Iranian Journal of Pathology
Year:2008 | Volume:3 | Issue:1|Papers Count:10

Background and Objectives: Hippocampal volume reduction has been reported in diabetes mellitus type 1. It is believed that hyperglycemia and oxidative stress mediate neuropathological changes in hippocampal neurons. In this study we aimed to study the effect of insulin and an antioxidant like ascorbic acid on preventing volume changes of dentate gyrus and CA3 region of hippocampus. Materials and Methods: This study was carried out on male Wistar rats. Experimental diabetes was induced by intraperitoneal injection of streptozotocin (80 mg/kg). Control animals (C) received only saline. Six weeks later diabetic rats were divided into four groups as follows: diabetic (D), diabetic/insulin (D/Ins), diabetic/insulin+ascorbic acid (D/Ins+AA), and diabetic/ascorbic acid (D/AA). Treatments were continued for two weeks. At the end of treatment course, the hippocampi were removed and dentate gyrus and CA3 region volumes were measured using Cavalieri principle. Results: STZ diabetic rats showed a reduction in DG and CA3 volumes. The volume of DG and CA3 in D and D/AA groups showed a reduction in comparison with control group (p<0.01). However, the volumes of DG and CA3 in groups D/Ins and D/Ins+AA showed no significant difference related to control group (p>0.05).Conclusion: Our findings showed that insulin administration reverse volume reduction of dentate and CA3 region.

Background and Objective: P53 is a suppressive gene that plays a key role in DNA repair and apoptosis. The purpose of this study was to investigate the effect of P53 protein over-expression and some clinicopathological factors on the esophageal squamous cell carcinoma (SCC) response to neoadjuvant chemo radiotherapy. Patients and Methods: In this retrospective cohort study, 44 patients with localized esophageal SCC undergoing neoadjuvant chemo radiotherapy (cisplatin + 5FU and 40 Gy in 20 fractions of irradiation) and surgery were evaluated. Pretreatment specimens were immunohistochemically assessed for p53 over-expression and scored according to the frequency of stained cells. The pathologic response in resected specimens was categorized as follows: complete response (CR), no evidence of malignant cell; partial response (PR), small foci of malignant cells and negative lymph nodes and minor response, macroscopic residual tumor or positive lymph nodes. Results: It was found out that p53 protein over-expression exists in 29 cases (65.9%). Following Chemo radiotherapy, CR and PR were found in 9 (20.5%) and 19 cases (43.2%) respectively. There were also no significant association between tumor response and clinicopathological features such as sex (p=1), age (p=0.82), dysphagia grade (p=0.82) and longitudinal length of the tumor (p=0.59). No significant correlation was found between p53 expression and pathological response to preoperative chemo radiotherapy (p=0.94).Conclusion: These findings suggest that p53 protein expression is not reliable for predicting the response to neoadjuvant chemo radiotherapy. There were also no correlations between pathological response to chemo radiotherapy and clinical features such as age, sex, dysphagia grade and longitudinal diameter of the tumor.

Background and Objective: Angiogenesis is a complex program of several steps and it is tightly regulated by pro- and anti-angiogenic factors. Angiogenesis is one of the key elements in cutaneous wound healing and skin cancers. Estrogen seems to have positive modulating effect on cutaneous wound healing and this effect may be explained by its angiogenic properties. This study aims to investigate the effect of estrogen on cutaneous wound angiogenesis in rats through histological criteria. Materials and Methods: This was an experimental study which was carried out at Esfahan University of Medical Sciences in August 2007. Forty rats were randomly allocated into two groups and an experimental wound was induced in their skin. Wounds in the case group were treated with daily topical estrogen and gentamicin, while the controls received only topical gentamicin. After 14 days of treatment, biopsies were obtained. Results: Evaluation of wounds through a validated histological scoring system revealed significant difference between control and treated mice. The latter exhibited increased microvasculature and significantly higher scores of angiogenesis.Conclusion: Our study suggests that topical estrogen is able to increase cutaneous wound angiogenesis considering objective histological criteria.

Background and Objective: Metallo-beta-lactamases (MBLS) mediated resistance is an emerging threat in hospital isolates of Pseudomonas aeruginosa. There is not enough information from Iran regarding the prevalence and the screening methods for such enzymes. The present study was undertaken to detect MBLS in strains of P. aeruginosa isolated from burned patient using phenotypic method. Materials and Methods: For this purpose, 128 consecutive P. aeruginosa isolates obtained from hospitalized patients were subjected to susceptibility testing to antipseudomonal drugs by disc diffusion and minimal inhibitory concentration (MIC) for ceftazidime was determined. The production of MBL was detected by the zone size enhancement with EDTA impregnated ceftazidime disc. Results: It was found out that 94 (73.44%) of the isolates were resistant to ceftazidime. These isolates screened as ESBLs producing strains and introduced for detection of MBL production. Out of the 94 P. aeruginosa that were resistant to ceftazidime, 50 (53.2%) isolates were MBL positive. This result indicated that 39.06% of all isolates were MBL positive.Conclusion: MBL-mediated ceftazidime resistance in P. aeruginosa is a cause for concern in the therapy of critically ill patients. The MBL producing P. aeruginosa isolates were more resistant to various antimicrobial agents. This result suggests that MBL producing isolates in hospitals may cause serious infections that illustrated when these strains were responsible for a nosocomial outbreak.

Background and Objective: Evaluation of tumor proliferative activity may provide a predicting parameter to estimate biologic aggression and a subsequent prognosis that has been evaluated in many malignancies. We have selected renal cell carcinoma (RCC) in this study. To determine tumor proliferative activity, KI67 antibody was applied and results were compared with apoptosis, applying P53 antibody and using immunohistochemical staining. Patients and Methods: Specimens of 30 patients who underwent radical nephrectomy for RCC were selected for histopathology and immunohistochemical study. Two different grading systems (S&H, Fuhrman) were used to calibrate average nucleoli diameter and tumor grading on all specimens. After processing of paraffin-embedded samples, they were immunohistochemically stained applying (MIB-1) KI67 monoclonal and P53 antibodies. Then, statistical analysis was done. Results: Tumor grading correlated with the average nucleus diameter. Positive reaction to KI67 and P53 antibodies in tumors increased as compared to control group. No significant relationship between age, sex and tumor grade was obtained. Conclusion: These two antibodies are as easy and reliable markers that could be applied on formalin-fixed tissues for better assessment of the biologic behavior of RCC and probably prediction of patients' outcome.

Background and Objective: Determination of hormone receptor status in the management of breast cancer is well-established. The aim of this study was to evaluate the frequency of androgen receptor (AR) expression in invasive ductal carcinoma of breast. Materials and Methods: For this purpose, 55 cases of invasive ductal breast carcinoma were examined using a monoclonal antibody against AR on formalin-fixed paraffin-embedded archival material. The results were correlated with the results of estrogen and progesterone receptors (ER and PR) previously done immunohistochemically on the specimens. Results: It was found out that AR was positive in 24 cases (43.6%). In addition, AR was positive in 33% (3) of grade 1, 45% (16) of grade 2, and 38% (15) of grade 3 tumors. Previously, ER and PR were done on 34 cases including 5 grade 1, 18 grade 2, and 11 grade 3 carcinomas. Among the grade 1 cases, 2 out of them were AR positive which were also ER and PR positive but 2 (11%) out of grade 2 and 3 (27%) out of grade 3 tumors were AR positive and ER negative. Also, 5 (28%) out of grade 2 and 3 (27%) out of grade 3 tumors were AR positive and PR negative. In grade 2 tumors, correlation between ER and PR negativity with AR positivity was significant.Conclusion: AR expression is common in invasive breast carcinomas. Some high grade carcinomas are ER and PR negative and AR positive. We suggest that immunohistochemical evaluation of AR may help in providing more information about steroid receptors in breast carcinomas.

Background and Objective: Long period risk of gastric carcinoma in people affected with chronic Helicobacter pylori gastritis is 5 times more than normal people. Perhaps histological changes due to helicobacter pylori infection could be used for screening people at risk of gastric carcinoma and peptic ulcer. Materials and Methods: This study has been carried out as a cross-sectional process and we compared histological changes observed in Helicobacter pylori chronic gastritis in 30 patients with peptic ulcer and 30 patients without the ulcer and then classified them according to Sydney scoring system, and after collecting data, we analyzed them by SPSS software. Results: Sixty percent of patients with ulcer were male and forty percent were female. In addition, 56.7% of patients without ulcer were male and 43/3% were female without a statistically significant difference (p=0.793). Mean age in ulcer group was 56.4 years and in non-ulcer group was 48.9 years that there was no significant statistical difference (p=0.057). Chronic gastritis frequency increases within people in their sixth decade and after that. There was no significant difference for degree of infection with Helicobacter pylori (p=0.346), metaplasia (p=0.885), chronicity (p=0.796) and degree of activity (p=0.249), atrophy (p=0.781) in patients with or without ulcer. Conclusion: There was no significant difference in any of the variables of the study including degree of infection with Helicobacter pylori, chronicity, disease activity and intestinal metaplasia between both groups with and without peptic ulcer.

Serratia marcescens (S.M) is a species of gram–negative bacteria in the family enterobacteriaceae. A human pathogen, S. marcescens is involved in nosocomial infections, particularly in urinary tract and wound infections. This report describes a 63 years-old man that referred to hospital with dyspnea FC IV and he underwent cardiac valves replacement surgery with a diagnosis of severe mitral stenosis (M.S), severe tricuspid regurgitation (T.R), and moderate aortic insufficiency (A.I). Five days after operation, he presented with 40oC fever, respiratory distress, elevation of liver enzymes, and decreased consciousness. Sepsis work up showed positive blood culture for Serratia marcescens. Despite therapy, he died due to Serratia marcescens endocarditis and mediastinitis. Positive blood culture for Serratia marcescens is very rare but it should be considered in post operation patients after cardiac valve replacement presenting with fever. Besides, prevention of endocarditis due to Serratia marcescens should be observed.

Schwannomas are benign nerve sheath tumors that originate from any anatomical site. Most of the schwannomas are found in the head, neck or limbs. Schwannoma arising in a lymph node is extremely rare. We have found only four cases in the review of the literature. We experienced a case of intranodal schwannoma in a perigastric lymph node. A 72 year-old female underwent cholecystectomy due to clinical signs of cholecystitis. A mass was found in perigastric area on lesser curvature of the stomach. The mass was excised in an encapsulated state.On histological examination, the node was composed of a proliferation of bland spindle cells, which immunohistochemically was positive for S100 protein and negative for smooth muscle actin, desmin, and cytokeratin. The morphologic and immunatistochemical studies revealed an extremely rare case of schwannoma of the lymph node.

Amoebiasis of the uterine cervix is an extremely rare entity and presentation as carcinoma cervix has only been reported once in the extensively searched English literature. It can clinically simulate cervical malignancy by virtue of surface papillomatous and overall ulcerated and necrotic appearance. We present a case of amoebic cervicitis in a 55-year old female which was suspected to be a squamous cell carcinoma until a punch biopsy disclosed a diagnosis of amoebic etiology thereby preventing unwarranted aggressive management.