A time integration of the structural equations of motion, with the governing flow equations, is conducted for the computation of the unsteady aerodynamic forces, which uses a transpiration boundary condition at the surface nodal points in lieu of the updating of the fluid mesh. Two example problems are presented herein to that effect. The first one relates to a cantilever wing with a NACA 0012 airfoil. The solution results demonstrate the effect of temperature loading that causes a significant increase in acoustic response. A second example, the hypersonic X-43 vehicle, is also analyzed; and relevant results are presented. The common finite element-based aerothermoelastic-acoustics simulation process, its applicability to the efficient and routine solution of complex practical problems, the employment of the effective transpiration boundary condition in the computational fluid dynamics solution, and the development and public domain distribution of an associated code are unique features of this paper.
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Bajpai SK, Daheriya P, Ahuja S, Gupta K. Water absorption and antimicrobial behavior of physically cross linked poly (vinyl alcohol)/carrageenan films loaded with minocycline. Des Monomers Polym 2016. [DOI: 10.1080/15685551.2016.1187444] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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98
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Patel ML, Sachan R, Verma A, Kamal R, Gupta KK. Neutrophil gelatinase-associated lipocalin as a biomarker of disease progression in patients with chronic kidney disease. Indian J Nephrol 2016; 26:125-30. [PMID: 27051137 PMCID: PMC4795428 DOI: 10.4103/0971-4065.157799] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Chronic kidney disease (CKD) is associated with early mortality, decreased quality of life and increased health care expenditures. The aim of this study was to determine whether or not urinary NGAL (uNGAL) level is associated with renal damage and kidney disease progression in patients with CKD and to evaluate the predictive value of uNGAL in progression of CKD. Totally, 91 cases of CKD stage II, III, IV, and 50 age-matched healthy controls were enrolled. The follow-up end-point was 18 months; end-point of the study was progression to an estimated glomerular filtration rate (eGFR) of <15 ml/min and/or CKD stage V. Forty-five cases (49.4%) were progressors and 46 were nonprogressors. uNGAL levels were significantly higher in CKD subjects as compared to healthy controls (log 1.09 ± 0.22 μg/ml in controls versus log 1.22 ± 2.08 μg/ml in stage II, log 3.34 ± 2.74 μg/ml in stage III and log 3.70 ± 0.18 μg/ml in stage IV). Univariate Cox proportional hazards model showed that only eGFR (hazard ratio [HR]: 0.95; 95% confidence interval [CI]: 0.93–0.96; P < 0.001) and uNGAL (HR: 1.11; 95% CI: 1.01–1.20; P < 0.001) were significantly associated with end-point of CKD stage V, but multiple Cox proportional regression model showed significant association of uNGAL (HR: 1.11; 95% CI: 1.01–1.20; P < 0.001) and eGFR (HR: 0.962, 95% CI: 0.95–0.98; P < 0.001) with end-point of CKD stage V. This suggests that uNGAL would not be a simple surrogate index of baseline eGFR, but a marker of CKD progression beyond the information provided by eGFR estimation.
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Gupta K, Gupta J, Miglani R. Computer aided morphometric analysis of oral leukoplakia and oral squamous cell carcinoma. Biotech Histochem 2016; 91:251-4. [PMID: 26983454 DOI: 10.3109/10520295.2016.1139181] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We compared the changes in the cells in the basal layer of normal mucosa, oral leukoplakia with dysplasia and different grades of oral squamous cell carcinoma (OSCC) using computer aided image analysis of tissue sections. We investigated three morphometric parameters: nuclear area (NA), cell area (CA) and their ratio (NA:CA). NA and NA:CA ratio showed a statistically significant increase from dysplasia to increasing grades of OSCC. Nuclear size was useful for differentiating normal tissue, potentially malignant leukoplakia and OSCC.
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Sapi E, Balasubramanian K, Poruri A, Maghsoudlou JS, Socarras KM, Timmaraju AV, Filush KR, Gupta K, Shaikh S, Theophilus PAS, Luecke DF, MacDonald A, Zelger B. Evidence of In Vivo Existence of Borrelia Biofilm in Borrelial Lymphocytomas. Eur J Microbiol Immunol (Bp) 2016; 6:9-24. [PMID: 27141311 PMCID: PMC4838982 DOI: 10.1556/1886.2015.00049] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 12/02/2015] [Indexed: 12/17/2022] Open
Abstract
Lyme borreliosis, caused by the spirochete Borrelia burgdorferi sensu lato, has grown into a major public health problem. We recently identified a novel morphological form of B. burgdorferi, called biofilm, a structure that is well known to be highly resistant to antibiotics. However, there is no evidence of the existence of Borrelia biofilm in vivo; therefore, the main goal of this study was to determine the presence of Borrelia biofilm in infected human skin tissues. Archived skin biopsy tissues from borrelial lymphocytomas (BL) were reexamined for the presence of B. burgdorferi sensu lato using Borrelia-specific immunohistochemical staining (IHC), fluorescent in situ hybridization, combined fluorescent in situ hybridization (FISH)–IHC, polymerase chain reaction (PCR), and fluorescent and atomic force microscopy methods. Our morphological and histological analyses showed that significant amounts of Borrelia-positive spirochetes and aggregates exist in the BL tissues. Analyzing structures positive for Borrelia showed that aggregates, but not spirochetes, expressed biofilm markers such as protective layers of different mucopolysaccharides, especially alginate. Atomic force microscopy revealed additional hallmark biofilm features of the Borrelia/alginate-positive aggregates such as inside channels and surface protrusions. In summary, this is the first study that demonstrates the presence of Borrelia biofilm in human infected skin tissues.
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