Synthesis,Analgesic and Anti-Inflammatory Activities of Aminobenzothiazole Derivatives of Mefenamic Acid

Pharmaceutical Chemistry Journal - Some new aminobenzothiazole derivatives of mefenamic acid were synthesized with potential analgesic and anti-inflammatory properties. The structures of newly...     

Derivation and validation of a practical Bedside Score for the diagnosis of cholecystitis

Objective

We sought to develop a practical Bedside Score for the diagnosis of cholecystitis and test its accuracy against the Tokyo Guidelines (TG13).

Epidermal growth factor receptor (EGFR) expression in periocular and extraocular sebaceous carcinoma

Sebaceous carcinoma has a predominant periocular origin but can also be extraocular. These two groups have distinct clinical courses. Insight into the molecular determinants of tumorigenesis and metastasis is limited. There is no effective treatment for metastatic sebaceous carcinoma. Epidermal growth factor receptor (EGFR) is implicated in tumorigenesis and can be a therapeutic target in certain settings. We evaluated EGFR levels by immunohistochemistry (IHC), comparing its expression between periocular and extraocular tumors and assessed EGFR mutation status. IHC was performed in 36 cases: 19 periocular and 17 extraocular (10 associated with Muir‐Torre syndrome—MTS). EGFR IHC was scored for percentage of positive cells (< 5%, 5–25%, 26–50%, > 50%) and intensity (+1 = low , +2 = moderate , +3 = high ). Extraocular carcinomas showed markedly increased levels of EGFR when compared to periocular carcinoma cases, both in terms of distribution (88% were > 25% of tumor cells vs. 16%) and intensity (77% were 2+ or 3+ vs. 21%) (p < 0.001). Among extraocular cases, there was significantly lower EGFR expression in MTS‐related cases (p < 0.05). No EGFR mutations were identified. Our results underscore the divergent mechanisms underlying the tumorigenesis of periocular and extraocular sebaceous carcinoma and suggest an association between aggressive behavior and increased EGFR expression in extraocular sebaceous carcinoma. Ivan D, Prieto VG, Esmaeli B, Wistuba II, Tang X, Lazar AJF. Epidermal growth factor receptor (EGFR) expression in periocular and extraocular sebaceous carcinomas.     

Appendiceal hydatid cyst: a case report and review of literature

Hydatid cyst has a predilection to involve liver and lungs. Most of the reported cases of appendiceal hydatid cyst are primary, and secondary involvement has been rarely reported in the English-language literature. Herein, we report a 47-year-old man who presented with abdominal pain, fatigue, and anorexia since 6 months ago. He had history of surgery for hepatic hydatid cyst 7 years ago. Diagnosis of secondary hydatidosis was made upon positive indirect hemagglutination assay and abdominopelvic computed tomography scan, which showed involvement of liver, appendix, and spleen. Albendazole was started, and surgical cystectomy, appendectomy, and splenectomy were performed. Albendazole was continued postoperatively for 6 months. During this period, liver function test and abdominal sonography were normal. Despite its rarity, our case emphasizes that primary care physicians should have high index of clinical suspicion of secondary hydatidosis of appendix when they detect cystic mass, especially in patients with previous hepatic hydatid disease.     

Does size matter? Comparison study between MRI,gross, and microscopic tumor sizes in breast cancer in lumpectomy specimens

Size of breast cancer is essential in staging cancer to determine type and extent of patient management. This study was conducted to assess accuracy in estimating tumor size by MRI and gross using microscopy as gold standard. A retrospective study was done on 33 patients, 30-75 years, who underwent MRI of breasts with subsequent lumpectomy, 2002-2006, for invasive breast cancer. Size of lesion(s) on MRI and gross were compared with histological size. Of 37 lesions, 27 (73%) were invasive ductal (IDC) and 10 (27%) invasive lobular carcinoma (ILC). Tumor size by MRI matched histological size in 3%, underestimated 27%, and overestimated 70% of cases. Tumor size by gross matched histological size in 22%, underestimated 57%, and overestimated 22% of cases. MRI as an imaging modality and gross pathology both have significant limitations in measuring tumor size particularly in cases of invasive breast carcinoma. Random sectioning of lumpectomy specimen in invasive breast carcinoma may result in inaccurate staging of tumor by leading to false impression of tumor size and multi-focality and/or multi-centricity of tumor particularly in cases of ILC. Microscopic measurements of tumor size are necessary for accurate T-staging and recommended for appropriate patient management.     

Evaluation of Calretinin as a New Marker in the Diagnosis of Hirschsprung Disease

Background:

Hirschsprung’s disease (HD) is a congenital intestinal motility disorder with absence of ganglion cells in the colonic wall. Diagnosis of the disease is mainly based on the identification of the lack of ganglion cells in the pathology sections of the colon which is very difficult and time consuming and also needs several serial cut sections. There are many proposed markers in this field in the literature but none of them has been satisfactory. Calretinin immunohistochemistry (IHC) has been introduced as a new diagnostic marker to overcome the problems in diagnosis of this disease about 5 years ago. However there are few studies regarding the benefits and pitfalls of this marker.

Objectives:

The aim of this study is to determine the diagnostic value of calretinin IHC in detecting aganglionosis (HD).

Patients and Methods:

27 HD patients and 28 non-Hirschsprung’s disease (NHD) patients were collected in a prospective study and calretinin IHC was performed on 31 aganglionic and 51 normoganglionic full wall thickness sections of colectomies (some of the cases had more than 1 section). The IHC slides were evaluated by two pathologists and the diagnostic value was calculated in comparison with gold standard which is the presence or absence of ganglion cells in serial Hematoxylin and Eosin (HE) stained sections of the colectomies.

Results:

There was great concordance between the final diagnosis of both pathologists and gold standard (k > 0.9). Calretinin immunostaining showed 100% specificity and positive predictive value and more than 90% sensitivity and negative predictive value. High agreement was present between the two pathologists (k > 0.9).

Conclusions:

Calretinin IHC is a very convenient, useful and valuable method to demonstrate aganglionosis in HD patients. Loss of calretinin immunostaining in lamina propria and submucosa is characteristic of HD.