Nawaluk Atiroj

Introduction: CD15 expression has been used as a marker of endothelial immaturity in the placenta and is linked to the setting of antenatal hypoxia. If so, expression should be increased in fetal anemia, especially when severe enough to cause hydrops fetalis. This has not been previously reported and the current study tested this hypothesis. Materials and Methods: The study group consisted of 10 cases of anemic hydrops in second to early third trimester of gestation and 10 controls matched for gestational age. The majority (70%) of hydrops cases were due to hemoglobin (Hb) Bart. Placentas underwent CD15 immunohistochemical staining and results were quantitatively assessed by counting 100 vessels in each case. Results: For the anemic group, the mean number of CD15+ vessels was 52.0% in the proximal vasculature and 91.3% in the distal vasculature. Values for controls were 32.9% and 42.2%, respectively. The CD15 expression in the distal vasculature was significantly higher in the anemic hydrops group ( P < .001), but not significantly higher for the proximal vasculature ( P = .14). In the control group, the number of CD15+ vessels decreased with increasing gestational age for both proximal and distal vasculatures. In contrast, in the anemic hydrops group, the number of CD15+vessels did not significantly change with gestational age, for both the proximal and distal vasculatures. Conclusion: Placentas belonging to anemic hydrops cases demonstrate significantly increased expression of CD15 in the distal vasculature. CD15 expression in HF may be driven by hypoxia, reflecting an attempt by the placenta to compensate for this.

This study evaluated ChatGPT's ability to generate clinically integrated multiple‐choice questions (MCQs) directly from digestive pathology lecture slides and assessed the educational quality of the output using expert review, psychometric analysis, and student feedback. Lecture slides covering 30 digestive diseases were uploaded to ChatGPT‐4o using a structured prompt to produce 30 MCQs, each with a clinical vignette, five answer choices, and explanations. Three pathologists and a gastrointestinal and hepatobiliary pathologist evaluated question quality. Psychometric analysis was conducted using difficulty index, discrimination index, and distractor quality based on responses from 31 s‐year medical students. Reviewer and student feedback were also analyzed. Of the 30 MCQs, 28 (93.3%) were rated as excellent by all pathologists. Minor issues such as factual inaccuracies or overly leading clues were found in 11 questions (36.7%) and corrected. Most questions showed acceptable psychometric properties: 23 items (76.7%) met difficulty index thresholds, and 28 (93.3%) met discrimination index thresholds. Of 120 distractors, 54 (45%) were functional. Students reported improved clarity, relevance, and clinical integration. ChatGPT can generate accurate, clinically relevant MCQs aligned with lecture material. With expert review, this approach provides a practical and scalable tool for pathology education in resource‐ and time‐limited settings.