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application/pdf, 新潟医療福祉会誌. 2021, 21(2), p. 85-91., 33111甲第72号

Introduction Lymph node (LN) dissection is an important prognostic factor in gastric cancer. There is little information comparing the LN count depending on whether they are dissected in the operating room or in the pathology laboratory. Aim To establish if the LN count is greater in either of them. Material and methods From 2015 to 2017 all consecutive gastrectomies with D2 dissection were prospectively evaluated based in either of 2 protocols: One started in the operating room where the surgeon separated the LN levels and then submitted the entire adipose tissue with LNs (undissected) to pathology in separate containers; the pathologist dissected the LNs from the specimens. The second protocol consisted of sending the tissue/LNs to pathology as usual (adipose tissue and LN attached to the stomach). Results A total of 83 patients were analysed. The mean age was 58.4 years. The median number of LNs dissected in the protocol starting in the operating room was 56 (IQR: 37-74), whereas the pathology laboratory dissected a median of 39 LNs (IQR 26-53) (p = 0.005). The survival of cases dissected by both protocols were comparable (median survival of 48 and 43 months, p = 0.316). Conclusions The LN final count is significantly higher when LN levels are separated beforehand in the operating room compared to dissection only in pathology; however, this does not impact survival, perhaps because the number of dissected nodes in both groups is high and the quality of the surgery is good.

Autonomous mobile delivery robots are used as a way to improve efficiency in hospitals and reduce staff workload amongst a growing workforce shortage in healthcare. These two case studies investigated the usability, acceptability and functionality of two GoCart delivery robots at two different healthcare settings. The GoCart robots assisted with delivering blood and urine samples at a pathology laboratory and delivering meals at a residential care facility during a two-week period. A total of 50 participants (direct and secondary users, and managers) were interviewed about their experiences with the robot and answered questions about its design and functionality, safety and security, usability and their overall attitudes towards having the robot at their facility. Results showed that the participants from both sites thought the robots could be a good addition to their facilities to improve efficiency and reduce staff workload. The robot was received more positively at the residential care facility than the pathology laboratory. Improvements still need to be made to adapt the robots to each site before implementing the GoCarts long term, including changes to the size and screen. These case studies demonstrate that autonomous mobile delivery robots could be a useful addition to residential care facilities and pathology laboratory sites. Overall, this research adds to the current evidence showing potential uses for delivery robots and highlights important design considerations.

BACKGROUND: The safety and health of healthcare workers employed in pathology laboratories and exposed to formaldehyde (FA) is a matter of concern worldwide, as several health effects have been observed in workers resulting from exposure to FA, both short and long-term. OBJECTIVE: The study was aimed to describe the strategy implemented in a hospital pathology laboratory to minimize workers’ exposure to FA through interventions to working environment and workforce. METHODS: The NIOSH 2016 method for detecting gaseous FA was adopted to perform personal and area active sampling of FA. The samples were subsequently analyzed by High Performance Liquid Chromatography. The exposure to FA was measured before and after improvement interventions. RESULTS: The pre-intervention step showed FA levels exceeding the threshold limit values (TLV) established by ACGIH, both the time-weighted average (TLV-TWA) and short term exposure limit (TLV-STEL); after the improvement interventions, the median concentrations of personal and area FA sampling were respectively of 0.025 ppm (Range = 0.023–0.027) and 0.023 ppm (Range = 0.022–0.028) and significantly lower than pre-intervention step (p

This review provides a summary of the development and current use of digital pathology in routine practice, with specific relevance to breast disease. It aims to be of interest to all members of the breast multidisciplinary team. Digital pathology is being increasingly used across many institutions internationally. It is gaining increased acceptance amongst pathologists due to improvements in technology, and there are published guidelines to assist in the validation of its use in routine practice. The adoption of digital pathology brings advantages to the pathologist, to the pathology laboratory, and to the multidisciplinary team. It also offers the potential for the development and use of artificial intelligence tools in pathology reporting. The use of digital pathology increases the efficiency of the pathology reporting of specimens, with the potential for more efficiency savings and improved accuracy with the use of artificial intelligence.

We determined the prevalence of diseases and pathogens associated with mortality in beef cattle in the State of Rio Grande do Sul, Brazil, based on pathology laboratory submissions. Postmortem examinations were conducted on 1,277 beef cattle that died between 2008 and 2018. Information regarding age, time of the year, breed, and regional location were analyzed statistically. Most cattle were from the surrounding region of Porto Alegre, and 78.7% of the analyzed cases had diagnostic value. The diagnostic category with most cases was infectious and/or parasitic diseases (60%), followed by toxic and toxicoinfectious (25%). Most cases occurred in the fall. Major disease conditions identified included hemoprotozoal infection (18.2%), rabies (8.2%), and plant intoxications by Senecio spp. (8.5%) and Pteridium arachnoideum (4.6%). Hemoprotozoal infection occurred at a higher frequency in young cattle, mainly in animals up to 1 y old. Intoxication by Senecio spp. was more frequent in cattle 2–3 y old.

Objectives Given adverse health effects of climate change and contributions of the US health care sector to greenhouse gas (GHG) emissions, environmentally sustainable delivery of care is needed. We applied life cycle assessment to quantify GHGs associated with processing a gastrointestinal biopsy in order to identify emissions hotspots and guide mitigation strategies. Methods The biopsy process at a large academic pathology laboratory was grouped into steps. Each supply and reagent was catalogued and postuse treatment noted. Energy consumption was estimated for capital equipment. Two common scenarios were considered: 1 case with 1 specimen jar (scenario 1) and 1 case with 3 specimen jars (scenario 2). Results Scenario 1 generated 0.29 kg of carbon dioxide equivalents (kg CO2e), whereas scenario 2 resulted in 0.79 kg CO2e—equivalent to 0.7 and 2.0 miles driven, respectively. The largest proportion of GHGs (36%) in either scenario came from the tissue processor step. The second largest contributor (19%) was case accessioning, mostly attributable to production of single-use disposable jars. Conclusions Applied to more than 20 million biopsies performed in the US annually, emissions from biopsy processing is equivalent to yearly GHG emissions from 1,200 passenger cars. Mitigation strategies may include modification of surveillance guidelines to include the number of specimen jars.

With a growing number of clinically relevant biomarkers needed to guide the management of patients with non-small cell lung cancer (NSCLC), pathologists are keenly aware of the need to collect adequate tissue not only for a diagnosis, but also for ancillary studies to provide predictive and prognostic information. Small specimens collected by minimally invasive techniques such as fine needle aspiration and core needle biopsy often fall short in meeting adequacy requirements for lung cancer molecular biomarkers. The College of American Pathologists (CAP) recently published an evidence-based clinical practice guideline, “Collection and Handling of Thoracic Small Biopsy and Cytology Specimens for Ancillary Studies”, to help direct clinicians and pathology laboratory personnel to optimally collect and handle thoracic small specimens for ancillary testing. This review summarizes the published guideline statements and provides a brief overview of the recommendations and how they impact the practice of pathology.

Artificial intelligence (AI) is a complex technology with a steady flow of new applications, including in the pathology laboratory. Applications of AI in pathology are scarce but increasing; they are based on complex software-based machine learning with deep learning trained by pathologists. Their uses are based on tissue identification on histologic slides for classification into categories of normal, nonneoplastic and neoplastic conditions. Most AI applications are based on digital pathology. This commentary describes the role of AI in the pathological diagnosis of the gastrointestinal tract and provides insights into problems and future applications by answering four fundamental questions.

The last two decades have been crucial for the assessment of airborne formaldehyde (FA) exposure in healthcare environments due to changes in limits and reference values, definition of carcinogenicity, and new monitoring methods. The aim of this study was to analyse twenty years (1999-2019) of experience in automatic, continuous airborne FA monitoring in the Pathology Laboratory and operating rooms at the Careggi University Hospital, Florence, Italy. These 20 years saw gradual improvements in FA monitoring of exposed employees considered at maximum risk, including improvements in analytical methods of detection and sampling strategies, which came with changes in procedures and workflow operations. In 2019, after the adoption of safe practices, including a closed-circuit system using pre-loaded containers and a vacuum sealing, 94 % of the total measurements (FA concentrations) were lower than 16 μg/m3, and only 6 % ranged from 21 to 75 μg/m3. In the studied work units, the ratio between area and personal readings ranged from 0.9 to 1.0, both for long and short-term sampling. Personal sampling was simplified with a new workstation, which integrated different monitoring systems into an innovative ergonomic armchair equipped with personal sampling devices. Area monitoring was also improved with a real-time, continuous photoacoustic instrument. Over these 20 years, FA exposure significantly dropped, which coincided with optimised histology workflow and implementation of safety practices. For high-throughput screening and cost savings we propose an innovative ergonomic armchair station which allows remote continuous monitoring.Posljednja dva desetljeća bila su iznimno važna za procjenu izloženosti formaldehidu (FA) u zraku u zdravstvenim ustanovama zahvaljujući promjenama u preporučenim maksimalnim i referentnim vrijednostima, definiciji njegove kancerogenosti i novim metodama mjerenja/praćenja. Cilj je ovog istraživanja bio analizirati dvadeset godina (1999. – 2000.) iskustva u automatskom, kontinuiranom mjerenju razina FA-a u laboratoriju za patologiju i operacijskim dvoranama talijanske sveučilišne bolnice Careggi u Firenzi. Tijekom tih dvadeset godina bolnica je postupno poboljšavala metode praćenja razina FA-a i osoblja izloženoga najvećem riziku, analitičke metode detekcije i strategije uzorkovanja koje su bile popraćene promjenama u odgovarajućim postupcima i organizaciji rada. Nakon usvajanja novih postupaka zaštite na radu 2019., uključujući i zatvoreni sustav rukovanja spremnicima i sustav vakuumskoga zatvaranja, razine FA-a u 94 % izmjera bile su niže od 16 μg/m

This is System very complex because have to earn to do record keeping of transaction start from inspection of laboratory, inspection of doctor, lodging, and apotek of Poli Clinic for the drug of road street, and also facility additional facility like infus, operation and others. For the system of inspection of just doctor, this system of this system have to earn to give information about ill history of patient, allergic of drug which in distress, drug history which have been consumed, doctor which have handled and inspection priode which have been done. For the inspection of, laboratory have to can give information about inspection type, laboratotium have to can give information about done inspection type and its result, what its of him which in giving by laboratory doctor about result of that inspection. Pathology Anatomy is science area doing pandemic research. Which in patient distress pursuant to anatomy which have been lifted from patient body checked by in anatomy pathology laboratory to know disease type.

Successful molecular research with reliable results depends on achieving significant and uniform amounts of genomic DNA from the parasite as the first and most basic step. Therefore, selection of an appropriate method that minimizes damage to the DNA of the parasite, is very important. In this study, we are going to describe a method that can extract DNA from human isolated paraffin-embedded hydatid cysts with a high quality and quantity. Formalin fixed and Paraffin-embedded hydatid cyst samples isolated from human lung and archived in the pathology laboratory were used for this purpose. Several sections of the paraffin blocks were prepared with 5 micron thickness and DNA were extracted by three different methods including; modified boiling, commercial kit and the method described by Larissa A. Pikor et al. The obtained DNA were evaluated by Nanodrop in terms of the yield of DNA and possible contaminations. To compare the quality of DNA prepared, cox1 region was amplified using specific primers. It was found that the DNA extracted by modified boiling had the lowest rate of contamination and the best electrophoretic band on the gel, compared to other two performed methods. Considering the findings of this study, this simple and high throughput DNA extraction method with high yield and quality can be recommended for extraction of DNA from formalin fixed and paraffin-embedded hydatid cysts.

Background: Meningiomas consist of 15%–30% of the primary intracranial tumors, and high-grade meningiomas have a higher recurrence after surgery. The human epidermal growth factor receptor 2 (HER2) status is important in the medical management of patients with various human cancers. This study aimed to evaluate HER2 expression in meningiomas and the correlation between this expression and age, gender, and grade. Materials and Methods: In a descriptive-analytic study, immunohistochemistry (IHC) with HER2 marker was done on confirmed cases of meningioma which were referred to the pathology laboratory from 2008 to 2015. The primary antihuman antibody against c-erbB-2 oncoprotein (DAKO Diagnostics) was used for IHC. Results: Of 117 patients, 68.4% were males. The mean age of the patients was 53.6 years. Grades I, II, and III tumors were 90.6%, 8.5%, and 0.9% of cases, respectively. Totally, 76 (65%) of patients were HER2 positive, with only 7.7% of highly expressed HER2. There was no significant correlation between the mean age (P = 0.672), age group (P = 0.256), sex (P = 0.574), and grade (P = 0.093) and HER2 expression status. Conclusions: We did not find a statistically significant correlation between age, sex, or grade and HER2 status; however, further studies with a higher number of Grades II and III meningiomas and using the fluorescent in situ hybridization in equivocal cases may be of benefit in this way.

Non-alcoholic steatohepatitis (NASH) is a liver disease characterized by excessive lipid accumulation and disease progression is typically assessed through inspection of a Trichrome stain for Fibrosis staging. As the public health burden of NASH worsens due to evolving lifestyle habits, pathology laboratory resources will become increasingly strained due to rising demand for specialized stains. Virtual staining processes, computational methods which can synthesize the application of chemical staining reagents, can potentially provide resource savings by obviating the need to acquire specialized stains. Virtual staining technologies are assessed by comparing virtual and real tissue stains for their realism and ability to stage. However, these assessment methods are rife with statistical mistreatment of observed phenomena that are difficult to account for. Bridge category ratings represent a phenomenon where a pathologist may assign two adjacent stages simultaneously, which may bias and/or reduce the power of research findings. Such stage assignments were frequently reported in a large-scale assessment of Virtual Trichrome technologies yet were unaccounted for since no statistical adjustment procedures existed. In this work, we provide an updated assessment of Virtual Trichrome technologies using Bridge Category Models, which account for these bridge ratings. We report that two of four pathologists tended to assign lower Fibrosis stages to virtually stained tissue while the other two pathologists assigned similar stages. These research findings differ when bridge ratings are not accounted for. While promising, these results indicate further room for algorithmic finetuning of Virtual Trichrome technologies.

Background: Scanners are the main tool in digital pathology. The technical abilities of scanners determine the workflow logic in the pathology laboratory. Its performance can be restricted by the divergence between the scanning time presented by the manufacturer and the actual scanning time. This could lead to critical deviations from the established business processes in a 24/7 laboratory. Aim: Our investigation is focused in exploring the performance of three main models of high-performance scanners available on the Russian market: 3DHistech, Hamamatsu и Leica. Objectives: We compared the performance of the scanners on the samples of a given size with the manufacturer's stated specifications and evaluated the speed of the scanners on the reference and routine laboratory material. Subjects and Methods: We examined 3DHistech Pannoramic 1000, Hamamatsu NanoZoomer s360 and Leica AT2 with default settings and automatic mode. Two sets of glasses were used (glass slide): Group 1 included 120 slides with 15 mm × 15 mm slices, Group 2 included 120 workflow slides. Results: The average slide scan times in Groups 1 and 2 for the C13220 (156 ± 1.25 s and 117 ± 4.17 s) and Pannoramic 1000 (210 ± 1.64 s and 183 ± 3.78 s) differ statistically significantly (P < 0.0001). Total scanning time including rack reloading was shorter for the workflow slide set group for the modern C13220 and Pannoramic 1000 scanner models. Conclusions: The scanner specifications provided by manufacturers are not sufficient to evaluate the performance. The guidelines and regulations concerning scanner selection should be consented by the digital pathology community. We suggest discussing criteria for evaluating scanner performance.

Digital pathology for the routine assessment of cases for primary diagnosis has been implemented by few laboratories worldwide. The Gravina Hospital in Caltagirone (Sicily, Italy), which collects cases from 7 different hospitals distributed in the Catania area, converted the entire workflow to digital starting from 2019. Before the transition, the Caltagirone pathology laboratory was characterized by a non-tracked workflow, based on paper requests, hand-written blocks and slides, as well as manual assembling and delivering of the cases and glass slides to the pathologists. Moreover, the arrangement of the spaces and offices in the department was illogical and under-productive for the linearity of the workflow. For these reasons, an adequate 2D barcode system for tracking purposes, the redistribution of the spaces inside the laboratory and the implementation of the whole-slide imaging (WSI) technology based on a laboratory information system (LIS)-centric approach were adopted as a needed prerequisite to switch to a digital workflow. The adoption of a dedicated connection for transfer of clinical and administrative data between different software and interfaces using an internationally recognised standard (Health Level 7, HL7) in the pathology department further facilitated the transition, helping in the integration of the LIS with WSI scanners. As per previous reports, the components and devices chosen for the pathologists’ workstations did not significantly impact on the WSI-based reporting phase in primary histological diagnosis. An analysis of all the steps of this transition has been made retrospectively to provide a useful “handy” guide to lead the digital transition of “analog”, non-tracked pathology laboratories following the experience of the Caltagirone pathology department. Following the step-by-step instructions, the implementation of a paperless routine with more standardized and safe processes, the possibility to manage the priority of the cases and to implement artificial intelligence (AI) tools are no more an utopia for every “analog” pathology department.

INTRODUCTION Eccrine and apocrine hidrocystomas are uncommon, benign, cystic proliferations of the sweat glands usually located on the head and neck area. OBJECTIVES To describe the key clinical and histopathological characteristics of a large series of hidrocystomas in Greece to improve diagnostic accuracy, and to perform a historical review of the medical term hidrocystoma. METHODS A case series of 22 hidrocystomas from 20 consecutive patients treated with surgery at University Hospital of Heraklion in Crete, Greece, from January 1, 1998 to January 1, 2020 was performed along with a comprehensive historical literature review of the term hidrocystoma and its corresponding term hydatis from ancient Greek literature to the present. Data were obtained from medical records. All patients had a histopathologically confirmed diagnosis of hidrocystoma. Formalin-fixed paraffin-embedded (FFPE) sections of 22 tumors of the 20 consecutive patients were retrieved from the pathology laboratory archive and stained for SMA, p63, and GCDFP-15 with immunochemistry and periodic acid-Schiff (PAS) histochemical stain. RESULTS Overall, 22 hidrocystomas (11 apocrine and 11 eccrine hidrocystomas) surgically excised from 20 patients were included in this study. Of the 20 patients, 10 (50%) were male and 10 (50%) were female, with a mean age of 56 ± 15 years. Hidrocystomas commonly occurred on the eyelids (73%), inner canthus (9%), eyebrow (4.5%), neck (4.5%), nose (4.5%), and ear (4.5%). All apocrine hidrocystomas stained positive for SMA, GCDFP-15, CAM 5.2, PAS, and PAS-D. No recurrence was observed. CONCLUSIONS Here we have presented the clinicopathological characteristics of the largest case series of hidrocystomas in Europe and the Mediterranean region. Only apocrine hidrocystomas stained positive for SMA, GCDFP-15, CAM 5.2, PAS, and PAS-D.

Akılcı laboratuvar kullanımı, doğru teşhisin konulması, gereksiz tetkiklerin önlenmesi ve maliyetlerin düşürülmesi amacıyla laboratuvar hizmetlerinin akılcı olarak kullanılmasıdır. Bu çalışmanın amacı, patoloji laboratuvar rutininde, gelen tetkik istemlerinde rapor sonuç sürelerinin ve örnek istemlerinin ön tanıya uyumu açısından değerlendirilmesi ve patoloji laboratuvarlarının akılcı kullanımının sağlanmasına yönelik çözüm önerileri sunmaktır. Çalışma, 1 0cak 2017 ve 31 Aralık 2018 tarihleri arasında İstanbul’da özel bir patoloji laboratuvarına gelen 814 tiroid İİAB (İnce İğne Aspirasyon Biyopsisi) isteminin retrospektif olarak değerlendirildiği kesitsel tanımlayıcı bir çalışmadır. Patoloji sonuçlarına göre olguların %35,8’i malign (277 olgu) ve %64,2’si (497 olgu) benign olduğu belirlenmiştir. Testin duyarlılığı %78,70, özgüllüğü %75,25, pozitif kestirim değeri %63,93, negatif kestirim değeri %76,37 ve doğruluğu %76,49 olarak hesaplanmıştır. Olguların patoloji sonuçları ile ön tanı sonuçları arasında istatistiksel olarak anlamlı uyum saptanmamıştır. Başka bir ifadeyle sürecin laboratuvar tarafında, analitik ve post-analitik evrelerinde, patoloji sonuçlarını etkileyecek bir uyumsuzluk olmadığı, bununla birlikte patoloji laboratuvarlarının akılcı kullanıldığı belirlenmiştir. Patoloji laboratuvarlarının akılcı kullanımı, iş akış süreçlerindeki tüm aşamaların iyi yönetilmesine ve sorunlar karşısında çözüm yollarının iyi bilinmesine bağlıdır. Bununla birlikte, hastanın klinik sürecinden sorumlu hekimin, istem sırasında hastayla ilgili istenen bilgileri eksiksiz olarak patoloji formlarına doldurması gerektiği ve sitopatolog-klinisyen iletişiminde belli algoritmaların kullanılması gerektiği düşünülmektedir., Rational laboratory use means the rational use of laboratory services to ensure accurate diagnosis, avoid unnecessary examinations and reduce costs. The aim of the study is to evaluate durations of test results in incoming test requests and sample requests in the pathology laboratory routine in terms of their consistency with the preliminary diagnosis and to offer solutions regarding the rational use of the pathology laboratories.The study is a cross-sectional descriptive study in which 814 thyroid FNAB (Fine Needle Aspiration Biopsy) requests received by a private pathology laboratory in Istanbul between 1 January 2017 and 31 December 2018 are evaluated retrospectively. According to pathology results, 35.8% of the cases are malignant (277 cases) and 64.2% (497 cases) are benign. The sensitivity and specificity of the test are calculated as 78.70%, 75.25%, respectively. Positive predictive value is calculated as 63.93%, negative predictive value as 76.37% and accuracy as 76.49%. No statistically significant consistency between pathology results of the cases and preliminary diagnosis results is identified. In other words, it is identified that there is no inconsistency in the analytical and post-analytical stages on laboratory side of the process that would affect the results of the pathology, but pathology laboratories are used rationally. The rational use of pathology laboratories depends on the well-managed management of all stages of workflow processes and the well-known solutions to problems. However, it is considered that the physician in charge of the clinical process of the patient should completely fill the requested information about the patient in the pathology forms during the request and that certain algorithms in cytopathologist-clinician communication should be used.

The introduction of fast and robust whole slide scanners has facilitated the implementation of 'digital pathology' with various uses, the final challenge being full digital diagnostics. In this article, we describe the implementation process of a fully digital workflow for primary diagnostics in 2015 at the University Medical Centre in Utrecht, The Netherlands, as one of the first laboratories going fully digital with a future-proof complete digital archive. Furthermore, we evaluated the experience of the first 2 years of working with the system by pathologists and residents. The system was successfully implemented in 6 months, including a European tender procedure. Most pathologists and residents had high confidence in working fully digitally, the expertise areas lagging behind being paediatrics, haematopathology, and neuropathology. Reported limitations concerned recognition of microorganisms and mitoses. Neither the age of respondents nor the number of years of pathology experience was correlated with the confidence level regarding digital diagnostics. The ergonomics of digital diagnostics were better than those of traditional microscopy. In this article, we describe our experiences in implementing our fully digital primary diagnostics workflow, describing in depth the implementation steps undertaken, the interlocking components that are required for a fully functional digital pathology system (laboratory management, hospital information systems, data storage, and whole slide scanners), and the changes required in workflow and slide production.

Introduction: Various QC and QA including the pre analytical, analytical and post analytical variables were taken into consideration for the internal quality indicators in department of cytopathology of a tertiary care hospital. Aims: To evaluate the importance of quality control (QC) and quality assurance (QA) parameters in the routine work of cytology pathology laboratory in a tertiary care hospital. Materials and Methods: This is a retrospective and quantitative study in a tertiary care hospital for a period of one year for the analysis of the internal quality indicators for Cytopathology laboratory for gynaecological and non- gynaecological cases with selected variables. Results: Data was analyzed using various mentioned formulas and excel sheet along with review of literature in the cytopathology laboratory. Conclusion: It is very important to set the standards and review the procedures of QA and QC as per the requirement for the laboratory to ensure the quality for the cytopathology laboratory. Keyword: Cytopathology, Quality assurance, Quality indicators.

Drinking water that is consumed should be clean and healthy. To avoid illness and disruption of bodily functions such as kidney function, liver, brain, teeth, and even mental disorders. Some people in Besole village still use dug well water as a source of drinking water. The geographical state of the town of Besole, Tulungagung district, is a mountainous area of marble containing lime which allows for mineral content, main calcium in the drinking water of residents. This study aims to determine the identification of urine sediments in residents who consume well water in Besole Village, Besuki District, Tulungagung Regency in 2018. This type of research is descriptive non-analytic, by determining the percentage of urine sediments that consume well water through an examination at the Pathology Laboratory STIKes Hutama Abdi Husada Tulungagung. The number of samples is 30 people, with simple random sampling technique. Based on the research conducted found the results of abnormal urine sediment percentage, ie, 6.7% leukocytes, 3.3% erythrocytes, 16.7% epithelium, 30% calcium oxalate and 3.3% bacteria. Water containing lime should be boiled, precipitated and filtered before consumption.

Advancements in computer vision and artificial intelligence (AI) carry the potential to make significant contributions to health care, particularly in diagnostic specialties such as radiology and pathology. The impact of these technologies on physician stakeholders is the subject of significant speculation. There is however a dearth of information regarding the opinions, enthusiasm, and concerns of the pathology community at large. Here, we report results from a survey of 487 pathologist-respondents practicing in 54 countries, conducted to examine perspectives on AI implementation in clinical practice. Despite limitations, including difficulty with quantifying response bias and verifying identity of respondents to this anonymous and voluntary survey, several interesting findings were uncovered. Overall, respondents carried generally positive attitudes towards AI, with nearly 75% reporting interest or excitement in AI as a diagnostic tool to facilitate improvements in workflow efficiency and quality assurance in pathology. Importantly, even within the more optimistic cohort, a significant number of respondents endorsed concerns about AI, including the potential for job displacement and replacement. Overall, around 80% of respondents predicted the introduction of AI technology in the pathology laboratory within the coming decade. Attempts to identify statistically significant demographic characteristics (e.g., age, sex, type/place of practice) predictive of attitudes towards AI using Kolmogorov–Smirnov (KS) testing revealed several associations. Important themes which were commented on by respondents included the need for increasing efforts towards physician training and resolving medical-legal implications prior to the generalized implementation of AI in pathology.

Objectives: To investigate pathology awareness in patients applying to a pathology laboratory. Method: This cross-sectional study included 150 patients and patients’ relatives. A questionnaire, prepared by the researchers according to the literature, was administered at the Pathology Laboratory, Necmettin Erbakan University, Konya, Turkey on May 2018. Results: Of the participants, 79 (52.7%) were female and 71 (47.3%) were male. The mean age was 39.56±14.16 years old. Ninety-eight (65.3%) of them thought that patients do not have right to choose their pathologist. Of the participants, 24 (16%) did not know that the medical school had to be completed in order to become a pathologist and 73 (48.7%) of them did not know that 4 years postgraduate training was required. Fifty-nine (39.3%) of the participants did not know the pathologists were a medical doctor. While 89 participants (59.4%) had no idea what “frozen section” means, 66 people (44%) did not know that the pathologist uses microscope and 64 (42.7%) of them thought that all diseases could be diagnosed 100% by pathological examination. Forty-six (30.7%) of the participants thought that all specimens are not needed to be examined. Conclusion: The knowledge and awareness of the participants about the pathology discipline came out to be inadequate. Saudi Med J 2019; Vol. 40 (11): 1150-1157 doi: 10.15537/smj.2019.11.24631 How to cite this article: Findik S, Cihan FG. Pathology awareness in patients and patient's relatives applying to a pathology laboratory. Saudi Med J . 2019 Nov;40(11):1150-1157. doi: 10.15537/smj.2019.11.24631.

Objective: To analyze placentas and newborns of patients with high blood pressure (HBP). Materials and Methods: Case-control study conducted from 1 January to 31 October 2017 in University Hospital of Brazzaville (birth room, anatomy and pathology laboratory) and Faculty of Health Sciences of Brazzaville (laboratory of anatomy and organogenesis). It concerned 40 placentas freshly delivered and newborns of patients with HBP compared to 40 placentas and newborns of patients without HBP. The variables analyzed were related to mothers, placentas and the newborns. Results: The patients were similar in age (26.9 ± 1.2 years VS 26.5 ± 1.1 years, p = 0.17) and parity (1.26 ± 0.7 VS 1.61 ± 0.3, p = 0.26). The type of hypertension in the cases was dominated by pre-eclampsia (68%). A significant reduction in placental measurements was more observed in case of HBP: weight (431 ± 37 g VS 503 ± 26 g, p < 0.05), diameter (17.40 ± 1.2 cm VS 19.25 ± 1 cm, p < 0.05), and area (239.82 ± 15.7 cm2 VS 292.1 ± 22.2 cm2, p < 0.05). The macroscopic lesions were calcifications (75% VS 43.8%, p < 0.05) and the retro placental hematoma cup (18.8%) among the cases. Microscopic lesions were more observed in hypertensives: infarction (68.8% VS 18.8%, p = 0.004) and endarteritis (93.8% VS 12.5%, p < 0.05). The characteristics of newborns were significantly different between the two populations: prematurity (34.3% VS 9.3%, p < 0.05), mean weight (2577 ± 102 g VS 3060 ± 109 g, p < 0.05), the average APGAR score (6.7 ± 1.6 VS 7.8 ± 0.9, p < 0.05), and the neonatal transfer (18.7% VS 3.1%; p < 0.05). Conclusion: High blood pressure affects the placenta and the newborn. The placenta deserves to be systematically examined.

Medical wastes account for around 1–2% of urban wastes, which are very important in terms of health. In this regard, they are very important and can jeopardize human health. The aim of this study was to determine the qualitative and quantitative characteristics of the wastes in medical clinics in the south of Iran and in order to present suitable management solutions. First, 14 medical clinics were chosen and 24 samples were taken from each clinic (two samples per month) with a total 336 samples. Considering the special properties and the risk potential, the wastes generated in medical clinics were categorized as infections and special waste groups. In terms of properties, they were classified as pseudo-household, infectious, sharp, pharmaceutical, and paper wastes. Once the samples were collected, they were weighed and the results were analyzed by SPSS. The results indicated that in terms of quantity, the waste generated in the first and second groups was 8550.377 and 8053.71 kg/year, respectively. Furthermore, most of the wastes generated in the first and second groups accounted for pseudo-household (80.7%) and infectious (72.77%) wastes, respectively. Due to presence of the specialty of pathology laboratory in the second group, the quantity of infectious waste has increased. Therefore, for proper management of medical wastes in the studied clinics, the clinics of the studied study should implement and apply the rules of waste management properly. Furthermore, training physicians and employees in clinics about reducing, recycling, and collecting wastes in a separate form in clinics should be done in priority. • In this study, the classification of Basel convention and World Health Organization was considered as the basis of waste classification. • The results indicated that in the first group of the studied clinics, the order of the waste quantity was as follows: pseudo-household > infectious > sharp > paper. • Due to large amounts of hazardous infectious wastes in the second group of the studied medical clinics, it necessitates proper management of collection and disposal of these wastes. • Results can be used to improve the management of waste generation practices in medical clinics with high risk and special wastes potential. Protocol name: Quantitative and qualitative analysis of medical wastes, Keywords: Waste management, Medical clinics, South of Iran

An invitro experiment was conducted to study the effect of different culture media on mycelial growth of Sclerotium rolfsii Sacc. in Plant pathology Laboratory of Agriculture and Forestry University, Nepal. The pathogenic isolate of S. rolfsii was isolated from symptomatic tomato and maintained in PDA. Seven different culture media viz. Potato Dextrose Agar (PDA), Chickpea Dextrose Agar (ChDA), Bean Dextrose Agar (BDA), Carrot Dextrose Agar (CDA), Papaya Dextrose Agar (PpDA), Czapek Dox Agar (CzDA) and Sabouraud’s Dextrose Agar (SDA) were prepared and 5-mm diameter mycelial plugs from the margins of 3-days old S. rolfsiiculture was transfer in the middle of each media plate. The radial mycelial growth was measured at 2 days interval for 14 days. Chickpea Dextrose Agar (ChDA) had significantly higher mycelia growth, which was superior than Potato dextrose agar (PDA). Papaya fruit, carrot root, chickpea grain and bean grain can be the common cheap source of carbon in industrial development of culture media.

Circulating tumor cells (CTCs) have long been assumed to be the substrate of cancer metastasis. However, only in recent years have we begun to leverage the potential of CTCs found in minimally invasive peripheral blood specimens to improve care for cancer patients. Currently, CTC enumeration is an accepted prognostic indicator for breast, prostate, and colorectal cancer; however, CTC enumeration remains largely a research tool. More recently, the focus has shifted to CTC characterization and isolation which holds great promise for predictive testing. This review summarizes the relevant clinical, biological, and technical background necessary for pathologists and cytopathologists to appreciate the potential of CTC techniques. A summary of relevant systematic reviews of CTCs for specific cancers is then presented, as well as potential applications to precision medicine. Finally, we suggest future applications of CTC technologies that can be easily incorporated in the pathology laboratory, with the recommendation that pathologists and particularly cytopathologists apply these technologies to small specimens in the era of "doing more with less."

An experiment was conducted to examine probable impact of location and handling on the fungi commonly associated with rotting watermelon (Citrullus lanatus). The rotting watermelon samples were obtained from two vendors each from five different markets (Bodija, Sango, Mokola, Eleyele, Agbowo and Ojoo) in Ibadan, Oyo state. They were placed in different sterile sample bags which were labeled appropriately before bringing them to the Pathology Laboratory, Department of Botany, University of Ibadan. Isolation of fungi from the rotting samples was carried out using pour plate method on acidified Potato Dextrose Agar (APDA). Pathogenicity test was also conducted for the isolated fungi. All experiments were done in duplicates and all plates were incubated at 25°C ± 2°C for 7 days. Pure cultures were obtained and identified and each isolated fungus was recorded as 1 which means present and 0 which means absent. The data obtained were analyzed using SAS version 9.3 at p ≤ 0.05. A total of three fungi were isolated viz., Aspergillus flavus, Saccharomyces cerevisae and Aspergillus niger. Occurrence of A. niger and A. flavus in samples obtained from Bodija, Mokola, Sango and Ojoo markets were significantly (P ≤ 0.05) higher than those from the other two markets. Occurrence of S. cerevisae in samples obtained from Bodija and Mokola markets were significantly (P ≤ 0.05) higher than those from the other three markets. Location had significant impact on the occurrence of isolated fungi in the rotting watermelons. However, handling by vendors had no significant impact on occurrence of the isolated fungi. Vendors and consumers are advised to be mindful of place of purchase and to also maintain good general hygiene before consumption.

Background:: Epithelial tumors of the salivary glands, including benign tumors and aggressive malignancies with different prognoses, are uncommon. Aim: To describe the frequency and distribution of salivary gland tumors according to age, gender and anatomical location. Material and Methods: Review of pathological reports of salivary gland tumors of a Pathology laboratory at a clinical hospital from 2006 to 2016. Results: Five hundred ninety salivary gland biopsies were reviewed. Of these, 286 (49%) were primary epithelial tumors of the salivary glands. Two hundred thirty (80%) were benign and 56 (20%) were malignant tumors. Regarding location, 274 (96%) were in the major salivary glands, and 12 (4%) in the minor salivary glands. The most common histological types were pleomorphic adenoma for benign tumors in 172 cases, followed by papillary cystadenoma lymphomatosum in 33 cases. Mucoepidermoid carcinoma was the most common malignant tumor in 14 cases. Conclusions: These results are similar to reports from abroad, however more studies are necessary to be able to establish a more representative and updated analysis.

Context.— The Surveillance, Epidemiology, and End Results (SEER) cancer registry program is currently evaluating the use of archival, diagnostic, formalin-fixed, paraffin-embedded (FFPE) tissue obtained through SEER cancer registries, functioning as honest brokers for deidentified tissue and associated data. To determine the feasibility of this potential program, laboratory policies for sharing tissue for research needed to be assessed. Objective.— To understand the willingness of pathology laboratories to share archival diagnostic tissue for cancer research and related policies. Design.— Seven SEER registries administered a 27-item questionnaire to pathology laboratories within their respective registry catchment areas. Only laboratories that processed diagnostic FFPE specimens and completed the questionnaire were included in the analysis. Results.— Of the 153 responding laboratories, 127 (83%) responded that they process FFPE specimens. Most (n = 88; 69%) were willing to share tissue specimens for research, which was not associated with the number of blocks processed per year by the laboratories. Most laboratories retained the specimens for at least 10 years. Institutional regulatory policies on sharing deidentified tissue varied considerably, ranging from requiring a full Institutional Review Board review to considering such use exempt from Institutional Review Board review, and 43% (55 of 127) of the laboratories did not know their terms for sharing tissue for research. Conclusions.— This project indicated a general willingness of pathology laboratories to participate in research by sharing FFPE tissue. Given the variability of research policies across laboratories, it is critical for each SEER registry to work with laboratories in their catchment area to understand such policies and state legislation regulating tissue retention and guardianship.

This study aims to explain the history of Medan Pathology Laboratory in the area of health in East Sumatra. The main discussion expressed in this study is the purpose of the establishment and the role of the Medan Pathology Laboratory in the health problems of the population and plantation workers in East Sumatra. The Medan Pathology Laboratory was founded on the initiative of a plantation owners in 1906. Many doctors and experts worked in the laboratory and carried out research on tropical diseases. The research included bacteriology, serology, chemistry, pathological anatomy, and vaccine development. In its development, this institution was able to solve problems related to epidemics in plantation areas such as cholera, dysentery, and beriberi. The experts and doctors at this institution found a relationship between the causes of the disease and the lifestyle of the plantation community and environmental conditions in East Sumatra. The sources used including documents and archives consisting of documents and annual laboratory reports, reports and notes from doctors who worked at the East Sumatra plantation hospital. This study used historical methods consisting of heuristics, verification, interpretation, and historiography.

*Eroğlu, Fadime ( Aksaray, Yazar ), It is known that miRNAs are effective in immune response in the diagnosis and treatment of many infectious diseases. However, the miRNAs profile is unknown in Alveolar and Cystic Echinococcosis which can be fatal if left untreated. The miRNAs profile that activates the T and B cells forming the immune system in Alveolar and Cystic Echinococcosis patients was investigated in this study. A total of 50 liver tissue samples were obtained from Alveolar and Cystic Echinococcosis patients in Kilis State Hospital Pathology Laboratory in southeast of Turkey. The circulating cell-free miRNAs were evaluated by a quantitative real-time polymerase chain reaction, statistically calculated within ΔΔCt values and fold changes were evaluated by Welch T test, in which P

Background Formaldehyde and xylene are two hazardous chemicals widely used in pathology laboratories all over the world. The aim of this work was to survey a large volume pathology lab, measuring exposure of workers and residents to formaldehyde and xylene, and verify the efficacy of the undertaken preventive actions and the accomplishment with occupational limit values. Methods Environmental, personal, and biological monitoring of exposure to formaldehyde and xylene in different lab rooms and in 29 lab attendants was repeated yearly from 2017 to 2020. Continuous monitoring of airborne formaldehyde was performed to evaluate the pattern of airborne concentrations while specific tasks were performed. Several risk management and mitigation measures, including setting a new grossing room, reducing the number of samples to be soaked in formaldehyde, and improving the lab practices and equipment, such as the use of chemical hoods, were undertaken after each monitoring campaign, based on the results obtained from the exposure monitoring. Results Significant exposures to formaldehyde in pathologists and residents, especially during the grossing of samples, were observed in the first 2 years, with exposure exceeding the occupational exposure limit value; the following surveys showed that the risk management and mitigation measures were effective in reducing airborne concentrations and personal exposure. Xylene, assessed with both environmental and biological monitoring, was always well below the occupational exposure limit value and biological limit values, respectively. Conclusion Critical exposure to air formaldehyde in attendants of a pathology laboratory could be reduced with the re-organization of lab spaces, new and improved work procedures, and awareness and training initiatives.

A recent article (1) and Commentary (2) in Diabetes Care have raised issues with respect to the method of handling blood samples for oral glucose tolerance tests (OGTT) and the prevalence of gestational diabetes mellitus (GDM). Many Australian sites continue to rely solely on collection tubes containing fluoride for stabilization of glucose. In outback Australia, this is a very real issue. We previously estimated a two- to threefold increase in GDM prevalence in rural and remote Australia had the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study preanalytical protocol been used (from 10.8 to 28.5% [95% CI 20.8–29.5%]) (3). The impact of glycolysis is likely exacerbated in remote compared with urban settings due to greater distances to the laboratory—up to 650 km (400 miles) in our study (3). Centrifugation within 10 min of sample collection can achieve glucose profiles similar to those with the HAPO study preanalytical protocol (3). Potter et al. (1) found a 1.8-fold increase in GDM prevalence after pathology laboratory collection centers implemented immediate centrifugation in a predominantly urban Australian setting. However, many rural and remote sites in …

Our study describes the epidemiology and aetiology of cervical lymphadenopathy in children diagnosed between 2003 and 2017 at the pathology laboratory of Lomé, Togo. A total of 221 cases were collected. The average age of diagnosis of the study population was 9.8 ± 0.3 years and consisted of 118 (53.4%) boys. HIV was confirmed by indirect ELISA test in 69 (31.2%) cases. The cohort consisted of infections (n = 128, 57.9%), tumours (n = 85, 38.5%) and others (n = 8, 1.6%). The main infectious aetiology was tuberculosis (n = 84). Tumour aetiology consisted of 79 primary malignancies and three metastatic cases. Primary tumours consisted predominantly of lymphoma (n = 74), with Burkitt's lymphoma (n = 44) being the most common. Tuberculosis on a background of HIV infection remains the dominant cause of cervical lymphadenopathy in the tropical region of Togo.

INTRODUCTION: This study investigated the effects of hyperbaric oxygen treatment (HBOT) on the accuracy and reliability of point-of-care fingertip capillary blood glucose values in euglycaemic non-diabetic participants compared against venous serum blood glucose samples processed in an accredited pathology laboratory. METHODS: Ten non-diabetic hyperbaric staff members (age 35–55 years) underwent a standard 243 kPa HBOT exposure for 95 minutes. Blood glucose levels were measured via (i) finger-prick capillary test using the FreeStyle Optium™ Neo H glucometer and (ii) venous serum test using the Cobas 6000 laboratory analyser. Samples were taken at (T1) 0 minutes (pre-HBOT), (T2) 25 minutes, and (T3) 55 minutes into HBOT. RESULTS: All participants were euglycaemic at T1 (BGL 3.8–5.4 mmol·L(-1)). The highest venous serum value was 5.90 mmol·L(-1) at T3 and the highest capillary value was 6.30 mmol·L(-1) at T1. Post hoc tests showed a statistically significant difference between the mean capillary result pre-dive (T1) and readings at T2 (P = 0.001) and T3 (P < 0.001) while differences between T2 and T3 capillary results were not statistically significant, illustrating the effect of HBOT on capillary beds. Differences in venous values across the time points were not significant. CONCLUSIONS: Venous serum glucose samples processed in an accredited laboratory may be more consistently accurate, but capillary point-of-care testing avoids delays in sample processing and provides glucose data that are of clinical relevance. The FreeStyle Optium™ Neo H glucometer is safe to use and provides a reliable measurement of blood glucose in the HBOT environment.

Summary Up to now, Italy is one of the European centers with the most active Coronavirus cases with 233,836 positive cases and 33,601 total deaths as of June 3rd. During this pandemic and dramatic emergency, Italian hospitals had also to face neoplastic pathologies, that still afflict the Italian population, requiring urgent surgical and oncological treatment. In our Cancer Center Hospital, the high volume of surgical procedures have demanded an equally high volume of intraoperative pathological examinations, but also posed an additional major challenge for the safety of the staff involved. The current commentary reports our experience in the past two months (since March 9th) for a total of 1271 frozen exams from 893 suspect COVID-19 patients (31 confirmed).

Aim: Report the epidemiologic and histologic characteristics of CNS lesions in the Lebanese population. Methods: We conducted a retrospective study evaluating 2025 CNS lesions diagnosed between 1998 and 2017 in the pathology laboratory of a Lebanese tertiary center. Results: 52.2% of patients were men with a median age of 50 years. The most frequent symptoms were epilepsy (22.5%), headache (20.6%) and motor impairment (19.9%). 90.7% of tumors were primary. Lung (35.6%) and breast (16.5%) were the most frequent primaries of metastases. 46.2% of primary CNS tumors were glial, predominantly astrocytic (56.4%), and (42.5%) were nonglial, predominantly meningeal tumors (58%). Conclusion: Compared with Western literature, the Lebanese population is characterized by a younger age of onset of brain tumors, a lower rate of meningiomas and a higher rate of gliomas.

There is high demand to develop computer-assisted diagnostic tools to evaluate prostate core needle biopsies (CNBs), but little clinical validation and a lack of clinical deployment of such tools. We report here on a blinded clinical validation study and deployment of an artificial intelligence (AI)-based algorithm in a pathology laboratory for routine clinical use to aid prostate diagnosis.An AI-based algorithm was developed using haematoxylin and eosin (HE)-stained slides of prostate CNBs digitised with a Philips scanner, which were divided into training (1 357 480 image patches from 549 HE-stained slides) and internal test (2501 HE-stained slides) datasets. The algorithm provided slide-level scores for probability of cancer, Gleason score 7-10 (vs Gleason score 6 or atypical small acinar proliferation [ASAP]), Gleason pattern 5, and perineural invasion and calculation of cancer percentage present in CNB material. The algorithm was subsequently validated on an external dataset of 100 consecutive cases (1627 HE-stained slides) digitised on an Aperio AT2 scanner. In addition, the AI tool was implemented in a pathology laboratory within routine clinical workflow as a second read system to review all prostate CNBs. Algorithm performance was assessed with area under the receiver operating characteristic curve (AUC), specificity, and sensitivity, as well as Pearson's correlation coefficient (Pearson's r) for cancer percentage.The algorithm achieved an AUC of 0·997 (95% CI 0·995 to 0·998) for cancer detection in the internal test set and 0·991 (0·979 to 1·00) in the external validation set. The AUC for distinguishing between a low-grade (Gleason score 6 or ASAP) and high-grade (Gleason score 7-10) cancer diagnosis was 0·941 (0·905 to 0·977) and the AUC for detecting Gleason pattern 5 was 0·971 (0·943 to 0·998) in the external validation set. Cancer percentage calculated by pathologists and the algorithm showed good agreement (r=0·882, 95% CI 0·834 to 0·915; p0·0001) with a mean bias of -4·14% (-6·36 to -1·91). The algorithm achieved an AUC of 0·957 (0·930 to 0·985) for perineural invasion. In routine practice, the algorithm was used to assess 11 429 HE-stained slides pertaining to 941 cases leading to 90 Gleason score 7-10 alerts and 560 cancer alerts. 51 (9%) cancer alerts led to additional cuts or stains being ordered, two (4%) of which led to a third opinion request. We report on the first case of missed cancer that was detected by the algorithm.This study reports the successful development, external clinical validation, and deployment in clinical practice of an AI-based algorithm to accurately detect, grade, and evaluate clinically relevant findings in digitised slides of prostate CNBs.Ibex Medical Analytics.

Screening protocols for colorectal cancer are broadly recommended and effective in reducing mortality. However, populations from different age groups can harbor distinct pathologic and molecular profiles that can also be influenced by screening and polyp resection, especially in older ages.We retrospectively analyzed tumors from stage IV colorectal cancer patients from a central pathology laboratory in Brazil that is a reference for mutational profiling countrywide. Patients were classified into age groups as follows: prescreening age (PrSA; 45 years old), screening age (SA; 45-75 years old), and postscreening age (PoSA;75 years old). Every tumor was centrally reviewed by the pathologist. Groups were compared regarding clinicopathologic features, and the presence of RAS (renin-angiotensin system) and BRAF (v-Raf murine sarcoma viral oncogene homolog B) mutations.We included 1635 patients (215 PrSA, 1213 SA, 207 PoSA). There was no difference among groups regarding sidedness (P = .65) and KRAS (Kirsten rat sarcoma viral oncogene) mutations (P = .57). Stage IV disease at diagnosis (P = .04), the presence of a signet-ring cell component (P .001), and poorly differentiated tumors (P = .02) were most common in young patients, while BRAF and NRAS (neuroblastoma RAS viral (v-ras) oncogene homolog) mutations were significantly more common among PoSA patients (P = .002 and .03, respectively). When divided by age decade, KRAS mutations seem to have a stable frequency among all ages, while the BRAF mutation rate increased with increasing age.BRAF mutations are more frequent among PoSA patients, and this seems to be a continuous trend. PrSA and PoSA patients seem to present a distinct profile from SA, including differences in molecular and pathologic aspects. These findings could impact the frequency of screening tests among different age groups.

The active compound in bitter melon, i.e., flavonoid, is allegedly inhibiting the formation of testoterone by Leydig cell. The aim of the research was investigating the Leydig cell and testoterone level due to the addition of bitter melon extract (Momordica charantia L.). This research was conducted on December 2016 at the Animal Testing Lab of Faculty of Veterinary Medicine Universitas Airlangga, while the production of histopathology preparations was at the pathology laboratory of Universitas Airlangga Surabaya, and the execution of testosterone level test was at Balai Besar Laboratorium Kesehatan Surabaya. The utilized research design was Completely Randomized Design, exploiting 20 male house mice which are divided into four experimental groups of 5 male house mice each. Each group had given the treatments of bitter melon extract of 23mg/kgBB, 35mg/kgBB, 45,5mg/kgBB, while the control group had given the drug solvent of CMC Na 1%, which is conducted by utilizing feeding needles. In the 41st day, the male house mice were being euthanized by cervical dislocation. The Leydig cells could be observed by utilizing 400x microscope zoom, while the testosterone was examined utilizing Enzym Linken Immunosorbent Assay (ELISA). The research result demonstrated that the bitter melon extract (Momordica charantia L.) addition could decrease the Leydig cells and the testosterone level.

Background: Extrapulmonary Tubercolosis (EPTB) is an infectious disease that affects tissue outside the lungs. EPTB patients cannot be source of infection, therefore the findings in the community indicate that there are still active pul- monary TB patients acting as a source of infection. Understanding distributions of EPTB can be used as indicator to individu- ate the unmonitored source of TB transmission in the community. Objectives: The aim of this study is to analyze EPTB using spatial modeling based on patients’ location. Methods: This study is an observational research with spatial analysis approach using SatScanv.9.4.4 and ArcGis v.10.4. Involving 46 samples of EPTB patients in Anatomy Pathology Laboratory of RSUD Abdul Wahab Sjahranie in 2017 and 7 pul- monary TB patients who were contacts of EPTB patients. The distribution of EPTB patients is mostly located in areas with high population density. Results: The results showed that the dis- tribution pattern of EPTB patients was mostly in areas with high population densi- ties. Space-time permutation model shows there are 3 clusters of EPTB with a 2.91, 0.97, 1.13 km radius centered on -0.504177 S/117.092132 E, -0.476895 S /117.141700 E, -0.517031 S/117.092132 E. Conclusion: The distribution of patients with EPTB and pulmonary TB indicates there is an interaction between EPTB and pulmonary TB in the cluster area. Bernoulli model shows that there is 1 cluster of EPTB and pulmonary TB with relative risk 5.29, radius of 3.19 km, and centered on - 0.458159 S / 117.149945 E.

PURPOSE To determine whether Demodex infestation in blepharitic patients can be confirmed by slit-lamp examination without the need for light microscopy. METHODS Demodex infestation was evaluated in 16 patients presenting with blepharitis and cylindrical dandruff at a single medical center from November 2014 to February 2015. Two lashes with cylindrical dandruff were epilated from each lid (8 per patient, total 128), mounted on slides, and examined in the clinic under a slit lamp equipped with a 90D condensing lens followed by light microscopy in the pathology laboratory. All evaluations were performed by the same pathologist. Mites were identified by their characteristic morphology and movement patterns. Findings were compared between the 2 methods. RESULTS The mean total Demodex count per lash was 1.5 ± 2.1 mites by using the slit lamp and 2 ± 2.9 mites by light microscopy. Corresponding counts per patient were 11.7 ± 9.4 and 16.1 ± 12.4. The correlation between the slit lamp and microscopy results was statistically significant, per lash (r = 0.922, P < 0.01) and per patient (r = 0.976, P < 0.01). On analysis by the more clinically relevant negative (no mites detected) or positive results (at least 1 mite detected), the accuracy of the slit-lamp examination for a single lash was 91.4% and the specificity and sensitivity were 89% and 94%, respectively; the negative predictive value was 93% [χ(1) = 87.94, P < 0.01)]. All 16 patients were positive for Demodex infestation by both methods (accuracy 100%). CONCLUSIONS Demodex infestation in blepharitic patients with cylindrical dandruff can be confirmed using only a slit lamp and common eye clinic equipment.

Arthur Davison Children's Hospital Pathology Laboratory’s Standard Operating Procedures used to test Project YES! (Youth Engaging for Success) HIV viral load and resistance testing.

The objective of this case study is to report the presence of rabies in three Cuniculus paca specimens, of kept in captivity, in Yucatan, Mexico. The specimens’ clinical signs were recorded before the death of each one, the brain was collected and sent to a certified animal pathology laboratory, to detect the Lyssavirus nucleoprotein by the immunofluorescence technique. The clinical picture of each of the affected specimens was described. The results showed positivity to the immune reaction.

Background/aim: Lymphoma cases diagnosed at one of the largest tertiary reference centers in Turkey were reviewed and findings were compared to those reported from other regions of the world. Materials and methods: Lymphomas diagnosed between 2000 and 2017 in the pathology laboratory of Hacettepe University were identified. A total of 4239 cases were analyzed. The WHO 2008 classification was used. Results: Hodgkin lymphomas accounted for almost 20% of cases. T-cell lymphomas were much more frequent (23% of our non- Hodgkin lymphoma (NHL) cases) in comparison to all other regions of the world. The reason for this difference was the high frequency of mycosis fungoides (MF) cases. We had significantly more cases of high-grade B-cell lymphoma (43.9% of NHLs) and fewer cases of low-grade B-cell lymphoma (33.5% of NHLs) in comparison to the rates of developed regions of the world and the reverse was true when compared to developing parts of the world. Burkitt lymphoma frequency (4% of NHLs) was also higher than in most parts of the world. Conclusion: Our data reveal that the frequency of MF, Burkitt lymphoma, and Hodgkin lymphoma are considerably higher, whereas follicular lymphoma rates are considerably lower than in most other parts of the world.

Background: Tissue microarray is widely used in histopathology and biomedical research. Construction of tissue microarray can help institutes to considerably reduce, cost of consumables, skilled man power needed and time needed in performing high output research. However resource poor centers in developing countries have hardly any access to such techniques. The aim of this research is to develop simple, cost effective technique for making tissue microarray.Materials and methods: Materials available in a standard pathology laboratory such as skin punch biopsy needle, bone marrow aspiration needle, trephine biopsy needle, stylet, paraffin wax, hot air oven, slide warming table, drawing pin and measuring scale were used in developing this tissue microarray. The tissue array thus developed was sectioned using a standard microtome. Immunohistochemical studies were also performed on these tissue array sections which yielded satisfactory results.Results: This technique for construction of TMAs is simple and cost effective. When 3.5 to 3mm cores were used we were able to construct arrays up to 32 cores in one block. When 1mm cores were used we were able to construct arrays with 100 representative cores in one block. Morphological identification, histological typing and grading could be done in TMA sectionsConclusion: Tissue microarray is a relatively recent innovation in the field of pathology. We hope that our technique will encourage the younger researchers to take up research projects of large sample size requiring molecular studies with significantly lesser economic burden and thus leading to a significant acceleration in the transition of basic research findings into clinical applications.