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Current trends in sexual assault medical forensic exams and examiners
Published in Rachel E. Lovell, Jennifer Langhinrichsen-Rohling, Sexual Assault Kits and Reforming the Response to Rape, 2023
Julie L. Valentine, Nancy R. Downing
Similar arguments could be made about the use of toluidine blue dye to visualize and document anogenital injuries. Toluidine blue dye is a nuclear stain that attaches to nucleated cells. Therefore, when it is placed on skin that is normally non-nucleated (i.e., epidermis), and toluidine blue dye uptake is positive, this indicates injury to the surface layer, which could corroborate a patient's history of sexual assault, though again, it cannot determine whether sexual contact was consensual. The National Protocol (Office on Violence Against Women, 2013) states the purpose of toluidine blue dye is to “highlight” external anogenital trauma (p. 98) and not to identify injuries that are not visible without it, presumably to mitigate the issue of identifying injuries so minor as to not be of evidentiary value. However, others have found toluidine blue dye is useful for identifying injuries that were missed using only visual inspection (Hirachan, 2019; Zink et al., 2010). The SANE profession would benefit from greater guidance, supported by evidence, on consistent use of toluidine blue dye and whether to use it only for highlighting detected injuries or for identifying injuries not otherwise observed.
The Mediastinum (including pre-and para-spinal lines, neural tumours, and pneumomediastinum).
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
Thirty years ago only plain radiographs, conventional tomograms, angiography and barium swallow (with large adenomas pressing on the oesophagus) were available, other than exploratory surgery. Fortunately experienced surgeons can find over 95% of parathyroid adenomas in the neck by careful dissection in both primary and secondary hyperparathyroidism. Surgical recognition can be aided by the use of methylene (or patent) blue. If the dye is injected IV immediately preoperatively, the parathyroids tend to 'stain' more than the surrounding tissues and become more easily recognised, and this method was used for many years at the author's hospital (see Dudley, 1971). Toluidine blue should not be used because of possible cardiac toxicity. Radioisotope labelled methylene (and toluidine) blue have been tried in some centres (see references).
Neoplasia in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Carcinoma of the vulva represents only about 4% of gynecologic malignancies and is quite rare in pregnancy, because the vast majority of vulvar malignancies occur in postmenopausal patients. Approximately 15% of vulvar cancers are found in women less than 40 years of age. Of these, about 90% of the cases are squamous cell cancers. Other cell types include melanoma, adenocarcinoma, basal cell carcinoma, and sarcoma. Presenting symptoms are similar to those of the nonpregnant state and include itching, irritation, discharge, and occasionally bleeding. The etiology of vulvar cancer is unknown, but common patient characteristics include obesity, diabetes, hypertension, and perhaps less-than-optimal vulvar hygiene. Recent evidence suggests that HPV infection is a causative or associative factor in preinvasive vulvar intraepithelial neoplasia as well as in invasive vulvar cancer. Examination of the vulva will demonstrate areas of ulceration, exophytic growth, hyper- or hypopigmentation, or red or white discoloration. The key to early diagnosis is biopsy. All abnormal areas of the vulva, including raised, depressed, discolored, or warty lesions, deserve consideration for biopsy. Biopsy may be performed in the office under local anesthesia by simple excision or by utilizing the Keyes punch biopsy instrument. Toluidine blue staining and colposcopy may be used as adjunctive procedures, but should not substitute for biopsies, even in lieu of pregnancy.
Therapeutic effects of mesenchymal stem cells and vitamin D on Bleomycin triggered lung damage in male adult albino rats
Published in Ultrastructural Pathology, 2022
Eman E. Elwakeel, Amira Z. Mohamed, Walaa M. Shaalan
Small lung specimens (1 mm3) were preserved for 2 hours in 2.5% glutaraldehyde in 0.1 M phosphate buffer (pH 7.4) to prepare the samples for examination with transmission electron microscopy (TEM), then added 1% osmium tetroxide as a post fixative (4 ◦C, 1.5 h). The sample was then placed in serial ethanol dilutions (each for 15 minutes, 50, 70, 90, 95, and four times 100%) for dehydration, then 30 minutes of dehydration with acetone. Finally, epoxy resin was used to embed the fixed specimens (Sigma; Medium Kit Epoxy Embedded). Semi-thin and ultra-thin sections were cut on an ultramicrotome (Ultramicrotome PowerTome RMC PT-XL). Toluidine blue was used to stain semi-thin sections (1 m) at a concentration of 1% and observed under a light microscope with an Olympus BX61. Ultrathin slices were cut at a thickness of 70–90 nm and then stained with the major stain of 2.5% uranyl acetate and the counterstain of lead citrate.20 Finally, ultrathin sections have been examined using transmission electron microscope 1400 Plus -JEM (Japan, JEOL) at the electron microscope unit in the faculty of Science, Alexandria University, Egypt.
Osteocalcin, Azan and Toluidine blue staining in fibrous dysplasia and ossifying fibroma of the jaws
Published in Alexandria Journal of Medicine, 2018
Samuel Ebele Udeabor, Akinyele Olumuyiwa Adisa, Anna Orlowska, Poju Chia, Robert A. Sader, Shahram Ghanaati
Distinguishing between FD and OF using either the genetic or immunohistochemical tests in each case of a FOL may not be feasible in all cases for all laboratories due to overhead costs and or patients inability to afford such tests. Also the results of tests may be needed in a relatively short turn-around time and this may not be possible with genetic or immunohistochemical analysis. Thus, we therefore conduct this study to detect any correlation between relatively simple histo-morphometric analysis with Azan and Toluidine blue as compared with immunohistochemistry by osteocalcin. These may offer a relatively less complex and quicker method for appropriate diagnosis. Azan is a trichrome stain that uses three anionic dyes to mark different tissues histologically. It is an improvement over the traditional Mallory’s method and stains muscle fibers red and cartilage/bone matrix blue.8 Toluidine blue is an acidophilic metachromatic dye that selectively stains acidic tissue components (sulfates, carboxylates, and phosphate radicals). It has been extensively used as a vital stain for mucosal lesions but has also found applications in tissue sections to specifically stain certain components owing to its metachromatic property.9
Microfluidic-based screening of resveratrol and drug-loading PLA/Gelatine nano-scaffold for the repair of cartilage defect
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2018
Li Ming, Yuan Zhipeng, Yu Fei, Rao Feng, Weng Jian, Jiang Baoguo, Wen Yongqiang, Zhang Peixun
HE staining: tissue specimens were fixed in 4% paraformaldehyde for 24 h, decalcified, and embedded in paraffin, serial 4-μm sections were obtained and HE-stained. The tissue sections were treated with haematoxylin for 5 min, differentiated with liquid differentiation for 2 s, and immersed in ammonia for 5 s. Next, the sections were treated with eosin for 1 min. Safranin O- fast green staining: tissue specimens were fixed in 4% paraformaldehyde for 24 h, decalcified, and embedded in paraffin. Serial 4-μm sections were obtained and safranin O- fast green-stained. The tissue sections were treated with Weigert for 5 min differentiated with acidic differentiation solution for 15 s, treated with solid green for 5 min, and treated with weak acid solution for 15 s. Next, the sections were treated with safranin O for 5 min. Toluidine blue staining:tissue specimens were fixed in 4% paraformaldehyde for 24 h, decalcified, and embedded in paraffin. Serial 4-μm sections were obtained and toluidine blue-stained. The tissue sections were treated with 1% toluidine blue for 60 min. Alcian blue staining: tissue specimens were fixed in 4% paraformaldehyde for 24 h, decalcified, and embedded in paraffin. Serial 4-μm sections were obtained and alcian blue-stained. The tissue sections were treated with Alcian blue acidizing fluid for 3 min, treated with alcian blue for 30 min.