Laboratory Medicine Commons^™

Stroke Survivors' Telemedicine Experiences During The Covid-19 Pandemic: A Phenomenological Investigation, Irene N Kasumba, Kit Tilly, Tao Lin, Steven J Norris, Patricia A Rosa

Faculty, Staff and Student Publications

The highly segmented genome of Borrelia burgdorferi, the tick-borne bacterium that causes Lyme disease, is composed of a linear chromosome and more than 20 co-existing endogenous plasmids. Many plasmid-borne genes are unique to B. burgdorferi and some have been shown to provide essential functions at discrete points of the infectious cycle between a tick vector and rodent host. In this study, we investigated the role of bba40, a highly conserved and differentially expressed gene on a ubiquitous linear plasmid of B. burgdorferi. In a prior genome-wide analysis, inactivation of bba40 by transposon insertion was linked with a …

The Correlation Between Neonatal Intensive Care Unit Safety Culture And Quality Of Care, Karan Sud, Navneet Narula, Elena Aikawa, Eloisa Arbustini, Philippe Pibarot, Giampaolo Merlini, Robert S Rosenson, Surya V Seshan, Edgar Argulian, Amir Ahmadi, Fang Zhou, Andre L Moreira, Nancy Côté, Sotirios Tsimikas, Valentin Fuster, Sam Gandy, Robert O Bonow, Olga Gursky, Jagat Narula

Faculty, Staff and Student Publications

Calcific aortic valve disease (CAVD) and stenosis have a complex pathogenesis, and no therapies are available that can halt or slow their progression. Several studies have shown the presence of apolipoprotein-related amyloid deposits in close proximity to calcified areas in diseased aortic valves. In this Perspective, we explore a possible relationship between amyloid deposits, calcification and the development of aortic valve stenosis. These amyloid deposits might contribute to the amplification of the inflammatory cycle in the aortic valve, including extracellular matrix remodelling and myofibroblast and osteoblast-like cell proliferation. Further investigation in this area is needed to characterize the amyloid deposits …

Evolving Landscape Of Carbapenem-Resistant Pseudomonas Aeruginosa At A Single Centre In The Usa, Aki Sakurai, An Q Dinh, Blake M Hanson, William C Shropshire, Samie A Rizvi, Kirsten Rydell, Truc T Tran, Audrey Wanger, Cesar A Arias, William R Miller

Faculty, Staff and Student Publications

OBJECTIVES: The increased identification of carbapenem-resistant

METHODS: A total of 169 CR-PA isolated from clinical specimens at a single centre in Houston, TX, USA were studied. Among them, 61 isolates collected between 1999 and 2005 were defined as historical strains, and 108 collected between 2017 and 2018 were defined as contemporary strains. Antimicrobial susceptibilities against selected β-lactams was determined. WGS data were used for the identification of antimicrobial resistance determinants and phylogenetic analysis.

RESULTS: Non-susceptibility to ceftolozane/tazobactam and ceftazidime/avibactam increased from 2% (1/59) to 17% (18/108) and from 7% (4/59) to 17% (18/108) from the historical to the contemporary collection, …

Rare Autoimmune Disease Caused By Not-So Rare Virus, Tiffany Marchewka, Acho Bernard, Molly Kempa, Kathryn Heal, Joseph M. Fullmer

Conference Presentation Abstracts

No abstract provided.

Correction: Deadly Combination Of Vaping-Lnduced Lung Injury And Influenza: Case Report, Bindu H Akkanti, Rahat Hussain, Manish K Patel, Jayeshkumar A Patel, Kha Dinh, Bihong Zhao, Shaimaa Elzamly, Kevin Pelicon, Klemen Petek, Ismael A Salas De Armas, Mehmet Akay, Biswajit Kar, Igor D Gregoric, L Maximilian Buja

Faculty, Staff and Student Publications

Following publication of the original article [1], In this article the title was incorrectly given as “Deadly combination of E-cigarettes has become a popular-lnduced lung injury and Influenza: case report” but should have been “Deadly combination of Vaping-lnduced lung injury and Influenza: case report”.

The original article has been updated.

Histopathology Of The Mitral Valve Residual Leaflet In Obstructive Hypertrophic Cardiomyopathy, Aaron L Troy, Navneet Narula, Daniele Massera, Elizabeth Adlestein, Isabel Castro Alvarez, Paul M L Janssen, Andre L Moreira, Iacopo Olivotto, Alexandra Stepanovic, Kristen Thomas, Briana Zeck, Luis Chiriboga, Daniel G Swistel, Mark V Sherrid

Faculty, Staff and Student Publications

BACKGROUND: Mitral valve (MV) elongation is a primary hypertrophic cardiomyopathy (HCM) phenotype and contributes to obstruction. The residual MV leaflet that protrudes past the coaptation point is especially susceptible to flow-drag and systolic anterior motion. Histopathological features of MVs in obstructive hypertrophic cardiomyopathy (OHCM), and of residual leaflets specifically, are unknown.

OBJECTIVES: The purpose of this study was to characterize gross, structural, and cellular histopathologic features of MV residual leaflets in OHCM. On a cellular-level, we assessed for developmental dysregulation of epicardium-derived cell (EPDC) differentiation, adaptive endocardial-to-mesenchymal transition and valvular interstitial cell proliferation, and genetically-driven persistence of cardiomyocytes in the …

Dpp8 Selective Inhibitor Tominostat As A Novel And Broad-Spectrum Anticancer Agent Against Hematological Malignancies, Shohei Kikuchi, Akinori Wada, Yusuke Kamihara, Kosuke Okazaki, Paras Jawaid, Mati Ur Rehman, Eiji Kobayashi, Takeshi Susukida, Tomoki Minemura, Yoshimi Nabe

Department of Biological & Biomedical Sciences

DPP8/9 inhibition induces either pyroptotic or apoptotic cell death in hematological malignancies. We previously reported that treatment with the DPP8/9 inhibitor 1G244 resulted in apoptotic cell death in myeloma, and our current study further evaluates the mechanism of action of 1G244 in different blood cancer cell lines. Specifically, 1G244 inhibited DPP9 to induce GSDMD-mediated-pyroptosis at low concentrations and inhibited DPP8 to cause caspase-3-mediated-apoptosis at high concentrations. HCK expression is necessary to induce susceptibility to pyroptosis but does not participate in the induction of apoptosis. To further characterize this DPP8-dependent broad-spectrum apoptosis induction effect, we evaluated the potential antineoplastic role for …

Epstein-Barr Virus-Associated Lymphoepithelial Carcinoma Arising In The Parotid Gland: A Case Report And Literature Review, Akinobu Kubota, Nobuyuki Bandoh, Takashi Goto, Ken-Ichi Matsumoto, Tomomi Yamaguchi-Ishochi, Yasutaka Kato, Hiroshi Nishihara, Hidehiro Takei

Faculty, Staff and Student Publications

A 60-year-old woman presented with a 3-year history of a slow-growing, painless mass in their left parotid gland. Ultrasonography revealed a well-circumscribed, lobulated, hypoechoic mass measuring 19x12x10 mm in the left parotid gland. Computed tomography revealed a well-circumscribed, solid mass with homogeneous enhancement. Fluorodeoxyglucose-positron emission tomography revealed uptake by the tumor but no uptake in other organs, including the nasopharynx. The patient underwent superficial parotidectomy with adequate safety margins and selective neck dissection followed by radiotherapy. No facial paralysis or recurrence of the tumor had been observed as of 20 months post-operation. Histologically, the tumor was composed of sheets of …

Ultrastructural Findings Of Budding Ballooning Clusters Are Best Correlated With Punctate Autoimmune Antibodies Seen By Immunofluorescence In Minimal Change Disease, Vasudevan Mahalingam, Seyedalireza Fatemi, Wei Li, Hassan Kanaan, Ping Zhang

Conference Presentation Abstracts

Background: The etiology of minimal change disease (MCD) remains a mystery as the only hallmark findings are the diffuse effacement of foot processes by electron microscopy (EM). Punctate IgG staining floating outside of glomerular capillary loops have recently been identified as autoimmune antibodies against nephrin in podocytes from a set of MCD cases (Watts AJB et al., JASN 2022;33:238-252). The corresponding ultrastructural findings by EM, however, of the autoimmune antibodies are not yet described. We hypothesized that budding ballooning clusters (BBC) seen in EM may be correlated with the punctate IgG staining granules. Design: We identified 7 patients with MCD …

Lingual Alveolar Soft Part Sarcoma In A 78-Year-Old Woman: A Case Report And Comprehensive Review Of The Literature From 1952 To 2022, Aliaksandr Aksionau, Nestor Enriquez Dela Cruz, Andrew T Meram, Hugo Cuellar-Saenz, Jillian R Aveni, Hidehiro Takei

Faculty, Staff and Student Publications

BACKGROUND: Alveolar soft part sarcoma (ASPS) is a rare translocation-related soft tissue sarcoma, occurring mainly in the limbs and trunk in young adults and adolescents. ASPS is rarely seen in the head and neck and one fourth of those cases described are tongue primary. Given its nonspecific symptoms, clinical findings, and rarity in this location, lingual ASPS (L-ASPS) has been reported to be commonly misdiagnosed as various benign tumors, leading to adverse outcomes.

METHODS: We report a case of L-ASPS occurring in the oldest (78 years) female patient published to date and comprehensively review the literature from 1952 to 2022. …

Injured Proximal Tubules Stain Positivity For Arginase-1 To Indicate Acute Tubular Injury (Ati), Jessica Anderson, Neal Blatt, Olabisi Afolayan-Oloye, Hassan Kanaan, Wei Li, Larysa Wickman, Ping Zhang

Conference Presentation Abstracts

Background: A recent study indicates that arginase-1 participates in M2 macrophage-mediated renal tubular regeneration in a rodent model (Shin et al. JASN 2022). As injured proximal tubule cells have a phagocytotic capacity (stain positively for CD68 and kidney injury moleucule-1 in previous studies), we hypothesized that the injured proximal tubules may stain positively for arginase1. Design: We analyzed PAS-stained renal biopsy sections for evidence of ATI using a semiquantitative scale: 0 (no injury) to 1-2+ (mild to moderate ATI) to 3+ (severe ATI). First group (N=7) consisted of renal biopsies that had no evidence of ATI or were obtained from …

3q262/Mecom Rearrangements By Pericentric Inv(3): Diagnostic Challenges And Clinicopathologic Features, Zhenya Tang, Wei Wang, Su Yang, Hanadi El Achi, Hong Fang, Karen Amelia Nahmod, Gokce A Toruner, Jie Xu, Beenu Thakral, Edward Ayoub, Ghayas C Issa, C Cameron Yin, M James You, Roberto N Miranda, Joseph D Khoury, L Jeffrey Medeiros, Guilin Tang

Faculty, Staff and Student Publications

MECOM rearrangement (MECOM-R) resulting from 3q26.2 aberrations is often associated with myeloid neoplasms and inferior prognosis in affected patients. Uncommonly, certain 3q26.2/MECOM-R can be subtle/cryptic and consequently overlooked by karyotyping. We identified 17 acute myeloid leukemia (AML) patients (male/female: 13/4 with a median age of 67 years, range 42 to 85 years) with a pericentric inv(3) leading to MECOM-R, with breakpoints at 3p23 (n = 11), 3p25 (n = 3), 3p21 (n = 2) and 3p13 (n = 1) on 3p and 3q26.2 on 3q. These pericentric inv(3)s were overlooked by karyotyping initially in 16 of 17 …

Extensive Fibrosis In Mediastinal Seminoma Is A Diagnostic Pitfall In Small Biopsies: Two Case Reports, Anthony R Liccardi, Kristen Thomas, Navneet Narula, Lea Azour, Andre L Moreira, Fang Zhou

Faculty, Staff and Student Publications

Background

In mediastinal biopsies that show fibrosis, the differential diagnosis includes fibrosing mediastinitis, immunoglobulin G subclass 4-related disease, Hodgkin lymphoma, as well as reactive fibrotic and inflammatory changes adjacent to other processes including neoplasms.

Cases Description

We report two cases of incidentally detected mediastinal seminoma that contained extensive areas of paucicellular fibrosis, which precluded accurate preoperative biopsy diagnosis. The fibrosis consisted of mildly inflamed, densely scarred tissue with thin dilated vessels, and was present to a significant extent that is suggestive of spontaneous regression. These features are not currently described in the World Health Organization Classification of Thoracic Tumors. In …

Molecular Detection Of Entamoeba Histolytica In Diarrheic Fecal Samples From Patients Attending National Hepatology And Tropical Medicine Research Institute, Azza Hasan Abbas, El Shahat Ahmed Elshahat, Heba Mohamed Abdelglil

Journal of Medicine in Scientific Research

Background: Amoebiasis is a worldwide disease caused by Entamoeba histolytica infection. The true prevalence is unknown due to the difficulty in distinguishing Entamoeba histolytica from non-pathogenic amoebas especially when microscopic diagnosis is performed, to overcome microscopy misidentification. Polymerase Chain Reaction (PCR) assay is necessary as a highly sensitive and specific technique. Objective: To determine the value of Real-Time PCR (RT.PCR) in the diagnosis of Entamoeba histolytica in the stool samples of diarrheic patients attending NHTMI versus microscopy, copro- antigen, and serum antibodies detection techniques. Subjects and Methods: A cross-sectional study was conducted on 150 diarrheic patients. Their stool samples were …

Angiotensin I-Converting Enzyme Insertion/Deletion Gene Polymorphism And Its Association With Diabetic Nephropathy In Type-2 Diabetes Mellitus Patients: An Egyptian Study, Yasmine M. Amrousy, Tamer M. Soliman, Haythem A. Tolba, Aisha Elshimy

Journal of Medicine in Scientific Research

Background Diabetic nephropathy (DN) is one of the most serious complications associated with type-2 diabetes mellitus (T2DM). With variable allele and genotype frequencies, the angiotensin I-converting enzyme (ACE) insertion–deletion (I/D) gene polymorphism has been suggested as a risk factor for DN. Objective The purpose of the study was to find whether ACE I/D polymorphism is associated with DN in Egyptian T2DM patients and its relation to ACE concentration and C-reactive protein quantitative level. Participants and methods A case–control study of 98 T2DM patients was divided into two groups: group 1, T2DM patients without DN, and group 2, T2DM patients with …

Assessing Serum Ferritin Together With Some Inflammatory Biomarkers In Overweight And Obese Hospital Care Workers At Elgalaa Teaching Hospital And Its Correlation With Metabolic Syndrome, Sahar Mohamed Said Elbayoumi, Hanan Farouk, Heba Abdelaziz

Journal of Medicine in Scientific Research

Obesity is known to be associated with elevated levels of inflammatory markers. One of the major problems associated with morbidity and mortality. The aim of the study was to assess the posing effect of obesity on the levels of serum ferritin, total cholesterol, HDL and LDL, triglycerides, HBA1C, CRP, and Uric acid with CBC, on random well-being colleague females. Patient and methods: 100 adult female health workers were categorized into three entities according to both BMI and waist circumference, as normal, overweight, and obese. Results: increased serum ferritin as an inflammatory marker might correlate to BMI, in juniors; and might …

Incidental Vascular Lesion In Explanted Liver: A Rare Case Report And Review Of The Literature, Rossana Kazemimood, Shohreh Eliaszadeh, Kenneth Wind

Faculty, Staff and Student Publications

Hepatic small vessel neoplasm (HSVN) is a rare vascular hepatic lesion that is usually an asymptomatic incidental finding. Here we present a case of a 66-year-old male with HSVN who was discovered to have a lesion presenting as a small nodule in an explanted liver. HSVN is a recently described hepatic vascular lesion that has been previously underdiagnosed. It has an uncertain long-term malignant potential, so close follow-up is recommended.

Futility In Acute Care Surgery: First Do No Harm, Melissa Hornor, Uzer Khan, Michael W Cripps, Allyson Cook Chapman, Jennifer Knight-Davis, Thaddeus J Puzio, Bellal Joseph

Faculty, Staff and Student Publications

The consequences of the delivery of futile or potentially ineffective medical care and interventions are devastating on the healthcare system, our patients and their families, and healthcare providers. In emergency situations in particular, determining if escalating invasive interventions will benefit a frail and/or severely critically ill patient can be exceedingly difficult. In this review, our objective is to define the problem of potentially ineffective care within the specialty of acute care surgery and describe strategies for improving the care of our patients in these difficult situations.

A Large Screen Identifies Beta-Lactam Antibiotics Which Can Be Repurposed To Target The Syphilis Agent, Kathryn A Hayes, Jules M Dressler, Steven J Norris, Diane G Edmondson, Brandon L Jutras

Faculty, Staff and Student Publications

Syphilis, caused by the spirochete Treponema pallidum subsp. pallidum (hereafter called T. pallidum), is re-emerging as a worldwide sexually transmitted infection. A single intramuscular dose of benzathine penicillin G is the preferred syphilis treatment option. Both supply shortage concerns and the potential for acquired antibiotic resistance further the need to broaden the repertoire of syphilis therapeutics. We reasoned that other β-lactams may be equally or more effective at targeting the disease-causing agent, Treponema pallidum, but have yet to be discovered due to a previous lack of a continuous in vitro culture system. Recent technical advances with respect to …

Clonal Isolates Of Treponema Pallidum Subsp Pallidum Nichols Provide Evidence For The Occurrence Of Microevolution During Experimental Rabbit Infection And In Vitro Culture, Diane G Edmondson, Bridget D De Lay, Blake M Hanson, Lindsay E Kowis, Steven J Norris

Faculty, Staff and Student Publications

The recent development of a system for long-term in vitro culture of the syphilis spirochete, Treponema pallidum subsp. pallidum, has introduced the possibility of detailed genetic analysis of this bacterium. In this study, the in vitro culture system was used to isolate and characterize clonal populations of T. pallidum subsp. pallidum Nichols, the most widely studied strain. In limiting dilutions experiments, it was possible to establish cultures with inocula as low as 0.5 T. pallidum per well despite the long generation time (~35 to 40 hours) of this organism. Six Nichols strain clones isolated by limiting dilution were characterized in …