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Wang BG, Li W, Lee IH, Mani H. Mimickers of neuroendocrine tumors on endoscopic ultrasound-guided fine-needle aspirate material: Need for caution. Diagn Cytopathol 2023; 51:E308-E313. [PMID: 37533282 DOI: 10.1002/dc.25204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/17/2023] [Accepted: 07/23/2023] [Indexed: 08/04/2023]
Abstract
Cytologic diagnosis of neuroendocrine tumors can be straightforward on cytologic preparations, given the classical neuroendocrine morphology and expression of neuroendocrine markers confirmed by immunohistochemistry. However, overreliance on neuroendocrine markers can lead to misdiagnosis even if individual cell features suggest a neuroendocrine tumor. We present three unusual cases, two of which were initially diagnosed as neuroendocrine tumors and the third one carried preliminary diagnosis of neuroendocrine tumor on endoscopic ultrasound-guided fine-needle aspirates. These cases subsequently turned out to be cholangioblastic cholangiocarcinoma, metastatic melanoma, and gastric glomus tumor, respectively. We suggest approaches that could have pointed us towards the correct diagnosis at the outset and discuss potential pitfalls.
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Affiliation(s)
- Brant G Wang
- Department of Pathology, Inova Fairfax Hospital, Falls Church, Virginia, USA
- School of Medicine Inova Campus, University of Virginia, Falls Church, Virginia, USA
- Department of Pathology, Georgetown University Medical Center, Washington, DC, USA
| | - Wenping Li
- Department of Pathology, Inova Fairfax Hospital, Falls Church, Virginia, USA
| | - Iris H Lee
- Division of Gastroenterology, Department of Medicine, Inova Fairfax Hospital, Falls Church, Virginia, USA
| | - Haresh Mani
- Department of Pathology, Inova Fairfax Hospital, Falls Church, Virginia, USA
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2
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Szafranski P, Garimella RP, Mani H, Hartman R, Deutsch G, Silk A, Benheim A, Stankiewicz P. Further refinement of the differentially methylated distant lung-specific FOXF1 enhancer in a neonate with alveolar capillary dysplasia. Clin Epigenetics 2023; 15:169. [PMID: 37865798 PMCID: PMC10589973 DOI: 10.1186/s13148-023-01587-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 10/12/2023] [Indexed: 10/23/2023] Open
Abstract
Heterozygous SNVs or CNV deletions involving the FOXF1 gene, or its distant enhancer, are causative for 80-90% of cases of alveolar capillary dysplasia with misalignment of pulmonary veins. Recently, we proposed bimodal structure and parental functional dimorphism of the lung-specific FOXF1 enhancer, with Unit 1 having higher activity on the paternal chr16 and Unit 2 on the maternal chr16. Here, we describe a novel unusually sized pathogenic de novo copy-number variant deletion involving a portion of the FOXF1 enhancer on maternal chr16 that implies narrowing Unit 2 to an essential ~ 9-kb segment. Using a restrictase-based assay, we found that this enhancer segment is weakly methylated at ApT adenine, with about twice the frequency of methylation on the maternal versus paternal chr16. Our data provide further insight into the FOXF1 enhancer structure and function.
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Affiliation(s)
- Przemyslaw Szafranski
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, ABBR-R809, Houston, TX, 77030, USA
| | - Rijutha P Garimella
- Department of Pediatrics, Inova LJ Murphy Children's Hospital, Falls Church, VA, USA
| | - Haresh Mani
- Department of Pathology, Inova Fairfax Hospital, Falls Church, VA, USA
| | - Ryan Hartman
- Inova Department of Genetics, Inova Fairfax Medical Campus, Falls Church, VA, USA
| | - Gail Deutsch
- University of Washington School of Medicine, Seattle, WA, USA
| | - Alan Silk
- Neonatology, Fairfax Neonatology Associates, Inova Fair Oaks Hospital, Inova LJ Murphy, Children's Hospital, Fairfax, VA, USA
| | - Alan Benheim
- Division of Pediatric Cardiology, Inova LJ Murphy Children's Hospital, Falls Church, VA, USA
| | - Paweł Stankiewicz
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, ABBR-R809, Houston, TX, 77030, USA.
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3
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Mishra A, Chung J, Mani H, Serrano M. Response to Mesalamine Therapy in Pediatric Collagenous Gastritis and Colitis: A Case Report and Review. Glob Pediatr Health 2022; 9:2333794X221094262. [PMID: 35465197 PMCID: PMC9021462 DOI: 10.1177/2333794x221094262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 03/25/2022] [Indexed: 11/16/2022] Open
Abstract
Collagenous gastritis and collagenous colitis are 2 rare gastrointestinal disorders in pediatric patients. Both of these disease processes exist on a clinical spectrum, and are extremely rare to be present together in the pediatric population. Due to the rarity and unknown etiology of these disease processes, standardized treatment protocols and objective clinical biomarkers of disease progression are missing. This is the first report to describe a 16 year old female with CG and CC who responded well to mesalamine therapy, evident by decreasing calprotectin levels after initiation of therapy.
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Affiliation(s)
- Ankit Mishra
- Georgetown University School of Medicine, Washington, DC, USA
| | - Joon Chung
- Georgetown University School of Medicine, Washington, DC, USA
| | - Haresh Mani
- Inova Fairfax Hospital, Falls Church, VA, USA
| | - Mariastella Serrano
- Georgetown University School of Medicine, Washington, DC, USA.,MedStar-Georgetown University Hospital, Washington, DC, USA
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4
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Catalano A, Ade P, Aravena M, Barria E, Beelen A, Benoit A, Béthermin M, Bounmy J, Bourrion O, Bres G, De Breuck C, Calvo M, Désert FX, Durán C, Duvauchelle G, Eraud L, Fasano A, Fenouillet T, Garcia J, Garde G, Goupy J, Groppi C, Hoarau C, Hu W, Lagache G, Lambert JC, Leggeri JP, Levy-Bertrand F, Macías-Pérez J, Mani H, Marpaud J, Marton M, Mauskopf P, Monfardini A, Pisano G, Ponthieu N, Prieur L, Raffin G, Roni S, Roudier S, Tourres D, Tucker C, Vivargent L. CONCERTO at APEX: Installation and first phase of on-sky commissioning. EPJ Web Conf 2022. [DOI: 10.1051/epjconf/202225700010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
CONCERTO (CarbON CII line in post-rEionisation and ReionisaTiOn) is a large field-of-view (FoV) spectro-imager that has been installed on the Cassegrain Cabin of Atacama Pathfinder EXperiment (APEX) telescope in April 2021. CONCERTO hosts 2 focal planes and a total number of 4000 Kinetic Inductance Detectors (KID), with an instantaneous FoV of 18.6 arcminutes in the range of 130-310 GHz. The spectral resolution can be easily tuned down to 1 GHz depending on the scientific target. The scientific program of CONCERTO has many objectives, with two main programs focused on mapping the fluctuations of the [CII] line intensity in the reionisation and postreionisation epoch (4.5<z<8.5), and on studying galaxy clusters via the thermal and kinetic Sunyaev-Zel’dovich (SZ) effect. CONCERTO will also measure the dust and molecular gas contents of local and intermediate-redshift galaxies, it will study the Galactic star-forming clouds and finally it will observe the CO intensity fluctuations arising from 0.3<z<2 galaxies.
The design of the instrument, installation at APEX and current status of the commissioning phase and science verification will be presented. Also we describe the deployment and first on-sky tests performed between April and June 2021.
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5
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Mani H, Ben Salem M, Ben Mahmoud N, Ben Salah M, Handous I, Letaief A, Hamouda M, Aloui S, Skhiri H. Les étiologies de la néphrocalcinose : à propos de 16 cas. Nephrol Ther 2021. [DOI: 10.1016/j.nephro.2021.07.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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6
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Thompson LDR, Fitzpatrick SG, Müller S, Eisenberg E, Upadhyaya JD, Lingen MW, Vigneswaran N, Woo SB, Bhattacharyya I, Bilodeau EA, Carlos R, Islam MN, Leon ME, Lewis JS, Magliocca KR, Mani H, Mehrad M, Purgina B, Richardson M, Wenig BM, Cohen DM. Proliferative Verrucous Leukoplakia: An Expert Consensus Guideline for Standardized Assessment and Reporting. Head Neck Pathol 2021; 15:572-587. [PMID: 33415517 PMCID: PMC8134585 DOI: 10.1007/s12105-020-01262-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 11/26/2020] [Indexed: 12/12/2022]
Abstract
The many diverse terms used to describe the wide spectrum of changes seen in proliferative verrucous leukoplakia (PVL) have resulted in disparate clinical management. The objective of this study was to produce an expert consensus guideline for standardized assessment and reporting by pathologists diagnosing PVL related lesions. 299 biopsies from 84 PVL patients from six institutions were selected from patients who had multifocal oral leukoplakic lesions identified over several years (a minimum follow-up period of 36 months). The lesions demonstrated the spectrum of histologic features described in PVL, and in some cases, patients developed oral cavity squamous cell carcinoma (SCC). An expert working group of oral and maxillofacial and head and neck pathologists reviewed microscopic features in a rigorous fashion, in combination with review of clinical photographs when available. The working group then selected 43 single slide biopsy cases for whole slide digital imaging (WSI) review by members of the consensus conference. The digital images were then reviewed in two surveys separated by a washout period of at least 90 days. Five non-PVL histologic mimics were included as controls. Cases were re-evaluated during a consensus conference with 19 members reporting on the cases. The best inter-observer diagnostic agreement relative to PVL lesions were classified as "corrugated ortho(para)hyperkeratotic lesion, not reactive" and "SCC" (chi-square p = 0.015). There was less than moderate agreement (kappa < 0.60) for lesions in the "Bulky hyperkeratotic epithelial proliferation, not reactive" category. There was ≥ moderate agreement (> 0.41 kappa) for 35 of 48 cases. This expert consensus guideline has been developed with support and endorsement from the leadership of the American Academy of Oral and Maxillofacial Pathology and the North American Society of Head and Neck Pathologists to recommend the use of standardized histopathologic criteria and descriptive terminology to indicate three categories of lesions within PVL: (1) "corrugated ortho(para)hyperkeratotic lesion, not reactive;" (2) "bulky hyperkeratotic epithelial proliferation, not reactive;" and (3) "suspicious for," or "squamous cell carcinoma." Classification of PVL lesions based on a combination of clinical findings and these histologic descriptive categories is encouraged in order to standardize reporting, aid in future research and potentially guide clinical management.
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Affiliation(s)
- Lester D. R. Thompson
- Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, 5601 De Soto Avenue Woodland Hills, CA 91364 Woodland Hills, USA
| | - Sarah G. Fitzpatrick
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL USA
| | - Susan Müller
- Atlanta Oral Pathology, Emory University School of Medicine, Decatur, GA USA
| | - Ellen Eisenberg
- Oral Health and Diagnostic Sciences, University of Connecticut Health, Farmington, CT USA
| | - Jasbir D. Upadhyaya
- Section of Diagnostic Sciences, Department of Applied Dental Medicine, Southern Illinois University School of Dental Medicine, Alton, IL USA
| | - Mark W. Lingen
- Department of Pathology, University of Chicago Medicine, Chicago, IL USA
| | - Nadarajah Vigneswaran
- Department of Diagnostic and Biomedical Sciences, University of Texas School of Dentistry at Houston, Houston, TX USA
| | - Sook-Bin Woo
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA USA
| | - Indraneel Bhattacharyya
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL USA
| | - Elizabeth A. Bilodeau
- Department of Diagnostic Sciences, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA USA
| | - Roman Carlos
- Centro Clínico de Cabeza y Cuello, Patología División, Guatemala City, Guatemala
| | - Mohammed N. Islam
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL USA
| | - Marino E. Leon
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL USA
| | - James S. Lewis
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN USA
| | - Kelly R. Magliocca
- Department of Pathology & Laboratory Medicine, Emory University School of Medicine, Atlanta, GA USA
| | - Haresh Mani
- Department of Pathology, Inova Fairfax Hospital, Falls Church, VA USA
| | - Mitra Mehrad
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN USA
| | - Bibianna Purgina
- Department of Pathology, University of Ottawa, Ottawa, Ontario Canada
| | - Mary Richardson
- Department of Pathology, MUSC Health-University Medical Center, Charleston, SC USA
| | - Bruce M. Wenig
- Department of Pathology, Moffitt Cancer Center, Tampa, FL USA
| | - Donald M. Cohen
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL USA
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Abstract
Corpora amylacea are predominantly found in the brain, prostate, and lung. Recent characterizations of their components suggest an important role in protection and clearing. We report the presence of corpora amylacea in pleural effusion in a patient with lupus. The differential diagnoses and potential significance are discussed.
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Affiliation(s)
- Haresh Mani
- Department of Pathology, Inova Fairfax Hospital, Falls Church, Virginia, USA
| | - Brant G Wang
- Department of Pathology, Inova Fairfax Hospital, Falls Church, Virginia, USA
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8
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Mani H, Hamouda M, Ayed A, Ben Salem M, Letaief A, Aloui S, Skhiri H. SUN-344 AVASCULAR NECROSIS IN KIDNEY TRANSPLANT RECIPIENTS. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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9
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Wang ZQ, Mani H, Lee IH, Webster KW, Wang BG. Ultrasound-guided fine-needle aspiration of a rectal submucosal nodule. Diagn Cytopathol 2019; 48:159-163. [PMID: 31697418 DOI: 10.1002/dc.24335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/07/2019] [Accepted: 10/22/2019] [Indexed: 11/07/2022]
Abstract
Although endoscopic biopsy of a rectal submucosal nodule may be nondiagnostic, endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) can be an important tool to make diagnosis. We report a case of a female patient who had an EUS-FNA of a submucosal nodule after a nondiagnostic rectal biopsy. The original diagnosis was erroneously rendered as concerning for necrotic neoplasm. The correct diagnosis of Solesta-induced foreign body reaction was made on reviewing the slides once the history of remote Solesta injection was made available. This case illustrates the pathognomonic features of Solesta-induced rectal nodule and underscores the importance of detailed history as well as inclusion of iatrogenic diseases in the differential to prevent erroneous diagnosis and management. Potential pitfalls in cytopathological diagnosis are discussed.
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Affiliation(s)
- Zoe Q Wang
- Department of Pathology, Inova Fairfax Hospital, Falls Church, Virginia
| | - Haresh Mani
- Department of Pathology, Inova Fairfax Hospital, Falls Church, Virginia
| | - Iris H Lee
- Division of Gastroenterology, Department of Medicine, lnova Fairfax Hospital, Falls Church, Virginia
| | | | - Brant G Wang
- Department of Pathology, Inova Fairfax Hospital, Falls Church, Virginia
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10
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Wang BG, Mani H, Wang ZQ, Nayer Z, Khan J. Unusual trifecta of infections, aspiration, and metastatic prostatic adenocarcinoma in a bronchoalveolar lavage specimen. Diagn Cytopathol 2019; 48:144-148. [PMID: 31639284 DOI: 10.1002/dc.24327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/16/2019] [Accepted: 10/03/2019] [Indexed: 11/05/2022]
Abstract
Bronchoalveolar lavage (BAL) is a useful procedure to evaluate lung infiltrates in order to identify infection, foreign body aspiration, and neoplasms. However, it is indeed unusual to find all three in the same sample. We report such a case in a 68-year-old male with a history of metastatic prostate adenocarcinoma and longstanding chronic obstructive pulmonary disease who presented with features of pneumonia. BAL revealed Aspergillus and parainfluenza infections, food particle aspiration pneumonia, as well as metastatic prostatic adenocarcinoma. The food particles were initially confused for yeast infection, but we finally identified them as nut products. This may be the first documented case of nut product aspiration diagnosed on BAL. The potential pitfalls that may complicate the evaluation are also discussed.
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Affiliation(s)
- Brant G Wang
- Department of Pathology, Inova Fairfax Hospital, Falls Church, Virginia
| | - Haresh Mani
- Department of Pathology, Inova Fairfax Hospital, Falls Church, Virginia
| | - Zoe Q Wang
- Department of Pathology, Inova Fairfax Hospital, Falls Church, Virginia
| | - Zacharia Nayer
- George Washington School of Medicine and Health Sciences, Washington, District of Columbia
| | - Jawad Khan
- Department of Internal Medicine, Inova Loudon Hospital, Leesburg, Virginia
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11
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Bhatnagar A, Gupta P, Singh PP, Mani H, Ahmad K, Aryal S. A CASE OF CLINICALLY AMYOPATHIC DERMATOMYOSITIS-RELATED INTERSTITIAL LUNG DISEASE DUE TO ANTI-MDA5 ANTIBODY AND HEPATITIS B INFECTION. Chest 2019. [DOI: 10.1016/j.chest.2019.08.254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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12
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Warren WA, Franco-Palacios D, King CS, Shlobin OA, Nathan SD, Katugaha SB, Mani H, Brown AW. A 24-Year-Old Woman With Precipitous Respiratory Failure After Lung Transplantation. Chest 2019. [PMID: 29519311 DOI: 10.1016/j.chest.2017.08.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
CASE PRESENTATION A 24-year-old woman with ΔF508/Y1092X cystic fibrosis (CF) complicated by severe obstructive lung disease (FEV1 of 30% predicted) was admitted for IV antibiotics for planned sinus surgery resulting from severe chronic sinusitis causing frequent exacerbations and declining lung function. She had persistent airway infection with multidrug-resistant Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, and growth of a fungus presumed to be an airway colonizer, identified as Stephanoascus ciferrii 1 year before presentation. Two days after surgery, she developed acute respiratory failure requiring mechanical ventilation. On day 4 of mechanical ventilation, venovenous-extracorporeal membrane oxygenation (VV-ECMO) was initiated for refractory respiratory failure. The following day, she was listed for bilateral lung transplant and was transplanted 4 days later. Following transplantation, she was decannulated from ECMO; however, over the next 12 hours, oxygenation deteriorated requiring reinstitution of VV-ECMO for presumed severe primary graft dysfunction. Despite treatment with broad spectrum antimicrobial coverage with piperacillin/tazobactam, ciprofloxacin, linezolid, micafungin, voriconazole, and ganciclovir, she failed to improve and developed complex bilateral pleural effusions.
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Affiliation(s)
- Whittney A Warren
- Walter Reed National Military Medical Center Department of Pulmonary and Critical Care, Walter Reed Military Medical Center, Bethesda, MD.
| | - Domingo Franco-Palacios
- Advanced Lung Disease and Transplant Program, Inova Heart and Vascular Institute, Inova Fairfax Hospital, Falls Church, VA
| | - Christopher S King
- Advanced Lung Disease and Transplant Program, Inova Heart and Vascular Institute, Inova Fairfax Hospital, Falls Church, VA
| | - Oksana A Shlobin
- Advanced Lung Disease and Transplant Program, Inova Heart and Vascular Institute, Inova Fairfax Hospital, Falls Church, VA
| | - Steven D Nathan
- Advanced Lung Disease and Transplant Program, Inova Heart and Vascular Institute, Inova Fairfax Hospital, Falls Church, VA
| | - Shalika B Katugaha
- Advanced Lung Disease and Transplant Program, Inova Heart and Vascular Institute, Inova Fairfax Hospital, Falls Church, VA; Infectious Diseases Physicians, Inc., Annandale, VA
| | - Haresh Mani
- Department of Pathology, Inova Fairfax Hospital, Falls Church, VA
| | - A Whitney Brown
- Advanced Lung Disease and Transplant Program, Inova Heart and Vascular Institute, Inova Fairfax Hospital, Falls Church, VA
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Webb MA, Mani H, Robertson SJ, Waller HL, Webb DR, Edwardson CL, Bodicoat DH, Yates T, Khunti K, Davies MJ. Moderate increases in daily step count are associated with reduced IL6 and CRP in women with PCOS. Endocr Connect 2018; 7:1442-1447. [PMID: 30475222 PMCID: PMC6301194 DOI: 10.1530/ec-18-0438] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 11/21/2018] [Indexed: 12/19/2022]
Abstract
Aims Physical activity has been proposed to be an effective non-pharmacological method of reducing systemic inflammation and therefore may prove particularly efficacious for women with polycystic ovary syndrome (PCOS) who have been shown to have high levels of inflammation and an increased risk of type 2 diabetes (T2DM) and cardiovascular disease (CVD). Therefore, the aim of the present study was to assess whether modest changes in daily step count could significantly reduce levels of inflammatory markers in women with PCOS. Subjects and Methods Sixty-five women with PCOS were assessed at baseline and again at 6 months. All had been provided with an accelerometer and encouraged to increase activity levels. Multivariate linear regression analyses (adjusted for age, ethnicity, baseline step count, change in BMI and change in accelerometer wear-time) were used to assess changes in daily step count against clinical and research biomarkers of inflammation, CVD and T2DM. Results Mean step count/day at baseline was 6337 (±270). An increase in step count (by 1000 steps) was associated with a 13% reduction in IL6 (β: -0.81 ng/L; 95% CI, -1.37, -0.25, P = 0.005) and a 13% reduction in CRP (β: -0.68 mg/L; 95% CI, -1.30, -0.06, P = 0.033). Additionally, there was a modest decrease in BMI (β: 0.20 kg/m2; 95% CI, -0.38, -0.01, P = 0.038). Clinical markers of T2DM and CVD were not affected by increased step count. Conclusions Modest increases in step count/day can reduce levels of inflammatory markers in women with PCOS, which may reduce the future risk of T2DM and CVD.
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Affiliation(s)
- M A Webb
- NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
- The Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK
| | - H Mani
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
- Department of Diabetes and Endocrinology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK
- Diabetes and Endocrinology Department, Kettering General Hospital NHS Foundation Trust, Kettering, UK
- Correspondence should be addressed to H Mani:
| | - S J Robertson
- The Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK
| | - H L Waller
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - D R Webb
- NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - C L Edwardson
- NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - D H Bodicoat
- NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - T Yates
- NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - K Khunti
- NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
- The Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - M J Davies
- NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
- The Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
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14
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Niture S, Ramalinga M, Kedir H, Patacsil D, Niture SS, Li J, Mani H, Suy S, Collins S, Kumar D. TNFAIP8 promotes prostate cancer cell survival by inducing autophagy. Oncotarget 2018; 9:26884-26899. [PMID: 29928491 PMCID: PMC6003558 DOI: 10.18632/oncotarget.25529] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 05/03/2018] [Indexed: 01/11/2023] Open
Abstract
Tumor necrosis factor-α-inducible protein 8 (TNFAIP8) is a TNF-α inducible anti-apoptotic protein with multiple roles in tumor growth and survival. Mechanisms of cell survival by TNFAIP8 remain elusive. We investigated the role of TNFAIP8 in the regulation of the cell cycle, autophagy, cell survival and neuroendocrine differentiation in prostate cancer cells. We showed that TNFAIP8 dysregulates cell-cycle-related proteins, in PC3 cells. Oncogenic cell survival, drug resistance and dysregulation of cell cycle-related proteins are often associated with autophagy. We demonstrated that TNFAIP8 induces autophagy by increasing expression of autophagy effectors such as LC3β I/II, Beclin1, 4EBP1, p62, and SIRT1. We also demonstrated that TNFAIP8 interacts with autophagy-related protein 3 (ATG3). TNFα treatment increased the expression of TNFAIP8, which was associated with increased autophagy and decreased apoptosis. We also observed an increase in expression of neuroendocrine differentiation markers, synaptophysin and chromogranin A, and drug resistance to anticancer drugs, docetaxel and doxorubicin, in cells transfected with TNFAIP8. Collectively, our findings reveal that by the creation of cellular autophagy events, TNFAIP8 promotes cell survival and drug resistance in prostate cancer cells.
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Affiliation(s)
- Suryakant Niture
- Julius L. Chambers Biomedical Biotechnology Research Institute, North Carolina Central University Durham, 27707 NC, USA.,Cancer Research Laboratory, University of the District of Columbia, Washington, 20008 DC, USA
| | - Malathi Ramalinga
- Cancer Research Laboratory, University of the District of Columbia, Washington, 20008 DC, USA
| | - Habib Kedir
- Julius L. Chambers Biomedical Biotechnology Research Institute, North Carolina Central University Durham, 27707 NC, USA.,Cancer Research Laboratory, University of the District of Columbia, Washington, 20008 DC, USA
| | - Dorrelyn Patacsil
- Cancer Research Laboratory, University of the District of Columbia, Washington, 20008 DC, USA
| | | | - James Li
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, 20008 DC, USA
| | - Haresh Mani
- Department of Pathology, Inova Fairfax Hospital, Falls Church, 22042 VA, USA
| | - Simeng Suy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, 20008 DC, USA
| | - Sean Collins
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, 20008 DC, USA
| | - Deepak Kumar
- Julius L. Chambers Biomedical Biotechnology Research Institute, North Carolina Central University Durham, 27707 NC, USA.,Cancer Research Laboratory, University of the District of Columbia, Washington, 20008 DC, USA.,Lombardi Comprehensive Cancer Center, Georgetown University, Washington, 20008 DC, USA
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15
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Abstract
SummaryBoth for diagnosis of congenital and acquired platelet dysfunction as well as for therapy monitoring after application of platelet function inhibitors various methods have been established for evaluation of platelet function. In contrast to the gold standard of platelet function testing, the light transmission aggregometry in platelet rich plasma the Point-of-care (POC) analyzers allow fast analysis of platelet function without extensive laboratory work up. The conditions of the pre-analytical phase, however, are still of enormous importance in the prevention of medical errors. There is increasing clinical data in monitoring the effect of platelet aggregation inhibitors, showing that quantitative determination of the platelet function degree correlates with risk of increased bleeding or stent thrombosis. However, it is still unclear, which is the optimal test system, to predict the clinical outcome of these patients.
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16
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Abstract
ZusammenfassungResistenz gegen Azetylsalizylsäure (ASS) bzw. Clopidogrel wird vom klinischen Gesichtspunkt als Unvermögen des Wirkstoffs angesehen, rezidivierende arterielle Gefäßverschlüsse zu verhindern. Aus laborchemischer Sicht hingegen wird die Non-Response gegenüber ASS und Clopidogrel als das Ausbleiben eines erwarteten Effektes in verschiedenen Thrombozytenfunktionstestsystemen beschrieben. Etablierte Thrombozytenfunktionsteste ermöglichen meist keine spezifischen Aussagen über die Thrombozytenaggregationshemmung durch ASS oder Clopidogrel. Wünschenswert wäre, die ASS- und Clopidogrel-Non-Response mit Plättchenfunktionstesten derart zu ermitteln, dass isoliert die spezifischen Effekte dieser Arzneimittel erfasst werden. Im Idealfall könnte eine solche Labordiagnostik helfen, klinische Ereignisse aufgrund eines Therapieversagens im Vorfeld zu verhindern. Studien, die eine Prävalenz von 5 bis 59% für die ASS- oder Clopidogrel-Non-Response angeben, geben erste Hinweise dafür, dass der Nachweis einer laborchemischen ASS- oder Clopidogrel-Non-Response mit dem nachfolgendem Auftreten vaskulärer Reereignisse assoziiert sein könnte. Allerdings sind diese Studien durch zu geringe Fallzahlen, fehlende Standardisierung der Labormethoden und sehr differente Einschlusskriterien in ihrer Aussagekraft limitiert. Deshalb bleibt die klinische Relevanz laborchemisch nachgewiesener ASS- oder Clopidogrel- Resistenz unklar und sollte umgehend in prospektiven Multizenterstudien geklärt werden. Die individuellen Ursachen einer reduzierten oder ausbleibenden Wirkung von ASS oder Clopidogrel können multifaktoriell sein. Die Mechanismen der ASS- bzw. Clopidogrel- Resistenz sind weitgehend ungeklärt.
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Bodian DL, Vilboux T, Hourigan SK, Jenevein CL, Mani H, Kent KC, Khromykh A, Solomon BD, Hauser NS. Genomic analysis of an infant with intractable diarrhea and dilated cardiomyopathy. Cold Spring Harb Mol Case Stud 2017; 3:mcs.a002055. [PMID: 28701297 PMCID: PMC5701300 DOI: 10.1101/mcs.a002055] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 06/26/2017] [Indexed: 12/22/2022] Open
Abstract
We describe a case of an infant presenting with intractable diarrhea who subsequently developed dilated cardiomyopathy, for whom a diagnosis was not initially achieved despite extensive clinical testing, including panel-based genetic testing. Research-based whole-genome sequences of the proband and both parents were analyzed by the SAVANNA pipeline, a variant prioritization strategy integrating features of variants, genes, and phenotypes, which was implemented using publicly available tools. Although the intestinal morphological abnormalities characteristic of congenital tufting enteropathy (CTE) were not observed in the initial clinical gastrointestinal tract biopsies of the proband, an intronic variant, EPCAM c.556-14A>G, previously identified as pathogenic for CTE, was found in the homozygous state. A newborn cousin of the proband also presenting with intractable diarrhea was found to carry the same homozygous EPCAM variant, and clinical testing revealed intestinal tufting and loss of EPCAM staining. This variant, however, was considered nonexplanatory for the proband's dilated cardiomyopathy, which could be a sequela of the child's condition and/or related to other genetic variants, which include de novo mutations in the genes NEDD4L and GSK3A and a maternally inherited SCN5A variant. This study illustrates three ways in which genomic sequencing can aid in the diagnosis of clinically challenging patients: differential diagnosis despite atypical clinical presentation, distinguishing the possibilities of a syndromic condition versus multiple conditions, and generating hypotheses for novel contributory genes.
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Affiliation(s)
- Dale L Bodian
- Inova Translational Medicine Institute, Inova Health System, Falls Church, Virginia 22042, USA
| | - Thierry Vilboux
- Inova Translational Medicine Institute, Inova Health System, Falls Church, Virginia 22042, USA
| | - Suchitra K Hourigan
- Inova Translational Medicine Institute, Inova Health System, Falls Church, Virginia 22042, USA.,Inova Children's Hospital, Falls Church, Virginia 22042, USA
| | - Callie L Jenevein
- Inova Translational Medicine Institute, Inova Health System, Falls Church, Virginia 22042, USA
| | - Haresh Mani
- Department of Pathology, Inova Fairfax Hospital, Falls Church, Virginia 22042, USA
| | | | - Alina Khromykh
- Inova Translational Medicine Institute, Inova Health System, Falls Church, Virginia 22042, USA
| | - Benjamin D Solomon
- Inova Translational Medicine Institute, Inova Health System, Falls Church, Virginia 22042, USA
| | - Natalie S Hauser
- Inova Translational Medicine Institute, Inova Health System, Falls Church, Virginia 22042, USA
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18
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Affiliation(s)
- M.N. Mishra
- INHS Asvini, Department of Pathology, Navy Nagar, Colaba, Mumbai 400 005, Maharashtra, India
| | - H. Mani
- INHS Asvini, Department of Pathology, Navy Nagar, Colaba, Mumbai 400 005, Maharashtra, India
| | - A.S. Narula
- INHS Asvini, Department of Nephrology, Navy Nagar, Colaba, Mumbai 400 005, Maharashtra, India
| | - V.K. Saxena
- INHS Asvini, Department of Urology, Navy Nagar, Colaba, Mumbai 400 005, Maharashtra, India
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19
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Abstract
Intensely eosinophilic and glassy intracytoplasmic inclusions were present in the neurons of the peripheral autonomic ganglia, Meissner's and Auerbach's plexus, and spinal ganglia in 20 aged white-nosed coatis ( Nasua narica, 7-19 years old) and in 4 of 7 brown-nosed coatis ( Nasua nasua, 2-21 years old) from multiple zoological institutions. Inclusions were single to numerous, sometimes distorting the cell. Pheochromocytomas were present in 5 of 16 white-nosed and 2 of 6 brown-nosed coatis, although no inclusions were present in the adrenal glands. Histochemically, immunohistochemically, and ultrastructurally, these inclusions were consistent with dense neurosecretory granules. Although similar inclusions have been reported sporadically in the adrenal medulla of humans and several other mammalian species as both incidental and pathologic findings, ganglionic inclusions reported herein appear to be unique and related to age in these species.
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Affiliation(s)
- Timothy K Cooper
- 1 Department of Comparative Medicine, Penn State Hershey Medical Center, Hershey, PA, USA.,2 Department of Pathology, Penn State Hershey Medical Center, Hershey, PA, USA
| | | | - Jennifer Baccon
- 2 Department of Pathology, Penn State Hershey Medical Center, Hershey, PA, USA.,4 Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, PA, USA
| | - Haresh Mani
- 5 Department of Pathology, Inova Fairfax Hospital, Falls Church, VA, USA
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Deeken JF, Mani H, Bajaj GK, Joshi A, Ahmad M, Iyer RK. Notch1 mutations in head and neck adenoid cystic carcinoma (HNAdCC) may define an aggressive genetic subtype. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e17520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Haresh Mani
- Inova Schar Cancer Institute, Falls Church, VA
| | | | - Arjun Joshi
- George Washington University, Washington, DC
| | - Moin Ahmad
- Inova Translational Medicine Insitute, Falls Church, VA
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21
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Affiliation(s)
- Farah Khan
- Inova Children's Hospital, Fairfax, VA, USA
| | | | - Catherine Chao
- Inova Children's Hospital, Fairfax, VA, USA; Pediatric Specialsits of Virginia, Fairfax, VA, USA
| | - Suchi Hourigan
- Inova Children's Hospital, Fairfax, VA, USA; Pediatric Specialsits of Virginia, Fairfax, VA, USA
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22
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Lokhandwala PM, Abendroth CS, Wang M, Mani H, Williams NC, Walls M, Zander DS. Assessment of cytotechnologist-cytopathologist interpretative agreement using the Bethesda system for reporting thyroid cytopathology. Diagn Cytopathol 2015; 44:113-8. [DOI: 10.1002/dc.23413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 11/22/2015] [Accepted: 11/25/2015] [Indexed: 01/21/2023]
Affiliation(s)
- Parvez M. Lokhandwala
- Department of Pathology; Pennsylvania State M. S. Hershey Medical Center; Hershey Pennsylvania
| | - Catherine S. Abendroth
- Department of Pathology; Pennsylvania State M. S. Hershey Medical Center; Hershey Pennsylvania
| | - Ming Wang
- Department of Public Health Sciences; Pennsylvania State College of Medicine; Hershey Pennsylvania
| | - Haresh Mani
- Department of Pathology; Inova Fairfax Hospital; Falls Church Virginia
| | - Nicole C. Williams
- Department of Pathology; Pennsylvania State M. S. Hershey Medical Center; Hershey Pennsylvania
| | - Michelle Walls
- Department of Pathology; Pennsylvania State M. S. Hershey Medical Center; Hershey Pennsylvania
| | - Dani S. Zander
- Department of Pathology; Pennsylvania State M. S. Hershey Medical Center; Hershey Pennsylvania
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23
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Lewis JS, Tarabishy Y, Luo J, Mani H, Bishop JA, Leon ME, Prasad ML, Xu H, Di Palma S. Inter- and intra-observer variability in the classification of extracapsular extension in p16 positive oropharyngeal squamous cell carcinoma nodal metastases. Oral Oncol 2015; 51:985-990. [PMID: 26293844 DOI: 10.1016/j.oraloncology.2015.08.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 07/05/2015] [Accepted: 08/03/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Discern inter- and intra-observer variability in the classification of extracapsular extension (ECE) in p16+ oropharyngeal (OP) SCC comparing pathologists' own criteria versus those of a well-defined classification system. METHODS Five pathologists reviewed 50 digitally scanned nodal metastasis slides in three Rounds. Round One was by their own criteria as ECE present or absent, and Rounds Two and Three were with a defined ECE system: Grade 0 (no ECE), 0c (no ECE - thick capsule; no infiltration), 1 (ECE - cells beyond capsule), and 2 (soft tissue metastasis - cells in soft tissue without residual node). Round Three assessed intra-observer variability after an 8 month washout period. RESULTS In Round One, all five agreed on only 48% of cases (n=24). Fleiss's Kappa value was 0.508 (95% CI: 0.357-0.644). For Rounds Two and Three, Grades 0 and 0c and Grades 1 and 2 were separately grouped as ECE absent or present. In Round Two, all five agreed on 68% of cases (n=34). Fleiss' Kappa was 0.635 (95% CI: 0.472-0.783), indicating statistically significantly better agreement. In Round Three, all five agreed on 64% of cases (n=32) giving a Fleiss's Kappa of 0.639. Pathologists agreed with their prior reads in approximately 90% of cases (average n=45.4, range n=42-49), an average intra-observer Cohen's Kappa of 0.8 (range: 0.68-0.95). Inter- and intra-observer variability rates for classification of soft tissue metastasis (ECE2) were substantially worse. CONCLUSION There is substantial inter-, and modest intra-, observer variability among head and neck pathologists for ECE in p16+ OPSCC, which is modestly improved by a defined system.
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Affiliation(s)
- James S Lewis
- Vanderbilt University Medical Center, Department of Pathology, Microbiology, and Immunology, Nashville, TN, United States; Vanderbilt University Medical Center, Department of Otolaryngology, Nashville, TN, United States; Washington University, Department of Pathology and Immunology, St. Louis, MO, United States.
| | - Yaman Tarabishy
- Washington University, Department of Pathology and Immunology, St. Louis, MO, United States
| | - Jingqin Luo
- Washington University, Division of Biostatistics, St. Louis, MO, United States
| | - Haresh Mani
- Inova Fairfax Hospital, Department of Pathology, Falls Church, VA, United States
| | - Justin A Bishop
- Johns Hopkins University, Department of Pathology, Baltimore, MD, United States
| | - Marino E Leon
- H. Lee Moffitt Cancer Center, Department of Pathology and Cell Biology, Tampa, FL, United States
| | - Manju L Prasad
- Yale University, Department of Pathology, New Haven, CT, United States
| | - Haodong Xu
- UCLA, Department of Pathology and Laboratory Medicine, Los Angeles, CA, United States
| | - Silvana Di Palma
- Royal Surrey County Hospital, Department of Histopathology, Guildford, Surrey, United Kingdom
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24
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Abstract
Diagnostic of global coagulation parameters is part of the daily clinical routine practice in conservative as well in operative disciplines. The correct interpretation of in vitro test results in context to the ex vivo influence of anticoagulant drugs and the in vivo hemostatic system of the individual patient is dependent on the doctors clinical and laboratory experience. This article shortly reviews the laboratory interference of oral anticoagulants including the target-specific inhibitors dabigatran, rivaroxaban and apixaban on coagulation parameters and discusses the potential of several methods for measuring the anticoagulant effect of the direct oral anticoagulants.
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Affiliation(s)
- H Mani
- Department of Internal Medicine, Division of Vascular Medicine, Johann Wolfgang Goethe-University Hospital Frankfurt/Main, Frankfurt, Germany
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25
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Mani H, Joshi S. Surgeon Captain I.K. Indrajit. Natl Med J India 2014; 27:283. [PMID: 26037433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Haresh Mani
- Inova Fairfax Hospital Falls Church Virginia USA,
| | - Sangeeta Joshi
- Department of Microbiology Manipal Hospital Bengaluru Karnataka India,
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26
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Mani H. US Food and Drug Administration (FDA) approves stand-alone HPV-DNA testing for cervical cancer screening. Natl Med J India 2014; 27:241. [PMID: 25668179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Affiliation(s)
- Haresh Mani
- Department of Pathology, Penn State Milton S. Hershey Medical Center/Penn State College of Medicine, Hershey, PA.
| | - Dani S Zander
- Department of Pathology, Penn State Milton S. Hershey Medical Center/Penn State College of Medicine, Hershey, PA
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Parekh S, Bodicoat DH, Brady E, Webb D, Mani H, Mostafa S, Levy MJ, Khunti K, Davies MJ. Clinical characteristics of people experiencing biochemical hypoglycaemia during an oral glucose tolerance test: cross-sectional analyses from a UK multi-ethnic population. Diabetes Res Clin Pract 2014; 104:427-34. [PMID: 24685116 DOI: 10.1016/j.diabres.2014.02.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 01/21/2014] [Accepted: 02/19/2014] [Indexed: 01/21/2023]
Abstract
AIMS People who experience biochemical hypoglycaemia during an oral glucose tolerance test (OGTT) may be insulin resistant, but this has not been investigated robustly, therefore we examined this in a population-based multi-ethnic UK study. METHODS Cross-sectional data from 6478 diabetes-free participants (849 with fasting insulin data available) who had an OGTT in the ADDITION-Leicester screening study (2005-2009) were analysed. People with biochemical hypoglycaemia (2-h glucose <3.3mmol/l) were compared with people with normal glucose tolerance (NGT) or impaired glucose regulation (IGR) using regression methods. RESULTS 359 participants (5.5%) had biochemical hypoglycaemia, 1079 (16.7%) IGR and 5040 (77.8%) NGT. Biochemical hypoglycaemia was associated with younger age (P<0.01), white European ethnicity (P<0.001), higher HDL cholesterol (P<0.01), higher insulin sensitivity (P<0.05), and lower body mass index (P<0.001), blood pressure (P<0.01), fasting glucose (P<0.001), HbA1C (P<0.01), and triglycerides (P<0.01) compared with NGT and IGR separately in both unadjusted and adjusted (age, sex, ethnicity, body mass index, smoking status) models. CONCLUSIONS Biochemical hypoglycaemia during an OGTT in the absence of diabetes or IGR was not associated with insulin resistance, but instead appeared to be associated with more favourable glycaemic risk profiles than IGR and NGT. Thus, clinicians may not need to intervene due to biochemical hypoglycaemia on a 2-h OGTT.
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Affiliation(s)
- S Parekh
- University of Leicester, Diabetes Research Centre, UK
| | - D H Bodicoat
- University of Leicester, Diabetes Research Centre, UK; University of Leicester, Leicester Clinical Trials Unit, UK.
| | - E Brady
- University of Leicester, Leicester Clinical Trials Unit, UK; Department of Diabetes Research, University Hospitals of Leicester, NHS Trust, UK
| | - D Webb
- University of Leicester, Diabetes Research Centre, UK; University of Leicester, Leicester Clinical Trials Unit, UK
| | - H Mani
- University of Leicester, Diabetes Research Centre, UK; Department of Diabetes and Endocrinology, University Hospitals of Leicester, NHS Trust, UK
| | - S Mostafa
- University of Leicester, Diabetes Research Centre, UK
| | - M J Levy
- Department of Diabetes Research, University Hospitals of Leicester, NHS Trust, UK
| | - K Khunti
- University of Leicester, Diabetes Research Centre, UK; University of Leicester, Leicester Clinical Trials Unit, UK
| | - M J Davies
- University of Leicester, Diabetes Research Centre, UK; University of Leicester, Leicester Clinical Trials Unit, UK
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29
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Bezinover D, Ramamoorthy S, Postula M, Weller G, Mahmoud S, Mani H, Kadry Z, Uemura T, Mets B, Spiess B, Brucklacher R, Freeman W, Janicki PK. Effect of cold perfusion and perfluorocarbons on liver graft ischemia in a donation after cardiac death model. J Surg Res 2014; 188:517-26. [PMID: 24582069 DOI: 10.1016/j.jss.2014.01.045] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Revised: 01/10/2014] [Accepted: 01/24/2014] [Indexed: 01/22/2023]
Abstract
BACKGROUND Effects of two perfluorocarbon (PFC) formulations (perfluorodecalin emulsion and perfluorodecalin liquid) on the quality of liver graft preservation, in a donation after cardiac death (DCD) rat model, were investigated. The significance of continuous graft perfusion during cold preservation was also explored. MATERIALS AND METHODS DCD model: 30 min after cardiopulmonary arrest was initiated, livers were excised and flushed with cold University of Wisconsin (UW) solution (± PFC) and preserved in the same solution for 8 h. The study groups were preserved as follows: group 1: no perfusion; group 2: perfusion with UW; group 3: PFC was administered before cardiac arrest and the liver was perfused with UW alone; and groups 4 and 5: perfused with UW + 1 of two PFCs. In a baseline group used only for comparison of gene expression, livers were quick-frozen after cardiac arrest. Microarrays were used to analyze liver messenger RNA transcripts. Histopathologic, immunohistochemical, and ADP/ATP ratio evaluations were performed to assess the quality of graft preservation. RESULTS Significant decreases in downregulation and increases in upregulation of hepatic genes (relative to baseline) were demonstrated in all perfusion groups. This trend was most pronounced in the PFC groups. Lower fat content and ADP/ATP ratio and a reduction in Caspase 3 activation were found in all perfusion groups. CONCLUSION Hypothermic perfusion of rat DCD liver grafts with oxygenated UW solution (± PFC) produced superior preservation compared with nonperfusion storage. The observed changes in expression of hepatic genes may represent a protective effect in the DCD model.
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Affiliation(s)
- Dmitri Bezinover
- Department of Anesthesiology, Penn State Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania.
| | - Saravanan Ramamoorthy
- Department of Anesthesiology, Penn State Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania
| | - Marek Postula
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland
| | - Gregory Weller
- Department of Anesthesiology, Penn State Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania
| | - Saifeldin Mahmoud
- Department of Anesthesiology, Penn State Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania
| | - Haresh Mani
- Department of Pathology, Penn State Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania
| | - Zakiyah Kadry
- Department of Transplant Surgery, Penn State Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania
| | - Tadahiro Uemura
- Department of Transplant Surgery, Penn State Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania
| | - Berend Mets
- Department of Anesthesiology, Penn State Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania
| | - Bruce Spiess
- Department of Anesthesiology, Virginia Commonwealth University Medical Center, Richmond, Virginia
| | - Robert Brucklacher
- Genome Sciences Core Facility, Penn State Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania
| | - Willard Freeman
- Genome Sciences Core Facility, Penn State Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania
| | - Piotr K Janicki
- Department of Anesthesiology, Penn State Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania
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30
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Mani H. Indian American nominated to be the US Surgeon General. Natl Med J India 2014; 27:57. [PMID: 25403140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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31
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Mani H. Healthcare politics shuts down US federal government. Natl Med J India 2013; 26:380. [PMID: 25074005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Lou LX, Uemura T, Mani H, Yang C, Li W, Kadry Z, Zhang SSM. Endogenous signal transducer and activator of transcription 3 is required for the protection of hepatocytes against warm ischemia/reperfusion injury. Liver Transpl 2013; 19:1078-87. [PMID: 23836400 DOI: 10.1002/lt.23693] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 06/05/2013] [Indexed: 01/12/2023]
Abstract
Warm ischemia/reperfusion (I/R) is a common clinical problem during liver transplantation and liver resection. Warm ischemia also occurs during trauma and shock. However, there is still no safe and promising strategy for protecting the liver from I/R injury. Signal transducer and activator of transcription 3 (STAT3) is a major immediate response molecule for protecting cell survival. In this study, we first confirmed that a pharmacological STAT3 inhibitor, (E)-2-cyano-3-(3,4-dihydrophenyl)-N-(phenylmethyl)-2-propenamide (AG490), significantly reduced the survival of HepG2 cells, regardless of the serum condition. Furthermore, we created hepatocyte-specific STAT3-deficient mice with the cyclization recombination-locus of X-over P1 (Cre-LoxP) system to study the mechanisms of STAT3 in liver I/R injury. We found that the alanine aminotransferase level was significantly higher in hepatocyte-specific STAT3-deficient mice versus wild-type (WT) mice in a 70% liver I/R injury model. A histopathological examination showed that hepatocyte-specific STAT3-deficient mice suffered more severe damage than WT mice despite similar numbers of polymorphonuclear neutrophils in the 2 groups. These results indicate that endogenous STAT3 signaling in hepatocytes is required for protection of the liver in vitro and in vivo against warm I/R injury. In conclusion, endogenous STAT3 plays an important role in protecting the liver against I/R injury, and STAT3-targeting therapy could be a therapeutic approach to combating liver I/R injury.
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Affiliation(s)
- Lucy Xi Lou
- Neural and Behavioral Sciences, College of Medicine, Pennsylvania State University, Hershey, PA
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Crist HS, Evans JJ, Mani H, Saunders B, Fornadley J, Camacho F, Goldenberg D. Do black (dark) lymph-node metastases in papillary thyroid carcinoma suggest more advanced or aggressive disease? Thyroid 2013; 23:977-81. [PMID: 23343222 DOI: 10.1089/thy.2012.0321] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND In some patients, papillary thyroid carcinoma (PTC) lymph-node metastases are noted to be black (dark) in color at the time of surgical removal. The goal of this project was to determine histological, genetic, and clinical features that are associated with regional black PTC metastasis. METHODS Fifteen patients with black PTC metastases (black-PTC) were compared to a control cohort of 15 patients with nonblack PTC metastasis (nonblack PTC). Each sample was evaluated for the histological characteristics, BRAF V600E mutational status, and associated patient clinical data. RESULTS The degree of cystic degeneration (80% vs. 27%, p=0.004), percent hemosiderin deposition (20% vs. 6%, p=0.001), and presence of classical variant (100% vs. 67%, p=0.018) were significantly greater in black PTC than nonblack PTC (α=0.05). Other results were not significantly different. CONCLUSION This study demonstrates that black compared to nonblack metastases have a greater degree of cystic degeneration and hemosiderin deposition leading to discoloration, and a trend toward an increased incidence in BRAF V600E mutations. This study is the first of its kind to describe the clinical, pathological, and genetic features associated with black PTC lymph-node metastasis.
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Affiliation(s)
- Henry S Crist
- Department of Pathology, College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA
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Qiu P, Li Y, Shiloach J, Cui X, Sun J, Trinh L, Kubler-Kielb J, Vinogradov E, Mani H, Al-Hamad M, Fitz Y, Eichacker PQ. Bacillus anthracis cell wall peptidoglycan but not lethal or edema toxins produces changes consistent with disseminated intravascular coagulation in a rat model. J Infect Dis 2013; 208:978-89. [PMID: 23737601 DOI: 10.1093/infdis/jit247] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Disseminated intravascular coagulation (DIC) appears to be important in the pathogenesis of Bacillus anthracis infection, but its causes are unclear. Although lethal toxin (LT) and edema toxin (ET) could contribute, B. anthracis cell wall peptidoglycan (PGN), not the toxins, stimulates inflammatory responses associated with DIC. METHODS AND RESULTS To better understand the pathogenesis of DIC during anthrax, we compared the effects of 24-hour infusions of PGN, LT, ET, or diluent (control) on coagulation measures 6, 24, or 48 hours after infusion initiation in 135 rats. No control recipient died. Lethality rates (approximately 30%) did not differ among PGN, LT, and ET recipients (P = .78). Thirty-three of 35 deaths (94%) occurred between 6 and 24 hours after the start of challenge. Among challenge components, PGN most consistently altered coagulation measures. Compared with control at 6 hours, PGN decreased platelet and fibrinogen levels and increased prothrombin and activated partial thromboplastin times and tissue factor, tissue factor pathway inhibitor, protein C, plasminogen activator inhibitor (PAI), and thrombin-antithrombin complex levels, whereas LT and ET only decreased the fibrinogen level or increased the PAI level (P ≤ .05). Nearly all effects associated with PGN infusion significantly differed from changes associated with toxin infusion (P ≤ .05 for all comparisons except for PAI level). CONCLUSION DIC during B. anthracis infection may be related more to components such as PGN than to LT or ET.
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Affiliation(s)
- Ping Qiu
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
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Huda MSB, Mani H, Durham BH, Dovey TM, Halford JCG, Aditya BS, Pinkney JH, Wilding JP, Hart IK. Plasma obestatin and autonomic function are altered in orexin-deficient narcolepsy, but ghrelin is unchanged. Endocrine 2013. [PMID: 23179778 DOI: 10.1007/s12020-012-9838-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Narcolepsy-cataplexy is characterised by orexin deficiency, sleep disturbance, obesity and dysautonomia. Ghrelin and obestatin affect both energy intake and sleep. Our aim was to investigate ghrelin, obestatin and metabolic/autonomic function in narcolepsy-cataplexy. Eight narcolepsy-cataplexy patients (seven CSF orexin-deficient) and eight matched controls were studied. The subjects had a fixed energy meal with serial blood samples and measurement of heart rate variability (HRV). Fasting plasma obestatin was more than threefold higher in narcolepsy subjects (narcolepsy 89.6 ± 16 pg/ml vs. control 24.9 ± 3 pg/ml, p < 0.001). There was no change in HRV total power, but post-prandial low-frequency (LF) power and high-frequency (HF) power were lower in the narcolepsy group [area under the curve (AUC): HF power narcolepsy 1.4 × 10(5) ± 0.2 × 10(5) vs. control 3.3 × 10(5) ± 0.6 × 10(5 )ms(2)/h, p < 0.001]. On multiple regression analyses, the only significant predictor of plasma obestatin was HF power, which was inversely correlated with obestatin (β = -0.65 R (2) = 38 %, p = 0.009). Fasting and post-prandial plasma ghrelin were similar in both groups (narcolepsy 589.5 ± 88 pg/ml vs. control 686.9 ± 81 pg/ml, p = 0.5; post-prandial AUC-narcolepsy 161.3 ± 22 ng/ml/min vs. control 188.6 ± 62 ng/ml/min, p = 0.4). Only the narcolepsy group had significant suppression of plasma ghrelin after the meal (ANOVA, p = 0.004). In orexin-deficient narcolepsy, fasting plasma ghrelin is unaltered, and post-prandial suppression is preserved. Fasting plasma obestatin is increased and correlates with autonomic dysfunction. As obestatin affects NREM sleep, we suggest that increased plasma levels contribute to the disrupted sleep-state control in narcolepsy.
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Affiliation(s)
- M S B Huda
- University of Liverpool Diabetes and Endocrinology Research Group, Clinical Sciences Centre, University Hospital Aintree, Liverpool, L9 7AL, UK.
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Abstract
Type 2 congenital pulmonary airway malformation (CPAM) has been reported in association with many other congenital anomalies. To the best of our knowledge, however, an association of type 2 CPAM with congenital nephrotic syndrome has not been heretofore reported. We present the 1st report of such an association in a boy who had a prenatal diagnosis of cystic lung malformation and was found to have congenital nephrotic syndrome (diffuse mesangial sclerosis) at 1 month of age. A prenatal ultrasonogram had also shown oligohydramnios, and additionally the child had cleft lip and palate. There was no family history of childhood renal or pulmonary disease, and genetic testing for genes mutated in congenital nephrotic syndrome was negative.
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Affiliation(s)
- Karmaine A Millington
- Department of Pathology, Pennsylvania State Milton S. Hershey Medical Center, Hershey, PA, USA.
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Turkbey B, Mani H, Aras O, Ho J, Hoang A, Rastinehad AR, Agarwal H, Shah V, Bernardo M, Pang Y, Daar D, McKinney YL, Linehan WM, Kaushal A, Merino MJ, Wood BJ, Pinto PA, Choyke PL. Prostate cancer: can multiparametric MR imaging help identify patients who are candidates for active surveillance? Radiology 2013; 268:144-52. [PMID: 23468576 DOI: 10.1148/radiol.13121325] [Citation(s) in RCA: 176] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To determine whether multiparametric magnetic resonance (MR) imaging can help identify patients with prostate cancer who would most appropriately be candidates for active surveillance (AS) according to current guidelines and to compare the results with those of conventional clinical assessment scoring systems, including the D'Amico, Epstein, and Cancer of the Prostate Risk Assessment (CAPRA) systems, on the basis of findings at prostatectomy. MATERIALS AND METHODS This institutional review board-approved HIPAA-compliant retrospectively designed study included 133 patients (mean age, 59.3 years) with a mean prostate-specific antigen level of 6.73 ng/mL (median, 4.39 ng/mL) who underwent multiparametric MR imaging at 3.0 T before radical prostatectomy. Informed consent was obtained from all patients. Patients were then retrospectively classified as to whether they would have met AS eligibility criteria or were better served by surgery. AS eligibility criteria for prostatectomy specimens were a dominant tumor smaller than 0.5 mL without Gleason 4 or 5 patterns or extracapsular or seminal vesicle invasion. Conventional clinical assessment scores (the D'Amico, Epstein, and CAPRA scoring systems) were compared with multiparametric MR imaging findings for predicting AS candidates. The level of significance of difference between scoring systems was determined by using the χ(2) test for categoric variables with the level of significance set at P < .05. RESULTS Among 133 patients, 14 were eligible for AS on the basis of prostatectomy results. The sensitivity, positive predictive value (PPV), and overall accuracy, respectively, were 93%, 25%, and 70% for the D'Amico system, 64%, 45%, and 88% for the Epstein criteria, and 93%, 20%, and 59% for the CAPRA scoring system for predicting AS candidates (P < .005 for all, χ(2) test), while multiparametric MR imaging had a sensitivity of 93%, a PPV of 57%, and an overall accuracy of 92% (P < .005). CONCLUSION Multiparametric MR imaging provides useful additional information to existing clinicopathologic scoring systems of prostate cancer and improves the assignment of treatment (eg, AS or active treatment).
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Affiliation(s)
- Baris Turkbey
- Molecular Imaging Program, Laboratory of Pathology, Radiation Oncology Branch, and Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, 10 Center Dr, MSC 1182 Bldg 10, Room B3B69, Bethesda, MD 20892-1088, USA
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Abstract
Immunohistochemistry has come to occupy a key position among the armamentarium of tools pathologists apply to the evaluation of lung and pleural neoplasms. This technique uses antibodies that bind to specific antigens, usually proteins, enabling microscopic detection of the antigens. Over the last several decades, an impressive array of antibodies has become commercially available, and many of these antibodies have become integrated into the routine practice of pathology. Evaluation of tissue or cytology samples with these antibodies can facilitate determination of tumor type and site of origin. Comments citing results of immunohistochemical staining with these antibodies frequently appear in pathology reports and may be difficult to translate for those less familiar with the technique. This review presents, in two parts, common diagnostic applications of immunohistochemistry, with information about strategies taken for frequently encountered differential diagnostic scenarios. This, the first of two parts, offers a basic overview of the technique and discusses its applications in the diagnosis of common primary lung carcinomas.
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Affiliation(s)
- Haresh Mani
- Department of Pathology, Penn State Milton S. Hershey Medical Center/Penn State College of Medicine, Hershey, PA.
| | - Dani S Zander
- Department of Pathology, Penn State Milton S. Hershey Medical Center/Penn State College of Medicine, Hershey, PA
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Baker AR, Ohanessian SE, Adil E, Crist HS, Goldenberg D, Mani H. Dedifferentiated epithelial-myoepithelial carcinoma: analysis of a rare entity based on a case report and literature review. Int J Surg Pathol 2012; 21:514-9. [PMID: 23222809 DOI: 10.1177/1066896912468153] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Dedifferentiated epithelial-myoepithelial carcinoma (DEMC) is very rare salivary gland neoplasm with only anecdotal reports. We present an analysis of DEMC, based on a case and review of literature. Our patient, an 85-year-old woman, presented with a submandibular mass of 5 years duration that was increasing in size over a 5-week period. Histologically, there were areas of typical epithelial-myoepithelial carcinoma, with dedifferentiation of both components, manifesting morphologically as salivary duct carcinoma and areas of myoepithelial carcinoma. A review of literature revealed 21 previously reported cases of DEMC. DEMC occurs at an average age of 72 years, most often in the parotid gland (72%) followed by submandibular gland (17%). Dedifferentiation more often involves the epithelial component (13/15 cases) than the myoepithelial component (5/15 cases). Although typical epithelial-myoepithelial carcinomas are fairly indolent (average disease-free survival of 11.34 years), dedifferentiation confers a poor prognosis (survival reported from 1 to 72 months).
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Affiliation(s)
- Aaron R Baker
- 1Penn State College of Medicine & Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
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Affiliation(s)
- Tarek Alhamad
- Division of Nephrology, Department of Internal Medicine, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, USA.
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Mani H, Hesse C, Stratmann G, Lindhoff-Last E. Ex vivo effects of low-dose rivaroxaban on specific coagulation assays and coagulation factor activities in patients under real life conditions. Thromb Haemost 2012. [DOI: 10.1160/th-12-04-0228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Shah V, Turkbey B, Mani H, Pang Y, Pohida T, Merino MJ, Pinto PA, Choyke PL, Bernardo M. Decision support system for localizing prostate cancer based on multiparametric magnetic resonance imaging. Med Phys 2012; 39:4093-103. [PMID: 22830742 DOI: 10.1118/1.4722753] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE There is a growing need to localize prostate cancers on magnetic resonance imaging (MRI) to facilitate the use of image guided biopsy, focal therapy, and active surveillance follow up. Our goal was to develop a decision support system (DSS) for detecting and localizing peripheral zone prostate cancers by using machine learning approach to calculate a cancer probability map from multiparametric MR images (MP-MRI). METHODS This IRB approved Health Insurance Portability and Accountability Act compliant retrospective study consisted of 31 patients (mean age and serum prostate specific antigen of 60.4 and 6.62 ng∕ml, respectively) who had MP-MRI at 3 T followed by radical prostatectomy. Seven patients were excluded due to technical issues with their MP-MRI (e.g., motion artifact, failure to perform all sequences). Cancer and normal regions were identified in the peripheral zone by correlating them to whole mount histology slides of the excised prostatectomy specimens. To facilitate the correlation, tissue blocks matching the MR slices were obtained using a MR-based patient-specific mold. Segmented regions on the MP-MRI were correlated to histopathology and used as training sets for the learning system that generated the cancer probability maps. Leave-one-patient-out cross-validation on the cancer and normal regions was performed to determine the learning system's efficacy, an evolutionary strategies approach (also known as a genetic algorithm) was used to find the optimal values for a set of parameters, and finally a cancer probability map was generated. RESULTS For the 24 patients that were used in the study, 225 cancer and 264 noncancerous regions were identified from the region maps. The efficacy of DSS was first determined without optimizing support vector machines (SVM) parameters, where a region having a cancer probability greater than or equal to 50% was considered as a correct classification. The nonoptimized system had an f-measure of 85% and the Kappa coefficient of 71% (Rater's agreement, where raters are DSS and ground truth histology). The efficacy of the DSS after optimizing SVM parameters using a genetic algorithm had an f-measure of 89% and a Kappa coefficient of 80%. Thus, after optimization of the DSS there was a 4% increase in the f-measure and a 9% increase in the Kappa coefficient. CONCLUSIONS This DSS provides a cancer probability map for peripheral zone prostate tumors based on endorectal MP-MRI. These cancer probability maps can potentially aid radiologists in accurately localizing peripheral zone prostate cancers for planning targeted biopsies, focal therapy, and follow up for active surveillance.
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Affiliation(s)
- Vijay Shah
- National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
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Zhang M, Mathur A, Zhang Y, Xi S, Atay S, Hong JA, Datrice N, Upham T, Kemp CD, Ripley RT, Wiegand G, Avital I, Fetsch P, Mani H, Zlott D, Robey R, Bates SE, Li X, Rao M, Schrump DS. Mithramycin represses basal and cigarette smoke-induced expression of ABCG2 and inhibits stem cell signaling in lung and esophageal cancer cells. Cancer Res 2012; 72:4178-92. [PMID: 22751465 PMCID: PMC6261440 DOI: 10.1158/0008-5472.can-11-3983] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Cigarette smoking at diagnosis or during therapy correlates with poor outcome in patients with lung and esophageal cancers, yet the underlying mechanisms remain unknown. In this study, we observed that exposure of esophageal cancer cells to cigarette smoke condensate (CSC) led to upregulation of the xenobiotic pump ABCG2, which is expressed in cancer stem cells and confers treatment resistance in lung and esophageal carcinomas. Furthermore, CSC increased the side population of lung cancer cells containing cancer stem cells. Upregulation of ABCG2 coincided with increased occupancy of aryl hydrocarbon receptor, Sp1, and Nrf2 within the ABCG2 promoter, and deletion of xenobiotic response elements and/or Sp1 sites markedly attenuated ABCG2 induction. Under conditions potentially achievable in clinical settings, mithramycin diminished basal as well as CSC-mediated increases in AhR, Sp1, and Nrf2 levels within the ABCG2 promoter, markedly downregulated ABCG2, and inhibited proliferation and tumorigenicity of lung and esophageal cancer cells. Microarray analyses revealed that mithramycin targeted multiple stem cell-related pathways in vitro and in vivo. Collectively, our findings provide a potential mechanistic link between smoking status and outcome of patients with lung and esophageal cancers, and support clinical use of mithramycin for repressing ABCG2 and inhibiting stem cell signaling in thoracic malignancies.
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Affiliation(s)
- Mary Zhang
- Thoracic Oncology Section, Surgery Branch, Laboratory of Pathology, Clinical Pharmacy Department, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland 20892, USA
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Mena E, Turkbey B, Mani H, Adler S, Valera VA, Bernardo M, Shah V, Pohida T, McKinney Y, Kwarteng G, Daar D, Lindenberg ML, Eclarinal P, Wade R, Linehan WM, Merino MJ, Pinto PA, Choyke PL, Kurdziel KA. 11C-Acetate PET/CT in localized prostate cancer: a study with MRI and histopathologic correlation. J Nucl Med 2012; 53:538-45. [PMID: 22343504 DOI: 10.2967/jnumed.111.096032] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED This work characterizes the uptake of (11)C-acetate in prostate cancer (PCa), benign prostate hyperplasia, and normal prostate tissue in comparison with multiparametric MRI, whole-mount histopathology, and clinical markers to evaluate the potential utility of (11)C-acetate for delineating intraprostatic tumors in a population of patients with localized PCa. METHODS Thirty-nine men with presumed localized PCa underwent dynamic-static abdominal-pelvic (11)C-acetate PET/CT for 30 min and 3-T multiparametric MRI before prostatectomy. PET/CT images were registered to MR images using pelvic bones for initial rotation-translation, followed by manual adjustments to account for prostate motion and deformation from the MRI endorectal coil. Whole-mount pathology specimens were sectioned using an MRI-based patient-specific mold resulting in improved registration between the MRI, PET, and pathology. (11)C-acetate PET standardized uptake values were compared with multiparametric MRI and pathology. RESULTS (11)C-acetate uptake was rapid but reversible, peaking at 3-5 min after injection and reaching a relative plateau at approximately 10 min. The average maximum standardized uptake value (10-12 min) of tumors was significantly higher than that of normal prostate tissue (4.4 ± 2.05 [range, 1.8-9.2] vs. 2.1 ± 0.94 [range, 0.7-3.4], respectively; P < 0.001); however, it was not significantly different from that of benign prostatic hyperplasia (4.8 ± 2.01 [range, 1.8-8.8]). A sector-based comparison with histopathology, including all tumors greater than 0.5 cm, revealed a sensitivity and specificity of 61.6% and 80.0%, respectively, for (11)C-acetate PET/CT and 82.3% and 95.1%, respectively, for MRI. The (11)C-acetate accuracy was comparable to that of MRI when only tumors greater than 0.9 cm were considered. In a small cohort (n = 9), (11)C-acetate uptake was independent of fatty acid synthase expression using immunohistochemistry. CONCLUSION (11)C-acetate PET/CT demonstrates higher uptake in tumor foci than in normal prostate tissue; however, (11)C-acetate uptake in tumors is similar to that in benign prostate hyperplasia nodules. Although (11)C-acetate PET/CT is not likely to have utility as an independent modality for evaluation of localized PCa, the high uptake in tumors may make it useful for monitoring focal therapy when tissue damage after therapy may limit anatomic imaging methods.
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Affiliation(s)
- Esther Mena
- Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Mani H. Death knell for PSA screening? Natl Med J India 2011; 24:380. [PMID: 22680272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Kemp CD, Rao M, Xi S, Inchauste S, Mani H, Fetsch P, Filie A, Zhang M, Hong JA, Walker RL, Zhu YJ, Ripley RT, Mathur A, Liu F, Yang M, Meltzer PA, Marquez VE, De Rienzo A, Bueno R, Schrump DS. Polycomb repressor complex-2 is a novel target for mesothelioma therapy. Clin Cancer Res 2011; 18:77-90. [PMID: 22028491 DOI: 10.1158/1078-0432.ccr-11-0962] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE Polycomb group (PcG) proteins are critical epigenetic mediators of stem cell pluripotency, which have been implicated in the pathogenesis of human cancers. This study was undertaken to examine the frequency and clinical relevance of PcG protein expression in malignant pleural mesotheliomas (MPM). EXPERIMENTAL DESIGN Microarray, quantitative reverse transcriptase PCR (qRT-PCR), immunoblot, and immunohistochemistry techniques were used to examine PcG protein expression in cultured MPM, mesothelioma specimens, and normal mesothelial cells. Lentiviral short hairpin RNA techniques were used to inhibit EZH2 and EED expression in MPM cells. Proliferation, migration, clonogenicity, and tumorigenicity of MPM cells either exhibiting knockdown of EZH2 or EED, or exposed to 3-deazaneplanocin A (DZNep), and respective controls were assessed by cell count, scratch and soft agar assays, and murine xenograft experiments. Microarray and qRT-PCR techniques were used to examine gene expression profiles mediated by knockdown of EZH2 or EED, or DZNep. RESULTS EZH2 and EED, which encode components of polycomb repressor complex-2 (PRC-2), were overexpressed in MPM lines relative to normal mesothelial cells. EZH2 was overexpressed in approximately 85% of MPMs compared with normal pleura, correlating with diminished patient survival. Overexpression of EZH2 coincided with decreased levels of miR-101 and miR-26a. Knockdown of EZH2 orEED, or DZNep treatment, decreased global H3K27Me3 levels, and significantly inhibited proliferation, migration, clonogenicity, and tumorigenicity of MPM cells. Common as well as differential gene expression profiles were observed following knockdown of PRC-2 members or DZNep treatment. CONCLUSIONS Pharmacologic inhibition of PRC-2 expression/activity is a novel strategy for mesothelioma therapy.
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Affiliation(s)
- Clinton D Kemp
- Thoracic Oncology Section, Surgery Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, Maryland 20892, USA
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Mukhopadhyay S, Farver CF, Vaszar LT, Dempsey OJ, Popper HH, Mani H, Capelozzi VL, Fukuoka J, Kerr KM, Zeren EH, Iyer VK, Tanaka T, Narde I, Nomikos A, Gumurdulu D, Arava S, Zander DS, Tazelaar HD. Causes of pulmonary granulomas: a retrospective study of 500 cases from seven countries. J Clin Pathol 2011; 65:51-7. [PMID: 22011444 DOI: 10.1136/jclinpath-2011-200336] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The frequencies of various causes of pulmonary granulomas in pathological material are unknown, as is the influence of geographical location on aetiology. The aim of this study was to identify the causes of pulmonary granulomas in pathological specimens, to define their frequencies, and to determine whether these causes vary by geographical location. METHODS 500 lung biopsies and resections containing granulomas were reviewed retrospectively by expert pulmonary pathologists from 10 institutions in seven countries. Fifty consecutive cases from each location were assigned a diagnosis based on histological features and available clinical/microbiological data. RESULTS A specific cause was identified in 58% of cases (290/500), most commonly sarcoidosis (136, 27%) and mycobacterial or fungal infections (125, 25%). Mycobacteria were identified in 19% of cases outside the USA versus 8% within the USA. In contrast, fungi accounted for 19% cases in the USA versus 4% in other locations. Fungi were mostly detected by histology, whereas most mycobacteria were identified in cultures. In 42% of cases (210/500) an aetiology could not be determined. CONCLUSIONS Across several geographical settings, sarcoidosis and infections are the most common causes of pulmonary granulomas diagnosed in pathological specimens. Fungi are more commonly identified than mycobacteria in the USA, whereas the reverse is true in other countries. A definite aetiology cannot be demonstrated in more than a third of all cases of pulmonary granulomas, even after histological examination. These findings highlight the need to submit material for histology as well as cultures in all cases in which granulomatous disease enters the differential diagnosis.
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Affiliation(s)
- Sanjay Mukhopadhyay
- Department of Pathology, State University of New York Upstate Medical University, Syracuse, New York 13210, USA.
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Turkbey B, Mani H, Shah V, Rastinehad AR, Bernardo M, Pohida T, Pang Y, Daar D, Benjamin C, McKinney YL, Trivedi H, Chua C, Bratslavsky G, Shih JH, Linehan WM, Merino MJ, Choyke PL, Pinto PA. Multiparametric 3T prostate magnetic resonance imaging to detect cancer: histopathological correlation using prostatectomy specimens processed in customized magnetic resonance imaging based molds. J Urol 2011; 186:1818-24. [PMID: 21944089 DOI: 10.1016/j.juro.2011.07.013] [Citation(s) in RCA: 374] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Indexed: 11/26/2022]
Abstract
PURPOSE We determined the prostate cancer detection rate of multiparametric magnetic resonance imaging at 3T. Precise one-to-one histopathological correlation with magnetic resonance imaging was possible using prostate magnetic resonance imaging based custom printed specimen molds after radical prostatectomy. MATERIALS AND METHODS This institutional review board approved prospective study included 45 patients (mean age 60.2 years, range 49 to 75) with a mean prostate specific antigen of 6.37 ng/ml (range 2.3 to 23.7) who had biopsy proven prostate cancer (mean Gleason score of 6.7, range 6 to 9). Before prostatectomy all patients underwent prostate magnetic resonance imaging using endorectal and surface coils on a 3T scanner, which included triplane T2-weighted magnetic resonance imaging, apparent diffusion coefficient maps of diffusion weighted magnetic resonance imaging, dynamic contrast enhanced magnetic resonance imaging and spectroscopy. The prostate specimen was whole mount sectioned in a customized mold, allowing geometric alignment to magnetic resonance imaging. Tumors were mapped on magnetic resonance imaging and histopathology. Sensitivity, specificity, positive predictive value and negative predictive value of magnetic resonance imaging for cancer detection were calculated. In addition, the effects of tumor size and Gleason score on the sensitivity of multiparametric magnetic resonance imaging were evaluated. RESULTS The positive predictive value of multiparametric magnetic resonance imaging to detect prostate cancer was 98%, 98% and 100% in the overall prostate, peripheral zone and central gland, respectively. The sensitivity of magnetic resonance imaging sequences was higher for tumors larger than 5 mm in diameter as well as for those with higher Gleason scores (greater than 7, p <0.05). CONCLUSIONS Prostate magnetic resonance imaging at 3T allows for the detection of prostate cancer. A multiparametric approach increases the predictive power of magnetic resonance imaging for diagnosis. In this study accurate correlation between multiparametric magnetic resonance imaging and histopathology was obtained by the patient specific, magnetic resonance imaging based mold technique.
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Affiliation(s)
- Baris Turkbey
- Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
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Gupta MK, Misra RN, Chawla N, Mani H, Chowdhry CN, Singh SP, Gupta S. IMMUNOCHROMATOGRAPHIC TEST: A NEW DIMENSION IN DIAGNOSIS OF PLASMODIUM FALCIPARUM MALARIA. Med J Armed Forces India 2011; 57:188-90. [PMID: 27365600 DOI: 10.1016/s0377-1237(01)80039-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
75 patients with clinical features suggestive of malaria were studied to evaluate the efficacy of immunochromatographic test (ICT), which detects histidine rich protein-2 antigen secreted by Plasmodium falciparum (Pfhrp-2), as against direct microscopy. There were 40 cases of P falciparum malaria, 14 cases of P vivax malaria and 21 cases of non-malarial fevers. Direct microscopy could detect 27(67.5%) P falciparum cases but failed to detect 13 cases (32.5%) whereas ICT could detect 35(87.5%) P falciparum cases out of 40 but failed to detect 5(12.5%) cases. All the P vivax cases and non-malarial fever cases were negative for ICT. The sensitivity and specificity of ICT is 87.5% and 100% respectively where as the positive predictive value and the negative predictive value of the test is 100% and 87.5% respectively. It is concluded that ICT test is a good adjunct to blood smear studies in fever cases with neurological and multiorgan dysfunction and in antenatal ladies.
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Affiliation(s)
- M K Gupta
- Senior Advisor (Pathology & Haematology), INHS Asvini, Colaba, Mumbai-400 005
| | - R N Misra
- Classified Specialist (Pathology), INHS Asvini, Colaba, Mumbai-400 005
| | - N Chawla
- Classified Specialist (Pathology), INHS Asvini, Colaba, Mumbai-400 005
| | - H Mani
- Classified Specialist (Pathology), INHS Asvini, Colaba, Mumbai-400 005
| | - C N Chowdhry
- Graded Specialist (Pathology), INHS Asvini, Colaba, Mumbai-400 005
| | - S P Singh
- Post Graduate Student (Pathology), INHS Asvini, Colaba, Mumbai-400 005
| | - S Gupta
- Post Graduate Student (Pathology), INHS Asvini, Colaba, Mumbai-400 005
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