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Aim: The diagnosis accuracy of computed tomography (CT) systems and the reliability of calculated Hounsfield Units (HUs) are critical in tumor detection and cancer patients' treatment planning. This study evaluated the effects of scan parameters (Kilovoltage peak or kVp, milli-Ampere-second or mAS reconstruction kernels and algorithms, reconstruction field of view, and slice thickness) on image quality, HUs, and the calculated dose in the treatment planning system (TPS)., Materials and Methods: A quality dose verification phantom was scanned several times by a 16-slice Siemens CT scanner. The DOSIsoft ISO gray TPS was applied for dose calculations. The SPSS.24 software was used to analyze the results and the P-value <0.05 was considered significant., Results: Reconstruction kernels and algorithms significantly affected noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). The noise increased and CNR decreased by raising the sharpness of reconstruction kernels. SNR and CNR had considerable increments at iterative reconstruction compared with the filtered back-projection algorithm. The noise decreased by raising mAS in soft tissues. Also, KVp had a significant effect on HUs. TPS--calculated dose variations were less than 2% for mediastinum and backbone and less than 8% for rib., Conclusions: Although HU variation depends on image acquisition parameters across a clinically feasible range, its dosimetric impact on the calculated dose in TPS can be neglected. Hence, it can be concluded that the optimized values of scan parameters can be applied to obtain the maximum diagnostic accuracy and calculate HUs more precisely without affecting the calculated dose in the treatment planning of cancer patients.

Background and Aims: This study aimed to evaluate the severity of diagnosed lung abnormalities of coronavirus disease 2019 (COVID-19) patients based on the pre-and postrecovery follow-up chest computed tomography (CT) scan findings done at regular intervals., Methods: This cross-sectional study was performed in three phases. The severity of lung abnormalities was recorded and compared based on the initial and follow-up chest CT findings carried out pre-and at regular intervals (3 and 6 months) of postrecovery of COVID-19 patients. Statistical data analysis was conducted using SPSS-Version 26. Pearson Chi-square test was used to analyze the results. p -value < 0.05 was considered statistically significant., Results: Regarding the initial chest CT findings, although ground-glass opacity (GGO) was observed as the most common lung lesion, almost all the evaluated COVID-19 patients had multiple lung lesions and involvements, especially with more involvement of the lower lobes. concerning the frequency of lung lesions and involvements in all phases of the study, almost no statistically significant differences were observed between male and female COVID-19 patients and different age groups. However, older age groups had relatively more lung abnormalities due to Covid-19 based on initial CT images which take more time to be eliminated. Lung abnormalities of Covid-19 patients decreased significantly during the follow ups based on chest CT findings at different study phases., Conclusion: According to evaluated pre- and post-recovery chest CT scans, the frequency of lung lesions and lung involvement distribution decreased significantly in COVID-19 patients, 3 and 6 months after recovery, and most of the recovered patients had no lung lesions or involvement anymore., Competing Interests: The authors have no conflict of interest. The financial support received from the Shoushtar Faculty of Medical Sciences covered the costs of undertaking follow‐up CT scans for participants in the second and third phases of the study. We declare that the Shoushtar Faculty of Medical Sciences as the financial supporter of the study was not involved in the study design; collection, analysis, and interpretation of data; writing of the report; and the decision to submit the report for publication., (© 2022 The Authors. Health Science Reports published by Wiley Periodicals LLC.)

In synthetic organic chemistry, the formation of carbon-carbon bonds is a significant and substantial reaction. As a result, developing a highly active magnetic heterogeneous catalyst with excellent performance is a very appealing technique for constructing C-C bonds in organic chemistry. The present study describes the fabrication of a novel and readily recoverable nickel-based metal-organic framework (MOF) for C-C bond formation through the Sonogashira coupling reaction. The efficient magnetic core-shell structure (Fe 3 O 4 @TEA@MOF) with a 3D dendritic fibrous morphology was successfully synthesized using a hydrothermal approach by immobilizing Ni-based MOF onto the Fe 3 O 4 @TEA core-shell structure. The fabrication of Fe 3 O 4 @TEA@MOF was confirmed by various analyses; Fourier-transform infrared spectroscopy (FT-IR), X-ray photoelectron spectroscopy (XPS), energy dispersive X-ray analysis (EDS), and elemental mapping confirmed the stepwise fabrication of catalyst. X-ray diffraction analysis (XRD) showed the crystalline nature of the catalyst. Field-emission scanning electron microscopy (FE-SEM) displayed the 3D dendritic fibrous morphology. Thermogravimetric analysis (TGA) and vibrating sample magnetometer analysis (VSM) showed the excellent thermal stability and magnetic properties of Fe 3 O 4 @TEA@MOF. The Brunauer-Emmett-Teller analysis (BET) found that the fabricated catalyst with a surface area of 36.2 m 2 g -1 , pore volume of 0.18 cm 3 g -1 , and mean pore diameter of 20.38 nm belongs to mesoporous structures. In addition, the information from the inductively coupled plasma-optical emission spectroscopy (ICP-OES) about fresh and reused catalysts showed that the metal leaching amount is slight and about 1.98%. Other advantages of the Fe 3 O 4 @TEA@MOF catalyst can be mentioned as easily reusable for four runs and high performance (above 98%) in synthesizing diphenylacetylene from phenylacetylene, aryl halide, and cesium carbonate (as the base) under solvent-free and microwave conditions.

Introduction: Artifacts created by the presence of metal objects in the jaw negatively affect the cone-beam computed tomographic image quality. This study compares artifacts produced by metal objects outside of the field of view (FOV) in a small FOV CBCT image with those produced in a large FOV image in which the metal object is within the FOV., Methods: We methodically placed 4 titanium implant-sized rods and 4 zirconium crown-sized disks on 1 side of a human cadaver mandible. Using the Accuitomo 170 CBCT machine (J Morita, Irvine, CA), a total of 18 scans (9 with a small FOV and 9 with a large FOV) were made. Ten axial slices from each scan were transferred to ImageJ software (National Institutes of Health, Bethesda, MD) for analysis. The mean standard deviation of all voxel values of a fixed region of interest (ie, uniform air located lingual to tooth #30) was compared between small and large FOV slices. Two blinded observers subjectively rated the images for diagnostic quality and the presence of artifacts., Results: The Wilcoxon signed rank test showed that the standard deviation for both small and large FOV slices increases as the number of metal objects increases. The mean of the standard deviation for small and large FOVs is 3.6 and 2.5, respectively (P = .0000). Fifty-three percent of the small FOV slices had more artifacts in the subjective analysis. One hundred percent of the small FOV slices were rated as higher quality., Conclusion: Metal objects outside of the FOV in the contralateral quadrant do affect the quality of small FOV images. However, small FOV images have a higher resolution compared with large FOV images., (Copyright © 2021 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Objective: Although epidemiological studies have failed to show the harmful effects of ultrasound in humans, as a form of energy, ultrasound has the potential to cause bio-effects in tissues. Therefore, clinical guidelines have been established for ultrasound technology related to human safety, which include Thermal (TI) and mechanical (MI) indices. The appropriate TI and MI ranges for embryonic examinations are between 0-1.0 and 0-0.4, respectively. The accepted TI and MI ranges are 0-2.0 and 0-1.9, respectively, for general ultrasound examinations. In addition, the scan duration should be kept as low as possible. Therefore, the present study aimed at evaluating the scan duration, TI, and MI as measures of acoustic output during ultrasound studies., Methods: A cross-sectional descriptive study was conducted for patients undergoing pregnancy checkups, routine checkups, and initial diagnosis ultrasound examinations. Samples were selected from imaging departments of 4 educational hospitals based on convenience sampling and 321 checklists completed by direct observation of ultrasound examinations., Results: For pregnancy scans, the mean TI and MI were obtained as 0.32 ± 0.27 and 1.15 ± 0.13, respectively. For non-pregnancy examinations, the mean value of TI and MI were 0.30 ± 0.29 and 1.07 ± 0.35, respectively. Therefore, mean TI for pregnancy and non-pregnancy examinations and mean MI for non-pregnancy studies obtained lower than the permitted values, while the mean MI was higher than the permitted level for first trimester of pregnancy. Also, relatively suitable scan durations were seen in reviewed studies., Conclusion: From this study, it may be concluded that the reported ultrasound scans were safe., (© 2020 American Institute of Ultrasound in Medicine.)

Purpose: Osteopontin (OPN) is a phosphoglycoprotein, with a wide range of physiological and pathological roles. High expression of OPN promotes aggressive behavior, causes poor prognosis in tumor cells, and reduces the survival of patients. Since overexpression of OPN gives rise to radioresistance, the effects of the gene knock out using the CRISPR/Cas9 system in combination with radiation are emphasized., Material and Methods: We used the CRISPR/Cas9 technique to knock out the OPN gene in the MDA-MB-231 cell line. After transfection, the cells were irradiated. The changes of the OPN mRNA levels, the apoptosis, and the differences in cell viability were assessed., Results: A significant reduction in the OPN expression was observed alone or along with irradiation. The knocked out gene alone increased apoptosis rate. The cell viability decreased to after knocking out of the OPN gene. The gene knocking-out combined with irradiation led to more decline of cell viability., Conclusion: Our results demonstrated that after knocking out the OPN gene, the MDA-MB-231 cells showed a significant radiosensitivity. Therefore, the OPN knock out in combination with conventional radiotherapy, may become an efficient therapeutic target in the future., (Copyright © 2020 Société française de radiothérapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.)

Introduction: Producing appropriate diagnostic images along with patient radiation protection is the goal of radiography. Due to the advancements of radiography, concerns about observing the principles of radiation protection exist. Therefore, this study aimed to evaluate the observance of the principles of radiation protection in radiographic examinations with emphasis on field size collimation, suitability of exposure factors and the use of protective equipment for the patients and their companions., Methods: Using a cross-sectional study design, two radiography students on their final year of study observed 100 radiographic examinations from the imaging departments of five educational hospitals. The SPSS version 24 software was used to analyse the results., Results: The radiation field collimation was obtained in 46% of the studied radiographs. Patients had companions present during the examination in 26% of the studies; however, protective equipment was only used for 4% of the patients' companions, and no protective equipment was applied for patients. The observance rate of the various principles of radiation protection including field size restriction, the use of protective equipment for the patients and their companions, and suitability of the selected exposure factors was on average 44.6%., Conclusion: The observance rate of the principles of radiation protection was insufficient in the studied educational hospitals, specifically in field size collimation and the use of protective equipment for the patients and their companions. Therefore, emphasis on the strict implementation of the radiation protection guidelines and continuous training of radiographers are required., (© 2020 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.)

The sodium-hydrogen exchanger isoform 3 (NHE3, SLC9A3) is abundantly expressed in the gastrointestinal tract and is proposed to play essential roles in Na+ and fluid absorption as well as acid-base homeostasis. Mutations in the SLC9A3 gene can cause congenital sodium diarrhea (CSD). However, understanding the precise role of intestinal NHE3 has been severely hampered due to the lack of a suitable animal model. To navigate this problem and better understand the role of intestinal NHE3, we generated a tamoxifen-inducible intestinal epithelial cell-specific NHE3 knockout mouse model (NHE3IEC-KO). Before tamoxifen administration, the phenotype and blood parameters of NHE3IEC-KO were unremarkable compared with control mice. After tamoxifen administration, NHE3IEC-KO mice have undetectable levels of NHE3 in the intestine. NHE3IEC-KO mice develop watery, alkaline diarrhea in combination with a swollen small intestine, cecum and colon. The persistent diarrhea results in higher fluid intake. After 3 weeks, NHE3IEC-KO mice show a ∼25% mortality rate. The contribution of intestinal NHE3 to acid-base and Na+ homeostasis under normal conditions becomes evident in NHE3IEC-KO mice that have metabolic acidosis, lower blood bicarbonate levels, hyponatremia and hyperkalemia associated with drastically elevated plasma aldosterone levels. These results demonstrate that intestinal NHE3 has a significant contribution to acid-base, Na+ and volume homeostasis, and lack of intestinal NHE3 has consequences on intestinal structural integrity. This mouse model mimics and explains the phenotype of individuals with CSD carrying SLC9A3 mutations., (© 2020 The Author(s).)

Introduction: Acute and chronic apical abscesses are 2 dramatic ways that periradicular tissues may react to pulpal infection and necrosis. Although both of these clinical states are the response to pulpal infection, their clinical manifestations are significantly different. It is not clear why the body responds to root canal infection in one way or another. The objective of this study was to evaluate the size and pattern of bone loss in patients with acute apical abscess (AAA) and chronic apical abscess (CAA) using cone-beam computed tomographic images., Methods: Twenty-three cone-beam computed tomographic images of cases with AAA and 25 cases with CAA were selected and evaluated. The presence and location of fenestration and the volume and pattern of the periradicular lesions were recorded and compared between the 2 groups using the Fisher exact and Mann-Whitney U tests., Results: One hundred percent of cases with CAA had cortical fenestration, but only 47% of cases with AAA had cortical fenestration (P < .05). The median volume of the lesions was 233 mm 3 in the CAA group and 109 mm 3 in the AAA group (P > .05). CAA cases, in comparison with the AAA group, had a relatively larger cortical disruptions., Conclusions: Cortical fenestration is fundamental for the development of CAA. However, periradicular lesions without evident cortical fenestration can still cause AAA and fascial space involvement., (Copyright © 2019 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

The goal of this paper was to review the current literature surrounding the use of cone beam computed tomography (CBCT) related to the diagnosis, prognostic determination, and treatment of periodontal diseases. A literature review was completed to identify peer-reviewed articles related to CBCT and periodontics. The results were filtered to pool only articles specific to CBCT and periodontal diagnosis, prognosis, and treatment/outcomes. The articles were reviewed and findings summarized. Author's commentary on technological advances and additional potential uses of CBCT in the field of periodontics were included. There is evidence to suggest that CBCT imaging can be more accurate in diagnosing specific periodontal defects (intrabony and furcation defects), and therefore be helpful in the prognostic determination and treatment planning. However, at this time, CBCT cannot be recommended as the standard of care. It is up to the individual clinician to use one's own judgment as to when the additional information provided by CBCT may be beneficial, while applying the As Low As Reasonably Achievable (ALARA) principle. With continued technological advances in CBCT imaging (higher resolution, reduced imaging artifacts, lower exposure, etc.) the author's believe that CBCT usage will become more prominent in diagnosis and treatment of periodontal diseases.

Background: Recently, magnetic resonance imaging (MRI)-based radiotherapy has become a favorite science field for treatment planning purposes. In this study, a simple algorithm was introduced to create synthetic computed tomography (sCT) of the head from MRI., Methods: A simple atlas-based method was proposed to create sCT images based on the paired T1/T2-weighted MRI and bone/brain window CT. Dataset included 10 patients with glioblastoma multiforme and 10 patients with other brain tumors. To generate a sCT image, first each MR from dataset was registered to the target-MR, the resulting transformation was applied to the corresponding CT to create the set of deformed CTs. Then, deformed-CTs were fused to generate a single sCT image. The sCT images were compared with the real CT images using geometric measures (mean absolute error [MAE] and dice similarity coefficient of bone [DSC bone ]) and Hounsfield unit gamma-index (Г HU ) with criteria 100 HU/2 mm., Results: The evaluations carried out by MAE, DSC bone , and Г HU showed a good agreement between the synthetic and real CT images. The results represented the range of 78-93 HU and 0.80-0.89 for MAE and DSC bone , respectively. The Г HU also showed that approximately 91%-93% of pixels fulfilled the criteria 100 HU/2 mm for brain tumors., Conclusion: This method showed that MR sequence (T1w or T2w) should be selected depending on the type of tumor. In addition, the brain window synthetic CTs are in better agreement with real CT relative to bone window sCT images., Competing Interests: There are no conflicts of interest.

Background and objectives: To determine the head scatter factor, a formalism presented by Vadash and Bjärngard has been employed to assess collimator exchange effects. The aim of this study was to determine the best Vadash correction factor (A) by introducing a new method based on the output factor measured in air for different square and rectangular fields. Materials and Methods: A new simple mathematical method based on selection of the best dosimetric data was proposed to obtain the A value for Vadash to predict the equivalent square field size. Measurements were performed with a Farmer chamber 0.6 cc in SSD 100 cm and build up cap of Plexiglas, 1.5 and 3.5 cm equal to water, for 6 and 18 MV, respectively, with a Perimus Plus linear accelerator. The output factor in air (OFair) was measured for square and rectangular fields. MATLAB software (version R2014a) was employed for calculations and curve fitting. Results: A power model with a constant value was applied to the output factor in air as a function of square field size. The output factor in air ranged from 0.983 to 1.038 at 6MV and from 0.731 to 1.05 at 18 MV with the Y collimator having a greater effect. Obtained values for A were 1.42 and 1.55 with respect to σmin=0.98 and 2.3 for 6 and 18 MV energies, respectively. Conclusion: The proposed A values minimize the collimator exchange effect in calculating equivalent squares, which plays an important role in patient dose calculation and treatment planning., (Creative Commons Attribution License)

Introduction: In the absence of nodal metastasis, pathologic tumor (pT) size remains one of the most important factors in adjuvant treatment decisions and patient prognosis in breast cancer. The aim of this study was to evaluate the effect of core needle biopsy (CNB) tumor size on final pT stage., Materials and Methods: Our information system was searched to identify all patients who underwent excisional procedures for invasive breast carcinoma from January 1 , 2014 to December 31, 2015. The tumor size on CNB and final excision, the number of cases in which the CNB size was larger, and the percentage of cases in which using the CNB tumor size changed the final pT stage were recorded., Results: From 1380 primary breast excisions/mastectomies, a total of 870 cases were included. In 82 (9.4%) the CNB tumor size was larger (63 of 82 cases) or no residual tumor was identified on excision (19 of 82 cases). From these 82 cases, 40 (48.7%) were properly staged on the basis of CNB tumor size, 16 (19.5%) were not staged, and 26 (31.7%) were staged using the final excision tumor size. Change in stage occurred in 7 of these 26 patients., Conclusion: Our study revealed that in most cases, the largest tumor size is found in the excision/mastectomy specimen. However, in 9.4% (82 of 870), the CNB contains the most accurate tumor size for pT staging. On the basis of our results, including the largest linear tumor extent on the CNB report is recommended., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: Glucose sensors have been extensively researched in patent studies and manufactured a tool for clinical diabetes diagnosis. Although some kinds of electrochemical enzymatic glucose sensors have been commercially successful, there is still room for improvement, in selectivity and reliability of these sensors. Because of the intrinsic disadvantages of enzymes, such as high fabrication cost and poor stability, non-enzymatic glucose sensors have recently been promoted as next generation diagnostic tool due to their relatively low cost, high stability, prompt response, and accuracy., Objective: In this research, a novel free standing and binder free non-enzymatic electrochemical sensor was manufactured using in situ grown copper (Cu) and cobalt (Co) on a silicon (Si) substrate., Methods: Scanning High-Energy Electron Diffraction (SHEED) and Edward deposition methods were used to synthesise the sensors., Results: Morphological observations showed that Cu and Co homogeneously formed nanorod-like shapes over the Si substrate. The elemental composition and structure of the prepared sensors were identified by Reflection High-Energy Electron Diffraction (RHEED). In terms of electrochemical properties, for the enzyme-free glucose sensor, voltammograms showed that the peak currents increased when the glucose solution was injected into the electrolytic cell. The electrical relation of voltage versus current was linear, as shown in the experimental data. Another effective parameter changed the magnetic field; and the linear behaviour of the electrical resistance of Co remained unaltered., Conclusion: In the optimum annealing temperature, where the magnetic field increased, the properties of the samples remained constant. In other words, in the selected annealing temperature, resistance and stability of the layers increased in a significant manner., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.)

Background: Integrated proton therapy - MRI systems are capable of delivering high doses to the target tissues near sensitive organs and achieve better therapeutic results; however, the applied magnetic field for imaging, influences the protons path, changes the penetration depth and deflects the particles, laterally, leading to dose distribution variations., Objective: To determine the effects of a magnetic field on the range and the lateral deflection of protons, analytically., Methods: An analytical survey based on protons energy and range power law relation, without using small angle assumption was done. The penetration depth and lateral deflection of protons with therapeutic energy ranges 60-250 MeV in the presence of uniform magnetic fields of 0-10T intensities, were calculated analytically. Calculations were done for relativistic conditions with Mathematica software version 7.0, and MATLAB 7.0 was applied to plot curves and curve fittings., Results: In the presence of a magnetic field, the depth of Bragg peak was decreased and it was shifted laterally. A second order polynomial model with power equation for its coefficients and a power model with quadratic polynomial coefficients predicted the maximum lateral deflection (y max ) and maximum penetration depth (z max ) variations with energy and magnetic field intensity, respectively., Conclusion: The applied correction for deflection angle will give more reliable results in initial energy of 250 MeV and 3T magnetic field intensity. For lower energies and magnetic field intensities the differences are negligible, clinically., Competing Interests: Conflict of Interest: There is no conflict of interest to be declared.

Introduction: Many studies have investigated the morphology of the mandibular molar, but the prevalence of the middle mesial (MM) canal in the mesial root of the mandibular molar is still the subject of controversy. In addition, in previous literature, a true MM canal has not been clearly distinguished from an isthmus between the mesiobuccal and mesiolingual canals. Therefore, the objectives of this study were 2-fold: METHODS: Ninety limited field of view cone-beam computed tomographic scans were observed. One hundred twenty-two mature mandibular first and second molars with no previous root canal treatment, no root resorption, and intact crowns were retrospectively evaluated. Data regarding the sex, age, presence of MM canals, and number of root canals in the mesial root were recorded., Result: Of the 122 teeth, 20 (16.4%) had true MM canals. The prevalence of MM canals was 26% in first molars and 8% in second molars (P < .05). The frequency of isthmi in the mesial roots was 64.7%. The frequency of isthmi was higher in second molars, but the difference was not statistically significant (P > .05)., Conclusions: This study showed a high prevalence of mandibular molars with MM canals or isthmi. The detection and biomechanical cleaning of these areas during nonsurgical or surgical root canal treatment are critical., (Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Walnut hull (wal hull) is an agricultural by-product that is widely used in traditional medicine for alleviating pain and treating skin diseases, however, recently it has gained much attention in modern pharmacology due to its antioxidant properties. The current study was aimed to determine the total phenolic, flavonoid, and tannin content of Persian wal hull extract and evaluate its biological effects on platelet function. Experimental data showed that acetone extract of wal hulls has a high content of polyphenolic compounds and antioxidant properties. The analytical study of crude extract by gas chromatography-mass spectrometry demonstrated different types of high- and low-molecular-weight compounds that are basically and biologically important. Moreover, an in vitro study revealed that wal hull extract at a concentration of 50 μg/mL inhibited thrombin-induced platelet aggregation and protein secretion by 50%, without any cytotoxic effects on platelets. The examined extract suppressed reactive oxygen species generation and also caspase activation in thrombin-stimulated platelets. Identically, N-acetylcysteine inhibited the increase of reactive oxygen species level induced by thrombin in platelets, and supported a link between cellular redox status and caspase activation in activated platelets. Presumably, the antiplatelet activity of wal hull extract is related to its polyphenolic compounds and their antioxidant properties. Therefore, wal hulls can be considered as a candidate for thrombotic disorders., (Copyright © 2017. Published by Elsevier B.V.)

Aim: To compare the sensitivity and specificity of CDX2 and alcian blue (AB) pH 2.5 staining in identifying esophageal intestinal metaplasia., Methods: One hundred and ninty-nine biopsies from 186 patients were retrospectively reviewed and categorized as Barrett's esophagus (BE) (n = 108); non-Barrett's esophagus (NBE) (n = 48); columnar blue cells (CB) and esophageal glands (EG) (n = 43). The biopsies were stained with AB and immunostained for CDX2 using a mouse monoclonal antibody from Biogenex (clone CDX2-88) and the Ventana Discovery X automated immunostainer. The positive and negative predictive value of each group was used to determine the predictive power of CDX2 and AB in diagnosing intestinal metaplasia., Results: All of the 108 BE biopsies (100%) were positive for AB and 102 of them (94.4%) were positive for CDX2. The six BE patients (5.6%) who failed to stain with CDX2 were found to have lost the focus of intestinal metaplasia upon deeper sectioning for immunostaining. Both AB and CDX2 were negative in 43 out of 48 (89.6%) NBE cases. Five NBE patients (10.4%) were falsely positive for AB due to the presence of EG and CB in these biopsies. These cases were all CDX2 negative. In addition, 5 AB negative NBE were found to be CDX2 positive. Based on these results the CDX2 immunostain had similar sensitivity but higher specificity (100% vs about 91%) than AB in detecting intestinal type metaplasia in these samples. Our data shows that CDX2 has a better PPV in detecting intestinal metaplasia as compared to AB (95.6% vs 71.5%, respectively)., Conclusion: CDX2 has a better positive predictive value than AB in detecting intestinal metaplasia. CDX2 may be useful when challenged by gastro-esophageal biopsies containing mimikers of BE.

We report a case of appendicial paraganglioma in a 40 year old female who presented with acute appendicitis and underwent laparoscopic appendectomy. To the best of our knowledge this is the first reported case of appendicial gangliocytic paraganglioma with features suggestive of malignancy in the modern literature. Van Eeden S. et al. reported the first case of appendicial paraganglioma in a 47 year old man who also presented with acute appendicitis. The appendectomy specimen showed a distended appendix with thickened wall, and a 1.3 cm mucosal based yellow lesion. Microscopically this lesion was centered in the submucosa and consisted of three different cell types: (a) epithelioid cells with pale eosinophilic finely granular cytoplasm containing bland oval nucleus with stippled chromatin, that form solid nests lying in a trabecular pattern and in formations reminiscent of 'Zellballen' as seen in paragangliomas (b) second type cells have large vesicular nuclei with prominent nucleoli and abundant cytoplasm that are scattered singly, (c) third type cells with bland elongated nuclei form broad fascicle and envelop the epithelioid and ganglion cells. Immunohistochemical analysis showed the epithelioid cell nests immunoreactive for synaptophysin and the ganglion-like cells and spindle Schwann cells to be immunoreactive for S100 protein, whereas all three cells populations were negative for CAM5.2 and Pancytokeratin. We do believe that an accurate diagnosis of Gangliocytic paraganglioma (GP) of the appendix was rendered, detailed microscopic examination of doubled hematoxylin and eosinophil stained sections as well as the immunohistochemical phenotype of the three components have been undertaken to confirm the diagnosis of GP.

Schwannoma (neurilemmoma) is a benign peripheral nerve sheath tumor that occurs in a wide variety of locations; however, its finding in the uterine cervix is extremely rare. We report a case of an incidental primary benign cervical schwannoma in a 48-year-old woman. In the English literature, a few cases of primary schwannoma of the cervix have been reported, which include seven cases of primary malignant cervical schwannoma and only two that are benign. These cases are reviewed in the following discussion.

Purpose: To translate long form, interview-administered International Physical Activity Questionnaire (IPAQ) from English to Persian and evaluate its validity, reliability and reproducibility., Methods: A forward-backward translation procedure was followed to develop the Persian version of the IPAQ. A total of 218 respondents (53.7% women, aged 22-76 yr) completed the Persian version in Tehran, Iran. To examine the test-retest reliability, 48 healthy volunteers completed the IPAQ twice during a 7-day period.. The PA indicators derived from the IPAQ were assessed for reliability and were compared with aerobic fitness and body mass index (BMI) for construct validity., Results: In general, the questionnaire was received well and all domains met the minimum reliability standards (intra-class correlation [ICC]>0.7), except for Leisure-time physical activity (PA). Aerobic fitness showed a weak positive correlation with all of the PA results derived from the IPAQ. A significant correlation was observed between the IPAQ data for total PA and both aerobic fitness (r=0.33, P<0.001) and BMI (r=0.26, P<0.001). Performing a known group comparison analysis, the results indicated that the questionnaire was discriminated well between the subgroups of the study samples expected to be different in their physical activity., Conclusions: The Persian version of the long form, interview-administered IPAQ had an acceptable reliability and validity for assessing total PA in our Iranian sample of individuals. It may be a useful instrument for generating internationally comparable data on PA.

Patellofemoral joint stability is a result of the restraining effects of the quadriceps muscles, the retinacular structures, and engagement of the bones. The role and significance of these mechanisms in restraining patellar lateral displacement was investigated in this study by measuring the force needed to cause 5 mm lateral displacement (i.e. the mechanical stability, or 'stabilising force') of the patella. Six cadaver knees had 175 N quadriceps load distributed among three muscle groups. With a force ratio matching the muscles physiological cross sectional areas, no significant change occurred in the patellar stabilising force between 0 and 60 degrees knee flexion, but a significant increase occurred between 60 and 90 degrees, presumably reflecting the contribution of the femoral groove. Variation of the quadriceps force distribution changed the stability significantly. Relaxing the vastus lateralis increased the patellar lateral stabilising force 52+/-8%, while relaxing vastus medialis reduced the stabilising force 47+/-9%. The minimum stabilising force was at 30 degrees knee flexion. Transection of the medial retinaculum reduced the lateral stabilising force 34% in the extended knee. This effect disappeared by 45 degrees knee flexion. It was concluded that the quadriceps muscles had a significant and consistent effect across the whole range of knee flexion, but the contribution of the medial retinaculum was restricted to extended knee postures.