scholarly journals Pitfalls in the histological diagnosis of total colonic aganglionosis on appendicectomy specimens

2022 ◽  
Vol 13 (1) ◽  
pp. 99-104
Author(s):  
Radhika Krishna O H ◽  
Srinivas Srirampur ◽  
Vani Padmaja G J ◽  
Ramesh Reddy Kota
Keyword(s):  
Acute Appendicitis ◽  
Ganglion Cell ◽  
Ganglion Cells ◽  
Histological Finding ◽  
Normal Appendix ◽  
High Power Field ◽  
Total Colonic Aganglionosis ◽  
Pediatric Age Group ◽  
Technical Errors ◽  
Significant Difference

Background: Hirschsprung’s disease is the most important cause of functional intestinal obstruction in children. It is characterized by the absence of ganglion cells in the submucosal and myenteric plexuses on histology. In 10% of Hirschsprungs disease patients, involvement of the entire colon is seen in a condition called total colonic aganglionosis (TCA). The absence of ganglion cells in the appendix on histology has been considered diagnostic of TCA. The validity of this histological finding being taken as criteria for diagnosis is not clear. Aims and Objectives: This study examines the presence and the number of myenteric and submucosal ganglion cells in the appendices of suspected cases of TCA and compares these findings with controls, specimens of acute appendicitis, and histologically normal appendix in pediatric cases. Materials and Methods: Thirty-six appendix specimens of suspected TCA cases and controls, that is, ten each of acute appendicitis and histologically normal appendix in pediatric age group were included in this study taken up in the pathology department of a tertiary pediatric referral hospital. The presence or absence and the number of ganglion cells in each specimen was semiquantitatively evaluated in a blinded manner. These findings were descriptively compared and analyzed. The difficulties faced by the pathologist in reporting the pediatric appendix specimens were also documented. Results: The cases and controls showed that aganglionosis and no significant difference were noted in the number of ganglion cells per high power field between the cases and controls. The reporting pathologists enumerated quite a few pitfalls and problems encountered by them in the process of interpreting ganglion cell status of pediatric, particularly neonatal appendicectomy specimens. Conclusion: Aganglionosis of the appendix on histology may not be an ideal tool for the diagnosis of TCA. Difficulties in histological characterization of ganglion cells, technical errors in tissue embedding and the presence aganglionic skip areas might cause errors in the interpretation of ganglion cell status of appendix specimens, particularly infants, and neonates.

scholarly journals Role of Mean Platelet Volume in Diagnosis of Childhood Acute Appendicitis

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Bunyamin Uyanik ◽  
Cemil Kavalci ◽  
Engin Deniz Arslan ◽  
Fevzi Yilmaz ◽  
Ozgur Aslan ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Mean Platelet Volume ◽  
Diagnostic Value ◽  
Control Group ◽  
Healthy Children ◽  
Platelet Volume ◽  
Pediatric Age Group ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Introduction. Acute appendicitis is the leading cause of abdominal pain in children requiring emergency surgical intervention. The aim of this study is to investigate the diagnostic value of MPV in early diagnosis of acute appendicitis cases in pediatric age group.Methods. This study was performed retrospectively. Three hundred five patients operated on with the diagnosis of appendicitis and pathologically found to be acute appendicitis were classified as Group 1 and 305 healthy children were classified as control Group 2.Results. One hundred ninety-seven of 305 cases in Group 1 are males (64.6%), in Group 2, 151 of 305 cases are males (49.5%). The mean MPV in Group 1 was7.9±0.9(fL), and whereas in Group 2 was7.7±0.8(fL). There was no statistically significant difference regarding MPV values (P>0.05).Conclusion. In our study we detected that mean platelet volume has no diagnostic value in pediatric acute appendicitis cases.

scholarly journals 651 An Audit of Negative Appendectomy Rate at A District General Hospital in the UK

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
Z Al-Hamid ◽  
S Jaskani ◽  
D Chattopadhyay
Keyword(s):  
Acute Appendicitis ◽  
Hospital Readmission ◽  
Readmission Rate ◽  
National Database ◽  
Negative Appendectomy ◽  
Normal Appendix ◽  
Hospital Readmission Rate ◽  
Significant Difference ◽  
Negative Appendectomy Rate ◽  
The Uk

Abstract Aim There is significant variation in management of acute appendicitis across the UK. Despite advancements in imaging modalities, acute appendicitis is still a clinical diagnosis. The primary aim of this study was to determine the negative appendectomy rate (NAR) and secondary aim was to look for the imaging results and hospital readmission rate in case of a normal appendix. Method It is a retrospective analysis of all the patients admitted with a suspicion of acute appendicitis from Jan 2018 to April 2019. For data collection hospital medical record was used. Information about patient demographic details, blood results, outcome, operative findings, and histology of appendix if removed, was collected. For Patients having negative appendectomy, hospital admission rate was calculated. Results Total 517 patients were admitted with suspected acute appendicitis and only 45.6% (n = 236) patients underwent surgery. Females=52.1%, Males 47.9%. Mean age was 31 years. NAR was 10.6% (n = 25). (Females= 9.3%, Males=1.3%), 8.4% female patients were below 35 years of age. Patients were divided into 3 groups (Normal appendix NA, Uncomplicated appendicitis UA, complicated appendicitis CA). There was a statistically significant difference in inflammatory markers between the groups. In NA group 17/25 patients underwent prior imaging and imaging suggested acute appendicitis in 7/17 patients. Post NA hospital readmission rate was 20%, all of them were females, and gynecology opinion was sought in all of them. Conclusions The negative appendectomy rate is at 10.6%, comparable to national database. It is more common in young females due to a range of differential diagnoses.

Amacrine and ganglion cell contributions to the electroretinogram in amphibian retina

2001 ◽  
Vol 18 (1) ◽  
pp. 147-156 ◽  
Author(s):  
GAUTAM AWATRAMANI ◽  
JUE WANG ◽  
MALCOLM M. SLAUGHTER
Keyword(s):  
Contrast Agents ◽  
Ganglion Cell ◽  
Neuronal Activity ◽  
Opposite Effect ◽  
Cell Function ◽  
Ganglion Cells ◽  
Field Potential ◽  
Tiger Salamander ◽  
Third Order ◽  
Light Responses

The neuronal generators of the b- and d-waves of the electroretinogram (ERG) were investigated in the tiger salamander retina to determine if amacrine and ganglion cells contribute to this field potential. Several agents were used that affect third-order neurons, such as tetrodotoxin, baclofen, and NMDA agonists and antagonists. Baclofen, an agent that enhances light responses in third-order neurons, increased the d-wave and reduced the b-wave. In contrast, agents that decrease light responses in third-order neurons had the opposite effect of enhancing the b-wave and depressing the d-wave. The effect on the d-wave was particularly pronounced. The results indicate that third-order neuronal activity influences b- and d-waves of the ERG. The opposing actions suggest that the b-wave to d-wave ratio might serve as an measure of ganglion cell function.

scholarly journals Is There Pathological Uniformity between the Periphery and Center of a Gastrointestinal Stromal Tumor?

2021 ◽  
Vol 10 (4) ◽  
pp. 687
Author(s):  
Seong Ji Choi ◽  
Kwan Hong Lee ◽  
Chan Kyoo Yoo ◽  
Jai Hoon Yoon ◽  
Ki Seok Jang ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Mitotic Index ◽  
High Power ◽  
Malignant Potential ◽  
Mitotic Count ◽  
Pathological Diagnosis ◽  
High Power Field ◽  
Gastric Gists ◽  
Significant Difference ◽  
The Mean

Background: Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors and have some malignant potential. Mitotic count is important for predicting the malignant potential of GISTs. Proper treatment of GISTs requires accurate pathological diagnosis. In general, endoscopic ultrasound-guided fine-needle aspiration and deep biopsy are used for pathological diagnosis of GIST before making decisions about surgery. This study sought to evaluate the pathological uniformity of gastric GISTs for mitotic index of the center and periphery of the GIST. Methods: We retrospectively reviewed the data of 37 gastric GIST patients who underwent wedge resection at Hanyang University Hospital. We used Armed Forces Institute of Pathology criteria to classify gastric GISTs. To determine the pathological uniformity of gastric GISTs, we compared GIST risk stratification between the center and periphery of GISTs. Results: The mean size of GISTs was 3.56 ± 2.10 cm. Three lesions were located in the antrum, 11 in the fundus, 9 in the cardia, and 14 in the body. The mean age of patients was 58.65 ± 9.44 years; 18 patients were male and 19 were female. Thirty-five patients (94.6%) showed the same level of risk stratification between the center and periphery of gastric GISTs, while two patients (5.4%) presented different levels of risk between the two sites. No significant difference in mitotic count was observed between the two sites (kappa value = 0.863; p = 0.001). Conclusions: Mitotic index category (either more than five mitoses per high-power field or five or fewer mitoses per high-power field) of GISTs showed good concurrence between the center and periphery.

scholarly journals Dynamic Expression of HDAC3 in db/db Mouse RGCs and Its Relationship with Apoptosis and Autophagy

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Yuhong Fu ◽  
Ying Wang ◽  
Xinyuan Gao ◽  
Huiyao Li ◽  
Yue Yuan
Keyword(s):  
Diabetic Retinopathy ◽  
Ganglion Cell ◽  
Retinal Ganglion Cells ◽  
Retinal Ganglion Cell ◽  
Ganglion Cells ◽  
Control Group ◽  
Diabetic Patients ◽  
Retinal Ganglion ◽  
Glucose Levels ◽  
Dynamic Expression

Background. Diabetic retinopathy (DR) is a severe complication of diabetes mellitus. DR is considered as a neurovascular disease. Retinal ganglion cell (RGC) loss plays an important role in the vision function disorder of diabetic patients. Histone deacetylase3 (HDAC3) is closely related to injury repair and nerve regeneration. The correlation between HDAC3 and retinal ganglion cells in diabetic retinopathy is still unclear yet. Methods. To investigate the chronological sequence of the abnormalities of retinal ganglion cells in diabetic retinopathy, we choose 15 male db/db mice (aged 8 weeks, 12 weeks, 16 weeks, 18 weeks, and 25 weeks; each group had 3 mice) as diabetic groups and 3 male db/m mice (aged 8 weeks) as the control group. In this study, we examined the morphological and immunohistochemical changes of HDAC3, Caspase3, and LC3B in a sequential manner by characterizing the process of retinal ganglion cell variation. Results. Blood glucose levels and body weights of db/db mice were significantly higher than that of the control group, P<0.01. Compared with the control group, the number of retinal ganglion cells decreased with the duration of disease increasing. HDAC3 expression gradually increased in RGCs of db/db mice. Caspase3 expression gradually accelerated in RGCs of db/db mice. LC3B expression dynamically changed in RGCs of db/db mice. HDAC3 was positively correlated with Caspase3 expression (r=0.7424), P<0.01. HDAC3 was positively correlated with LC3B expression (r=0.7336), P<0.01. Discussion. We clarified the dynamic expression changes of HDAC3, Caspase3, and LC3B in retinal ganglion cells of db/db mice. Our results suggest the HDAC3 expression has a positive correlation with apoptosis and autophagy.

scholarly journals Spatial receptive field properties of rat retinal ganglion cells

2011 ◽  
Vol 28 (5) ◽  
pp. 403-417 ◽  
Author(s):  
WALTER F. HEINE ◽  
CHRISTOPHER L. PASSAGLIA
Keyword(s):  
Receptive Field ◽  
Ganglion Cell ◽  
Retinal Ganglion Cells ◽  
Ganglion Cells ◽  
Cell Types ◽  
Quantitative Information ◽  
Retinal Ganglion ◽  
X And Y Cells ◽  
Y Cells

AbstractThe rat is a popular animal model for vision research, yet there is little quantitative information about the physiological properties of the cells that provide its brain with visual input, the retinal ganglion cells. It is not clear whether rats even possess the full complement of ganglion cell types found in other mammals. Since such information is important for evaluating rodent models of visual disease and elucidating the function of homologous and heterologous cells in different animals, we recorded from rat ganglion cells in vivo and systematically measured their spatial receptive field (RF) properties using spot, annulus, and grating patterns. Most of the recorded cells bore likeness to cat X and Y cells, exhibiting brisk responses, center-surround RFs, and linear or nonlinear spatial summation. The others resembled various types of mammalian W cell, including local-edge-detector cells, suppressed-by-contrast cells, and an unusual type with an ON–OFF surround. They generally exhibited sluggish responses, larger RFs, and lower responsiveness. The peak responsivity of brisk-nonlinear (Y-type) cells was around twice that of brisk-linear (X-type) cells and several fold that of sluggish cells. The RF size of brisk-linear and brisk-nonlinear cells was indistinguishable, with average center and surround diameters of 5.6 ± 1.3 and 26.4 ± 11.3 deg, respectively. In contrast, the center diameter of recorded sluggish cells averaged 12.8 ± 7.9 deg. The homogeneous RF size of rat brisk cells is unlike that of cat X and Y cells, and its implication regarding the putative roles of these two ganglion cell types in visual signaling is discussed.

scholarly journals Ganglion cell complex scan in the early prediction of glaucoma

2012 ◽  
Vol 4 (2) ◽  
pp. 236-241
Author(s):  
S Ganekal
Keyword(s):  
Ganglion Cell ◽  
Cell Complex ◽  
P Value ◽  
Ganglion Cell Complex ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Fiber Layer ◽  
Color Code ◽  
Rnfl Thickness ◽  
Significant Difference

Objective: To compare the macular ganglion cell complex (GCC) with peripapillary retinal fiber layer (RNFL) thickness map in glaucoma suspects and patients. Subjects and methods: Forty participants (20 glaucoma suspects and 20 glaucoma patients) were enrolled. Macular GCC and RNFL thickness maps were performed in both eyes of each participant in the same visit. The sensitivity and specificity of a color code less than 5% (red or yellow) for glaucoma diagnosis were calculated. Standard Automated Perimetry was performed with the Octopus 3.1.1 Dynamic 24-2 program. Statistics: The statistical analysis was performed with the SPSS 10.1 (SPSS Inc. Chicago, IL, EUA). Results were expressed as mean ± standard deviation and a p value of 0.05 or less was considered significant. Results: Provide absolute numbers of these findings with their units of measurement. There was a statistically significant difference in average RNFL thickness (p=0.004), superior RNFL thickness (p=0.006), inferior RNFL thickness (p=0.0005) and average GCC (p=0.03) between the suspects and glaucoma patients. There was no difference in optic disc area (p=0.35) and vertical cup/disc ratio (p=0.234) in both groups. While 38% eyes had an abnormal GCC and 13% had an abnormal RNFL thickness in the glaucoma suspect group, 98% had an abnormal GCC and 90% had an abnormal RNFL thickness in the glaucoma group.Conclusion: The ability to diagnose glaucoma with macular GCC thickness is comparable to that with peripapillary RNFL thickness. Macular GCC thickness measurements may be a good alternative or a complementary measurement to RNFL thickness assessment in the clinical evaluation of glaucoma.DOI: http://dx.doi.org/10.3126/nepjoph.v4i2.6538 Nepal J Ophthalmol 2012; 4 (2): 236-241 

Specification of retinotectal connexions during development of the toad Xenopus laevis

Development ◽  
1980 ◽  
Vol 55 (1) ◽  
pp. 77-92
Author(s):  
S. C. Sharma ◽  
J. G. Hollyfield
Keyword(s):  
Xenopus Laevis ◽  
Ganglion Cell ◽  
Retinal Ganglion Cells ◽  
Optic Tectum ◽  
Ganglion Cells ◽  
The Other ◽  
Retinal Ganglion ◽  
Visual Projection ◽  
Series Of Experiments ◽  
The Right

The specification of central connexions of retinal ganglion cells was studied in Xenopus laevis. In one series of experiments, the right eye primordium was rotated 180° at embryonic stages 24–32. In the other series, the left eye was transplanted into the right orbit, and vice versa, with either 0° or 180° rotation. After metamorphosis the visual projections from the operated eye to the contralateral optic tectum were mapped electrophysiologically and compared with the normal retinotectal map. In all cases the visual projection map was rotated through the same angle as was indicated by the position of the choroidal fissure. The left eye exchanged into the right orbit retained its original axes and projected to the contralateral tectum. These results suggest that retinal ganglion cell connexions are specified before stage 24.

Decreased Mononuclear and Polymorphonuclear Chemotaxis in Human Newborns,Infants, and Young Children

PEDIATRICS ◽  
1977 ◽  
Vol 60 (4) ◽  
pp. 467-472
Author(s):  
Robert B. Klein ◽  
Thomas J. Fischer ◽  
Sherrie E. Gard ◽  
Michael Biberstein ◽  
Kenneth C. Rich ◽  
...  
Keyword(s):  
Young Infant ◽  
Skin Tests ◽  
Boyden Chamber ◽  
High Power Field ◽  
Inflammatory Reactions ◽  
Adult Control ◽  
Susceptibility To Infection ◽  
Significant Difference ◽  
Monocyte Chemotaxis ◽  
Hypersensitivity Skin

A new method, chemotaxis under agarose gel, was used to assess the directed motility of polymorphonuclear (PMN) and mononuclear (MN) phagocytes of 21 newborns, 71 infants and children, and 50 adults. This assay requires only small quantities of cells and is rapid, easy, reproducible, and provides a permanent record. The chemotactic substance was zymosan-activated human serum. Monocyte chemotaxis in the newborn was approximately 50% of adult control values, using the Boyden chamber (8.1 ± 2 cells per high-power field[HPF] [SE] in newborns compared to 17 ± 3 cells per HPF in adults), and 25% of adult control values, using the agarose method (50 ± 10 cells in newborns compared to 216 ± 15 cells in adults). Both are significant differences (P &lt; .005). MN chemotaxis remains extremely low through age 5, and remains moderately reduced until age 10. PMN chemotaxis in the newborn was 82 ± 21 cells compared to adult controls of 300± 42 cells, also a significant difference (P &lt; .05). PMN chemotaxis remains markedly depressed through age 2. Thereafter, PMN chemotaxis increases but remains significantly less than in adults until age 16. These chemotactic defects may play an important role in depressed delayed hypersensitivity skin tests, diminished inflammatory reactions, and increased susceptibility to infection present in the newborn and young infant.

Preoperative neuropsychological and behavioral evaluation of children with thalamic tumors

2014 ◽  
Vol 13 (5) ◽  
pp. 507-513 ◽  
Author(s):  
Daniela Chieffo ◽  
Gianpiero Tamburrini ◽  
Massimo Caldarelli ◽  
Concezio Di Rocco
Keyword(s):  
Cognitive Processing ◽  
Right Hemisphere ◽  
Histological Finding ◽  
Neurological Deficits ◽  
Low Grade ◽  
Neuropsychological Evaluation ◽  
Thalamic Tumor ◽  
Significant Difference ◽  
And Performance ◽  
Thalamic Tumors

Object Functional involvement of the thalamus in cognitive processing has been only anecdotally reported in the literature, and these cases are mostly related to thalamic hemorrhages; there is no available information on cognitive development in children with thalamic tumors. Methods All children admitted with a diagnosis of thalamic tumor at the authors' institution between January 2008 and January 2011 were considered for the present study. Exclusion criteria were age less than 18 months and the presence of severe neurological deficits, both of which prevented a reliable neuropsychological evaluation. A complete preoperative neuropsychological evaluation was performed. Results Twenty children were selected (mean age 102.4 months). Total IQ was in the normal range in all patients (mean 90.1, SD 13.87) with a significant difference between verbal IQ (mean 97.70, SD 17.77) and performance IQ (mean 84.82, SD 17.01). A significant correlation was found between global cognitive impairment and a histological finding of low-grade tumors (p < 0.001). Children with a mesial thalamic tumor had a higher working memory deficit and delayed recall disorders (p < 0.001). Naming disorders were related to the presence of a bilateral (p < 0.001) or mesial (p < 0.001) thalamic tumor, without a significant difference between left or right hemisphere involvement. A significant correlation was also found between the presence of neurolinguistic disorders and mesially located tumors (p < 0.001). Children with right-sided tumors more frequently had constructional apraxia and executive function disorders (p < 0.001). Conclusions The present study suggests that thalamic tumors in different locations might have specific neuropsychological profiles.

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