Medical Specialties Commons^™

The First Histological Analysis Of The Tissues Lining The Fossa Navicularis: Insights To Its Etiology., Sarvenaz Sheikh, Joe Iwanaga, Steven Rostad, Tarush Rustagi, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

The fossa navicularis (FN) is an anatomical variant on the ventral surface of the basilar part of the occipital bone that, to date, has only been investigated in bone specimens. We aim to clarify the structure of the fossa navicularis by gross anatomical, radiological, and histological methods. The FN was found in the occipital bone of the Caucasian male cadaver. There was no bony or histological continuity between the FN and posterior cranial fossa. The histological analysis found that the overlying tissue was composed of loose connective tissue with a mixture of collagen and elastic fibers and a vascular matrix …

Internal Hernia Of The Greater Omentum: Cadaveric Findings Of A Previously Unreported Variant., Andrea Andrea, Vy Tran, Cameron K Schmidt, Christian Fisahn, Joe Iwanaga, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

Transomental hernias (TOHs) are a rare finding, constituting a fraction of all intestinal hernias. Here, we report the cadaveric discovery of a spontaneous TOH involving the sigmoid colon in an 82-year-old female and discuss the relevant literature. To our knowledge, a TOH involving the sigmoid colon has not been previously reported.

Johann Gaspar Spurzheim: A Life Dedicated To Phrenology., Mohammad Bilal, Bryan Edwards, Marios Loukas, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

Loved for his empathetic nature but admired for his analytical mind, Gaspar Spurzheim (1776-1832) was a prominent contributor to phrenology, a field of neuroscience focused on studying the shapes of the skulls in relation to the activity levels of certain functional areas of the brain. This curiosity about the connection between physical characteristics and brain function was seeded in the young mind of Spurzheim when he observed that classmates with seemingly superb memories also appeared to have bright eyes. It launched Spurzheim on a journey to study the shape and function of the brain, which eventually led him to his …

Prevalence Of Double Myc/Bcl2 Expression And The Cell Of Origin In Diffuse Large B-Cell Lymphomas Diagnosed At A Tertiary Level Referral Laboratory, Jonathan Wawire

Master of Medicine in Anatomic Pathology

Introduction: Diffuse large B-cell lymphoma (DLBCL) is the most commonly diagnosed non-Hodgkin’s lymphoma in adults worldwide. In Kenya DLBCL accounts for 64% of all non-Hodgkin’s lymphomas diagnosed in adults. It is a heterogeneous disease and patients show varying outcomes despite standard treatment. This variability is attributed to the differences in the biology and molecular pathogenesis of DLBCL. The five most important prognostic factors for DLBCL include scores for the revised international prognostic index (R-IPI), the cell of origin (COO), presence of myelocytomatosis (MYC) and B-cell lymphoma 2 (BCL2) gene rearrangements by fluorescent in situ hybridisation (FISH) or standard cytogenetics, the …

Diagnostic Accuracy Of Hba1c Test In Diagnosis Of Diabetes And Prediabetes In A Multiethnic Population At Aga Khan University Hospital, Nairobi., Francis Kiigu Wathigo

Master of Medicine in Clinical Pathology

Introduction: Diabetes mellitus is a metabolic disease characterized by hyperglycaemia secondary to impaired insulin secretion, impaired insulin action or both. In Kenya, an estimated 750,000 people are diabetic with more than 50% estimated to be unaware of their status. Conventionally, diagnosis has been based on plasma glucose levels. In 2010, Haemoglobin A1c (HbA1c) was approved by the American Diabetes Association (ADA) and World Health Organisation (WHO) for diagnosis of diabetes. However, different studies have shown variations in diagnostic performance of HbA1c. Research question: What is the diagnostic sensitivity and specificity of HbA1c in diagnosis of diabetes and prediabetes at Aga …

Comparison Of The Sensitivity Of Biomarker Based Matrix Assisted Laser Desorption Ionization-Time Of Flight Mass Spectrometry (Maldi-Tof Ms) And Conventional Methods In The Identification Of Clinically Relevant Bacteria And Yeast, Ali Abdow Kassim

Master of Medicine in Clinical Pathology

Background: MALDI-TOF MS is an analytical method that has recently become integral in the identification of microorganisms in clinical laboratories. It relies on databases that majorly employ pattern recognition or fingerprinting. Biomarker based databases have also been developed and there is optimism that these may be superior to pattern recognition based databases. This study compared the performance of ribosomal biomarker based MALDI-TOF MS and conventional methods in the identification of selected bacteria and yeast. Methodology: The study was a cross sectional study carried out in collaboration with the Swiss Tropical and Public Health Institute, Switzerland and Mabritec laboratory, Riehen, Switzerland. …

Comparison Of Biomarker Based Matrix Assisted Laser Desorption Ionization-Time Of Flight Mass Spectrometry (Maldi-Tof Ms) And Conventional Methods In The Identification Of Clinically Relevant Bacteria And Yeast, Ali Kassim, Valentin Pflüger, Zul Premji, Claudia Daubenberger, Gunturu Revathi

Pathology, East Africa

Background: MALDI-TOF MS is an analytical method that has recently become integral in the identification of microorganisms in clinical laboratories. It relies on databases that majorly employ pattern recognition or fingerprinting. Biomarker based databases have also been developed and there is optimism that these may be superior to pattern recognition based databases. This study compared the performance of ribosomal biomarker based MALDI-TOF MS and conventional methods in the identification of selected bacteria and yeast.

Methods: The study was a cross sectional study identifying clinically relevant bacteria and yeast isolated from varied clinical specimens submitted to a clinical laboratory. The identification …

Hybrid Peripheral Nerve Sheath Tumors: Report Of Five Cases And Detailed Review Of Literature, Nasir Ud Din, Zubair Ahmad, Jamshid Abdul Ghafar, Rashida Ahmed

Department of Pathology and Laboratory Medicine

BACKGROUND: Hybrid peripheral nerve sheath tumors (PNSTs) have been recognized recently and were first included in the 4th edition of World Health Organization (WHO) Classification of Tumors of Soft tissue and Bone, published in 2013. These tumors show combined features of more than one type of conventional benign peripheral nerve sheath tumors. The most common combinations are those of schwannoma/perineurioma followed by combinations of neurofibroma/schwannoma and neurofibroma/perineurioma. A detailed literature review of published cases is presented. We have discussed the types and etiology, epidemiology and sites of localization, gross and microscopic appearances and immunohistochemical features of hybrid PNSTs and association …

The Nephrotoxicity Of Vancomycin., Edward J. Filippone, Walter K. Kraft, John L. Farber

Department of Medicine Faculty Papers

No abstract provided.

Chat Expression In Chlamydia Muridarum-Infected Female Murine Genital Tract, Hallie Sartain

Undergraduate Honors Theses

Chlamydia trachomatis is the most prevalent agent of bacterial sexually transmitted infections in the world. However, a profuse number of cases are unreported, as the infection is often asymptomatic. Sequelae such as pelvic inflammatory disease, an increased risk of cervical cancer, premature birth, and perinatal infections in pregnant women can occur. Inflammation occurs in the body in response to infection or injury. Although inflammation can lead to some unwanted secondary effects, such as pain, it serves to return the body to homeostasis by restoring injured tissues and eliminating pathogens. One recently identified connection between the central nervous system and the …

Eliminating Wrong Blood Transfusions - Recent Advances, Farheen Karim, Salman Naseem Adil

Department of Pathology and Laboratory Medicine

No abstract provided.

Antibiotic Prophylaxis Is Associated With Subsequent Resistant Infections In Children With An Initial Extended-Spectrum-Cephalosporin-Resistant Enterobacteriaceae Infection., Sibani Das, Amanda L. Adler, Arianna Miles-Jay, Matthew P. Kronman, Xuan Qin, Scott J. Weissman, C A. Burnham, Alexis Elward, Jason G. Newland, Rangaraj Selvarangan, Kaede V. Sullivan, Theoklis Zaoutis, Danielle M. Zerr

Manuscripts, Articles, Book Chapters and Other Papers

The objective of this study was to assess the association between previous antibiotic use, particularly long-term prophylaxis, and the occurrence of subsequent resistant infections in children with index infections due to extended-spectrum-cephalosporin-resistant Enterobacteriaceae We also investigated the concordance of the index and subsequent isolates. Extended-spectrum-cephalosporin-resistant Escherichia coli and Klebsiella spp. isolated from normally sterile sites of patients aged species, resistance determinants, and fumC-fimH (E. coli) or tonB (Klebsiella pneumoniae) type were identical to those of the index isolate. In total, 323 patients had 396 resistant isolates; 45 (14%) patients had ≥1 subsequent resistant infection, totaling 73 …

Knowledge And Awareness Regarding Cervical Cancer And Uptake Of Pap Smear Among Women In Karachi, Pakistan, Shama Razzaq, Sayeeda Amber Sayed Amber Sayeeda Amber Sayed, Sumera Aziz Ali

Community Health Sciences

Objective: To determine the knowledge regarding cervical cancer, its symptoms and risk factors among women of 18 years and above attending the gynecology OPD in two public hospitals Karachi, Pakistan.
Methodology: A cross-sectional survey was held from February to June 2013 in Karachi, Pakistan. 384 females aged 18 years and above attending gynecology clinics in two public sector hospitals were taken through non-probability sampling method. The knowledge was assessed using a point scale method which had binary response i.e. correct and incorrect. A score of 50% (≥ 11 correct responses) was considered as optimum knowledge.
Results: Overall knowledge of cervical …

Multiple Large Perineural (Tarlov) Cysts In The Sacrum Of A Cadaver: A Case Report And Review., Jocelyn Gonzales, Joe Iwanaga, Nitsa Topale, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

Tarlov or perineural cysts are cerebrospinal fluid (CSF)-filled sacs found between the perineurium and epineurium of the nerve roots. It is still unsure whether the origin of these cysts is intradural or extradural. They can either be asymptomatic or create a variety of negative impacts on comfort and quality of life. In this case report, we describe the presentation of multiple Tarlov cysts including one large cyst discovered during a routine cadaveric spinal dissection and the relevant and related literature. To our knowledge, this is the only cadaveric case report of Tarlov cysts and offers an interesting window into their …

Exploring Therapeutic Approaches For Marfan Syndrome Associated Aortic Aneurysm, Mitra Esfandiarei

Science Seminar Series

Esfandiearei will be discussing her research on understanding the underlying mechanisms contributing to the progression of aortic aneurysm in Marfan syndrome and the protective effects that exercise may have on the disease process in both laboratory animal models and human patients. Her research has been supported by the Canadian Institutes of Health Research (CIHR), Rare Diseases Foundation, and the Marfan Foundation.

Mct1 In Invasive Ductal Carcinoma: Monocarboxylate Metabolism And Aggressive Breast Cancer., Jennifer M. Johnson, Paolo Cotzia, Roberto Fratamico, Lekha Mikkilineni, Jason Chen, Daniele Colombo, Mehri Mollaee, Diana Whitaker-Menezes, Marina Domingo-Vidal, Zhao Lin, Tingting Zhan, Madalina Tuluc, Juan P. Palazzo, Ruth C. Birbe, Ubaldo E. Martinez-Outshoorn

Department of Medical Oncology Faculty Papers

Introduction: Monocarboxylate transporter 1 (MCT1) is an importer of monocarboxylates such as lactate and pyruvate and a marker of mitochondrial metabolism. MCT1 is highly expressed in a subgroup of cancer cells to allow for catabolite uptake from the tumor microenvironment to support mitochondrial metabolism. We studied the protein expression of MCT1 in a broad group of breast invasive ductal carcinoma specimens to determine its association with breast cancer subtypes and outcomes. Methods: MCT1 expression was evaluated by immunohistochemistry on tissue micro-arrays (TMA) obtained through our tumor bank. Two hundred and fifty-seven cases were analyzed: 180 cases were estrogen receptor and/or …

Performance Of Non-Invasive Tests To Predict Significant Liver Fibrosis In Patients With Morbid Obesity, Ahmed Bakhshwin, Patricia Latham

GW Research Days 2016 - 2020

Non-Alcoholic Fatty Liver Disease (NAFLD) affects more than 90% of patients with morbid obesity (MO) and approximately 30% have significant liver fibrosis and/or cirrhosis. Liver biopsy is the gold standard for diagnosis of significant liver fibrosis and cirrhosis; however, several non-invasive tests have been suggested to predict the presence or absence of significant liver fibrosis and to avoid liver biopsy in these patients. The aim of this study was to determine the ability of these tests to predict significant liver fibrosis, specifically in patients with MO.

Methods:

Liver biopsies from patients with MO undergoing gastric bypass surgery were studied in …

Perception Of Pathology As A Future Career Choice Among Medical Students From Karachi, Pakistan: Experience From A Private Medical School, Najia Bano Ghanchi, Raabia Nizamuddin Nizamuddin, Amna Qasim, Zahra Nur Khaled, Ahmed Buksh Raheem, Natasha Bahadur Ali, Naila Kayani, Mohammad Asim Beg

Medical College Documents

To determine the perception of pathology as a future career choice among medical students of a private medical school from Karachi, Pakistan. A descriptive cross-sectional study was conducted at the Aga Khan University, Karachi, Pakistan. A total of 201 students participated in this study. All Students were approached randomly to participate. A total of 201 students participant survey forms were evaluated in this study. The overall satisfaction level with pathology was observed in 61.8% ofthe students. Majority of the students understood subspecialties which were a part of clinical medicine. Over half of the students thought pathology as a specialty should …

Outcomes After Diagnosis Of Mild Cognitive Impairment In A Large Autopsy Series, Erin L. Abner, Richard J. Kryscio, Frederick A. Schmitt, David W. Fardo, Daniela C. Moga, Eseosa T. Ighodaro, Gregory A. Jicha, Lei Yu, Hiroko H. Dodge, Chengjie Xiong, Randall L. Woltjer, Julie A. Schneider, Nigel J. Cairns, David A. Bennett, Peter T. Nelson

Epidemiology and Environmental Health Faculty Publications

OBJECTIVE: To determine clinical and neuropathological outcomes following a clinical diagnosis of mild cognitive impairment (MCI).

METHODS: Data were drawn from a large autopsy series (N = 1,337) of individuals followed longitudinally from normal or MCI status to death, derived from 4 Alzheimer Disease (AD) Centers in the United States.

RESULTS: Mean follow‐up was 7.9 years. Of the 874 individuals ever diagnosed with MCI, final clinical diagnoses were varied: 39.2% died with an MCI diagnosis, 46.8% with a dementia diagnosis, and 13.9% with a diagnosis of intact cognition. The latter group had pathological features resembling those with a final clinical …

Gene Expression Profiles Among Murine Strains Segregate With Distinct Differences In The Progression Of Radiation-Induced Lung Disease., Isabel L. Jackson, Fitsum Baye, Chirayu Pankaj Goswami, Barry P. Katz, Andrew Zodda, Radmila Pavlovic, Ganga Gurung, Don Winans, Zeljko Vujaskovic

Jefferson Hospital Staff Papers and Presentations

Molecular mechanisms underlying development of acute pneumonitis and/or late fibrosis following thoracic irradiation remain poorly understood. Here, we hypothesize that heterogeneity in disease progression and phenotypic expression of radiation-induced lung disease (RILD) across murine strains presents an opportunity to better elucidate mechanisms driving tissue response toward pneumonitis and/or fibrosis. Distinct differences in disease progression were observed in age- and sex-matched CBA/J, C57L/J and C57BL/6J mice over 1 year after graded doses of whole-thorax lung irradiation (WTLI). Separately, comparison of gene expression profiles in lung tissue 24 h post-exposure demonstrated >5000 genes to be differentially expressed (P<0.01; >twofold change) between strains …

Increasing Usage Of Rapid Diagnostics For Dengue Virus Detection In Pakistan, Zahra Hasan, Saher Razzak, Muhammad Farhan, Maryam Rahim, Nazneen Islam, Azra Samreen, E. Khan

Department of Pathology and Laboratory Medicine

No abstract provided.

Atypical Teratoid/ Rhabdoid Tumor Of Brain: A Clinicopathologic Study Of Eleven Patients And Review Of Literature, Nasir Ud Din, Abrar Barakzai, Aisha Memon, Sheema Hasan, Zubair Ahmad

Department of Pathology and Laboratory Medicine

Creative Commons Attribution LicenseBackground: Atypical teratoid/ rhabdoid tumor (AT/RT) is a rare aggressive embryonal central nervous system(CNS) tumor of infancy and early childhood. Majority of the cases arise in the posterior fossa, and remaining in thecerebrum. Aims: To analyze the clinicopathologic features of AT/RT on a cohort of cases. Materials and methods:All reported cases of AT/RT at the Department of Pathology and Laboratory Medicine, Aga Khan University Hospital(AKUH) from 2007 to 2016 were reviewed for clinical and pathological features. Immunohistochemical stain for INI-1was performed in all 11 cases. Follow up was obtained. Results: A total of 11 cases were identified. …

Enterobius Vermicularis In Tubo-Ovarian Abscess: A Rare And Interesting Incidental Finding - A Case Report, Faryal Saleem, Faizan Malik, Saira Fatima

Department of Pathology and Laboratory Medicine

Enterobius vermicularis is a common intestinal nematode; however, rare extraintestinal Enterobius infections have been reported from different parts of the world. Here, we present a case of tubo-ovarian abscess in an otherwise healthy young sexually active female with no known comorbids with history of on and off lower abdominal pain for one year and high grade fever for one month. On the basis of further workup and radiological evaluation, a preoperative diagnosis of right sided tubo-ovarian abscess was made and salpingo-oophorectomy was performed laproscopically in July 2015. Histopathology of the resected tissue revealed necrosis and in one area Enterobius vermicularis …

Selective Screening For Organic Acidurias And Amino Acidopathies In Pakistani Children, Noreen Abbas Sherazi, Aysha Habib Khan, Lena Jafri, Azeema Jamil, Nasir Ali Khan, Bushra Afroze

Department of Pathology and Laboratory Medicine

Objective: To determine the frequency of organic acidurais (OA) and amino acidopathies (AA) in selected high-risk patients screened in two years.
Study Design: Retrospective Observational study.
Place and Duration of Study: The Aga Khan University Hospital (AKUH), Karachi, from January 2013 to December 2014.
Methodology: Patients with OA and AA were included in the study and patients with IMDs other than OA and AA were excluded. Amino acids and organic acids were analyzed on high performance liquid chromatography and gas chromatography-mass spectrometry respectively. Clinical data and chromatograms of patients screened for IMDs were reviewed by chemical pathologist and metabolic physician. …

Forensic And Clinical Diagnosis In "Shaken Baby Syndrome", Between Child Abuse And Iatrogenic Abuse, Roxana M. Duncea, Irina Apostol, Relu G. Calota, Vladimir Belis

Journal of Mind and Medical Sciences

“Shaken baby syndrome” in child abuse cases is a challenge for pediatrician and forensic experts, often a diagnosis of exclusion, with overwhelming moral and legal implications. Diagnosis is based on: subdural bleeding, rupture of retinal vessels, traumatic diffuse axonal injury with diffuse brain encephalopathy in the absence of external traumatic injuries and anamnesis data of an accidentally head injury.

Microscopic findings in diffuse axonal injuries were initially considered as a specific traumatic effect due to unrestricted movement and accelerated rotation of the head. Immunohistochemistry of beta amyloid protein precursor is gold standard method for identifying pathological diffuse axonal lesions, which …

GabaB Receptor Attenuation Of GabaA Currents In Neurons Of The Mammalian Central Nervous System, Wen Shen, Changlong Nan, Peter T. Nelson, Harris Ripps, Malcolm M. Slaughter

Pathology and Laboratory Medicine Faculty Publications

Ionotropic receptors are tightly regulated by second messenger systems and are often present along with their metabotropic counterparts on a neuron's plasma membrane. This leads to the hypothesis that the two receptor subtypes can interact, and indeed this has been observed in excitatory glutamate and inhibitory GABA receptors. In both systems the metabotropic pathway augments the ionotropic receptor response. However, we have found that the metabotropic GABA_B receptor can suppress the ionotropic GABA_A receptor current, in both the in vitro mouse retina and in human amygdala membrane fractions. Expression of amygdala membrane microdomains in Xenopus oocytes by microtransplantation …

Microscopic Examination Of Findings Encountered During Cadaver Dissection: Malignant, Benign Or Anatomic Variation?, Maria Cicioni, Vandi Ly, Guiyun Zhang, Bruce Fenderson

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Pathologic findings encountered during cadaver dissection provide an opportunity for integrating the preclinical basic sciences and encouraging critical thinking. The objective of this study was to determine whether it is possible to make a pathologic diagnosis of an unknown mass from an embalmed cadaver. Diagnoses would have to be based solely on gross and microscopic appearance of tissue, without clinical histories of the cadaveric donors. The tissue samples we removed from each mass were surprisingly well preserved and showed minimal autolysis. Indeed, some of the histological detail was as clear as may be found in any textbook. We were able …

Relationship Of The Median And Radial Nerves At The Elbow: Application To Avoiding Injury During Venipuncture Or Other Invasive Procedures Of The Cubital Fossa., Vlad Voin, Joe Iwanaga, Juan P Sardi, Christian Fisahn, Marios Loukas, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

INTRODUCTION: The median and radial nerves are two important neural structures found in the cubital fossa. The trajectory and landmarks used to identify their location are important when procedures are done in this area.

METHODS AND MATERIALS: Ten fresh-frozen cadavers were dissected (20 upper limbs) and measurements were taken from the medial epicondyle to the median and radial nerves as well as to the lateral epicondyle of each limb.

RESULTS: The distance between the medial epicondyle and the median nerve was found to be three centimeters with a range of 2.1 to four centimeters and the distance from the medial …

Camp Signaling Enhances Hiv-1 Long Terminal Repeat (Ltr)-Directed Transcription And Viral Replication In Bone Marrow Progenitor Cells., Anupam Banerjee, Luna Li, Vanessa Pirrone, Fred C. Krebs, Brian Wigdahl, Michael R. Nonnemacher

Kimmel Cancer Center Papers, Presentations, and Grand Rounds

CD34⁺ hematopoietic progenitor cells have been shown to be susceptible to HIV-1 infection, possibly due to a low-level expression of CXCR4, a coreceptor for HIV-1 entry. Given these observations, we have explored the impact of forskolin on cell surface expression of CXCR4 in a cell line model (TF-1). The elevation of intracellular cyclic adenosine monophosphate (cAMP) by forskolin through adenylyl cyclase (AC) resulted in transcriptional upregulation of CXCR4 with a concomitant increase in replication of the CXCR4-utilizing HIV-1 strain IIIB. Transient expression analyses also demonstrated an increase in CXCR4-, CCR5-, and CXCR4-/CCR5-utilizing HIV-1 (LAI, YU2, and 89.6, respectively) promoter …

Osborne's Ligament: A Review Of Its History, Anatomy, And Surgical Importance., Andre Granger, Juan P Sardi, Joe Iwanaga, Thomas J Wilson, Lynda Yang, Marios Loukas, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

When discussing the pathophysiology of ulnar neuropathy, Geoffrey Vaughan Osborne described a fibrous band that can be responsible for the symptoms seen in this disorder. In this paper, we take a glimpse at the life of Osborne and review the anatomy and surgical significance of Osborne's ligament. This band of tissue connects the two heads of the flexor carpi ulnaris and thus forms the roof of the cubital tunnel. To our knowledge, no prior publication has reviewed the history of this ligament, and very few authors have studied its anatomy in any detail. Therefore, the aim of the present paper …