Retained gauze after surgery is an uncommon error and it may be associated with many complication... more Retained gauze after surgery is an uncommon error and it may be associated with many complications. We are reporting our case to call attention to the fact that retained gauze may become symptomatic even after a very long interval. Herein we report on a patient who developed infection and fistula with discharge from this error 35 years after a surgery for femur fracture and insertion of a IM nail. The diagnosis was easily made because of a marker in the gauze. Removal of the gauze and irrigation and debridement of the wound in two stages led to complete recovery of the patient as was shown in the 1 year follow up. Retained gauze after surgery is a preventable complication and may be asymptomatic for a very long period, but can become a complication post-operatively at any time. Hence, if diagnosed immediately after the surgery or at any other time, the gauze should be removed.
Microscopy and microanalysis : the official journal of Microscopy Society of America, Microbeam Analysis Society, Microscopical Society of Canada, 2012
The current hypothesis of alveolar capillary membrane dysfunction fails to completely explain the... more The current hypothesis of alveolar capillary membrane dysfunction fails to completely explain the severe and persistent leak of protein-rich fluid into the pulmonary interstitium, seen in the exudative phase of acute lung injury (ALI). The presence of intact red blood cells in the pulmonary interstitium may suggest mechanical failure of pulmonary arterioles and venules. These studies involved the pathological and ultrastructural evaluation of the pulmonary vasculature in Staphylococcal enterotoxin B (SEB)-induced ALI. Administration of SEB resulted in a significant increase in the protein concentration of bronchoalveolar lavage fluid and vascular leak in SEB-exposed mice compared to vehicle-treated mice. In vivo imaging of mice demonstrated the pulmonary edema and leakage in the lungs of SEB-administered mice. The histopathological studies showed intense clustering of inflammatory cells around the alveolar capillaries with subtle changes in architecture. Electron microscopy studies ...
Blastomycosis is a chronic fungal infection often diagnosed in the south-central and midwestern U... more Blastomycosis is a chronic fungal infection often diagnosed in the south-central and midwestern United States. Lungs are primarily involved, with lymphatic or hematogenous spread to other organs. Bronchoscopy is considered when the noninvasive tests fail to establish the diagnosis. We describe bronchoscopic finding of blastomycosis involving the upper and lower respiratory tract. Inhaled steroids may have suppressed cellular immunity, allowing fungus to grow in the submucosa with histology significant for extensive eosinophilic infiltration. To our knowledge, such a detailed pictorial description of pulmonary blastomycosis with a cobblestone appearance of the tracheobronchial mucosa has not been reported in the past.
Coexistence of pulmonary actinomycosis with tuberculosis has rarely been reported. The presence o... more Coexistence of pulmonary actinomycosis with tuberculosis has rarely been reported. The presence of Actinomyces in sputum and bronchoalveolar lavage is inadequate for diagnosis, as it may represent mere colonization. Traditionally, excisional biopsy is considered to be the gold standard for histologic diagnosis. There are multiple case reports in which the diagnosis of pulmonary actinomycosis was based on bronchial biopsy and Wang needle aspiration. We describe an incidental finding of a bronchial communication with passage of a flexible bronchoscope into the tuberculosis cavity. The images reveal a 5-cm cavity with a whitish, stone-like structure noticed to move back and forth with respiration. Colonies of Actinomyces were seen on transbronchial brushing cytology. Bronchoalveolar lavage cultures were negative. To our knowledge such a detailed pictorial description of a tuberculosis cavity with Actinomyces has not been reported in the past.
Investigative ophthalmology & visual science, Jan 5, 2015
Purpose: The primary objective of the present study was to identify the kinetics and origin of oc... more Purpose: The primary objective of the present study was to identify the kinetics and origin of ocular infiltrating T cells in a pre-clinical model of graft-versus-host disease (GVHD) which induces eye tissue damage. Methods: GVHD was induced using an MHC-matched, minor histocompatibility mismatched hematopoietic stem cell transplant (HSCT) model. This approach - which utilized congenic and EGFP labeled donor populations, mimics a matched, clinically unrelated donor (MUD) cell transplant. Systemic and ocular GVHD were assessed at varying time points using clinical examination, intra-vital microscopy, immune phenotype via flow cytometric analyses and immunohistochemical staining. Results: Following transplant, we observed characteristic changes in GVHD associated immune phenotype as well as clinical signs present in recipients post-transplant. Notably, the kinetics of the systemic changes and the ocular damage paralleled what is observed clinically including damage to the cornea as we...
Age-related macular degeneration (AMD) is a major disease affecting central vision, but the patho... more Age-related macular degeneration (AMD) is a major disease affecting central vision, but the pathogenic mechanisms are not fully understood. Using a mouse model, we examined the relationship of two factors implicated in AMD development: oxidative stress and the immune system. Carboxyethylpyrrole (CEP) is a lipid peroxidation product associated with AMD in humans and AMD-like pathology in mice. Previously, we demonstrated that CEP immunization leads to retinal infiltration of pro-inflammatory M1 macrophages before overt retinal degeneration. Here, we provide direct and indirect mechanisms for the effect of CEP on macrophages, and show for the first time that antigen-specific T cells play a leading role in AMD pathogenesis. In vitro, CEP directly induced M1 macrophage polarization and production of M1-related factors by retinal pigment epithelial (RPE) cells. In vivo, CEP eye injections in mice induced acute pro-inflammatory gene expression in the retina and human AMD eyes showed disti...
Oxidative stress is key in the pathogenesis of several diseases including age-related macular deg... more Oxidative stress is key in the pathogenesis of several diseases including age-related macular degeneration (AMD), atherosclerosis, diabetes, and Alzheimer's disease. It has previously been established that a lipid peroxidation product, carboxyethylpyrrole (CEP), accumulates in the retinas of AMD patients. Retinal infiltrating macrophages also accumulate in the retinas of both AMD patients and in a murine model of AMD. We therefore investigated the ability of CEP-adducts to activate innate immune signaling in murine bone-marrow derived macrophages (BMDMs). We found that CEP specifically synergizes with low-dose TLR2-agonists (but not agonists for other TLRs) to induce production of inflammatory cytokines. Moreover, CEP selectively augments TLR2/TLR1-signaling instead of TLR2/TLR6-signaling. These studies uncover a novel synergistic inflammatory relationship between an endogenously produced oxidation molecule and a pathogen-derived product, which may have implications in the AMD d...
BACKGROUND: Most studies exploring ethnic/racial disparities in nonsmall cell lung cancer (NSCLC)... more BACKGROUND: Most studies exploring ethnic/racial disparities in nonsmall cell lung cancer (NSCLC) compare black patients with whites. Currently, the effect of Hispanic ethnicity on the overall survival of NSCLC is poorly understood. Therefore, the authors carried out a large-scale, population-based analysis using the Surveillance, Epidemiology, and End Results (SEER) data base to determine the impact of Hispanic ethnicity the survival of patients with NSCLC. METHODS: The authors identified 172,398 adult patients with pathologically confirmed NSCLC from the SEER data base who were diagnosed between 1988 and 2007. A multivariate Cox proportional hazards regression analysis was used to determine the impact of race/ethnicity on overall survival. Pair-wise comparisons were used to determine whether Hispanic ethnicity influenced NSCLC histology or stage at diagnosis. RESULTS: Compared with non-Hispanic white patients, Hispanic white patients had a statistically significant better overall survival (hazard ratio [HR], 0.85; 95% confidence interval [CI], 0.83-0.87), and black patients had worse survival (HR, 1.091; 95% CI, 1.072-1.109). Within the bronchioalveolar carcinoma (BAC) subtype, Hispanic-white patients tend to be over represented (8.1% Hispanic whites vs 5.5% non-Hispanic whites vs 3.7% blacks; P < .001). CONCLUSIONS: The current study demonstrated that Hispanic-white patients with NSCLC had a decreased risk for overall mortality compared with non-Hispanic whites and blacks. Moreover, Hispanic patients were over represented within the BAC histologic subtype. Thus, the overall survival advantage of Hispanic NSCLC patients may be because of their predilection toward developing certain histologic subtypes of NSCLC. Further studies are warranted to determine the etiologies of such predilections and may reveal certain genetic, environmental, and/or epigenetic factors associated with Hispanic ethnicity. Cancer 2012;118:4495-
The most vital component for any software
development process is, “quality”, as it ensures the re... more The most vital component for any software development process is, “quality”, as it ensures the reliability and effectiveness of new software. Software Quality Assurance (SQA) techniques as well as a standardized qualitative metric known as Capability Maturity Model Integration (CMMI) are used to ensure this quality. The purposes of both the practices are same as both make efforts for end product’s quality. In spite of this, CMMI certified organizations have SQA function, but face a lot of issues, which resulted in lowering the quality of the products. Standards usually provide documentation, but SQA consider testing as a chief element and also documentation only for authentication and appraisals. The relationship of the SQA function with CMMI has not attended much in common literatures. This paper is centered on investigation conducted through data collection from diverse CMMI certified software development firm to check the practice of SQA function.
Retained gauze after surgery is an uncommon error and it may be associated with many complication... more Retained gauze after surgery is an uncommon error and it may be associated with many complications. We are reporting our case to call attention to the fact that retained gauze may become symptomatic even after a very long interval. Herein we report on a patient who developed infection and fistula with discharge from this error 35 years after a surgery for femur fracture and insertion of a IM nail. The diagnosis was easily made because of a marker in the gauze. Removal of the gauze and irrigation and debridement of the wound in two stages led to complete recovery of the patient as was shown in the 1 year follow up. Retained gauze after surgery is a preventable complication and may be asymptomatic for a very long period, but can become a complication post-operatively at any time. Hence, if diagnosed immediately after the surgery or at any other time, the gauze should be removed.
Microscopy and microanalysis : the official journal of Microscopy Society of America, Microbeam Analysis Society, Microscopical Society of Canada, 2012
The current hypothesis of alveolar capillary membrane dysfunction fails to completely explain the... more The current hypothesis of alveolar capillary membrane dysfunction fails to completely explain the severe and persistent leak of protein-rich fluid into the pulmonary interstitium, seen in the exudative phase of acute lung injury (ALI). The presence of intact red blood cells in the pulmonary interstitium may suggest mechanical failure of pulmonary arterioles and venules. These studies involved the pathological and ultrastructural evaluation of the pulmonary vasculature in Staphylococcal enterotoxin B (SEB)-induced ALI. Administration of SEB resulted in a significant increase in the protein concentration of bronchoalveolar lavage fluid and vascular leak in SEB-exposed mice compared to vehicle-treated mice. In vivo imaging of mice demonstrated the pulmonary edema and leakage in the lungs of SEB-administered mice. The histopathological studies showed intense clustering of inflammatory cells around the alveolar capillaries with subtle changes in architecture. Electron microscopy studies ...
Blastomycosis is a chronic fungal infection often diagnosed in the south-central and midwestern U... more Blastomycosis is a chronic fungal infection often diagnosed in the south-central and midwestern United States. Lungs are primarily involved, with lymphatic or hematogenous spread to other organs. Bronchoscopy is considered when the noninvasive tests fail to establish the diagnosis. We describe bronchoscopic finding of blastomycosis involving the upper and lower respiratory tract. Inhaled steroids may have suppressed cellular immunity, allowing fungus to grow in the submucosa with histology significant for extensive eosinophilic infiltration. To our knowledge, such a detailed pictorial description of pulmonary blastomycosis with a cobblestone appearance of the tracheobronchial mucosa has not been reported in the past.
Coexistence of pulmonary actinomycosis with tuberculosis has rarely been reported. The presence o... more Coexistence of pulmonary actinomycosis with tuberculosis has rarely been reported. The presence of Actinomyces in sputum and bronchoalveolar lavage is inadequate for diagnosis, as it may represent mere colonization. Traditionally, excisional biopsy is considered to be the gold standard for histologic diagnosis. There are multiple case reports in which the diagnosis of pulmonary actinomycosis was based on bronchial biopsy and Wang needle aspiration. We describe an incidental finding of a bronchial communication with passage of a flexible bronchoscope into the tuberculosis cavity. The images reveal a 5-cm cavity with a whitish, stone-like structure noticed to move back and forth with respiration. Colonies of Actinomyces were seen on transbronchial brushing cytology. Bronchoalveolar lavage cultures were negative. To our knowledge such a detailed pictorial description of a tuberculosis cavity with Actinomyces has not been reported in the past.
Investigative ophthalmology & visual science, Jan 5, 2015
Purpose: The primary objective of the present study was to identify the kinetics and origin of oc... more Purpose: The primary objective of the present study was to identify the kinetics and origin of ocular infiltrating T cells in a pre-clinical model of graft-versus-host disease (GVHD) which induces eye tissue damage. Methods: GVHD was induced using an MHC-matched, minor histocompatibility mismatched hematopoietic stem cell transplant (HSCT) model. This approach - which utilized congenic and EGFP labeled donor populations, mimics a matched, clinically unrelated donor (MUD) cell transplant. Systemic and ocular GVHD were assessed at varying time points using clinical examination, intra-vital microscopy, immune phenotype via flow cytometric analyses and immunohistochemical staining. Results: Following transplant, we observed characteristic changes in GVHD associated immune phenotype as well as clinical signs present in recipients post-transplant. Notably, the kinetics of the systemic changes and the ocular damage paralleled what is observed clinically including damage to the cornea as we...
Age-related macular degeneration (AMD) is a major disease affecting central vision, but the patho... more Age-related macular degeneration (AMD) is a major disease affecting central vision, but the pathogenic mechanisms are not fully understood. Using a mouse model, we examined the relationship of two factors implicated in AMD development: oxidative stress and the immune system. Carboxyethylpyrrole (CEP) is a lipid peroxidation product associated with AMD in humans and AMD-like pathology in mice. Previously, we demonstrated that CEP immunization leads to retinal infiltration of pro-inflammatory M1 macrophages before overt retinal degeneration. Here, we provide direct and indirect mechanisms for the effect of CEP on macrophages, and show for the first time that antigen-specific T cells play a leading role in AMD pathogenesis. In vitro, CEP directly induced M1 macrophage polarization and production of M1-related factors by retinal pigment epithelial (RPE) cells. In vivo, CEP eye injections in mice induced acute pro-inflammatory gene expression in the retina and human AMD eyes showed disti...
Oxidative stress is key in the pathogenesis of several diseases including age-related macular deg... more Oxidative stress is key in the pathogenesis of several diseases including age-related macular degeneration (AMD), atherosclerosis, diabetes, and Alzheimer's disease. It has previously been established that a lipid peroxidation product, carboxyethylpyrrole (CEP), accumulates in the retinas of AMD patients. Retinal infiltrating macrophages also accumulate in the retinas of both AMD patients and in a murine model of AMD. We therefore investigated the ability of CEP-adducts to activate innate immune signaling in murine bone-marrow derived macrophages (BMDMs). We found that CEP specifically synergizes with low-dose TLR2-agonists (but not agonists for other TLRs) to induce production of inflammatory cytokines. Moreover, CEP selectively augments TLR2/TLR1-signaling instead of TLR2/TLR6-signaling. These studies uncover a novel synergistic inflammatory relationship between an endogenously produced oxidation molecule and a pathogen-derived product, which may have implications in the AMD d...
BACKGROUND: Most studies exploring ethnic/racial disparities in nonsmall cell lung cancer (NSCLC)... more BACKGROUND: Most studies exploring ethnic/racial disparities in nonsmall cell lung cancer (NSCLC) compare black patients with whites. Currently, the effect of Hispanic ethnicity on the overall survival of NSCLC is poorly understood. Therefore, the authors carried out a large-scale, population-based analysis using the Surveillance, Epidemiology, and End Results (SEER) data base to determine the impact of Hispanic ethnicity the survival of patients with NSCLC. METHODS: The authors identified 172,398 adult patients with pathologically confirmed NSCLC from the SEER data base who were diagnosed between 1988 and 2007. A multivariate Cox proportional hazards regression analysis was used to determine the impact of race/ethnicity on overall survival. Pair-wise comparisons were used to determine whether Hispanic ethnicity influenced NSCLC histology or stage at diagnosis. RESULTS: Compared with non-Hispanic white patients, Hispanic white patients had a statistically significant better overall survival (hazard ratio [HR], 0.85; 95% confidence interval [CI], 0.83-0.87), and black patients had worse survival (HR, 1.091; 95% CI, 1.072-1.109). Within the bronchioalveolar carcinoma (BAC) subtype, Hispanic-white patients tend to be over represented (8.1% Hispanic whites vs 5.5% non-Hispanic whites vs 3.7% blacks; P < .001). CONCLUSIONS: The current study demonstrated that Hispanic-white patients with NSCLC had a decreased risk for overall mortality compared with non-Hispanic whites and blacks. Moreover, Hispanic patients were over represented within the BAC histologic subtype. Thus, the overall survival advantage of Hispanic NSCLC patients may be because of their predilection toward developing certain histologic subtypes of NSCLC. Further studies are warranted to determine the etiologies of such predilections and may reveal certain genetic, environmental, and/or epigenetic factors associated with Hispanic ethnicity. Cancer 2012;118:4495-
The most vital component for any software
development process is, “quality”, as it ensures the re... more The most vital component for any software development process is, “quality”, as it ensures the reliability and effectiveness of new software. Software Quality Assurance (SQA) techniques as well as a standardized qualitative metric known as Capability Maturity Model Integration (CMMI) are used to ensure this quality. The purposes of both the practices are same as both make efforts for end product’s quality. In spite of this, CMMI certified organizations have SQA function, but face a lot of issues, which resulted in lowering the quality of the products. Standards usually provide documentation, but SQA consider testing as a chief element and also documentation only for authentication and appraisals. The relationship of the SQA function with CMMI has not attended much in common literatures. This paper is centered on investigation conducted through data collection from diverse CMMI certified software development firm to check the practice of SQA function.
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Papers by Ali Saeed
development process is, “quality”, as it ensures the reliability and
effectiveness of new software. Software Quality Assurance (SQA)
techniques as well as a standardized qualitative metric known as
Capability Maturity Model Integration (CMMI) are used to
ensure this quality. The purposes of both the practices are same
as both make efforts for end product’s quality. In spite of this,
CMMI certified organizations have SQA function, but face a lot
of issues, which resulted in lowering the quality of the products.
Standards usually provide documentation, but SQA consider
testing as a chief element and also documentation only for
authentication and appraisals. The relationship of the SQA
function with CMMI has not attended much in common
literatures. This paper is centered on investigation conducted
through data collection from diverse CMMI certified software
development firm to check the practice of SQA function.
development process is, “quality”, as it ensures the reliability and
effectiveness of new software. Software Quality Assurance (SQA)
techniques as well as a standardized qualitative metric known as
Capability Maturity Model Integration (CMMI) are used to
ensure this quality. The purposes of both the practices are same
as both make efforts for end product’s quality. In spite of this,
CMMI certified organizations have SQA function, but face a lot
of issues, which resulted in lowering the quality of the products.
Standards usually provide documentation, but SQA consider
testing as a chief element and also documentation only for
authentication and appraisals. The relationship of the SQA
function with CMMI has not attended much in common
literatures. This paper is centered on investigation conducted
through data collection from diverse CMMI certified software
development firm to check the practice of SQA function.