Medical Pathology Commons^™

Diagnostic Accuracy Of Cerebral Amyloid Angiopathy Criteria In The First Pathologically Confirmed Thai Cohort: A Pilot Study, Thanapoom Taweephol, Thachamai Smitasiri, Thanakit Pongpitakmetha, Sekh Thanprasertsuk, Anand Viswanathan

Chulalongkorn Medical Journal

Background: The gold standard for diagnosing cerebral amyloid angiopathy (CAA), full brain post-mortem examination, is rarely performed. Current diagnostic criteria, primarily based on clinico-radiological features, were developed from Western populations and may have limited applicability to Asian populations.

Objective: We aimed to evaluate the accuracy of current diagnostic criteria and examine the clinico-radiological characteristics of Thai CAA patients.

Methods: Brain histopathological specimens from patients with clinical symptoms of CAA who underwent neurosurgical procedures, including intracerebral hemorrhage (ICH) evacuation, between 2011 and 2021 at King Chulalongkorn Memorial Hospital, Thailand, were reviewed. Patient characteristics and clinical events for each individual were retrospectively …

Oropharyngeal Syphilis Presenting As Tongue Based Ulcer With Lymphadenopathy, Serena F. Pu, Kevin J. Carlson, Jonathan R. Mark, Benjamin J. Rubinstein

Department of Otolaryngology (ENT) Faculty Publications

Within the aerodigestive tract, syphilis presents with varied signs and symptoms, some of which may mimic malignancy or other disease processes. We present the case of a 29-year-old man with otalgia and odynophagia who was found on physical examination and office laryngoscopy to have a 4-cm ulcerative mass of the tongue base and cervical lymphadenopathy. While planning for tissue diagnosis, the patient’s serologies revealed positive treponemal antibody testing and elevated rapid plasma reagin (RPR) titers, confirming syphilitic infection, likely representing secondary syphilis. While awaiting operative biopsy, the patient received intramuscular penicillin with complete resolution of the mass and symptoms, and …

Consensus And Controversies Of International Guidelines For The Diagnosis, Surveillance, And Management Of Fetal Growth Restriction: An Updated Comparison, Daniele Diane Mascio, Suneet P. Chauhan, Tullio Ghi, Asma Khalil, Juliana G. Martins, Sara Sorrenti, Tamara Stampalija, Fabrizio Zullo, Francesc Figueras

Department of Obstetrics & Gynecology Faculty Publications

OBJECTIVE: To compare areas of consensus and disagreements across contemporary international and national guidelines on the diagnosis, surveillance, and management of fetal growth restriction (FGR).

DATA SOURCES: Electronic searches of MEDLINE from database inception up to March 2026 using MeSH terms and keywords related to FGR and guidelines. STUDY ELIGIBILITY CRITERIA: Critical, structured comparison of national or international guidelines on FGR published since 2010. Final inclusion required unanimous agreement from all authors.

STUDY APPRAISAL AND SYNTHESIS METHODS: Pre-specified extraction across domains: definition; prediction/prevention; surveillance tools and frequency; delivery timing and mode; and labor induction methods. Dual data …

Assessment Of Skin In Patients With Systematic Sclerosis Using High-Frequency Ultrasound And Shear Wave Elastography: A Comparative Study With Histology, Molecular, And Clinical Parameters, Ruhani Desai, Filemon Tan, Minghua Wu, Jeffery L. Browning, Samuel Theodore, Meng Zhang, Brian Skaug, Harshdeep Singh Chawla, Manmohan Singh, Salavat Aglyamov, Kirill V. Larin, Maureen Mayes, Shervin Assassi

Department of Medicine Faculty Publications

Objective: Ultrasound (US) has been proposed as a potential tool for assessing skin fibrosis in systemic sclerosis (SSc). However, a large-scale comparison of US-based assessment with histologic markers of skin fibrosis has not been reported. We evaluated US-based skin assessments for their face validity (differentiation between involved SSc and healthy control [HC] skin), construct validity (comparison to modified Rodnan skin score [mRSS]), and criterion validity (comparison to histologic and gene expression fibrosis markers).

Methods: Twenty HCs and 52 patients with SSc underwent clinical and US assessment followed by a forearm skin biopsy. Predefined areas were assessed on the finger, hand, …

Cold-Sensitive Acral Hand Lesions, Avery H. Seward, Jocelyn H. Larocque

Department of Medicine Faculty Publications

[Case description] An otherwise healthy woman in her 60s presented with a 2-year history of a persistent, itchy, and tender rash on the dorsal hands. The rash fluctuated in severity with the seasons, worsening during the colder months. The patient denied joint pain and fatigue, or lesions elsewhere.

Examination revealed partially blanchable violaceous plaques on the dorsal hands with partial sparing of the proximal and distal interphalangeal joints (Fig 1). A few punctate, crusted erosions and purpuric macules were present on the dorsal and volar distal phalanges (Figs 2 and 3).

Comparison Of Fully Covered Self-Expandable Metal Biliary Stents With Or Without Anchoring Double-Pigtail Plastic Stents: A Systematic Review And Meta-Analysis, Samuel Tanner, Fadi Hawa, Alejandra Vargas, Priyata Dutta, Antonio Facciorusso, Jean M. Chalhoub, Jorge D. Machicado

Department of Medicine Faculty Publications

Background and AIMS

Fully covered self-expandable metal stents (FcSEMSs) have become the mainstay of treatment for a variety of biliary pathologies. However, FcSEMSs have been associated with a greater rate of stent migration than other types of stents. A technique of anchoring double-pigtail plastic stents (DPPSs) has been proposed to minimize migration of biliary FcSEMSs. Herein, we evaluated the efficacy of anchoring DPPSs among patients treated with biliary FcSEMSs.

Methods

We performed a systematic review using PubMed, EMBASE, and Web of Science from database inception through August 2023. Full-text articles comparing FcSEMSs with or without anchoring DPPSs were included. We …

Educational Case: Atypical Presentation Of Primary Hyperparathyroidism With Brown Tumor, Ariel Flotte, Jonathan Light, Harrison Klause, Richard M. Conran

Department of Biomedical and Translational Sciences Faculty Publications

The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology.

Corticobasal Syndrome With Mixed Pathology In The Absence Of Grn Mutation: A Clinico-Pathological Case Of Ftld-Tdp With Coexisting Alzheimer’S And Lewy Body Pathology, Hugo Zamarron, David Irwin, Jeffery Phillips, Edward Lee, Matthew Tisdall, Corey Mcmillan

Research Colloquium

Background: Corticobasal syndrome (CBS) is a neurodegenerative disorder characterized by often asymmetric fronto-pariteal and extra-pyramidal features that is traditionally associated with tauopathy, but pathological findings are heterogenous, including other forms of frontotemporal lobar degeneration (FTLD) and mixed pathologies of aging. We present clinical, radiographic, and histopathologic features of asymmetry in a unique patient with CBS and underlying FTLD with TDP-43 pathology (FTLD-TDP), co-occurring with other age-related pathologies.

Case Presentation: A 76-year-old man presented with progressive cognitive and motor dysfunction including asymmetric parkinsonism, left-sided dystonia and rigidity, apraxia, visuospatial impairment, and a subtle social disorder including apathy and social withdrawal. The …

Topical Lifitegrast Therapy For Dry Eye Disease, Lama Assi, Salim C. Lutfallah, Tsz Wing Yim, Su Hsun Liu, Sharon J. Duffy, Jayne Weiss

School of Medicine Faculty Publications

Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To assess the effectiveness and safety of topical lifitegrast therapy alone or in combination with artificial tears, compared with a placebo, artificial tears alone, or no treatment for dry eye disease.

Discrepancy Between Hyaluronic Acid Levels And Mri-Based Measurements Of Hepatic Fat And Fibrosis, Daniel Aaron Borman, Rachel L. Chevalier, Jonathan Body Ingestion Clinical Wagner, Michele T. Pritchard, Sherwin S. Chan, Nathan S. Artz, Johnston K. Fite, Yoon Y. Cho, Valentina Shakhnovich, Veronica Williams, Voytek Slowik

Research Days

Introduction

Metabolic-dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease in children in the United States and, when left untreated, can progress to liver fibrosis. Clinicians currently utilize imaging and biopsy to assess fibrosis in this patient population as there is no validated serum biomarker available for detecting fibrosis. Previous research suggests that serum hyaluronic acid levels are predictive of hepatic fibrosis in children with MASLD.

Methods

Retrospective data were obtained from the Children’s Mercy Hospital Liver Lab study. Pediatric subjects with both hyaluronic acid (HA) samples and MRI evaluation within a month were identified and included for …

Pseudomonas Aeruginosa Exoenzyme Y Enzymatic Activity Inhibits Exoenzyme S-Induced Caspase Activation But Not Cytotoxicity In Pulmonary Microvascular Endothelial Cells, Connor Holm

Honors Theses

Pseudomonas aeruginosa (P. aeruginosa) is the most common cause of ventilator-associated pneumonia in intensive care unit patients. P. aeruginosa utilizes a type III secretion system that injects exoenzymes U, S, T, and/or Y into the host cell cytosol. A majority of clinically isolated P. aeruginosa strains express ExoY often in combination with ExoU and ExoT, or ExoS and ExoT. Host signaling mechanisms in response to intoxication with individual exoenzymes have been extensively studied, yet little is known about host cell response to co-intoxication. In this study, pulmonary microvascular endothelial cells (PMVECs) were infected with P. aeruginosa strains expressing different combinations …

Surgical Specimen Management Protocols In The Pre-Analytical Phase, Jordan L. Hall

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement (QI) project aimed to decrease surgical specimen errors during the pre-analytical phase at the target institution by 50% by January 2025 by developing best practices for specimen labeling and documentation.

Background

The QI project was implemented within a level two trauma center with a 24-suite operating room (OR) in The Woodlands, Texas, which provides care across all surgical specialties except ophthalmology.

Methodology

The target institution changed from nurse-hand-written specimen labels and requisition sheets to electronic medical record (EMR) generated specimen labels and requisition sheets. The change was congruent with the target institution’s shift to a new …

Zonal Hepatocellular Responses To Acute Ethanol: Impacts On Mitochondrial Function And Metabolism, Matthew T. Savoca

MUSC Theses and Dissertations

Background: Ethanol (EtOH) consumption causes hepatocellular mitochondrial depolarization (mtDepo) and mitophagy. Here, the Aims were to develop techniques to characterize sublobular hepatocellular metabolism and the distribution of mtDepo and mitophagy after acute EtOH. Methods: Wildtype and GFP-LC3 transgenic mice were treated with EtOH or vehicle and administered the covalently labeling mitochondrial membrane potential (ΔΨ) reporter, MitoTracker Red (MTR), and/or the non-covalent ΔΨ reporter, rhodamine 123 (Rh123), prior to intravital imaging, liver fixation, or hepatocyte isolation. After in vivo MTR, hepatocytes were isolated and sorted. Enrichment in E-cadherin (ECAD) and cytochrome P4502E1 in periportal (PP) and pericentral (PC) hepatocytes, respectively, validated …

An Analytical Model Of Motion Artifacts In A Measured Arterial Pulse Signal—Part I: Accelerometers And Ppg Sensors, Md Mahfuzur Rahman, Subodh Toraskar, Mamun Hasan, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

This paper, the first of two parts, presents an analytical model of motion artifacts (MAs) in measured pulse signals by accelerometers and photoplethysmography (PPG) sensors. As the transmission path from the true pulse signal in an artery to the sensor output (measured pulse signal), the tissue-contact-sensor (TCS) stack is modeled as a 1DOF (degree-of-freedom) system. MAs cause baseline drift of the mass and simultaneously time-varying system parameters (TVSPs) of the TCS stack. With arterial wall displacement and pulsatile pressure serving separately as the true pulse signal, an analytical model is developed to mathematically relate baseline drift and TVSP to a …

Physician Modified Stent Grafts Created Using 3-Dimensional Printing In The Management Of Aortic Disease: A Systematic Review, Gregory Alfieri, Jack Stensland, Sydney Elness, Khavir Sharieff Do,Mba

HCA-NSU MD Research Day

Objective: This study evaluates the effectiveness and applicability of PMSGs created from 3D-printed models in managing aortic disease. Background: Endovascular treatment of aortic disease can be challenging, especially with complex anatomy. Three-dimensional (3D) printed models, derived from computed tomography (CT) and magnetic resonance imaging (MRI) scans, have been used to create physician-modified stent grafts (PMSGs) for vascular procedures involving the aorta. Methods: A systematic search was conducted in July 2024 across Embase, Ovid Medline, and Web of Science using PRISMA guidelines. Keywords included “aorta”, “3-dimensional printing”, and “implant”. Only studies reporting use of 3D printing-assisted PMSGs in aortic disease repair, …

Li-Fraumeni Syndrome And The Benefits Of Annual Comprehensive Screening: A Pancreatic Adenocarcinoma Case, Alice He Bs, Wern Lynn Ng Md, Faith Seltun Do, Lay She Ng Md, Si Yuan Khor Md, Elham Nasrollahi Md, Chandi Garg Md, Rong Rong Ge Md

Tower Health Research Day

No abstract provided.

Cd133-Dependent Activation Of Phosphoinositide 3-Kinase /Akt/Mammalian Target Of Rapamycin Signaling In Melanoma Progression And Drug Resistance, Naji Kharouf, Thomas W. Flanagan, Abdulhadi A. Alamodi, Youssef Al Hmada, Sofie Yasmin Hassan, Hosam Shalaby, Simeon Santourlidis, Sarah Lilly Hassan, Youssef Haikel, Mossad Megahed, Robert T. Brodell, Mohamed Hassan

School of Medicine Faculty Publications

Melanoma frequently harbors genetic alterations in key molecules leading to the aberrant activation of PI3K and its downstream pathways. Although the role of PI3K/AKT/mTOR in melanoma progression and drug resistance is well documented, targeting the PI3K/AKT/mTOR pathway showed less efficiency in clinical trials than might have been expected, since the suppression of the PI3K/mTOR signaling pathway-induced feedback loops is mostly associated with the activation of compensatory pathways such as MAPK/MEK/ERK. Consequently, the development of intrinsic and acquired resistance can occur. As a solid tumor, melanoma is notorious for its heterogeneity. This can be expressed in the form of genetically divergent …

Mechanisms Of Melanoma Progression And Treatment Resistance: Role Of Cancer Stem-Like Cells, Youssef Al Hmada, Robert T. Brodell, Naji Kharouf, Thomas W. Flanagan, Abdulhadi A. Alamodi, Sofie Yasmin Hassan, Hosam Shalaby, Sarah Lilly Hassan, Youssef Haikel, Mosaad Megahed, Simeon Santourlidis, Mohamed Hassan

School of Medicine Faculty Publications

Melanoma is the third most common type of skin cancer, characterized by its heterogeneity and propensity to metastasize to distant organs. Melanoma is a heterogeneous tumor, composed of genetically divergent subpopulations, including a small fraction of melanoma-initiating cancer stem-like cells (CSCs) and many non-cancer stem cells (non-CSCs). CSCs are characterized by their unique surface proteins associated with aberrant signaling pathways with a causal or consequential relationship with tumor progression, drug resistance, and recurrence. Melanomas also harbor significant alterations in functional genes (BRAF, CDKN2A, NRAS, TP53, and NF1). Of these, the most common are the BRAF and NRAS oncogenes, with 50% …

Efficient Classification Of Very High Resolution Images, Mohammad I. Nouyed

Graduate Theses, Dissertations, and Problem Reports (ETD)

In recent decades, deep learning approaches have shown significant improvement in various image understanding tasks. However, analysis of high-resolution images remains a major challenge. In this work, we address the challenge of very high-resolution histopathological image (VHRHI) classification using a new information-theoretic discriminative patch selection approach. We show results on a high-resolution image dataset, namely, gigapixel whole slide tissue images for cancer tumors. Then we address how to efficiently classify challenging histopathology images, such as gigapixel whole-slide images for cancer diagnostics with image-level annotation. These ``weak labels'' are applied throughout the image but describe tumor regions of variable sizes and …

Socioeconomic Status And Health Disparities Drive Differences In Accelerometer-Derived Physical Activity In Fatty Liver Disease And Significant Fibrosis, Lucia Tabacu, Sajag Swami, Mark Ledbetter, Mohamad S. Siddiqui, Ekaterina Smirnova

Mathematics & Statistics Faculty Publications

Background and aims

The cornerstone of clinical management of patients with nonalcoholic fatty liver disease (NAFLD) are lifestyle changes such as increasing physical activity (PA) aimed at improving cardiometabolic risk. To inform NAFLD prevention and treatment guidelines we aimed to: (i) quantify the role of PA on lowering the risk for NAFLD and fibrosis; (ii) characterize NAFLD and fibrosis association with PA in the context of socioeconomic environment.

Methods

A sample of 2648 participants from the NHANES 2003–2006 was selected to develop survey weighted multivariable logistic regression models for predicting NAFLD and significant fibrosis, diagnosed non-invasively via fatty liver index …

The Role Of Molecular Thyroseq V3 Testing For Diagnosis And Management Of Indeterminate Thyroid Nodules., Ruth Delahunty

International Undergraduate Journal of Health Sciences

Worldwide, thyroid cancer is the 8^th most common malignancy (3^rd most common in women) and in recent years, there has been increased incidence of thyroid cancer worldwide. There is currently said to be a of thyroid nodules as of 2022. When it comes to the management of indeterminate thyroid nodules, clinical decision making can be challenging.

Thyroseq V3 testing may be used to determine the percentage probability of a thyroid nodule of being either malignant or benign, through a complex algorithm with next generation sequencing techniques, currently testing is done in the University of Pittsburgh and therefore is …

Cervical Steroid Injections Are Not Effective For Prevention Of Surgical Treatment Of Degenerative Cervical Myelopathy., Mustfa K. Manzur, Andre M Samuel, Avani Vaishnav, Catherine Himo Gang, Evan D Sheha, Sheeraz A Qureshi

Student Papers, Posters & Projects

STUDY DESIGN: Retrospective cohort study.

OBJECTIVE: The objective of this study is to determine how often patients with degenerative cervical myelopathy (DCM) and initially treated with cervical steroid injections (CSI) and to determine whether these injections provide any benefit in delaying ultimate surgical treatment.

METHODS: All patients with a new diagnosis of DCM, without previous cervical spine surgery or steroid injections, were identified in PearlDiver, a large insurance database. Steroid injection and surgery timing was identified using Current Procedural Terminology (CPT) codes. Multivariate logistic regression identified associations with surgical treatment.

RESULTS: A total of 686 patients with DCM were identified. …

Head And Neck Tumor Histopathological Image Representation With Pre- Trained Convolutional Neural Network And Vision Transformer, Ranny Rahaningrum Herdiantoputri, Daisuke Komura, Tohru Ikeda, Shumpei Ishikawa

Journal of Dentistry Indonesia

Image representation via machine learning is an approach to quantitatively represent histopathological images of head and neck tumors for future applications of artificial intelligence-assisted pathological diagnosis systems. Objective: This study compares image representations produced by a pre-trained convolutional neural network (VGG16) to those produced by a vision transformer (ViT-L/14) in terms of the classification performance of head and neck tumors. Methods: W hole-slide images of five oral t umor categories (n = 319 cases) were analyzed. Image patches were created from manually annotated regions at 4096, 2048, and 1024 pixels and rescaled to 256 pixels. Image representations were …

Classification Of Breast Cancer Histopathological Images Using Semi-Supervised Gans, Balaji Avvaru, Nibhrat Lohia, Sowmya Mani, Vijayasrikanth Kaniti

SMU Data Science Review

Breast cancer is diagnosed more frequently than skin cancer in women in the United States. Most breast cancer cases are diagnosed in women, while children and men are less likely to develop the disease. Various tissues in the breast grow uncontrollably, resulting in breast cancer. Different treatments analyze microscopic histopathology images for diagnosis that help accurately detect cancer cells. Deep learning is one of the evolving techniques to classify images where accuracy depends on the volume and quality of labeled images. This study used various pre-trained models to train the histopathological images and analyze these models to create a new …

Healthy Exosomes And Their Effects On Diabetic Cardiomyocytes, Miguel A. Garza, Genaro A. Ramírez-Correa, Maria Lourdes Garza-Rodríguez, Andres J. Medina

MEDI 9331 Scholarly Activities Clinical Years

Extracellular Vesicles, and more specifically, exosomes, are essential for effective cell-to-cell communication in a wide variety of tissues. In the last couple of decades, these nanovesicles have been proven to be active participants and regulators in many disease processes; therefore, their therapeutic effects have been widely studied and proven in various cardiovascular diseases both, in vitro and in vivo. Thus, this study aims at assessing the effects of running healthy mice exosomes on cardiomyocyte and cardiac tissue samples obtained from diabetic mice. Here, we successfully extract exosomes from mice plasma and detect their presence through the use of anti-CD9 and …

Imaging Based Prediction Of Pathology In Adult Diffuse Glioma With Applications To Therapy And Prognosis, Evan Gates

Dissertations and Theses (Open Access)

The overall aggressiveness of a glioma is measured by histologic and molecular analysis of tissue samples. However, the well-known spatial heterogeneity in gliomas limits the ability for clinicians to use that information to make spatially specific treatment decisions. Magnetic resonance imaging (MRI) visualizes and assesses the tumor. But, the exact degree to which MRI correlates with the actual underlying tissue characteristics is not known.

In this work, we derive quantitative relationships between imaging and underlying pathology. These relations increase the value of MRI by allowing it to be a better surrogate for underlying pathology and they allow evaluation of the …

Tick-Borne Infections In New Hampshire: An Evaluation Of The Diagnostic Process In A Local Patient Population, Katherine Anderson

Honors Theses and Capstones

Overall, approximately 95 percent of reported cases of vector-borne disease were associated with ticks, making these the most medically important group of arthropods in the United States.¹ Despite the prevalence of tick-borne infections, the process for the diagnosis of this condition is not well studied. This study aims to analyze data from a pool of 100 patients who underwent testing for tick-borne disease in the same institution in Dover, New Hampshire during the most recent peak tick season of 2019. Information utilized in this study included: patient age, sex, location of testing (inpatient versus outpatient), diagnostic testing methods used …

Oral Contraceptives As Possible Acl Injury Prevention Method, Haley Schweizer

Capstone Showcase

ABSTRACT

Introduction: Anterior Cruciate Ligament (ACL) injuries are an upsetting setback for many athletes that require a long and costly recovery process. The injury rates are four times greater in women than men. Preventative measures that help to prevent ACL injuries are limited to stretching and strengthening. Therefore, this review aims to investigate if oral contraceptive [I] usage provides a possible new avenue for prevention of ACL injury [O] in young female athletes (ages 18-30) [P] compared to those that do not take oral contraceptives [C].

Methods: A literature review was performed though PubMed, Google Scholar, SCOPUS Database, and ClinicalKey …

Community-Acquired Pneumonia In Adults: Diagnostic Reliability Of Physical Examination Techniques And Their Teaching In Academia, Amber Tordoff, Lauren A. Williams

Physician Assistant Capstones, 2016 to 2019

Background: Chest physical examination techniques are taught in academia, but their usefulness in the evaluation and diagnosis of patients in the clinical setting is controversial. Objective: To investigate the accuracy of physical examination techniques and their reliability in diagnosing community acquired pneumonia (CAP) and suggest a modified teaching approach to be used in academia. Design: Systematic Literature Review. Methods: Database search of PubMed and Google Scholar using the search terms “prediction of pneumonia in adults” and “prediction rule for pulmonary infiltrates.” Filters were implemented to include articles that only dealt with human subjects and were full text. Articles …

Coping With Chronic Fungal Rhinosinusitis: Diagnosis To Therapy, Veronica Corcino, Leslie Beavin, Shengli Lu, Ashley Ross, Carmen V. Sciortino Jr.

The University of Louisville Journal of Respiratory Infections

No abstract provided.