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Brickman A, Baykara Y, Carabaño M, Hacking SM. Whole slide images as non-fungible tokens: A decentralized approach to secure, scalable data storage and access. J Pathol Inform 2024; 15:100350. [PMID: 38162951 PMCID: PMC10757022 DOI: 10.1016/j.jpi.2023.100350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/06/2023] [Indexed: 01/03/2024] Open
Abstract
Background Distributed ledger technology (DLT) enables the creation of tamper-resistant, decentralized, and secure digital ledgers. A non-fungible token (NFT) represents a record on-chain associated with a digital or physical asset, such as a whole-slide image (WSI). The InterPlanetary File System (IPFS) represents an off-chain network, hypermedia, and file sharing peer-to-peer protocol for storing and sharing data in a distributed file system. Today, we need cheaper, more efficient, highly scalable, and transparent solutions for WSI data storage and access of medical records and medical imaging data. Methods WSIs were created from non-human tissues and H&E-stained sections were scanned on a Philips Ultrafast WSI scanner at 40× magnification objective lens (1 μm/pixel). TIFF images were stored on IPFS, while NFTs were minted on the Ethereum blockchain network in ERC-1155 standard. WSI-NFTs were stored on MetaMask and OpenSea was used to display the WSI-NFT collection. Filebase storage application programing interface (API) were used to create dedicated gateways and content delivery networks (CDN). Results A total of 10 WSI-NFTs were minted on the Ethereum blockchain network, found on our collection "Whole Slide Images as Non-fungible Tokens Project" on Open Sea: https://opensea.io/collection/untitled-collection-126765644. WSI TIFF files ranged in size from 1.6 to 2.2 GB and were stored on IPFS and pinned on 3 separate nodes. Under optimal conditions, and using a dedicated CDN, WSI reached retrieved at speeds of over 10 mb/s, however, download speeds and WSI retrieval times varied significantly depending on the file and gateway used. Overall, the public IPFS gateway resulted in variably poorer WSI download retrieval performance compared to gateways provided by Filebase storage API. Conclusion Whole-slide images, as the most complex and substantial data files in healthcare, demand innovative solutions. In this technical report, we identify pitfalls in IPFS, and demonstrate proof-of-concept using a 3-layer architecture for scalable, decentralized storage, and access. Optimized through dedicated gateways and CDNs, which can be effectively applied to all medical data and imaging modalities across the healthcare sector. DLT and off-chain network solutions present numerous opportunities for advancements in clinical care, education, and research. Such approaches uphold the principles of equitable healthcare data ownership, security, and democratization, and are poised to drive significant innovation.
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Affiliation(s)
- Arlen Brickman
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Yigit Baykara
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Miguel Carabaño
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Sean M. Hacking
- Department of Pathology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, United States
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Baykara Y, Lu S, Yang D, Wang Y, Yakirevich E, Hacking S, Pisharodi L, Maleki S. Utility of Wnt family member 9b (Wnt9b) immunohistochemistry in the cytologic diagnosis of metastatic breast carcinoma. Virchows Arch 2023:10.1007/s00428-023-03645-z. [PMID: 37718335 DOI: 10.1007/s00428-023-03645-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/27/2023] [Accepted: 09/03/2023] [Indexed: 09/19/2023]
Abstract
Wnt family member 9b (Wnt9b) has been demonstrated as a valuable marker for breast cancer diagnosis in surgical pathology. In this study, we examined the utility of Wnt9b in diagnosing metastatic breast carcinoma in cytology samples. Cell blocks from fine needle aspirations (FNA) and fluid specimens of 96 metastatic breast carcinomas and 123 primary and metastatic non-breast neoplasms from various organ systems were evaluated by Wnt9b and GATA3 immunohistochemistry (IHC). Wnt9b and GATA3 were positive in 81.3% and 92.7% of metastatic breast carcinomas, respectively. Conversely, 93.5% and 90.0% of non-breast, non-urothelial carcinomas were negative for Wnt9b and GATA3, respectively. Wnt9b expression was positive in rare gastrointestinal, gynecological, lung, pancreas, and salivary gland tumors. All twenty-eight urothelial carcinomas were negative for Wnt9b, while twenty-six (92.9%) were positive for GATA3. Wnt9b was slightly less sensitive but more specific than GATA3 in diagnosing metastatic breast cancer in cytology samples. Particularly, Wnt9b shows higher specificity in differentiating breast and urothelial primaries. The combined use of Wnt9b and GATA3 may increase diagnostic accuracy.
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Affiliation(s)
- Yigit Baykara
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Lifespan Academic Medical Center, Providence, RI, 02903, USA.
| | - Shaolei Lu
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Lifespan Academic Medical Center, Providence, RI, 02903, USA
| | - Dongfang Yang
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Lifespan Academic Medical Center, Providence, RI, 02903, USA
| | - Yihong Wang
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Lifespan Academic Medical Center, Providence, RI, 02903, USA
| | - Evgeny Yakirevich
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Lifespan Academic Medical Center, Providence, RI, 02903, USA
| | - Sean Hacking
- Department of Pathology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, 10016, USA
| | - Latha Pisharodi
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Lifespan Academic Medical Center, Providence, RI, 02903, USA
| | - Sara Maleki
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Lifespan Academic Medical Center, Providence, RI, 02903, USA
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Baykara Y, Gamsiz Uzun ED, Jackson C, Kurt H. Exon 19 Deletion in EGFR in a Patient with a High-Grade Glioma: A Case Report. Ann Clin Lab Sci 2023; 53:789-791. [PMID: 37945023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Affiliation(s)
- Yigit Baykara
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Ece D Gamsiz Uzun
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Cynthia Jackson
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Habibe Kurt
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
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4
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Baykara Y, Kurt H. Low-grade follicular lymphoma with extensive marginal zone differentiation and expression of MUM1 and CD30. Blood 2023; 141:1363. [PMID: 36929428 DOI: 10.1182/blood.2022018806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
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5
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Baykara Y, Van Truong L, Akgun Y. Letter to the Editor: The Role of Therapeutic Plasma Exchange for the Treatment of COVID-19 Associated Psychosis. Ann Clin Lab Sci 2023; 53:334-335. [PMID: 37094851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Affiliation(s)
- Yigit Baykara
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Lance Van Truong
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Yamac Akgun
- Department of Pathology and Laboratory Medicine, Cedars Sinai Medical Center, Los Angeles, CA, USA
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6
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Baykara Y, Pepkowitz SH, Akgun Y. The
pro‐B
‐type natriuretic peptide dilemma in hematopoietic progenitor cell collection. J Clin Apher 2022; 37:613. [DOI: 10.1002/jca.22031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 10/13/2022] [Indexed: 11/15/2022]
Affiliation(s)
- Yigit Baykara
- Department of Pathology and Laboratory Medicine The Warren Alpert Medical School of Brown University Providence Rhode Island USA
| | - Samuel H. Pepkowitz
- Department of Pathology and Laboratory Medicine Cedars Sinai Medical Center Los Angeles California USA
| | - Yamac Akgun
- Department of Pathology and Laboratory Medicine Cedars Sinai Medical Center Los Angeles California USA
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Baykara Y, Trapassi C, Miceli G, Bouchard C, Bilida S, Lonks JR, Mileno M, Radhakrishnan P, Whitehead V, Hong T. Brucella Species Staining as Gram-Positive Rod and Gram-Positive Cocci in Chains. R I Med J (2013) 2022; 105:34-36. [PMID: 36300962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Two cases of Brucellosis were identified at a hospital in Rhode Island. In both cases, the organisms were isolated from the blood cultures. The bacteria did not appear as the classical textbook description of Brucella spp. as short, Gram-negative rods; instead, Gram-positive rods and Gram-positive cocci in chains were observed. Due to the atypical Gram stain morphology, Brucella spp. were not initially considered as a possible pathogen. Antimicrobial prophylaxes were offered to the technologists who were exposed to the organisms.
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Affiliation(s)
- Yigit Baykara
- Microbiology Laboratory, Department of Pathology and Laboratory Medicine, The Miriam Hospital and Rhode Island Hospital, Providence, Rhode Island
| | - Carlotta Trapassi
- Microbiology Laboratory, Department of Pathology and Laboratory Medicine, The Miriam Hospital and Rhode Island Hospital, Providence, Rhode Island
| | - Gina Miceli
- Microbiology Laboratory, Department of Pathology and Laboratory Medicine, The Miriam Hospital and Rhode Island Hospital, Providence, Rhode Island
| | - Christopher Bouchard
- Microbiology Laboratory, Department of Pathology and Laboratory Medicine, The Miriam Hospital and Rhode Island Hospital, Providence, Rhode Island
| | - Sarah Bilida
- Microbiology Laboratory, Department of Pathology and Laboratory Medicine, The Miriam Hospital and Rhode Island Hospital, Providence, Rhode Island
| | - John R Lonks
- Division of Infectious Diseases, The Miriam Hospital and Rhode Island Hospital, Providence, Rhode Island
| | - Maria Mileno
- Division of Infectious Diseases, The Miriam Hospital and Rhode Island Hospital, Providence, Rhode Island
| | - Parvathi Radhakrishnan
- Division of Infectious Diseases, The Miriam Hospital and Rhode Island Hospital, Providence, Rhode Island
| | - Valerie Whitehead
- Microbiology Laboratory, Department of Pathology and Laboratory Medicine, The Miriam Hospital and Rhode Island Hospital, Providence, Rhode Island
| | - Tao Hong
- Microbiology Laboratory, Department of Pathology and Laboratory Medicine, The Miriam Hospital and Rhode Island Hospital, Providence, Rhode Island
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Akgun Y, Baykara Y, Langlie J, Van Truong L, Poveda J. Valproic Acid Induced Thrombocytopenia and Dysmegakaryopoiesis in a Pediatric Patient. Ann Clin Lab Sci 2022; 52:843-845. [PMID: 36261178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Valproic acid (VPA) is an effective first-line anticonvulsant that is associated with several side effects including bone marrow suppression and subsequent cytopenia. However, VPA associated myelodysplasia is not a well described entity that can be seen in patients on VPA treatment. CASE REPORT Herein, we describe a 9-year-old female patient with a past medical history of seizure disorder who presented with 3-week history of intermittent fevers, fatigue, weakness, and multiple unexplained bruises. Complete blood count (CBC) was remarkable for marked thrombocytopenia. Trephine biopsy showed a normocellular marrow with maturing trilineage hematopoiesis and scattered atypical megakaryocytes including numerous small hypolobated forms with frequent forms showing separated nuclei. Her CBC showed normalization 7 months after VPA was stopped. CONCLUSIONS The presence of bone marrow suppression and myelodysplasia in patients on VPA treatment should be taken into consideration as it can cause a diagnostic pitfall especially in pediatric and elderly populations. A careful review of past medical history and medications can help make the correct diagnosis.
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Affiliation(s)
- Yamac Akgun
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yigit Baykara
- Department of Pathology and Laboratory Medicine, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Jake Langlie
- University of Miami Miller School of Medicine, University of Miami and Jackson Health System, Miami, FL, USA
| | - Lance Van Truong
- Department of Pathology and Laboratory Medicine, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Julio Poveda
- Department of Pathology and Laboratory Medicine, University of Miami and Jackson Health System, Miami, FL, USA
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9
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Akgun Y, Baykara Y, Hacking SM, Langlie J, Huberman MA, Espejo AP, Chapman J, Poveda J. Describing IgA Myeloma: An Immunophenotypic and Molecular Approach. R I Med J (2013) 2022; 105:41-45. [PMID: 35882000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Plasma cell myeloma (PCM) is defined as a clonal disease of terminally differentiated plasma cells that secrete immunoglobulin. The biologic underpinnings of IgA-type multiple myeloma's (IgAMM) aggressive nature, including its increased morbidity and mortality, have not been elucidated. We describe the clinical, phenotypic, and cytogenetic characteristics of IgA-MM. Flow-cytometry analysis was performed to phenotype clonal plasma cell populations, and interface with fluorescent in situ hybridization (iFISH) to exploit cytogenetics to determine risk stratification; 68.1% of cases were of intermediate or high risk. On flow cytometry, samples from our IgA-PCM cohort revealed less frequent CD56 expression when compared to samples with other PCM subtypes. Our study demonstrated lower frequency of CD56 expression (52.8%). We hypothesize that loss of CD56 may play a significant role in the aggressive behavior of IgA-PCM due to the loss of cell-to-cell adhesion resulting in a higher propensity for extramedullary presentation.
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Affiliation(s)
- Yamac Akgun
- Department of Pathology and Laboratory Medicine, University of Miami and Jackson Health System, Miami, Florida
| | - Yigit Baykara
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital and Lifespan Medical Center, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Sean M Hacking
- Department of Pathology and Laboratory Medicine, The Warren Alpert Medical School of Brown University; Department of Pathology and Laboratory Medicine, Donald and Barbara Zucker School of Medicine at Northwell
| | - Jake Langlie
- University of Miami Miller School of Medicine, University of Miami and Jackson Health System, Miami, Florida
| | - Melissa Ann Huberman
- University of Miami Miller School of Medicine, University of Miami and Jackson Health System, Miami, Florida
| | - Andrea P Espejo
- Department of Hematology and Medical Oncology, University of Miami, Jackson Health System, Miami, Florida
| | - Jennifer Chapman
- Department of Pathology and Laboratory Medicine, University of Miami and Jackson Health System, Miami, Florida
| | - Julio Poveda
- Department of Pathology and Laboratory Medicine, University of Miami and Jackson Health System, Miami, Florida
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10
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Baykara Y, Akgun Y, Van Truong L, Corbett M, Hacking SM. Malignant Variant of Calcifying Epithelial Odontogenic Tumor with Neuroendocrine Differentiation. R I Med J (2013) 2022; 105:24-27. [PMID: 35881995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A 60-year-old female presented with asymptomatic failing mandibular dental implants. Computed tomography (CT) showed a partially calcified, hypointense lesion within the soft tissues, measuring 1.3 x 0.8 x 1.0 cm along the buccal cortex. Incisional biopsy demonstrated a basaloid type of tumor composed of sheets of cells with plump ovoid nuclei, distinct nucleoli, and scant eosinophilic cytoplasm. Mitoses were present, averaging about 2 per 10 high power fields with scattered individual apoptotic cells. Numerous laminated calcified bodies (Liesegang rings) were observed with confluence of these bodies to form larger foci of dystrophic mineralization. These features clearly established the malignant nature of this tumor. Immunohistochemically, the tumor was positive for synaptophysin, focally positivity for CAM 5.2 and had a Ki-67 proliferation index of approximately 25%. This is the first report of a tumor with features of a malignant variant of calcifying epithelial odontogenic tumor and neuroendocrine differentiation.
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Affiliation(s)
- Yigit Baykara
- Department of Pathology and Laboratory Medicine, The Warren Alpert Medical School of Brown University
| | - Yamac Akgun
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center
| | - Lance Van Truong
- Department of Pathology and Laboratory Medicine, The Warren Alpert Medical School of Brown University
| | - Mel Corbett
- Department of Otolaryngology/Head and Neck Surgery, University Hospital Galway, National University of Ireland
| | - Sean M Hacking
- Department of Pathology and Laboratory Medicine, The Warren Alpert Medical School of Brown University; Department of Pathology and Laboratory Medicine, Donald and Barbara Zucker School of Medicine at Northwell
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11
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Baykara Y, Hacking SM, Akgun Y. Granulocyte products: An ongoing mystery. Transfusion 2022; 62:1464-1465. [PMID: 35815727 DOI: 10.1111/trf.16901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/21/2022] [Accepted: 04/26/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Yigit Baykara
- Department of Pathology and Laboratory Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Sean M Hacking
- Department of Pathology and Laboratory Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Yamac Akgun
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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12
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McCormick W, Baykara Y, Siddique A, Van Truong L, Corbett M, Hacking SM. Lung Findings in a Patient with a History of Nicotine Vaping and Cannabis Smoking. R I Med J (2013) 2022; 105:36-40. [PMID: 35617040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
We report a collection of lung findings in a patient with a remote history of cigarette smoking, but now engaged in heavy nicotine vaping with daily edible and combustible cannabis use. Computed tomography (CT) imaging demonstrated numerous, small, and bilateral nodules with ground-glass appearance. The largest nodule is demonstrated in the right upper lung lobe. Clinically the differential diagnosis at this time included hypersensitivity pneumonitis and sarcoidosis. Atypical infection, particularly of a fungal etiology, and metastatic malignancy were also considered. Initial pathology of the right lung needle biopsy revealed alveolar septal thickening with associated atypical pneumocyte proliferation, suggestive of atypical adenomatous hyperplasia (AAH). Subsequently the patient underwent wedge resection of the right upper, middle and lower lobes. Pathology examination revealed pulmonary Langerhans cell histiocytosis (PLCH) in the upper and lower lobes, with CD1a staining highlighting the aggregates of Langerhans cells. Vascular changes were also present including intimal thickening of muscular pulmonary arteries, consistent with pulmonary hypertensive changes. Background lung parenchyma demonstrated respiratory bronchiolitis, smoking-related interstitial fibrosis, an organizing thrombus in muscular artery and associated pneumocyte hyperplasia.
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Affiliation(s)
| | - Yigit Baykara
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital and Lifespan Medical Center, Warren Alpert Medical School of Brown University
| | - Ayesha Siddique
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital and Lifespan Medical Center, Warren Alpert Medical School of Brown University
| | - Lance Van Truong
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital and Lifespan Medical Center, Warren Alpert Medical School of Brown University
| | - Mel Corbett
- Department of Otolaryngology/Head and Neck Surgery, University Hospital Galway, National University of Ireland
| | - Sean M Hacking
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital and Lifespan Medical Center, Warren Alpert Medical School of Brown University
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Baykara Y, Xiao Y, Yang D, Yakirevich E, Garcia‐Moliner ML, Maleki S, Wang LJ, Huang C, Lu S. Utility of Secretagogin as a Novel Marker for the Diagnosis of Lung Neuroendocrine Carcinoma. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.0r693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Yigit Baykara
- Pathology and Lab MedicineBrown University School of MedicineProvidenceRI
| | - Ying Xiao
- Pathology and Lab MedicineBrown University School of MedicineProvidenceRI
| | - Dongfang Yang
- Pathology and Lab MedicineBrown University School of MedicineProvidenceRI
| | - Evgeny Yakirevich
- Pathology and Lab MedicineBrown University School of MedicineProvidenceRI
| | | | - Sara Maleki
- Pathology and Lab MedicineBrown University School of MedicineProvidenceRI
| | - Li J. Wang
- Pathology and Lab MedicineBrown University School of MedicineProvidenceRI
| | - Chiung‐Kuei Huang
- Pathology and Lab MedicineTulane University School of MedicineNew OrleansLA
| | - Shaolei Lu
- Brown University School of MedicineProvidenceRI
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Baykara Y, Xiao Y, Yang D, Yakirevich E, Maleki S, Garcia-Moliner M, Wang LJ, Huang CK, Lu S. Utility of secretagogin as a marker for the diagnosis of lung neuroendocrine carcinoma. Virchows Arch 2022; 481:31-39. [PMID: 35357570 DOI: 10.1007/s00428-022-03312-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/22/2022] [Accepted: 03/14/2022] [Indexed: 12/01/2022]
Abstract
Small-cell lung cancers (SCLC) and large-cell neuroendocrine carcinomas (LCNEC) are two types of high-grade pulmonary neuroendocrine carcinomas (NECs). Diagnostic neuroendocrine markers commonly include synaptophysin, chromogranin A, CD56, and insulinoma-associated protein 1 (INSM1). In this study, the utility of secretagogin (SCGN) was examined in the context of pulmonary NEC diagnosis. The study included 71 pulmonary NEC cases (18 SCLCs, 13 combined-SCLCs, 23 LCNECs, and 17 combined-LCNECs). Immunohistochemical stains of SCGN, synaptophysin, chromogranin A, CD56, and INSM1 were performed on whole tumor sections. The stains were evaluated based on combined staining intensity and the proportion of positive tumor cells. At least mild staining intensity in at least 1% of the cells was considered positive. Bioinformatic studies showed specific SCGN expression in neuroendocrine cells and NECs. SCGN showed diffuse nuclear and cytoplasmic staining in NECs with intra-tumoral heterogeneity. The non-neuroendocrine components were negative. The sensitivity of SCGN was no better than the other established neuroendocrine markers based on all NECs combined or LCNECs/c-LCNECs only. However, the sensitivity of SCGN (71%) was higher than chromogranin A (68%) for SCLCs/c-SCLCs only. The average proportion of SCGN positive tumor cells was 8% higher than chromogranin A (22% versus 14%, P = 0.0332) in all NECs and 18% higher for SCLC and c-SCLC cases only (32% versus 13%, P = 0.0054). The above data showed that SCGN could be used as a supplemental neuroendocrine marker to diagnose SCLC.
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Affiliation(s)
- Yigit Baykara
- Department of Pathology and Laboratory Medicine, Alpert Medical School of Brown University, Providence, RI, 02903, USA
| | - Ying Xiao
- Department of Pathology and Laboratory Medicine, Alpert Medical School of Brown University, Providence, RI, 02903, USA
| | - Dongfang Yang
- Department of Pathology and Laboratory Medicine, Alpert Medical School of Brown University, Providence, RI, 02903, USA
| | - Evgeny Yakirevich
- Department of Pathology and Laboratory Medicine, Alpert Medical School of Brown University, Providence, RI, 02903, USA
| | - Sara Maleki
- Department of Pathology and Laboratory Medicine, Alpert Medical School of Brown University, Providence, RI, 02903, USA
| | - Maria Garcia-Moliner
- Department of Pathology and Laboratory Medicine, Alpert Medical School of Brown University, Providence, RI, 02903, USA
| | - Li Juan Wang
- Department of Pathology and Laboratory Medicine, Alpert Medical School of Brown University, Providence, RI, 02903, USA
| | - Chiung-Kuei Huang
- Department of Pathology and Laboratory Medicine, Tulane University School of Medicine, New Orleans, LA, 70112, USA
| | - Shaolei Lu
- Department of Pathology and Laboratory Medicine, Alpert Medical School of Brown University, Providence, RI, 02903, USA.
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15
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Baykara Y, Dogon C, McCormick W, Siegert T, Hong T. Pasteurella Multocida Urinary Tract Infection in a Susceptible Patient with Non-Traumatic Feline Contact. R I Med J (2013) 2022; 105:17-19. [PMID: 35081183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Pasteurella multocida is a part of the normal oral flora of domestic animals. Humans can develop skin and soft tissue infections from P. multocida after traumatic animal contact, usually through bites and scratches from domestic animals. Although rare, there have been documented case reports where P. multocida has been isolated from patients even after minimal casual animal contact. Even rarer, is the isolation of P. multocida from urine. The few documented cases of urine isolation have been described in patients who have underlying medical conditions, particularly those with urologic abnormalities. Here we present a 34-year-old female patient with known congenital neurological and urological anomalies who developed a P. multocida urinary tract infection from casual contact with a household feline, a previously unrecognized risk factor for P. multocida UTI in anatomically susceptible individuals.
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Affiliation(s)
- Yigit Baykara
- Warren Alpert Medical School of Brown University, Providence, RI
| | - Calli Dogon
- Warren Alpert Medical School of Brown University, Providence, RI
| | | | - Thomas Siegert
- Warren Alpert Medical School of Brown University, Providence, RI
| | - Tao Hong
- Warren Alpert Medical School of Brown University, Providence, RI
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Zhao CW, Gebre R, Baykara Y, Chen W, Vitkovskiy P, Li N, Johnson M, Chen EY, Kluger D, Blumenfeld H. Reliability of patient self-report of cognition, awareness, and consciousness during seizures. Ann Clin Transl Neurol 2022; 9:16-29. [PMID: 35014222 PMCID: PMC8791805 DOI: 10.1002/acn3.51485] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 11/29/2022] Open
Abstract
Objective Clinicians rely on patient self‐report of impairment during seizures for decisions including driving eligibility. However, the reliability of patient reports on cognitive and behavioral functions during seizures remains unknown. Methods We administered a daily questionnaire to epilepsy patients undergoing continuous video‐EEG monitoring, asking about responsiveness, speech, memory, awareness, and consciousness during seizures in the preceding 24 hours. We also administered a questionnaire upon admission about responsiveness, speech, and awareness during seizures. Subjective questionnaire answers were compared with objective behavioral ratings on video review. Criteria for agreement were Cohen’s kappa >0.60 and proportions of positive and negative agreement both >0.75. Results We analyzed 86 epileptic seizures in 39 patients. Memory report on the daily questionnaire met criteria for agreement with video review (κ = 0.674 for early, 0.743 for late recall). Subjective report of awareness also met agreement criteria with video ratings of memory (κ = 0.673 early, 0.774 late). Concordance for speech was relatively good (κ = 0.679) but did not meet agreement criteria, nor did responsiveness or consciousness. On the admission questionnaire, agreement criteria were met for subjective report of awareness versus video ratings of memory (κ = 0.814 early, 0.806 late), but not for other comparisons. Interpretation Patient self‐report of memory or awareness showed the best concordance with objective memory impairment during seizures. Self‐report of impairment in other categories was less reliable. These findings suggest that patient reports about impaired memory during seizures may be most reliable, and otherwise determining functional impairments should be based on objective observations.
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Affiliation(s)
- Charlie W Zhao
- Departments of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut, 06520, USA
| | - Rahiwa Gebre
- Departments of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut, 06520, USA
| | - Yigit Baykara
- Departments of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut, 06520, USA
| | - William Chen
- Departments of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut, 06520, USA
| | - Petr Vitkovskiy
- Departments of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut, 06520, USA
| | - Ningcheng Li
- Departments of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut, 06520, USA
| | - Michelle Johnson
- Departments of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut, 06520, USA
| | - Eric Y Chen
- Departments of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut, 06520, USA
| | - Dan Kluger
- Departments of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut, 06520, USA
| | - Hal Blumenfeld
- Departments of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut, 06520, USA.,Department of Neuroscience, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut, 06520, USA.,Department of Neurosurgery, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut, 06520, USA
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McCormick W, Baykara Y, Yoon J, Schechter S. An Incidental Appendix Cystadenoma in a 47-Year-Old Male. R I Med J (2013) 2021; 104:76-78. [PMID: 34705916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Winston McCormick
- The Warren Alpert Medical School of Brown University, Providence, RI
| | - Yigit Baykara
- The Warren Alpert Medical School of Brown University, Providence, RI
| | - Jessica Yoon
- The Warren Alpert Medical School of Brown University, Providence, RI
| | - Steven Schechter
- The Warren Alpert Medical School of Brown University, Providence, RI
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